产后血虚，腠理不密，故多汗。因遇风邪搏之，则变痉，痉者口噤不开，背强而直，如发痫状，宜速 开口，灌小
续命汤。稍缓即汗出如雨，手摸空者，不可治也。薛立斋云∶产后发痉，因去血过多，元气亏极，或外邪相搏，以致牙
关紧闭急，四肢痉强，或腰背反张，肢体抽搐。若有汗而不恶寒者，曰柔痊；若无汗而恶寒，曰刚痉。产后患之，实由
亡血过多，筋无所养而致。故伤寒汗下过多，溃疡脓血大泄，患之乃败证也，大补血气，多保无虞。若攻风邪，死无疑
矣。一产妇牙关紧急，腰背反张，四肢抽搐，两目连札，余以为去血过多，元气亏损，阴火炽盛，用十全大补加炮姜，
一剂面苏，又数剂而安。吴江史万湖家人妇忽仆，牙关紧急，已死矣。询之是新产妇出直厨，知其劳伤血气而发痉也，
急用十全大补加附子，煎滚。令人推正其身，一人以手挟正其面。却掰开其口，灌之不咽，药已冷，令侧其面出之，仍
正其面，复灌以热药。又冷又灌，如此五次，方咽下，随灌以热药，遂苏。夷坚志云∶杜壬治郝质子妇，产四日螈 ，
戴眼，弓背反张。壬以为痉病，与大豆紫汤，独活汤而愈。政和间，余妻方娩，犹在蓐中，忽作此证，头足反接，相去
二尺，家人惊骇，以数婢强拗之，以数婢强拗不直。适记所云，药草有独活，乃急为之。召医未至，连进三剂遂能直，
医至即愈矣。更不复药，乃知古人处方之神验。产妇四肢挛急者，因脏腑俱虚，月内未满，起早劳役，动伤脏腑。虚损
未复，为风所乘。风邪冷气客于皮肤经络，则令人顽痹不仁，羸乏，少气。筋脉挟寒则挛急也。薛立斋曰∶前证若肝经
风热血燥，用加味逍遥散。如不应，用六味地黄丸，以补肾水，仍参前杂证诸风血方论治之。
小续命汤
治产后中风及刚痉柔痉。
防风（一钱） 麻黄（去节） 黄芩（去朽） 白芍 人参（各八分） 川芎 防己 肉桂（各七分） 附子（炮，
去皮脐） 杏仁（去皮尖） 麸炒（各五分） 甘草（炙，四分）
上姜枣水煎服。春夏加石膏、知母、黄芩；秋冬加官桂、附子、芍药。柔痉自汗者，去麻黄，加葛根。
按上方朱奉议称刚柔二痉，并可加减与之。但产后血气大虚之人，恐不宜轻发其表。若邪气实，脉浮弦有力者，用
之固宜。其虚弱之人，不若用大豆紫汤及防风当归散。
大豆紫汤
治产后中风痱痉，背强口噤，直视烦热。若脉紧大者不治。
川独活（去芦，一两半） 大豆（半升） 酒（三斤）
上先用酒浸独活一两，沸。别炒大豆极焦烟出，急投酒中密封。候冷去豆，每服一二小钟许，得少汗则愈。日进十
服。此药能去风、消血结。如妊娠胎死腹中，服此得瘥。
大豆汤
治产后风痉，不省人事，及妊娠挟风，一切蓐草之间，诸般病证。
大豆（五合，炒黄） 独活（去芦） 葛根（各八分） 防己（去皮，六两）
上 咀，每服五钱，酒二盏，煎至一盏半，不拘时，日三服。
防风当归散
此方最稳妥。
防风 当归 川芎 地黄（各一两）
上每服一两，水煎温服。
芎 散
治产后四肢筋脉挛急疼痛，背项强直。
芎 羌活 当归（各去芦） 酸枣仁（炒） 羚羊角屑（各七钱半） 防风 牛蒡子（炒，各一两） 桂心 赤
芍药（各五钱）
上 咀，每服八钱，水煎去渣，温服，不拘时。如服不应，可用八珍汤。更不应，用十全大补汤。
产后手足厥冷，宜灸肩井穴。一妇人产后日食茶粥二十余碗，至一月后，遍身冰冷数块，以指按其冷处，即冷从指
下，上应至心，如是者二年，诸治不效。以八物汤去地黄，加橘红，入姜汁、竹沥一酒钟，十服乃温。
Postpartum blood deficiency leads to loose interstices (the spaces between skin pores and subcutaneous tissues), resulting in profuse sweating. If wind-pathogen invades and contends with the body's righteous qi, it transforms into Jing disease (a syndrome characterized by stiffness of the neck and back, and spasms of the limbs). Patients with Jing disease have their jaws tightly clenched and cannot open their mouths, their backs are stiff and straight, resembling an epileptic seizure. It is advisable to quickly pry open the mouth and administer Xiao Xuming Tang (Minor Cinnamon Twig Decoction). If treatment is delayed slightly and the patient sweats profusely like rain and performs aimless hand movements (grasping at air), the condition is incurable.
