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Patient Chen experienced vomiting and nausea for several days. After these symptoms ceased, spasms developed, occurring three to five times daily. This is due to Liver Qi rebellion invading the Stomach, where fluids condense into phlegm, and internal Wind-Yang expands unchecked, causing Phlegm to become pathogenic as well. The proposed treatment is to harmonize the Stomach and extinguish Wind.
Antelope Horn (Lingyang Jiao), Uncaria Ramulus cum Uncis (Gouteng), Pinellia Rhizoma Preparatum (Banxia), Citrus Reticulatae Pericarpium (Chenpi), Gardeniae Fructus Carbonized (Hei Shanzhi), Argoconcha (Shijueming), Chrysanthemi Flos (Juhua), Scrophulariae Radix (Xuanshen), and Bambusae Caulis in Taeniam (Zhuru).

Second consultation: Spasms and syncope occur multiple times daily; the jaw is clenched preventing speech, yet the mind remains clear. The disease lies not in the Heart but in the Liver. The Heart is the Sovereign Monarch, while the Liver is the General. When Qi, Fire, and Wind fan each other into flame, it is akin to a general operating outside whose orders may sometimes go unheeded by the sovereign; thus, even if the Monarch is wise, how can it immediately restrain such violence? Moreover, the Stomach is the Son of the Heart. The Phlegm in the Stomach and the Wind in the Liver collaborate to cause harm. The tongue is red with ulcerations and pain, presenting an unrestrainable势头 of blazing heat. To resolve Stomach Phlegm, one must first clear Liver Fire.
Antelope Horn (Lingyang Jiao), Rehmanniae Radix Recens (Dishengdi), Rhinocerotis Cornu (Xijiao), Poria (Fuling), Gardeniae Fructus (Shanzhi), Trichosanthis Semen Cum Cochleae Concha et Nipponapis Aneurae Mucilago (Tianzhuhuang), Argoconcha (Shijueming), Scrophulariae Radix (Xuanshen), Uncaria Ramulus cum Uncis (Gouteng), Aurum Folium (Jinbo), Ziziphi Spinosae Semen (Suanzaoren) stir-fried with Coptidis Rhizoma (Huanglian), Bamboo Juice (Zhuyu) taken by mixing, and Ginger Juice (Jiangzhi) taken by mixing.

Patient Qian: "The Liver suffers from tension; eat sweet substances to relax it."
Raw Glycyrrhizae Radix et Rhizoma (Sheng Gancao) (one jin, ground into powder), Red Dates (Hongzao) (one jin).
Boil until soft, remove skins and pits, mix with the Licorice powder to form pills. Take three qian per dose, washed down with boiled water.
This patient had no exterior syndrome nor internal heat. Despite dozens of spasms in a month, recovery occurred after taking two doses.

Ren Yuan commented: Deficiency of the Stomach generates Phlegm; excess of the Liver generates Fire. Fire stirs Phlegm, which the Stomach cannot resist, leading to upward rebellion and vomiting. Extreme vomiting further weakens the Stomach and strengthens the Liver, continuing until Wind moves and causes spasms and syncope. By "Stomach deficiency," we mean the descending Qi of the Stomach is not smooth; by "Liver excess," we mean the stagnant Heat of the Liver rises. Qi rebellion transforms into Fire. It is called Liver Wind, Liver Fire, or Liver Qi because the Liver belongs to Xun Wood, is the organ generating Wind and Fire, has an urgent and violent nature, and is known as the Official of the General. All rebellious ascending Qi is primarily governed by the Liver. Treatment employs cooling and descending methods, using the Qi of Autumn Metal to counteract the excess of Spring Wood. Regarding spasms and syncope, they are not limited to vomiting. If spasms result from Wood overacting on Earth (Liver attacking Spleen/Stomach), this is common in cholera-like disorders. Externally, there are cases of warm pathogens depleting fluids, wind-stroke with phlegm blocking orifices, and pediatric phlegm-heat obscuring the mind. Wu Jutong wrote *Spasm Etiology Questioned*, discussing the *Neijing* statement "All spasms and neck stiffness belong to Dampness," arguing that "Dampness" was a typo for "Wind." I believe that without Phlegm, Wind alone would not necessarily cause spasms; many instances of "Dampness" in the *Neijing* should be interpreted as "Phlegm." However, without Wind, Phlegm also does not cause spasms. Generally, Wind, Fire, and Phlegm act together pathogenically. Currently, spasms (jing) and clonic jerking (chi zong) are often confused. Spasms involve opisthotonos, teeth grinding, and foaming at the mouth; clonic jerking involves muscle twitching and finger convulsions. Spasms are caused by the interaction of Wind, Fire, and Phlegm closing the joints, mostly excess syndromes; clonic jerking results from fluid depletion and blood emptiness failing to nourish meridians, mostly deficiency syndromes. Tonification and purgation differ greatly, and treatment methods vary significantly; careful differentiation is essential.