Headache is one of the most common clinical symptoms, and it can be said that almost everyone has tasted a headache in their lifetime. In the middle of October this year, a young man in his 30s came to the clinic, and as soon as he sat down, he said, “Director Liu, I really have no choice but to hope for Chinese medicine, the headache has been so painful that I can’t live, even Tramadol is useless. “Tell me, how long has the headache been going on? How does it hurt?” I’ve had recurring headaches since I was in first or second grade, but I usually got better after I slept, so I didn’t care too much when I was a kid. “Does it still hurt like this”, “No, it’s changed since 2016, the headache started at the junction of spring and summer that year, it hurts continuously every day, sometimes once a day, sometimes 2 times a day, most of them come on in the middle of the day, about 15 minutes or so can hurt to The majority of the attacks were in the middle of the day, with the pain reaching its peak in about 15 minutes and relieved in about 2 hours, each time in the right temple and around the eyes. The pain was the same as in 2016, and lasted for 3-4 months each year. The pain started again on September 15, and it’s still exactly the same as before. I am also a doctor, in the hospital checkup convenience, head MRI and MRA were done, are no problem.” After listening to the medical history, I basically had a good idea, but I still needed to determine the accompanying symptoms again, “Do you have any symptoms of redness in the right eye, tearing, nasal congestion and runny nose when you have headache?” “You are so right, all these symptoms are there”. At this point, the diagnosis is basically clear – cluster headache. In addition to the above headache characteristics, this patient felt comfortable when he had headache with heat and was afraid of wind, because the headache did not heal secondary to anxiety, distress, insomnia, bitterness in the mouth, red tongue with thick yellow coating and slippery pulse. The treatment is to invigorate blood circulation, resolve phlegm and clear heat, and relieve pain. Blood Mansions and Blood Stasis Tang is a famous formula for activating blood circulation, resolving blood stasis and clearing ligaments, and treating chest pain and headache caused by blood stasis. There is a saying in TCM theory that “if it does not pass, it hurts”, and all pains, regardless of physical deficiency, have the factor of “not passing”, that is, the veins and channels are stagnant and the meridians are not passing. Therefore, I judged that this patient’s stagnation was very serious, and his mouth was bitter, his tongue was red, his fur was yellow and greasy, and his pulse was stringent and slippery, so he was suffering from phlegm and heat. anxiety and insomnia. The patient started to take herbal medicine on the same day after the visit and had no attack for 4 consecutive days. On the 5th day, she had an attack with severe pain and used Nefopam injection (for moderate to severe pain) plus oxygen, which relieved her after 2 hours, and then she had occasional attacks but the pain level was significantly reduced and within the tolerable range. The name cluster headache is unfamiliar not only to the general public, but also to most non-neurologists. Cluster headache is an extremely severe primary headache, mostly with acute onset of severe episodes of pain confined to the orbital, temporal and frontal regions, often accompanied by ipsilateral autonomic symptoms (tearing, conjunctival bleeding, nasal congestion, runny nose, etc.), which can seriously affect the patient’s quality of life. Cluster headache is the most severe primary headache in terms of pain level. If the pain is rated on a scale of 0 to 10, with the most painful being 10, patients with cluster headache may score themselves as high as 13, which can even exceed the pain of childbirth. The frequency of attacks can range from 1 every other day to 8 times a day, and the period of attacks can range from 10 days to 1 or 2 months, or even 3 or 4 months. Although the incidence and prevalence of cluster headache is not as high as migraine and tension-type headache, it often causes great pain to patients and makes them feel like they are in pain. These methods are either limited in their use (most people do not have access to oxygen at the time of the attack and few hospitals have oxygen concentrations that can reach pure oxygen) or are ineffective. Although the pain relief strength of a single Chinese medicine is not as strong as that of western medicine, the balance of the human body is regulated by the combination of drugs, so that the pain can be relieved without specializing in pain relief, the reason of which may be difficult to explain clearly for a while, and further research is needed. If you are suffering from headache, why don’t you come to see a Chinese medicine doctor, there may be a surprise.