《金匮要略》曰∶新产妇人有三病，一者病痉，何谓也？曰∶新产血虚，多汗出，喜中风，故令病痉。
郭稽中曰∶产后血虚，腠理不密，故多汗。因遇风邪抟之，则变痉。痉者，口噤开，背强而直，如发痫状，
摇头马鸣，身反折，气息如绝，汗出如雨，两手摸空者，不可治。
薛立斋曰∶产后发痉，因去血过多，元气亏损，或外邪相抟，致牙关紧急，四肢痉强，或腰背反张，肢体
抽搐。若有汗不恶寒，曰柔痉。无汗恶寒，曰刚痉。然产后患之，由亡血过多，筋无所养而致。大补气血，多
保无虞。若攻风邪，死无疑矣。
缪仲淳曰∶产后血虚，角弓反张，病名曰痉。痉者，劲也。去血过多，阴气暴虚，阴虚生内热，热极生风，
故外现风证。其实阴血不足，无以养筋所致。足厥阴肝经大虚之候，宜益阴补血，清热则愈。
薛立斋曰∶仲景云，伤寒有汗为柔痉，用桂枝汤。无汗为刚痉，用麻黄汤。产后得此，血气俱虚。败证不
可与伤寒例看，丹溪云，产后当大补气血为主，多服参、 、附子。中
风乃虚极之象，固其本元，诸病自退。
娄全善曰∶小续命、大豆紫汤、举卿古拜散，俱太阳厥阴药也。如邪实而脉来浮弦有力者固宜，但产后气血
大虚人，不宜轻发其表，但用防风当归散治之为妙。
武叔卿曰∶寒主收引，风寒在太阳经，项背强直者，太阳筋病也，诸方皆主续命，从仲景论也。郭氏不问
产后虚实，邪之有无，概宗之，似乎一偏。至薛氏，又以产后亡血过多，非十全大补不可，又一见也。及《夷
坚志》，按以大豆紫汤、独活汤而愈，又主于风矣。是续命亦不为妄也。但本方有麻黄、附子，气血两虚人，不
可轻用。而郭氏论又有速灌之说，稍缓即汗出如雨，反不以麻黄为忌，何语之切也。二说似不可废，临证之际详之。
慎斋按∶以上八条，序产后有痉证也。产后成痉，大抵血虚所致。故《金匮》以下四条，均主于亡血过多，
当从立斋、仲淳治例。后二条，辨不可用续命汤，致有误治之失，以示戒也。
《金匮要略》说：刚生产完的产妇有三种病，第一种就是病痉（痉挛），这是什么意思呢？回答说：产后血虚，出汗多，容易感受风邪，所以导致病痉。
郭稽中说：产后血虚，腠理（皮肤毛孔及肌肉间隙）不紧密，所以多汗。如果遇到风邪侵袭搏结，就会变成痉证。所谓痉证，表现为牙关紧闭或张开困难，背部僵硬挺直，像发作癫痫的样子，摇头发出马叫般的声音，身体向后反折，气息微弱好像断绝，出汗如雨，两手在空中摸索抓取的，属于不可治疗的危重症。
薛立斋说：产后发生痉证，是因为失血过多，元气亏损，或者外邪相搏结，导致牙关紧急，四肢痉挛强直，或者腰背向后反张，肢体抽搐。如果有汗且不恶寒，称为柔痉（Sunstroke with sweating）。无汗且恶寒，称为刚痉（Sunstroke without sweating）。然而产后患此病，是由于亡血过多，筋脉失去滋养所致。应当大补气血，大多能保全无事。如果去攻伐风邪，必定死亡无疑。
缪仲淳说：产后血虚，出现角弓反张，病名叫做痉。痉，就是劲急的意思。失血过多，阴气突然虚弱，阴虚产生内热，热极生风，所以外在表现出风证的样貌。其实质是阴血不足，无法滋养筋脉所致。这是足厥阴肝经极度虚弱的征候，应当益阴补血，清热即可痊愈。
薛立斋说：张仲景讲，伤寒病有汗的是柔痉，用桂枝汤（Cinnamon Twig Decoction）。无汗的是刚痉，用麻黄汤（Ephedra Decoction）。产后得了这种病，气血都虚弱。败坏严重的证候不能按照伤寒的常规来看待，朱丹溪说，产后应当以大补气血为主，多服用人参、[缺字，推测为白术]、附子。中风是极度虚弱的表现，巩固其根本元气，各种病症自然消退。
娄全善说：小续命汤（Minor Xu Ming Decoction）、大豆紫汤（Soybean Purple Decoction）、举卿古拜散（Ju Qing Gu Bai Powder），都是治疗太阳经和厥阴经疾病的方药。如果是邪气实盛而脉象浮弦有力的固然适宜使用，但产后气血大虚的人，不宜轻易发汗解表，只用防风当归散（Fangfeng Danggui San）来治疗才是妙法。
武叔卿说：寒性主收引，风寒在太阳经，出现项背强直的，是太阳经筋的病，各方都主张用续命汤，这是遵循张仲景的论述。郭氏不问产后体质的虚实、邪气的有无，一概宗奉这种方法，似乎有些偏颇。至于薛氏，又认为产后亡血过多，非十全大补汤（Shiquan Dabu Decoction）不可，这也是另一种见解。以及《夷坚志》中，用大豆紫汤、独活汤治愈，又是侧重于治风。这样看来，续命汤也不算妄用。但是本方含有麻黄、附子，对于气血两虚的人，不可轻率使用。而郭氏的论述中又有迅速灌服的說法，稍一迟缓就会汗出如雨，反而不把麻黄作为禁忌，这话切中要害吗？这两种说法似乎都不应废弃，临证时要详细斟酌。
慎斋按语：以上八条，叙述了产后出现痉证的情况。产后形成痉证，大抵是由血虚引起的。所以《金匮要略》以下的四条，都主要着眼于亡血过多，应当遵从薛立斋、缪仲淳的治疗法则。后两条，辨析了不可使用续命汤，以免导致误治的错误，以此作为警戒。
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: There are three diseases in women immediately after childbirth, one of which is Jing syndrome (spasm). What does this mean? It is said: After childbirth, blood deficiency occurs, accompanied by profuse sweating and a predisposition to wind pathogen invasion, thus leading to Jing syndrome.
