素问曰。诸痉项强。皆属于湿。
痉。音颈。强。上声。下皆仿此。诸。犹凡也。痉。广韵风强病。俗谓打寒噤是也。项。颈
后也。强。筋脉牵强。木劲而不和柔。反拗而不顺从。受病之经。其经之筋皆然。湿则下文是也。
金匮曰。太阳病。发汗太多因致痉。
金匮。痉。皆 。叔和注。 。当作痉。今从之。以便初学。太阳病。伤寒论曰。太阳之
为病脉浮。头项强痛而恶寒。是也。发汗本伤寒之治法。而中风之治。亦在法中。其例一也。太
多者。汗法以微似为度。苟至于如水流漓而湿。则过度而为太多也。此举伤寒而言。虽不及中风
与湿。而中风与上文湿。义具见言表。可知矣。致。与下文变意同。
千金曰。太阳中风。重感于寒湿则变痉也。（中。音众。）
寒湿者。中风本自汗出。出不已。而至于如水流漓。则与发之过多而湿。湿而生寒。其义一
也。上条举发汗包自汗而言。
此举中风该伤寒而言。通前三条并而观之。文虽出于三家。而风寒变痉之所以然者具见。义
则诚如互发。学人最宜精玩。痉自素问以来。其见于伤寒论者。乃叔和所述金匮之略也。千金虽
有此语。未见其精悉。自此以下。无痉文本可稽。近来乡俗。未闻曾有一人能言痉者。虽医亦然。
不但痉也。强亦未见有能分晓者。斯道之不明。岂其遭 讹误以致如斯乎。诚可叹惜。愚以两娶
五出。一女四男。皆殇于惊风。遍观儿医之家。惊风之论。辞甚鄙野。大都末流之俚谚。古无此
等荒唐之说。来历不明。其详不可考。疑憾数年。不能自释。既而偶病伤寒。死信宿而重生。感
天有所警也。改故业
而致身仲景之门。受读金匮伤寒论。愤力敏求。私淑其旨趣。寤寐其神妙。以病时多艰。印证二书
条目。心融意会。恍如鉴对梦醒。若有默迪在前。难以告语人者。见叔和 当作痉之注。忆病初项
强KT KT 之不能自胜。念儿家口不能言之自苦。岂旁窥侧测之所能喻及。大悟惊风之谬。悉皆痉语之
讹。因集诸痉。刷正警非。别为次序如今。窃案以候照对云。
金匮又曰。太阳病。发热。脉沉而细者。名曰痉。为难治。（伤寒论。无为。难治三字。）
太阳者。以太阳经所主之部属皮肤言也。皮肤为人一身之表。表之为言外也。风寒本天之二
气。于人身为外物。故其中伤于人。必自外而内。人之中伤之。必皮肤先受起。以病方在皮肤。
皮肤属太阳。故曰太阳病。盖举大纲而言始。以见周身之皮肤具病。所包详备。辞简而意周。微
哉旨也。后人不察。如诸家纷纷争以经络之一线而器讼。岂不大谬。发热。风寒之邪。客于太阳。
与正交争。蒸而为热也。然病在太阳。其脉必浮。沉细者。重感寒湿。变也。六经主病。其各该
所主之经络部属。灵素自有章章明文。道之原也。凡病无有不属六经者。言病必称六经。古意原
来如此。仲景为方法之祖。祖是道也。末流不究。骋以小智。妄凿非端。求其己私。无过务为矜
侉炫售。媒 名利而已。非为道也。识者鄙之。适所以见其弄巧卖乖。叛经悖道。徒自取垢招尤。
则亦竟成何益。来学贤能。切宜省戒。太阳发热。具见上矣。惊风论云。治惊。要识惊风痰热四
个字。又自饰云。小儿血气虚弱。虚则生热。热盛生痰。痰盛生惊。惊盛生风。风盛发搐。夫既
曰虚矣。虚则无物。无物如何生出热来。热是何物。如何又生得痰出来。痰虽有形。惊是着骇。
心之知觉。神之感应耳。无踪迹可寻也。痰如何骇得人生出惊来。惊于自己。且无踪迹。有何生
出风来。风虽寓形于动。搐是如何动。六书无搐。义不可稽。夫热既无一毫实可言。只是生于虚起。从头一直虚到底。
毕竟仍是没来由虚空不可稽之搐结证。
天下有此事理乎。然则人虽虚弱惊骇。不致卒生妄热。肢体虽动。不属无稽之搐。但卒感风寒。
太阳必当发热。变则筋脉牵强。必痉可知。以此言之。惊之谬。 之讹。大端明矣。想当愎惊谬
论之初。谬家多应未读仲景之书。未睹叔和之注。见病若然。一则不知痉亡于 。二则不识强之
名义。只是必定个惊骇。以为应当胶固。诬在儿家身上。更不思病情正理。致妄谬端。厄道酿
祸。至死不寤。流毒至今。痛惜儿家。口不能言。衔冤莫雪。予甚哀之。天既觉予以警。予既觉
之而不言。其如与谬同归何。窃为此惧。故不避僭。以致吊如斯。诚不得已也。然虚之一字。
大抵弊在医门。其为不明久矣。明而以正言者。必也君子乎。仲景以下。惜乎予未见其人也。呜
呼。不亦可慨也夫。
夫痉脉。按之紧如弦。直上下行。
紧则为寒。如弦直上下行。申释上文。
脉经云。痉家其脉伏。坚直上下。
伏。犹前沉细。大意与上同。盖脉经乃叔和所述。金匮乃仲景之书。世谓叔和为仲景之徒。
以此观之。亦不为虚称也。
