论曰柔 之状，摇头发热，颈项强急，腰身反张，或螈 口噤，与刚 同，然谓之柔
者，特以其自汗不恶寒故也， 又谓之痉者，盖痉 一类，古人特以强直名之。
治伤寒柔 ，项背强几几，反汗出恶风。桂枝加葛根汤方
葛根（四两） 麻黄（去节煎掠去沫焙） 芍药（各三两） 甘草（炙锉） 桂（去粗
皮各二两）
上五味，粗捣筛，每服五钱匕，水二盏，入生姜五片，大枣两枚劈破，煎至一盏，去滓
温服，良久再服，以衣被覆微汗出瘥，不须啜粥。
治伤寒柔 ，手足厥冷，筋急汗不止，桂术汤方
桂（去粗皮一两） 白术 人参 附子（炮裂去脐皮各三分） 防风（去叉） 干姜（炮）
甘草（炙各半两）
上七味，锉如麻豆，每服五钱匕，水一盏半，煎至八分，去滓温服，日二服。
治伤寒柔 ，手足逆冷，筋脉拘急，汗出不止，颈项强直，摇头口噤。附子白术汤方
附子（炮裂去皮脐） 白术（各一两） 芎 （三分） 独活（去芦头） 桂（去粗皮
各半两）
上五味，锉如麻豆，每服三钱匕，水一盏，入生姜半分拍碎，枣二枚劈破，同煎至七分，
去滓温服，不计时候。
治伤寒柔 汗出，身体强直，手足多寒。五味子汤方
五味子（炒一两） 附子（炮裂去脐皮） 木香 槟榔（各三分） 白术 桂（去粗皮）
干姜（炮） 甘草（炙各半两）
上八味，锉如麻豆，每服五钱匕，水一盏半，煎至八分，去滓食后温服，晚再服。
治伤寒柔 ，身体强直，汗出不止，腹内急痛。附子散方
附子（炮裂去皮脐） 干姜（炮） 甘草（炙锉） 桂（去粗皮） 人参（各半两）
上五味，捣罗为散，每服二钱匕，以姜粥饮调下，不拘时。
治时行及伤寒后，虚弱发即闭眼合面者，柔 之候也，手足厥冷，筋脉强急，汗出不止。
姜
干姜（炮） 白术 桂（去粗皮各一两） 附子（炮裂去脐皮） 甘草（炙各半两） 防
风（去叉一两）
上六味，锉如麻豆，每服五钱匕，用水一盏半，煎至八分，去滓温服。
治伤寒柔 ，四肢逆冷，汗不止，腹中痛，筋脉急。柴胡饮方
柴胡（去苗） 赤茯苓（去黑皮各三分） 槟榔（煨锉） 五味子（炒各半两） 桂（去
粗皮） 高良姜 羌活（去芦头各一分）
上七味，粗捣筛，每服五钱匕，用水一盏半，煎至八分，去滓温服。
治伤寒柔 病经三日不瘥，恐阴气攻五脏致损。茯苓汤方
赤茯苓（去黑皮） 五味子（炒） 麦门冬（去心焙各二两） 柴胡（去苗一两半） 桂
（去粗皮一两） 槟榔（锉） 细辛（去苗叶各半两）
上七味，粗捣筛，每服四钱匕，水一大盏，煎至六分，去滓温服。
论述说：柔痉（一种以项背强直、角弓反张为特征的病证，因伴有汗出而得名）的症状表现为摇头、发热、颈项僵硬紧急、腰身向后反折如弓状，有时出现肢体抽搐、牙关紧闭，这些症状与刚痉相同。之所以称为“柔”，特别是因为患者自汗出且不恶寒的缘故。“痉”又被称为痉病，大概是因为这类病症古人特以身体强直来命名。
治疗伤寒引起的柔痉，症见项背部僵硬拘紧，反而有汗出且怕风。使用桂枝加葛根汤方：
葛根（四两）、麻黄（去掉节，煎煮时撇去浮沫，焙干）、芍药（各三两）、甘草（炙过并切碎）、桂枝（去掉粗皮，各二两）。
以上五味药，捣碎并筛成粗末，每次服用五钱匕，加水两盏，放入生姜五片、大枣两枚掰破，煎煮至一盏，滤去药渣，温服。隔一段时间再服一次，用衣被覆盖使微微出汗即可痊愈，不需要喝热粥助汗。
治疗伤寒引起的柔痉，症见手脚冰凉，筋脉拘急且汗出不止。使用桂术汤方：
桂枝（去掉粗皮一两）、白术、人参、附子（炮裂后去掉脐皮，各三分）、防风（去掉叉枝）、干姜（炮制）、甘草（炙过，各半两）。
以上七味药，锉成如麻豆大小的颗粒，每次服用五钱匕，加水一盏半，煎煮至八分，滤去药渣，温服，每日两次。
治疗伤寒引起的柔痉，症见手脚逆冷，筋脉拘急，汗出不止，颈项强直，摇头且牙关紧闭。使用附子白术汤方：
