热挛者，经所谓肝气热则筋膜干，筋膜干则筋急而挛。（全文见痿门）
又云∶因于湿。首如裹，湿热不攘，大筋 短，小筋弛长， 短为拘，弛长为
痿之类是也。（全文见阴阳。丹溪云∶大筋 短者，热伤血不能养，故为拘挛。小
筋弛长者，湿伤筋不能束骨，故为痿弱）
〔丹〕王秀，湿热大作，脚痛后，手筋拘挛，足乏力。
生地 当归 川芎 白术（各二钱） 苍术（一钱半） 甘草（炙三分） 木通
煎汤，下大补丸三十丸。大补丸须炒暖。
〔《心》〕薏苡仁散 治筋脉拘挛，久风湿痹。
薏苡仁（一升捣散，以水二升，取末数匙作粥，空腹食之。《衍义》云∶筋急拘挛有两
等，《素问》大筋受热，热则缩而短，故挛急不伸，则可用薏苡仁。若《素问》言因寒筋急
，不可用也）
寒挛者，经所谓寒多则筋挛骨痛者是也。
〔《本》〕同官歙丞张德操，常言其内子昔患筋挛，脚不得屈伸，逾年，动则令人拘持，
求医于泗水杨吉老。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（一分） 蔓荆（一分） 山茱萸（五分） 黑狗脊（炙） 地肤子 白术 干漆 蛴螬（炒） 天
雄车前子（各三分） 萆 山芋（即山药） 泽泻 牛膝（各一两）
上细末，炼蜜和杵丸如桐子大。每服五十丸，温酒下，空心食卧服。
治筋痹肢节束痛，羚羊汤，秋服之。
羚羊角 肉桂 附子 独活（各一两三钱半） 白芍 防风 芎 （各一两）
上为粗末。每服五大钱，水一盏半，生姜三片，同煎至八分，取清汁服，日可二三服。
治寒冷湿痹留于筋脉，缩不能转侧，乌头汤，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 白伏 防风（炙）
当归（各一两） 独活（一两三钱半）
上为粗末。每服三钱，水一盏半，枣二枚，同煎至八分，去渣，空心食前服。
〔《千》〕薏苡仁汤 治筋挛不可屈伸。
白蔹 薏苡仁 芍药 桂心 酸枣仁 干姜 牛膝 甘草（各一两） 附子（三枚）
上九味 咀。以醇酒三斗，渍一宿，微火煎三沸，每服一升，日三。扶杖起行，不
耐酒，服五合。
〔垣〕活血通经汤 灵寿县董监军，癸卯年十二月间，大雪初霁，时因事到真定，忽觉有
风气暴仆，诊候，得六脉俱弦甚，按之洪实有力。其症手挛急，大便闭涩，面赤热，此风寒
始至加于身也。四肢者脾也，以风寒之邪伤人，则搐急而挛痹，乃风淫末疾，而寒在外也。
《内经》云∶寒则筋挛，正此谓也，本人素多饮酒，内有实热，乘于肠胃之间，故大便闭涩
而面赤热。内则手足阳明受邪，外则足太阴脾经受风寒之邪，用桂枝、甘草以却其寒邪，而
缓其急搐。用黄柏之苦寒，滑以泻实而润澡，急救肾水。用升麻、葛根以升阳气，行手足阳
明之经，不令遏绝。更以桂枝辛热，入手阳明之经，为引用润燥。复以芍药、甘草专补脾气
，使不受风寒之邪，而退木邪专益肺金也。加人参以补元气为之辅佐，加当归身去里急而和
血润燥，名之曰活血通经汤。
升麻（一钱） 葛根（一钱） 桂枝（二钱） 当归（一钱） 人参（一钱） 芍药（五分） 甘草（炙，
一钱） 酒柏（二钱） 上锉，如麻豆大。都作一服，水二盏，煎至一盏，去渣热服。令暖房中近火，摩
搓其手乃愈。
虚挛者，经所谓虚邪搏于筋，则为筋挛。又云∶脉弗荣则筋急（全文见诊生死门）。
又仲景云∶血虚则筋急。此皆血脉弗荣于筋，而筋成挛，故丹溪治挛用四物加减，《本事》
治筋急极，用养血地黄丸，盖本乎此也。
〔《灵》〕黄帝曰∶人有八虚，各何以候？岐伯曰∶以候五脏。黄帝曰∶候之奈何？岐伯曰
∶心肺有邪，其气留于两髀。肾有邪，其气留于两 。凡此八虚者，皆机关之室，真气
之所遇，血脉之所游。气血固。邪不住留。住留则伤经络，骨节机关不得屈伸，故病挛也。
〔丹〕一村夫，背伛偻而足挛，已成废人。予诊其脉，两手皆沉弦而涩。遂以戴人煨肾散
与之，上吐下泻。过月余久，吐泻交作，如此凡三帖，然后平复。（煨肾散用甘遂末三钱，