金匮曰。太阳病。发热。汗出而不恶寒者。名曰柔痉。
恶。去声。下同。此以自中风而变者言。风为阳。而属木。木性曲直。故曰柔。谓和软也。
此与下文刚是反对。惊风之慢。此痉之柔也。下皆金匮。
太阳病。其证备。身体强。KT KT 然。脉反沉迟。此为痉。栝蒌桂枝汤主之。
KT 。音殊。其。承上指太阳也。证备。言头项强痛汗出恶风寒具见也。身体强。太阳阳明合
也。KT KT 者。颈项俱痛。俯仰不能自如也。此互上条而出治。惊风之抽掣搐搦。不识此强。而滥
谬也。
栝蒌桂枝汤方
栝蒌根（三两） 桂枝（三两去皮） 芍药（三两） 甘草（二两炙） 生姜（三两切）
大枣（十二枚擘）
上六味。以水九升。煮取三升。去滓。分。温。三服。取微似汗。汗不出。食顷。啜热稀粥
发之。
此桂枝汤加栝蒌根之六物也。汤义见伤寒论。盖擅固表之能。神解肌之奥。栝蒌根。消渴而
生津。导湿以彻热。肌表解而湿热彻。强不待疏而疏自至矣。
太阳病。其证备。或恶热。项背强。手足拘挛者。痉也。桂枝葛根汤主之。
此以太阳初交阳明言。病在太阳则恶风寒。交阳明。则反恶热。太阳之热翕翕。阳明之热蒸
蒸。拘挛。拘束而蜷挛也。庸俗不识强之所以为痉者。狃于俚谚。而文理字义之不明也。
桂枝葛根汤方
桂枝（三两去皮） 葛根（三两） 芍药（三两） 甘草（二两炙） 生姜（三两切） 大枣
（十二枚擘）
上六味。以水九升。先煮葛根减二升。内诸药。煮取三升。服如上法。（内。音纳。）
此亦桂枝加葛根之六物也。葛根者。阳明经之的药也。以太阳初交阳明。故用桂枝以加葛根。
经络明而药物对。理意至而功效奏矣。
太阳病。发热。无汗而反恶寒者。名曰刚痉。
此以自伤塞而变者言。寒为阴而属水。水寒则冰。故曰刚。坚劲也。与上柔对举而互发。以
见阴阳二义。彼此两相反。而寓戒谨致勿误之意。学人不可不知。然无汗不湿。不湿何痉。曰。
太阳强已微而内隐矣。痉则强之发而外着耳。惊风之急。此刚之讹也。
太阳病。无汗。而小便反少。气上冲胸。口噤不得语。欲作刚痉。葛根汤主之。
上。上声。小便少。气上冲胸。寒饮涌逆也。口为脾之窍。而胃脉夹口环唇。噤。脾虚胃寒
而寒 也。欲作。待作未作之意。此亦互上条而出治。（夹。音协。）
葛根汤方
葛根（四两） 麻黄（三两去节） 桂枝（二两去皮） 芍药（二两） 甘草（二两炙）
生姜（三两切） 大枣（十二枚擘）
上七味。 咀。以水一斗。先煮葛根麻黄减二升。去沫。纳诸药。煮取三升。去滓。温服一
升。覆取微似汗。不须啜粥。余如桂枝法将息及禁忌。
麻黄散太阳之表。葛根解阳明之肌。桂枝主营卫之和。则强自释而痉自定矣。
病者。身热。足寒。颈项强急。恶寒。时头热面赤。目赤。独头动摇。卒口噤。背反张者。
痉病也。
伤寒论。病下无者字。目下有脉字。卒。读仓卒之卒。反。音板。身热。阳明主肌肉也。足
寒。阳不下也。颈属阳明。项属太阳。
急者强之甚。时。谓不常也。三阳聚于头面。热。阴不生也。赤。表未解也。太阳之脉。挟脊。循
背。反张者。不柔和。不顺从。牵强益甚也。此盖以痉之具证言。亦风寒俱中伤之致变。与凡久
而至于剧者为然耳。反张灼然在背。惊风远谬角弓。则是忘其背而不知有其身。知逐物而不知有
道。夫如是。安得不凿空而滥谬乎。
痉为病。胸满。口噤。卧不着席。脚挛急。必 齿。可与大承气汤。
。音械。胸满。即气上冲胸之互文。卧不着席。亦反张之互词也。脚挛急。脾阴主四肢。
而胃阳为之合。阴阳不相顺接而厥逆也。必。定然之词。 者。齿上下相抵之谓。盖胃寒变热。
胃家实热甚而不和也。此谓 齿。惊风乃谬切牙。天生牙咬物。何物能切牙哉。鄙俚不经。无足
道也。且儿医之家。于痘既以切牙为寒颤。乃又授以为惊使之然。岂不自相矛盾乎。
大承气汤方
大黄（四两酒洗） 浓朴（半斤去粗皮炙） 枳实（五枚炙） 芒硝（三合）（本经无芒硝。
芒疑朴误。）
上四味。以水一斗。先煮二物取五升。去滓。内大黄煮取二升。去滓。内芒硝。更上火。微
一二沸。分。温。再服。得下利。止后服。
阳明主胃。胃廪水谷为五脏六腑之海。百骸藉养于斯。而人之吉凶死生系焉。故病凡入阳明
而胃不和。则无论轻重。皆当先以和胃为要务。承气者。和胃药也。胃凡不和。以此和之皆得愈。
故古今通行和胃皆以之。世固有惧其大黄毒而不敢行者。殊不知本草大黄无毒。而药道之论良毒
亦不在此。盖谓对病为良。苟不对病。虽良亦毒也。然药不自对。
对之者医。主药而不主对。医云乎哉。近时俗习。争言药而不言对。夫药无非物也。用之于病之
