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The so-called Jing disease (Spasm) is precisely the Spasm disease recorded in the *Neijing* (Classic of Internal Medicine). The character "Zhi" (痓) used for "Jing" (痉) is likely a transcription error. Its symptoms include opisthotonos (backward arching of the back), head shaking, trismus (lockjaw), upward staring of the eyes, neck stiffness, and spasticity or contracture of the four limbs. It may also present with fever in the body but coldness in the feet, aversion to cold, and a red face. These are all manifestations of this condition.

Zhang Zhongjing stated: In Taiyang disease (Disease of the Taiyang/Bladder channel), if there is fever, absence of sweating, and aversion to cold, it is named Gang Jing (Yang Spasm/Rigid Spasm). In Taiyang disease, if there is fever, sweating, and no aversion to cold, it is named Rou Jing (Yin Spasm/Soft Spasm). In Taiyang disease, if there is fever with a deep and fine pulse, it is named Jing (Spasm), which is difficult to treat. If Taiyang disease undergoes excessive sweating, it leads to Jing (Spasm). In Wind diseases, if purgation is applied followed by re-sweating, it will inevitably cause contractures. For patients with sores/ulcers, even if they have body pain, sweating therapy should not be used; if sweating is induced, it will lead to Jing (Spasm).

Chen Wuyue stated: The tendons of the human body follow the meridians and emerge throughout the body. When internal Qi and Blood are deficient, external pathogenic factors such as Wind, Cold, Dampness, and Heat can invade, leading to spasms. Because Wind disperses Qi, sweating without aversion to cold is termed Rou Jing (Yin Spasm). Because Cold congeals Blood, absence of sweating with aversion to cold is termed Gang Jing (Yang Spasm). Tracing the etiology, it mostly arises from blood loss, where the tendons lack nourishment, allowing pathogens to attack. Thus, in Shanghan (Cold Damage) cases with excessive sweating or purgation, as well as in patients with sores or postpartum women, the occurrence of this disease can be understood through this principle. Pulse diagnosis reveals deep, hidden, wiry, and tight pulses. If Yang is relaxed and Yin is tense, chronic contractures occur; if Yin is relaxed and Yang is tense, opisthotonos and rigidity occur. These two presentations differ significantly and must be distinguished.

I consider that Jing (Spasm) is a disease characterized by rigidity and opisthotonos, located in the sinews and vessels. Sinew contracture causes the backward arching. The root lies in the Blood; when Blood is dry and depleted, sinew cramping occurs. Observing Zhang Zhongjing's statements: excessive sweating in Taiyang disease leads to Spasm; purgation in Wind disease leads to Spasm; inducing sweat in sore-patients leads to Spasm. From these few words, it is evident that most cases of Spasm result from mismanagement and deterioration, revealing that the underlying nature is deficiency rather than excess. After Zhang Zhongjing, only Chen Wuyue identified the cause correctly, stating that it mostly arises from blood loss and lack of sinew nourishment. However, his statement that "internal deficiency of Qi and Blood combined with external invasion of Wind, Cold, Dampness, and Heat causes Spasm" is flawed. This view prioritizes Wind-Damp pathogens over deficiency. He failed to realize that Wind disperses with sweat, so why mention Wind after sweating? Dampness moves downward with purgation, so why mention Dampness after purging? Improper sweating damages Blood; improper purgation damages True Yin. Injury to Yin and Blood leads to Blood dryness; Blood dryness deprives sinews of nourishment, inevitably leading to contracture and opisthotonos, without waiting for external Wind-Cold-Damp-Heat invasion. Furthermore, Zhang Zhongjing referred to inappropriate sweating and purgation. Once these treatments are misapplied, Spasm results from the mismanagement itself. Does one need additional external pathogens to form Spasm after mismanagement? If there are no external pathogens, is there no Spasm? Chen's words not only contradict Zhang Zhongjing's intent but also confuse later practitioners, causing them to hesitate between theories. Consequently, modern practitioners often focus on dispelling Wind and removing Dampness. Who realizes whether patients with Blood dryness and Yin deficiency can tolerate such dispersing and draining methods? This requires clarification. Therefore, I present both scholars' arguments for students to verify.

First, although Spasm has many types, people fail to recognize it because they do not understand its etiology and rarely investigate. Any acute illness presenting with opisthotonos, upward staring, trismus, and contracture is Spasm. Zhang Zhongjing cited sweating and purgation to explain that mismanagement leading to Yin depletion causes this. By analogy, I observe that many cases not caused by mismanagement involve individuals with Yin deficiency and Blood insufficiency who cannot nourish the sinews, resulting in convulsions, cramps, and collapse. For example, in Stroke patients, this results from declining vitality and failing Yin. In postpartum women, it results from excessive blood loss and exhaustion of the Chong and Ren vessels. In sore-patients, it results from blood loss with pus and depletion of Ying Qi. In children, it may result from Wind-Heat injuring Yin (leading to Acute Convulsion) or sweating/purgation depleting Yin (leading to Chronic Convulsion). All these belong to Yin deficiency syndromes. If Essence and Blood are not deficient, even if pathogens interfere, sinew contracture will not occur. The progression to rigidity indicates severe depletion. Therefore, treatment must prioritize replenishing Qi and Blood. If pathogens are strong, address them concurrently; if weak, do not treat pathogens at all. The urgency lies in restoring Yuan Qi (Original Qi); once Yuan Qi recovers and blood vessels flow freely, minor pathogens cannot remain. Why worry? Yet, modern practitioners categorize every case and treat solely for Wind. They fail to distinguish that external Wind is a Cold pathogen requiring dispersion, while internal Wind is a Blood dryness syndrome requiring tonification. Since these cases stem from internal conditions without external pathogens, treating them as Wind-Phlegm is erroneous. I write this to clarify the essentials of Spasm.

Second, why did Zhang Zhongjing state that Spasm belongs only to the Taiyang channel and omit others? Spasm involves opisthotonos, affecting the back. The meridians of the back are primarily the Taiyang and Du Mai (Governing Vessel). Mentioning Taiyang implicitly includes the Du Mai. However, Zhang only discussed exterior aspects without detailing interior aspects. Examining the *Meridian Chapter* of the *Neijing*: The Foot-Shaoyin Kidney meridian passes through the spine and connects to the Kidney; its straight branch ascends from the Kidney through the Liver and Diaphragm. The *Sinew Meridian Chapter* states: The Foot-Shaoyin sinew follows the inside of the spine, ascends to the nape, and knots at the occiput, merging with the Foot-Taiyang sinew. It further states: Pathology of the Foot-Taiyang sinew causes spinal reversal and neck stiffness. Pathology of the Foot-Shaoyin sinew governs epilepsy, clonic seizures, and Spasm. Yang channel pathology causes spinal reversal preventing flexion; Yin channel pathology prevents extension. Thus, Spasm is a disease of both Taiyang and Shaoyin channels. Since the Kidney and Bladder are interior-exterior pairs, and the Bladder stores fluids while the Kidney stores Essence, pathology in these two channels indicates Water/Essence deficiency. Therefore, treatment must primarily focus on nourishing True Yin.