〔大全〕产后热闷气上，转为香港脚者何？答曰∶产卧血虚生热，复因春夏取凉过多，地
之蒸湿，因足履之，所以着为香港脚。其状热闷，掣 惊悸心烦，呕吐气上，皆其候也。可
服小续命汤（方见杂病中风。）两三剂必愈。若医者误以逐败血药攻之，则血去而疾益增矣。
陈无择评曰∶香港脚固是常病，未闻产后能转为者，往往读《千金》见产妇多有此疾
之语，便出是证，文辞害意，盖可见矣。设是热闷气上，如何便服续命汤，此药本主少
阳经中风，非均治诸经香港脚，要须根据香港脚方论阴阳经络调之，此涉专门，未易轻论，既
非产后要病，更不繁引。
陈无择虽有此论，然小续命汤加减与之，用无不效。故《百问》云∶寒中三阳，所患
必冷，小续命汤主之。（加生姜汁更快。）暑中三阴，所患必热，小续命汤。（去附子，减桂一半。）
大烦躁者，紫雪最良。（予取《百问》中加减法，庶使后人均得治疗。）如无紫雪，用真薄荷煎冷水嚼
下。（娄云∶诸方必与四物汤各半服之。）
〔薛〕前证当补气血为主，佐以小续命汤、寄生汤。如不应，用大防风汤。一产
妇患前证，或用独活寄生汤而痊。后复作，服前汤，其汗如水，更加口噤吐痰。余用十全
大补汤培养血气，渐愈。后饮食日少，肌体日瘦，吐痰如涌。此命门火衰，脾土虚寒，用
八味丸及加味归脾汤，诸证渐退，肌肉渐生。
独活寄生汤 治肝肾虚弱，或久履湿冷之地，或洗足当风，湿毒内攻，两胫缓纵，
挛痛痹弱，或皮肉紫破，足膝挛重。又专治产后香港脚。
川独活（三两） 桑寄生（如无，以续断代） 杜仲（炒） 牛膝（去芦，酒浸） 细辛
官桂（不见火） 白茯苓 防风 川芎 当归 人参 熟地黄（酒洗） 芍药 秦艽（各二两）
甘草（炙，一两）
上为 咀，每服四钱，姜五片，水煎温服。
【《产育宝庆集》】产后出现热闷、气逆上冲，并转化为香港脚（脚气病）的原因是什么？回答说：分娩后卧床休息导致血虚而生内热，又因在春夏季节贪凉过度，地面的蒸腾湿气通过足部侵入人体，因此发为香港脚。其症状表现为热闷感，肢体抽搐、惊悸、心烦意乱，呕吐且气逆上冲，这些都是该病的征候。可以服用小续命汤（方剂见杂病中风章节）两三剂即可痊愈。如果医生错误地使用逐瘀败血的药物进行攻伐，那么血液耗损而疾病反而会加重。
陈无择评论说：香港脚确实是常见病症，但从未听说过产后会转化为此病。人们往往阅读《千金方》时，看到书中提到产妇多有此类疾病的语句，便据此推断出这种证型，这真是文辞误导了医理，由此可见一斑。如果是热闷气上之证，怎么能直接服用小续命汤呢？此药原本主治少阳经中风，并非通治所有经络的香港脚，必须根据香港脚的方论，结合阴阳经络进行调理。这涉及专门学问，不易轻易议论，既然不是产后的主要病症，便不再繁琐引用。
虽然陈无择有上述言论，但在临床实践中，对小续命汤进行加减化裁使用，往往没有不奏效的。所以《百问》中说：寒邪侵袭三阳经，患病必然表现为寒冷，用小续命汤主治。（加入生姜汁效果更快。）暑邪侵袭三阴经，患病必然表现为发热，用小续命汤。（去掉附子，减少桂枝用量一半。）若出现极度烦躁者，紫雪散最为适宜。（我选取《百问》中的加减法，以便让后人都能得到治疗。）如果没有紫雪散，可用真薄荷煎煮冷水送服。（娄全善评论说：各方书都主张与小续命汤各半量同服。）
【薛己】前述证候应当以补益气血为主，佐以小续命汤、独活寄生汤。如果无效，则使用大防风汤。有一位产妇患上述证候，服用独活寄生汤后痊愈。后来病情复发，再次服用前药，出汗如水，并出现牙关紧闭、吐痰的症状。我用十全大补汤来培补气血，病情逐渐好转。后来患者饮食日渐减少，身体日渐消瘦，吐痰如涌。这是命门火衰，脾土虚寒所致，于是使用八味丸及加味归脾汤，各种症状逐渐消退，肌肉逐渐恢复。
独活寄生汤 治疗肝肾虚弱，或因长期行走于湿冷之地，或洗脚时当风受邪，湿毒内攻，导致两小腿松弛无力，痉挛疼痛、痹痛软弱，或皮肤肌肉紫暗破损，足膝拘挛沉重。又专门治疗产后香港脚。
川独活（三两） 桑寄生（如无，可用续断代替） 杜仲（炒制） 牛膝（去芦头，酒浸） 细辛 官桂（不经过火炒） 白茯苓 防风 川芎 当归 人参 熟地黄（酒洗） 芍药 秦艽（各二两） 甘草（炙，一两）
以上药材切碎，每次服用四钱，加生姜五片，水煎温服。
[From *Chan Yu Bao Qing Ji*] What is the reason for postpartum heat oppression, rebellious Qi rising, and transformation into Hongxiangjiao (Jiaogi / Foot Qi)? The answer is: After childbirth, lying in bed leads to blood deficiency generating internal heat. Furthermore, due to excessive cooling measures taken during spring and summer, the steaming dampness of the earth enters through the feet upon walking, thus manifesting as Hongxiangjiao. Its manifestations include a sensation of heat and oppression, muscle twitching, palpitations, irritability, vomiting, and rebellious Qi rising; these are all its signs. One may take Xiao Xuming Tang (Decoction for Minor Continuation, see Miscellaneous Diseases - Stroke) for two or three doses, and it will surely be cured. If a physician mistakenly uses drugs that purge stagnant blood to attack the condition, the loss of blood will cause the disease to increase further.