谓药。对不言矣。其如病何。其如争尚何。谓道不在厄。吾不敢允也。噫。可慨也已。
问曰。新产妇人有三病。一者病痉。二者病郁冒。三者大便难。何谓也。师曰。新产血虚。
多汗出。喜中风。故令病痉。去血。复汗。寒多。故令郁冒。亡津液。胃燥。故大便难。产妇郁
冒。其脉微弱。不能食。大便反坚。但头汗出。所以然者。血虚而厥。厥而必冒。冒家欲解。必
大汗出。以血虚下厥。孤阳上出。故头汗出。所以产妇喜汗出者。亡阴血虚。阳气独盛。故当汗
出。阴阳乃复。大便坚。呕不能食。小柴胡汤主之。
三病虽殊。其为血虚则一。所以并为设一问答而同出。方见伤寒论。
病解能食。七八日。更发热者。此为胃实。宜大承气汤。
此结上文三病而言。以致慎余之意。方见前。想设问答之意。其亦有所为而然与。且以痉言
之。如今时之人。绝无言此病者。而言产后惊风者。则纷纷然。何哉。只缘痉在乱亡。人皆不识
痉名。又不识强字之义。所以妄认筋脉牵强为抽筋。而谩谰抽掣搐搦之谬。夫以惊诬诸儿家。儿
家幼痴。不能言。诚难审理。乃又以诬妇人。而曰产后惊风。妇人者。以产育为任者也。既产矣。
儿女在抱矣。方幸庆慰。天下皆称贺喜。喜不自胜矣。何惊邪。妇人虽愚懦。不似儿家无知识也。
病虽惑乱。不似儿家不能言也。痉必作辍。当其辍时。有虚己详细以审问之。心诚求之。无有不
得其情者。审得被骇。则惊不为诬。不骇则痉明而斯案定矣。夫何难哉。惜乎人固逞己傲物。不
屑如此耳。虽然。苟或此而不详细。则又不可。
夫风病。下之则痉。复发汗。必拘急。
风必自汗。表固虚矣。下则又虚其里。所以痉也。仍复发汗。以更虚其表。是谓重亡津液。拘
急者。津液重亡。而强益甚也。
疮家虽身疼痛。不可发汗。汗出则痉。
血热则生疮身疼痛者。血涩不利。乖而不和也。汗者血之液。发而迫使之出。则血愈乖而愈
不和伤之矣。故亦致痉也。
伤寒头痛。翕翕发热。形象中风。常微汗出。自呕者。下之益烦。心中懊 如饥。发汗则致
痉。身强难以屈伸。熏之则发黄。不得小便。灸则发咳唾。
形象中风。与伤寒论第九篇病如桂枝证。异文同旨而互发。故曰。常微汗出。
以上三条。皆通前申致叮咛戒谨之意。
案成。藏诸金HT 以待。越明年。生今男。三岁亦病惊
风。时值外出。家人促归。困顿已二日。启HT 照案。急以寸匕灌之。不待终剂。应手立苏而回生。
案斯对矣。效斯验矣。嗣后慎斯法。由斯道而行。行皆若是。周旋四十余年于斯矣。坦坦如也。今
老矣。男有孙矣。顾念天之所以与我。不敢弃天。条辨伤寒论时。欲附此语痉湿 篇中。以彼此
详略不同。未之及也。兹以不敢忘宿念。痛斯民斯道困于厄而不敢忍。故订案具书。以申请当道
君子。详允施行。庶几将来。幸辅拨 以弭其祸乱。正经而反其风土。底绩平成。风土平成而
削。 削而痉复。痉复而道明。道明而厄解。则于医门。虽未可以得仁言。而于求仁之方。实则
不外是矣。志仁后彦。其勖之哉。
The *Suwen* (Basic Questions) states: Various types of Jing disease (a syndrome characterized by stiffness and rigidity of the neck and back, and trismus) are all attributable to Dampness.
"Jing" is pronounced like "jing" (neck); "Qiang" is pronounced with the rising tone; the following text follows this pronunciation rule. "Zhu" means "all" or "general". "Jing", according to the *Guangyun*, refers to a disease of wind-induced muscle spasm, commonly known as shivering chills. "Xiang" refers to the back of the neck. "Qiang" describes tendons and vessels being pulled stiffly, hard like wood and lacking flexibility, twisting and refusing to comply. The meridians affected by the disease, and their associated sinews, all exhibit this condition. The situation regarding Dampness is described in the following text.