Guo Jizhong stated: Postpartum blood deficiency leads to loose cou li (skin pores and interstices), resulting in profuse sweating. If wind pathogen invades and binds with it, Jing syndrome develops. Jing syndrome manifests as trismus or difficulty opening the mouth, rigidity and straightening of the back, resembling an epileptic seizure, head shaking, sounds like neighing horses, opisthotonos (body bending backward), breathlessness as if severed, sweating like rain, and picking at empty air; these are untreatable critical conditions.
Xue Lizhai stated: Postpartum Jing syndrome arises from excessive blood loss and depletion of Yuan Qi (primordial qi), or binding with external pathogens, causing trismus, spasticity and rigidity of the four limbs, or opisthotonos and limb convulsions. If there is sweating and no aversion to cold, it is called Rou Jing (Soft Spasm). If there is no sweating and aversion to cold, it is called Gang Jing (Hard Spasm). However, when occurring postpartum, it is caused by excessive blood loss leaving the sinews without nourishment. One should greatly tonify Qi and Blood, and safety can usually be ensured. If one attacks the wind pathogen, death is inevitable.
Miao Zhongchun stated: Postpartum blood deficiency leads to opisthotonos, named Jing syndrome. "Jing" means stiffness. Excessive blood loss causes sudden deficiency of Yin Qi. Yin deficiency generates internal heat; extreme heat generates wind, thus manifesting external wind symptoms. The essence is insufficient Yin and Blood failing to nourish the sinews. This is a sign of severe deficiency of the Foot Jueyin Liver Meridian. One should nourish Yin and tonify Blood, and clear heat for recovery.
Xue Lizhai stated: Zhang Zhongjing said that in Shang Han (Cold Damage) disease, sweating indicates Rou Jing, treated with Guizhi Tang (Cinnamon Twig Decoction). No sweating indicates Gang Jing, treated with Mahuang Tang (Ephedra Decoction). When contracted postpartum, both Qi and Blood are deficient. Critical postpartum syndromes should not be viewed according to standard Shang Han protocols. Zhu Danxi stated that postpartum treatment should primarily focus on greatly tonifying Qi and Blood, frequently administering Renshen (Ginseng Root), [missing character, likely Baizhu], and Fuzi (Aconite Root). Wind stroke here is a manifestation of extreme deficiency; consolidating the root Yuan Qi will cause various diseases to recede naturally.
Lou Quanshan stated: Xiao Xuming Tang (Minor Xu Ming Decoction), Dadouzi Tang (Soybean Purple Decoction), and Juqing Gubai San (Ju Qing Gu Bai Powder) are all formulas targeting the Taiyang and Jueyin meridians. They are suitable if the pathogen is excess and the pulse is floating, wiry, and forceful. However, for postpartum patients with severe Qi and Blood deficiency, one should not lightly induce sweating to release the exterior. Using Fangfeng Danggui San (Saposhnikovia and Angelica Powder) is the superior approach.
Wu Shuqing stated: Cold naturedly contracts and draws inward. Wind-Cold in the Taiyang meridian causing neck and back rigidity is a disease of the Taiyang sinews. Most formulas advocate Xuming Tang, following Zhang Zhongjing’s discussion. Guo’s approach, ignoring postpartum deficiency/excess and presence/absence of pathogen, blindly follows this method, which seems biased. Xue’s view, insisting on Shiquan Dabu Decoction (Ten Complete Tonic Decoction) due to massive blood loss, is another perspective. Meanwhile, *Yijian Zhi* records cures using Dadouzi Tang and Duhuo Tang, emphasizing wind treatment. Thus, Xuming Tang is not entirely baseless. However, the formula contains Mahuang (Ephedra Herb) and Fuzi (Aconite Root); it must not be used lightly in patients with dual Qi and Blood deficiency. Furthermore, Guo’s discussion advocates rapid administration, warning that delay leads to profuse sweating, yet he does not strictly forbid Mahuang. Is his reasoning sound? Both viewpoints should not be discarded but carefully considered during clinical practice.
Shen Zhai commented: The above eight passages describe the occurrence of Jing syndrome postpartum. Postpartum Jing syndrome is largely caused by blood deficiency. Therefore, the four passages below *Jin Gui* focus on excessive blood loss and should follow the treatment principles of Xue Lizhai and Miao Zhongchun. The last two passages analyze why Xuming Tang should not be used, to prevent misdiagnosis and serve as a warning.