【转筋之症】霍乱后，腿筋收引，甚则转折挛缩，遍身疼痛难忍，俗名抽筋泻，此乃外
【转筋之因】阳明主束骨而利关节，润养宗筋，今因外感风寒暑湿 热之气，一时暴
吐暴下，宗筋失养，外感之邪，又束其故热，无从发泄，则筋转而抽痛矣。
【转筋之脉】脉多微涩，或代而散，或隐而伏，不可凶断。
【转筋之治】宜祛风湿，清暑 。风胜者，平胃散，加荆芥、防风、木瓜、秦艽。湿
胜者，平胃散，加秦艽，木瓜。 气胜者，清暑汤。转筋主阳明，倍用木瓜、秦艽。转筋虽
主乎火，若外有风寒所束，或无汗脉伏，忌用木瓜、秦艽酸收之味，又忌寒凉抑渴，必用羌
平胃散 见腹痛。
清暑益气汤 见咳嗽。
羌独败毒散 见痧胀腹痛。
【转筋之症】四肢牵引，筋急抽搐，痛不甚痛，见于霍乱之后，较之外感转筋，则缓而
【转筋之因】吐泻太多，津液暴亡，不能荣养筋脉，则筋急而搐矣。
【转筋之脉】多见细数，或见空大，或见双弦。
【转筋之治】补肝散，加木瓜、秦艽，活血散，加木瓜、秦艽。内伤转筋，主肝经者多
，故宜养血生津，舒筋活血，人参竹沥汤最妙，兼治痰，霍乱转筋。外冒三气，兼用风湿热治
补肝散
川芎 陈皮 生姜 防风 当归身 白芍药 羌活 木瓜 秦艽
活血散
当归 白芍 熟地 川芎 苍术 黄柏 秦艽 木瓜
人参竹沥汤 见中风门。
[Symptoms of Muscle Cramps] After the onset of cholera morbus (acute gastroenteritis with vomiting and diarrhea), the leg tendons become contracted and drawn inward; in severe cases, twisting and spasmodic contraction occur, accompanied by unbearable pain throughout the body. This is commonly known as "cramping diarrhea," which belongs to external contraction...
[Etiology of Muscle Cramps] The Yangming channel governs the binding of bones and the facilitation of joints, moistening and nourishing the Zongjin (major tendons). Currently, due to the sudden exposure to pathogenic factors of wind, cold, summerheat, dampness, or heat, causing sudden violent vomiting and profuse diarrhea, the Zongjin loses its nourishment. Meanwhile, the external pathogenic factors bind the latent internal heat, preventing it from being vented, thereby causing the tendons to twist and spasm with pain.
[Pulse of Muscle Cramps] The pulse is often fine and choppy, or intermittent and scattered, or hidden and deep. It should not be hastily judged as a ominous sign.
[Treatment of Muscle Cramps] The treatment should focus on dispelling wind-dampness and clearing summerheat. If wind predominates, use Pingwei San (Calm the Stomach Powder) with added Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Mugua (Chaenomelis Fructus), and Qinjiao (Gentianae Macrophyllae Radix). If dampness predominates, use Pingwei San with added Qinjiao and Mugua. If summerheat qi predominates, use Qingshu Tang (Clear Summerheat Decoction). Muscle cramps are primarily related to the Yangming channel, so Mugua and Qinjiao should be used in doubled doses. Although muscle cramps are mainly associated with fire, if there is external constraint by wind-cold, or if there is no sweating and the pulse is hidden, one must avoid using sour and astringent herbs like Mugua and Qinjiao. One must also avoid using cold-natured herbs to suppress thirst. Instead, Qiang [huo] must be used.
*Note: Pingwei San see Abdominal Pain chapter.*
*Note: Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) see Cough chapter.*
*Note: Qiangdu Baidu San (Qianghuo and Duho Detoxification Powder) see Sha Zhang Abdominal Pain chapter.*
[Symptoms of Muscle Cramps] The four limbs are pulled and drawn, with tight tendons and spasmodic convulsions, but the pain is not severe. This appears after cholera morbus. Compared to muscle cramps caused by external contraction, the symptoms are milder...
[Etiology of Muscle Cramps] Excessive vomiting and diarrhea cause a sudden loss of body fluids (Jinye), which fail to nourish the tendons and vessels, leading to tendon tightness and convulsions.
[Pulse of Muscle Cramps] The pulse is mostly fine and rapid, or hollow and large, or double-string-like.
[Treatment of Muscle Cramps] Use Bulgan San (Tonify Liver Powder) with added Mugua and Qinjiao; or use Huoxue San (Invigorate Blood Powder) with added Mugua and Qinjiao. Internal injury-induced muscle cramps are mostly related to the Liver channel; therefore, the treatment should focus on nourishing blood and generating fluids, relaxing tendons and invigorating blood. Ren Shen Zhuli Tang (Ginseng and Bamboo Sap Decoction) is excellent, treating phlegm simultaneously for cholera morbus with muscle cramps. If externally affected by wind, cold, and summerheat, treat with methods that dispel wind-dampness and clear heat.
*Bulgan San Composition: Chuanxiong (Ligustici Chuanxiong Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Shengjiang (Zingiberis Rhizoma Recens), Fangfeng (Saposhnikoviae Radix), Dangguishen (Angelicae Sinensis Radix), Baishaoyao (Paeoniae Radix Alba), Qianghuo (Notopterygii Rhizoma et Radix), Mugua (Chaenomelis Fructus), Qinjiao (Gentianae Macrophyllae Radix).*
*Huoxue San Composition: Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Shudi (Rehmanniae Radix Preparata), Chuanxiong (Ligustici Chuanxiong Rhizoma), Cangzhu (Atractylodis Rhizoma), Huangbai (Phellodendri Chinensis Cortex), Qinjiao (Gentianae Macrophyllae Radix), Mugua (Chaenomelis Fructus).*
*Note: Ren Shen Zhuli Tang see Stroke chapter.*