。痉字之误也。强 者。坚强而劲直。颈项牵急而背反张也。此因风寒湿三者。客于
太阳
伤其大筋。筋牵而急。故令 也。然得之风湿者。令人有汗而不恶寒。名曰柔 。昔人以
桂枝加葛根汤主之是也。得之寒湿者。令人无汗恶寒。名曰刚 。昔人以葛根汤主之是也。
小续命汤有麻黄、附子、杏仁。可以发表散寒。有桂枝、芍药。则可以解肌驱风。有防风、
防己
则可以驱邪胜湿。有人参、甘草。则可以益气柔筋。有川芎、黄芩。则可以和阴去热。乃
附子之热。则可以温经。而亦可以去湿者也。
原来 病属膀胱。口噤如痫身反张。此是伤风感寒湿。故分两症有柔刚。
无汗为刚须易识。惟有葛根汤第一。有汗为柔见的端。桂枝葛根汤救急。
二症皆宜续命汤。刚 去桂用麻黄。柔 去麻当用桂。只根据此法最为良。
小续命汤
麻黄（去节） 人参 黄芩（酒炒） 白芍（酒炒） 川芎（酒洗） 防己 杏仁（去皮尖） 桂
枝甘草（各一钱） 防风 附子（炮去皮各五分）
上锉一剂。水煎。温服。
葛根汤
葛根（二钱） 麻黄（八分） 桂枝（八分） 芍药（二钱） 甘草（八分）
上锉。生姜、大枣、水煎服。
一论刚柔二症。头摇口噤。身反张。手足挛搐。头面赤。项强急。与螈 同治法。
如圣饮
柴胡 黄芩 半夏 赤芍 川芎 甘草 白芷 当归 防风 羌活 乌药
上锉。生姜。水煎服。有汗是柔 。加白术、桂枝。无汗是刚 。加麻黄、苍术。口噤
切牙。大便实。加大黄利之。
一论 病有二。发热恶寒。头项牵强。腰脊反张。口噤面赤。螈 如痫。有汗柔 。无
汗刚
以补中益气汤内去黄 、柴胡、升麻。加川芎、白芍、熟地、白茯苓。刚 身热面赤。脉
紧。加羌活、防风、黄芩、干葛。去白术。柔 身不热。手足冷。脉沉细。加熟附子、羌
活。风
痰。加羌活、防风、栝蒌、枳实、桔梗、片芩、竹沥、姜汁。去人参、白术。破伤风 。
加僵蚕、全蝎、防风、羌活、南星、栝蒌仁、枳实、黄芩、桔梗、竹沥、姜汁去白术、人参
汗吐下多。发 者。本方倍人参、黄 、当归、生地、荆芥、羌活、白术。
这是“痉”字的误写。所谓“强”，是指身体僵硬强劲、挺直。表现为颈项部牵引拘急，背部向后反折张开。这是因为风寒湿三种邪气，侵袭于太阳经，损伤了大筋，导致筋脉牵拉而拘急，所以出现这种症状。然而，如果是因风湿所致，患者会有汗出但不怕冷，称为“柔痉”。过去用桂枝加葛根汤来主治，是正确的。如果是因寒湿所致，患者无汗且怕冷，称为“刚痉”。过去用葛根汤来主治，也是正确的。
小续命汤含有麻黄、附子、杏仁，可以发散表邪、驱散寒气；含有桂枝、芍药，则可以解除肌表之邪、驱逐风邪；含有防风、防己，则可以驱除邪气、战胜湿气；含有人参、甘草，则可以补益元气、柔和筋脉；含有川芎、黄芩，则可以调和阴血、清除热邪；附子的热性，则可以温通经脉，同时也能够去除湿气。
原来，痉病属于膀胱经病变，表现为牙关紧闭如癫痫发作，身体向后反张。这是由于伤风感受寒湿所致，因此分为两种证候：柔痉和刚痉。无汗的为刚痉，容易识别，首选葛根汤；有汗的为柔痉，症状明显，可用桂枝加葛根汤急救。这两种证候都适宜使用小续命汤。治疗刚痉时去掉桂枝，改用麻黄；治疗柔痉时去掉麻黄，应当用桂枝。只依据这种方法最为良善。
小续命汤方剂组成：麻黄（去节）、人参、黄芩（酒炒）、白芍（酒炒）、川芎（酒洗）、防己、杏仁（去皮尖）、桂枝、甘草（各一钱）、防风、附子（炮制后去皮，各五分）。以上药材锉碎为一剂，用水煎煮，温服。
葛根汤方剂组成：葛根（二钱）、麻黄（八分）、桂枝（八分）、芍药（二钱）、甘草（八分）。以上药材锉碎，加入生姜、大枣，用水煎煮服用。
关于刚痉和柔痉的论述，症状包括头部摇动、牙关紧闭、身体向后反张、手足挛缩抽搐、头面部发红、颈项强直拘急，其治疗方法与瘛疭（chì zòng，指筋脉拘急收缩）相同。
如圣饮方剂组成：柴胡、黄芩、半夏、赤芍、川芎、甘草、白芷、当归、防风、羌活、乌药。以上药材锉碎，加入生姜，用水煎煮服用。如果有汗，属于柔痉，加白术、桂枝；如果无汗，属于刚痉，加麻黄、苍术。如果牙关紧闭咬紧牙齿，大便干结，加大黄以通便泄热。
