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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states that all types of tendon contracture (*Jin Luan*) are associated with the Liver, because the Liver governs the tendons of the body. Furthermore, when there is a rebounding pathogenic factor in the Yangming channel, severe cases may affect the Liver, resulting in fright and tendon contracture. Additionally, if Cold from the Spleen transfers to the Liver, it can cause carbuncles and swelling along with tendon contracture. These conditions can be categorized into Heat, Cold, Deficiency, and Excess patterns.

In cases of Heat-induced contracture, as stated in the classics: "When Liver Qi is hot, the fascia becomes dry; when the fascia is dry, the tendons become tight and contract." It also says: "Affected by Dampness, the head feels wrapped; if Damp-Heat is not dispelled, the large tendons become soft and short, while the small tendons become lax and long. Shortening leads to constraint (*Ju*), while laxity leads to flaccidity (*Wei*)." (Zhu Danxi said: Large tendons becoming soft and short indicates that Heat has damaged the Blood, failing to nourish the tendons, thus causing contracture. Small tendons becoming lax and long indicates that Dampness has damaged the tendons, failing to bind the bones, thus causing flaccidity.) For cases of dry fascia, herbs such as Sheng Di Huang (Rehmanniae Radix Preparata) and Dang Gui (Angelicae Sinensis Radix) are used to moisten and nourish. For cases where large tendons are soft and short, Yi Yi Ren San (Coix Seed Powder) is the primary prescription. The *Bencao Yan yi* (Supplement to Materia Medica) states that there are two types of tendon urgency and contracture: according to the *Suwen*, when large tendons are affected by Heat, they shrink and shorten, causing urgency and inability to extend; in such cases, Yi Yi Ren (Coicis Semen) can be used. However, if the condition is due to Cold as described in the *Suwen*, Yi Yi Ren should not be used.

In cases of Cold-induced contracture, as stated in the classics: "Excessive Cold causes the tendons to curl and the bones to ache." Wutou Tang (Aconite Decoction) or Yi Yi Ren Tang (Coix Seed Decoction) from the *Qianjin Fang* can be used.

In cases of Deficiency-induced contracture, as stated in the classics: "Deficient pathogens attacking the tendons result in tendon curling." It also says: "If the vessels do not nourish, the tendons become urgent." Zhang Zhongjing also stated: "Blood deficiency leads to tendon urgency." All these indicate that tendon contracture arises because the blood vessels fail to nourish the tendons. Therefore, Zhu Danji treated contracture using Si Wu Tang (Four Substances Decoction) with modifications. The *Ben Shi Fang* treated extreme tendon urgency with Yang Xue Di Huang Wan (Blood-Nourishing Rehmannia Pill), based on this principle.

In cases of Excess-induced contracture, for example, Zhu Danji once treated a villager who was hunchbacked and had contracted feet, rendering him disabled. His pulse was deep, wiry, and choppy in both hands. Zhu administered Dai Ren Wei Shen San (Dai Person's Roasted Kidney Powder). Through induced vomiting and purging, over more than a month, vomiting and diarrhea alternated. After three doses of this regimen, the patient recovered. Li Dongyuan once treated Supervisor Dong. In the twelfth lunar month, after heavy snow cleared, Dong went outside and suddenly felt a violent wind causing him to collapse. His six pulses were extremely wiry, forceful and full upon pressure. His symptoms included hand contracture, constipation, redness, and heat in the face. This indicated that Wind-Cold had just invaded the body. The limbs are governed by the Spleen; when injured by Wind-Cold pathogens, they twitch, become urgent, and suffer from contracture and numbness. This is a disease of the extremities caused by excessive Wind, with Cold remaining on the exterior. The *Neijing* states: "Cold causes tendon contracture," which applies here. The patient usually drank alcohol, leading to internal Excess Heat accumulating in the intestines and stomach, causing constipation and facial redness/heat. Internally, the Hand and Foot Yangming channels were affected; externally, the Foot Taiyin Spleen channel was affected by Wind-Cold. Guizhi (Cinnamomi Ramulus) and Gancao (Glycyrrhizae Radix et Rhizoma) were used to expel Cold and relieve urgency/twitching. Huangbai (Phellodendri Cortex), bitter, cold, and slippery, was used to drain Excess and moisten dryness, urgently saving Kidney Water. Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Lobatae Radix) were used to raise Yang Qi and circulate the Hand and Foot Yangming channels, preventing stagnation. Guizhi, being acrid and hot, served as a guiding herb entering the Hand Yangming channel. Shaoyao (Paeoniae Radix Alba) and Gancao were added to moisten dryness and specifically tonify Spleen Qi, protecting against Wind-Cold and subduing Wood (Liver) to benefit Metal (Lung). Renshen (Ginseng Radix) was added to tonify Yuan Qi as an assistant. Danggui Shen (Angelicae Sinensis Radix Root) was added to relieve interior urgency, harmonize Blood, and moisten dryness. This formula was named Huoxue Tongjing Tang (Invigorate Blood and Unblock Channels Decoction). He also instructed the patient to stay in a warm room near fire and rub his hands until healed. The *Ben Shi Fang* records taking Yang Xue Di Huang Wan in Spring and Summer, Lingyang Jiao Tang (Antelope Horn Decoction) in Autumn, and Wutou Tang in Winter.

Lower Deficiency accompanied by lower back and knee pain is treated with Fangfeng San (Saposhnikoviae Powder). Upper Deficiency accompanied by mental restlessness, heat, and insomnia is treated with Maimendong San (Ophiopogonis Powder) and Huang Wan (Yellow Pill). External contraction of Wind-Dampness causing four-limb constraint is treated by decocting Cang Er Zi (Xanthii Fructus) powder. Mu Gua (Chaenomelis Fructus) boiled in wine until soft, ground into porridge, and applied to the contracted area (replacing when cold) is also effective. For tendon contracture preventing walking, moxibustion is used: forty moxa cones on the medial malleolus for medial ankle contracture, and thirty moxa cones on the lateral malleolus for lateral ankle contracture, resulting in immediate cure.