喻昌曰∶六淫之邪，至于成痉，乃病证之最多最深最恶最易惑人者。轩岐仲景，奥中之奥，后世罔解。因至肆无忌
惮，凿空妄谭，此唱彼和，夭枉接踵，岂操生人之术以杀人耶！繇辨之不蚤辨耳。夫痉者，强也。后名为 ，传者之误
也。《素问》谓诸痉项强，皆属于湿，是病机颛主于湿矣。《千金》推展其义，谓太阳中风，重感寒湿则变痉，见太阳中
风身必多汗，或衣被不更，寒湿内袭，或重感天时之寒，地气之湿，因而变痉，是合风寒湿三者以论痉矣。《金匮》以
痉湿 名篇，又合热暑湿三者言之，然所谓柔痉、刚痉，未尝不兼及风寒。且亦云发汗过多因致痉，见夏月人本多汗，
尤不可过发其汗也。古今言痉之书止此，后世王海藏论痉，知宗仲景，虽识有未充，要亦识大之贤矣。《伤寒论》载痉
病五条，《尚论篇》中已明之。兹复详《金匮》所增十条，其旨已悉，然终古大惑，不立论以破其疑，心有未慊。诚以
仲景论
痉病，所举者太阳一经耳。后之治此病者，谓太阳行身之背，故颈项强，背反张，属在太阳，而用《金匮》桂枝葛根二
方。茫不应手，每归咎仲景之未备，不思外感六淫之邪，由太阳而传六经，乃自然之行度，邪不尽传即不已，故三阳三
阴皆足致痉。仲景之书，通身手眼，虽未明言，其隐而不发之旨，未尝不跃然心目。如太阳之传阳明项背KT KT ，
少阳之颈项强，是知三阳皆有痉矣。而三阴岂曰无之？海藏谓三阳太阴皆病痉，独不及少阴厥阴。云背反张属太阳，低
头视下，手足牵引，肘膝相构，属阳明。一目或左或右斜视，一手一足搐搦，属少阳。发热脉沉细腹痛，属太阴。以防
风当归汤治太阳阳明，发汗过多而致痉者。以柴胡加防风汤治少阳汗后不解，寒热往来而成痉者。虽不及少阴厥阴，然
其制附子散、桂心白术汤、附子防风散，意原有在。观其白术汤下云∶上解三阳，下安太阴。一种苦心，无非谓传入少
阴厥阴必成死证耳。讵知传经之邪，如风雨之来，而画地以限其不至，岂可得乎？况足少阴厥阴之痉，不死者亦多。《灵
枢》谓足少阴之经筋，循脊内侠膂，上至顶与足太阳筋合，其病在此，为主 及痉。在外阳病者不能俯，在内阴病者
不能仰。是则足少阴之藏，与足太阳之府。两相联系，而以不能俯者，知为太阳主外。不能仰者，知为少阴主内，其辨
精矣。《素问》亦谓太阳者，一日而主外，则二日阳明，三日少阳之主外，从可识矣。少阴主内，则太阴厥阴之主内，
从
可识矣。仲景之以头强脊强不能俯者，指为太阳之痉，原以该三阳也。而其以身蜷足蜷不能仰者，指为少阴之痉，以该
三阴。实所谓引而不发，跃然心目者也。《素问》谓肾病者善胀，尻以代踵，脊以代头，形容少阴病俯而不能仰之状更着。
海藏谓低头视下，肘膝相构，正不能仰之阴病，反指为阳明之痉，立言殊有未确。况仲景谓少阴病下利，若利自止，恶
寒而蜷卧，手足温者可治。又谓少阴病，恶寒而蜷，时自烦，欲去衣被者可治，言可用温以治之也。然仲景于太阳证，
独见背恶寒者，无俟其身蜷，蚤已从阴急温，而预救其不能仰。于少阴证而见口燥咽干，及下利纯清水者，无俟项背牵
强，蚤已从阳急下，而预救其不能俯。盖藏阴之盛，府有先征；府阳之极，入藏立槁，此皆神而明之之事。后代诸贤，
非不心维其义，究莫能口赞一辞，亦可见由贤希圣，升天之难。若不肖者之涉诞，则坠渊之易矣。即如小儿之体脆神怯，
不耐外感壮热，多成痉病。后世妄以惊风立名，有四证生八候之凿说，实则指痉病之头摇手劲者，为惊风之抽掣。指痉
病之卒口噤脚挛急者，为惊风之搐搦。指痉病之背反张者，为惊风之角弓反张。幼科翕然宗之，病家坦然任之，不治外
淫之邪，反投金石脑麝之药，千中千死而不悟也。又如新产妇人，血舍空虚，外风袭入，而成痉病。仲景之所明言，不
肖者罔顾悖圣，辄称产后惊风，妄投汤药，亦千中千死而不悟也。昌不惜金度针人，其如若辈之不受度者，转生仇恨，
何哉？可慨也已！
喻昌说：六淫（风、寒、暑、湿、燥、火六种外感病邪）之邪，发展到形成痉病（以项背强直、口噤不开、甚至角弓反张为主要表现的病证），是病证中最常见、最深重、最恶劣、最容易迷惑人的。黄帝、岐伯以及张仲景的医理，深奥中的深奥，后世之人大多无法理解。因此导致人们肆无忌惮，凭空妄谈，此唱彼和，致使夭折枉死的人接踵而至，这难道是掌握救人医术的人在杀人吗！这是因为辨析得不够早罢了。所谓“痉”，就是僵硬的意思。后来被称为“痓”（chì，同痉，指筋脉拘急），是传抄者的错误。《素问》说各种痉病出现的颈项强直，都归属于湿，这是病机专门主于湿。《千金方》推展其义，说太阳中风证，如果再感受寒湿就会变成痉病，看到太阳中风证身体必然多汗，或者衣被不更换，寒湿内袭，或者再次感受天时之寒、地气之湿，因而变成痉病，这是结合了风、寒、湿三者来论述痉病。《金匮要略》以“痉湿暍”名篇，又结合了热、暑、湿三者来说，然而所说的柔痉、刚痉，未尝不涉及风、寒。并且也说发汗过多导致痉病，可见夏季人本来多汗，尤其不可过度发汗。古今论述痉病的书只有这些，后世王海藏论述痉病，知道尊崇张仲景，虽然见识还不够充实，但也算是见识宏大的贤者了。《伤寒论》记载了五条痉病条文，《尚论篇》中已经阐明。这里再详细阐述《金匮要略》所增加的十条，其旨意已经完全知晓，然而千古大惑不解，如果不立论来破除疑惑，心中感到不满意。诚然因为张仲景论述痉病，所列举的只是太阳一经而已。后世的医生治疗这种病，认为太阳经行于背部，所以颈项强直、背部反张，属于太阳经，而使用《金匮要略》中的桂枝加葛根汤、葛根汤两个方剂。茫然无应验，往往归咎于张仲景论述不完备，不想想外感六淫之邪，由太阳经传入其他六经，是自然的传变规律，邪气不传尽就不会停止，所以三阳经和三阴经都足以导致痉病。张仲景的书，通身都是手眼，虽然没有明说，但其含蓄不发露的旨意，未尝不在心目间跃然显现。比如太阳经传入阳明经出现项背强几几（形容项背拘紧不舒），少阳经出现颈项强直，这就知道三阳经都有痉病了。那么三阴经难道就没有吗？王海藏说三阳经和太阴经都会病痉，唯独不及少阴经和厥阴经。他说背部反张属于太阳经，低头视下，手足牵引，肘膝相凑，属于阳明经；一眼或左或右斜视，一手一足抽搐，属于少阳经；发热脉沉细腹痛，属于太阴经。用防风当归汤治疗太阳阳明经因发汗过多而导致痉病的患者。用柴胡加防风汤治疗少阳经发汗后不解，寒热往来而成痉病的患者。虽然不及少阴经和厥阴经，然而他制定的附子散、桂心白术汤、附子防风散，用意原本就在这里。看他在白术汤下注解说：“上解三阳，下安太阴。”一种苦心，无非是说传入少阴经和厥阴经必定成为死证罢了。哪里知道传经的邪气，像风雨一样袭来，却画地为牢限制它不到达，怎么可能呢？况且足少阴经和足厥阴经的痉病，不死的人也很多。《灵枢》说足少阴经的经筋，沿着脊柱内部夹着脊肉，上至头顶与足太阳经的筋汇合，病症发生在这里，主要表现为俯不能仰及痉病。在外侧阳经发病者不能俯身，在内侧阴经发病者不能仰头。这样足少阴脏与足太阳腑，两者相互联系，而从不能俯身可知为太阳主外，从不能仰头可知为少阴主内，辨析非常精微。《素问》也说太阳经一日主外，那么二日阳明、三日少阳主外，从此可以认识。少阴主内，那么太阴、厥阴主内，从此可以认识。张仲景将头强、脊强、不能俯身的，指为太阳经的痉病，原意是涵盖三阳经。而他将以身蜷缩、足蜷缩、不能仰头的，指为少阴经的痉病，以涵盖三阴经。这实在是所谓的引而不发，在心目间跃然显现。