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According to traditional Chinese medicine (TCM), the head is where the yang meridians of the
arms and legs met, and the governor vessel which controls yang qiof the whole body also
reaches the head. TCM regards the head as "the confluence of yang".
Moreover, essence and blood of the five zang organs and lucid yang (pure essence) of the six
fu organs are all infusing into the head, which nourish the brain (sea of marrow) and orifices of
the head. The head is closely connected with other parts of the body, and all the organs are
responsible for nourishing it. Factors such as abnormal weathers, external pathogens,
emotional or organ problems can easily affect the head. Headaches will be triggered when
these external or internal factors impede the flow of the meridians, disturb nutrient supply to
the head, or block the orifices.
Headache is a subjective symptom and a common pain. It can develop on its own or as a sign
of other health problems. Headaches may be caused by problems in the head or elsewhere
inside the body. Headaches have numerous causes and can involve different pathological
mechanisms, TCM generally classifies into two major categories: exogenous headaches and
endogenous headaches.
Exogenous headaches
The headaches are associated with external pathogens. Unhealthy lifestyle or temporary bodily
weakness can make the head susceptible to external pathogens.Six pathogens (or evils as
they are often known in TCM) may enter the meridians of the head, interrupt the body's yang qi
flowing upward, and cause blood and qistagnated in the head. The headaches are often
induced by a combined attack ofwind pathogens and other seasonal pathogens, which make
the body act differently during the development process. For example, wind along with cold
pathogens are likely to enter the blood vessels, lead to a sluggish flow of blood and has a
wind-cold headache pattern; wind along with heat pathogens tend to irritate the whole head
and make its orifice dysfunction, and thus has a wind-heat headache pattern; wind along
with dampness pathogens tend to obstruct the orifices and disturb the yang qi flowing into the
head, thus has a wind-dampness headache pattern.
Endogenous headaches
In TCM, the brain is the sea of marrow, which derived from essence and blood of
theliver and kidney, and nourished by nutrient essence of the spleen and stomach.
Endogenous headaches are associated with internal health problems.
Depletion of kidney essence or insufficiency of brain marrow makes the head under
nourished and dysfunction, leading to symptoms like headaches.
Emotional upset or stress can lead to liver qi stagnation; as time passes the stagnated liver
will generate fire. The fire may attack the head, interrupt its orifices and induce headaches.
When the spleen is dysfunctional, it cannot transform food and drinks into nutrient essence
effectively, there will be inadequate nutrient essence to supply the head and mental activity
will weaken. A dysfunctional spleen also produces dampness and phlegm that attack the
head orifices directly, and so cause headaches.
Headaches following head injuries are due to blood stasis formed in the head. Also, longterm and persistent headaches that present with a stabbing pain are related to localized
blood stagnation, the collaterals of the head are usually affected.
Basically, TCM believes that headaches are either due to excessive pathogens that block the
collaterals and impair the orifices of the head, or due to insufficiency of essence and blood that
fail to nourish and support the brain.
As headache symptoms are manifested in different ways, it will be a great difference in the
treatment strategies and drug applications. When making a headache diagnosis, TCM
physicians focus on the details such as nature of pain, location of pain, frequency, duration,
triggering or aggravating factors, accompanied symptoms,pulse and tongue manifestations. A
thorough medical history and physical examination is crucial to identify the headache types
and the underlying disharmonies of the body, appropriate treatment plan can then be decided
on. Some diagnostic criteria for headaches are listed below.
Exogenous headaches
Endogenous headaches
Pattern of
onset
Nature of
pain
Exterior
symptoms
No exterior syndrome
Triggers
Nature of pain
Hyperactive yang
Fire or heat
Phlegm or dampness
Coldness
Blood stasis
Hyperactive yang
Qi stagnation
Liver fire
Wind-heat
Locations of pain
Head crown
Coldness
Liver fire
Stomach meridian
Bladder meridian
Gallbladder meridian
Liver meridian
Kidney meridian
Spleen meridian