Setting constitution aside for the moment, let me continue with headache in general. In the previous article I explained that headache can arise from either an excess or a deficiency of energy. There is, however, one pathological feature common to both cases: sangyeol-hahan (上熱下寒) — heat above and cold below.
In Summary
- Sangyeol-hahan means the upper body is hot while the lower body is cold. In headache it appears whether the pattern is deficiency or excess.
- Above: the face and the back of the neck grow hot, and pain and adverse qi crowd upward.
- Below: the stomach, colon and lower abdomen turn cold and their function stalls and weakens — or the qi of organs such as the liver and kidney becomes deficient and cold.
- The head grows hot because an excessive load falls on it and qi crowds there. Pain is what arises when qi crowds too thickly or stagnates.
- So bringing the heat down looks like the priority — but for a chronic headache, warming the lower body works better than cooling the upper. Warm the stomach and colon, add to the qi of liver and kidney, and the heat in the head disperses on its own.
- Heavy mental work makes the lower organs spend energy producing the qi and blood to send upward — and in that process the stomach and intestines are left depleted and cold.
What Heat Above, Cold Below Means
A state in which the upper part of the body is hot and the lower part cold is called sangyeol-hahan. Here is how it presents in headache specifically.
Above, the face and the region around the back of the neck become hot; pain and adverse qi crowd upward. Below — in the middle and lower body, the stomach, colon and lower abdomen — things turn cold, and function stalls and weakens. Alternatively the qi of organs situated low in the body, such as the liver and kidney, becomes deficient or turns cold.
Why the Head Grows Hot
The head becomes hot in headache because an excessive load has fallen on it and qi has crowded there. When qi crowds too thickly, or when qi stagnates, what results is pain.
The Direction of Treatment: Warm Below Rather Than Cool Above
Given all that, calming a headache would seem to be chiefly a matter of bringing down the heat and the crowded qi. In an acute episode, that holds. For a headache that has become chronic, though, the approach differs.
With chronic headache, it is better to address the cold below than to cool the heat above — that is, to warm the stomach and colon and to add to the qi of the liver and kidney, which sit low in the body. Do that and the heat in the head resolves, and the headache diminishes.
Looked at from another angle, the reasoning is easy to follow. When you use the brain heavily, or when the brain demands a great deal of energy, the tissues low in the body — the stomach and intestines — expend energy producing the qi and blood to send up to the head. In that very process, the stomach and intestines exhaust their energy, grow feeble, and turn cold. The heat in the head and the chill in the belly are not two separate events but two faces of one.
In Summary
So when a headache arrives, cool the head and reduce mental activity — and at the same time warm the lower abdomen and the trunk, whether with a half-body bath or with food. Rather than straining to put out the fire above, light one below. For chronic headache, that direction works unexpectedly well.
Related reading: Is a Headache Too Much Energy, or Too Little? · The Brain in Korean Medicine: The Sea of Marrow
This article reflects the teaching and research of Professor Seungho Baek, Professor of Korean Medicine at Dongguk University College of Korean Medicine, specializing in Pathology and Oncology.
