薛立斋曰∶肝属木主筋，若肝经风热血燥，用加味逍遥散，不应，六味丸以补肾水。经云∶风客淫气，精
乃亡，邪伤肝也。
慎斋按∶以上五条，序产后有口噤、角弓、 ，拘挛诸证也。诸证为中风内见证，虽有口噤、角弓异名，
总以产后气血大虚所致。故一切风药，概不可用。唯遵丹溪、立斋之论治，为产后中风病之要道也。
郭稽中曰∶产后不语者何？答曰∶人心
有七孔三毛。心者，君主之官，神明出焉，外应于舌，舌者声之机。产后虚弱，多致败血停蓄，上干于心，心
窍闭塞，神志不能明了。又心气通于舌，心气闭则舌强不语，但服七珍散。
武叔卿曰∶产后不语，有临产服药与汤过多，胃湿使然。又有热痰迷于心不语，导痰汤。
方约之曰∶产后不语，有热血迷塞心窍者，有热痰迷塞心窍者，前方七珍散治热血，孤凤散治热痰。肥人
多是热痰，瘦人多是热血。
薛立斋曰∶经云，大肠之脉散舌下。又云∶脾之脉，是动病舌本强，不能言。又云∶肾之别脉，上入于心，
系舌本，虚则不能言。前证若心肾气虚，用七珍散。肾虚风热，地黄饮。大肠风热，加味逍遥散加防风、白芷。
脾经风热，秦艽升麻汤。肝经风热，柴胡清肝散加防风、白芷。脾气郁结，加味归脾汤加升麻。肝木太过，小
柴胡加钩藤。脾受木侮，加白芷、升麻、钩藤。肝脾血虚，佛手散。脾气虚，四君子汤。气血俱虚，八珍汤。
不应，独参汤加附子，补其气而生血。若竟用血药，则误矣。
慎斋按∶以上四条，序产后有不语之证也。产后不语，稽中主于败血迷心，《济阴》主于胃湿热痰，此皆
论病之属有余也。产后去血过多，阴火上乘，郁冒心神为不语，此证之属虚者为多，而败血热痰，亦间有之。
至论胃湿使然，则迂矣。若立斋又兼肝脾风热用药，多以防、芷、升、柴为发散，似未切中病机也。
薛立斋说：肝属木，主管筋脉。如果是肝经风热血燥，使用加味逍遥散；如果无效，用六味丸来补肾水。《内经》说：“风邪客居体内导致气机紊乱，精气就会耗亡，这是因为邪气伤害了肝脏。”
慎斋按语：以上五条内容，叙述了产后出现口噤（牙关紧闭）、角弓反张、抽搐、拘挛等各种证候。这些证候属于中风内风的见证，虽然名称不同（如口噤、角弓反张），但总归是由产后气血严重亏损所致。因此，一切祛风药物都不可使用。只有遵循丹溪、立斋的论述进行治疗，才是治疗产后中风的要领。
郭稽中说：产后不语是怎么回事？回答说：人心有七孔三毛。心是君主之官，精神意识由此产生，外部对应于舌头，舌头是发声的关键机关。产后身体虚弱，容易导致败血停滞蓄积，向上干扰心脏，使心窍闭塞，神志不能清明。另外，心气通达于舌，心气闭塞则舌体僵硬而不能言语，只需服用七珍散。
武叔卿说：产后不语，有的是因为临产时服药和汤剂过多，导致胃中有湿气的缘故。还有的是因为热痰迷蒙心窍导致不语，可用导痰汤治疗。
方约之说：产后不语，有的因热血迷塞心窍，有的因热痰迷塞心窍。前面的七珍散治疗热血证，孤凤散治疗热痰证。肥胖的人多是热痰，瘦弱的人多是热血。
薛立斋说：《内经》说，大肠的经脉散布在舌下。又说，脾的经脉发生变动，病证表现为舌根僵硬，不能说话。还说，肾的别行经脉，上行进入心中，联系舌根，肾虚则不能说话。上述证候如果是心肾气虚，使用七珍散。肾虚兼风热，用地黄饮。大肠风热，用加味逍遥散加防风、白芷。脾经风热，用秦艽升麻汤。肝经风热，用柴胡清肝散加防风、白芷。脾气郁结，用加味归脾汤加升麻。肝木太过，用小柴胡汤加钩藤。脾受肝木克制（木侮土），加白芷、升麻、钩藤。肝脾血虚，用佛手散。脾气虚，用四君子汤。气血俱虚，用八珍汤。如果无效，用独参汤加附子，补气以生血。如果竟只用补血药，那就错了。
慎斋按语：以上四条，叙述了产后不语的证候。郭稽中主张败血迷心，《济阴纲目》主张胃湿热痰，这些都是论述属于实证有余的病机。产后失血过多，阴火上乘，郁冒心神导致不语，这种证候属于虚证的居多，而败血和热痰，也偶尔存在。至于说是胃湿导致的，就太迂腐了。至于薛立斋又兼顾肝脾风热用药，多使用防风、白芷、升麻、柴胡作为发散药，似乎没有切中病机。
Xue Lizhai stated: The Liver belongs to Wood and governs the sinews. If there is wind-heat and blood dryness in the Liver channel, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder); if ineffective, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) to tonify Kidney Water. The Classic says: "When wind lodges and disrupts Qi, essence is depleted, because pathogenic factors damage the Liver."
