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Guo Jizhong stated: When excessive sweating after childbirth transforms into Jing disease (spasm), it is due to blood deficiency postpartum, where the Cou Li (skin pores and interstitial spaces) are not tight, leading to profuse sweating. Upon encountering wind pathogen invasion and binding, Jing disease occurs. Jing disease refers to trismus (lockjaw) where the mouth cannot open, back stiffness and straightness, resembling an epileptic seizure, with head shaking and sounds like a horse neighing, opisthotonos (body arching backward), recurring in moments, with breath appearing as if cut off. One should quickly pry open the mouth and administer Xiao Xuming Tang (Minor Cinnamon Twig Decoction). If the condition slightly relieves but presents with sweat pouring like rain and picking at empty air (carphologia), it is incurable.

Xue Shi stated: Postpartum Jing disease arises from excessive blood loss causing extreme depletion of Yuan Qi (Original Qi), or interaction with external pathogens, resulting in urgent jaw clenching, spastic rigidity of the four limbs, or opisthotonos of the waist and back, and limb convulsions. Those with sweating but no aversion to cold are called Rou Jing (Soft Spasm); those without sweating and with aversion to cold are called Gang Jing (Hard Spasm). This is caused by excessive blood loss leaving the sinews without nourishment. Thus, patients who have undergone excessive sweating or purgation in Shanghan diseases, or those with massive discharge of pus and blood from ulcers, often suffer from this; it is a critical syndrome. Urgently use Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) to greatly tonify blood and Qi. If the pulse responds favorably, urgently add Fuzi (Prepared Aconite Root); survival may be ensured. If one attacks the wind pathogen, death is inevitable.

The Yijian Zhi records: Du Ren treated the wife of Hao Zizhi, four days postpartum, presenting with eyes rolling upward and opisthotonos. Du Ren diagnosed it as Jing disease and administered Da Dou Zi Tang (Soybean Purple Decoction) and Duhuo Tang (Angelica Pubescens Decoction), resulting in recovery. During the Zhenghe era, my wife had just given birth and was still in bed when she suddenly developed this symptom; her head and feet bent backward towards each other, nearly two chi apart. Family members were terrified; several maids tried forcibly to straighten her body but failed. Recalling the text, and finding Duhuo among the herbs, I hastily prepared it. Before the physician arrived, three doses were administered consecutively, allowing her body to straighten. The physician's arrival coincided with full recovery, making Da Dou Zi Tang unnecessary. Ancient prescriptions proved effective repeatedly.

Chen Linchuan stated: Any postpartum case involving trismus, back stiffness, and opisthotonos is named Jing (Spasm), also referred to as Chi (Stiffness). Ancients distinguished between Gang (Hard) and Rou (Soft) types based on the presence or absence of sweating to guide treatment according to Yin-Yang principles. Current texts such as Chanbao include sections on "Stroke with Trismus" and "Opisthotonos," which are essentially the same entity. Symptoms like aversion to cold and fever resemble Shanghan, yet these are often overlooked. How can such conditions be treated with only one or two remedies?

According to Suwen, the character for Jing exists, but Chi does not. Zhang Zhongjing discussed Jing disease in the Taiyang channel chapter but did not provide a specific formula for it. Therefore, the character Chi in current texts is likely a transcription error for Jing. The characters Jin and Jing share similar forms and sounds. Given that Jing disease manifests with stiff neck and back and opisthotonos, using Jing is undoubtedly correct, whereas Chi lacks clear semantic meaning. Cold governs contraction and pulling; wind-cold in the Taiyang channel causing neck and back stiffness indicates a Taiyang sinew pathology. Most formulas advocate Xuming Tang, following Zhongjing’s theory. Guo’s approach, ignoring postpartum deficiency/excess and the presence/absence of pathogens, blindly adheres to this method, showing bias. Conversely, Xue’s assertion that postpartum blood loss requires urgent Shiquan Dabu Tang and forbids attacking wind pathogens is another form of one-sidedness. The Yijian Zhi case, cured with Da Dou Zi Tang and Duhuo Tang, emphasizes treating wind. Thus, Xuming Tang is not entirely baseless, but it contains Mahuang (Ephedra Herb) and Fuzi, which should not be used lightly in patients with dual Qi and Blood deficiency. Guo’s advice to administer it rapidly, warning that delay causes profuse sweating (contradicting the caution against Mahuang), seems overly hasty. Both perspectives have merit and should be carefully considered clinically.

