东庵曰∶药品多端。理可融会，性不过寒、热、温、凉，味不过辛、甘，酸、涩、苦、咸六种
而已。寒者凝滞，热者宣行，温者热之次，凉者寒之轻，酸则必收，涩则必固，苦则必降，辛则必散，咸能
润下，甘能缓中。香燥者其性窜烈，多服则耗气。滋润者其性濡湿，多服则伤脾。消导者其性甚劣，多服
则破气。推荡者其性迅烈，多服则伤阴。渗泄者其性下流，多用则走泄。诸凡种种，可以类推。是能
于去病之功，但用之不宜偏务；推有补益之品，久服多服不妨，但不宜呆补。以行滞分消之品，用之则万
全而无弊矣。
张景岳曰∶痉之为病，即《内经》之 病也。以痉作 ，盖传写之误耳。其证脊背反张，头摇口噤，
戴眼项强，四肢拘急，或见身热足寒，恶寒面赤之类。仲景以汗、下为言，谓其误治亡阴所致。然有不因
误治者。而凡属阴虚血少，不能荣养筋脉，致搐挛僵仆者，皆是此证、但人多不识耳。如中风有此者，
必年力衰残，阴之败也。产妇有此者，必去血过多，冲任竭也。疮家有此者，必血随脓出，营气涸也。
小儿有此者，或风热伤阴，遂为急惊；或汗泻亡阴，遂为慢惊，此皆阴虚之证。盖精血不亏，虽有邪干，
断无筋脉拘急之病。而病至坚强，其枯可知。治此者，当先以气血为主，邪甚者兼治其邪，邪微者不必治
之。盖此证所急在元气，元气复而血脉行，则微邪自不能留矣。今人误从风治，不知此内生之风燥症也，
止宜滋补，本无外邪。即以伤精败血，枯燥而成，若再治风痰，难乎免矣。
陈无择曰，血气内虚，外为风寒湿热之所中则 。盖风散气，故有汗而不恶寒，曰柔痉；寒泣血，故
无汗而恶寒，曰
刚。原其所因，多由亡血，筋无所荣，故邪得以袭之。其病在筋脉，筋脉拘急，所以反张。
其病在血液，血液枯燥，所以筋挛。仲景曰∶太阳病，发汗太多，因致痉。风病下之则成痉。疮家发
汗亦成痉。可见病痉者多由误治，虚实了然矣。陈无择能知所因，而犹有未善者。外为风寒湿热所中，
则仍是风湿为邪，而虚反次之。不知发汗必伤血液，误下必伤真阴，阴血伤则血燥，血燥则筋失所滋，
拘挛、反张、强直之病，势所必至，岂待风寒湿热之相袭，而后为痉邪？必再受邪，而后成痉，无邪则无
痉哉？如以散风去湿为事，岂血燥阴虚所能堪乎？仲景言痉病，止属太阳，以痉之反张在背，背之经络惟
太阳、督脉，言太阳则督在其中。然仲景止言表，而未详里。《内经》曰∶足少阴之脉，贯脊属肾，其直
者从肾上贯肝膈。又曰∶足少阴之筋，循脊内，挟膂上至项，结于枕骨，与足太阳之经合。又曰∶足太阳
之筋病，脊反折，项筋急。足少阴之筋病，主痫螈及痉。阳病者腰反折，不能俯；阴病者不能仰。观此，
则痉病乃太阳、少阴之病。膀胱主津液，肾主藏精，病在二经，水亏可知。治此当以真阴为主。
治法∶因汗因泻，其气必虚，微虚宜三阴煎、五福饮；大虚阴胜，脉沉细，大营煎、大补元煎。多汗者
，三阴煎、参归汤、人参建中汤；
阳气大虚，汗出，或亡阳者，参附汤、 附汤、大补元煎。汗出兼火热燥者，当归六黄汤。因泄泻者，
胃关煎、温胃饮。泻止而痉者，大营煎、五福饮。兼火者，必脉有洪数滑，症见烦热，宜一阴煎，或加减一
阴煎。火盛而阴血燥涸者，清化饮、玉女煎。若有表邪未解者，当察邪之微甚，及证之阴阳。身有微热，
脉不紧数者，微邪也，只补正气，五福饮。若表邪未解，阴虚无汗，身热，宜三四柴胡饮、补阴益气煎。
若阳气大虚，阴极畏寒，邪不能解而痉者，
大温中饮。痰盛者先清上焦。火盛多痰，清膈煎、抱龙丸。多痰无火，六安煎。此证多属虚痰、虚火，
因其壅满，不得不暂为清理。但得痰气稍开，盒饭调理血气。若兼湿，以王海藏法治之，刚痉神术汤加
羌活、麻黄，柔痉白术汤加桂心、黄 。
喻嘉言曰∶《素问》谓诸痉项强，皆属于湿。《千金》推展其义，谓太阳中风，重感寒湿，则变痉。
是合风、寒、湿三者以论痉矣。《金匮》以痉、湿、 名篇，又合暑、湿、热三者言之。然所谓柔痉、