附子（炮裂后去皮和脐）、白术（各一两）、川芎（三分）、独活（去掉芦头）、桂枝（去掉粗皮，各半两）。
以上五味药，锉成如麻豆大小的颗粒，每次服用三钱匕，加水一盏，放入生姜半分拍碎，大枣两枚掰破，一同煎煮至七分，滤去药渣，温服，不限具体时间。
治疗伤寒引起的柔痉，症见汗出，身体强直，手脚多寒冷。使用五味子汤方：
五味子（炒制一两）、附子（炮裂后去掉脐皮）、木香、槟榔（各三分）、白术、桂枝（去掉粗皮）、干姜（炮制）、甘草（炙过，各半两）。
以上八味药，锉成如麻豆大小的颗粒，每次服用五钱匕，加水一盏半，煎煮至八分，滤去药渣，饭后温服，晚上再服一次。
治疗伤寒引起的柔痉，症见身体强直，汗出不止，腹部内部拘急疼痛。使用附子散方：
附子（炮裂后去皮和脐）、干姜（炮制）、甘草（炙过并切碎）、桂枝（去掉粗皮）、人参（各半两）。
以上五味药，捣碎过筛制成散剂，每次服用二钱匕，用姜粥水调服，不限时间。
治疗时行疫病及伤寒之后，虚弱发作时闭眼伏面的，这是柔痉的征候，表现为手脚冰凉，筋脉强直，汗出不止。使用方剂：
干姜（炮制）、白术、桂枝（去掉粗皮，各一两）、附子（炮裂后去掉脐皮）、甘草（炙过，各半两）、防风（去掉叉枝，一两）。
以上六味药，锉成如麻豆大小的颗粒，每次服用五钱匕，用水一盏半，煎煮至八分，滤去药渣，温服。
治疗伤寒引起的柔痉，症见四肢逆冷，汗出不止，腹部疼痛，筋脉拘急。使用柴胡饮方：
柴胡（去掉苗）、赤茯苓（去掉黑皮，各三分）、槟榔（煨制后切碎）、五味子（炒制，各半两）、桂枝（去掉粗皮）、高良姜、羌活（去掉芦头，各一分）。
以上七味药，捣碎并筛成粗末，每次服用五钱匕，用水一盏半，煎煮至八分，滤去药渣，温服。
治疗伤寒引起的柔痉，病程经过三天未愈，担心阴气攻伐五脏导致损伤。使用茯苓汤方：
赤茯苓（去掉黑皮）、五味子（炒制）、麦门冬（去掉心，焙干，各二两）、柴胡（去掉苗，一两半）、桂枝（去掉粗皮，一两）、槟榔（切碎）、细辛（去掉苗叶，各半两）。
以上七味药，捣碎并筛成粗末，每次服用四钱匕，加水一大盏，煎煮至六分，滤去药渣，温服。
It is discussed that the presentation of Rou Jing (Soft Spasm, a condition characterized by stiffness and opisthotonos accompanied by sweating) involves shaking of the head, fever, stiffness and tension in the neck and nape, hyperextension of the waist and body resembling a bow, or occasionally convulsions and lockjaw. These symptoms are identical to those of Gang Jing (Hard Spasm). However, it is termed "Rou" specifically because of the presence of spontaneous sweating and absence of aversion to cold. The term "Jing" refers to spasm; generally, this category of diseases was named by ancient physicians primarily for its manifestation of rigidity and straightness.
