（改门人包镜澄稿）
痉者，强直反张之象也。内经云、诸痉项强，皆属于湿，金匮曰、太阳病发热无汗，反恶寒者，曰刚痉太阳
病发热汗出而不恶寒者，曰柔痉。此明言痉之初起，必由太阳而发。以太阳主一身之表，其脉起于目
内，从头下后项，连风府，行身之背，并循督脉而行，故痉之见证，必有颈项强急，口噤背反，其所病之
位，皆经脉所过之处。刚痉无汗，以表实也，柔痉有汗，以表虚也，表实者邪不能出，表虚者邪即能入，此
得之于外而有余者也。又曰、太阳病发汗太多，因致痉。盖太阳为肾之外府，若太阳之邪，过于发汗，以
致津液外脱，则少阴水亏，木少敷和，遂燥而生风，风生则伤筋，筋失血养，而亦成痉，此戕伐于内而不
足者也。又曰、风病下之则痉。盖太阳之接壤，即是阳明，若太阳之邪，误于攻下，以致阴亡阳亢，则阳明
土燥，土失培化而变热，热盛则灼筋而亦成痉，此又涸竭其内而不足者也。既言风寒在表之有余，复
言汗下伤阴之不足，仲景于此，可谓反复推详，补泻之法，流露言外。然与内经皆属于湿之旨意似相
悬异，何欤吾见夫湿伤寒水，而痉起于湿寒，湿郁生热，风淫火炽，而痉起于湿热，寒热悬异，而其湿则
一，非所谓皆属者欤。夫至湿郁生热，火炽风淫，其脱液伤津，亦在所必至，则是内经不言燥而言湿，言
湿而燥已囊括乎其中。若能推展其义，则是产后之去血过多，孤阳无根据，大伤冲任督奇经之脉，以致
反张强直，口噤拳挛，小儿之体禀纯阳，阴分未充，重感外邪，以成急慢惊风，噤口不语诸症，无不在范围之内矣。
（修改门人包镜澄的稿件）
痉病，表现为身体强直、角弓反张的症状。《内经》说：各种痉病导致的项部强急，都归属于湿邪。《金匮要略》说：太阳病（太阳经受邪所致的病证），发热且无汗，反而恶寒的，称为刚痉；太阳病发热且有汗，不恶寒的，称为柔痉。这明确指出了痉病的初起，必定由太阳经发起。因为太阳经主管一身之表，其经脉起始于目内眦，从头向下经过后项，连接风府穴，沿背部下行，并与督脉并行。所以痉病显现出的症状，必然有颈项强急、牙关紧闭、背反张等表现，其所病变的部位，都是经脉循行经过的地方。刚痉无汗，是因为表实；柔痉有汗，是因为表虚。表实则邪气不能外出，表虚则邪气容易侵入，这是外感邪气有余的情况。又说：太阳病发汗过多，因而导致痉病。盖因太阳与肾相表里，太阳为肾之外府，如果太阳经的邪气，通过过度发汗，导致津液向外脱失，那么少阴肾水就会亏虚，肝木失去濡养和调和，于是干燥而生风，风生则损伤筋脉，筋脉失去血液滋养，也就形成了痉病，这是内部受损而不足的情况。又说：风病误用攻下法会导致痉病。盖因太阳经的接壤之处即是阳明经，如果太阳经的邪气，被错误地采用攻下法治疗，导致阴液亡失、阳气亢盛，那么阳明胃土就会干燥，土失去培补运化而变生热邪，热邪炽盛则会灼伤筋脉从而形成痉病，这又是内部枯竭而不足的情况。既讲了风寒在表的有余实证，又讲了汗法和下法损伤阴液的不足虚证，张仲景在这里，可以说是反复推演详述，补法和泻法的运用，流露在言语之外。然而这与《内经》“皆属于湿”的宗旨似乎相差很大，为什么呢？我见到湿邪夹带伤寒水气，痉病起于湿寒；湿邪郁结产生热邪，风邪淫溢火势炽盛，痉病起于湿热。虽然寒热性质悬殊，但其根源中的湿邪是一致的，这不就是所说的“皆属于湿”吗？至于湿邪郁结产生热邪，火势炽盛风邪淫溢，导致津液脱失、阴伤，也是必然的结果，那么《内经》不言燥而言湿，言湿而燥的含义已经包含在其中了。如果能推展其中的义理，那么产后失血过多，孤阳没有依附，严重损伤冲脉、任脉、督脉及奇经八脉，以致出现角弓反张、强直、牙关紧闭、手握拳挛缩等症状；小儿体质禀赋纯阳，阴分尚未充盈，再次感受外邪，形成急惊风和慢惊风、噤口不语等各种病症，无不都在这个理论范围之内的。
(Revised from the manuscript of disciple Bao Jingcheng)
Jing disease (Spasm) manifests as stiffness, rigidity, and opisthotonos (backward arching of the body). The *Neijing* (Inner Canon) states: "All spasms with neck stiffness belong to Dampness." The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: "In Taiyang disease (disease of the Taiyang channel), if there is fever, anhidrosis (absence of sweating), and aversion to cold, it is called Gang Jing (Rigid Spasm); if there is fever, diaphoresis (sweating), and no aversion to cold, it is called Rou Jing (Flexible Spasm)." This clearly indicates that the onset of Jing disease must originate from the Taiyang channel. Since the Taiyang channel governs the exterior of the entire body, its vessel originates at the inner canthus of the eye, descends from the head through the posterior neck, connects to Fengfu (GV16), runs along the back of the body, and travels alongside the Du Mai (Governing Vessel). Therefore, the manifestations of Jing disease necessarily include neck stiffness, trismus (lockjaw), and opisthotonos; the sites of pathology are all locations where the meridians pass. Gang Jing presents with anhidrosis due to Exterior Excess (Biao Shi); Rou Jing presents with diaphoresis due to Exterior Deficiency (Biao Xu). In cases of Exterior Excess, pathogenic factors cannot exit; in cases of Exterior Deficiency, pathogenic factors