总括 项病原来风湿居，失枕闪挫亦因之；左血右痰须记取，详分虚实是灵机。
《内经》曰∶春风生于春，病在肝俞在颈项。又曰∶诸颈项强皆属于湿。戴氏曰∶项痛非是风邪即是气挫，亦有落
枕而成痛者，宜服和气之剂，亦有挫闪及久睡失枕而致项强不可转移者，此由肾虚不能生肝，肝虚无以养筋、故机关不
利，宜服补肾之剂。亦有患筋急项不能转侧者，此必从足起。《经》言∶十二经各有筋，惟足太阳之经自足至项故也。《准
绳》曰∶颈项强急、发热恶寒之症，多因风寒客三阳经也，寒搏则筋急，风搏则筋弛，左多属血，右多属痰，并宜驱邪
汤。若动则微痛，脉弦而数实，右为甚，此痰热客三阳经也，宜消风豁痰汤；若动则微痛，脉弦而涩，左为甚，作血虚
邪客太阳阳明经治，宜疏风滋血汤。
〔附方〕
驱邪汤 麻黄 桂枝 杏仁 甘草 防风 羌活 独活 川芎 本 柴胡 家葛 白芷 升麻 生姜 薄
荷水煎服（又方多加紫金藤）。
消风豁痰汤 黄芩（酒炒） 羌活 红花 半夏（姜制） 陈皮 白茯苓 甘草 独活 防风 白芷 家葛 柴
胡升麻 生姜 煎服（又方多加紫金藤）。
疏风滋血汤 当归 川芎 白芍药 熟地黄 羌活 独活 红花 牛膝 防风 白芷 家葛 升麻 甘草
柴胡 桃仁 生姜 煎服（又方多加紫金藤）。
总括：颈项部的疾病，原本多由风湿之邪所致；落枕或闪挫损伤也是常见原因。左侧病变多与血有关，右侧多与痰有关，必须牢记；详细分辨虚实才是诊疗的灵妙关键。
《黄帝内经》说：春风生于春季，病位在肝，对应的腧穴在颈项。又说：所有的颈项强急症状，都归属于湿邪。戴氏说：颈项疼痛，不是风邪作祟就是气机挫伤，也有因落枕而引发疼痛的，适宜服用调和气机的方剂。也有因挫伤、闪失以及长时间睡眠姿势不当（失枕）导致颈项强直、无法转动的情况，这是由于肾虚不能滋养肝木，肝血虚无法濡养筋脉，所以关节机关不利，适宜服用补肾的方剂。也有患筋脉拘急、颈项不能转侧的疾病，这必定是从足部经脉起始的。《内经》记载：十二经脉各有其筋，只有足太阳膀胱经从足部一直上行至颈项。《准绳》说：颈项强急并伴有发热恶寒的症状，多因风寒之邪客居于三阳经。寒邪搏结则筋脉拘急，风邪搏结则筋脉弛缓。左侧病变多属血分问题，右侧多属痰饮问题，均适宜使用驱邪汤。如果活动时有轻微疼痛，脉象弦而数实，右侧更为明显，这是痰热之邪客居三阳经，适宜使用消风豁痰汤；如果活动时有轻微疼痛，脉象弦而涩，左侧更为明显，当作血虚兼外邪客居太阳、阳明经来治疗，适宜使用疏风滋血汤。
〔附方〕
驱邪汤：麻黄、桂枝、杏仁、甘草、防风、羌活、独活、川芎、藁本、柴胡、葛根、白芷、升麻、生姜，用薄荷水煎服。（另一配方多加紫金藤）。
消风豁痰汤：黄芩（酒炒）、羌活、红花、半夏（姜制）、陈皮、白茯苓、甘草、独活、防风、白芷、葛根、柴胡、升麻、生姜，煎服。（另一配方多加紫金藤）。
疏风滋血汤：当归、川芎、白芍药、熟地黄、羌活、独活、红花、牛膝、防风、白芷、葛根、升麻、甘草、柴胡、桃仁、生姜，煎服。（另一配方多加紫金藤）。
General Summary: Neck and nape disorders originally stem from wind-dampness; stiff neck (luozhen) or sprain/contusion are also causes. Left-sided issues pertain to blood, right-sided to phlegm—this must be remembered; detailed differentiation of deficiency and excess is the key to effective treatment.