Chen Wuyue commented: Hongxiangjiao is indeed a common disease, but I have never heard of it transforming from the postpartum state. People often read *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold), seeing statements that many puerperae suffer from this disease, and thus deduce this syndrome. This shows how textual descriptions can mislead the meaning. If there is heat oppression and rebellious Qi, how can one directly administer Xuming Tang? This medicine originally treats Wind-Stroke of the Shaoyang Meridian, not all meridians' Hongxiangjiao uniformly. One must regulate according to the treatises on Hongxiangjiao, balancing Yin and Yang meridians. This involves specialized knowledge and is not easy to discuss lightly. Since it is not a critical postpartum disease, further citation is omitted.
Although Chen Wuyue has this argument, in practice, modifying and administering Xiao Xuming Tang yields efficacy without fail. Thus, *Baiwen* (Hundred Questions) states: When Cold invades the Three Yang meridians, the affliction must be cold; Xiao Xuming Tang governs it. (Adding ginger juice acts faster.) When Summerheat invades the Three Yin meridians, the affliction must be hot; Xiao Xuming Tang [remove Fuzi, reduce Guizhi by half]. For those with extreme restlessness, Zixue San (Purple Snow Powder) is best. (I selected the modification methods from *Baiwen* so that later generations may receive treatment.) If Zixue San is unavailable, use genuine Bohe (Menthae Haplocalycis Herba) decocted in cold water to chew and swallow. (Lou Quanshan commented: Various formularies prescribe taking it mixed equally with Siwu Tang.)
[Xue Ji] The aforementioned syndromes should primarily be treated by tonifying Qi and Blood, assisted by Xiao Xuming Tang and Duhuo Jisheng Tang. If ineffective, use Dafangfeng Tang. A certain puerpera suffered from the aforementioned syndrome and recovered after taking Duhuo Jisheng Tang. Later, it recurred; upon taking the previous formula, she sweated profusely like water, accompanied by trismus (lockjaw) and expectoration. I used Shiquan Dabu Tang (Decoction for Complete Great Tonification) to cultivate Qi and Blood, and she gradually improved. Subsequently, her dietary intake decreased daily, her body emaciated, and expectoration surged. This indicated decline of Mingmen Fire (Fire of the Gate of Life) and deficiency-cold of Spleen Earth. I used Bawei Wan (Eight-Ingredient Pill) and Jiawei Guipi Tang (Modified Restore the Spleen Decoction); various symptoms gradually receded, and muscle mass gradually regenerated.
Duhuo Jisheng Tang (Decoction for Nourishing the Liver and Kidneys with Angelica Pubescens) Treats deficiency of the Liver and Kidneys, or prolonged exposure to damp-cold environments, or washing feet while exposed to wind, causing damp-toxin to attack internally. Symptoms include flaccidity and weakness of both calves, spasmodic pain, bi-syndrome weakness, or purple/broken skin and flesh, with contracted and heavy feet and knees. It also specifically treats postpartum Hongxiangjiao.
Chuan Duhuo (Angelicae Pubescentis Radix, 3 liang) Sangjisheng (Taxilli Caulis, substitute with Xuanduan if unavailable) Duzhong (Eucommiae Cortex, stir-fried) Niuxi (Achyranthis Bidentatae Radix, remove radicle, wine-soaked) Xixin (Asari Radix et Rhizoma) Guizhi (Cinnamomi Ramulus, do not roast) Baifuling (Poria, white) Fangfeng (Saposhnikoviae Radix) Chuanxiong (Ligustici Chuanxiong Rhizoma) Danggui (Angelicae Sinensis Radix) Renshen (Ginseng Radix) Shudihuang (Rehmanniae Radix Praeparata, wine-washed) Shaoyao (Paeoniae Radix) Qinjiao (Gentianae Macrophyllae Radix) (each 2 liang) Gancao (Licorice Radix et Rhizoma, honey-fried, 1 liang)
Grind the above herbs into coarse powder. Each dose consists of 4 qian, with 5 slices of fresh ginger, decocted in water and taken warm.