刚痉，未尝不兼及风寒。又云发汗过多因致痉。古今言痉之书止此。王海藏论痉，知宗仲景，可谓识大之
贤矣。夫以仲景论痉病所举者，太阳一经耳。后之治此病者，知为太阳，或用《金匮》桂枝、葛根二方，
茫不应手，每归咎仲景未备。不思外感六淫之邪，由太阳而传六经，邪不尽传即不已，故三阴三阳皆足致
痉。仲景之书虽未明言，其隐而不发之旨，未尝不跃然，如太阳之传阳明，项背几几；少阳之颈项强。是
知三阳皆有痉矣。而三阴岂曰无之？王海藏谓三阳、太阴皆病痉，独不及少阴、厥阴。云背反张属太阳；
低头视下，手足牵引，肘膝相构属阳明；一目或左或右斜视，一手一足搐溺属少阳；发热，脉沉细，腹痛
属太阴。治太阴以防风当归汤。治太阳、阳明发汗过多而致痉者，以柴胡加防风。治少阳汗后不解，寒热往
来而成痉者，制附子散、桂心白术汤、附子防风散。虽不及少阴、厥阴，意原有在。观其白术汤下，云上解
三阳，下安太阴，一种苦心，无非谓传入少阴、厥阴，必成死症耳。《灵枢》谓足少阴之经筋，循脊内，
挟膂上至项，与太阳筋合，其病在此，为主痫螈及痉，在外阳病不能俯，在内阴病不能仰。是则足少阴与
足太阳，两相内外，以不能俯者，知为太阳主外；不能仰者，
知为少阴主内。其辨精矣。太阳主外，则阳明、少阳主外可知；少阴主内，则太阴、厥阴之主
内可知。故仲景之以项强、脊强、不能俯者，指为太阳之痉，原以该三阳也；以身蜷、足蜷、不能仰者，
指为少阴之痉，以该三阴。所谓引而不发，跃如也。《素问》谓肾病者喜胀，尻以代踵，脊以代头，形容少
阴病俯而不能仰之状更着。海藏所谓低头视下，肘膝相构，正不能仰之阴病，反指为阳明之痉，立言殊
有未确。况仲景谓∶少阴病下利，若利自止，恶寒而蜷卧，手足温者可治。又谓∶少阴病，恶寒而蜷，
时自烦，欲去衣被者，可治。言可用温以治之也。然仲景于太阳症，独见背恶寒者，无俟其身蜷，蚤已从阴
急温，而预救其不能仰。于少阴症而见口燥咽干，及下利纯青水者，无俟项背牵强，蚤已从阳急下，而预
救其不能俯。盖脏阴之盛，腑有先征；府阳之极，入脏立槁。此皆神而明之之事，后代诸贤，不能赞一辞耳。
此外如小儿之体脆神怯，不耐外感壮热，多成痉病，后世以惊风立名，投金石脑麝之药，死而不悟。又如
新产妇人，血室空虚，外风袭入而成痉病。辄称产后惊风，妄投汤药，可慨也已。
凡痉病所因，或外感六淫，或发汗过多，或疮家误汗，或风病误下，或灸后火炽，或阴血素亏，或阳
气素弱，各各不同。故痉病之壤、不出亡阴、亡阳两途。亡阴者，津液精血素亏，不能营养其筋脉，此宜急
救其阴也；亡阳者，阳气素薄，不能充养柔和其筋脉，此宜急救其阳也。阴已亏而复补其阳，则阴立尽；
阳已薄而复补其阴，则阳立尽。不明伤寒、经络、脉理，动手辄错。无怪矣。
东庵说：药物的种类繁多，但其道理是可以融会贯通的。药性不过分为寒、热、温、凉四种，药味不过分为辛、甘、酸、涩、苦、咸六种而已。寒性的药物具有凝滞的作用，热性的药物具有宣通运行的作用，温性是热的次一等，凉性是寒的轻一等；酸味必然具有收敛作用，涩味必然具有固摄作用，苦味必然具有降泄作用，辛味必然具有发散作用，咸味能够润下，甘味能够缓急和中。香气燥烈的药物，其性质窜动猛烈，多服会耗伤正气。滋润的药物，其性质濡湿，多服会损伤脾脏。消食导滞的药物，其性质甚为劣弱（指攻伐之力），多服会破气。推荡泻下的药物，其性质迅疾猛烈，多服会损伤阴液。渗湿利水的药物，其性质向下流动，多用会导致正气走泄。诸如此类种种情况，都可以以此类推。这些药物虽然都有祛除病邪的功效，但使用不宜偏执一端；至于有补益作用的药物，久服多服不妨碍，但不宜呆板地进补。如果使用行气滞、分消积滞的药物，则能万无一失且没有弊端。
