1. Acupuncture Treatment of Diseases Neurology 3: Headache 头痛

2. Definition: 1.Can be seen in many acute and chronic diseases. 2.It is a disorder in the channels of the head leading to disharmony of the qi and blood. 3.Obstruction of the collaterals or malnutrition of the brain may also cause headache. 4.In western medicine, headache is commonly seen in diseases such as hypertension, vascular headache, encephalitis, meningitis, acute cerebral vascular diseases and glucoma.

3. Causes and Pathogenesis : A.External Contraction 1.Wind-cold, 2.Wind-dampness and 3.Wind-heat invades the head and blocks the channels and collaterals. B.Internal Injury 1.Emotional depression may lead to failure of the free flow of liver qi resulting in hyper-activity of the liver disturb the clear orifices. 2.Deficiency of kidney, weak constitution and insufficiency of qi and blood may caused the brain to be malnourished leading to headache. 3.Improper food intake may produce phlegm and dampness in the body causing obstruction of the brain collaterals. 4.Trauma may cause qi stagnation and blood stasis resulting in blocking brain collaterals.

4. Clinical Manifestations: A.External Contraction Chief symptoms: i.Persistence headache radiating to neck and back. ii.Sudden onset. iii.May be accompanied by exterior symptoms caused by external pathogenic factors.

5. Clinical Manifestations: 1.Wind-cold type i.Aversion to wind and cold. ii.No thirst. iii.Light coloured tongue. iv.Thin white tongue coating. v.Floating, tight pulse.

6. Clinical Manifestations: 2.Wind-heat type i.Distending sensation in the head. ii.Fever. iii.Thirst with preference to drink. iv.Constipation. v.Dark yellow urine. vi.Red tongue. vii.Yellow tongue coating. viii.Floating, rapid pulse.

7. Clinical Manifestations: 3.Wind-dampness type i.Heavy sensation in the head as if wrapped up. ii.Lassitude. iii.Heaviness in the limbs. iv.Light coloured tongue. v.White greasy tongue coating. vi.Soggy pulse.

8. Clinical Manifestations: B.Internal Injury Chief symptoms: i.Intermittent and lingering headache. ii.Accompanied by vertigo. iii.May be provoked by emotional or excertion stimulation.

9. Clinical Manifestations: 1.Hyperactivity of liver yang type i.Distending sensation in the head. ii.Blurred vision. iii.Restlessness and irritability. iv.Flushed complexion. v.Red eyes. vi.Bitter taste in the mouth. vii.Red tongue with thin yellow coating. viii.Wiry pulse.

10. Clinical Manifestations: 2.Liver-Kidney yin deficiency type i.Vertigo. ii.Tinnitus. iii.Soreness and weakness in the loins and knees. iv.Seminal emission. v.Red coloured tongue with thin coating. vi.Wiry, thready pulse.

11. Clinical Manifestations: 3.(Qi) Blood deficiency type i.Headache with a void sensation. ii.Vertigo. iii.Lassitude. iv.Pale complexion. v.Worsen by exertion. vi.Light coloured tongue with thin white coating. vii.Thready, weak pulse.

12. Clinical Manifestations: 4.Phlegm turbidity type i.Hazy dizziness in the head. ii.Oppression in the chest and abdomen. iii.Light coloured tongue iv.White and greasy coating. v.Slippery pulse.

13. Clinical Manifestations: 5.Collateral obstruction with blood stasis type i.Fixed pricking pain. ii.Dark purplish tongue with petechia and thin coating. iii.Thready, rough pulse.

14. Treatment : General principle A.External contraction Smooth and dredge channel and collateral qi. Dispel wind and promote blood circulation. Relieve pain. Dispel external pathogens. Principle channels: 1.GB channel. 2.GV channel. 3.LU channel. 4.EX-O. 5.Ashi.

15. Principle acupoints : 1.GB 20 Fengchi 风池. 2.GV 20 Baihui 百会. 3.LU 7 Lieque 列缺. 4.EX-HN 5 Taiyang 太阳. 5.Ashi 阿是穴.

16. Prescription explanation (Principle acupoint): 1.GB 20 Fengchi 风池 ： Channel acupoint of the GB channel, chosen to dispel wind and promote blood circulation. 2.GV 20 Baihui 百会 and EX-HN 5 Taiyang 太阳 : Channel acupoint of the GV channel and extra-ordinary point, chosen to dredge channel and collateral qi of the head. 3.LU 7 Lieque 列缺 : Luo-Connecting acupoint of the LU channel, chosen to remove external pathogenic factors. 4.Ashi point 阿是穴. Chosen to relieve pain by dredging local channels and collaterals.

