之为言痉也。痉直而不柔和也。凡病至此。实危且迫。仲景以有汗无汗
分刚与柔。尤当以失汗过汗分实与虚可也。如云太阳中风。重感寒湿则
成。盖湿伤筋则拘挛。寒入骨则强直。小续命汤。有汗去麻黄。无汗去附
子治之。此因邪气盛。而筋脉为之不利也。如云大发湿家汗。则成 。盖湿
流肢节。大发其汗。则湿气复袭而侵之。筋脉重伤。关节不利。宜秦艽等舒
筋利湿以和之。如云发产后病后失血疮家汗。则成 盖气血既亏。复耗
其液。则筋脉失所滋养。而角弓反张之症见。乃气血大损故也。立斋以十
全大补参附归脾肾气等汤。随症选用。实有卓见。若作风治。则失之矣。
小续命汤
麻黄（去节） 人参（去芦） 黄芩 芍药（酒炒） 甘草（炙）
川芎 杏仁（去皮尖炒） 防己 官桂（各一两） 防风（一两半）
附子（炮去皮脐五钱）
每服五钱。姜五片。水煎服。刚 去附子。柔 减麻黄。
秦艽升麻汤
升麻 葛根 甘草（炙） 芍药（炒） 人参（各五钱） 秦艽 白芷 防风 桂枝（各三钱）
每服一两。葱白三茎。水煎。
十全大补汤
肉桂（去皮） 甘草（炙） 芍药（炒） 黄 （蜜炙） 当归（酒净）
川芎 人参（去芦） 白术（土炒） 茯苓 熟地黄（各等分）
每服六钱。姜三片。枣二枚。水煎。
人参养荣汤
白芍药（一钱五分酒炒） 人参 黄 （蜜炙） 白术（土炒） 炙甘草
陈皮 桂心 当归（各一钱） 熟地黄 五味子（杵） 茯苓（各七分） 远志肉（五分）
姜枣水煎。
“痉”这个字的含义就是筋脉拘急僵硬。所谓痉，是指身体挺直且不能柔和屈伸的状态。凡是疾病发展到这种程度，既危险又紧迫。张仲景根据患者有汗还是无汗，将痉病分为刚痉和柔痉两种类型；更重要的是，应当根据是否误用发汗法或发汗过度，来区分实证与虚证。
例如，有的情况是太阳中风证，又重感寒湿邪气而形成的。因为湿气损伤筋脉会导致拘挛，寒气深入骨骼则导致强直。这种情况可用小续命汤治疗：如果有汗，去掉麻黄；如果无汗，去掉附子。这是因为邪气盛实，导致筋脉功能不利。
又如，对于素患湿病的患者（湿家），如果大发其汗，则会形成痉病。因为湿气流注于四肢关节，若大发其汗，湿气反而再次侵袭并深入体内，导致筋脉受到严重伤害，关节活动不利。适宜使用秦艽等药物来舒缓筋脉、利湿和解。
再如，产后病后、失血患者或疮疡患者，如果误发其汗，也会形成痉病。这是因为气血已经亏虚，如果再耗伤津液，就会导致筋脉失去滋养，从而出现角弓反张的症状，这是气血大损的缘故。薛立斋（薛己）主张使用十全大补汤、参附汤、归脾汤、肾气丸等方剂，根据具体症状选用，确实有独到的见解。如果按照风邪来治疗，那就错了。
小续命汤
麻黄（去节） 人参（去芦） 黄芩 芍药（酒炒） 甘草（炙）
川芎 杏仁（去皮尖炒） 防己 官桂（各一两） 防风（一两半）
附子（炮去皮脐五钱）
每次服用五钱，加生姜五片，水煎服。刚痉去掉附子，柔痉减少麻黄用量。
秦艽升麻汤
升麻 葛根 甘草（炙） 芍药（炒） 人参（各五钱） 秦艽 白芷 防风 桂枝（各三钱）
每次服用一两，加葱白三茎，水煎服。
十全大补汤
肉桂（去皮） 甘草（炙） 芍药（炒） 黄芪（蜜炙） 当归（酒净）
川芎 人参（去芦） 白术（土炒） 茯苓 熟地黄（各等分）
每次服用六钱，加生姜三片，大枣二枚，水煎服。
人参养荣汤
白芍药（一钱五分酒炒） 人参 黄芪（蜜炙） 白术（土炒） 炙甘草
陈皮 桂心 当归（各一钱） 熟地黄 五味子（杵碎） 茯苓（各七分） 远志肉（五分）
加生姜、大枣，水煎服。
The term "Jing" (Spasm/Stiffness) refers to the condition of tendon constriction and stiffness. Jing is characterized by the body being straight and unable to flex or relax smoothly. When a disease progresses to this stage, it becomes both critical and urgent. Zhang Zhongjing classified Jing into Gang Jing (Rigid Spasm) and Rou Jing (Flexible Spasm) based on the presence or absence of sweating. More importantly, one should distinguish between Excess (Shi) and Deficiency (Xu) patterns based on whether diaphoresis was misused or excessive.
For instance, some cases arise from Taiyang Wind Strike syndrome compounded by cold-dampness. Dampness damages the tendons leading to cramping, while cold entering the bones leads to rigidity. Xiao Xuming Tang (Minor Decoction for Continuing Life) can be used: if there is sweating, remove Ephedrae Herba (Mahuang); if there is no sweating, remove Aconiti Lateralis Radix Praeparata (Fuzi). This is because the pathogenic factors are abundant, causing dysfunction of the tendons and vessels.