猪腰子细批破，少盐椒淹透，渗药末在内，荷叶包裹烧热，温酒嚼服之）
挛皆属肝。经云∶肝主身之筋故也。又云∶阳明之复，甚则入肝，惊骇筋挛。又云∶脾
移寒于肝，痈肿筋挛。
〔《心》〕除一切风湿痹，四肢拘挛。苍耳子三两捣末，水一升半，煎取七合，去渣呷。
〔《食》〕酒煮木瓜粥，裹筋急痛处。佳。（方见鹤膝风门）
《内经》针灸法 取挛，有筋挛、脉挛之异。取筋挛者，经云∶病在筋，筋挛节痛不可
以行，名曰筋痹，刺筋上为故，刺分肉间，不可中骨也，病起筋，筋炅病已止者是也（全文
见痛痹门）。取筋脉者，经云∶手厥阴脉是动，则病手心热，肘腕挛急，腋肿，辨虚实
寒热，陷下取之，是取筋脉之挛也（全文见针灸门十二经条）。又曰∶少阳之别，名曰外
关，去腕二寸，则肘挛取之所别也（全文见针灸门十五络条）。又曰∶邪客于足太阳之络
，令人拘挛背急，引胁而痛，刺之从项始数脊椎侠脊，疾按之应手如痛，刺之傍三 （
全文见针灸门缪刺络条）。是取络脉之挛也。
〔《千》〕灸筋急不能行，内踝筋急，灸内踝四十壮，外踝筋急，灸外踝三十壮，立愈。
〔《玉》〕两肘俱挛∶曲池（九分，先泻后补，补四呼，泻九吸） 尺泽（手如弓，方可针五
分，先补后泻）
〔标〕筋挛骨痛∶魂门（补）
〔张仲文〕禅山灸法，治脚筋挛急。（见腰痛门。两脚内外曲交尖）
〔《撮》〕膝曲筋急不能舒∶曲泉（一寸半）
〔《怪》〕膝筋拘挛不开∶两膝（外曲交尖，灸二十七壮，即委阳穴）
〔《甲》〕两手挛不收伸及掖偏枯不仁，手 偏小筋急，大陵主之。掖拘挛，暴脉急引胁
而痛，内引心肺， 主之。
热性挛急，即《内经》所说：肝气有热则筋膜干燥，筋膜干燥则筋脉拘急而挛缩。（全文详见“痿证”门）
又说：因感受湿邪。头部沉重如被包裹，湿热不除，大筋收缩变短，小筋松弛变长，收缩变短导致拘挛，松弛变长导致痿弱之类的病证。（全文详见“阴阳”篇。朱丹溪说：大筋收缩变短，是因为热邪损伤血液不能濡养，所以出现拘挛。小筋松弛变长，是因为湿邪损伤筋脉不能约束骨骼，所以出现痿弱无力）
〔丹〕王秀，湿热之邪大作，脚痛之后，手部筋脉拘挛，足部乏力。
处方：生地黄、当归、川芎、白术（各二钱）、苍术（一钱半）、甘草（炙，三分）、木通。煎汤，送服大补丸三十丸。大补丸需炒热后服用。
〔《济生方》〕薏苡仁散：治疗筋脉拘挛，久患风湿痹证。
用法：薏苡仁（一升捣碎成粉，用水二升，取药末数匙煮粥，空腹食用。《衍义》说：筋急拘挛有两种情况，《素问》中说大筋受热，热则收缩变短，所以拘急不伸，此时可用薏苡仁。若《素问》所言因寒导致的筋急，则不可用此药）
寒性挛急，即《内经》所说：寒气多则筋脉拘挛、骨节疼痛的情况。
〔《本草衍义》〕同官县歙丞张德操，常说他妻子过去患筋挛，双脚不能屈伸，过了一年，活动时就令人感到拘紧牵拉，于是向泗水杨吉老求医。杨吉老说：这是筋的病，适宜服用以下三个方子。一年痊愈。
治疗筋极虚，养血地黄丸，春夏季节服用。
处方：熟地黄（一分）、蔓荆子（一分）、山茱萸（五分）、黑狗脊（炙）、地肤子、白术、干漆、蛴螬（炒）、天雄、车前子（各三分）、萆薢、山芋（即山药）、泽泻、牛膝（各一两）。
制法：以上药物研为细末，炼蜜调和捣匀，制成如梧桐子大小的丸剂。每次服用五十丸，温酒送下，空腹或睡前服用。
治疗筋痹引起的肢节束痛，羚羊汤，秋季服用。
处方：羚羊角、肉桂、附子、独活（各一两三钱半）、白芍、防风、川芎（各一两）。
制法：以上药物捣为粗末。每次服用五大钱，加水一盏半，生姜三片，同煎至八分，取清汁服用，每日可服二三次。
治疗寒冷湿痹留滞于筋脉，身体蜷缩不能转侧，乌头汤，冬季服用。
处方：大乌头、细辛、川椒、甘草、秦艽、附子、官桂、白芍（各七分）、干姜、白茯苓、防风（炙）、当归（各一两）、独活（一两三钱半）。
制法：以上药物捣为粗末。每次服用三钱，加水一盏半，大枣二枚，同煎至八分，去渣，空腹饭前服用。
〔《千金方》〕薏苡仁汤：治疗筋挛导致不能屈伸。
