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Ms. Sui, nearing sixty years of age, has frequently suffered from limb numbness and dizziness. This spring, numbness on the right side of her head extended to the tip of her tongue, accompanied by slurred speech (Yan Jian), red eyes, swollen gums, and toothache. This is due to the rebellious ascent of Jue Yang Qi (Vessel of Shaoyin), which stirs up phlegm-fire, invading the orifices and collaterals. Mild cases manifest as numbness and blurred vision; severe cases lead to deviation of the mouth and eye, inability to move the limbs freely, hemiplegia, and stroke-like syndromes, which develop gradually over time. Treatment should employ nourishing Yin and subduing Yang to extinguish wind; a slow effect is appropriate. Prescription: Shu Di Huang (Prepared Rehmannia Root) 4 qian, Gou Teng (Uncaria Rhynchophylla) 3 qian, Shi Hu (Dendrobium Stem), Qi Zi (Goji Berry), Fu Shen (Poria with Hostwood), Bai Shao (White Peony Root), Mu Li (Oyster Shell), Ci Shi (Magnetite) each 2 qian, Ling Yang Jiao (Antelope Horn) 7 fen, Shan Zhi (Gardenia Fruit), Gan Ju (Chrysanthemum Flower) all stir-fried, each 1 qian. After taking more than ten doses, symptoms subsided. Ci Shi was removed, Dong Sang Ye (Mulberry Leaf) and Hei Zhi Ma (Black Sesame Seed) were added. Subsequently, Gou Teng, Shan Zhi, Gan Ju, and Ling Yang Jiao were removed, and Lu Shen (Codonopsis Root) was added. Mulberry fruit was decocted into an extract and combined with E Jiao (Donkey-hide Gelatin) to make pills. The condition gradually stabilized.

Jing Syndrome (Spasm/Opisthotonos) is characterized by body stiffness and backward arching of the back; the pathology lies in the sinews. Sinews are nourished by blood; when injured by pathogenic factors, Jing syndrome forms. The Classics state: "All spasms with neck stiffness belong to Dampness." There are also Gang Jing (Rigid Spasm) and Rou Jing (Flaccid Spasm) differentiated by Cold or Wind pathogens. Jing syndrome can result from erroneous sweating or purgation, sweating in patients with sores/ulcers, sudden collapse from wind-stroke, excessive blood loss postpartum, acute or chronic convulsions in children, or traumatic wind-dampness transforming into spasm. Sudden onset of trismus, head shaking, upward staring of eyes, and opisthotonos also constitute Jing syndrome. Symptoms include fever in the upper body and cold feet, neck stiffness, trismus, twitching of hands and feet, and opisthotonos. The pulse is typically deep, hidden, wiry, and tight. Etiology often involves deficiency and dryness of blood, causing sinews and vessels to lose nourishment, allowing Wind-Cold-Damp-Heat pathogens to invade the meridians. This is why Chen Wuzhe, Xue Lizhai, and Zhang Jiebin emphasized that Jing syndrome belongs to blood loss and Yin deficiency. Therefore, treatment should nourish Ying fluids to address the root and disperse Wind-Dampness to address the branch.

If the syndrome is exterior, as stated in *Jin Gui Yao Lue*: "Taiyang disease with fever, no sweat, and aversion to cold is Gang Jing," treated with Ge Gen Tang (Kudzu Decoction). "Taiyang disease with fever, sweating, and no aversion to cold is Rou Jing," treated with Gua Lou Gui Zhi Tang (Trichosanthes Root and Cinnamon Twig Decoction). If interior, Jing syndrome with chest fullness, trismus, inability to lie flat (back not touching the bed), leg cramps, and teeth grinding belongs to Yangming. If stool is hard, Da Cheng Qi Tang (Major Order the Qi Decoction) may be given. If half-exterior half-interior, as stated in *Yi Tong*: "Unilateral twitching and one eye deviated belongs to Shaoyang." If accompanied by alternating chills and fever, Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Gui Zhi (Cinnamon Twig) and Bai Shao (White Peony Root) is used. These are the three Yang Jing syndromes.

For the three Yin Jing syndromes, all present with cold extremities, sinew constriction, sweating, neck stiffness, and a deep pulse. Taiyin Jing presents with flaccidity of the four limbs, treated with Zhu Fu Tang (Atractylodes and Aconite Decoction) plus Gan Cao (Licorice Root) and Sheng Jiang (Fresh Ginger). Shaoyin Jing presents with closed eyes and face turned inward, treated with Shen Fu Tang (Ginseng and Aconite Decoction) plus Gan Cao and Sheng Jiang. Jueyin Jing presents with head shaking and trismus, treated with Fu Zi Tang (Aconite Decoction) plus Dang Gui (Angelica Sinensis) and Rou Gui (Cinnamon Bark). These are the three Yin Jing syndromes.