张景岳说：痉病，就是《内经》中提到的“瘛疭”（抽搐）病。将“瘛疭”写作“痉”，大概是传抄书写时的错误。它的症状表现为脊背向后反折，头部摇动，牙关紧闭，两眼上视，项部强直，四肢拘挛紧急，或者出现身体发热而脚冷，恶寒面红等情况。仲景提到汗法、下法，认为是误治导致亡阴所致。然而也有并非因误治引起的。凡是属于阴虚血少，不能荣养筋脉，导致抽搐痉挛、僵倒的患者，都是这种证候，只是人们大多不认识罢了。比如中风患者出现这种情况，一定是年力衰残，阴气败坏所致。产妇出现这种情况，一定是失血过多，冲任二脉枯竭所致。疮疡患者出现这种情况，一定是血液随脓液流出，营气枯竭所致。小儿出现这种情况，或是风热伤阴，遂成为急惊风；或是汗法、泻下法导致亡阴，遂成为慢惊风，这些都是阴虚的证候。大概精血不亏损，即使有邪气干扰，也绝不会发生筋脉拘急的疾病。病情发展到僵硬强直的程度，其干枯可知。治疗此病，应当首先以气血为主，邪气重的兼治其邪气，邪气轻的不必专门治疗。因为此病所急需的是元气，元气恢复而血脉运行，那么微弱的邪气自然不能停留。现在的人误从风邪论治，不知道这是内生之风燥症，只适宜滋补，本无外邪。这即使是因伤精败血，枯燥而成，如果再按风痰治疗，恐怕难免失误了。
陈无择说：血气内部虚弱，外部被风寒湿热所侵袭，就会发生痉病。盖风性散气，所以有汗而不恶寒，称为柔痉；寒性使血液凝泣，所以无汗而恶寒，称为刚痉。推究其起因，多由亡血，筋脉无所荣养，所以邪气得以侵袭。病在筋脉，筋脉拘急，所以身体反折。病在血液，血液枯燥，所以筋脉挛缩。仲景说：太阳病，发汗太多，因而导致痉病。风病用下法则会形成痉病。疮疡患者发汗也会形成痉病。可见患痉病的多由误治引起，虚实的情况就很清楚了。陈无择知道起因，但还有不完善的地方。外部被风寒湿热所侵袭，那仍然是风湿作为邪气，而虚证反而排在次要地位。他不知道发汗必然损伤血液，误下必然损伤真阴，阴血受伤则血燥，血燥则筋脉失去滋养，拘挛、反张、强直的疾病，是势所必至的，难道一定要等到风寒湿热相侵袭，才成为痉病吗？一定要再受邪气，然后才成痉病，没有邪气就没有痉病吗？如果以散风去湿为主要事务，难道是血燥阴虚所能承受的吗？仲景论述痉病，只归属于太阳经，因为痉病的反张在背部，背部的经络只有太阳经和督脉，说太阳经则督脉包含在其中。然而仲景只说了表证，而没有详细论述里证。《内经》说：足少阴肾经，贯穿脊柱属于肾脏，其直行者从肾脏向上贯穿肝脏膈肌。又说：足少阴之筋，沿脊柱内侧，夹着脊肉上行至项部，结于枕骨，与足太阳经相合。又说：足太阳之筋发病，脊背反折，项部筋脉紧急。足少阴之筋发病，主癫痫抽搐及痉病。阳病者腰背反折，不能前俯；阴病者不能后仰。看这些记载，则痉病乃是太阳经、少阴经的病。膀胱主管津液，肾脏主管藏精，病在二经，水亏可知。治疗此病应当以真阴为主。
治疗方法：因发汗或泻下导致的气虚，轻微虚损适宜用三阴煎、五福饮；大虚且阴盛，脉象沉细，适宜用大营煎、大补元煎。多汗者，适宜用三阴煎、参归汤、人参建中汤；阳气大虚，出汗，或亡阳者，适宜用参附汤、附子汤、大补元煎。出汗兼有火热燥热者，适宜用当归六黄汤。因泄泻者，适宜用胃关煎、温胃饮。泄泻停止但仍有痉病者，适宜用大营煎、五福饮。兼有火邪者，脉象必有洪数滑，症状见烦热，适宜用一阴煎，或加减一阴煎。火盛而阴血燥竭者，适宜用清化饮、玉女煎。如果有表邪未解，应当观察邪气的轻重，以及证候的阴阳属性。身体有微热，脉象不紧数，是微邪，只需补益正气，用五福饮。若表邪未解，阴虚无汗，身体发热，适宜用三四柴胡饮、补阴益气煎。若阳气大虚，阴极畏寒，邪气不能解除而致痉者，适宜用大温中饮。痰盛者先清理上焦。火盛多痰，适宜用清膈煎、抱龙丸。多痰无火，适宜用六安煎。此证多属虚痰、虚火，因其壅满，不得不暂时进行清理。只要痰气稍微通畅，就应当调理血气。若兼有湿邪，按照王海藏的方法治疗，刚痉用神术汤加羌活、麻黄，柔痉用白术汤加桂心、黄芪。