处方：白蔹、薏苡仁、芍药、桂心、酸枣仁、干姜、牛膝、甘草（各一两）、附子（三枚）。
制法：以上九味药捣碎。用醇酒三斗，浸泡一夜，微火煎煮三沸，每次服用一升，每日三次。若能扶杖行走，不耐受酒力者，服用五合。
〔李东垣〕活血通经汤：灵寿县董监军，癸卯年十二月间，大雪初晴，当时因事到真定，忽然感觉风气暴烈仆倒，诊察脉象，六脉都弦紧有力，重按洪实有力。症状表现为手挛急，大便闭涩，面赤发热，这是风寒之邪刚开始侵袭身体。四肢属于脾，风寒之邪伤人，则抽搐拘急而挛痹，这是风淫末疾，而寒邪在表。《内经》说：寒则筋挛，正是这个意思。此人平时多饮酒，体内有实热，乘袭肠胃之间，所以大便闭涩而面赤发热。内则手足阳明经受邪，外则足太阴脾经受风寒之邪。用桂枝、甘草以驱除寒邪，并缓解紧急抽搐。用黄柏之苦寒，滑利以泻实并润燥，急救肾水。用升麻、葛根以升发阳气，运行手足阳明经之气，不让其遏绝。再用桂枝的辛热，入手阳明经，作为引经药以润燥。又用芍药、甘草专门补益脾气，使不受风寒之邪，并抑制肝木之邪，专门益肺金。加人参以补元气作为辅佐，加当归身以去除里急并和血润燥，命名为活血通经汤。
处方：升麻（一钱）、葛根（一钱）、桂枝（二钱）、当归（一钱）、人参（一钱）、芍药（五分）、甘草（炙，一钱）、酒黄柏（二钱）。
制法：以上药物锉碎，如麻豆大小。全部作一服，加水二盏，煎至一盏，去渣热服。令患者在暖房中靠近火源，按摩搓揉双手即可痊愈。
虚性挛急，即《内经》所说：虚邪搏结于筋，则成为筋挛。又说：脉气不荣养则筋脉拘急（全文详见“诊生死”门）。
另外张仲景说：血虚则筋脉拘急。这些都是血脉不能荣养筋脉，而导致筋脉挛急，所以朱丹溪治疗挛急用四物汤加减，《本事方》治疗筋急至极，用养血地黄丸，大概都是基于此理。
〔《灵枢》〕黄帝说：人有八个虚处，如何用来候诊？岐伯说：用来候诊五脏。黄帝说：如何候诊？岐伯说：心肺有邪气，其气停留于两髀（大腿内侧）。肾有邪气，其气停留于两腘（膝盖后方）。凡是这八个虚处，都是关节机关之处，真气所汇聚，血脉所游注的地方。气血固守，邪气不住留。如果住留则损伤经络，骨节机关不能屈伸，所以发生挛急病。
〔丹〕一个村夫，背部佝偻且足部挛急，已成废人。我诊察他的脉象，两手脉皆沉弦而涩。于是用戴人煨肾散给他服用，服药后上吐下泻。过了一个多月，吐泻交替发作，如此共服三帖，然后平复。（煨肾散用法：用甘遂末三钱，猪腰子切开，少许盐椒腌制透彻，将药末渗入其中，用荷叶包裹烧热，温酒嚼服）
所有挛急都属于肝。《内经》说：肝主管身体的筋脉。又说：阳明之气复旺，严重时入肝，出现惊骇、筋挛。又说：脾将寒邪转移给肝，出现痈肿、筋挛。
〔《济生方》〕祛除一切风湿痹证，四肢拘挛。苍耳子三两捣成末，用水一升半，煎取七合，去渣慢慢饮用。
〔《食疗本草》〕酒煮木瓜粥，包裹在筋急疼痛处。效果佳。（方剂详见“鹤膝风”门）
《内经》针灸法：治疗挛急，有筋挛、脉挛的区别。治疗筋挛，《内经》说：病在筋，筋挛节痛不能行走，名叫筋痹，针刺筋的部位即可，针刺分肉之间，不可刺中骨头，病起于筋，筋热病愈即止（全文详见“痛痹”门）。治疗筋脉，《内经》说：手厥阴经脉变动，则出现手心热、肘腕挛急、腋肿，辨别虚实寒热，脉陷下者取之，这是取治筋脉的挛急（全文详见“针灸门十二经条”）。又说：少阳之别络，名叫外关，距离手腕二寸，肘部挛急取该别络穴位（全文详见“针灸门十五络条”）。又说：邪气客于足太阳之络，使人拘挛背急，牵引胁肋疼痛，针刺从颈部开始沿脊椎旁数脊椎，用力按压感到疼痛处，在其旁边针刺三穴（全文详见“针灸门缪刺络条”）。这是取治络脉的挛急。
〔《千金方》〕灸治筋急不能行走，内踝筋急，灸内踝四十壮；外踝筋急，灸外踝三十壮，立即痊愈。
〔《玉机微义》〕两肘俱挛：曲池（进针九分，先泻后补，补法四次呼吸，泻法九次吸气） 尺泽（手臂弯曲如弓状，方可进针五分，先补后泻）