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: In Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang meridian), excessive sweating therapy leads to Jing disease.
In the *Jingui Yaolue*, the character for "Jing" appears in a variant form noted by Wang Shuhe, who stated it should be read as "Jing"; we follow his correction here for the benefit of beginners. "Taiyang disease" is defined in the *Shanghan Lun* (Treatise on Cold Damage): The characteristics of Taiyang disease are a floating pulse, stiffness and pain in the head and neck, and aversion to cold. Sweating is originally a treatment method for Shanghan (cold damage), but it also applies to Zhongfeng (wind strike), as their principles are similar. "Too much" refers to sweating beyond the appropriate limit; the correct degree is slight perspiration. If sweating becomes profuse like flowing water, it is considered excessive. This example discusses Shanghan; although Zhongfeng and Dampness are not explicitly mentioned here, their implications are evident from the context. "Zhi" (leads to/causes) has the same meaning as "Bian" (transforms/changes) in the subsequent text.
The *Qianjin Fang* (Thousand Gold Formulas) states: Taiyang Zhongfeng, when compounded by cold-dampness, transforms into Jing disease. ("Zhong" is pronounced like "zhong" in "zhongyu").
Cold-dampness arises because Zhongfeng naturally involves spontaneous sweating. If this sweating continues until it flows like water, it equates to excessive sweating leading to dampness, which generates cold; the principle is identical. The previous clause mentioned sweating, encompassing both induced and spontaneous sweating.