For treating Taiyang disease (Exterior Syndrome) complicated with Rou Jing, presenting with stiffness and tightness in the neck and back, accompanied by sweating and aversion to wind, use Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Puerariae Radix):
Puerariae Radix (Gegen, 4 liang), Ephedrae Herba (Mahuang, de-stemmed, boiled and scum removed, dried), Paeoniae Radix Alba (Baishao, each 3 liang), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried and chopped), Cinnamomi Ramulus (Guizhi, bark removed, each 2 liang).
The above five herbs are coarsely crushed and sieved. Each dose consists of 5 qianbi (approx. 15-20g depending on era/measure), boiled in 2 zhan (approx. 400ml) of water with 5 slices of Zingiberis Rhizoma Recens (Shengjiang, fresh ginger) and 2 fractured Ziziphi Jujubae Fructus (Dazao, jujube). Boil until reduced to 1 zhan, strain, and take warm. Repeat after some time. Cover with blankets to induce slight sweating for recovery; there is no need to drink hot porridge to assist sweating.
For treating Taiyang disease complicated with Rou Jing, presenting with cold extremities, tendon cramping, and incessant sweating, use Guizhu Tang (Cinnamon Twig and Atractylodes Macrocephala Decoction):
Cinnamomi Ramulus (Guizhi, bark removed, 1 liang), Atractylodis Macrocephalae Rhizoma (Baizhu), Ginseng Radix et Rhizoma (Renshen), Aconiti Lateralis Radix Praeparata (Fuzi, roasted, umbilical scar and skin removed, each 3 fen), Saposhnikoviae Radix (Fangfeng, forked parts removed), Zingiberis Rhizoma (Ganjiang, roasted), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried, each 0.5 liang).
The above seven herbs are chopped into particles the size of hemp seeds. Each dose of 5 qianbi is boiled in 1.5 zhan of water until reduced to 80%, strained, and taken warm. Administer twice daily.
For treating Taiyang disease complicated with Rou Jing, presenting with cold limbs, tendon and vessel cramping, incessant sweating, stiff neck, head shaking, and lockjaw, use Fuzi Baizhu Tang (Aconite and Atractylodes Macrocephala Decoction):
Aconiti Lateralis Radix Praeparata (Fuzi, roasted, skin and umbilical scar removed), Atractylodis Macrocephalae Rhizoma (Baizhu, each 1 liang), Ligustici Chuanxiong Rhizoma (Chuanxiong, 3 fen), Angelicae Pubescentis Radix (Duhuo, rhizome removed), Cinnamomi Ramulus (Guizhi, bark removed, each 0.5 liang).
The above five herbs are chopped into particles the size of hemp seeds. Each dose of 3 qianbi is boiled in 1 zhan of water with half a portion of smashed Zingiberis Rhizoma Recens (Shengjiang, fresh ginger) and 2 fractured Ziziphi Jujubae Fructus (Dazao, jujube). Boil until reduced to 70%, strain, and take warm at any time.
