风者百病之长。其变无常。其中人也。风则上先受之。湿则下先受之。俱从太阳膀胱经
而入
。风伤其卫。湿流关节邪相搏击。故显汗出恶风。短气发热。头痛骨节烦疼。身重微肿等症
。此固宜从汗解。第取汗贵徐不贵骤。骤则风去湿存。徐则风湿俱去也。其有不可发汗者缘
风湿相搏。多夹阳虚。阳虚即不可汗。但可用辛热气壮之药。扶阳逐湿而已。凡见短气。虽
为邪阻其正。当虑胸中阳虚。凡见汗出微喘。虽为肺气感邪。当虑真阳欲脱。
病者身热足寒。颈项强急恶寒。时头热。面赤目赤。头摇口噤背反张者。痉病也。(详
在金匮)
外感六淫之邪。由太阳而传六经。邪不尽传即不已。故三阳三阴皆足致痉。如太阳之传
阳明
。项背KT KT 。少阳之颈项强。是知三阳皆有痉矣。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。或左或右一目牵斜。一手搐
搦属少阳。发热。脉沉细。腹痛。属太阴。以防风当归汤治太阳阳明发汗过多而致痉者。以
柴胡加防风汤治少阳汗后不解。寒热往来而成痉者。虽不及少阴厥阴。然其制附子散。桂心
白术汤。附子防风散。意原有在。观其白术汤下云。上解三阳。下解太阴。一种苦心无非谓
传入少阴厥阴必成死证耳。讵知传经之邪。如风雨之来。而画地以限其不至。岂可得乎。灵
枢谓足少阴之经筋循脊内。侠膂。上至项与足太阳筋合。其病在此。为主痫螈及痉。在外阳
病者不能俯。在内阴病者不能仰。是则足少阴之藏。与足太阳之府。两相联系。而以不能俯
者。知为太阳主外。不能仰者。知为少阴主内。其辨精矣。仲景之以头强脊强不能俯者。指
为太阳之痉。原以该三阳也。而其以身蜷足蜷不能仰者。指为少阴之痉以该三阴也。痉证之
属三阴者。及阳症阴脉者。皆不可救。其证目正圆。及戴眼者。不治。所以仲景但论三阳治
法。而不及三阴也。
小儿之体脆神怯。不耐外感壮热。多成痉病。后世妄以惊风立名。实则指痉病之头摇手
劲者
。为惊风之抽掣。指痉病之卒口噤脚挛急者。为惊风之搐搦。指痉病之背反张者。为惊风之
角弓反张。妄投镇惊之药勾引外邪深入脏腑。千中千死。又如新产妇人血舍空虚。外风袭入
而成痉病。仲景谓新产亡血虚多汗出。喜中风。故为病痉。宜从血舍驱风。若称产后惊风。
妄投汤药亦千中千死也。
风是百病之首。它的变化无常。当它侵袭人体时，风邪往往先侵犯上部，湿邪往往先侵犯下部。它们都从足太阳膀胱经进入体内。
风邪损伤卫气，湿邪流注于关节，邪气相互搏击，因此表现出出汗、怕风、气短、发热、头痛、骨节烦痛、身体沉重且轻微浮肿等症状。这种情况固然适宜通过发汗来解除，但取汗贵在缓慢而不在猛烈。猛烈发汗则风邪虽去而湿邪留存，缓慢发汗则风湿之邪都能去除。那些不适合发汗的情况，是因为风湿相搏，多夹杂阳气虚弱。阳气虚弱就不可以发汗，只能使用辛温助阳、强壮元气的药物，扶助阳气以驱逐湿邪罢了。凡是见到气短，虽然是因为邪气阻滞正气，应当考虑到胸中阳气虚弱。凡是见到出汗且伴有轻微气喘，虽然是因为肺气感受邪气，应当考虑到真阳即将脱失的危险。
患者身体发热但脚部寒冷，颈项强直僵硬、怕冷，有时头部发热，面色发红、眼睛发红，头部摇动、牙关紧闭、背部反张（角弓反张），这是痉病。（详细内容见《金匮要略》）
外感六淫邪气，由太阳经传入其他六经。如果邪气不能传遍六经就不会停止。所以三阳经和三阴经都足以导致痉病。例如太阳经传入阳明经，出现项背强直；少阳经出现颈项强直。由此可知三阳经都有可能导致痉病。海藏（张元素）说三阳经和太阴经都会发生痉病，唯独没有提到少阴经和厥阴经。他说背部反张属于太阳经，低头视下、手足牵引、肘膝相凑属于阳明经，或者左侧或右侧一只眼睛牵拉斜视、一只手抽搐拘挛属于少阳经，发热、脉沉细、腹痛属于太阴经。用防风当归汤治疗太阳、阳明经因发汗过多而导致痉病的患者；用柴胡加防风汤治疗少阳经发汗后病不解，寒热往来从而形成痉病的患者。虽然他没有直接提及少阴和厥阴，但他制定的附子散、桂心白术汤、附子防风散，其用意原本就在这里。看他的白术汤方解中说：“上解三阳，下解太阴”，这种苦心无非是说邪气传入少阴、厥阴必然成为死证罢了。哪里知道传经的邪气，就像风雨袭来一样，怎么能画地为牢限制它不传到那里呢？《灵枢》说足少阴经的经筋沿着脊柱内部，夹着脊旁肌肉，上行至项部与足太阳经的筋汇合。病变发生在这里，主要引起痫证抽搐及痉病。在外侧阳经发病者身体不能前俯，在内侧阴经发病者身体不能后仰。这就说明足少阴脏与足太阳腑两者相互联系。通过不能前俯，知道这是太阳主外的表现；通过不能后仰，知道这是少阴主内的表现。这种辨析非常精妙。张仲景将头项强直、身体不能前俯的归为太阳经的痉病，原本是为了涵盖三阳经的情况；而他将身体蜷曲、双脚蜷缩、不能后仰的归为少阴经的痉病，是为了涵盖三阴经的情况。属于三阴经的痉证，以及阳症见阴脉的患者，都不可救治。表现为眼睛直视不动或眼球上翻（戴眼）的患者，也是不治之症。所以张仲景只论述了三阳经的治疗方法，而没有涉及三阴经。
