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When pathogenic factors of Cold Damage (Shanghan) invade, causing a combination of Taiyang disease and dampness, these three conditions should be discussed separately because their manifestations resemble those of standard Cold Damage, hence their appearance here.

Taiyang disease presenting with fever, absence of sweating, and paradoxically no aversion to cold is termed Gang Jing (Yang Spasm, a type of spastic disease characterized by rigidity of the neck and back and lockjaw).
Taiyang disease presenting with slight fever, presence of sweating, and no aversion to cold is termed Rou Jing (Yin Spasm). (The *Zhubing Yuanhou Lun* records it as having aversion to cold.)
Its symptoms include body heat with cold feet, stiffness in the head and urgency in the neck, alternating aversion to cold and heat in the head, red face with congested eye vessels, isolated head tremor, sudden lockjaw, and opisthotonos (arching of the back like a bow); this is Bing Ji (Spasm disease).
If Taiyang disease is treated with excessive sweating, it may lead to Bing Ji. (The *Suwen* states: "When Taiyang qi is abnormal, it leads to nocturnal sweating." It also states: "Lung heat transfers to the Kidney, transmitting into Rou Jing." Initially, there is Taiyang Wind Strike; excessive fever forces Lung Metal. As the mother of Kidney Water, Lung Metal avoids harm by transferring heat to Kidney Water. Forced by Fire, Water rises and invades the Heart position. When Water enters the Fire realm, it transforms into sweat. If sweating is excessive, followed by deep sleep, the sweat turns into cold-damp qi that re-attaches to the Taiyang meridian, thus causing Bing Ji.)
For patients with Bing Ji who cannot touch the mat when lying down, where children's lumbar region is two fingers' width off the mat, or adults can fit a palm behind them when lying on their side, the condition is difficult to treat. The pulse for Bing Ji is wiry and straight, extending up and down.
Zhang Zhongjing said: In Taiyang disease with spasm signs, if the body is rigid and stiff, and the pulse is surprisingly deep and slow, it indicates impending Bing Ji; Guizhi Jia Gualou Tang (Cinnamon Twig Decoction plus Trichosanthes Root Decoction) is appropriate. (Gualou does not primarily treat Wind Strike; regarding neck rigidity, its intent is to clear Lung heat to prevent transfer to the Kidney. Four liang of Gualou should be added to Guizhi Tang.)
Bing Ji should not be treated with heavy sweating or acupuncture; mild sweating is appropriate.
Rou Jing is treated with Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Pueraria Root Decoction) (Add four liang of Gegen to Guizhi Tang).
Gang Jing is treated with Gegen Mahuang Tang (Pueraria and Ephedra Decoction). (Formula found in the Exterior-Resolving chapter.)
Modified Gegen Mahuang Tang for Gang-Rou Jing.
Ingredients: Gegen (Puerariae Radix), Mahuang (Ephedrae Herba), Shengjiang (Zingiberis Rhizoma Recens) (each 1 liang), Fangfeng (Saposhnikoviae Radix), Shaoyao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix), Xiongqiong (Chuanxiong Rhizoma), Huangqin (Scutellariae Radix), Fangji (Stephaniae Tetrandrae Radix), Guizhi (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 liang), Fuzi (Aconiti Lateralis Radix Praeparata) (one piece).
Coarsely crush, add six sheng of water, first boil Mahuang and Gegen for several boils, remove the foam on top, add remaining herbs, boil to obtain two sheng, strain. Drink one zhan, repeat after a short interval, four to five times during the day, two to three times at night. For Rou Jing with spontaneous sweating, remove Mahuang and increase Gegen to 1.5 liang.
For Gang Jing with chest fullness, lockjaw, inability to touch the mat when lying down, leg cramps, and teeth grinding, Da Chengqi Tang (Major Order the Qi Decoction) should be used to purge. (Formula found in the Purging chapter.)