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Chen Liangfu stated: Women suffering from stiffness, spasm, and pain in the neck and nape often find that while treatment appears easy, it is actually difficult. However, records in medical texts are scarce; even when mentioned, discussions are brief. Based on my examination, since this disease exists, there must be corresponding prescriptions. Why did ancient authors discuss this condition so briefly without detailed theories? It is likely because this condition arises in conjunction with various other diseases, hence lacking a specialized approach. I have collected famous ancient prescriptions during my leisure time for reference. Given my limited knowledge, this collection may not be exhaustive. I hope learned scholars will identify omissions and help complete it.

The neck and nape region belongs to the Foot-Taiyang Bladder Meridian. Additionally, Xu Taixue noted that it is also traversed by the Foot-Shaoyin Kidney Meridian, primarily because the Kidney and Bladder are exterior-interiorly related. From the perspective of external pathogenic factors, if the Foot-Taiyang Meridian is first affected by Wind, followed by Cold-Dampness, it leads to exterior symptoms such as fever and aversion to cold, resembling Shanghan (Cold Damage). Symptoms include stiffness and tension in the neck and nape, opisthotonos (arching of the back) similar to Zhongfeng (Wind Stroke), convulsions, and trismus (lockjaw). The body feels stiff and uncomfortable. Ancient texts refer to this state of rigidity as Jing (Spasm). The pulse is typically deep, slow, wiry, and thin. Postpartum women, due to blood deficiency and excessive sweating, are prone to Wind invasion and may exhibit these symptoms. For details, see "Postpartum Wind Strike"; here we do not repeat. Cases involving restricted neck movement due to pillow issues or awkward turning can be treated with Sanwuqi San (Three-Five Seven Powder) and Zhuifeng San (Wind-Chasing Powder), applied topically to the neck with Jifeng San (Urgent Wind Powder). If wind exposure causes dizziness and headache affecting both the Taiyang meridian and the brain, with stiffness in the neck and back muscles, Xie Fu San (Scorpion and Aconite Powder) or Duliang Wan (Duliang Pill) may be used. Xu Taixue treated severe neck stiffness preventing head rotation using Mugua Jian (Quince Decoction).

[Xue Ji] For the aforementioned conditions: If caused by hyperactive Liver Wood, use Xieqing Wan (Drain Green Pill). [Accompanied by headache.] If due to insufficiency of essence and blood, use Liuwei Wan (Six-Ingredient Pill). [In miscellaneous diseases involving deficiency consumption.] If Wind-Heat invades the Liver excessively, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). [For regulating menstruation.] If anger stirs Liver Fire, use Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction). [For Heat entering the Blood Chamber.] If there is Liver Meridian blood deficiency, use Jiawei Siwu Tang (Modified Four Substances Decoction, i.e., Siwu Tang plus Chai Hu, Mu Dan Pi, Zhi Zi). If the Kidney fails to nourish the Liver, use Liuwei Wan. If there is Qi stagnation in the Bladder, use Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness). [For miscellaneous disease lower back pain.] Generally, when Liver Fire is hyperactive, Liver blood becomes deficient, leading to dry tendons. This results in neck stiffness, opisthotonos, flexion spasms of the four limbs, or nodules in the neck area. One woman experienced pain in or behind the ear and on the side of the neck, accompanied by alternating chills and fever, bitter taste, and irregular menstruation. This was due to Liver-Gallbladder fire combined with Spleen-Stomach injury. She recovered after taking Sijunzi Tang (Four Gentlemen Decoction) added with Chai Hu, Sheng Ma, Huang Qi, and Bai Shao. Later, due to overwork and anger, she suffered vomiting and hypochondriac distension, which stabilized after taking Liujunzi Tang (Six Gentlemen Decoction) added with Zhi Zi and Chai Hu. Another woman, angered, developed chills, fever, thirst, a small left eye, tremors of the head and neck, limb convulsions, and generalized body pain. This was wind generated from blood deficiency and Liver heat. After several doses of Jiawei Xiaoyao San added with Gou Teng (Uncaria Hook), her symptoms gradually improved, and she fully recovered after taking Bazhen Tang (Eight Treasures Decoction).

Zhuifeng San (Wind-Chasing Powder) treats chronic, recurrent lateral and frontal headaches. It also treats long-term Liver deficiency with weakened Qi and blood, where Wind-Toxin attacks upward, causing headache, dizziness, blurred vision, palpitations, irritability, joint soreness, brain fog, eye pain, nasal congestion, heavy voice, neck-back stiffness, skin itching, migratory facial wind-rashes (feeling like insects crawling), and all types of Head Wind disorders. It also treats women's Blood-Wind attacking the chest/head, causing dizziness and pain.