easily enter. This represents an excess condition caused by external pathogens. It is also stated: "Excessive sweating in Taiyang disease leads to Jing disease." This is because Taiyang is the exterior mansion of the Kidney. If the pathogen in the Taiyang channel is treated with excessive sweating, leading to the external depletion of Body Fluids (Jin Ye), then Shaoyin Water (Kidney Yin) becomes deficient. With insufficient nourishment and harmonization of Wood (Liver), dryness generates Wind. Once Wind arises, it damages the Sinews (Jin). When the Sinews lose blood nourishment, Jing disease forms. This represents a deficiency condition caused by internal damage. It is further stated: "Applying purgation to Wind disease leads to Jing disease." This is because the area adjacent to Taiyang is Yangming. If the pathogen in the Taiyang channel is mistakenly treated with purgation, leading to the loss of Yin fluids and hyperactivity of Yang, then Yangming Earth (Stomach/Spleen) becomes dry. Without proper transformation and transportation, Earth generates Heat. When Heat is excessive, it scorches the Sinews, leading to Jing disease. This represents another form of deficiency condition caused by internal exhaustion. Having discussed the excess of Wind-Cold on the exterior, it subsequently discusses the deficiency of Yin injury caused by sweating and purging methods. Zhang Zhongjing here has indeed repeatedly deduced and detailed these points, revealing the principles of tonification and drainage beyond the explicit words. However, this seems quite different from the principle in the *Neijing* that "all belong to Dampness." Why? I have observed that when Dampness combines with Cold-Damage water, Jing disease arises from Cold-Damp; when Dampness stagnates and generates Heat, and Wind flourishes with blazing Fire, Jing disease arises from Damp-Heat. Although Cold and Heat are vastly different, the underlying Dampness remains one and the same. Is this not what is meant by "all belong to [Dampness]"? Furthermore, when Dampness stagnates to generate Heat, and Fire blazes while Wind flourishes, the depletion of fluids and injury to Jin Ye are inevitable. Thus, although the *Neijing* speaks of Dampness rather than Dryness, the concept of Dryness is encompassed within the discussion of Dampness. If one can expand upon this meaning, then conditions such as excessive blood loss after childbirth, where solitary Yang lacks foundation, severely damaging the Chong Mai (Penetrating Vessel), Ren Mai (Conception Vessel), Du Mai (Governing Vessel), and the Eight Extraordinary Vessels, resulting in opisthotonos, rigidity, trismus, and clenched fists; or children, whose constitution is purely Yang and Yin is not yet fully developed, who contract external pathogens again, leading to acute and chronic infantile convulsions (Jing Feng) and symptoms like lockjaw and muteness—all these fall within the scope of this theory.