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Tu Weisheng stated: The disease of Jing (spasm) arises from excessive sweating, which injures the Wei-Yang Qi (defensive yang energy), or from the inappropriate use of purgatives in wind diseases, which excessively damages the Yin-Ning Blood (nutritive yin blood). As Zhang Zhongjing said: In Taiyang disease (disease pattern caused by pathogenic invasion of the Taiyang channel), if there is fever, no sweat, and aversion to cold, it is named Gang-Jing (rigid spasm, characterized by neck stiffness, trismus, and anhidrosis). In Taiyang disease, if there is fever, sweating, but no aversion to cold, it is named Rou-Jing (flexible spasm, characterized by neck stiffness, diaphoresis, and absence of aversion to cold). The terms "rigid" and "flexible" are derived from the symptoms of Taiyang cold damage and wind strike complicated with diarrhea. It is evident that these differ from the true form of Jing disease. Therefore, he further states: Excessive sweating in Taiyang disease leads to Jing. If purgatives were used for a wind disease resulting in rigid spasm, and sweating is induced again, limb rigidity will inevitably occur. Patients with chronic sores who experience body pain should not be subjected to sweating; if sweating occurs, Jing will result. This makes it clear that Jing is caused by blood depletion and fluid deficiency, leading to the inability to nourish the sinews and vessels.

However, fearing that physicians might be too rigid and fail to adapt to changing symptoms, he subsequently states: In Taiyang disease, when all symptoms are present, the body is stiff, KT KTran (describing a state of stiffness and rigidity), and the pulse is unexpectedly deep and slow, this is Jing, treated with Gualou Guizhi Tang (Trichosanthes Twig Decoction). In Taiyang disease, if there is no sweat, yet urination is surprisingly scanty, qi rushes upward to the chest, trismus prevents speech, and Gang-Jing is about to manifest, Gegen Tang (Kudzu Root Decoction) should be administered. For Jing disease, if there is chest fullness, trismus, inability to lie flat with the back touching the bed (opisthotonos), leg cramps, and teeth grinding, Da Chengqi Tang (Major Order the Qi Decoction) may be given. This illustrates that while Jing generally contraindicates sweating, if accompanied by cold stagnation in the Taiyang channels, sweating may be indicated. Similarly, while Jing generally contraindicates purging, if accompanied by heat scorching fluids in the Yangming channels, purging may be indicated. Although the standard treatment method is not explicitly stated, his remarks that "purging causes Jing" and "sweating causes Jing" clearly teach that the correct treatment for Jing should avoid sweating and purging, focusing instead on generating fluids and harmonizing the sinews and vessels. Many physicians after the Han dynasty failed to understand this rhetorical technique of using contrast to highlight the main point and did not elucidate its profound meaning. Some even claimed the existence of Yang-Jing and Yin-Jing beyond Gang-Jing and Rou-Jing, which is quite strange. It was not until the modern era, with the emergence of Tang Rongchuan, that the subtleties here were revealed. He can truly be said to have had unique insight, dispelling millennia of obscurity and awakening ages of confusion. Based on my reading of Tang Rongchuan's section, I have summarized the essentials as a discussion on Jing syndrome.

Zhang Zhongjing's Gualou Guizhi Tang (Guizhi Tang plus Trichosanthes Radix)

Tu Weisheng stated: Gualou Guizhi Tang and Gegen Tang are formulas used by Zhang Zhongjing for wind strike and cold damage complicated by Jing disease; they are not the primary formulas for treating Jing itself. The former focuses on Trichosanthes Radix (Gualou) to generate fluids, relieve thirst, and clear heat in the Yangming channel. The latter focuses on Kudzu Root (Gegen) to unblock the channels and directly resolve cold in the Taiyang channel. However, carefully analyzing the definitions within, the medication for the true form of Jing disease should primarily include Bupleuri Radix (Chaihu), Kudzu Root (Gegen), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Rehmanniae Radix Preparata (Shengdi), Chuanxiong Rhizoma (Chuanxiong), Scutellariae Radix (Huangqin), Codonopsis Radix (Dangshen), Gypsum Fibrosum (Shigao), Anemarrhenae Rhizoma (Zhimu), Trichosanthes Radix (Huafen), and Glycyrrhizae Radix et Rhizoma (Gancao). This resembles the previous approach for treating wind generated by deficient heat, avoiding the taboo of severely damaging fluids and the concern of wind-cold stagnating in the channels. It serves as a remedial formula for recovery after disaster.

Zhang Zhongjing's Da Chengqi Tang
Rhei Radix et Rhizoma (Dahuang) (1 qian)
Magnoliae Officinalis Cortex (Nongpu) (0.7 qian)
Immature Citrus Fruit (Zhishi) (0.7 qian)
Mirabilite (Mangxiao) (1 qian)

Tu Weisheng stated: This formula is used by Zhang Zhongjing for cold damage transmitted to the Yangming channel, where heat is extremely intense, external symptoms are absent, and symptoms such as constipation, fever, and abdominal distension and fullness are present. Using it for diseases in the channels involving blood deficiency and dryness of the channels, does one not risk violating the prohibition against "making the deficient more deficient"? However, when internal heat is severe, fluids are indeed damaged. If fire-heat is not reduced promptly, fluids cannot be generated; purging one unit of fire-heat preserves one unit of fluids. The phrase "may be given" implies that in cases where internal heat exceeds external heat, and the condition in the channels reaches a critical danger, one must take a desperate measure and resort to purging. If our understanding is insufficient and we dare not act rashly, we may add Rehmanniae Radix Preparata (Shengdi), Paeoniae Radix Alba (Hangshao), Angelicae Sinensis Radix (Danggui), and Chuanxiong Rhizoma (Chuanxiong) to protect the fluids. Once the internal heat is cleared, we can then proceed to nourish yin-blood and harmonize the sinews and vessels.