For Jing caused by blood deficiency, Da Ying Jian (Great Nourishing Decoction) is suitable. For blood deficiency with fire, manifested by a surging pulse and irritability/fever, Yi Yin Jian (One Yin Decoction) is primary. For excessive fire drying out Yin blood, Bao Yin Jian (Preserve Yin Decoction) and Yu Nu Jian (Jade Woman Decoction) are used. For fluid deficiency with profuse sweating, San Yin Jian (Three Yin Decoction) is indicated. For profuse sweating with fire, Dang Gui Liu Huang Tang (Angelica Sinensis and Six Yellow Decoction) is used. For phlegm-fire induced Jing, Gua Lou Zhi Shi Tang (Trichosanites Root and Immature Bitter Orange Decoction) is used. For Wind-Heat and Phlegm obstruction inducing Jing, Qu Feng Dao Tan Tang (Expel Wind and Guide Out Phlegm Decoction) is used. For vomiting and diarrhea inducing Jing, Wei Guan Jian (Stomach Gate Decoction) or Wen Wei Yin (Warm Stomach Infusion) is used. For cold body, Jing, and syncope with a deep-thin pulse, Shen Fu Tang and Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) are used. For summerheat-wind convulsions leading to Jing, San Wu Xiang Ru Tang (Three Ingredient Elsholtzia Decoction) plus Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root), Huang Qi (Astragalus Root), and Bai Shao is used. For warm pathogens depleting fluids leading to Jing, Mai Mai Fu Mai Tang (Decoction for Restoring the Pulse) is used, removing Jiang (Ginger) and Gui (Cinnamon). For postpartum blood deficiency with profuse sweating leading to Jing, Shi Quan Da Bu Tang is used; if ineffective, Fu Zi (Aconite) should be urgently added. For the Three Causes, Xiao Xu Ming Tang (Minor Extending Life Decoction) is used, preferably without Ma Huang (Ephedra).

Chen Wuzhe said: "Cold congeals blood, hence no sweat and aversion to cold, termed Gang Jing. Wind disperses Qi, hence sweating and no aversion to cold, termed Rou Jing." Investigating the cause, it mostly stems from blood loss, where sinews lose nourishment, allowing pathogens to invade. Xu Zhongke said: "Fever, aversion to cold, and no sweat are originally Shang Han (Cold Damage) symptoms; if they develop into Jing, it is Taiyang Cold-Damp clashing and invading Shaoyin, hence aversion to cold. Cold is rigid, hence 'Gang'. Fever, sweating, and no aversion to cold are originally Shang Feng (Wind Injury) with Yangming symptoms; if they develop into Jing, it is Taiyang-Yangming dampness injury with Wind. Wind is warm, hence 'Rou'." Zhang Zhongjing uses Ge Gen Tang to treat Gang Jing to prevent Taiyang neck stiffness from progressing to Yangming chest fullness. He uses Gua Lou Gui Zhi Tang to treat Rou Jing to moisten depleted fluids in Taiyang, unblocking meridian Qi and dispersing Wind-Damp. He uses Da Cheng Qi Tang for interior syndromes because heat pathogens have entered internally, so he directly attacks the Stomach to dissipate the pathogen.

Xue Lizhai said: "Differentiate Gang and Rou by presence or absence of sweat; differentiate Yin and Yang by presence or absence of Jue Ni (cold extremities/reversal). Although Zhongjing stated Jing involves fever and cold feet, Yang syndromes do not involve Jue Ni; those with Jue Ni are all Yin syndromes."

Zhang Jiebin said: "Sinew constriction causes backward arching; blood dryness causes sinew cramping. Observe Zhongjing's statement: 'Excessive sweating in Taiyang disease leads to Jing.' 'Purgation in Wind diseases leads to Jing.' 'Patients with sores must not sweat; sweating leads to Jing.' Thus, erroneous sweating damages fluids, erroneous purgation damages Yin. When Yin fluids are damaged, sinews lose nourishment. Stroke-related Jing occurs in those with declining vitality due to Yin failure. Postpartum Jing results from excessive blood loss depleting the Chong and Ren vessels. Ulcer-related Jing results from blood loss with pus, depleting Ying Qi. Pediatric Jing is either Ji Jing (Acute Convulsion) from Wind-Heat damaging Yin, or Man Jing (Chronic Convulsion) from vomiting/diarrhea losing Yin. Although not caused by erroneous treatment, these all belong to Yin deficiency syndromes. Treating such syndromes prioritizes Qi and Blood. If pathogens are strong, treat them concurrently; if weak, urgently tonify Yuan Qi. Once Yuan Qi recovers, blood vessels function naturally, and minor pathogens dissipate. Treating this as a Wind syndrome is difficult to avoid error."

Danxi said: "Jing resembles Xian (Epilepsy) but differs. Xian features a soft body with periodic recovery. Jing features a stiff body without periodic recovery; severe cases may lead to coma and death."