This clause mentions Zhongfeng while covering Shanghan. Observing the first three clauses together, although the texts originate from three different sources, the reasons why wind-cold transforms into Jing are fully revealed, and the meanings interrelate like mutual elaboration. Students should study them carefully. Since the *Suwen*, references to Jing in the *Shanghan Lun* come from Wang Shuhe's compilation of the *Jingui Yaolue*. Although the *Qianjin Fang* contains this statement, it lacks precision. From this point onward, there is no verifiable text on Jing. Recently, in local customs, no one—not even doctors—can explain Jing. Similarly, no one can clearly distinguish "Qiang". Is the obscurity of our medical tradition due to such errors? It is truly lamentable. I had five wives and six children (one daughter, four sons), all dying from Jingfeng (startling wind). Reviewing pediatric medical literature, theories on Jingfeng are vulgar and crude, mostly folk rhymes of later generations. Such absurd claims have unclear origins and cannot be verified. I harbored doubts for years without resolution. Later, I contracted Shanghan, died for two days, and revived, feeling a divine warning. I then devoted myself to studying Zhang Zhongjing’s works, reading the *Jingui Yaolue* and *Shanghan Lun*, striving diligently to understand their essence, dreaming of their profundity. Having experienced illness, I cross-referenced these texts, achieving deep comprehension as if waking from a dream or seeing clearly in a mirror, guided by unseen mentors. Seeing Wang Shuhe’s note correcting the character to "Jing," I recalled my own initial neck stiffness and the suffering of children unable to speak, realizing that lateral speculation could never grasp this. I greatly realized the fallacy of Jingfeng theory: it is entirely an error stemming from misreading "Jing." Thus, I collected various discussions on Jing, corrected errors, and reorganized them as follows, recording them for future reference.
The *Jingui Yaolue* further states: In Taiyang disease, if there is fever and the pulse is deep and thin, it is named Jing disease, which is difficult to treat. (Note: The *Shanghan Lun* does not contain the words "wu wei" or "nan zhi".)
"Taiyang" refers to the body surface governed by the Taiyang meridian. Skin is the exterior of the body; "exterior" means outside. Wind and cold are atmospheric qi, external pathogens to humans. Therefore, they invade from outside in. When invaded, the skin suffers first. Since the disease begins in the skin, and skin belongs to Taiyang, it is called Taiyang disease. This outlines the general principle, indicating widespread skin involvement, concise yet comprehensive, profound in meaning. Later scholars failed to investigate, arguing over single meridians, which is a major error. Fever results from wind-cold pathogens interacting with healthy qi in the Taiyang, generating heat. However, Taiyang disease typically presents with a floating pulse. A deep, thin pulse indicates secondary contraction of cold-dampness, representing a change. The Six Meridians govern specific pathways, clearly stated in the *Lingshu* and *Suwen*, the origin of the Dao. All diseases belong to the Six Meridians; ancient texts always refer to them. Zhang Zhongjing is the ancestor of methods, inheriting this Dao. Later practitioners, ignoring this, rely on petty wisdom, making unfounded alterations for personal gain or fame, betraying the classics. Wise people despise this. Scholars should beware. Taiyang fever was discussed above. Jingfeng theory claims treating Jing requires understanding "Jing, Feng, Tan, Re" (Startling, Wind, Phlegm, Heat). It argues children have weak blood/qi, weakness generates heat, heat generates phlegm, phlegm generates startling, startling generates wind, wind generates convulsions. But if it is "weakness," there is nothing to generate heat. What is heat? How does it generate phlegm? Phlegm has form, but startling is a mental shock, a perception of the heart/spirit, traceless. How can traceless phlegm cause startling? Startling itself is traceless; how does it generate wind? Wind manifests in movement, but what is "convulsion"? The character "chu" (convulsion) is not in standard dictionaries, its meaning unverified. If heat is insubstantial, arising only from emptiness, the resulting convulsion is baseless and unverifiable. Does such logic exist? Although people may be weak and startled, sudden false heat does not arise. Limb movement is not baseless convulsion. Sudden wind-cold causes Taiyang fever; transformation leads to tendon stiffness, definitely Jing. Thus, the fallacy of Jingfeng and the error of characters are clear. Initially establishing Jingfeng theory, physicians likely hadn't read Zhang Zhongjing or Wang Shuhe. Seeing symptoms, they ignored the textual loss of "Jing" and the meaning of "Qiang," insisting on "startling," falsely attributing it to children, ignoring pathology, causing harm. This poison persists today. Children suffer silently. Heaven warned me; having awakened, I must speak, lest I share their fate. I fear this, so I speak out reluctantly. The concept of "deficiency" is a major flaw in medicine, long misunderstood. Only gentlemen speak truth. Since Zhang Zhongjing, I have seen none. Alas, how sigh-worthy!