Xiao Xuming Tang treats postpartum sweating transforming into Jing disease, characterized by trismus, neck stiffness, head shaking resembling horse neighing, intermittent attacks, and breathlessness.
Formula see previous Stroke section.

Chen Linchuan cited Chen Wuyue’s evaluation: Allowing Xiao Xuming Tang for postpartum sweating-induced Jing disease is hard to believe. Since sweating is already excessive, how can one administer Mahuang, Guizhi (Cinnamon Twig), Fangji (Stephania Root), Huangqin (Scutellaria Root)? Da Dou Zi Tang is preferable. Dasheng San (Great Sage Powder) from Ju Fang is also a good medicine. Observing Zhu Fengyi’s statement: For both Gang and Rou Chi, Xiao Xuming Tang can be modified and administered. For Rou Chi with spontaneous sweating, removing Mahuang and adding Gegen (Kudzu Root) must have a basis. Although Da Dou Zi Tang and Dasheng San are excellent, one should not hold biased views that distort ancient intentions.

Da Dou Zi Tang treats stroke with dizziness, aversion to wind, spontaneous sweating, vomiting cold water, and various postpartum ailments. It also treats stroke-induced Fei (flaccidity) or Jing disease, back stiffness, trismus, staring gaze, irritability, and heat. If the pulse is tight and large, it is untreatable.
Formula see previous Stroke section.

Da Dou Tang treats sudden wind-stroke in postpartum women causing Chi disease, fainting and unconsciousness, as well as pregnancy complicated by wind, and various disorders during confinement.
Da Dou (Soybean, 5 sheng, stir-fried until slightly scorched), Gegen (Puerariae Radix), Duhuo (Angelicae Pubescentis Radix) (each 1 liang), Fangji (Stephaniae Tetrandrae Rhizoma) (6 liang). (Fangji circulates through the twelve meridians; contraindicated in deficiency. The dosage here is particularly high; use discretion.)
Crush the ingredients. Take 5 qian per dose, decoct with 2 zhan of wine to 1.5 zhan. Strain and take warm. No fixed time; three times daily.
Another prescription treats postpartum wind-stroke with generalized pain and spontaneous sweating, along with other ailments.
Duhuo (8 liang), Danggui (Angelicae Sinensis Radix) (4 liang).
Crush the ingredients. Decoct with 8 sheng of wine to obtain 4 sheng. Strain. Divide into four doses. Take three times during the day and once at night, aiming for mild sweating. If there is rebellious Qi, add Guixin (Cinnamomi Cortex) 2 liang. Repeat if ineffective.

Lingyang Jiao Yinzi treats postpartum excess Qi, abdominal hardness, distension in the hypochondrium, mental restlessness and heat, thirst for water, impending Gang Chi, and wind-stroke diseases.
Lingyang Jiao (Antelope Horn) (0.5 liang, sliced), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Jiegeng (Platycodonis Radix) (all remove rhizome), Baijiangcao (Patriniae Herba) (each 8 qian). (Baijiangcao is rarely recognized nowadays; substitute appropriately.) Guixin, Chaihu (Bupleuri Radix), Dahuang (Rhei Radix et Rhizoma) (soaked in wine and roasted) (each 1 liang 2 qian).
Crush the ingredients. Take 5 qian per dose, decoct with 1.5 zhan of water to 1 zhan. Strain and take warm. No fixed time. Also take Dihuang Jiu (Rehmannia Wine): Cut 1 sheng of Dihuang (Rehmanniae Radix Praeparata), stir-fry until black, place in a porcelain jar, add 3 sheng of hot wine, seal tightly, and boil until reduced by half. Drink as desired.

Fangfeng Danggui San
Fangfeng, Chuanxiong (Ligusticum Chuanxiong Rhizoma), Danggui, Dihuang (Rehmanniae Radix Praeparata) (each 5 qian).
Cut the ingredients. Take 1 liang per dose, decoct with 3 zhan of water to 2 zhan. Take warm.

Lou Shi stated: Xuming Tang, Da Dou Zi Tang, and Juqing Gubai San are medicines targeting the Taiyang and Jueyin channels. They are suitable for cases with excess pathogens and floating, wiry, forceful pulses. However, for postpartum women with severe Qi and Blood deficiency, one should not lightly induce diaphoresis to release the exterior. Using Fangfeng Danggui San is the superior approach.