For treating Taiyang disease complicated with Rou Jing, presenting with sweating, bodily rigidity, and predominantly cold hands and feet, use Wuweizi Tang (Schisandra Decoction):
Schisandrae Chinensis Fructus (Wuweizi, stir-fried, 1 liang), Aconiti Lateralis Radix Praeparata (Fuzi, roasted, umbilical scar and skin removed), Costi Rhizoma (Muxiang), Arecae Semen (Binglang, each 3 fen), Atractylodis Macrocephalae Rhizoma (Baizhu), Cinnamomi Ramulus (Guizhi, bark removed), Zingiberis Rhizoma (Ganjiang, roasted), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried, each 0.5 liang).
The above eight herbs are chopped into particles the size of hemp seeds. Each dose of 5 qianbi is boiled in 1.5 zhan of water until reduced to 80%, strained, and taken warm after meals, with another dose in the evening.
For treating Taiyang disease complicated with Rou Jing, presenting with bodily rigidity, incessant sweating, and internal abdominal urgency and pain, use Fuzi San (Aconite Powder):
Aconiti Lateralis Radix Praeparata (Fuzi, roasted, skin and umbilical scar removed), Zingiberis Rhizoma (Ganjiang, roasted), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried and chopped), Cinnamomi Ramulus (Guizhi, bark removed), Ginseng Radix et Rhizoma (Renshen, each 0.5 liang).
The above five herbs are pounded and sifted into a powder. Each dose of 2 qianbi is taken mixed with ginger porridge water, without restriction on timing.
When treating epidemic febrile diseases or post-Taiyang disease weakness, if the patient exhibits symptoms such as closing eyes and lying face down upon onset, this indicates Rou Jing. Symptoms include cold extremities, rigid tendons and vessels, and incessant sweating. Use the following formula:
Zingiberis Rhizoma (Ganjiang, roasted), Atractylodis Macrocephalae Rhizoma (Baizhu), Cinnamomi Ramulus (Guizhi, bark removed, each 1 liang), Aconiti Lateralis Radix Praeparata (Fuzi, roasted, umbilical scar and skin removed), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried, each 0.5 liang), Saposhnikoviae Radix (Fangfeng, forked parts removed, 1 liang).
The above six herbs are chopped into particles the size of hemp seeds. Each dose of 5 qianbi is boiled in 1.5 zhan of water until reduced to 80%, strained, and taken warm.
For treating Taiyang disease complicated with Rou Jing, presenting with cold extremities, incessant sweating, abdominal pain, and tendon cramping, use Chaihu Yin (Bupleurum Drink):
Bupleuri Radix (Chaihu, seedlings removed), Poria (Chifuling, black skin removed, each 3 fen), Arecae Semen (Binglang, baked and chopped), Schisandrae Chinensis Fructus (Wuweizi, stir-fried, each 0.5 liang), Cinnamomi Ramulus (Guizhi, bark removed), Alpiniae Officinarum Rhizoma (Gaoliangjiang), Notopterygii Rhizoma et Radix (Qianghuo, rhizome removed, each 1 fen).
The above seven herbs are coarsely crushed and sieved. Each dose of 5 qianbi is boiled in 1.5 zhan of water until reduced to 80%, strained, and taken warm.
If Taiyang disease complicated with Rou Jing persists for three days without improvement, there is a risk of Yin pathogenic factors attacking the Five Zang Organs causing damage. Use Fuling Tang (Poria Decoction):
Poria (Chifuling, black skin removed), Schisandrae Chinensis Fructus (Wuweizi, stir-fried), Ophiopogonis Radix (Maidong, heart removed and dried, each 2 liang), Bupleuri Radix (Chaihu, seedlings removed, 1.5 liang), Cinnamomi Ramulus (Guizhi, bark removed, 1 liang), Arecae Semen (Binglang, chopped), Asari Radix et Rhizoma (Xixin, seedlings and leaves removed, each 0.5 liang).
The above seven herbs are coarsely crushed and sieved. Each dose of 4 qianbi is boiled in one large zhan of water until reduced to 60%, strained, and taken warm.