喻嘉言说：《素问》说各种痉病项部强直，都归属于湿。《千金方》推展其含义，说太阳中风，又重感寒湿，就会变成痉病。这是结合风、寒、湿三者来论述痉病了。《金匮要略》以痉、湿、暍（中暑）名篇，又结合了暑、湿、热三者来说。然而所谓的柔痉、刚痉，未尝不兼及风寒。又说发汗过多因而导致痉病。古今论述痉病的书籍仅此而已。王海藏论述痉病，知道尊崇仲景，可以说是见识宏大的贤人了。以仲景论述痉病所列举的，只是太阳一经罢了。后世治疗此病的人，知道是太阳经病，或用《金匮》中的桂枝汤、葛根汤两方，茫然不应手，往往归咎于仲景论述不完备。却不思考外感六淫邪气，由太阳经传入六经，邪气不尽传即不止息，所以三阴三阳都足以导致痉病。仲景的书虽然没有明言，但他隐而未发的旨意，未尝不跃然纸上，比如太阳经传入阳明经，出现项背强几几；少阳经出现颈项强直。由此可知三阳经都有痉病。而三阴经难道说没有吗？王海藏说三阳经、太阴经都会病痉，唯独不及少阴经、厥阴经。他说背反张属于太阳经；低头视下，手足牵引，肘膝相凑属于阳明经；一目或左或右斜视，一手一足抽搐属于少阳经；发热，脉沉细，腹痛属于太阴经。治疗太阴经用防风当归汤。治疗太阳经、阳明经发汗过多而致痉者，用柴胡加防风汤。治疗少阳经汗后不解，寒热往来而成痉者，用制附子散、桂心白术汤、附子防风散。虽然不及少阴经、厥阴经，意图原本就在这里。看他白术汤下注说，上解三阳，下安太阴，一种苦心，无非是说传入少阴经、厥阴经，必定成为死症罢了。《灵枢》说足少阴经的经筋，沿脊柱内侧，夹着脊肉上行至项部，与太阳经筋相合，其病在此，主癫痫抽搐及痉病，在外阳病不能前俯，在内阴病不能后仰。这样则足少阴与足太阳，两者内外相对，以不能前俯者，知道是太阳经主外；不能后仰者，知道是少阴经主内。其辨析非常精确。太阳经主外，则阳明经、少阳经主外可知；少阴经主内，则太阴经、厥阴经主内可知。所以仲景以项强、脊强、不能前俯者，指为太阳经的痉病，原是以该涵盖三阳经；以身蜷、足蜷、不能后仰者，指为少阴经的痉病，以该涵盖三阴经。这就是所谓引而不发，跃跃欲试的样子。《素问》说肾病者喜欢腹胀，屁股代替脚踵走路，脊背代替头部抬起，形容少阴病俯而不能仰的状态更加显著。海藏所说的低头视下，肘膝相凑，正是不能仰的阴病，却反而指为阳明经的痉病，立言确实有不准确之处。况且仲景说：少阴病下利，如果利自止，恶寒而蜷卧，手足温者可治。又说：少阴病，恶寒而蜷，时常自觉烦躁，想要去掉衣被者，可治。意思是可用温法来治疗它。然而仲景对于太阳症，唯独见到背恶寒者，不需要等到身蜷，早就应从阴急温，而预先救治其不能仰。对于少阴症而见口燥咽干，以及下利纯青水者，不需要等到项背牵强，早就应从阳急下，而预先救治其不能俯。大概脏阴之盛，腑有先兆；腑阳之极，入脏立刻枯槁。这都是神妙明察的事情，后代各位贤人，不能赞一词罢了。此外如小儿体质脆弱神气怯懦，不耐受外感壮热，多形成痉病，后世以惊风立名，投用金石脑麝等药物，死了也不醒悟。又如新产后的妇人，血室空虚，外风袭入而形成痉病。辄称产后惊风，妄投汤药，真是令人感慨啊。
凡痉病的起因，或外感六淫，或发汗过多，或疮家误汗，或风病误下，或灸后火炽，或阴血素亏，或阳气素弱，各不相同。所以痉病的根源，不出亡阴、亡阳两条途径。亡阴者，津液精血素来亏损，不能营养其筋脉，这应当急救其阴；亡阳者，阳气素来薄弱，不能充养柔和其筋脉，这应当急救其阳。阴已亏损而复补其阳，则阴立即耗尽；阳已薄弱而复补其阴，则阳立即耗尽。不明白伤寒、经络、脉理，动手就会出错。难怪了。
