Food

Barring the vast subject of intolerance of certain foods, headaches which get worse after eating
indicate Dampness, Phlegm, retention of food or Stomach-Heat.

Headaches which get better with eating indicate deficiency of Qi or Blood. Headaches which are
aggravated by the consumption of sour foods (such as oranges, grapefruit, vinegar, etc.) are due
to Liver-Yang rising.

Posture

If a headache improves when the patient is lying down it is due to a Deficiency; if it worsens
when lying down (and improves when sitting) it is due to an Excess. For example, severe
headaches from Liver-Yang rising usually get better sitting up and the patient dislikes lying
down.

Menstruation

Many types of headaches are closely affected by the menstrual function. Headaches which
precede the onset of the period are usually due to Liver-Yang rising. If they worsen during the
period, they may be due to Liver-Fire or stasis of Blood. If they occur towards the end of the
period, they indicate Blood Deficiency.

Pressure

If the person dislikes pressure on the part of the head where the headache occurs, it indicates an
Excess condition. Conversely, if the headache improves with pressure, it indicates a Deficiency
condition.

Differentiation and Treatment

When identifying patterns for the treatment of headaches the first differentiation to make is
between exterior and interior headaches. From an 8-Principle perspective, exterior headaches are
of Excess-type by definition. Within the interior headaches, it is important to differentiate
between Deficiency or Excess type. Zhang Jie Bin in his "Classic of Categories" says that all
headaches are simply due to either too much or too little Qi in the head: the former is an
Excess-type, the latter a Deficiency-type. He says: "When the head is painful, it indicates a
deficiency below and an excess above ... When Qi cannot ascend, the head aches ... when Qi