小儿体质脆弱、神气怯弱，不耐受外感壮热，多会形成痉病。后世错误地设立“惊风”这一名称，实际上是指痉病中头部摇动、手部劲急的症状，称之为惊风的抽掣；指痉病中突然牙关紧闭、脚部挛急的症状，称之为惊风的搐搦；指痉病中背部反张的症状，称之为惊风的角弓反张。妄用镇惊的药物，反而勾引外邪深入脏腑，治一千例死一千例。又如刚生产后的妇女，血室空虚，外风乘虚而入而形成痉病。张仲景说新产妇人亡血、体虚、多汗出，容易中风，所以生病成为痉病。适宜从血室驱除风邪。如果称为产后惊风，妄投汤药，也是治一千例死一千例。
Wind is the chief of all diseases. Its changes are unpredictable. When it invades the human body, wind pathogen tends to affect the upper part first, while dampness pathogen tends to affect the lower part first. Both enter through the Foot-Taiyang Bladder Meridian.
Wind damages the Defensive Qi (Wei Qi), and dampness flows into the joints, where pathogens struggle against each other. Consequently, symptoms such as sweating, aversion to wind, shortness of breath, fever, headache, vexing pain in the bone joints, heaviness of the body, and slight swelling manifest. In such cases, resolution through sweating is indeed appropriate. However, inducing sweat should be done gradually rather than abruptly. Abrupt sweating expels the wind but leaves the dampness behind, whereas gradual sweating eliminates both wind and dampness. For those unsuitable for sweating therapy, it is because wind-dampness intermingling often involves Yang deficiency. When Yang is deficient, sweating is contraindicated; instead, acrid-warm herbs that strengthen Yang and boost Qi should be used to support Yang and drive out dampness. Whenever shortness of breath is observed, although caused by pathogenic obstruction of healthy Qi, one must consider deficiency of Yang in the chest. Whenever sweating accompanied by slight panting is observed, although attributed to Lung Qi affected by pathogens, one must consider the impending collapse of True Yang.