Dong'an stated: The varieties of medicinal materials are numerous, but their principles can be integrated. Their properties do not go beyond cold, heat, warm, and cool; their flavors do not go beyond pungent, sweet, sour, astringent, bitter, and salty. Cold substances cause coagulation and stagnation; heat substances promote circulation and movement; warm is the secondary degree of heat; cool is the mild degree of cold. Sour flavor necessarily has an astringent effect; astringent flavor necessarily has a consolidating effect; bitter flavor necessarily has a descending effect; pungent flavor necessarily has a dispersing effect; salty flavor can moisten and direct downwards; sweet flavor can moderate and harmonize the middle. Aromatic and drying substances have a penetrating and fierce nature; excessive use consumes Qi. Moistening and nourishing substances have a damp and wet nature; excessive use damages the Spleen. Digestive and resolving substances have a rather inferior (draining) nature; excessive use breaks Qi. Pushing and purging substances have a swift and fierce nature; excessive use damages Yin fluids. Diuretic and draining substances have a downward-flowing nature; excessive use causes leakage of Zheng Qi. All such cases can be inferred by analogy. Although these substances all possess the merit of eliminating disease, they should not be used with bias; as for tonifying substances, long-term or heavy use is acceptable, but one should avoid rigid tonification. Using substances that move stagnation and resolve accumulation ensures safety without drawbacks.
