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Cheng Wuji's Commentary: Chou (convulsion) refers to the tendons becoming tense and contracting, while Chi (spasm/relaxation) refers to the tendons becoming loose and extending. If these extending and contracting movements continue without stopping, it is called Chou Chi. Commonly known as twitching or spasms, this is a disease caused by extreme wind-heat. It is appropriate to use cooling agents that dispel wind and purge heat; perhaps there is still hope for survival. If cauterization with fire and diaphoretic (sweat-inducing) medicines are recklessly applied, disaster will follow swiftly.

After the Taiyang disease has been treated with sweating therapy, if the body remains burning hot, it is named Feng Wen (Wind-Warmth). The pulse is floating at all three positions (Cun, Guan, Chi), there is spontaneous sweating, heaviness of the body, somnolence, snoring, and difficulty in speech. In such cases, purgation is contraindicated, as is fire therapy. If mistakenly subjected to fire therapy, mild cases result in jaundice, while severe cases result in Jing Xian (startle epilepsy) and Chou Chi. (Fangfeng Tongsheng San may be used.)

Wu Kun's Commentary: What is termed Chou Chi involves alternating contraction and extension, with the hands and feet pulling each other in continuous spasms. This is generally similar to convulsions seen in infants. Ancient physicians often attributed this syndrome to Wind, as Wind governs movement. Luo Longji stated that the Heart governs the vessels, and the Liver governs the tendons. The Heart belongs to Fire, and the Liver belongs to Wood. Fire governs Heat, and Wood governs Wind. When Wind and Fan stir each other, Chou Chi occurs. If this condition arises not after sweating or purging therapies, one should soothe the Liver Wood, descend Heart Fire, and assist with formulas that harmonize the blood vessels. Herbs such as Qiang Huo, Fang Feng, Huang Qin, Chai Hu, Huang Lian, Shao Yao, Sheng Di Huang, Dang Gui, Chuan Xiong, and Tian Ma may be used. If phlegm is present, Zhu Li, Tian Nan Xing, and Ban Xia must be added. If the spasms are urgent due to Wind pathogen, Quan Xie and Bai Jiang Can should be added.

If this syndrome develops after many days following sweating or purging treatments for Shang Han (Cold Damage), the pathological process is advanced and difficult to treat. This is caused by extreme deficiency generating internal Wind. Xiao Xuming Tang or Da Jianzhong Tang, with minor modifications, should be used. For cases where sweating from Shang Han exposes the patient to wind, causing sweat flow to stagnate and leading to tendon cramping and limb spasms, Niubang Gen San is indicated. Additionally, for Feng Wen injured by fire therapy, resulting in mild jaundice or severe symptoms resembling startle epilepsy with recurrent Chou Chi, Weirui Tang is indicated. If Chou Chi is accompanied by Dai Yan (upward deviation of the eyes), Fan Zhe (opisthotonos), and Jue Han (terminal sweating) where sweat beads form like strings and do not flow, this indicates the exhaustion of the Taiyang channel qi and is incurable. Furthermore, if the limbs tremble continuously but lack the strength for full convulsions, resembling Chou Chi, this indicates the exhaustion of the Liver. Cases arising after sweating and purging therapies usually result in death. When using Xiao Xuming Tang, remove Ma Huang if there is sweating, and remove Huang Qin if there is no sweating; flexibility is key.

Cheng Wuji's Commentary: There are two types of "Wind-Dampness Mutual Combating" (Feng Shi Xiang Bo). The first type originates from Shang Han; on the eighth or ninth day, if exposed to wind-dampness again, Guizhi Fuzi Tang is used to disperse wind-dampness from the exterior. The second type is purely Wind-Dampness Mutual Combating, presenting with painful joints, etc., and Gancao Fuzi Tang is used to dispel dampness and secure the defensive qi. The subtlety in recognizing this syndrome lies in the pulse being floating, deficient, and choppy. If the pulse is deep, solid, slippery, large, or rapid, it is not this syndrome.

In Taiyang Shang Han lasting eight or nine days, with Wind-Dampness Mutual Combating, causing bodily pain and inability to turn over, without vomiting or thirst, and with a floating, deficient, and choppy pulse, Guizhi Fuzi Tang is indicated. If the stool is hard and urination is normal, Guizhi Qu Gui Jia Baizhu Tang is indicated. For Wind-Dampness Mutual Combating causing painful joints, pulling pain preventing flexion and extension, severe pain upon touch, sweating, shortness of breath, difficulty in urination, aversion to wind with reluctance to remove clothing, or slight edema, Gancao Fuzi Tang is indicated.