TCM Syndrome Differentiation and Classification of Headache

Traditional Chinese medicine believes that headaches are mainly caused by exogenous colds and internal injuries, leading to multiple stiffness or deficiency, and poor clear orifices, resulting in a disease with head pain as the main clinical feature. Headache is both a common disease and a common symptom. It can occur in the course of a variety of acute and chronic diseases, and is sometimes a precursor to the aggravation or deterioration of some related diseases. So why not take a look at the TCM differentiation and clinical diagnosis of headaches.

Clinical diagnosis based on syndrome differentiation

1) Wind-cold headache symptoms: headache occurs when the head hurts, pain extends to the neck and back, especially when there is wind, cold limbs, fear of cold, and no thirst. The tongue coating is thin white and the pulse is floating.

Symptom analysis: The head is the meeting point of all Yang, and cold symptoms attack from the outside, along the Taiyang meridian to the top of the head, and the clear Yang Qi is blocked, so headache occurs; Taiyang meridian governs the body's surface, and its meridians go up to the top of the head, along the neck and back, and the pain extends to the neck and back; cold symptoms are bound to the surface of the muscles, and the Wei Yang is blocked and cannot be circulated, so the limbs are cold and afraid of cold; there is no thirst in the mouth if there is no fever; white greasy tongue coating and floating pulse are both signs of cold symptoms on the surface.

2) Wind-cold and wind-heat headache symptoms: Headache and distension, even splitting headache, fever or cold limbs, flushed face and eyes, dry mouth and thirst, constipation and jaundice. The tongue is red with thin coating and the pulse is floating and rapid.

Symptom analysis: Heat is a Yang evil, and its nature is inflammatory. Wind-cold and wind-heat attack the Yang meridians and disturb the clear orifices, so there is headache and distension, or even a splitting headache; facial flushing and red eyes are also signs of heat evil inflammatory; wind-cold and wind-heat evils invade the Wei, so there is fever and cold limbs; excessive heat consumes body fluids, so there is dry mouth, thirst, constipation and red urine; red tongue with thin coating, and floating and rapid pulse are all signs of the prevalence of wind-cold and wind-heat evils.

3) Rheumatic headache symptoms: Headache as if wrapped in a cloth, heavy body, poor appetite, chest tightness and shortness of breath, difficulty urinating, and loose bowel movements. The tongue coating is white and greasy, and the pulse is weak.

Symptom analysis: Rheumatism is caused by wind evil, which invades the top of the head, and its removal is blocked, so the headache feels like being wrapped; the spleen is responsible for transportation and transformation and governs the limbs, and dampness and turbidity block the middle part of the body. The spleen yang is trapped by dampness, so the body feels heavy, the appetite is poor, the chest is stuffy and the breath is short; dampness and turbidity are contained inside the body and cannot be distinguished from secretion and turbidity, so urination is not smooth and the stool may be loose; white greasy tongue coating and moist pulse are both signs of dampness and turbidity blocking the middle part of the body.

The above three types are headaches caused by exogenous wind and cold.

4) Symptoms of liver yang headache: headache and dizziness, irritability, restless sleep, or accompanied by flank pain, facial flushing, bitter taste in the mouth and bad breath. The tongue coating is thin yellow and the pulse is deep and strong.

Symptom analysis: All kinds of dizziness and vertigo are attributed to the liver. When the liver fails to function properly, the liver yang becomes hyperactive, which disturbs the clear orifices along the meridians, resulting in headaches and dizziness. Hyperactive liver fire disturbs the mind, causing irritability and restless sleep. Stagnation of gallbladder and liver qi turns into fire, and liver yang becomes hyperactive, resulting in flank pain, bitter taste in the mouth, bad breath, and flushed face. Thin yellow tongue coating and deep, strong pulse are all signs of hyperactivity of liver yang.

5) Symptoms of headache due to kidney deficiency: headache with emptiness, often accompanied by dizziness, back pain, fatigue, frequent and thin spermatorrhea, tinnitus and insomnia. The tongue is red with little coating and the pulse is thin.

Symptom analysis: The brain is the sea of ​​marrow, which is controlled by the kidney. If the kidney is deficient, the marrow cannot be nourished, and the mind will feel depressed, resulting in empty pain in the brain, dizziness and tinnitus. The waist is the home of the kidney. If the kidney is deficient, the spermatorrhea will be frequent, and in women, the belt meridian will be loose and the spermatorrhea will be thin. Insomnia, red tongue with little coating, and thin pulse are signs of insufficient kidney yin and disharmony between the heart and kidney.

6) Symptoms of headache due to deficiency of both Qi and blood: headache and dizziness, palpitations, restlessness, fatigue, and pale face. The tongue is pale, the tongue coating is white and greasy, and the pulse is deep and fine.

Symptom analysis: Insufficient blood, virtual heat rising up, so headache and dizziness; insufficient blood will damage the heart and soul, so palpitations and panic: deficiency of both Qi and blood can easily lead to Qi deficiency, and Qi deficiency will cause fatigue; pale face, pale tongue, and deep and thin pulse are all signs of deficiency of both Qi and blood.

7) Symptoms of phlegm-induced headache: headache, dizziness, chest fullness and stuffiness, vomiting and phlegm. The tongue coating is white and greasy, and the pulse is slippery or stringy and slippery.

Symptom analysis: The spleen is not functioning properly, phlegm and turbidity are blocking the middle part of the body, covering the clear orifices, and the clear yang cannot expand, so there is headache and dizziness; phlegm blocks the chest diaphragm, so there is fullness and stuffiness in the chest and abdomen; phlegm and turbidity rise here, causing vomiting and spitting of phlegm; white and greasy tongue coating and slippery or stringy and slippery pulse are all signs of damp phlegm stagnation inside the body.

8) Symptoms of congestion headache: The headache is long-lasting and difficult to heal, the pain point is fixed and does not move, the pain is like a needle prick, or there is a history of head trauma. The tongue is purple, the tongue coating is white and greasy, and the pulse is thin or fine and astringent.

Symptom analysis: Long-term illness affects the meridians, or there is head trauma, blood stasis inside the body, and multiple circulation is not smooth, so the headache is long-lasting and difficult to heal, the pain is in a fixed place, and it feels like being pricked by a needle; the purple tongue and thin and wiry pulse are signs of internal resistance caused by blood stasis.

The above five types are internal injury headaches.