Chuan Wu (Aconiti Lateralis Radix Praeparata, processed, tip/skin/navel removed) Fang Feng (Saposhnikoviae Radix, rhizome removed) Shi Gao (Gypsum Fibrosum, calcined) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) Jing Jie Sui (Schizonepetae Spica)
Bai Jiang Can (Bombyx Batryticatus, stir-fried, silk removed, each 1 liang) Tian Nan Xing (Arisaematis Rhizoma, processed) Qiang Huo (Notopterygii Rhizoma et Radix) Tian Ma (Gastrodiae Rhizoma) Di Long (Pheretima) Bai Fu Zi (Typhonii Rhizoma, processed) Quan Xie (Scorpio, tail/stinger removed)
Bai Zhi (Angelicae Dahuricae Radix, each 0.5 liang) Cao Wu Tou (Aconiti Kusnezoffii Radix, processed, skin/navel/tip removed) Mo Yao (Myrrha) Ru Xiang (Olibanum) Xiong Huang (Realgar, each 2.5 qian)
Grind into fine powder. Take 0.5 qian per dose, mixed with a little good tea. Take after meals and before bed. Regular use clears the head and eyes, benefits the throat and diaphragm, dispels wind, and resolves phlegm.

Jifeng San (Urgent Wind Powder)
Cao Wu Tou (Aconiti Kusnezoffii Radix, 3 liang; half calcined to retain character, dipped in wine to cool; half raw) Dan Sha (Cinnabaris, separately ground, 1 liang, water-suspended)
Hei Dou (Sojae Semen Nigrum, 2.5 qian, powdered together with Cao Wu Tou) She Xiang (Moschus, separately ground, 2.5 qian)
Grind into fine powder, mix evenly with the separately ground ingredients. Apply to the painful area mixed with wine.

Xie Fu San (Scorpion and Aconite Powder) Treats all wind-pathogen headaches, Brain Wind, copious phlegm-saliva, vomiting/nausea, clear water spitting, silent wind/dizziness, seeing black spots before eyes, trismus, facial paralysis (deviation of mouth and eyes), twitching of face/eyes, neck stiffness, radiating shoulder-back pain, itchy ears, blurry vision, limb numbness. Also treats sudden wind invasion after bathing, causing dizziness/pain, bilateral temporal pain, chronic refractory Head Wind.

Quan Xie (Scorpio, processed) Xiong Huang (Realgar, water-suspended) Zhu Sha (Cinnabaris, each 1.5 qian, water-suspended) Fu Zi (Aconiti Lateralis Radix Praeparata, processed, skin/navel removed)
Chuan Wu Tou (Aconiti Lateralis Radix Praeparata, processed, skin/navel removed) Ma Huang (Ephedrae Herba, joints removed) Tian Nan Xing (Arisaematis Rhizoma, ginger-processed) Fang Feng (Saposhnikoviae Radix, rhizome removed) Bai Jiang Can (Bombyx Batryticatus, stir-fried, each 3 qian) Ben Cao (Ligustici Wallichii Rhizoma et Radix, rhizome/dirt removed) Bai Zhi (Angelicae Dahuricae Radix, each 0.5 liang)
Grind into fine powder. Take 0.5 qian per dose, taken down with green onion and tea, after meals. Pregnant women should not take this.
Doctors in the capital use this medicine chewed alongside Rusheng Bingzi (Like-Sage Cake) to treat photophobia, tearing, and blurred vision, with efficacy. Another formula uses Bai Fu Zi and Xie Shao (Scorpion tail).

Mugua Jian (Quince Decoction)
Xuan Zhou Mugua (Chaenomelis Fructus, 2 pieces, cut top as lid, hollow out pulp) Mo Yao (Myrrha, 2 liang, separately ground) Ru Xiang (Olibanum, 2.5 qian, separately ground)
Place the two medicines inside the quince, replace the lid, secure with bamboo pins, and steam over rice three or four times until soft. Grind into a paste. Take 3 spoons per dose, mixed with half a cup of fresh Sheng Di Huang juice (Rehmanniae Radix) and two cups of good unadulterated wine.
A patient suffered from this condition, starting in the afternoon and resolving at dusk. I said: This illness must originate from the feet. The classics state that the twelve meridians have their associated tendons, but only the Shaoyin tendon of the foot extends from the sole to the head. Generally, tendons are the exterior correspondence of the Liver. From noon to dusk is Yang time, specifically Yin within Yang, which corresponds to the Lung. From Li (Wu hour, noon) to Dui (You hour, dusk), Yin grows strong while Yang weakens. Thus, *Lingbao Mifa* states: From Li to Qian, Kidney Qi exhausts and Liver Qi weakens. The Liver and Kidney organs are affected by Yin Qi, causing onset at this time. I prescribed this decoction; three doses resulted in recovery.
Discussions on other syndromes and formulas are detailed in the main section on Miscellaneous Diseases.