The pulse of Jing disease, when pressed, is tight like a string, running straight up and down.
"Tight" indicates cold. "Like a string running straight up and down" explains the previous text.
The *Mai Jing* (Pulse Classic) states: Patients with Jing disease have a hidden pulse, firm and straight up and down.
"Heavy/Hidden" is similar to deep and thin, consistent with the above. The *Mai Jing* is by Wang Shuhe, while the *Jingui Yaolue* is by Zhang Zhongjing. Wang Shuhe is considered Zhang's disciple, validating this view.
The *Jingui Yaolue* states: Taiyang disease with fever, sweating, and no aversion to cold is named Rou Jing (Soft Jing).
"Aversion" is pronounced with the departing tone. This refers to changes from Zhongfeng. Wind is Yang, associated with Wood; Wood bends and straightens, hence "Rou" (soft/pliable). This contrasts with "Gang" (Hard) below. The slowness of Jingfeng corresponds to this Soft Jing. The following quotes are from the *Jingui Yaolue*.
Taiyang disease with complete symptoms, body stiffness, neck tension, and a reverse deep-slow pulse is Jing disease, treated with Gualou Guizhi Tang.
"Pishu" (tension/stiffness) sounds like "shu". "Qi" refers to Taiyang. "Symptoms complete" means headache, neck stiffness, sweating, and aversion to wind/cold are all present. "Body stiffness" indicates combined Taiyang and Yangming disease. "Pishu" means neck pain with inability to bend or extend freely. This offers treatment corresponding to the previous clause. The jerking of Jingfeng fails to recognize this stiffness, leading to error.
Gualou Guizhi Tang Formula
Gualou Gen (Trichosanthes Root) (3 liang) Guizhi (Cinnamon Twig) (3 liang, bark removed) Shaoyao (Peony Root) (3 liang) Gancao (Licorice Root) (2 liang, honey-fried) Shengjiang (Fresh Ginger) (3 liang, sliced) Dazao (Jujube) (12 pieces, split)
These six ingredients are boiled in 9 sheng of water to yield 3 sheng. Strain and take warm in three doses. Aim for slight perspiration. If no sweat occurs, drink hot rice gruel to induce sweating.
This is Guizhi Tang plus Gualou Gen. The function of decoctions is explained in the *Shanghan Lun*. It strengthens the exterior and resolves the muscle layer. Gualou Gen clears thirst, generates fluids, drains dampness, and removes heat. Once the muscle layer is resolved and damp-heat cleared, stiffness relaxes naturally.
Taiyang disease with complete symptoms, possibly aversion to heat, neck/back stiffness, and limb spasms is Jing disease, treated with Guizhi Ge Gen Tang.
This addresses the transition from Taiyang to Yangming. Taiyang disease causes aversion to wind/cold; Yangming involvement causes aversion to heat. Taiyang heat is mild; Yangming heat is steaming. Spasms involve constriction and curling. Vulgar ignorance of the cause of stiffness-as-Jing leads to reliance on folklore and misunderstanding of terms.
Guizhi Ge Gen Tang Formula
Guizhi (Cinnamon Twig) (3 liang, bark removed) Gegen (Kudzu Root) (3 liang) Shaoyao (Peony Root) (3 liang) Gancao (Licorice Root) (2 liang, honey-fried) Shengjiang (Fresh Ginger) (3 liang, sliced) Dazao (Jujube) (12 pieces, split)
These six ingredients are boiled in 9 sheng of water. First boil Gegen to reduce by 2 sheng, then add other herbs. Boil to yield 3 sheng. Administer as above. ("Na" means add.)
This is Guizhi Tang plus Gegen. Gegen is the key herb for the Yangming meridian. Since Taiyang transitions to Yangming, Guizhi is used with Gegen. Clear meridians and matching herbs lead to efficacy.
Taiyang disease with fever, no sweating, and reverse aversion to cold is named Gang Jing (Hard Jing).
