薛氏曰∶ 者，筋脉拘急也； 者，筋脉张纵也。（ 者抽搐伸缩也）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。治法当用八珍加丹皮钩藤，以
生阴血（丹皮钩藤为肝火而用），则阳火自退，诸症自愈。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，脾胃虚损，亦多患之，乃虚象
也（所谓虚象者，土虚反见风木之化也），无风可逐，无痰可消。若属阳气脱陷者，用补中益
气加姜桂，阳气虚败者，用十全大补加桂附，亦有复生者。此等症候，若肢体恶寒，脉微细
者，此为真状，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。（真假虚实之辨）
一产妇因劳两臂不能屈，服苏合香丸，肢体痿软，汗出如水。余谓前药辛香，耗散真气，
腠理虚而津液妄泄也，先用十全大补汤加五
味子，补实腠理，收敛真气，汗顿止，又佐以四君子调补元气，渐愈，用逍遥散大补汤调理而痊。
一产妇先胸胁乳内胀痛，后因怒口噤吐痰，臂不能伸，小便自遗，左三部脉弦。余谓此
肝经血虚，而风火所致，不能养筋，先用加味逍遥散治之，臂能屈伸，又以补肝散六味丸，诸症悉愈。
一妇人发 ，遗尿自汗，面赤或时面青，饮食如故，肝脉弦紧。余曰∶此肝经血燥风热，
名也，肝主小便，其色青，人心则赤，法当滋阴血，清肝火。遂用加味逍遥散，不数剂，诸症
悉退而安。
一妇人产后血风患此，以小续命汤数服而安。
产后因虚，伤风 ，同伤寒表症未传入里，宜服防风汤。（前止言虚而施补，此又因风
而治风，具见圆通之妙）
防风汤 治风虚发热，项背拘急，肢体不随，恍惚狂言，来去无时，不自觉悟，亦治香港脚
缓弱甚效，此药温和，不虚人。
秦艽 独活 麻黄（去节） 半夏（汤洗七次） 防风（去芦，各二两） 升麻 防己 白术 石膏（ ）
白芍 黄芩 当归（去芦） 人参（去芦） 远志（去骨） 甘草（各一两）
上为粗末，每服四钱，水二中盏，生姜七八分，煎至一盏，去滓，取清汁六分，入麝香末
少许，食后临卧带热服。
华佗愈风散
方见前中风。
当归散 治产后中风，牙关紧急，不省人事，口吐涎沫，手足 。（此即愈风汤法）
当归（去芦） 荆芥穗（各等分）
上为细末，每服二钱，水一盏、酒半盏煎至一盏，灌之，如牙关紧急，斡开微微灌之，但
下咽即生，屡用救人，大有神效。
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（炙） 半夏（各一钱半） 黄 （一钱）
石膏（二钱） 知母（一钱）
上 咀，分二服，水二盏，生姜三片，枣二枚，煎八分，不拘时服。（此以小柴胡合白虎加
黄，治虚热痰饮变怪诸症，乃阳明少阳药也，内无血药，亦有见）
秦艽汤 前证已去，次服此药，去其风邪。（此方荣肝去风，是肝胆二经寒热药）
秦艽 芍药 柴胡（各一钱七分） 防风 黄芩（各一钱二分） 人参 半夏（各一钱） 甘草（炙，
一钱三分）
上 咀，作二帖，每帖加生姜三片，水煎，食远服。
薛氏说：瘛（chì，筋脉收缩牵引），是筋脉拘挛紧急；瘲（zhōng，筋脉弛缓纵伸），是筋脉松弛舒展。（瘛瘲表现为抽搐伸缩）。《内经》云：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，筋脉失去滋养而引发的。所以痈疽疮疡脓水流出过多，金刃创伤出血过甚，也会导致阳气随着阴血耗散，从而多引发此病。治疗方法应当使用八珍汤加牡丹皮、钩藤，来滋生阴血（牡丹皮、钩藤是针对肝火而用的药物），这样阳火自然消退，各种症状也会自愈。如果无效，应当使用四君子汤加川芎、当归、牡丹皮、钩藤，来补益脾土，因为血液生于至阴之地，至阴之地就是脾土，所以小儿在吐泻之后，脾胃虚损，也常患此病，这是虚象（所谓虚象，是指脾土虚弱反而显现出风木之气的变化），没有实风可以驱除，没有痰浊可以消除。如果属于阳气脱陷的，用补中益气汤加生姜、肉桂；如果属于阳气虚败的，用十全大补汤加肉桂、附子，也有恢复生机的。这类症候，如果肢体恶寒，脉象微细的，这是真寒假热之象；如果脉象浮大，发热烦渴的，这是假热之象，只应当固护根本为善。如果出现无力抽搐，两目上视反折，汗出如珠且流动不止的，都是不治之症。（真假虚实之辨别）
一位产妇因劳累导致双臂不能弯曲，服用苏合香丸后，肢体痿软无力，汗出如水。我认为前药辛香走窜，耗散了真气，腠理空虚导致津液妄泄，先用十全大补汤加五味子，补实腠理，收敛真气，汗立刻停止，又辅以四君子汤调补元气，逐渐痊愈，最后用逍遥散和十全大补汤调理而康复。
一位产妇先出现胸胁及乳房内部胀痛，后来因发怒导致口噤（牙关紧闭）、吐痰，手臂不能伸展，小便失禁，左手寸关尺三部脉象弦。我认为这是肝经血虚，由风火所致，不能滋养筋脉，先用加味逍遥散治疗，手臂能屈伸了，又以补肝散合六味地黄丸治疗，各种症状全部痊愈。
一位妇人发病时出现瘛瘲，遗尿自汗，面色发红或有时发青，饮食正常，肝脉弦紧。我说：这是肝经血燥风热，名为瘛瘲，肝主司小便，其色对应青，若涉及心则色赤，治法应当滋阴血，清肝火。于是使用加味逍遥散，不到几剂药，各种症状全部消退而安宁。
一位妇人产后患血风导致此病，服用小续命汤几剂后安宁。
产后因身体虚弱，感受风邪导致瘛瘲，如同伤寒表证未传入里，适宜服用防风汤。（前面只谈论因虚而施以补法，这里又因风而治风，体现了用药圆通精妙之处）
防风汤 治疗风虚发热，项背部拘急，肢体活动不遂，神志恍惚狂言，发作无定时，自己不能察觉醒悟，也治疗脚气病缓弱非常有效，此药性质温和，不会损伤正气。
秦艽、独活、麻黄（去节）、半夏（汤洗七次）、防风（去芦，各二两）、升麻、防己、白术、石膏（煅）、白芍、黄芩、当归（去芦）、人参（去芦）、远志（去骨）、甘草（各一两）。
以上药材捣成粗末，每次服用四钱，用水二盏，生姜七八分厚，煎煮至一盏，滤去药渣，取澄清汁液六分，加入少许麝香末，饭后临睡前趁热服用。
