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The *Ren Jian Shu* (Book of Vitality) states that there are two types of Jing disease (spasm/stiffness): Yang Jing belongs to Gang Jing (rigid spasm), and Yin Jing belongs to Rou Jing (flexible spasm). Formulas such as Fuzi San (Aconite Powder), Guixin Baizhu Tang (Cinnamon Twig and Atractodes Decoction), Fuzi Fangfeng San (Aconite and Saposhnikovia Powder), and Bawu Baizhu Tang (Eight-Ingredient Atractodes Decoction) can be selected for use.

Commentary: Zhang Zhongjing’s discussion on rigid and flexible Jing both belongs to Taiyang disease (diseases caused by pathogenic factors invading the Taiyang channel). The *Ren Jian Shu*’s discussion on Yin and Yang Jing, having classified Yang Jing as rigid and Yin Jing as flexible, yet uses hot-natured herbs such as Baizhu (Atractodis Rhizoma), Fuzi (Aconiti Lateralis Radix Preparata), Ganjiang (Zingiberis Rhizoma), and Rongui (Cinnamomi Cortex) to treat Yin Jing. This treats Yin Jing exclusively as a cold syndrome, which is likely not the most appropriate theory. I shall await correction from wise scholars; the specific formulas are not recorded here but are detailed in this chapter.

The book by Zihe (Zhang Congzheng, courtesy name Renfu) states: The wife of Mr. Lv Junyu, aged thirty, suffered from Feng Chu (wind-induced convulsions), Xuan Yun (vertigo/dizziness), and Gong Fan (opisthotonos/backward arching of the body), unable to eat for several days. All physicians treated it as Jing Feng (startle wind), An Feng (hidden wind), or Feng Xian (wind epilepsy), using Nanxing (Arisaematis Rhizoma), Xionghuang (Realgar), Wutou (Aconiti Radix), and Fuzi (Aconiti Lateralis Radix Preparata), but with no effect. Dairen (Zhang Congzheng) said: "All wind-induced tremors and vertigo belong to Liver Wood. Yang governs movement, Yin governs stillness. Due to excessive Fire suppressing Metal (Lung), Metal cannot control Wood, causing Liver Wood to become excessive and diseased. First, induce vomiting to expel two to three sheng of wind-phlegm; then purge with cold-natured medicines; finally, puncture the Baihui GV20 acupoint to bleed two cups. The patient was cured immediately."

Commentary: Feng Chu (wind convulsion) is originally different from Ji disease (stiffness/spasm). Ji disease belongs to extreme Damp-Earth, inevitably involving the transformation of Wind-Wood shaking. Feng Chu belongs to extreme Wood, inevitably manifesting the form of Dry-Metal contraction. In essence, they can be discussed together. Therefore, this case is cited to prove that Ji disease is not solely caused by external Wind-Cold-Damp pathogens, but also by internal Wind-Fire-Heat.

The *San Yin Fang* (Formulas of Three Causes) states: The tendons of humans extend along the meridians throughout the body. If Qi and Blood are internally deficient and externally invaded by Wind, Cold, Damp, or Heat, Ji disease occurs. Because Wind disperses Qi, sweating without aversion to cold is called Rou Jing (flexible spasm); because Cold congeals Blood, no sweating with aversion to cold is called Gang Jing (rigid spasm). Tracing the etiology, it mostly arises from blood loss, leaving tendons without nourishment, allowing pathogens to invade. Thus, it is evident that excessive sweating or purging in Shanghan (Cold Damage) diseases, as well as conditions following sores/ulcers or postpartum states, can lead to this disease. Pulse diagnosis reveals sinking, hidden, wiry, and tight pulses. However, if Yang is relaxed and Yin is tense, chronic contracture ensues; if Yin is relaxed and Yang is tense, opisthotonos and stiffness occur. These two syndromes are distinct and must be differentiated.

Commentary: Zhang Zhongjing’s discussion on Ji disease in the *Shanghan Lun* primarily attributes it to external pathogens. Chen Wuyue elucidated the aspect of internal Qi and Blood deficiency, which aligns with Zhang Zhongjing’s statement regarding excessive sweating and purging. This is an excellent insight. Unfortunately, his medication instructions were not detailed enough. He further stated: Yin relaxation and Yang tension constitute Taiyang Ji disease; Yang relaxation and Yin tension constitute Yangming Ji disease.