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Cheng Wuji's commentary: "Chou" (convulsion) refers to the contraction and shortening of tendons, while "Chi" (relaxation) refers to the elongation and relaxation of tendons. If these movements occur incessantly, it is termed Chou Chi. Commonly known as twitching or spasms, this is a disease caused by extreme wind-heat. It is appropriate to use cooling agents that dispel wind and purge heat; there may be hope for survival. However, if moxibustion, fire therapy, or diaphoretic (sweat-inducing) medicines are erroneously applied, disaster will follow immediately.

After the Taiyang syndrome has been treated with sweating, if the body remains burning hot, this is called Feng Wen (Wind-Warmth). The pulse is floating at all three positions (Cun, Guan, Chi), accompanied by spontaneous sweating, heaviness of the body, somnolence, snoring, and difficulty in speech. Purging methods are contraindicated, as are fire therapies. If subjected to fire therapy, mild cases result in jaundice, while severe cases lead to Jing Xian (startle and epilepsy) and Chou Chi. (Fangfeng Tongsheng San [Saposhnikoviae Root and Sage Decoction] may be used.)

Wu Kun stated: Regarding Chou Chi, it involves alternating contraction and extension, with the limbs pulling each other in continuous spasms. This is largely similar to convulsions in infants. Ancient physicians attributed this syndrome mostly to Wind, because Wind governs movement and shaking. Luo Longji said: The Heart governs the vessels, and the Liver governs the tendons. The Heart belongs to Fire, and the Liver belongs to Wood. Fire governs Heat, and Wood governs Wind. When Wind and Fan stir each other, Chou Chi occurs. If this condition arises not after sweating or purging, one should calm the Liver Wood, descend Heart Fire, and assist with formulas that harmonize the blood vessels. Examples include Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Huang Qin (Scutellariae Radix), Chai Hu (Bupleuri Radix), Huang Lian (Coptidis Rhizoma), Shao Yao (Paeoniae Radix), Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), and Tian Ma (Gastrodiae Rhizoma). If phlegm is present, Zhu Li (Bambusae Succus) and Tian Nan Xing (Arisaematis Rhizoma) and Ban Xia (Pinelliae Rhizoma) must be added. If the wind pathogen causes urgent spasms, Quan Xie (Scorpio) and Bai Jiang Can (Bombyx Batryticatus) should be added.

If this syndrome develops days after Taiyang cold damage has undergone sweating or purging, the pathological process has progressed deeply, and it is generally difficult to treat. This is due to internal wind generated by extreme deficiency. Xiao Xuming Tang (Minor Continuation Life Decoction) or Da Jianzhong Tang (Major Construct the Middle Decoction) should be used, with minor adjustments to one or two herbs. In cases where Taiyang cold damage leads to sweating followed by exposure to wind, causing sweat flow obstruction and resulting in tendon contraction and limb spasms, Niubang Gen San (Arctii Radix Powder) is indicated. Furthermore, if Wind-Warmth is injured by fire therapy, mild cases show slight yellowing, while severe cases resemble startle-epilepsy with frequent Chou Chi; Wei Rui Tang (Polygonati Odorati Rhizoma Decoction) is indicated. If Chou Chi is accompanied by Dai Yan (eyes staring upward), Fan Zhe (opisthotonos), and Jue Han (terminal sweating) where sweat beads are large like strings and do not flow off the body, this indicates the exhaustion of the Taiyang meridian qi and is incurable. There are also cases of continuous, weak trembling of the four limbs resembling Chou Chi but lacking forceful spasms; this indicates the exhaustion of the Liver. Generally, conditions arising from sweating/purging complications leading to this state often result in death. When using Xiao Xuming Tang, remove Ma Huang (Ephedrae Herba) if there is sweating, and remove Huang Qin if there is no sweating; flexibility is key.

Cheng Wuji's commentary: There are two types of Shi Re Xiang Bo (Dampness and Wind Interacting). One type originates from Taiyang cold damage; on the eighth or ninth day, if dampness and wind interact, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is used to disperse wind-dampness in the exterior. The other type involves pure wind-damp interaction presenting with painful joints; Gancao Fuzi Tang (Licorice and Aconite Decoction) is used to dispel dampness and secure the defensive qi. Recognizing this syndrome relies on identifying a pulse that is floating, deficient, and choppy. Pulses that are deep, solid, slippery, large, or rapid are incorrect for this diagnosis.

In Taiyang cold damage lasting eight or nine days, with wind-damp interaction causing bodily pain and inability to turn over, without vomiting or thirst, and with a floating, deficient, and choppy pulse, Guizhi Fuzi Tang is used. If the stool is hard and urination is normal, Guizhi Qu Gui Jia Baizhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Atractylodes Macrocephala Rhizoma) is used. For wind-damp interaction causing painful joints, pulling pain, inability to flex or extend, severe pain upon touch, sweating, shortness of breath, dysuria, aversion to wind, reluctance to remove clothing, or slight edema, Gancao Fuzi Tang is indicated.