关于痉病的论述有两种情况：发热恶寒，头颈部牵引强直，腰脊向后反张，牙关紧闭，面色发红，肢体抽搐如癫痫发作。有汗的为柔痉，无汗的为刚痉。可以使用补中益气汤，去掉黄芪、柴胡、升麻，加入川芎、白芍、熟地黄、白茯苓。如果是刚痉，伴有身热面赤，脉象紧，加羌活、防风、黄芩、干葛，去掉白术。如果是柔痉，身体不热，手足冰冷，脉象沉细，加熟附子、羌活。如果有风痰，加羌活、防风、瓜蒌、枳实、桔梗、片芩、竹沥、姜汁，去掉人参、白术。如果是破伤风，加僵蚕、全蝎、防风、羌活、天南星、瓜蒌仁、枳实、黄芩、桔梗、竹沥、姜汁，去掉白术、人参。如果是发汗、催吐、泻下过多导致的痉病，本方加倍使用人参、黄芪、当归、生地黄、荆芥、羌活、白术。
This is a miswriting of the character "Jing" (Spasm). "Qiang" refers to stiffness, strength, and rigidity. It manifests as traction and urgency in the neck and nape, with opisthotonos (backward bending of the back). This occurs because Wind-Cold-Dampness pathogens invade the Taiyang channel (Taiyang Channel Disease), damaging the large tendons, causing tendon traction and urgency, thus leading to this condition. However, if caused by Wind-Dampness, the patient will have sweating but no aversion to cold, named Rou Jing (Soft Spasm). In the past, Guizhi Jia Gegen Tang (Cinnamon Twig plus Kudzu Root Decoction) was used for treatment, which is correct. If caused by Cold-Dampness, the patient will have no sweating and aversion to cold, named Gang Jing (Hard Spasm). In the past, Gegen Tang (Kudzu Root Decoction) was used for treatment, which is also correct.
Xiao Xuming Tang (Minor Continuation of Life Decoction) contains Mahuang (Ephedrae Herba), Fuzi (Aconiti Lateralis Radix Praeparata), and Xingren (Armeniacae Semen Amarum), which can release the exterior and disperse cold; it contains Guizhi (Cinnamomi Ramulus) and Shaoyao (Paeoniae Radix Alba/Rubra), which can resolve the muscle layer and expel wind; it contains Fangfeng (Saposhnikoviae Radix) and Fangji (Stephaniae Tetrandrae Rhizoma), which can expel pathogens and overcome dampness; it contains Renshen (Ginseng Radix) and Gancao (Glycyrrhizae Radix et Rhizoma), which can tonify qi and soften tendons; it contains Chuanxiong (Ligustici Chuanxiong Rhizoma) and Huangqin (Scutellariae Radix), which can harmonize yin and clear heat; the heat nature of Fuzi can warm the meridians and also dispel dampness.