Shen Zhai commented: The above five items describe postpartum syndromes such as trismus (lockjaw), opisthotonos (arched back), convulsions, and spasms. These syndromes are manifestations of internal wind from stroke. Although they have different names (such as trismus and opisthotonos), they are all caused by severe deficiency of Qi and Blood after childbirth. Therefore, all wind-dispelling herbs should not be used. Only by following the theories of Danxi and Lizhai for treatment can one grasp the essential approach to treating stroke in postpartum women.
Guo Jizhong asked: What causes aphasia after childbirth? He answered: The human heart has seven apertures and three hairs. The Heart is the sovereign official, from which spirit and consciousness emerge, externally corresponding to the tongue; the tongue is the mechanism of speech. After childbirth, due to weakness,敗血 (retained blood/stasis) often stagnates and accumulates, disturbing the Heart upwards, closing the Heart orifices, and preventing clear consciousness. Furthermore, Heart Qi connects to the tongue; when Heart Qi is blocked, the tongue becomes stiff and speechless. One should simply administer Shizhen San (Seven Treasures Powder).
Wu Shuqing said: Postpartum aphasia may result from taking too many medicines and decoctions during labor, causing dampness in the Stomach. It may also result from phlegm-heat confusing the Heart, leading to aphasia, which can be treated with Daotan Tang (Phlegm-Conducting Decoction).
Fang Yuezhi stated: Postpartum aphasia can be caused by hot blood blocking the Heart orifices, or by phlegm-heat blocking the Heart orifices. The aforementioned Shizhen San treats hot blood, while Gufeng San (Lone Phoenix Powder) treats phlegm-heat. Obese individuals tend to have phlegm-heat, while thin individuals tend to have hot blood.
Xue Lizhai stated: The Classic says, the meridians of the Large Intestine spread under the tongue. It also says, when the meridians of the Spleen undergo change, the disease manifests as stiffness of the tongue root and inability to speak. It further states, the divergent meridian of the Kidney enters the Heart and connects to the tongue root; deficiency leads to inability to speak. For the aforementioned conditions, if there is deficiency of Heart and Kidney Qi, use Shizhen San. For Kidney deficiency with wind-heat, use Dihuang Yin (Rehmannia Decoction). For Large Intestine wind-heat, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with Fangfeng (Saposhnikovia Root) and Baizhi (Angelica Dahurica). For Spleen channel wind-heat, use Qinjiao Shengma Tang (Gentian and Cimicifuga Decoction). For Liver channel wind-heat, use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) with Fangfeng and Baizhi. For Spleen Qi stagnation, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction) with Shengma (Cimicifuga Rhizome). For excessive Liver Wood, use Xiao Chaihu Tang (Minor Bupleurum Decoction) with Gouteng (Uncaria Ramulus). When Spleen is invaded by Liver Wood (Wood insulting Earth), add Baizhi, Shengma, and Gouteng. For Liver and Spleen blood deficiency, use Foshou San (Buddha's Hand Powder). For Spleen Qi deficiency, use Sijunzi Tang (Four Gentlemen Decoction). For combined Qi and Blood deficiency, use Bazhen Tang (Eight Treasures Decoction). If ineffective, use Dushen Tang (Single Ginseng Decoction) with Fuzi (Aconite Lateral Root) to tonify Qi to generate Blood. If one merely uses blood-tonifying herbs, it would be a mistake.
Shen Zhai commented: The above four items describe postpartum aphasia. Guo Jizhong attributes it to retained blood confusing the Heart, while *Jiyin Gangmu* attributes it to Stomach dampness, heat, and phlegm; both discuss pathological excess. Postpartum excessive blood loss leads to deficient fire ascending, depressing and confusing the Heart spirit, causing aphasia; this type of syndrome is mostly deficiency. Retained blood and phlegm-heat occur only occasionally. To attribute it to Stomach dampness is overly pedantic. As for Xue Lizhai addressing Liver and Spleen wind-heat, frequently using Fangfeng, Baizhi, Shengma, and Chaihu as dispersing agents, it seems he did not accurately target the pathogenesis.