《素问》说肾病的人容易腹胀，屁股代替脚跟走路，脊背代替头部抬起，形容少阴病俯而不能仰的状态更加显著。王海藏说低头视下，肘膝相凑，正是不能仰头的阴病，反而指为阳明经的痉病，立言确实有不准确之处。况且张仲景说少阴病下利，如果利自止，恶寒而蜷卧，手足温的，可治。又说少阴病，恶寒而蜷，时常自觉烦闷，想要去掉衣被的，可治，意思是可用温法治疗。然而张仲景对于太阳证，唯独见到背恶寒的，不需要等到其身蜷缩，早就应当从阴急温，预先救治其不能仰的情况。对于少阴证而见口燥咽干，以及下利纯清水的，不需要等到项背牵强，早就应当从阳急下，预先救治其不能俯的情况。大概脏阴之气过盛，腑有先兆；腑阳之气极盛，入脏立刻枯槁，这都是神妙明察的事情。后代各位贤者，并非不心中思考其义理，终究不能口头称赞一句，也可见由贤人希求圣人，升天之难。不像那些不肖之徒涉猎荒诞之说，则是坠入深渊之易。就像小儿体质脆弱、神气怯弱，不耐受外感壮热，多形成痉病。后世胡乱以惊风立名，有四证生八候的穿凿之说，实际上是将痉病头摇手劲的，说成是惊风的抽掣；将痉病突然口噤脚挛急的，说成是惊风的搐搦；将痉病背部反张的，说成是惊风的角弓反张。儿科医生一致尊崇，病人家属坦然听任，不治疗外感六淫之邪，反而投用金石、脑麝等药物，千次治疗千次死亡而不醒悟。又如新产后的妇女，血舍空虚，外风袭入，而成痉病。这是张仲景明确说明的，不肖之徒不顾违背圣训，辄且称产后惊风，胡乱投药，也是千次治疗千次死亡而不醒悟。我不惜金玉般珍贵的针石去度化世人，对于那些不接受度化的人，反而产生仇恨，为什么呢？真是令人感慨啊！
Yu Chang said: When the pathogenic factors of the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) develop into Jing disease (a syndrome characterized by stiffness and spasm of the neck and back, trismus, and opisthotonos), it is one of the most common, profound, severe, and confusing syndromes. The medical principles of Huangdi (Yellow Emperor), Qibo (Grand Duke Qi), and Zhang Zhongjing are profound beyond measure, yet later generations largely fail to comprehend them. Consequently, people act without restraint, making baseless speculations; one sings and another echoes, leading to a succession of premature deaths. Is this not using the art of saving lives to kill? It is precisely because differentiation was not performed early enough. "Jing" means stiffness. It was later named "Chi" (synonymous with Jing, referring to tendon spasms), which is an error of transmission. The *Suwen* states that various Jing syndromes presenting with neck stiffness belong to Dampness, indicating that the pathogenesis is primarily governed by Dampness. The *Qianjin Fang* expands on this meaning, stating that if Taiyang Wind-stroke is compounded by Cold and Dampness, it transforms into Jing. Noting that Taiyang Wind-stroke involves profuse sweating, or failure to change clothes when sweaty, allowing Cold and Dampness to invade internally, or being re-exposed to seasonal Cold and terrestrial Dampness, thereby transforming into Jing, this approach combines Wind, Cold, and Dampness to discuss Jing. The *Jingui Yaolue* titles its chapter "Jing, Shi, and E," combining Heat, Summerheat, and Dampness in its discussion. However, the mentioned Rou-Jing (Soft Jing) and Gang-Jing (Hard Jing) do involve Wind and Cold. It also states that excessive sweating can cause Jing, implying that since people sweat naturally in summer, one must be especially cautious against excessive diaphoresis. Ancient and modern texts on Jing are limited to these works. Later, Wang Haicang discussed Jing, acknowledging Zhang Zhongjing as his source; although his insights were not fully comprehensive, he was undoubtedly a sage of broad vision. The *Shanghan Lun* records five clauses on Jing disease, which have already been clarified in the *Shanglun Pian*. Here, I will elaborate on the ten additional clauses added in the *Jingui Yaolue*, whose purport is now clear. However, given the