Diagnosis According to Channels
The "Medical Talks from the Deserted Cottage" says:
The Greater Yang type of headache affects the occiput, the Bright Yang type
affects the forehead, the Lesser Yang type affects the sides of the head ... the
Terminal Yin type affects the top of the head ... the Greater and Lesser Yin do not
ascend to the head, but Phlegm can prevent Qi from descending and the pure
Yang from ascending freely to the head. 5(61)This classification provides a useful guideline in clinical practice for a quick identification of the
channel involved in a given type of headache (Figure 1.5(62)).
However, this is only a broad guideline which first of all needs to be further refined, and
secondly needs to be integrated with the identification of internal-organ patterns. For example,
while a headache on the top of the head often involves the Terminal-Yin channel, i.e. the Liver
channel, it can be due to either Liver-Yang rising or Liver-Blood deficiency. Furthermore, a
headache on the top of the head can also be due to deficient Qi and/or Blood unable to reach the
head, and not necessarily reflect a Liver channel involvement at all.
A further analysis of the channel affecting various head areas in headaches is as follows.
Top of the Head
The Liver channel reaches the top of the head internally and is the most frequent cause of
headache there (Figure 1.6(63)).
A headache on top of the head is most often due to deficient Liver-Blood being unable to reach
the area. This headache will improve if the patient lies down and it will be dull in character. In a
few cases a headache in this area may be due to Liver-Yang rising, in which case it will be sharp
in character.
There are also other causes of headache in this area not related to the Liver channel, such as
deficient Qi and Blood unable to reach the top and Heart-Blood deficiency.
A headache on the top of the head only, should not be confused with one that affects the top but
starts all the way from the base of the occiput. This type of headache is due to the Bladder
channel.