This is the most common approach. In most cases it is possible and necessary to deal with both
the Root and the Manifestation simultaneously. For example, if a headache is due to Liver-Yang
rising deriving from Kidney-Yin deficiency, the most obvious course of action is to tonify the
Kidneys and subdue Liver-Yang simultaneously.
However, even if both Root and Manifestation are treated at the same time, it is often necessary
to place the emphasis on one rather than the other. If the headaches are very severe with very
frequent attacks, it may be necessary to concentrate one's attention on treating the Manifestation
rather than the Root. In the example given above, if the headaches caused by Liver-Yang rising
are very severe and frequent, it would be important to direct one's attention to treating the
Manifestation first, i.e. subduing Liver-Yang.
On the other hand, if the Manifestation is not causing very severe headaches, then it might be
sufficient to give primary importance to treatment of the Root. For example, if a person suffers
from mild headaches from Qi deficiency, one would concentrate one's attention on treating the
Root, i.e. tonify Qi.
Treating the Manifestation First, the Root Second
This approach is necessary when the headaches caused by the Manifestation are extremely
severe and frequent so as to impede any form of normal life. For example, if the headaches from
Liver-Yang are of such intensity and frequency, one would concentrate one's attention first on
treating the Manifestation only, i.e. subdue Liver-Yang. Once the severity and the frequency of
the headaches have been reduced, then one can start treating the Root too.
Treating the Root Only
This is possible when the headaches are mild and infrequent. These headaches are usually
deficient in nature; for example, mild headaches from Qi or Blood deficiency. In these cases it
might be enough to concentrate simply on tonifying Qi or Blood, so that the headaches will
gradually disappear.
Point Selection
In the treatment of headaches it is essential to combine local with distal points. The more chronic
or intense the headache the more local points are required. Local points are also especially
required when a chronic headache appears always in the same spot. This indicates a local stasis
of Blood which always calls for the use of local points to disperse it.
Generally speaking, distal points are chosen according to the pattern characterizing the headache
and according to the channel involved. The two may not necessarily coincide. For example, a
Liver-Yang headache nearly always manifests on the Gall-Bladder channel. We might therefore