（俗作 ）
经曰∶诸痉项强，皆属于湿。又曰∶诸暴强直，皆属于风。刘河间曰∶诸痉强直，乃筋劲而
不柔和也。盖脾土主安静，湿胜过极则反兼风化。亢则害，承乃制，实非风也。身热足冷，颈项
强急，恶寒口噤，头摇面赤，背反张如弓者，痉证也。阴痉曰柔，阳痉曰刚。如伤寒太阳发汗过
多，或疮家过汗，或大发湿家汗。亦有气血内虚，风湿外袭；有火热伤肺，金不平木；有产后血
枯；有破伤风，皆能致此。脉浮缓有汗为柔，浮紧无汗为刚。治宜养血为主，分虚实。
主方 当归 川芎 芍药 熟地 白术 茯苓（等分） 甘草（减半）加姜、枣煎。
无汗加羌活、防风、苍术、柴胡、葛根；冬加麻黄，去芍、地、白术；有汗加桂枝、黄 ，
去川芎；厥冷加熟附、羌活；虚加人参。烦渴，麦冬、知母、干葛、黄芩，去白术、川芎。身热
烦渴，卧不着席，大便秘，大黄、枳实、浓朴、黄芩，去白术、川芎、茯苓。汗吐下后发者，重
加参、 、归、地、羌、荆。痰火发 ，二陈、蒌、贝、枳、桔、参、麦、栀、芩、当归、苏子
，加姜煎，入竹沥，姜汁服。
栝蒌桂枝汤 太阳病，其证备，身体强，KT KT 然，脉反沉迟， 病。
栝蒌根 桂枝 芍药（各钱半） 甘草（五分）
姜五片，枣二枚煎。
(Spelled as "Jing" in common usage)
The *Classic of Difficult Issues* (referring to *Huangdi Neijing*) states: All spasms and neck stiffness belong to dampness. It also states: All sudden rigidity and straightening belong to wind. Liu Hejian stated: All spasms and rigidity are manifestations of sinews being tense and lacking flexibility. Generally, the Spleen Earth governs tranquility; when dampness is excessive to the extreme, it counterfeits the manifestation of wind. When things reach an extreme, they cause harm; only through control can balance be maintained. In reality, this is not true wind. Symptoms include fever in the body, coldness in the feet, stiff and tight neck, aversion to cold, locked jaw, head shaking, red face, and opisthotonos (back arched like a bow); these constitute the syndrome of spasm (*Jing Zheng*). Yin spasm is called soft spasm (*Rou Jing*), and Yang spasm is called rigid spasm (*Gang Jing*). For instance, excessive sweating in Taiyang disease from Cold Damage, or excessive sweating in patients with sores/ulcers, or inducing heavy sweating in patients with dampness, can all lead to this condition. There are also cases where internal deficiency of Qi and Blood allows external invasion by Wind-Damp; cases where Fire-Heat injures the Lung, causing Metal (Lung) to fail to subdue Wood (Liver); cases of blood depletion after childbirth; and tetanus from wound injury, all of which can cause this disease. A floating and moderate pulse with sweating indicates soft spasm; a floating and tight pulse without sweating indicates rigid spasm. Treatment should primarily nourish Blood, distinguishing between excess and deficiency.
Main Formula: Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Shao Yao (Paeoniae Radix Alba), Shu Di Huang (Rehmanniae Radix Praeparata), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), each in equal parts; Gan Cao (Glycyrrhizae Radix et Rhizoma), halved in amount. Decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus).
If there is no sweating, add Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Cang Zhu (Atractylodis Rhizoma), Chai Hu (Bupleuri Radix), Ge Gen (Puerariae Lobatae Radix); in winter, add Ma Huang (Ephedrae Herba), remove Shao Yao, Shu Di Huang, and Bai Zhu; if there is sweating, add Gui Zhi (Cinnamomi Ramulus), Huang Qin (Scutellariae Radix), remove Chuan Xiong; if there is cold extremities, add Shu Fu Zi (Aconiti Lateralis Radix Praeparata), Qiang Huo; if deficient, add Ren Shen (Ginseng Radix). If there is irritability and thirst, use Mai Dong (Ophiopogonis Radix), Zhi Mu (Anemarrhenae Rhizoma), Gan Ge (Puerariae Flos), Huang Qin, remove Bai Zhu and Chuan Xiong. If there is body heat, irritability and thirst, inability to lie flat on the bed (opisthotonos severe enough that back does not touch mat), and constipation, use Da Huang (Rhei Radix et Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), Hou Po (Magnoliae Officinalis Cortex), Huang Qin, remove Bai Zhu, Chuan Xiong, and Fu Ling. If the condition arises after sweating, vomiting, or purging, heavily increase the dosage of Ren Shen, Huang Qi (Astragali Radix), Dang Gui, Shu Di Huang, and add Qiang Huo, Jing Jie (Schizonepetae Spica). If caused by Phlegm-Fire, use Er Chen Tang (Two-Cured Decoction) plus Gua Lou (Trichosanthis Radix), Bei Mu (Fritillariae Thunbergii Bulbus), Zhi Shi, Jie Geng (Platycodonis Radix), Ren Shen, Mai Dong, Zhi Zi (Gardeniae Fructus), Huang Qin, Dang Gui, Su Zi (Perillae Fructus), decoct with Sheng Jiang, and administer with Zhu Li (Bambusae Caulis in Taenia) and Jiang Zhi (Zingiberis Juice).
Gualou Guizhi Decoction: Treats Taiyang disease where symptoms are complete, body is stiff, the spine is rigid and uncomfortable, and the pulse is surprisingly deep and slow; this is classified as a spasm disorder.
Gua Lou Gen (Trichosanthis Radix), Gui Zhi (Cinnamomi Ramulus), Shao Yao (Paeoniae Radix Alba) (each 1.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.5 qian).
Decoct with five slices of Sheng Jiang (Zingiberis Rhizoma Recens) and two Da Zao (Jujubae Fructus).