当归散 治疗产后中风，牙关紧急，不省人事，口吐涎沫，手足抽搐。（此即愈风汤的法度）
当归（去芦）、荆芥穗（各等分）。
以上药材研为细末，每次服用二钱，用水一盏、酒半盏煎煮至一盏，灌服。如果牙关紧闭，撬开微微灌服，只要药液下咽即可苏醒，多次使用救人，大有神效。
增损柴胡汤 治疗产后感受异常病症，手足牵拉抽搐，痰涎上潮昏闷。
柴胡（三钱）、黄芩（一钱二分）、人参、甘草（炙）、半夏（各一钱半）、黄芪（一钱）、石膏（二钱）、知母（一钱）。
以上药材切碎，分两次服用，用水二盏，生姜三片，大枣二枚，煎煮至八分，不拘时间服用。（此处是将小柴胡汤与白虎加黄芪汤结合，治疗虚热痰饮变生的怪异诸症，属于阳明、少阳经的药物，方内无补血药，也有其见解）
秦艽汤 前述症状已去除，接着服用此药，以祛除风邪。（此方荣养肝血并祛风，是肝胆二经治疗寒热的药物）
秦艽、芍药、柴胡（各一钱七分）、防风、黄芩（各一钱二分）、人参、半夏（各一钱）、甘草（炙，一钱三分）。
以上药材切碎，作两帖，每帖加生姜三片，水煎，饭后再服用。
Xue said: "Chi" (spasm and contraction of sinews and vessels) refers to the tightness and cramping of sinews and vessels; "Zhong" (relaxation and extension of sinews and vessels) refers to the flaccidity and stretching of sinews and vessels. (Chi-Zhong manifests as convulsions and twitching). The *Classic of Internal Medicine* states: "The Liver governs the sinews and stores blood." Generally, Liver Qi belongs to Yang and Fire, while Liver Blood belongs to Yin and Water. The aforementioned conditions arise because postpartum loss of Yin blood is excessive, leading to blazing Yang Fire, causing the sinews to lose nourishment. Therefore, when pus and water from carbuncles and sores are excessively discharged, or when bleeding from metal wounds is too severe, Yang Qi may dissipate along with Yin blood, often resulting in this condition. The treatment method should employ Bazhen Tang (Eight Treasure Decoction) added with Mudanpi (Moutan Cortex) and Gouteng (Uncaria Rhynchophylla) to generate Yin blood (Mudanpi and Gouteng are used for Liver Fire), whereby Yang Fire will naturally recede and all symptoms will heal spontaneously. If there is no response, one should use Sijunzi Tang (Four Gentlemen Decoction) added with Xiongqiong (Ligusticum Chuanxiong), Danggui (Angelica Sinensis), Mudanpi, and Gouteng to tonify Spleen Earth, for blood is generated from the Supreme Yin, which is Spleen Earth. Thus, after infants suffer from vomiting and diarrhea, if their Spleen and Stomach are damaged and deficient, they also frequently suffer from this condition; this is a deficiency manifestation (what is meant by deficiency manifestation is that weak Earth reveals the transformation of Wind-Wood); there is no excess wind to expel and no phlegm to resolve. If it belongs to the sinking and collapse of Yang Qi, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark); if it belongs to the failure of Yang Qi due to deficiency, use Shiquan Dabu Tang (Ten Great Tonics Decoction) added with Rougui