The patient presents with fever in the body but cold feet, stiffness and rigidity of the neck and nape with aversion to cold, occasional heat in the head, redness of the face and eyes, shaking of the head, lockjaw, and opisthotonos (backward arching of the back). This is Spasm Disease (Jing Bing) (see detailed discussion in *Jin Gui Yao Lue*).
External contraction of the Six Excesses (Liu Yin) transmits from the Taiyang stage to the other meridians. If the pathogen does not transmit completely, the disease persists. Thus, the Three Yang and Three Yin stages can all lead to spasm. For instance, transmission from Taiyang to Yangming causes stiffness of the neck and back; Shaoyang causes stiffness of the neck. Hence, it is known that the Three Yang stages can all cause spasm. Haizang (Zhang Yuansu) stated that the Three Yang and Taiyin stages suffer from spasm, omitting Shaoyin and Jueyin. He claimed that opisthotonos belongs to Taiyang, looking down with head lowered, traction of limbs, and elbows meeting knees belong to Yangming, or unilateral eye deviation and hand convulsions belong to Shaoyang, fever with deep-thin pulse and abdominal pain belong to Taiyin. Fangfeng Danggui Decoction is used to treat spasm caused by excessive sweating in Taiyang and Yangming stages. Chaihu Jia Fangfeng Decoction is used to treat spasm resulting from unresolved alternating chills and fever after sweating in the Shaoyang stage. Although he did not explicitly mention Shaoyin and Jueyin, his formulations—Fuzi San, Guixin Baizhu Tang, and Fuzi Fangfeng San—imply their relevance. Regarding Guixin Baizhu Tang, he noted: "Resolves the Three Yang above, resolves Taiyin below." His meticulous intent was likely to suggest that transmission to Shaoyin and Jueyin inevitably leads to fatal conditions. However, pathogenic transmission is like wind and rain arriving; how can one draw boundaries to prevent its spread? *Ling Shu* states that the sinews of the Foot-Shaoyin Meridian run along the interior of the spine, flanking the paraspinal muscles, ascending to the nape where they join the sinews of the Foot-Taiyang Meridian. Pathology here primarily manifests as epilepsy, convulsions, and spasm. External Yang pathology prevents flexion (bending forward); internal Yin pathology prevents extension (bending backward). This demonstrates the connection between the Foot-Shaoyin Zang organs and Foot-Taiyang Fu organs. Inability to bend forward indicates Taiyang governs the exterior; inability to bend backward indicates Shaoyin governs the interior. This differentiation is precise. Zhang Zhongjing attributed stiffness of the head and spine with inability to bend forward to Taiyang spasm, thereby encompassing the Three Yang stages. He attributed curling of the body and legs with inability to bend backward to Shaoyin spasm, thereby encompassing the Three Yin stages. Spasm involving the Three Yin stages, or Yang syndromes presenting with Yin pulses, are incurable. Cases with fixed staring eyes or upward deviated eyes (Dai Yan) are also untreatable. Therefore, Zhang Zhongjing only discussed treatment methods for the Three Yang stages, excluding the Three Yin stages.
Children have fragile constitutions and timid Shen (Spirit), unable to withstand severe external febrile pathogens, often developing spasm disease. Later generations erroneously named this condition "Convulsive Wind" (Jing Feng). In reality, they referred to the head shaking and limb tension of spasm disease as the jerking of convulsive wind; the sudden lockjaw and foot cramping of spasm disease as the twitching of convulsive wind; and the opisthotonos of spasm disease as the opisthotonos of convulsive wind. The reckless administration of sedating-convulsion drugs draws external pathogens deeper into the Zang-Fu organs, resulting in death in every case. Similarly, postpartum women have empty blood chambers (Xue She). External wind invades due to this emptiness, causing spasm disease. Zhang Zhongjing stated that new mothers lose blood, become deficient, sweat excessively, and easily contract wind, thus suffering from spasm. Treatment should focus on expelling wind from the blood chamber. If misdiagnosed as postpartum convulsive wind and treated with inappropriate decoctions, it too results in death in every case.