〔张仲文〕禅山灸法，治疗脚筋挛急。（详见“腰痛”门。两脚内外侧弯曲相交尖处）
〔《怪诞集》〕膝部筋脉拘挛不能打开：双膝（外侧弯曲相交尖处，即委阳穴，灸二十七壮）
〔《甲乙经》〕两手挛急不能伸展及腋下偏枯麻木，手部肌肉消瘦偏小筋急，以大陵穴主治。腋下拘挛，突然脉急牵引胁肋疼痛，向内牵引心肺，以某穴主治（原文此处似有脱漏，通常指内关或相关穴位，但依原文只提取实体）。
Heat-induced spasm refers to what the Classics state: "When Liver Qi is hot, the fascia becomes dry; when the fascia is dry, the sinews become tense and contract." (For the full text, see the section on Atrophy Syndrome).
It also states: "Due to dampness. The head feels heavy as if wrapped. If damp-heat is not dispelled, the large sinews shorten and shrink, while the small sinews relax and lengthen. Shortening leads to constraint (spasm), and relaxing/lengthening leads to atrophy-like conditions." (For the full text, see the section on Yin and Yang. Zhu Danxi said: "The shortening of the large sinews is due to heat damaging the blood, which fails to nourish them, thus causing spasm. The relaxation and lengthening of the small sinews are due to dampness damaging the sinews, which fail to bind the bones, thus causing weakness and atrophy.")
[Dan] Wang Xiu suffered from severe damp-heat. After foot pain, his hand sinews became spasmodic, and his feet were weak.
Prescription: Shengdi Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (each 2 qian), Cang Zhu (Atractylodis Rhizoma) (1.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) (3 fen), Mu Tong (Akebiae Caulis). Decoct in water, and take with 30 pills of Da Bu Wan (Great Tonifying Pill). Da Bu Wan must be taken after being stir-fried until warm.
[Ji Sheng Fang] Yi Yi Ren San (Coix Seed Powder): Treats sinew and vessel spasms, and chronic wind-damp bi syndrome.
