挛皆属肝，经云∶肝主身之筋膜故也。有热，经云∶肝气热，则筋膜干。筋膜干，则筋
急而
挛是也。有寒，经云∶寒多则筋挛骨痛。又云∶寒则筋急是也。有湿热，经云∶湿热不攘，
大筋软短，小筋弛长，软短为拘，驰长为痿是也。有虚，经云∶脉弗荣则筋急，屈伸不利。
仲景云∶血虚则筋急是也。
治案∶杨吉老治歙丞张德操内筋挛，脚不得屈伸，逾年，动则令人抱。杨吉老云
∶此筋病，宜服下三方，一年而愈。
治筋极养血地黄丸（春夏服之。）
熟地 蔓荆（各一分） 山萸 黑狗脊（炙） 地肤子 白术 干漆 蛴螬（炒） 天雄 车
前子（各三分） 萆 山药 泽泻 牛膝
上为细末，炼蜜为丸，如梧子大，每服五十丸，温酒下空心。
治筋痹肢节冷痛，羚羊角汤（秋服之。）
羚羊角 肉桂 附子 独活（各一两三钱半） 白芍 防风 川芎（各一两）
上为粗末，每服五钱，水一盏半，生姜同煎至八分，取清汁服，日可二三服。
治寒冷湿痹，留于筋脉，挛急不能转侧，乌头汤方（冬服之。）
大乌头 细辛 川椒 甘草 秦艽 附子 官桂 白芍（各七分） 干姜 茯苓 防风
当归（各一两） 独活（一两三钱五分）
上为粗末，每服三钱，水一盏半，枣一枚，同煎至八分，去滓空心食前服。
Spasm (muscle contraction and stiffness) all belongs to the Liver. The Classic states: "The Liver governs the sinews of the body." If there is Heat, the Classic states: "When Liver Qi is hot, the sinews become dry. When sinews are dry, they become tense and spastic." If there is Cold, the Classic states: "Excess Cold leads to sinew spasm and bone pain." It also says: "Cold causes sinew tension." If there is Damp-Heat, the Classic states: "If Damp-Heat is not dispelled, the large sinews become short and soft, and the small sinews become lax and long. Shortness and softness manifest as constraint (Ju), while laxity and length manifest as flaccidity (Wei)." If there is Deficiency, the Classic states: "If the vessels do not nourish, the sinews become tense, and flexion and extension are difficult." Zhang Zhongjing said: "Blood deficiency leads to sinew tension."
Treatment Case: Yang Jilao treated Zhang Decao, the Magistrate of She County, for internal sinew spasm. His feet could not flex or extend; for over a year, any movement caused him to clutch himself in distress. Yang Jilao stated: "This is a disease of the sinews. It is appropriate to take the following three formulas, and he will recover in one year."
Formula for Treating Extreme Sinew Disease with Blood Nourishing Dihuang Wan (To be taken in Spring and Summer.)
Prepared Rehmannia Root (Shu Di Huang), Vitex Fruit (Man Jing Zi) [each 1 fen], Cornus Fruit (Shan Yu Rou), Black Dogwood Root Bark (Hei Gou Ji) [roasted], Kochia Seed (Di Fu Zi), Atractylodes Rhizome (Bai Zhu), Dry Resin of Lac Insect (Gan Qi), Larva of Meloidae Beetle (Qi Cao) [fried], Aconitum Lateralis Radix Praeparata (Tian Xiong), Plantago Seed (Che Qian Zi) [each 3 fen], Dioscorea Rhizome (Shan Yao), Alisma Rhizome (Ze Xie), Achyranthes Root (Niu Xi).
Grind the above into a fine powder, mix with refined honey to make pills the size of wutong seeds. Take 50 pills each time, swallowed with warm wine on an empty stomach.
Lingyangjiao Tang (Antelope Horn Decoction) for Treating Sinew Bi Syndrome with Cold Pain in Limbs and Joints (To be taken in Autumn.)
Antelope Horn (Ling Yang Jiao), Cinnamon Twig (Rou Gui), Prepared Aconite Root (Fu Zi), Angelica Pubescens Root (Du Huo) [each 1 liang 3 qian 5 fen], White Peony Root (Bai Shao), Saposhnikovia Root (Fang Feng), Szechuan Lovage Rhizome (Chuan Xiong) [each 1 liang].
Grind the above into a coarse powder. Take 5 qian each time, decoct with 1.5 cups of water and fresh ginger until reduced to 0.8 cup. Strain and take the clear liquid. Can be taken two to three times daily.
Wutou Tang (Aconite Decoction) for Treating Cold-Damp Bi Syndrome Stagnating in Sinews and Vessels, Causing Spasm and Inability to Turn (To be taken in Winter.)
Large Aconite Root (Da Wu Tou), Asarum Root (Xi Xin), Sichuan Pepper (Chuan Jiao), Licorice Root (Gan Cao), Gentiana Macrophylla Root (Qin Jiao), Prepared Aconite Root (Fu Zi), Cassia Twig (Guan Gui), White Peony Root (Bai Shao) [each 7 fen], Dried Ginger (Gan Jiang), Poria (Fu Ling), Saposhnikovia Root (Fang Feng), Chinese Angelica Root (Dang Gui) [each 1 liang], Angelica Pubescens Root (Du Huo) [1 liang 3 qian 5 fen].
Grind the above into a coarse powder. Take 3 qian each time, decoct with 1.5 cups of water and one jujube until reduced to 0.8 cup. Strain and take before meals on an empty stomach.