This refers to changes from Shanghan. Cold is Yin, associated with Water; cold water freezes, hence "Gang" (hard/firm). It contrasts with Rou above, illustrating Yin-Yang opposition and caution against error. Students must know this. No sweating implies no dampness; how can there be Jing? Answer: Taiyang stiffness is subtle and internal. Jing is the external manifestation of stiffness. The urgency of Jingfeng is an error of Gang.
Taiyang disease with no sweating, reduced urination, Qi rushing to the chest, trismus (lockjaw), and inability to speak, indicating impending Gang Jing, is treated with Ge Gen Tang.
"Shang" is rising tone. Reduced urination and Qi rushing indicate cold-fluid counterflow. The mouth is the orifice of the Spleen; the Stomach meridian surrounds the lips. Trismus results from Spleen deficiency and Stomach cold. "Yu zuo" means about to occur. This treatment corresponds to the previous clause.
Ge Gen Tang Formula
Gegen (Kudzu Root) (4 liang) Mahuang (Ephedra Stem) (3 liang, joints removed) Guizhi (Cinnamon Twig) (2 liang, bark removed) Shaoyao (Peony Root) (2 liang) Gancao (Licorice Root) (2 liang, honey-fried) Shengjiang (Fresh Ginger) (3 liang, sliced) Dazao (Jujube) (12 pieces, split)
These seven ingredients are crushed. Boil in 1 dou of water. First boil Gegen and Mahuang to reduce by 2 sheng, skim foam, add other herbs. Boil to yield 3 sheng. Strain and take 1 sheng warm. Cover for slight perspiration. No need for rice gruel. Rest and dietary restrictions follow Guizhi Tang protocol.
Mahuang releases the Taiyang exterior; Gegen resolves Yangming muscles; Guizhi harmonizes Ying and Wei. Stiffness relaxes, and Jing settles.
A patient with body heat, cold feet, neck stiffness, aversion to cold, occasional facial redness and eye redness, isolated head tremor, sudden trismus, and opisthotonos (backward arching) has Jing disease.
(In the *Shanghan Lun*, "zhe" is omitted after "bing"; "mai" is added after "mu". "Cu" is pronounced "cangcu". "Fan" is pronounced "ban". Body heat relates to Yangming governing muscles. Cold feet indicate Yang failing to descend. Neck belongs to Yangming; nape to Taiyang. "Ji" is severe stiffness. "Shi" means intermittent. Three Yang meridians converge at the head; heat indicates Yin failure. Redness indicates unresolved exterior. Taiyang meridian runs along the spine and back. Opisthotonos reflects lack of flexibility and compliance, increasing stiffness. This describes full Jing symptoms, caused by combined wind-cold invasion, similar to chronic severe cases. Opisthotonos clearly affects the back; Jingfeng erroneously compares it to bow-string posture, ignoring the body and focusing on objects, leading to baseless errors.)
For Jing disease with chest fullness, trismus, inability to lie flat (back arching off the bed), leg cramps, and teeth grinding, Da Chengqi Tang may be given.
"Xie" is pronounced "xie". Chest fullness is synonymous with Qi rushing to the chest. Inability to lie flat is synonymous with opisthotonos. Leg cramps involve Spleen Yin governing limbs and Stomach Yang cooperating; failure of Yin-Yang connection leads to Jue (reversal). "Bi" means certainly. "Xie" refers to teeth grinding (upper and lower teeth clashing). Stomach cold transforming to heat causes excess heat and disharmony. This is teeth grinding; Jingfeng erroneously calls it "cutting teeth." Natural teeth bite things; what cuts teeth? This is vulgar and unworthy of mention. Pediatricians confuse teething/chattering with cold shivers, then attribute it to Jing, creating contradictions.
Da Chengqi Tang Formula
Dahuang (Rhubarb Root) (4 liang, wine-washed) Houpo (Magnolia Bark) (0.5 jin, rough bark removed, fried) Zhishi (Immature Bitter Orange) (5 pieces, fried) Mangxiao (Mirabilite) (3 he) (Note: *Benjing* does not list Mangxiao; "Mang" may be a typo for "Pu".)
These four ingredients are boiled in 1 dou of water. First boil Houpo and Zhishi to yield 5 sheng, strain, add Dahuang, boil to yield 2 sheng, strain, add Mangxiao, boil briefly. Take warm in two doses. Stop after diarrhea occurs.