Originally, Jing disease belongs to the Bladder channel pathology, manifesting as trismus (lockjaw) resembling epilepsy and opisthotonos. This is due to wind injury and cold-dampness invasion, hence divided into two syndromes: Soft Spasm and Hard Spasm. No sweating indicates Hard Spasm, which is easy to identify; Gegen Tang is the first choice. Sweating indicates Soft Spasm, with evident signs; Guizhi Jia Gegen Tang is used for emergency rescue. Both syndromes are suitable for Xiao Xuming Tang. For Hard Spasm, remove Guizhi and use Mahuang; for Soft Spasm, remove Mahuang and use Guizhi. Following this method is the most excellent.
Xiao Xuming Tang Formula: Mahuang (remove nodes), Renshen, Huangqin (wine-fried), Baishao (wine-fried), Chuanxiong (wine-washed), Fangji, Xingren (remove skin and tips), Guizhi, Gancao (each 1 qian), Fangfeng, Fuzi (processed, peeled, each 0.5 qian). All ingredients are cut into pieces for one dose, decocted in water, and taken warm.
Gegen Tang Formula: Gegen (2 qian), Mahuang (0.8 fen), Guizhi (0.8 fen), Shaoyao (2 qian), Gancao (0.8 fen). All ingredients are cut into pieces, decocted in water with Shengjiang (Fresh Ginger) and Dazao (Jujube), and taken warm.
Regarding the discussion on Hard and Soft Spasms, symptoms include head shaking, trismus, opisthotonos, limb contracture and convulsions, redness of the head and face, neck stiffness and urgency. The treatment method is the same as for Chi Zong (tendon spasms/clonic movements).
Rusheng Yin (Like-Sage Drink): Chaihu (Bupleuri Radix), Huangqin, Banxia (Pinelliae Rhizoma Preparatum), Chishao (Paeoniae Radix Rubra), Chuanxiong, Gancao, Baizhi (Angelicae Dahuricae Radix), Danggui (Angelicae Sinensis Radix), Fangfeng, Qianghuo (Notopterygii Rhizoma et Radix), Wuyao (Linderae Radix). All ingredients are cut into pieces, decocted in water with Shengjiang. If there is sweating, it is Soft Spasm; add Baizhu (Atractylodis Macrocephalae Rhizoma) and Guizhi. If there is no sweating, it is Hard Spasm; add Mahuang and Cangzhu (Atractylodis Rhizoma). If there is trismus and teeth grinding with solid stool, add Dahuang (Rhei Radix et Rhizoma) to promote bowel movement.
Regarding Jing disease, there are two types: fever and aversion to cold, head and neck traction and stiffness, lumbar spine opisthotonos, trismus, facial redness, and convulsions resembling epilepsy. Sweating indicates Soft Spasm; no sweating indicates Hard Spasm. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), removing Huangqi (Astragali Radix), Chaihu, and Shengma (Cimicifugae Rhizoma), and adding Chuanxiong, Baishao, Shudi (Rehmanniae Radix Preparata), and Baifuling (Poria with Hostwood). For Hard Spasm with body heat and facial redness and tight pulse, add Qianghuo, Fangfeng, Huangqin, and Gange (dry Gegen), and remove Baizhu. For Soft Spasm without body heat, cold extremities, and deep-thin pulse, add Shu Fuzi (Prepared Aconite) and Qianghuo. If there is Wind-Phlegm, add Qianghuo, Fangfeng, Gualou (Trichosanthis Fructus), Zhishi (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Pianqing (Scutellariae Radix), Zhuli (Bambusa Textilis Caulis Sap), and Jiangzhi (Zingiberis Recensis Juice); remove Renshen and Baizhu. For Traumatic Wind (tetanus from wounds), add Jiangcan (Bombyx Batryticatus), Quanxie (Scorpio), Fangfeng, Qianghuo, Nanting (Arisaematis Rhizoma Preparatum), Gualou Ren (Trichosanthis Semen), Zhishi, Huangqin, Jiegeng, Zhuli, and Jiangzhi; remove Baizhu and Renshen. If Jing disease arises from excessive sweating, vomiting, or purging, double the dosage of Renshen, Huangqi, Danggui, Shengdi (Rehmanniae Radix), Jingjie (Schizonepetae Spica), Qianghuo, and Baizhu in this formula.