Zhang Jingyue stated: Jing illness (Spasm), is the "Chi Zong" (Convulsion/Clonic seizure) disease mentioned in the *Nei Jing* (Inner Canon). Writing "Jing" instead of "Chi Zong" is likely a transcription error. Its symptoms include opisthotonos (backward arching of the back), head shaking, trismus (lockjaw), upward staring of the eyes, neck stiffness, and limb contracture. It may also present with fever in the body and coldness in the feet, aversion to cold, and a red face. Zhongjing attributed it to the misuse of sweating and purging methods, leading to the loss of Yin. However, there are cases not caused by iatrogenic errors. Any case belonging to Yin deficiency and blood insufficiency, where the sinews and vessels cannot be nourished, resulting in twitching, convulsions, rigidity, and collapse, is this type of syndrome, though people often fail to recognize it. For instance, if a stroke patient exhibits this, it must be due to declining years and failing Yin. If a postpartum woman exhibits this, it must be due to excessive blood loss and exhaustion of the Chong and Ren vessels. If a patient with sores/ulcers exhibits this, it must be due to blood loss accompanying pus and depletion of Ying Qi. If a child exhibits this, it may be due to wind-heat damaging Yin, leading to acute convulsive disorder (Ji Jing); or due to sweating and purging causing loss of Yin, leading to chronic convulsive disorder (Man Jing). These are all Yin deficiency syndromes. Generally, if essence and blood are not depleted, even if pathogenic factors interfere, there will absolutely no be disease of sinew contracture. When the disease reaches a state of rigidity, its dryness is evident. In treating this, one should prioritize Qi and Blood first. If pathogens are severe, treat them concurrently; if pathogens are mild, no specific treatment is needed. The urgency lies in Yuan Qi; once Yuan Qi recovers and blood vessels flow, minor pathogens cannot remain. Nowadays, people mistakenly treat it as Wind, unaware that this is internally generated Wind-Dryness. Only tonification is suitable, as there is no external pathogen. Even if caused by injury to essence and deterioration of blood leading to dryness, treating it as Wind-Phlegm would likely lead to error.
Chen Wuyue stated: Internal deficiency of Qi and Blood, combined with external invasion by Wind, Cold, Dampness, and Heat, leads to Jing illness. Wind scatters Qi, hence there is sweating without aversion to cold, called Rou Jing (Soft Spasm); Cold congeals Blood, hence there is no sweating with aversion to cold, called Gang Jing (Hard Spasm). Investigating the cause, it mostly stems from blood loss, leaving sinews without nourishment, allowing pathogens to invade. The pathology is in the sinews and vessels; sinew contracture causes backward arching. The pathology is in the Blood; blood dryness causes sinew cramping. Zhongjing said: Taiyang disease, if too much sweat is induced, spasm results. Wind disease treated with purging leads to spasm. Patients with sores treated with sweating also develop spasm. This shows that most spasm cases result from iatrogenic errors, making excess and deficiency clear. Chen Wuyue identified the cause but was incomplete. He suggested external invasion by Wind-Cold-Damp-Heat makes Wind-Damp the primary pathogen, with deficiency secondary. He failed to realize that sweating inevitably damages Blood, and erroneous purging damages True Yin. Injury to Yin-Blood leads to Blood dryness; Blood dryness means sinews lose nourishment. Contracture, arching, and rigidity are inevitable consequences. Does one need Wind-Cold-Damp-Heat invasion to cause spasm? Must one suffer another pathogen to form spasm? Without pathogens, is there no spasm? If the focus is on dispersing Wind and removing Dampness, how can Blood dryness and Yin deficiency endure? Zhongjing associated spasm only with the Taiyang channel because the arching occurs in the back, where only the Taiyang and Du Mai channels run; mentioning Taiyang implies Du Mai. However, Zhongjing only discussed exterior patterns, not interior ones. The *Nei Jing* states: The Foot-Shaoyin channel penetrates the spine and connects to the Kidney; its straight branch rises from the Kidney through the Liver and Diaphragm. It also states: The Foot-Shaoyyin sinew runs along the inner spine, flanking the erector muscles up to the neck, knotting at the occiput, combining with the Foot-Taiyang channel. Furthermore: Disease of the Foot-Taiyang sinew causes spinal reversal and neck stiffness. Disease of the Foot-Shaoyyin sinew governs epilepsy, clonic seizures, and spasm. Yang diseases cause spinal reversal and inability to bend forward; Yin diseases cause inability to extend backward. Observing this, spasm involves both Taiyang and Shaoyin channels. The Bladder governs Jin-Ye (Body Fluids), and the Kidney stores Essence. Pathology in these two channels indicates Water deficiency. Treatment should prioritize True Yin.