Yangming governs the Stomach, the sea of water and grain for the Five Zang and Six Fu organs. Human life depends on it. When disease enters Yangming and the Stomach is disharmonious, harmonizing the Stomach is priority regardless of severity. "Chengqi" means harmonizing the Stomach. It cures all Stomach disharmonies. It is universally used. Some fear Dahuang's toxicity, but *Bencao* states Dahuang is non-toxic. Efficacy depends on appropriateness to the disease, not inherent toxicity. Medicine does not self-match; the physician matches it. Modern practice focuses on drugs rather than diagnosis. Drugs are mere substances; their value lies in treating disease. Ignoring diagnosis renders drugs useless. To say the Dao is not in difficulty, I cannot agree. Alas, how sigh-worthy!
Question: New postpartum women have three diseases: one is Jing disease, one is Yumao (depression/dizziness), one is difficult defecation. Why? Master says: Postpartum blood deficiency, excessive sweating, prone to wind strike, thus Jing disease. Blood loss plus sweating, excessive cold, thus Yumao. Loss of body fluids, dry Stomach, thus difficult defecation. For postpartum Yumao, pulse is weak, inability to eat, stool is hard, only head sweats. Reason: Blood deficiency leads to Jue, Jue leads to Mao. Resolution requires profuse sweating. Due to blood deficiency and lower Jue, solitary Yang rises, causing head sweating. Postpartum women sweat because Yin-blood is deficient, Yang is abundant, so sweating restores Yin-Yang balance. Hard stool, vomiting, inability to eat, treated with Xiao Chaihu Tang.
Although the three diseases differ, they share blood deficiency, hence the joint Q&A. Formulas are in the *Shanghan Lun*.
If the patient recovers, eats well, but develops fever again after 7-8 days, this is Stomach excess, suitable for Da Chengqi Tang.
This concludes the discussion on the three diseases, urging caution. Formulas are listed above. The intent of the Q&A may be purposeful. Regarding Jing, modern people rarely mention it, instead discussing postpartum Jingfeng. Why? Because "Jing" is lost; people don't know the name or the meaning of "Qiang," mistaking tendon stiffness for "pulling tendons" and confusing jerking with convulsions. Attributing this to children is hard to judge since they can't speak. But attributing it to women is wrong. Women bear children; after birth, they hold their babies, rejoicing. Why "startling"? Women are not ignorant like infants. Though confused, they can speak. When Jing subsides, ask carefully. If truly startled, it's Jing; if not, it's Jing disease. It's not difficult. People are arrogant and disdain such diligence. Still, neglect is unacceptable.
For Wind disease, purgation leads to Jing; subsequent sweating causes spasms.
Wind involves spontaneous sweating; the exterior is already deficient. Purgation further depletes the interior, causing Jing. Subsequent sweating further depletes the exterior, causing double loss of body fluids. Spasms result from fluid loss and increased stiffness.
Patients with sores, even with body pain, should not be sweated. Sweating causes Jing.
Blood heat causes sores; body pain indicates blood stasis and disharmony. Sweat is the fluid of blood. Forcing sweat damages blood further, causing Jing.
Shanghan headache, mild fever, resembling Zhongfeng, with slight sweating and spontaneous vomiting: Purgation increases irritability and inner restlessness; sweating causes Jing, body stiffness, and difficulty bending/extending; moxibustion causes jaundice and urinary retention; cupping/sweating induces cough and sputum.
"Resembling Zhongfeng" parallels "symptoms like Guizhi pattern" in Chapter 9 of the *Shanghan Lun*, sharing the same meaning. Hence, slight sweating.
The above three clauses reinforce cautionary advice.
The manuscript is completed and stored for future reference. Next year, my son fell ill with Jingfeng at age three. While I was away, family urged return. After two days of distress, I consulted my notes, administered the formula immediately, and he recovered before finishing the dose. The case matched, the effect verified. I adhered to this method for over forty years, finding peace. Now old, with grandchildren, remembering Heaven's gift, I dare not abandon it. While annotating the *Shanghan Lun*, I intended to include this in the Jing-Damp-Warmth chapter but omitted it due to length differences. Not forgetting my past thoughts and pitying the people's suffering and the Dao's obscurity, I compile this record to petition authorities for implementation. Hopefully, this will correct chaos, restore proper practices, and eliminate Jing. As Jing returns, the Dao clarifies, and difficulties resolve. Though I may not achieve perfect benevolence, this is the path to seeking it. Future scholars of benevolence, strive for this!