17. Principle of treatment External Contraction 1.Wind cold type: Smooth and dredge channel and collateral qi, dispel wind and cold and relieve pain. Principle acupoints: as stated Supplementary acupoints: 1.BL 12 Fengmen 风门.

18. Principle of treatment 2.Wind heat type: Smooth and dredge channel and collateral qi, dispel wind and heat and relieve pain. Principle acupoints: as stated Supplementary acupoints: 1.LI 11 Quchi 曲池. 2.GV 14 Dazhui 大椎.

19. Principle of treatment 3.Wind dampness type: Smooth and dredge channel and collateral qi, dispel wind and dampness and relieve pain. Principle acupoints: as stated Supplementary acupoints: 1.SP 9 Yinlingquan 阴陵泉.

20. Treatment : General principle B.Internal contraction Nourish brain and marrow by soothing and regulating circulation of qi and blood. Dredge the channels and collaterals of the head. Supplement the channels and collaterals to nourish brain and marrow. Relieve pain. Principle channels: 1.GB channel. 2.GV channel. 3.ST channel. 4.Ashi.

21. Principle acupoints : 1.GB 20 Fengchi 风池. 2.GV 20 Baihui 百会. 3.ST 8 Touwei 头维. 4.ST 36 Zusanli 足三里. 5.Ashi 阿是穴.

22. Prescription explanation (Principle acupoint): 1.GB 20 Fengchi 风池 ： Channel acupoint of the GB channel, chosen to dredge the channel, and clear head. 2.GV 20 Baihui 百会 ： Channel acupoint of the GV channel chosen to regulate qi blood of the head. 3.ST 8 Touwei 头维： : Channel acupoint of the ST channel, chosen to dredge the channel of the head. 4. ST 36 Zusanli 足三里： He-Sea and Lower He-Sea acupoint of the ST channel where the qi of the channel congregates, chosen supplement the qi and blood of the brain and marrow. 5.Ashi point 阿是穴. Chosen to relieve pain by dredging local channels and collaterals.

23. Principle of treatment Internal Injury 1. Hyper-activity of liver yang type Soothing and regulating circulation of qi and blood, dredge the channels and collaterals of the head and suppress liver yang. Principle acupoints: as stated Supplementary acupoints: 1.LR 3 Taichong 太冲. 2.KI 3 Taixi 太溪.

24. Principle of treatment 2.Liver-Kidney yin deficiency type: Soothing and regulating circulation of qi and blood, dredge the channels and collaterals of the head and nourish kidney yin. Principle acupoints: as stated Supplementary acupoints: 1.BL 23 Shenshu 肾俞. 2.GV 4 Mingmen 命门.

25. Principle of treatment 3.(Qi) Blood deficiency type: Soothing and regulating circulation of qi and blood, dredge the channels and collaterals of the head and nourish blood. Principle acupoints: as stated Supplementary acupoints: 1.BL 20 Pishu 脾俞. 2.SP 10 Xuehai 血海.

26. Principle of treatment 4.Turbid-phlegm type: Soothing and regulating circulation of qi and blood, dredge the channels and collaterals of the head and dissipate phlegm and dampness. Principle acupoints: as stated Supplementary acupoints: 1.ST 40 Fenglong 丰隆. 2.SP 9 Yinlingquan 阴陵泉.

27. Principle of treatment 5.Blood stasis type: Soothing and regulating circulation of qi and blood, dredge the channels and collaterals of the head and invigorate blood. Principle acupoints: as stated Supplementary acupoints: 1.BL 17 Geshu 膈俞. 2.SP 6 Sanyinjiao 三阴交.

28. TCM medical advises: 1.Stop smoking and drinking. 2.Regular light diet habit avoiding raw, cold and greasy, pungent and spicy food. 3.Regular exercises. 4.Exertions and emotional stress must be avoided.