Heaviness of head is a subjective symptom of a heavy sensation in the head, commonly referred to as "head heaviness."

The Lingshu · Zhong Shi chapter states: "Diseases arising in the head cause heaviness of head." This term has been used consistently in later generations.

In clinical practice, heaviness of head is often seen alongside headache and dizziness. This section only discusses cases where heaviness of head is the primary symptom.

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1. Wind-dampness Clouding the Upper︰The head feels heavy and painful, as if wrapped by something, worsening during rainy weather, with nasal congestion and aversion to wind, a heavy and sore body, chest tightness, and epigastric fullness. The tongue coating is thin and greasy, and the pulse is floating and moderate or soggy. This syndrome arises from exposure to external pathogens. Suwen-Zhizhenyao Da Lun states: "When Taiyin prevails, ... dampness accumulates internally, ... heaviness of the head, ..." Dampness is a yin pathogen, characterized by stickiness and sedimentation. When wind carries dampness upward to cloud the senses, the seven orifices become obstructed, leading to a heavy, dull headache. If the pathogen lingers in the superficial muscles and lung qi fails to disperse, nasal congestion occurs. When defense qi is obstructed, aversion to wind and a heavy, sore body manifest. Symptoms worsen in damp, rainy conditions. Since the illness is superficial, its course is brief. If pathogens stagnate in the chest and epigastrium, fullness and discomfort arise. A thin, greasy tongue coating and a floating, moderate pulse are signs of wind-dampness in the exterior. Treatment should focus on dispelling wind and overcoming dampness. The formula Notopterygium Overcoming Dampness Decoction is used to release the exterior and eliminate dampness. If dampness obstructs the stomach, causing nausea and vomiting, Magnolia Bark, Atractylodes Rhizome, and Pinellia can be added to regulate qi, harmonize the stomach, dry dampness, and invigorate the spleen.
2. Dampness-heat︰The head feels heavy, accompanied by distending pain, which worsens at noon. There is facial redness, bodily heat, irritability, chest tightness, loss of appetite, deep yellow urine, a yellow and greasy tongue coating, and a slippery-rapid or soggy-rapid pulse. This condition arises from external contraction of dampness transforming into heat, or exposure to summerheat-dampness in the summer, or due to spleen-stomach weakness leading to internal accumulation of dampness, which stagnates and transforms into heat. When dampness-heat rises and steams upward, obstructing the seven orifices, it causes heaviness and distending pain in the head along with facial redness. Suwen·Cire states: "In cases of spleen heat, the patient first experiences heaviness of the head, cheek pain, irritability,... and bodily heat." Clinically, symptoms such as heaviness of the head with distending pain, worsening in the afternoon, facial redness, bodily heat, yellow urine, and a yellow-greasy tongue coating are observed. Treatment should focus on clearing heat and resolving dampness, using Head-Clearing Ointment as the prescription. If heat predominates over dampness, presenting with high fever, thirst, restlessness, and heaviness of the head with pain, the primary approach should be clearing heat while also resolving dampness, using Gypsum Dahurian Angelica Decoction.
3. Damp Phlegm︰Heaviness of head and dizziness, tinnitus, somnolence, more severe in the morning, gastric stuffiness in the chest, nausea with salivation, mental discomfort, white and greasy tongue coating, soggy and slippery pulse manifestation. This syndrome is often caused by dietary irregularities, excessive consumption of rich and greasy foods, injury to the spleen and stomach, dysfunction of the spleen in transportation, failure to transform water-dampness, which accumulates and produces phlegm, belonging to excess. When phlegm-dampness ascends and harasses, obstructing clear yang, it leads to heaviness of the head, dizziness, and tinnitus. When phlegm-dampness internally obstructs, it causes stuffiness and fullness, depression, vomiting with salivation, somnolence, white and greasy tongue coating, and soggy-slippery pulse. Treatment should focus on drying dampness and resolving phlegm, using formulas such as Erchen Pingwei Decoction, Pinellia Gastrodia Tuber White Atractylodes Rhizome Decoction.
4. Spleen Qi Deficiency︰The head feels heavy, with a sensation of dizziness and floating. The course of the illness is relatively long, and there may be empty pain accompanied by dizziness, a dull complexion, mental fatigue and lack of strength, reduced appetite, loose stools, a pale tongue with tooth marks, and a slow, weak pulse. This condition is often caused by excessive overstrain, which damages the original qi; or it may be due to a generally weak constitution, with middle qi deficiency and decline, leading to failure of clear yang to ascend, resulting in a heavy head, dizziness, floating sensations, empty pain, and dizziness—all signs of deficiency. Spleen-stomach qi deficiency impairs transportation and transformation, leading to reduced appetite and loose stools. Deficiency of qi and blood results in a dull complexion, a pale tongue with tooth marks, and a slow, weak pulse. Treatment should focus on tonifying the middle and replenishing qi, using Middle-Tonifying Qi-Replenishing Decoction to lift clear yang.

The obstruction of phlegm-dampness differs from wind-dampness in that the former is on the exterior with aversion to wind, while the latter is an internal obstruction of phlegm-dampness without an exterior pattern. It differs from dampness-heat in that the latter involves dampness combined with pathogenic heat, manifesting as a red face and body heat, whereas the former shows no signs of heat. The obstruction of phlegm-dampness is characterized by heaviness of the head, dizziness, epigastric stuffiness, and vomiting of saliva.

The symptom of heaviness of the head can be either deficiency or excess in nature. The deficiency type often arises from overwork damaging qi or after a prolonged illness, where the original qi is deficient and weakened, and the clear yang fails to rise, leading to a sensation of heaviness in the head. The excess type is necessarily caused by dampness pathogens; the sticky and heavy nature of dampness, when it invades the head, feels as if the head is wrapped, with a sensation of distension and heaviness, often accompanied by fullness and stuffiness in the chest and epigastrium, nausea, vomiting of saliva, a greasy tongue coating, and a slippery pulse. The excess pattern of heaviness of the head can be further differentiated into wind-dampness, dampness-heat, and phlegm-dampness. By grasping the characteristic symptoms and signs, it is not difficult to differentiate them.

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1. Lingshu．Jingmai Chapter: "The collateral of the Governor Vessel is named Changqiang, ... it diverges to the taiyang, penetrates the spine, in excess it causes rigidity of the spine, in deficiency it causes heaviness of the head."
2. Zhengyin Maizhi．Damp-phlegm: "The symptoms of damp-phlegm include chills and fever, swelling of the face and eyes, aversion to cold and heaviness of the head. Body pain and inability to turn, vomiting, nausea, fullness and discomfort without thirst."
3. 《Songya Zunsheng Shu．Head Section》: "Heaviness of the head, ... often occurs in people with qi deficiency. Qi deficiency causes the stagnant and steaming qi of heaven and earth to rise and accumulate above, unable to disperse. Even in cold weather, it feels warm, hence heaviness of the head is due to dampness-heat."