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Zhu Danxi stated: The previous practice of attributing Gang-Jing (Stiff Spasm) and Rou-Jing (Soft Spasm) to Wind-Dampness is incorrect; they should be differentiated by Deficiency (Xu, 虚) and Excess (Shi, 实). Gang-Jing belongs to External Contraction (Wai-Gan, 外感), suitable for formulas such as Gualou Guizhi Gegen Tang (Trichosanthes Root, Cinnamon Twig, and Pueraria Decoction) and Chengqi Tang (Descending the Qi Decoction); Rou-Jing belongs to Internal Injury (Nei-Shang, 内伤), suitable for formulas such as Siwu Tang (Four Substances Decoction), Bawu Tang (Eight Substances Decoction), and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). I note: This is a half-clear, half-obscure argument. Both Gang-Jing and Rou-Jing belong to Excess patterns; so-called Xu-Jing (Deficiency Spasm) is a distinct syndrome and cannot be equated with Rou-Jing. Generally, there are Jing caused by Wind-Cold, Jing caused by Damp-Heat, Jing occurring postpartum, and Jing resulting from Febrile Diseases (Re-Bing, 热病). Jing caused by Wind-Cold arises when Wind-Cold stagnates Body Fluids (Jin-Ye, 津液), preventing the sinews and vessels from being moistened and relaxed; since Cold has a contracting nature, spasm and tightness occur. Jing caused by Damp-Heat corresponds to what *The Inner Canon* describes as "when Damp-Heat is not dispelled, the large sinews become contracted and short, while the small sinews become lax and long"; contraction leads to spasm, while laxity leads to Wei syndrome (flaccidity). Postpartum Jing, although caused by Blood Deficiency, also involves Wind-Cold; without Wind-Cold invasion, Blood Deficiency alone does not form Jing. Thus, Wind-Cold-induced Jing can be either Gang or Rou: severe Cold constitutes Gang-Jing, while dominant Wind with internal Heat constitutes Rou-Jing. Damp-Heat-induced Jing has only Rou characteristics, not Gang; their pathological bodies differ, yet both fall under Excess. Only Jing caused by Febrile Diseases, as stated in *Ling Shu: Re Bing Pian*: "When heat accompanies spasm, there is opisthotonos, convulsions, trismus, and clenched teeth." This represents a critical failure where Body Fluids are depleted and Blood is ruined, leaving sinews without nourishment; this is called Xu-Jing, where does the distinction of Gang and Rou apply? Xu Lingtai claimed that Jing is a deteriorated disease of Shanghan (Cold Damage), and none of Zhang Zhongjing's formulas were effective. This demonstrates ignorance of the pathology of Gang and Rou Jing, and even more so, ignorance of the treatment methods for Xu-Jing. Wind-Cold-induced Jing belongs to the Taiyang (Greater Yang) channel; even postpartum Wind-Cold belongs to Taiyang, treated primarily with Guizhi Gegen Tang, supplemented by blood-nourishing herbs for postpartum cases. Damp-Heat-induced Jing and Febrile Disease-induced Jing may involve Yangming Interior Excess, treated with Chengqi Tang; those Febrile Disease-induced Jing belonging to Jueyin (Terminal Yin) involve depletion of Kidney Water and chaotic Liver Wind, for which Siwu Tang is inappropriate, let alone Zhang Zhongjing's formulas for Excess patterns. I propose using a large dose of Sheng Di Huang (Rehmanniae Radix), mixed with crushed Tao Ren (Persicae Semen) taken as a slurry, possibly adding Fang Feng (Saposhnikoviae Radix). Zhang Zhongjing's Zhufu Tang (Pig Skin Decoction) method may also be applicable. "Excess" and "Deficiency" refer to constitutional vitality; "Gang" and "Rou" refer to clinical manifestations. These terms merely distinguish the severity of Wind-Cold versus Damp-Heat. Upon closer examination, even Gang-Jing stems from insufficiency of Jin-Qi (Fluids and Vital Qi). If fluids are abundant and Qi is vigorous, even deep penetration by Wind-Cold would not result in Jing.

There are cases of Jing caused by external constraint of Cold-Dampness and internal entrapment of Yang Qi, characterized by a tight pulse and absence of sweating. There are cases caused by downward rushing of Cold-Dampness and upward obstruction of Yang Qi, characterized by facial redness and cold feet. These symptoms resemble Hong Kong Foot (Jiao Qi, foot-and-mouth disease/beriberi). In Hong Kong Foot, there is a type that rushes to the heart, where Cold-Dampness rises from below via Qi transformation into the interior; here, it ascends along the meridians to the exterior. With the blockage of ascending and descending movements, and the closure of interior-exterior respiration, the Great Qi becomes stagnant within the vessels, resulting in a hidden, firm, and straight pulse. A deep and fine pulse indicates internal entrapment of Yang Qi. A pulse resembling a snake, accompanied by sudden abdominal distension, suggests impending resolution if the pulse changes from deep/fine to coarse/long and soft; this indicates Heat generated within Dampness, possessing a warming and moistening quality. As Body Fluids gradually circulate and the mechanism of Yang Qi is activated, it battles Cold-Dampness in the Middle Jiao, causing agitation and abdominal distension. This is the turning point where Gang-Jing transforms from Yin to Yang, unrelated to Rou-Jing or Xu-Jing.

Zhang Zhongjing listed multiple descriptions of Jing syndromes without rigidly adhering to the terms "Gang" and "Rou." Readers must study the meaning of each description and not keep these two terms fixed in their minds. Patients suffering from Jing typically have heavy Dampness and stagnant Qi, or dry Blood and sluggish Qi in daily life. They already possess a tendency to fail to transform Body Fluids and nourish sinews. When invaded by Wind-Cold, lack of sweat causes further stagnation of fluids; when invaded by Wind-Warmth, excessive sweating causes further depletion of fluids. This describes Jing appearing at the onset of illness. Generally, if the spasm relaxes and does not recur, it is mild; if it alternates between relaxation and tension, occurring several times a day, it is severe, distinguishing involvement of the meridians from entry into the interior. If Jing appears after two to three days of fever, without sweating and with bone/joint pain, it remains Gang-Jing; if sweating has occurred and Yangming Interior Excess signs are present, it remains Rou-Jing. If Jing appears after prolonged illness without exterior or interior signs, it is a fatal syndrome of Qi collapse, fluid depletion, and dry blood. Symptoms include alternating relaxation and tension, and alternating coma and consciousness. Generally, Jing often accompanies Jue (cold extremities/collapse); in Excess Jing, coma is severe with open mouth and clenched hands; in Deficiency Jing, there is delirious speech with an open mouth and relaxed hands, resembling the terminal stage of Stroke (Zhong Feng, 中风). Stroke may present with Jing or without; Jing may be caused by Wind or not. It is erroneous for predecessors to equate Jing directly with Stroke. There are also cases where the body bends forward uncontrollably, limbs curl, and head touches knees; in acute onset, this is pathogenic factor invading the Yangming channel; in chronic illness, it is exhaustion of Yangming Qi and Blood. Yangming is the sea of Qi and Blood and the source for all Zang-Fu organs. If exhausted to this degree, how can Zang-Fu survive? Compared to opisthotonos with upward thrusting, this is even harder to treat and leads to death more rapidly.