enduring confusion throughout history, if I do not establish a treatise to dispel doubts, my heart remains unsatisfied. Indeed, Zhang Zhongjing’s discussion of Jing disease focuses solely on the Taiyang channel. Later physicians treating this disease argue that since the Taiyang channel runs along the back, neck stiffness and back arching belong to Taiyang, and thus they use the Guizhi Jia Gegen Tang (Cinnamon Twig plus Kudzu Decoction) and Gegen Tang (Kudzu Decoction) from the *Jingui Yaolue*. These treatments often fail to produce results, and practitioners frequently blame Zhang Zhongjing for incompleteness, failing to realize that exogenous Six Excess pathogens transmit from Taiyang through the Six Channels as a natural progression; the pathogen does not cease until transmission is complete. Therefore, all Three Yang and Three Yin channels can lead to Jing. Zhang Zhongjing’s writings are full of insight; though not explicitly stated, his implicit meanings are vividly apparent. For instance, when Taiyang transmits to Yangming, causing neck and back stiffness (described as "Ji Ji"), or Shaoyang presents with neck stiffness, it is evident that all Three Yang channels can suffer from Jing. Do not the Three Yin channels also experience this? Wang Haicang stated that the Three Yang channels and Taiyin channel can suffer from Jing, omitting Shaoyin and Jueyin. He claimed that back arching belongs to Taiyang; lowering the head to look down, with limbs pulling together and elbows/knees meeting, belongs to Yangming; unilateral eye deviation with limb twitching belongs to Shaoyang; fever, deep/thready pulse, and abdominal pain belong to Taiyin. He used Fangfeng Danggui Tang (Saposhnikovia and Angelica Decoction) for Taiyang/Yangming Jing caused by excessive sweating, and Chaihu Jia Fangfeng Tang (Bupleurum plus Saposhnikovia Decoction) for Shaoyang Jing following failed sweating therapy with alternating chills and fever. Although he omitted Shaoyin and Jueyin, his formulations such as Fuzi San (Aconite Powder), Guixin Baizhu Tang (Cinnamon Heart and Atractylodes Macrocephala Decoction), and Fuzi Fangfeng San (Aconite and Saposhnikovia Powder) imply their relevance. His note under Baizhu Tang—"Upper resolves the Three Yang, lower stabilizes Taiyin"—reveals his intent: he likely believed transmission to Shaoyin and Jueyin inevitably leads to death. Yet, how can one restrict pathogenic transmission like wind and rain by drawing boundaries? Moreover, many patients with Shaoyin and Jueyin Jing survive. The *Lingshu* states that the foot-Shaoyin tendon system runs along the interior of the spine, up to the vertex, merging with the foot-Taiyang tendons. Pathology here manifests as inability to bend forward and Jing. External Yang pathology prevents bending forward; internal Yin pathology prevents extending backward. Thus, foot-Shaoyin (Zang) and foot-Taiyang (Fu) are interconnected; inability to bend indicates Taiyang governs the exterior, while inability to extend indicates Shaoyin