仲景云∶诸痉项强，皆属于湿。又云∶太阳病，发汗太多致痉。风病下之则痉，复发
汗则拘急。疮家发汗则痉，是汗下重亡津液所致。有汗而不恶寒，曰柔痉，以风能散气
也，宜白术汤加桂心、黄 。无汗而恶寒，曰刚痉，以寒能涩血也，宜葛根汤。皆气血内
伤，筋无所营而变，非风也。杖疮及劳伤气血而变者，当补气血，未应，用独参汤，手
足冷，加桂、附，缓则不救。详见杂病第五。
有一患者，内溃针出脓三五碗，遂用大补之剂，翌日热甚汗出，足冷口噤，腰背反张，
众欲投发散之剂。薛曰∶此气血虚极而变痉也，若认作风治则误矣，用十全大补等药而
愈。此证多因伤寒，汗下过度，与产妇，溃疡，气血亏损所致，但当调补气血为善。若
服克伐之剂，多致不救。 有一患者，两月余矣，疮口未完，因怒发痉，疮口出血，此
怒动肝火而为患耳，用柴胡、芩、连、山栀、防风、桔梗、天麻、钓藤钩、甘草治之顿愈。
刘宗浓先生云∶痉有属风火之热内作者，有因七情怒气而作者，亦有湿热内盛，痰涎壅
遏经络而作者，惟宜补虚降火，敦土平木，清痰去湿。
有一患者，服行气之剂，胸痞气促，食少体倦，色黯脓清，此形气俱虚之证也，先
用六君桔梗二剂，胸膈气和；后用补中益气，去升麻，加茯苓、半夏、五味、麦门治之，元
气渐复而愈。若用前剂 贼元气，多至不救。
张仲景说：各种痉病出现颈项强直的症状，都属于湿邪致病。他又说：太阳病（太阳经受邪所致的病证），如果发汗过多会导致痉病；风病（外感风邪引起的疾病）如果用攻下法治疗会导致痉病，如果再发汗则会出现肢体拘挛急迫；患有疮疡的人如果发汗会导致痉病，这些都是因为汗法和下法过度导致津液严重耗损所致。如果有汗且不恶寒的，称为柔痉（伴有汗出的痉病），这是因为风邪能耗散正气，适宜用白术汤加入桂心、黄芪；如果没有汗且恶寒的，称为刚痉（无汗的痉病），这是因为寒邪能使血液凝涩，适宜用葛根汤。这些情况都是气血在内受损，筋脉得不到濡养而发生变化，并非外风所致。因杖刑创伤以及劳损伤及气血而引发变证的，应当补益气血，如果无效，使用独参汤，若伴有手足冰冷，加入肉桂、附子，如果病情迟缓则难以救治。详细内容见杂病第五卷。
有一位患者，体内溃烂针刺排出脓液三五碗之多，随后使用了大补的药剂，第二天高热严重并出汗，脚冷口噤（牙关紧闭），腰背反张（角弓反张），众人想要投用发散表邪的药剂。薛己说：这是气血极度虚弱而引发的痉病，如果误认为是外风来治疗就错了，使用十全大补汤等药物而痊愈。这种病症多因伤寒，汗法和下法过度，以及产妇、溃疡患者气血亏损所致，只应当调理补益气血为好。如果服用克伐（攻伐削弱）的药剂，大多导致无法救治。
又有一位患者，患病两个多月了，疮口尚未愈合，因为愤怒引发痉病，疮口出血，这是怒气触动肝火而造成的病患，使用柴胡、黄芩、黄连、山栀、防风、桔梗、天麻、钓藤钩、甘草治疗，顿时痊愈。
刘宗浓先生说：痉病有属于风火之热在内部发作的，有因七情中的怒气而发作的，也有因湿热在体内旺盛，痰涎壅塞阻滞经络而发作的，只适宜补虚降火，培土平木（健脾疏肝），清化痰湿。
又有一位患者，服用了行气的药剂后，出现胸中痞闷、气短急促、饮食减少、身体疲倦、面色晦暗、脓液清稀，这是形体与元气都虚弱的证候，先用六君子汤加桔梗两剂，使胸膈之气调和；后用补中益气汤，去掉升麻，加入茯苓、半夏、五味子、麦门冬治疗，元气逐渐恢复而痊愈。如果使用前面的行气药剂，会贼害元气，大多导致无法救治。
Zhang Zhongjing stated: Various cases of spasm (Jing, characterized by neck stiffness and convulsions) with neck rigidity all belong to dampness. He also said: In Taiyang disease (diseases affecting the Taiyang channel), excessive sweating can lead to spasm; if purgation is used for wind diseases, it leads to spasm, and subsequent sweating causes limb contraction and urgency. If sweating is induced in patients with sores/ulcers, it leads to spasm; these are caused by severe depletion of body fluids due to excessive sweating and purgation. Cases with sweating but no aversion to cold are called Soft Spasm (Rou Jing, spasm with sweating), because wind can scatter qi; Baizhu Tang (Atractylodes Macrocephala Decoction) added with Guixin (Cinnamon Twig) and Huangqi (Astragalus Root) is appropriate. Cases without sweating and with aversion to cold are called Hard Spasm (Gang Jing, spasm without sweating), because cold can obstruct blood flow; Gegen Tang (Kudzu Root Decoction) is appropriate. All these conditions result from internal injury to qi and blood, where sinews fail to receive nourishment and undergo changes; they are not caused by external wind. For changes resulting from beating injuries or labor-induced qi and blood deficiency, one should tonify qi and blood. If ineffective, use Dushen Tang (Single Ginseng Decoction); if accompanied by cold hands and feet, add Rongui (Cortex Cinnamomi) and Fuzi (Prepared Aconite Root). If treatment is delayed, rescue is unlikely. See Volume 5 of Miscellaneous Diseases for details.
