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After suffering from heatstroke, the tongue is pale and there is no thirst, body pain, a soft pulse, and loss of appetite; this indicates that the pathogenic factor has departed but yang qi is damaged. It is appropriate to use Huangqi Wuwu Tang (Astragalus Five-Ingredient Decoction) [1] added with Maiya (Sprouted Barley), Guya (Sprouted Millet), Mugua (Chaenomeles Fruit), Huoxiang (Patchouli), etc., employing sweet-warm methods to support yang qi.

The preceding clause discussed yin damage after the departure of the pathogen, treated with sweet-sour methods. This clause discusses yang damage after the departure of the pathogen, primarily using sweet-warm methods. Furthermore, since body pain and a soft pulse indicate that exterior yang is also damaged, using Huangqi Wuwu Tang combined with Huoxiang, Yizhi (Alpinia Oxyphylla), Maiya, and Guya—substances with sweet-warm properties—to secure the exterior and support yang is indeed in accordance with proper principles.

Heatstroke accompanied by aversion to cold and fever, soreness and pain in the limbs and joints, headache, and neck stiffness indicates that summer-heat wind has attacked the exterior, with a risk of developing into spasm (jing). It is appropriate to use Guizhi (Cinnamon Twig), Xingren (Apricot Seed), Huangqi (Astragalus), Fangfeng (Saposhnikovia), Jili (Tribulus), Gouteng (Uncaria), Haifengteng (Trichosanthes Vine), Sangye (Mulberry Leaf), Fangji (Stephania), and Dilong (Earthworm) to dispel wind and unblock collaterals.

During summer, intense summer-heat causes excessive sweating and leakage of qi, making one susceptible to wind invasion. This leads to headache, neck stiffness, aversion to cold, fever, and disharmony in the bone joints, constituting a deficiency pattern complicated by wind. Therefore, it is appropriate to use Guizhi and Huangqi to secure the exterior, and Fangfeng, Xingren, the two vines (Haifengteng, Gouteng), Dilong, and Sangye to dispel wind, so that when the exterior harmonizes and wind subsides, it will not progress to the disaster of spasm and convulsion. Regarding jing (spasm), Zhang Zhongjing originally distinguished between Gang Jing (Stiff Spasm) and Rou Jing (Flexible Spasm), likely because later generations found it difficult to distinguish deficiency and excess; thus, the presence or absence of sweating serves as the criterion for differentiation. However, in my opinion: absence of sweating, aversion to cold, fever, headache and neck stiffness, twitching of the hands and feet, and opisthotonos constitute wind coming from outside, which is Gang Jing (Stiff Spasm) characterized by anhidrosis. Conversely, following vomiting and diarrhea, postpartum blood deficiency, or extreme heat injuring fluids leading to excessive sweating and fluid depletion, resulting in fever, trismus (lockjaw), head shaking, fixed gaze, twitching, and opisthotonos, constitutes wind arising from within, which is Rou Jing (Flexible Spasm) characterized by hyperhidrosis. Thus, wind has internal and external origins, and disease has deficiency and excess aspects. For externally acquired wind, dispersion and clearing are indicated; for internally generated wind, softening and tonification are indicated. For those requiring clearing and dispersion, Xiao Xuming Tang (Minor Continuation Life Decoction) with modifications is used; for those requiring softening and tonification, Fumai Tang (Restore Pulse Decoction) with salty substances is used. These represent the balancing principles for treating spasm, to be judged by those who understand the theory.

[1] Huangqi Wuwu Tang, originally named "Huangqi Guizhi Wuwu Tang" (Astragalus, Cinnamon Twig, and Five-Ingredient Decoction) in the *Jinkui Yaolue* chapter on Blood Bi and Deficiency Consumption Patterns.