典藏书目

Physicians practicing pulse diagnosis nowadays, regardless of which pathogenic factor from the four seasons has affected the patient, indiscriminately use *Qianghuo* (Notopterygii Rhizoma et Radix), *Fangfeng* (Saposhnikoviae Radix), *Chaihu* (Bupleuri Radix), and *Gegen* (Puerariae Lobatae Radix). They are unaware that Master Zhang Zhongjing established four contraindications for sweating therapy: "contraindicated in patients with wind disorders," "contraindicated in patients who have lost blood," "contraindicated in patients with dampness disorders," and "contraindicated in patients with sores/ulcers." All these are due to the fact that blood deficiency leads to *Jingbing* (Spasm disease, characterized by stiffness of the neck and back, trismus, and opisthotonos). Therefore, most cases of pediatric spasm disease are iatrogenic, caused by physicians' ignorance of the etiologies of the Six Qi (Wind, Cold, Summerheat, Dampness, Dryness, Fire).

Regarding the etiology of spasm disease, *Suwen* states: "All spasms with neck stiffness belong to Dampness." This character "Dampness" is highly questionable; it is likely that the character "Wind" was mis-transcribed as "Dampness" during transmission. In my youth, I read Mr. Fang Zhongxing's *Jing Shu* (Book on Spasm). He devoted his life to treating diseases and paying close attention to spasm syndromes. I believe that all Six Qi can cause spasm. Wind is the chief of a hundred diseases; none of the Six Qi harm the human body without passing through Wind. The clinical manifestations of all spasm diseases reflect the image of the rigid and flexing nature of Wind-Wood. Dampness tends to flow downward and is soft; Wood tends to ascend and is rigid. A single concept of "Dampness" seems insufficient to encompass all types of spasm. Moreover, "Dampness" does not correspond well with "neck stiffness." In the eighteen entries of Fang Zhongxing's *Jing Shu*, except for two citations from *Suwen* and *Qianjin Yaofang*, the remaining sixteen entries—two regarding pulses and fourteen regarding symptoms—lack evidence of Dampness. For example, the two pulse descriptions: one states, "In spasm patients, the pulse is tight and string-like upon pressure, moving straight up and down"; the other cites *Maijing*: "In spasm patients, the pulse is deep, firm, and moves straight up and down." These are images of Wind-Wood, which is the opposite of Dampness. Among the fourteen symptom descriptions, ten are caused by Wind, one is the contraindication for wind patients, one is the contraindication for sore patients, and two are related to postpartum blood loss; none involve Dampness. Even the one entry from *Qianjin Yaofang* stating, "Taiyang Wind-strike, compounded by Cold and Dampness, transforms into spasm," lacks coherence in context and cannot serve as evidence. Fang Zhongxing annotated: "Spasm disease, since *Suwen*, appears in *Shanghan Lun* as a condensed version described by Wang Shuhe in *Jingui Yaolue*; although *Qianjin Yaofang* contains this statement, it is not precise enough." This shows that Fang Zhongxing also harbored doubts. Furthermore, *Qianjin Yaofang* is disorganized and contains many later interpolations, making it unreliable. *Lingshu* and *Suwen* are texts that only sages and divines could articulate, yet they were largely written by people from the Warring States to Han periods. About 80-90% are credible, while 10-20% are not; for instance, they contain official titles and place names from later eras. Could Huangdi (Yellow Emperor) and Qibo have predicted future terminology? Given the vast passage of time, there are inevitably missing bamboo slips and errors. Wu Tang (Wu Jutong, self-reference), with my shallow scholarship, dare not accept this "Dampness" character, nor dare I definitively declare it wrong. I leave this doubt for future scholars to verify.