（附∶角弓反张）
薛立斋云∶ 者，筋脉拘急也， 者，筋脉弛纵也。经云∶肝主筋而藏血。盖肝气为阳为火，肝血为阴为水，前证
因产后阴血去多，阳火炽盛，筋无所养而然耳。故痈疽脓水过多，金疮出血过甚，则阳随阴散，亦多致此。治洁当用八
珍加丹皮、钩藤，以生阴血，则阳火自退，诸证自愈。如不应，当用四君，芎、归、丹皮、钩藤，以补脾土。盖血生于
至阴，至阴者脾土也，故小儿吐泻之后，脾胃亏损，亦多患之，乃虚象也，无风可逐，无痰可消。若属阳气脱陷者，用
补中益气汤加姜、桂，阳气虚败者，用十全大补汤加桂附；亦有复生者。此等证候，若肢体恶寒，脉微细者为真，若脉
浮大，发热烦渴，此为假象，惟当固本为善。若无力抽搐，戴眼反折，汗出如珠流者皆不治。又有角弓反张者，风邪乘
虚入于诸阳阿经，则腰背反折，挛急如角弓之状也。皆因气血耗损，腠理不密，汗出过多，宜固气血为主，佐以本方。
丹溪所谓产后以大补气血为主，虽有杂病证，以末治之此也。如恶寒发热等证，乃气血虚耗之极，宜大剂参、 、归、
术、肉桂以培养之。如不应，急用炮附子。再不应，用人参一两，炮附子二三钱，名参附汤。若犹未应，药力未及也，
宜多用之。
增损柴胡汤
治产后感异证，手足牵搐，涎潮，昏闷。
柴胡（三钱） 黄芩（一钱二分） 人参 甘草 半夏（各一钱半） 石膏（二钱） 黄 （一钱半） 知母（一
钱）
上 咀，分二服，水二盏，姜三片，枣二枚，煎八分，不拘时服。
秦艽汤
治产后血虚生风，手足螈 。
秦艽 芍药 柴胡（各一钱七分） 甘草（炙，一钱三分） 黄芩 防风（各一钱二分） 人参 半夏（各一钱）
上水二钟，姜三片，煎八分，食远服。
愈风汤、交加散俱可用（二方见前）。
（附注：角弓反张）
薛立斋说：瘛（chì，筋脉拘急收缩），是筋脉拘急；瘲（zhòng，筋脉弛缓松弛），是筋脉弛纵。医经说：肝主司筋脉并贮藏血液。大概肝气属于阳、属于火，肝血属于阴、属于水，上述病证是因为产后阴血流失过多，导致阳火炽盛，筋脉得不到滋养而形成的。所以痈疽疮疡脓水流出过多，金刃创伤出血过甚，就会造成阳气随着阴血耗散，也大多会导致这种病症。治疗应当使用八珍汤（由四君子汤和四物汤组成，气血双补）加入牡丹皮、钩藤，以滋生阴血，那么阳火自然消退，各种症状自然痊愈。如果无效，应当使用四君子汤（补气基础方）加上川芎、当归、牡丹皮、钩藤，来补益脾土。因为血液产生于至阴之地，所谓至阴就是脾土，所以小儿在呕吐腹泻之后，脾胃亏损，也大多患有此症，这是虚损的表现，没有风邪可以驱逐，没有痰浊可以消除。如果属于阳气脱陷的，用补中益气汤（补中益气，升阳举陷）加入生姜、肉桂；如果属于阳气虚败的，用十全大补汤（温补气血）加入肉桂、附子；也有能够复生的案例。这类证候，如果肢体恶寒，脉象微细，这是真寒假热或纯虚之象；如果脉象浮大，伴有发热、烦躁、口渴，这是假象，只应当以固护根本为善策。如果出现无力抽搐，眼睛上翻（戴眼），身体向后反折如弓状，汗出如珠且流动不止的，都属于不治之症。又有角弓反张的情况，是风邪乘虚侵入诸阳经，导致腰背反折，挛急僵硬如同角弓的形状。这都是因为气血耗损，腠理（皮肤毛孔及纹理）不紧密，出汗过多所致，应当以固护气血为主，辅以本方。朱丹溪所说的产后以大补气血为主，即使有其他的杂病证候，也只作为次要问题来处理，就是这个道理。如果有恶寒发热等症状，这是气血极度虚耗的表现，应当用大剂量的人参、白术、当归、白术、肉桂来培养正气。如果无效，紧急使用炮制过的附子。如果再无效，用人参一两，炮附子二三钱，名为参附汤。如果仍然没有反应，是因为药力尚未到达病所，应当加大剂量继续使用。
增损柴胡汤
治疗产后感受异常证候，手足牵引抽搐，涎液上涌，神志昏闷。
柴胡（三钱） 黄芩（一钱二分） 人参 甘草 半夏（各一钱半） 石膏（二钱） 黄芪（一钱半） 知母（一钱）
以上药材切碎，分为两次服用，加水两盏，生姜三片，大枣二枚，煎煮至剩余八分水量，不拘时间服用。
秦艽汤
治疗产后血虚生风，手足抽搐。
秦艽 芍药 柴胡（各一钱七分） 甘草（炙，一钱三分） 黄芩 防风（各一钱二分） 人参 半夏（各一钱）
以上药材加水两钟，生姜三片，煎煮至剩余八分水量，饭后较远时服用。
(Note: Opisthotonos)
Xue Lizhai stated: "Chi" (spasm, contraction of tendons and vessels) refers to the tightness and contraction of tendons and vessels; "Zhong" (flaccidity, relaxation of tendons and vessels) refers to the laxity and relaxation of tendons and vessels. The Classics state: The Liver governs the tendons and stores blood. Generally, Liver Qi belongs to Yang and Fire, while Liver Blood belongs to Yin and Water. The aforementioned conditions occur because excessive loss of Yin blood after childbirth leads to blazing Yang Fire, causing the tendons to lack nourishment. Therefore, when pus and water from carbuncles and sores are excessively discharged, or when bleeding from metal wounds is too severe, Yang dissipates along with Yin, often resulting in these conditions. Treatment should employ Bazhen Tang (Eight-Treasure Decoction, a formula for tonifying both Qi and Blood) added with Mudanpi (Cortex Moutan Radicis) and Gouteng (Uncariae Ramulus cum Uncis) to generate Yin blood, whereupon Yang Fire will naturally recede and all symptoms will resolve spontaneously. If there is no response, Sijunzi Tang (Four-Gentlemen Decoction, a basic formula for tonifying Qi) should be used combined with Chuanxiong (Rhizoma Ligustici Chuanxiong), Danggui (Radix Angelicae Sinensis), Mudanpi, and Gouteng to tonify Spleen Earth. Since blood is generated from the Supreme Yin, and the Supreme Yin is Spleen Earth, children who suffer from vomiting and diarrhea subsequently often develop this condition due to Spleen-Stomach deficiency. This is a manifestation of deficiency, with no pathogenic Wind to expel and no Phlegm to eliminate. If it belongs to sinking and collapse of Yang