and Fuzi (Aconite Lateral Root), and recovery is possible. For such syndromes, if the limbs feel aversion to cold and the pulse is minute and fine, this is a true deficiency cold image; if the pulse is floating and large, accompanied by fever, vexation, and thirst, this is a false heat image. In either case, securing the root is the best approach. If there is powerless convulsion, eyes rolling upward with opisthotonos, and sweating like pearls flowing, these are all untreatable conditions. (Differentiation of True/False and Deficiency/Excess)
A parturient woman, due to overwork, could not flex her arms. After taking Suhexiang Wan (Styrax Pill), her limbs became flaccid and she sweated profusely like water. I stated that the previous medicine was pungent and aromatic, consuming the True Qi, leaving the Couli (pores/skin texture) deficient and causing fluids to leak recklessly. I first used Shiquan Dabu Tang added with Wuweizi (Schisandra Berry) to solidify the Couli and consolidate the True Qi, which stopped the sweating immediately. Then, assisted by Sijunzi Tang to regulate and tonify Yuan Qi (Primal Qi), she gradually recovered, and finally healed after conditioning with Xiaoyao San (Free and Easy Wanderer Powder) and Shiquan Dabu Tang.
A parturient woman first experienced distending pain in the chest, hypochondrium, and inside the breasts. Later, due to anger, she developed trismus (lockjaw), expectorated phlegm, could not extend her arms, had urinary incontinence, and her pulse at the three positions on the left hand was wiry. I stated this was caused by Liver Channel Blood deficiency leading to Wind-Fire, which failed to nourish the sinews. I first treated her with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder); once her arms could flex and extend, I administered Bugan San (Nourish Liver Powder) combined with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), and all symptoms completely resolved.
A woman suffered from Chi-Zhong, enuresis, and spontaneous sweating. Her face was red or sometimes green. Her diet was normal, and her Liver pulse was wiry and tight. I said: This is Liver Channel Blood dryness with Wind-Heat, named Chi-Zhong. The Liver governs urination; its color corresponds to Green. If it affects the Heart, the color becomes Red. The method should be to nourish Yin Blood and clear Liver Fire. Thus, I used Jiawei Xiaoyao San. Within a few doses, all symptoms subsided, and she became peaceful.