Xue Lizhai stated: Postpartum Jing disease occurs due to excessive blood loss leading to extreme depletion of Yuan Qi (Original Qi), or due to contention with external pathogens, resulting in tight jaw clenching, spasticity and rigidity of the four limbs, opisthotonos (backward arching of the back), and limb convulsions. If there is sweating without aversion to cold, it is called Rou Jing (Soft Spasm); if there is no sweating with aversion to cold, it is called Gang Jing (Hard Spasm). Contracting this postpartum is actually caused by excessive blood loss, leaving the sinews without nourishment. Therefore, when Jing disease occurs after excessive sweating or purgation in Shanghan (Cold Damage) diseases, or after massive discharge of pus and blood from ulcers, it is a sign of collapsing Zheng (deficiency syndrome). In such cases, vigorously tonifying Blood and Qi will mostly ensure safety. However, if one attacks the wind-pathogen, death is inevitable.
A parturient presented with tight jaw clenching, opisthotonos, limb convulsions, and upward deviation of the eyes. I attributed this to excessive blood loss, depletion of Yuan Qi, and flourishing Yin Fire (deficient fire). I used Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) added with Pao Jiang (Prepared Ginger). After one dose, her complexion recovered and she revived; after several more doses, she was stable.
The wife of Shi Wanhu in Wujiang suddenly collapsed, with tight jaw clenching, appearing dead. Upon inquiry, it was learned that she was a new mother who had gone out to the kitchen, indicating that labor had injured Blood and Qi, triggering Jing disease. I urgently prepared Shiquan Dabu Tang added with Fuzi (Prepared Aconite Root) and boiled it. I had someone straighten her body while another held her head steady. We pried open her mouth to administer the medicine, but she did not swallow. The medicine had cooled, so we turned her head to let her spit it out, then straightened her head again and administered hot medicine. This cycle of cooling and re-administering hot medicine was repeated five times before she finally swallowed. Subsequent administration of hot medicine led to her revival.
Yijian Zhi records: Du Ren treated the daughter-in-law of Hao Zhi. On the fourth day postpartum, she experienced convulsions, upward deviation of the eyes, and opisthotonos. Du Ren diagnosed it as Jing disease and prescribed Doudaizi Tang (Soybean Purple Decoction) and Duhuo Tang (Angelica Pubescens Decoction), which cured her. During the Zhenghe era, my wife had just given birth and was still in confinement when she suddenly developed this syndrome, with her head and feet touching each other, separated by only two chi. Her family was terrified. Several maids tried forcibly to straighten her body but failed. Recalling the text mentioning Duhuo (Angelica Pubescens) as an herb, I hastily prepared it. Before the doctor arrived, three doses were administered, and her body could be straightened. By the time the doctor arrived, she was cured. No further medication was needed, confirming the miraculous efficacy of ancient prescriptions.
Parturients with spasmodic urgency in the four limbs suffer because all Zang-Fu organs are deficient. Rising early for labor within the first month after childbirth damages the Zang-Fu. When deficiency has not yet recovered, it is exploited by Wind. Cold-dampness pathogenic factors lodging in the skin and meridians cause numbness and insensitivity (Wan Bi), emaciation, fatigue, and shortness of breath. When sinews and vessels are combined with Cold, spasmodic urgency occurs.
Xue Lizhai said: For the aforementioned syndromes, if they are caused by Wind-Heat in the Liver Meridian and dry Blood, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If ineffective, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to tonify Kidney Water (Kidney Yin), and refer to the discussions on various Wind and Blood formulas for miscellaneous diseases mentioned earlier.
