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Treatment for convulsions caused by wind invasion after childbirth.

Danggui (Radix Angelicae Sinensis) (1 liang), Sheng Huangqi (Astragali Radix, raw) (6 qian), Zhen Ejiao (Colla Corii Asini, authentic) (4 qian, not stir-fried), Fangfeng (Saposhnikoviae Radix) (3 qian), Jingjie (Schizonepetae Spica) (3 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma) (3 qian).
Sheng Baishao (Paeoniae Radix Alba, raw) (2 qian), Honghua (Carthami Flos) (1 qian), Sheng Taoren (Persicae Semen, raw, with skin and tip, crushed) (1.5 qian).

Although this formula is used to treat wind invasion after childbirth, its primary function is actually to tonify Qi and Blood. Tonifying the righteous Qi is the method to expel pathogenic factors; once the blood circulation is unobstructed, the wind naturally disperses ("When blood moves freely, wind self-disperses" is a common saying in medical texts). If convulsions occur due to excessive bleeding during delivery or excessive sweating, this formula should still not be used because it contains herbs that release the exterior. In such cases, one should nourish Yin and Blood to moisten the sinews and extinguish internal wind, so that the convulsions will stop spontaneously. If there is both Blood deficiency and Qi deficiency, Qi-tonifying herbs should be added as assistance. Among Qi-tonifying herbs, Huangqi is the best, because Huangqi not only tonifies Qi but also treats severe wind pathogens (The *Shennong Bencao Jing* states that Huangqi governs "great wind").

One woman suffered from convulsions seven or eight days postpartum. After taking several doses of diaphoretic (sweat-inducing) medicines without effect, she consulted me. Considering that her repeated sweating had been ineffective, I reasoned that further sweating would be inappropriate as it would damage body fluids. Therefore, I prescribed only Ejiao (1 liang), dissolved in water, which cured her.

Another woman, more than ten days postpartum, suffered from continuous whole-body sweating and convulsions. I treated her with Shanzhuyu (Corni Fructus, seeds removed completely) and Sheng Shanyao (Dioscoreae Rhizoma, raw), each 1 liang, decocted and taken for two doses. The sweating stopped, and the convulsions resolved.

A fisherman's wife in the East Sea area suffered from cold body, absence of sweat, and severe convulsions three days postpartum. At that time, I was traveling along the coast. Her family came to my residence to seek a prescription. Since the nearest pharmacy was far away, but Ephedra (Mahuang) grew abundantly on the coast, I instructed them to gather a handful of Mahuang and boil it together with one piece of Yubiao Jiao (Fish Bladder Gelatin) in a large bowl of water. She drank it while hot, sweated, and recovered. Yubiao Jiao was used to prevent convulsions caused by Yin deficiency due to excessive blood loss, and also because it was a product readily available to fishermen.

Another woman, having sweated excessively postpartum and then wearing three layers of clothing soaked through with sweat, developed palpitations (Zhengdong), mental confusion, and a sensation of floating up to the roof. This indicated extreme deficiency approaching collapse, with the Shen (Spirit) flying away. Upon examination, her sweating continued, and all six pulses were deficient and floating, vanishing upon pressure. I urgently prescribed Sheng Shanyao (1 liang), Jing Yurou (Corni Fructus, cleaned) (1 liang), and Sheng Baishao (4 qian), decocted and administered. The sweating stopped, and her spirit settled. However, when the medicinal effect wore off the next day, the condition recurred. By then, I had returned home. The family brought the prescription to consult again. I added Longgu (Fossilia Ossis Mastodi) and Muli (Concha Ostreae), neither calcined, each 8 qian, and advised them to take several doses for a cure. Unexpectedly, the pharmacy staff claimed the herbs were too cooling for postpartum use and insisted the condition was "postpartum wind," recommending their own proven formula. Persuaded by them, the family mistakenly used that formula, leading to uncontrollable sweating and collapse. Since the original condition was caused by excessive sweating, using exterior-releasing drugs for "postpartum wind" is akin to poison. This serves as a stern warning against inducing sweat without assessing deficiency or excess.

