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Wind-stiffness (Pòshāngfēng) is caused by the severe heat of a wound being constrained and accumulated, preventing the smooth circulation of Ying (Nutritive Qi) and Wei (Defensive Qi). The constrained heat spreads throughout the body, often resulting in white crusts. At this time, the wound opening is closed, making it difficult for Qi to circulate freely, so excessive heat generates wind. First, distinguish the condition: if the wound is flat with no exudate, it is due to Wind invasion; if yellow fluid oozes from the edges, it is due to Water-Dampness invasion. Both conditions may develop into spasms and clonic jerks (Chìzòng), requiring urgent treatment. Furthermore, if the pain is not localized at the wound but involves the meridians and collaterals, it is also a critical condition. Initially, when swelling appears with white crusts accompanied by chills and fever, apply Yuzhen San (Jade True Powder) externally to the affected area immediately. If the injury is on the head or face, chew fresh almonds and mix them with Realgar (Xionghuang) and wheat flour to apply as a poultice over the wound until the swelling gradually subsides. If opisthotonos (retraction of the back), rigidity of the limbs, trismus (lockjaw), coldness of the whole body, and loss of consciousness occur, grind Centipede (Wugong) into fine powder and rub it on the teeth; expelling salivary foam will lead to immediate recovery. Massage and Dao Yin (guiding and pulling exercises) are also appropriate.

[Li Dongyuan] In Wind-stiffness, if wind-heat is agitated and severe, constrained in the exterior while interior Qi remains relatively peaceful, symptoms include frequent stretching and yawning, tendon and vessel constriction, occasional aversion to cold, muscle twitching, or convulsions, with a floating, rapid, and wiry pulse. It is suitable to use acrid-hot herbs that dispel wind to open up and scatter the constraint, leading to recovery. This is similar to exterior heat constraint in Cold Damage (Shanghan), treated with Mahuang Tang (Ephedra Decoction) to disperse via acrid-hot properties. Whenever using acrid-hot medicines to open and scatter wind-heat constraints, it is advisable to assist with cold-natured herbs to prevent the medicine from hitting the pathogen but causing the wind-heat to intensify. For example, treating fever in Cold Damage by adding Scutellariae Radix (Huangqin), Gypsum Fibrosum (Shigao), and Anemarrhenae Rhizoma (Zhimu) alongside Ephedrae Herba (Mahuang) and Cinnamon Twig (Guizhi). Using only Licorice Root (Gancao), Talcum (Huashi), Scallion Stem (Congbai), and Fermented Soybean (Douchi) as cold-natured dispersants is also excellent. If the exterior syndrome persists and the pathogen gradually transmits inward, but the interior is not yet severely affected and the pulse is wiry and small, regulate with cold-natured herbs that clear wind-heat and open constraints, or slightly add acrid-hot wind-dispelling herbs. This is analogous to treating Cold Damage at the half-exterior half-interior level with Xiaochaihu Tang (Minor Bupleurum Decoction) for harmonization. If the interior syndrome becomes severe, presenting with a stiff tongue, lockjaw, opisthotonos, frightfulness, twitching, viscous saliva, chest and abdominal fullness, constipation of urine and stool, occasional sweating, and a deep, surging, rapid, and wiry pulse: the sweating occurs because wind-heat is severely constrained internally, causing exterior heat to subside slightly, leading to loose pores and excessive Heart Fire, thus inducing sweat. The method should be to dispel wind and scatter constraints, purge with cold-natured herbs, and subsequently regulate with cold-natured herbs that clear wind-heat and open constraints. Then heat recedes, constraints dissipate, and wind heals naturally.

For spasms pulling backward, use Notopterygii Rhizoma et Radix (Qianghuo), Angelicae Pubescentis Radix (Duohuo), Saposhnikoviae Radix (Fangfeng), and Glycyrrhizae Radix et Rhizoma (Gancao); for spasms pulling forward, use Cimicifugae Rhizoma (Shengma), Angelicae Dahuricae Radix (Baizhi), Angelicae Pubescentis Radix (Duohuo), Saposhnikoviae Radix (Fangfeng), and Glycyrrhizae Radix et Rhizoma (Gancao); for spasms pulling to both sides, use Bupleuri Radix (Chaihu), Saposhnikoviae Radix (Fangfeng), and Glycyrrhizae Radix et Rhizoma (Gancao); add Talcum (Huashi) for spasms on the right side.

[Li Dongyuan] Yuzhen San (Jade True Powder)
Arisaema Cum Bile (Nanxing) and Saposhnikoviae Radix (Fangfeng) in equal parts.
Grind into powder. Mix with ginger juice and wine for oral administration, and apply the powder to the injured site.

Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) Treats Wind-stiffness where the initial pathogen has transmitted to the exterior.
Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Chuanxiong Rhizoma (Chuanxiong), Ligustici Rhizoma et Radix (Guben), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Shaoyao), Glycyrrhizae Radix et Rhizoma (Gancao), Sanguisorbae Radix (Diyu), Asari Radix et Rhizoma (Xixin) (each 1 liang).
Cut into pieces. Take 5 qian per dose, boil in 2 zhan of water until reduced to 0.8 zhan, and take hot. Add Scutellariae Radix (Huangqin) 1 liang if there is heat; add Rheum Palmatum Radix (Dahuang) 1 liang if constipated.

Fangfeng Tang (Saposhnikovia Decoction). (See previous section on Wind.)

Wugong San (Centipede Powder)
Centipede (Scolopendra Subspinipes mutilans) (1 pair), Fish Swim Bladder (Yubiao) (5 qian, stir-fried), Left-coiling Dragon (Zuo Panlong - likely referring to a specific insect or part, traditionally interpreted as dried centipede or similar arthropod, here kept as Zuo Panlong) (0.5 liang, stir-fried until smoke ceases).
Grind into fine powder. Take with Fangfeng Tang (Saposhnikovia Decoction).

Baizhu Fangfeng Tang (Atractylodes Macrocephala and Saposhnikovia Decoction) If previous medications have harmonized the Zang-Fu organs and spontaneous sweating occurs, this formula is suitable.
Atractylodis Macrocephalae Rhizoma (Baizhu), Saposhnikoviae Radix (Fangfeng), Astragali Radix (Huangqi) (each 1 liang).
Cut into pieces. Take 7 qian per dose, boil in 2 zhan of water until reduced to 1 zhan, remove dregs, and take warm.

Da Xionghuang Tang (Major Chuanxiong and Rhubarb Decoction) Suitable for rapid purgation if Zang-Fu organs are constipated, urine is red, and spontaneous sweating persists.
Chuanxiong Rhizoma (Chuanxiong) (1 liang), Scutellariae Radix (Huangqin) (6 qian), Glycyrrhizae Radix et Rhizoma (Gancao) (0.5 liang), Rheum Palmatum Radix (Dahuang) (1 liang).
Cut into pieces. Take 5 qian per dose, boil in 1.5 zhan of water until reduced to 1 zhan, remove dregs, and take warm. Stop when bowel movement is achieved.

Jiangtiao Wan (Fish Bladder Pill) Treats Wind-stiffness with fright-induced convulsions, constipation of Zang-Fu organs, indicating the pathogen is in the interior.
Fish Swim Bladder (Jiangtiao) (0.5 liang, stir-fried), Wild Pigeon Droppings (Yegefen) (0.5 liang, stir-fried), Realgar (Xionghuang) (1 qian), Centipede (Wugong) (1 pair), Gastrodiae Rhizoma (Tianma) (1 liang), Bombyx Batryticatus (Bai Jiangcan) (0.5 liang).
Grind into fine powder and divide into three parts. Use two parts first, make pills with steamed rice, size of paulownia seeds, coated with Cinnabar (Zhusha). Use the remaining one part, mix with 1 qian of Semen Crotonis (Badou) frost, make pills with steamed rice without Cinnabar coating. Take 20 pills of the Cinnabar-coated variety and 1 pill of the Badou-frost variety together. Increase the Badou-frost pills gradually until purgation occurs. Resume taking the Cinnabar-coated pills until the disease resolves.

Qianghuo Tang (Notopterygium Decoction) Suitable after purgation; also suitable if spasms persist.
Notopterygii Rhizoma et Radix (Qianghuo), Angelicae Pubescentis Radix (Duohuo), Sanguisorbae Radix (Diyu) (each 1 liang).
Take 5 qian per dose, boil in 1.5 zhan of water until reduced to 1 zhan, remove dregs, and take warm. Add Scutellariae Radix (Huangqin) if heat is present; add Pinelliae Rhizoma (Banxia) if phlegm is present.

Diyu Fangfeng San (Sanguisorba and Saposhnikovia Powder) Treats pathogen at the half-exterior half-interior level, with slight sweating on the head and no sweating on the body.
Sanguisorbae Radix (Diyu), Saposhnikoviae Radix (Fangfeng), Illicium Difengengi Fructus (Didingxiang), Portulacae Herba (Machixian) (each 1 liang).
Grind into powder. Take 3 qian per dose, mix with warm rice water.

Yangxue Danggui Dihuang San (Blood-Nourishing Angelica and Rehmannia Powder) Suitable for long-standing cases where Qi and Blood are gradually deficient and the pathogen enters the Stomach, requiring blood nourishment. Siwu Tang (Four Substances Decoction) plus Saposhnikoviae Radix (Fangfeng), Ligustici Rhizoma et Radix (Guben), Angelicae Dahuricae Radix (Baizhi), and Asari Radix et Rhizoma (Xixin) in equal parts. Grind into fine powder. Take 5 qian per dose, boil in 1.5 zhan of water until reduced to 1 zhan, and take warm.