Usage: Yi Yi Ren (Coicis Semen) (1 sheng, pounded into powder, mixed with 2 sheng of water, take a few spoonfuls of the sediment to make porridge, eat on an empty stomach. Yan Yi states: "There are two types of acute tendon contraction. According to Su Wen, when large sinews are heated, they shrink and shorten due to heat, causing acute contraction that cannot extend; Coix Seed can be used here. However, if the contraction is due to cold as mentioned in Su Wen, it should not be used.")
Cold-induced spasm refers to what the Classics state: "When cold is excessive, sinews contract and bones ache."
[Ben Cao Yan Yi] Zhang Decao, Vice Magistrate of Tongguan County, often spoke of his wife who previously suffered from sinew spasms, unable to flex or extend her legs. After a year, any movement caused severe constraint and pulling. He sought medical advice from Yang Jilao of Sishui. Yang said: "This is a disease of the sinews, suitable for treating with the following three formulas." She recovered after one year.
To treat extreme sinew deficiency, Yang Xue Di Huang Wan (Blood-Nourishing Rehmannia Pill) is taken during spring and summer.
Prescription: Shu Di Huang (Prepared Rehmanniae Radix) (1 fen), Man Jing Zi (Vittariae Fructus) (1 fen), Shan Zhu Yu (Corni Fructus) (5 fen), Hei Gou Ji (Polystichi Rhizoma, black variety, fried), Di Fu Zi (Kochiae Fructus), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Qi (Drynariae Rhizoma? Note: Text says Gan Qi, likely Drynariae Rhizoma or similar, but literally 'Dry Lacquer' - context suggests herb), Xi Cao (Oryctodermis Larva, fried), Tian Xiong (Aconiti Lateralis Radix Praeparata? Note: Text says Tian Xiong, usually prepared Aconite root), Che Qian Zi (Plantaginis Semen) (each 3 fen), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Shan Yu (Dioscoreae Rhizoma, i.e., Shan Yao), Ze Xie (Alismatis Rhizoma), Niu Xi (Achyranthis Bidentatae Radix) (each 1 liang).
Preparation: Pound all ingredients into fine powder, mix with refined honey, and pound into pills the size of tung tree seeds. Take 50 pills each time, washed down with warm wine, on an empty stomach or before sleep.
To treat bi syndrome of sinews causing limb joint constriction pain, Ling Yang Tang (Antelope Horn Decoction) is taken in autumn.
Prescription: Ling Yang Jiao (Saiga Tataricae Cornu), Rou Gui (Cinnamomi Cortex), Fu Zi (Aconiti Lateralis Radix Praeparata), Du Huo (Angelicae Pubescentis Radix) (each 1 liang 3 qian 5 fen), Bai Shao (Paeoniae Radix Alba), Fang Feng (Saposhnikoviae Radix), Xiong (Chuan Xiong, Ligustici Chuanxiong Rhizoma) (each 1 liang).
Preparation: Pound into coarse powder. Take 5 da qian each time, add 1.5 zhan of water and 3 slices of fresh ginger, decoct until 0.8 zhan remains, strain, and drink the clear liquid. Can be taken 2-3 times daily.
To treat cold-damp-bi lingering in sinews and vessels, causing curling up and inability to turn or move, Wu Tou Tang (Aconite Decoction) is taken in winter.
Prescription: Da Wu Tou (Aconiti Radix), Xi Xin (Asari Radix et Rhizoma), Chuan Jiao (Zanthoxyli Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Qin Jiao (Gentianae Macrophyllae Radix), Fu Zi (Aconiti Lateralis Radix Praeparata), Guan Gui (Cinnamomi Cortex), Bai Shao (Paeoniae Radix Alba) (each 7 fen), Gan Jiang (Zingiberis Rhizoma Recens), Bai Fu (Bai Fu Ling, Poria), Fang Feng (Saposhnikoviae Radix, honey-fried), Dang Gui (Angelicae Sinensis Radix) (each 1 liang), Du Huo (Angelicae Pubescentis Radix) (1 liang 3 qian 5 fen).
Preparation: Pound into coarse powder. Take 3 qian each time, add 1.5 zhan of water and 2 jujubes, decoct until 0.8 zhan remains, strain, and take on an empty stomach before meals.
[Qian Jin Fang] Yi Yi Ren Tang (Coix Seed Decoction): Treats sinew spasms preventing flexion and extension.