Treatment Methods: Due to sweating or purging, Qi becomes deficient. Mild deficiency suits Sanyin Decoction (Three Yin Decoction) and Wufu Yin (Five Blessings Drink); severe deficiency with Yin excess and deep, fine pulse suits Daying Decoction (Great Camp Decoction) and Dabu Yuanyian Decoction (Great Tonification of Original Source Decoction). For excessive sweating, Sanyin Decoction, Shengui Tang (Ginseng and Angelica Decoction), and Renshen Jianzhong Tang (Ginseng Middle-Building Decoction) are suitable. For severe Yang deficiency, sweating, or Yang collapse, Shenfu Tang (Ginseng and Aconite Decoction), Fuzi Tang (Aconite Decoction), and Dabu Yuanyuan Decoction are suitable. For sweating accompanied by fire-heat dryness, Danggui Liuhuang Tang (Angelica Hexa-Huang Decoction) is suitable. Due to diarrhea, Weiguan Decoction (Stomach Gate Decoction) and Wenwei Yin (Warming Stomach Drink) are suitable. If diarrhea stops but spasm persists, Daying Decoction and Wufu Yin are suitable. If accompanied by Fire, with surging, rapid, slippery pulse and irritability/heat, Yiyin Decoction (One Yin Decoction) or Modified Yiyin Decoction is suitable. For severe Fire causing Yin-Blood exhaustion, Qinghua Yin (Clearing Transformation Drink) and Yuniu Jian (Jade Maiden Decoction) are suitable. If exterior pathogens remain unresolved, assess the severity of pathogens and Yin/Yang status. Slight fever with non-tight/non-rapid pulse indicates minor pathogens; simply tonify Zheng Qi with Wufu Yin. If exterior pathogens remain unresolved, Yin deficiency with no sweat, and body heat, Sanchasi Hu Yin (Three-Four Bupleurum Drink) and Buyin Yiqi Jian (Tonifying Yin and Boosting Qi Decoction) are suitable. If severe Yang deficiency, extreme Yin with fear of cold, and unresolved pathogens causing spasm, Dawenzhong Yin (Great Warming Middle Drink) is suitable. For abundant Phlegm, clear the Upper Jiao first. For Fire excess with Phlegm, Qingge Jian (Clearing Diaphragm Decoction) and Baolong Wan (Embracing Dragon Pill) are suitable. For Phlegm without Fire, Liu'an Jian (Six-Safe Decoction) is suitable. This condition mostly involves Deficient Phlegm and Deficient Fire; due to obstruction, temporary clearing is necessary. Once Phlegm-Qi opens slightly, regulate Qi and Blood. If accompanied by Dampness, follow Wang Haizang's method: Gang Jing uses Shenzhu Tang (Divine Efficacy Perilla Decoction) plus Qianghuo and Mahuang; Rou Jing uses Baizhu Tang (Atractylodes Macrocephala Decoction) plus Guixin and Huangqi.