A woman suffered from this condition postpartum due to Blood Wind. She found relief after taking several doses of Xiao Xuming Tang (Minor Continuation of Life Decoction).
Postpartum deficiency with Wind invasion leading to Chi-Zhong is similar to Taiyang syndrome in Cold Damage where the pathogen has not yet entered the interior. It is appropriate to take Fangfeng Tang (Saposhnikovia Decoction). (Previously, only tonification for deficiency was discussed; here, treating Wind for Wind demonstrates the subtlety of flexible application.)
Fangfeng Tang treats Wind-Deficiency fever, stiffness in the neck and back, inability to move limbs, mental confusion with delirious speech, attacks occurring at unpredictable times without self-awareness, and is also highly effective for treating foot-wind (gouty arthritis) with weakness. This medicine is mild and does not damage healthy Qi.
Ingredients: Qinjiao (Gentianae Radix), Duhuo (Angelicae Pubescentis Radix), Mahuang (Ephedrae Herba - removed nodes), Banxia (Pinelliae Rhizoma - washed seven times in boiling water), Fangfeng (Saposhnikoviae Radix - removed radix head, each 2 liang), Shengma (Cimicifugae Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Shigao (Gypsum Fibrosum - calcined), Baishao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix - removed radix head), Renshen (Ginseng Radix - removed radix head), Yuanzhi (Polygalae Radix - removed woody core), Gancao (Glycyrrhizae Radix et Rhizoma, each 1 liang).
Grind into coarse powder. Take 4 qian per dose, decoct with 2 zhen of water and 7-8 fen of fresh ginger until reduced to 1 zhen. Strain, take 6 fen of the clear liquid, add a small amount of Moshe (Musk) powder, and drink warm after meals and before sleep.
Huato Yufeng San (Huato's Wind-Dispelling Powder)
See the preceding section on Zhongfeng (Wind-Stroke).
Danggui San (Angelica Powder) treats postpartum Zhongfeng with trismus, unconsciousness, foaming at the mouth, and convulsions of hands and feet. (This follows the method of Yufeng Tang).
Ingredients: Danggui (Angelicae Sinensis Radix - removed radix head), Jingjie Sui (Schizonepetae Spica) in equal parts.
Grind into fine powder. Take 2 qian per dose, decoct with 1 zhen of water and half a zhen of wine until reduced to 1 zhen. Administer orally. If trismus is present, pry open the mouth and administer slowly. Once swallowed, life is restored. Used repeatedly to save lives with great efficacy.
Zengsun Chaihu Tang (Modified Bupleurum Decoction) treats postpartum abnormal syndromes characterized by pulling and convulsions of hands and feet, flooding of saliva/phlegm, and drowsiness/confusion.
Ingredients: Chaihu (Bupleuri Radix, 3 qian), Huangqin (Scutellariae Radix, 1.2 qian), Renshen (Ginseng Radix), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Banxia (Pinelliae Rhizoma, each 1.5 qian), Huangqi (Astragali Radix, 1 qian), Shigao (Gypsum Fibrosum, 2 qian), Zhimu (Anemarrhenae Rhizoma, 1 qian).
Cut into pieces. Divide into two doses. Decoct with 2 zhen of water, 3 slices of fresh ginger, and 2 jujubes until reduced to 0.8 zhen. Take at any time. (This combines Xiao Chaihu Tang with Baihu Jia Huangqi Tang to treat strange syndromes arising from deficiency-heat and phlegm-fluids, belonging to the Yangming and Shaoyang channels. Although it contains no blood-nourishing herbs, it has its own merit.)
Qinjiao Tang (Gentian Decoction) Take this next after the aforementioned symptoms have subsided, to dispel Wind pathogens. (This formula nourishes Liver Blood and dispels Wind, addressing cold and heat in the Liver and Gallbladder channels).
Ingredients: Qinjiao (Gentianae Radix), Shaoyao (Paeoniae Radix), Chaihu (Bupleuri Radix, each 1.7 qian), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix, each 1.2 qian), Renshen (Ginseng Radix), Banxia (Pinelliae Rhizoma, each 1 qian), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma, 1.3 qian).
Cut into pieces. Make two packets. Add 3 slices of fresh ginger to each packet. Decoct in water. Take well after meals.