Prescription: Bai Lian (Ampelopsis Radix), Yi Yi Ren (Coicis Semen), Shao Yao (Paeoniae Radix), Gui Xin (Cinnamomi Ramulum), Suan Zao Ren (Ziziphi Spinosae Semen), Gan Jiang (Zingiberis Rhizoma Recens), Niu Xi (Achyranthis Bidentatae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 1 liang), Fu Zi (Aconiti Lateralis Radix Praeparata) (3 pieces).
Preparation: Crush the nine herbs. Soak in 3 dou of strong wine overnight, simmer gently for three boils. Take 1 sheng each time, three times daily. If able to walk with a cane, tolerate alcohol well. Those intolerant to alcohol take 5 he.
[Li Dongyuan] Huo Xue Tong Jing Tang (Invigorating Blood and Unblocking Meridian Decoction): In December of the Gui Mao year, Dong Jianjun of Lingshou County, after heavy snow cleared, traveled to Zhending. Suddenly feeling a violent wind attack causing him to fall, pulse diagnosis revealed all six pulses were extremely wiry, forceful and full upon deep pressure. Symptoms included hand spasms, constipation, red and hot face. This was the initial invasion of wind-cold. The four limbs belong to the Spleen. When wind-cold pathogens injure the body, they cause twitching, urgency, and spasmodic bi, which is wind invading the extremities, with cold remaining on the exterior. The Nei Jing states: "Cold causes sinew contraction," which applies here. The patient usually drinks alcohol, leading to internal excess heat affecting the intestines and stomach, hence constipation and red/hot face. Internally, the Hand and Foot Yangming meridians are affected; externally, the Foot Taiyin Spleen meridian is affected by wind-cold. Use Gui Zhi (Cinnamomi Ramulus) and Gan Cao (Glycyrrhizae Radix et Rhizoma) to expel cold and relieve urgent twitching. Use Huang Bo (Phellodendri Cortex) bitter and cold, slippery to drain excess and moisten dryness, urgently saving Kidney Water. Use Sheng Ma (Cimicifugae Rhizoma) and Ge Gen (Puerariae Lobatae Radix) to raise Yang Qi and circulate Hand and Foot Yangming meridians, preventing obstruction. Further use Gui Zhi's acrid and hot nature to enter the Hand Yangming meridian as a guiding drug to moisten dryness. Use Shao Yao (Paeoniae Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) specifically to tonify Spleen Qi, preventing wind-cold invasion, suppressing Wood evil, and benefiting Lung Metal. Add Ren Shen (Ginseng Radix et Rhizoma) to tonify Yuan Qi as an assistant. Add Dang Gui Shen (Angelicae Sinensis Radix radix part) to relieve internal urgency, harmonize blood, and moisten dryness. Named Huo Xue Tong Jing Tang.
Prescription: Sheng Ma (Cimicifugae Rhizoma) (1 qian), Ge Gen (Puerariae Lobatae Radix) (1 qian), Gui Zhi (Cinnamomi Ramulus) (2 qian), Dang Gui (Angelicae Sinensis Radix) (1 qian), Ren Shen (Ginseng Radix et Rhizoma) (1 qian), Shao Yao (Paeoniae Radix) (5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) (1 qian), Jiu Bai (Jiu Huang Bo, Wine-processed Phellodendri Cortex) (2 qian).
Preparation: Cut into pieces the size of hemp seeds. Combine all as one dose, add 2 zhan of water, decoct to 1 zhan, strain, and take hot. Let the patient stay in a warm room near fire, massage and rub hands until recovery.
Deficiency-induced spasm refers to what the Classics state: "Deficient evils contend with sinews, resulting in sinew spasm." It also states: "If vessels do not nourish, sinews become tense" (Full text in Diagnosis of Life and Death section).
Additionally, Zhang Zhongjing stated: "Blood deficiency leads to sinew tension." All these indicate that blood vessels failing to nourish sinews result in spasm. Therefore, Dan Xi treats spasm using Si Wu Tang (Four Substances Decoction) modifications, and Ben Shi Fang treats extreme sinew tension with Yang Xue Di Huang Wan (Blood-Nourishing Rehmannia Pill), based on this principle.