Yu Jiayan stated: The *Suwen* says various spasms with neck stiffness belong to Dampness. *Qianjin Fang* expanded this, stating Taiyang Wind-stroke compounded by Cold-Damp transforms into spasm. This combines Wind, Cold, and Damp. *Jingui Yaolue* titles chapters on Spasm, Dampness, and Yue (Heatstroke), combining Heat, Dampness, and Heat. Yet Rou Jing and Gang Jing involve Wind-Cold. It also states excessive sweating causes spasm. Ancient and modern texts on spasm end here. Wang Haizang respected Zhongjing regarding spasm, showing great insight. Zhongjing cited only the Taiyang channel for spasm. Later practitioners, knowing it is Taiyang, used Guizhi Tang and Gegen Tang from *Jingui*, but found them ineffective, blaming Zhongjing's incompleteness. They failed to consider that external Six Excesses transmit from Taiyang through the Six Channels; if pathogens do not fully transmit, they persist, so all Three Yin and Three Yang can cause spasm. Though Zhongjing did not explicitly state this, his implicit meaning is clear: Taiyang transmitting to Yangming causes stiff neck and back; Shaoyang causes neck stiffness. Thus, all Three Yang have spasm. Do not Three Yin lack it? Wang Haizang said Three Yang and Taiyin cause spasm, omitting Shaoyin and Jueyin. He stated: Back arching belongs to Taiyang; looking down, limb traction, elbows/knees touching belongs to Yangming; unilateral eye deviation, unilateral limb tremor belongs to Shaoyang; fever, deep/fine pulse, abdominal pain belongs to Taiyin. Taiyin is treated with Fengwang Danggui Tang. Taiyang/Yangming spasm from excessive sweating is treated with Chaihu Plus Fengwang Tang. Shaoyang spasm from unresolved sweating with alternating chills/fever is treated with Zhi Fuzi San, Guixin Baizhu Tang, or Fuzi Fengwang San. Though omitting Shaoyin/Jueyin, the intent is there. His note on Baizhu Tang says "Upper resolves Three Yang, Lower pacifies Taiyin," implying transmission to Shaoyin/Jueyin leads to death. *Ling Shu* states Foot-Shaoyin sinew runs along inner spine to neck, combining with Taiyang sinew; pathology here governs epilepsy, clonic seizures, and spasm. Exterior Yang disease prevents bending forward; Interior Yin disease prevents extending backward. Thus, Foot-Shaoyin and Foot-Taiyang are interior/exterior pairs. Bending forward prevented indicates Taiyang exterior; extending backward prevented indicates Shaoyin interior. This distinction is precise. Taiyang governs exterior, so Yangming/Shaoyang govern exterior; Shaoyin governs interior, so Taiyin/Jueyin govern interior. Thus, Zhongjing's neck/back stiffness preventing forward bending refers to Taiyang spasm, encompassing Three Yang; body curling preventing backward extension refers to Shaoyin spasm, encompassing Three Yin. This is "drawing the bow without releasing the arrow." *Suwen* describes Kidney disease as preferring bloating, sitting on buttocks instead of walking, back replacing head, describing Shaoyin inability to extend backward. Haizang's description of looking down/elbow-knee contact is indeed Yin disease preventing extension, yet he labeled it Yangming spasm, which is inaccurate. Moreover, Zhongjing said: Shaoyin disease with diarrhea, if diarrhea stops, aversion to cold, curling up, warm hands/feet is treatable. Also: Shaoyin disease, aversion to cold, curling, occasional irritability, desire to remove covers is treatable, indicating warming therapy. For Taiyang with back aversion to cold, without waiting for curling, one should urgently warm Yin to prevent inability to extend. For Shaoyin with dry mouth/throat or pure green watery diarrhea, without waiting for neck stiffness, one should urgently purge Yang to prevent inability to bend. Visceral Yin excess has Fu signs first; Fu Yang extremity leads to visceral withering. These are subtle matters later scholars could not comment on. Additionally, children have fragile bodies and timid spirits, intolerant of external high fever, often developing spasm. Later generations named this Jing Feng (Startle Wind), using metallic/musk drugs, leading to death without realization. Postpartum women have empty Blood Chambers, susceptible to external Wind invading and causing spasm. Calling this Postpartum Startle Wind and prescribing blindly is lamentable.
The causes of spasm vary: external Six Excesses, excessive sweating, erroneous sweating in sore patients, erroneous purging in wind disease, fire blazing after moxibustion, inherent Yin-Blood deficiency, or inherent Yang Qi weakness. Thus, the root of spasm lies in either Loss of Yin or Loss of Yang. Loss of Yin: inherent deficiency of Jin-Ye, Essence, and Blood, unable to nourish sinews; urgent rescue of Yin is required. Loss of Yang: inherent thinness of Yang Qi, unable to fill and soften sinews; urgent rescue of Yang is required. Tonifying Yang when Yin is already depleted causes immediate Yin exhaustion; tonifying Yin when Yang is already thin causes immediate Yang exhaustion. Ignoring Shanghan, meridians, and pulse diagnosis leads to errors. No wonder mistakes occur.