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1. Spasm disease is characterized by stiffness of the neck and opisthotonos (backward bending of the back). Those with sweating are classified as Soft Spasm (Rou Jing), while those without sweating are classified as Hard Spasm (Gang Jing). Conditions such as excessive blood loss after childbirth, excessive sweating following treatment, ulcerative wounds, or dog bites can all lead to this disease due to wind pathogen invasion.

[Note] The manifestations of spasm disease are detailed in "Shang Han Xin Fa" (Essentials of Cold Damage). Soft Spasm presents with sweating, while Hard Spasm presents without sweating. Excessive blood loss postpartum or excessive diaphoresis during the treatment of cold damage constitute internal causes. Ulcerative wounds and dog bites constitute external causes. In all these cases, wind pathogen invades the Taiyang Meridian (Foot-Taiyang Bladder Meridian) while the body's defensive qi is deficient, resulting in this disease.

2. If a patient with spasm disease has a scattered pulse, death is likely. If the body bends backward so far that it lifts off the bed by the width of a palm, death is inevitable. If the eyes are narrowed, the eyeballs are fixed and immobile, accompanied by coma and inability to speak, or if beads of sweat appear on the forehead, life will be severely endangered.

[Note] "Lifting off the bed by a palm's width" refers to a gap of approximately four fingers plus five fingers between the back and the bed. "Eyes narrowed" refers to tight contraction of the eyelids. "Fixed eyes" refers to immobility of the eyeballs.
Formulas mentioned: Ge Gen Tang (Kudzu Decoction), Gui Zhi Jia Ge Gen Tang (Cinnamon Twig Decoction Plus Kudzu Root), Xiao Xu Ming Tang (Minor Continuation of Life Decoction), Gui Zhi Jia Fu Zi Tang (Cinnamon Twig Decoction Plus Aconite Root), Dang Gui Bu Xue Tang (Angelica Sinensis Blood-Nourishing Decoction), Da Cheng Qi Tang (Major Order the Qi Decoction), Tao Ren Cheng Qi Tang (Peach Kernel Order the Qi Decoction).

3. For Hard Spasm, use Ge Gen Tang to induce sweating and release the exterior. For Soft Spasm, use Gui Zhi Jia Ge Gen Tang to harmonize the nutritive and defensive levels and relieve the muscles. For complex mixed etiologies, use Xiao Xu Ming Tang. For excessive sweating leading to exterior deficiency, use Gui Zhi Jia Fu Zi Tang. For blood injury, combine Gui Zhi Tang with Dang Gui Bu Xue Tang. For interior excess with blood stasis, use Cheng Qi Tang formulas. For ulcers with excessive pus and blood loss, use Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) plus wind-dispelling herbs. For traumatic wounds and dog bites, refer to separate detailed discussions.

[Note] Hard Spasm is treated with Ge Gen Tang, which is Gui Zhi Tang added with Ephedrae Herba (Mahuang) and Puerariae Radix (Gegen). Soft Spasm is treated with Gui Zhi Jia Ge Gen Tang, which is Gui Zhi Tang added with Puerariae Radix, treating via sweating. "Mixed etiology" refers to diseases caused by the intermingling of wind, cold, and dampness; Xiao Xu Ming Tang is used, treating according to the severity of wind, cold, and dampness. Excessive sweating leads to exterior deficiency and continuous sweating, subsequently causing spasm; Gui Zhi Jia Fu Zi Tang (Gui Zhi Tang added with Aconiti Lateralis Radix Praeparata, Fuzi) is used. "Blood injury" refers to massive blood loss after childbirth or metal trauma (Jin Chuang); Gui Zhi Tang combined with Dang Gui Bu Xue Tang (consisting of Angelicae Sinensis Radix, Danggui and Astragali Radix, Huangqi) is used. "Interior excess" refers to abdominal fullness and constipation/urinary retention in spasm disease, treated with Da Cheng Qi Tang; and for postpartum lochia remaining in the lower abdomen causing hardness and urgency, Tao Ren Cheng Qi Tang is used to purge. For ulcers with excessive discharge of pus and blood, invaded by wind pathogen, Shi Quan Da Bu Tang plus wind-dispelling herbs is used for treatment.