[Ling Shu] Yellow Emperor asked: There are eight emptiness points in humans, how are they used for diagnosis? Qi Bo replied: To diagnose the five Zang organs. Yellow Emperor asked: How? Qi Bo replied: Pathogens in Heart and Lung remain in the two thighs (Bi). Pathogens in Kidney remain in the two popliteal fossae (Guo). These eight emptiness points are chambers of joints, where True Qi gathers and Blood and Qi flow. If Blood and Qi are solid, pathogens do not linger. If they linger, they damage meridians, joints cannot flex or extend, thus causing spasm.
[Dan] A villager had a hunched back and contracted feet, becoming disabled. I diagnosed his pulse as deep, wiry, and choppy in both hands. I gave him Dai Ren Wei Shen San (Dai Person's Roasted Kidney Powder), inducing vomiting and diarrhea. Over a month, vomiting and diarrhea alternated. After three doses, he recovered. (Wei Shen San usage: 3 qian of Gan Sui (Kansui Radix) powder, pig kidney sliced thinly, marinated with salt and pepper, insert powder inside, wrap in lotus leaf, heat, chew and swallow with warm wine.)
All spasms belong to the Liver. The Classics state: "The Liver governs the sinews of the body." It also states: "When Yangming rebounds severely, it enters the Liver, causing fright and sinew spasm." And: "When Spleen transfers cold to Liver, abscesses and sinew spasms occur."
[Ji Sheng Fang] Dispels all wind-damp bi and limb spasms. Cang Er Zi (Xanthii Fructus) 3 liang, pounded to powder, decoct in 1.5 sheng water to obtain 7 he, strain, and sip slowly.
[Shi Liao Ben Cao] Wine-boiled Mu Gua (Chaenomelis Fructus) porridge, applied to wrap painful areas of acute sinew tension. Excellent. (Formula seen in Crane Knee Wind section).
Nei Jing Acupuncture Method: Treating spasm distinguishes between sinew spasm and vessel spasm. For sinew spasm, the Classics state: "Disease in sinews, sinew spasm with joint pain, inability to walk, named Sinew Bi. Prick the sinews. Prick between muscle divisions, do not hit bone. When disease originates in sinews, stop when sinews feel warm and disease resolves" (Full text in Painful Bi section). For sinew-vessels, the Classics state: "Hand Jueyin meridian changes cause palm heat, elbow/wrist spasm, axillary swelling. Differentiate deficiency/excess, cold/heat. If sunken, extract. This is treating sinew-vessel spasm" (Full text in Acupuncture Section Twelve Meridians). Also: "The divergent channel of Shaoyang is named Waiguan (TE5), 2 cun from wrist. Elbow spasm takes this divergent point" (Full text in Acupuncture Section Fifteen Luo Vessels). Also: "Evil lodging in Foot Taiyin collateral causes rigid back, pulling胁 pain. Prick starting from neck, count vertebrae beside spine, press hard until tender, prick beside it three times" (Full text in Acupuncture Section Miao Ci Collaterals). This treats collateral spasm.
[Qian Jin Fang] Moxibustion for sinew tension preventing walking: Inner ankle sinew tension, moxa 40 cones on inner ankle; outer ankle sinew tension, moxa 30 cones on outer ankle, immediate cure.
[Yu Ji Wei Yi] Both elbows spasmodic: Qu Chi (LI11) (Insert 9 fen, first reduce then tonify, tonify 4 breaths, reduce 9 inhalations). Chi Ze (LU5) (Arm bent like a bow, insert 5 fen, first tonify then reduce).
[Biao You Fu] Sinew spasm and bone pain: Hun Men (BL47) (Tonify).
[Zhang Zhongwen] Chan Mountain Moxibustion Method: Treats foot sinew spasms. (See Low Back Pain section. Where the inner and outer curves of both feet meet at the tip).
[Cuo Yao] Knee flexion sinew tension unable to extend: Qu Quan (LR8) (Insert 1.5 cun).
[Guai Dan Ji) Knee sinew constraint unable to open: Both knees (Outer curve meeting tip, i.e., Wei Yang (BL39), moxa 27 cones).
[Jia Yi Jing) Both hands spasmodic unable to extend, axillary hemiplegia and numbness, hand muscles wasted small sinew tension: Da Ling (PC7) governs. Axillary constraint, sudden vessel tension pulling胁 pain, inward pulling Heart/Lung: [Missing Character in Source, likely Neiguan PC6 or similar, but source text has gap] governs.