governs the interior—a precise differentiation. The *Suwen* also notes Taiyang governs the exterior on day one, implying Yangming and Shaoyang follow suit for the exterior. Shaoyin governs the interior, implying Taiyin and Jueyin follow for the interior. Zhang Zhongjing identified head/back stiffness and inability to bend as Taiyang Jing, encompassing the Three Yang. He identified body/leg curling and inability to extend as Shaoyin Jing, encompassing the Three Yin. This is indeed "leading without revealing," vividly present in mind and eye. The *Suwen* describes Kidney disease as prone to distension, where the patient sits on the buttocks instead of heels, and bows the spine instead of lifting the head, vividly depicting the Shaoyin inability to extend. Wang Haicang’s classification of downward gaze and elbow-knee convergence as Yangming Jing is inaccurate, as these are signs of Yin pathology preventing extension. Furthermore, Zhang Zhongjing stated that in Shaoyin disease with diarrhea, if diarrhea stops spontaneously, accompanied by aversion to cold and curling up, but with warm hands and feet, it is treatable. Also, if there is aversion to cold, curling up, occasional irritability, and desire to remove coverings, it is treatable with warming methods. Regarding Taiyang syndrome, if only back aversion to cold is seen, before curling occurs, one should urgently warm the Yin to prevent inability to extend. In Shaoyin syndrome, if dry mouth/throat or pure watery diarrhea appears, before neck/back stiffness occurs, one should urgently purge the Yang to prevent inability to bend. When Zang Yin is excessive, Fu organs show signs first; when Fu Yang is extreme, entering Zang leads to withering. These are matters of divine clarity. Later sages pondered these principles but could not articulate them, showing the difficulty of rising from Sagehood to Perfection, unlike fools who easily fall into abyssal absurdity. Consider children, whose fragile constitution cannot withstand high fever from exogenous pathogens, often developing Jing. Later practitioners erroneously named this "Jing Feng" (Convulsive Wind), inventing theories of "Four Syndromes generating Eight Signs." They misidentified Jing symptoms: head shaking and hand rigidity as convulsive jerking; sudden trismus and foot cramping as spasms; back arching as opisthotonos. Pediatricians adopted this blindly, and families accepted it passively. Instead of treating exogenous pathogens, they administered mineral, borneol, and musk drugs, resulting in death after every attempt, without realization. Similarly, postpartum women, with empty blood reservoirs, are susceptible to external Wind invasion, causing Jing. Zhang Zhongjing clearly stated this, yet ignoramuses ignored the sages, falsely diagnosing "Postpartum Convulsive Wind" and administering wrong medicines, again leading to death without awakening. I spare no effort to guide others with precious knowledge, yet those who refuse guidance turn hostile. How lamentable!