Xiao Xuming Tang (Minor Cinnamon Twig Decoction)
Treats postpartum Zhongfeng (Wind-Stroke) and both Gang Jing (Hard Spasm) and Rou Jing (Soft Spasm).
Fangfeng (1 qian) Mahuang (remove nodes) Huangqin (remove rotten parts) Baishao Renshen (each 8 fen) Chuanxiong Fangji Rougui (each 7 fen) Fuzi (prepared, remove skin and navel) Xingren (remove skin and tips) Mai Fu Chao (bran-fried, each 5 fen) Gancao (honey-fried, 4 fen)
Decoct with water containing Shengjiang (Fresh Ginger) and Dazao (Jujube). In spring and summer, add Shigao (Gypsum), Zhimu (Anemarrhena), and Huangqin (Scutellaria); in autumn and winter, add Guigui (Cassia Bark), Fuzi (Aconite), and Shaoyao (Peony). For Rou Jing with spontaneous sweating, remove Mahuang and add Gegen (Kudzu Root).
Regarding the above formula, Zhu Fengyi stated that both Gang Jing and Rou Jing can be treated with modifications. However, for those with severe postpartum Blood and Qi deficiency, it is feared that lightly inducing sweating to release the exterior is inappropriate. If the pathogenic factor is excess and the pulse is floating, wiry, and forceful, using this formula is indeed suitable. For weak individuals, it is better to use Doudaizi Tang (Soybean Purple Decoction) and Fangfeng Danggui San (Saposhnikovia and Angelica Powder).
Doudaizi Tang (Soybean Purple Decoction)
Treats postpartum Zhongfeng causing Fei Jing (paralytic spasm), stiff back, jaw clenching, fixed gaze, and irritability with heat. If the pulse is tight and large, it is untreatable.
Chuan Duhuo (remove rhizome, 1.5 liang) Doudou (Soybeans, half sheng) Jiu (Wine, 3 jin)
Soak 1 liang of Duhuo in wine and boil separately. Stir-fry soybeans until extremely charred and smoking, then immediately throw them into the boiling wine and seal tightly. After cooling, remove the beans. Take one or two small cups per dose. Recovery occurs with slight sweating. Administer ten doses daily. This medicine dispels Wind and resolves Blood stasis. It is also effective for retained dead fetus in pregnancy.
Dadou Tang (Soybean Decoction)
Treats postpartum Wind-Jing, unconsciousness, and Wind-complication during pregnancy, covering various conditions during confinement.
Dadou (Soybeans, 5 he, stir-fried yellow) Duhuo (remove rhizome) Gegen (Kudzu Root) (each 8 fen) Fangji (remove skin, 6 liang)
Crush the herbs. Take 5 qian per dose, decoct with 2 zhan of wine until 1.5 zhan remains. Take at any time, three times daily.
Fangfeng Danggui San (Saposhnikovia and Angelica Powder)
This formula is the most safe and reliable.
Fangfeng Danggui Chuanxiong Dihuang (each 1 liang)
Take 1 liang per dose, decoct with water and take warm.
[Xiong] San ([Missing Character] Powder)
Treats postpartive spasmodic pain in the sinews and vessels of the four limbs, and stiffness of the back and neck.
[Xiong] Qianghuo Danggui (each remove rhizome) Suanzaoren (stir-fried) Lingyangjiaoxie (Antelope Horn chips) (each 7.5 qian) Fangfeng Niubangzi (stir-fried) (each 1 liang) Guixin (Cinnamon Heart) Chishaoyao (Red Peony Root) (each 5 qian)
Crush the herbs. Take 8 qian per dose, decoct with water, strain, and take warm at any time. If ineffective, use Bazhen Tang (Eight-Treasure Decoction). If still ineffective, use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction).
For postpartum cold extremities, moxibustion on Jianjing (GB21) is appropriate. A woman consumed over twenty bowls of tea porridge daily after childbirth. One month later, she had patches of ice-cold skin on her body. Pressing these cold spots with a finger made the cold sensation travel up from the finger to the heart. This persisted for two years despite various treatments. Using Bayi Tang (Eight-Ingredient Decoction) minus Dihuang (Rehmannia), plus Juhong (Tangerine Peel), mixed with Jiangzhi (Ginger Juice) and Zhuli (Bamboo Sap) equal to one wine cup, she warmed up after ten doses.