The *Neijing* states: Spring wind arises in spring, affecting the Liver, with its Shu points located at the neck and nape. It also states: All cases of neck stiffness belong to dampness. Dai Shi stated: Neck pain is either due to wind pathogen or Qi injury. There are also cases where pain results from a stiff neck (luozhen), for which harmonizing Qi formulas are appropriate. Cases of neck stiffness and immobility caused by sprains, contusions, or sleeping in an awkward position (shi zhen) arise because Kidney deficiency fails to nourish the Liver, and Liver blood deficiency fails to moisten the tendons, resulting in joint dysfunction; tonifying Kidney formulas are appropriate. For conditions involving tendon spasm and inability to turn the head, this must originate from the foot meridians. The *Jing* records: Each of the twelve meridians has associated tendons, but only the Foot-Taiyang Bladder Meridian runs from the foot up to the nape. The *Zhunseng* states: Symptoms of neck stiffness accompanied by fever and aversion to cold are mostly due to wind-cold invading the Three Yang meridians. Cold contraction leads to tendon stiffness, while wind contraction leads to tendon flaccidity. Left-sided issues mostly pertain to blood, right-sided to phlegm; both are suitable for Quxie Tang. If movement causes slight pain, with a wiry, rapid, and full pulse, more pronounced on the right, this indicates phlegm-heat invading the Three Yang meridians; Xiaofeng Huotan Tang is appropriate. If movement causes slight pain, with a wiry and choppy pulse, more pronounced on the left, it should be treated as Blood deficiency with external pathogens invading the Taiyang and Yangming meridians; Shufeng Zixue Tang is appropriate.
[Attached Formulas]
Quxie Tang: Ephedrae Herba (Mahuang), Cinnamon Twig (Guizhi), Apricot Seed (Xingren), Licorice Root (Gancao), Saposhnikovia Root (Fangfeng), Notopterygium Rhizome et Radix (Qianghuo), Angelica Pubescens Root (Duhuo), Szechwan Lovage Rhizome (Chuanxiong), Ligusticum Chuanxiong Rhizome (Gaoben), Bupleurum Root (Chaihu), Pueraria Lobata Root (Ge Gen), Angelica Dahurica Root (Baizhi), Cimicifuga Rhizome (Shengma), Fresh Ginger (Shengjiang). Decoct with Mint Water (Bohe Shui). (Another prescription adds More Purple Vine Stem [Zijin Teng]).
Xiaofeng Huotan Tang: Scutellaria Root (Huangqin, stir-fried with wine), Notopterygium Rhizome et Radix (Qianghuo), Safflower (Honghua), Pinellia Tuber (Banxia, processed with ginger), Tangerine Peel (Chenpi), White Poria (Baifuling), Licorice Root (Gancao), Angelica Pubescens Root (Duhuo), Saposhnikovia Root (Fangfeng), Angelica Dahurica Root (Baizhi), Pueraria Lobata Root (Ge Gen), Bupleurum Root (Chaihu), Cimicifuga Rhizome (Shengma), Fresh Ginger (Shengjiang). Decoct and take. (Another prescription adds More Purple Vine Stem [Zijin Teng]).
Shufeng Zixue Tang: Chinese Angelica Root (Danggui), Szechwan Lovage Rhizome (Chuanxiong), White Peony Root (Baishaoyao), Prepared Rehmannia Root (Shudihuang), Notopterygium Rhizome et Radix (Qianghuo), Angelica Pubescens Root (Duhuo), Safflower (Honghua), Achyranthes Bidentata Root (Niuxi), Saposhnikovia Root (Fangfeng), Angelica Dahurica Root (Baizhi), Pueraria Lobata Root (Ge Gen), Cimicifuga Rhizome (Shengma), Licorice Root (Gancao), Bupleurum Root (Chaihu), Peach Kernel (Taoren), Fresh Ginger (Shengjiang). Decoct and take. (Another prescription adds More Purple Vine Stem [Zijin Teng]).