Headaches that keep coming back

The tradition has two words, and the difference between them is the whole subject of this page. 头痛 tóu tòng is a headache: the thing itself, on the day. 头风 tóu fēng, head wind, is the headache that goes away and comes back — named for wind because wind is the thing in the Chinese natural world that arrives suddenly, moves, and returns without being asked. A physician who hears that the pain is one-sided, that it recurs, that it has a warning and a schedule, writes head wind in the notes, and has been doing so since the Song.

That one clause from the Neijing is why the liver appears on this page so often. In the tradition’s map of the body the liver is the network that governs smooth movement and rises when it is thwarted; wind, dizziness and the pain that climbs the side of the head into the eye are all filed under it. The Jin dynasty physician Li Gao then did something a modern reader will recognise at once. In his Lanshi Micang he sorted headaches by location, assigning each region of the head to one of the six channels that run there: the nape and the back of the head to the taiyang channels, the forehead to yangming, the temples and sides to shaoyang, the crown to jueyin.

Seventy years later Zhu Danxi added the second sorting question: not only where, but with what. His Danxi Xinfa observes that headache mostly travels with phlegm, and that where the pain is severe there is usually fire — which is to say heat rising. Between the two of them, location and companion, the tradition has had a working way of telling headaches apart for seven hundred years.

Many people who find this page have been given a precise word for it by a clinician: migraine. It is a good word, more precise than most, and if you have it you should keep it. It describes a particular kind of returning headache — often one-sided, often with a warning, often with nausea or a dislike of light — and the person who gave it to you will have ruled some other things out first, which matters more than anything on this page. We do not use the word in a reading. The tradition has its own for the same experience, and head wind is the closest.

What the tradition adds is not a better name but a second set of questions. Where does it land: the temple, the forehead, the back of the head, the crown? What comes with it: heat in the face, nausea, a heavy fog, a stiff neck? What was true the day before: a short night, a skipped meal, a glass of red wine, a bad argument? A clinician where you live has already told you what it is. A reading tries to say what it is riding on.

Head wind is not one picture. It is one experience that four pictures produce, and they are eased in different directions.

The tongue tells most of these apart. Red at the edges points to the rising picture; pale and thin to the ground; a thick greasy coat to the heavy one. A reading asks for one photograph in daylight for exactly this reason, and it asks about the days between attacks — the question the attacks themselves cannot answer.

People who carry head wind usually know their own triggers better than any book, and the tradition mostly agrees with them. Alcohol, and red wine in particular, which it reads as heat and damp together. Skipped meals and short nights, which thin the ground and let the yang rise. Anger held in, which is the liver’s own complaint. For the heavy picture, rich food, dairy and cold drinks, which add damp to damp. A neck and jaw held tight over a screen for eight hours, which the tradition would have filed under the taiyang channels and a modern physiotherapist files under the same thing by another name.

• Eat at regular hours, and never skip breakfast on a day you can feel one coming. An empty stomach is the most reliable way to invite the rising picture.
• Keep the same bedtime and rising hour, including at weekends. The weekend headache that arrives after a lie-in is common enough to have its own name in our clinic notes.
• Cool the head and warm the feet. A basin of hot water for the feet as the warning starts is old, cheap and does no harm.
• Between attacks, not during, hold Hegu for a minute on each side, with the out-breath.

The tradition’s kitchen answer to head wind is light, cool and floral, and it is mostly tea.

• Chrysanthemum 菊花, the flower the Bencao Gangmu names first for wind and heat in the head and eyes. A few dried flowers in hot water, taken through the afternoon, for the rising picture.
• Mulberry leaf 桑叶, its usual companion, which the tradition pairs with chrysanthemum for the same climbing heat.
• For the ground, goji 枸杞 and jujube 大枣 in the morning congee, as the slow way of thickening what the yang is rising from.
• For the heavy picture, tangerine peel 陈皮 and poria 茯苓 in the pot instead, and nothing cold, rich or sweet — the flowers alone will not move a head that is wrapped in damp.

The warning is the same one that runs through this site. Chrysanthemum is cool, and for a person whose headache is the dull, tired, cold kind that comes with a pale tongue, it is the wrong direction; that person wants the jujube and the ginger in the morning, not the flowers in the afternoon. The complaint does not tell you which you are. The tongue does.

The oldest mnemonic in the point tradition, the song of the four command points, gives one line to the head: 头项寻列缺, for head and neck seek Lieque, a point on the wrist we have not written about yet. The point we have written about, and the one a physician in our clinic would show you first, is Hegu, Large Intestine 4, 合谷, in the web of the hand, whose line in the same song is 面口合谷收: the face and mouth are gathered at Hegu. Its entry explains how to find it and, more importantly, when not to press it.

Two rules. Hold it between attacks, as a habit, rather than during one, when most people find pressure anywhere unwelcome. And do not press it in pregnancy at all: it is the one point on this site with a hard classical prohibition, and the entry says so in cinnabar.

Once those have been looked at, everything above still stands. Head wind is a good description of a returning headache in a person who has been examined; it is a dangerous one in a person who has not.