*Fu Qingzhu Nu Ke* states: Postpartum sudden deficiency of Qi and Blood leaves the bones and muscles lacking blood nourishment. Suddenly, the mouth becomes tight, teeth are clenched, and hand/foot sinews contract and convulse, resembling stroke, epilepsy, or tetanus. Although there may be phlegm due to floating deficient fire, treatment should focus on the root. Do not adhere to heterodox methods using wind-expelling and phlegm-resolving formulas, which would further weaken the puerpera. Instead, use Shenghua Tang, adding Renshen (Ginseng Radix et Rhizoma) [text missing, likely Qishi or similar] to benefit Qi.
It also states: Postpartum women with aversion to cold, nausea, body tremors, fever, and thirst are often mistaken as having postpartum Taiyang syndrome. Who knows it is actually due to dual deficiency of Qi and Blood, where righteous Qi cannot resist the pathogen? Generally, if Qi is not deficient, pathogens rarely invade. Excessive blood loss postpartum causes significant Qi deficiency. Qi deficiency means the skin and hair lack Wei (Defensive) protection, making invasion easy. Wind can enter through mere movement, not just external attacks. However, wind invading postpartum is easy to enter and easy to exit. For any external pathogenic factors, specific wind-expelling measures are unnecessary. Moreover, postpartum aversion to cold stems from internal cold. Fever stems from internal weakness. Tremors stem from Qi deficiency. Treating internal cold dissipates external cold. Treating internal weakness resolves external heat. Strengthening Yuan Qi eliminates tremors.

Commentary: Fu's discussion is profound. However, his statement "even with external contraction, wind-expelling is unnecessary" is debatable. If there is indeed an external contraction postpartum, treating it with external-contraction remedies is appropriate, provided they are supplemented with Qi-tonifying and Blood-nourishing herbs. If wind-heat has entered the Yangming Fu organs, presenting with heat in both interior and exterior and a surging, solid pulse, even Shigypsum (Gypsum Fibrosum) can be used. Thus, *Jin Gui Yao Lue* contains Zhupi Da Wan for treating deficiency during lactation with irritability, vomiting, and regurgitation, which originally includes Shigypsum. The *Shennong Bencao Jing* explicitly states Shigypsum treats postpartum conditions. However, it should not be combined with Zhimu (Anemarrhenae Rhizoma). One should follow the principle of Baihu Jia Renshen Tang, heavily using Renshen to greatly tonify Yuan Qi, and substituting Xuanshen (Scrophulariae Radix) for Zhimu. This allows the expulsion of pathogens. The cooling nature of Shigypsum, aided by the warming-tonic nature of Renshen, remains in the stomach to resolve dryness-heat without rushing to the lower jiao, thus avoiding harm to the puerpera (The properties of Shigypsum are discussed in detail below).

[Attached Formula] *Yi Lin Gai Cuo* treats postpartum wind with Huangqi Taohong Tang, using Sheng Huangqi (8 liang), Sheng Taoren with skin and tip (3 qian, crushed), and Honghua (2 qian), decocted in water. Note: For postpartum wind presenting with opisthotonos (stiff neck and back), this formula is most effective.

[Attached Formula] A folk remedy for postpartum wind uses Danggui (5 qian), Mahuang (Ephedrae Herba), Honghua, and Baizhu (Atractylodis Macrocephalae Rhizoma) each 3 qian, Dahuang (Rhei Radix et Rhizoma), Chuanxiong, Rougui (Cinnamomi Cortex), and Ziwan (Adenophorae Radix) each 2 qian, decocted and taken. Note: This formula is exceptionally effective. Even in cases of trismus (locked jaw) where oral medication is difficult, prying the teeth open for administration often results in recovery. People fear Dahuang and dare not use it, unaware that Western medicine also frequently uses blood-breaking herbs for postpartum wind. This is because blood stasis is common postpartum; using Dahuang to break stasis aligns with the principle "when blood moves freely, wind self-disperses." Furthermore, the acrid-warm nature of Mahuang and Rougui, combined with the tonic effects of Danggui and Baizhu, provides modulation.