Another scenario involves patients with chronic dampness (Shijia). If heavy diaphoresis is induced, Jing may develop. Since dampness flows through the limbs and joints, excessive sweating allows dampness to re-invade and penetrate deeper, severely injuring the tendons and vessels and impairing joint mobility. It is appropriate to use herbs such as Gentianae Macrophyllae Radix (Qinqiang) to soothe the tendons, promote diuresis, and harmonize the body.
Furthermore, in postpartum patients, those after illness, patients with blood loss, or those with sores/ulcers, inducing sweating can also lead to Jing. This occurs because Qi and Blood are already deficient; further depletion of fluids causes the tendons and vessels to lose nourishment, resulting in opisthotonos (rigid arching of the back like a bow). This is due to severe damage to Qi and Blood. Xue Lizhai (Xue Ji) advocated using formulas such as Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction), Shenfu Tang (Ginseng and Aconite Decoction), Guipi Tang (Restore the Spleen Decoction), and Shenqi Wan (Kidney Qi Pill), selected according to specific symptoms. This demonstrates profound insight. Treating these conditions as Wind disorders would be erroneous.
Xiao Xuming Tang (Minor Decoction for Continuing Life)
Ephedrae Herba (Mahuang, 麻黄) [stems removed]
Panax Ginseng Radix et Rhizoma (Renshen, 人参) [rhizome removed]
Scutellariae Radix (Huangqin, 黄芩)
Paeoniae Radix Alba (Shaoyao, 芍药) [stir-fried with wine]
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted]
Chuanxiong Rhizoma (Chuanxiong, 川芎)
Prunus Armeniaca Semen (Xingren, 杏仁) [skin and tips removed, stir-fried]
Stephaniae Tetrandrae Radix (Fangji, 防己)
Cinnamomi Ramulus (Guigui, 官桂) [each 1 liang]
Saposhnikoviae Radix (Fangfeng, 防风) [1.5 liang]
Aconiti Lateralis Radix Praeparata (Fuzi, 附子) [processed, skin and navel removed, 5 qian]
Take 5 qian per dose, add 5 slices of Zingiberis Rhizoma Recens (Shengjiang, 生姜), decoct in water and take orally. For Gang Jing, remove Fuzi; for Rou Jing, reduce the amount of Mahuang.
Qinqiang Shengma Tang (Gentian Macrophylla and Cimicifuga Decoction)
Cimicifugae Rhizoma (Shengma, 升麻)
Puerariae Lobatae Radix (Gegen, 葛根)
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted]
Paeoniae Radix Alba (Shaoyao, 芍药) [stir-fried]
Panax Ginseng Radix et Rhizoma (Renshen, 人参) [each 5 qian]
Gentianae Macrophyllae Radix (Qinqiang, 秦艽)
Angelicae Dahuricae Radix (Baizhi, 白芷)
Saposhnikoviae Radix (Fangfeng, 防风)
Cinnamomi Ramulus (Guizhi, 桂枝) [each 3 qian]
Take 1 liang per dose, add 3 stems of Allii Fistulosi Bulbus (Congbai, 葱白), decoct in water.
Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction)
Cinnamomi Cortex (Rougui, 肉桂) [bark removed]
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted]
Paeoniae Radix Alba (Shaoyao, 芍药) [stir-fried]
Astragali Membranacei Radix (Huangqi, 黄芪) [honey-roasted]
Angelicae Sinensis Radix (Danggui, 当归) [washed with wine]
Chuanxiong Rhizoma (Chuanxiong, 川芎)
Panax Ginseng Radix et Rhizoma (Renshen, 人参) [rhizome removed]
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) [soil-stir-fried]
Poria (Fuling, 茯苓)
Rehmanniae Radix Praeparata (Shudihuang, 熟地黄) [equal parts]
Take 6 qian per dose, add 3 slices of Zingiberis Rhizoma Recens (Shengjiang, 生姜) and 2 Jujubae Fructus (Zao, 大枣), decoct in water.
Renshen Yangrong Tang (Ginseng Nourishing Harmony Decoction)
Paeoniae Radix Alba (Baishaoyao, 白芍药) [1.5 qian, stir-fried with wine]
Panax Ginseng Radix et Rhizoma (Renshen, 人参)
Astragali Membranacei Radix (Huangqi, 黄芪) [honey-roasted]
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) [soil-stir-fried]
Glycyrrhizae Radix et Rhizoma (Zhigancao, 炙甘草)
Chenpi (Citri Reticulatae Pericarpium, 陈皮)
Guixin (Cinnamomi Cortex, 桂心)
Angelicae Sinensis Radix (Danggui, 当归) [each 1 qian]
Rehmanniae Radix Praeparata (Shudihuang, 熟地黄)
Schisandrae Chinensis Fructus (Wuweizi, 五味子) [crushed]
Poria (Fuling, 茯苓) [each 0.7 qian]
Polygalae Radix (Yuanzhi, 远志肉) [0.5 qian]
Decoct with Zingiberis Rhizoma Recens (Shengjiang, 生姜) and Jujubae Fructus (Zao, 大枣).