Qi, Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) added with Shengjiang (Zingiberis Rhizoma Recens) and Rougui (Cinnamomi Cortex) should be used; if it belongs to failure of Yang Qi, Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) added with Rougui and Fuzi (Aconiti Lateralis Radix Praeparata) should be used; some cases may recover. In such syndromes, if there is aversion to cold in the limbs and a faint, fine pulse, this is the true presentation; if the pulse is floating and large, accompanied by fever, restlessness, and thirst, this is a false presentation. One should only focus on consolidating the root as the best approach. If there is weak convulsions, eyes rolling upward (Daiyan), opisthotonos with the body bent backward like a bow, and sweating profusely with beads of sweat flowing, these are all untreatable conditions. There is also opisthotonos, caused by Wind pathogen entering the Yang meridians through deficiency, leading to backward bending of the waist and back, with spasms and stiffness resembling the shape of a horned bow. All these result from depletion of Qi and Blood, loose interstices (Couli), and excessive sweating. The primary treatment should be to consolidate Qi and Blood, assisted by the aforementioned formulas. As Zhu Danxi said, postpartum treatment should primarily focus on greatly tonifying Qi and Blood; even if other miscellaneous disease patterns exist, they should be treated as secondary concerns. If there are symptoms such as aversion to cold and fever, this indicates extreme depletion of Qi and Blood, and large doses of Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui, Baizhu, and Rougui should be used to cultivate the body. If there is no response, Pao Fuzi (Prepared Aconite Root) should be urgently administered. If still ineffective, use one liang of Renshen and two to three qian of Pao Fuzi, named Shenfu Tang (Ginseng and Aconite Decoction). If there is still no response, it is because the medicinal power has not yet reached the disease site; the dosage should be increased and continued.
Zengsun Chaihu Tang (Modified Bupleurum Decoction)
Treats abnormal postpartum conditions characterized by pulling and convulsions of hands and feet, surging saliva, and mental dullness.
Chaihu (Bupleuri Radix) (3 qian), Huangqin (Scutellariae Radix) (1.2 qian), Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Banxia (Pinelliae Rhizoma Preparatum) (each 1.5 qian), Shigao (Gypsum Fibrosum) (2 qian), Huangqi (Astragali Radix) (1.5 qian), Zhimu (Anemarrhenae Rhizoma) (1 qian).
The above herbs are coarsely crushed, divided into two doses. Add two zhan of water, three slices of ginger, and two jujubes. Decoct until eight parts remain. Take at any time.
Qinjiao Tang (Gentianae Macrophyllae Decoction)
Treats postpartum wind generation due to Blood deficiency, manifesting as convulsions of hands and feet.
Qinjiao (Gentianae Macrophyllae Radix), Shaoyao (Paeoniae Radix Alba), Chaihu (Bupleuri Radix) (each 1.7 qian), Gancao (Glycyrrhizae Radix et Rhizoma Preparata) (1.3 qian), Huangqin (Scutellariae Radix), Fangfeng (Saposhnikoviae Radix) (each 1.2 qian), Renshen (Ginseng Radix et Rhizoma), Banxia (Pinelliae Rhizoma Preparatum) (each 1 qian).
Add two zhong of water and three slices of ginger. Decoct until eight parts remain. Take well after meals.
Yufeng Tang (Wind-Extinguishing Decoction) and Jiaojiao San (Intersecting Powder) can also be used (see previous sections for these two formulas).