One patient had internal ulceration with pus drained via needle puncture amounting to three to five bowls. Subsequently, a strong tonic was administered. The next day, high fever and sweating occurred, followed by cold feet, trismus (lockjaw), and opisthotonos (backward arching of the back). The collective physicians wished to administer diaphoretic agents. Xue Ji stated: This is spasm caused by extreme deficiency of qi and blood. If treated as external wind, it would be an error. Using Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) and similar medicines led to recovery. This condition often arises from excessive sweating and purgation in Shanghan (Cold Damage), or from qi and blood deficiency in postpartum women and ulcer patients. The proper approach is to regulate and tonify qi and blood. Administering attacking/depleting agents often leads to untreatable outcomes.
Another patient had been ill for over two months with unhealed sores. Due to anger, spasm occurred, and bleeding from the sores ensued. This was caused by anger stirring up Liver fire. Treatment with Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Shanzhi (Gardeniae Fructus), Fangfeng (Saposhnikoviae Radix), Jiegeng (Platycodonis Radix), Tianma (Gastrodiae Rhizoma), Gouteng (Uncariae Ramulus cum Uncis), and Gancao (Liquorice Root) resulted in immediate recovery.
Mr. Liu Zongnong stated: Spasm may arise from internal heat generated by wind-fire; from emotional disturbances, specifically anger; or from internal excess of damp-heat with phlegm-saliva obstructing the meridians. The appropriate treatment is to tonify deficiency and descend fire, strengthen Spleen earth to pacify Liver wood, and clear phlegm while removing dampness.
Another patient, after taking qi-moving agents, developed chest fullness, shortness of breath, poor appetite, fatigue, dark complexion, and thin pus. This indicated a syndrome of both physical form and primal qi being deficient. Initially, Liujunzi Tang (Six Gentlemen Decoction) added with Jiegeng (Platycodonis Radix) was administered for two doses to harmonize the chest and diaphragm qi. Subsequently, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used, with Shengma (Cimicifugae Rhizome) removed, and Fuling (Poria), Banxia (Pinelliae Tuber), Wuweizi (Schisandrae Fructus), and Maimendong (Ophiopogonis Radix) added. Primal qi gradually recovered, leading to healing. If the previous qi-moving agents had been used, they would have harmed the primal qi, likely leading to untreatable outcomes.