吾郡别驾何公，续迁甘肃，眷属仍居郡城。宅中一仆妇，重身九月，偶患头痛，医作外
感
治，其痛益甚，呕吐汗淋。至二鼓时，忽神迷肢掣，目吊口噤，乍作乍止，何公少君六吉兄
，当
晚遣力相召，晓造其宅，六兄告以病危之故，入视搐搦形状，诊脉虚弦劲急，谓曰∶此子痫
证也。势虽危险，幸在初起，当不殒命。六兄曰∶昨夕仓皇，恐驾到迟，故近邀女科一看，
亦言证属子痫。然服药不效奈何?出方阅之，羚羊角散也。予曰∶此乃古方，原属不谬，不
知子痫疾作之由。因子在母腹，阴虚火炽，经脉空疏，精不养神，柔不养筋，而如厥
如痫，神魂失守，手足抽掣。其病初头痛者，即内风欲动之征也。医家误作外风，浪投疏散
，致变若此。至羚羊角散，方内惟羚角入肝舒筋，当归、枣仁补肝益血，茯神安神，甘草缓
急，与证相符，其余防、独、木香、杏仁，俱耗真气，苡仁下胎，多不合宜，岂可以为古人
成方，漫不加察耶。于是仍以本方除去防独等味，参入熟地、沙参、麦冬、阿胶、芝麻，养
阴濡液，少佐钩藤、桑寄生，平肝熄风。头煎服后，其搐渐平，随服二煎，搐定头痛亦减。
六兄喜甚，予曰∶病来势暴，今虽暂熄，犹恐复萌。嘱再市药一剂，尽今晚服尽，搐不再作
，方许无虞。次日复诊，痛搐俱止，神清脉静，纳食不呕。方除钩藤寄生，加白芍、玉竹、
女贞、石斛，逾月分娩，母子俱得无恙。
安波按∶论证一端，总在灵机活泼，随症变化，不可效尾生之见，至死不悟也。
我郡的别驾何公，后来调任甘肃，家眷仍居住在郡城。宅中有一位女仆，怀孕九个月时，偶然患上头痛，医生当作外感病治疗，结果疼痛更加剧烈，并出现呕吐、大汗淋漓的症状。到了二更天（约晚上11点至凌晨1点），突然神志昏迷、四肢抽搐、眼球上翻、牙关紧闭，症状时发时止。何公的小儿子六吉兄当晚派人紧急召请，次日清晨到我府邸告知病情危急的情况。我入内查看其抽搐痉挛的形状，诊得脉象虚弦劲急，便说道：“这是子痫证（妊娠晚期出现的以眩晕、头痛、抽搐甚至昏迷为主要表现的病症）。虽然形势危险，但幸好处于发病初期，应当不会危及生命。”六吉兄说：“昨晚仓促慌乱，担心您到得太晚，所以就近邀请了一位妇科医生诊治，也说是子痫证。但是服药后不见效果，该怎么办呢？”拿出处方给我看，是羚羊角散。我说：“这是古方，原本没有错误，只是不知道子痫发作的原因。因为胎儿在母腹中，导致孕妇阴虚火旺，经脉空疏，精血不能养神，阴柔不能养筋，从而出现类似厥证和痫证的表现，神魂失守，手足抽掣。起初头痛，就是内风欲动的征兆。医生误认为是外风，盲目使用疏散风邪的药物，才导致变成这样。至于羚羊角散这个方子，其中只有羚羊角入肝舒筋，当归、枣仁补肝益血，茯神安神，甘草缓急止痛，与证候相符；其余的防风、独活、木香、杏仁，都会耗伤真气，薏苡仁有下胎之弊，大多不合宜，怎么能因为是古人成方，就不加考察地随意使用呢？”于是仍然保留原方，去掉防风、独活等药味，加入熟地黄、沙参、麦冬、阿胶、芝麻，以滋养阴液，稍加钩藤、桑寄生，以平肝熄风。头煎服后，抽搐逐渐平息，接着服用二煎，抽搐停止，头痛也减轻了。六吉兄非常高兴，我说：“病势来势凶猛，现在虽然暂时平息，还恐怕会复发。嘱咐再买一剂药，今晚全部服完，如果抽搐不再发作，才可以保证无虞。”第二天复诊，头痛和抽搐都停止了，神志清醒，脉象平静，进食不呕吐。处方中去掉钩藤、桑寄生，加入白芍、玉竹、女贞子、石斛。过了一个月分娩，母子都平安无事。
安波按语：论证这一方面，关键在于思维灵活，随症变化，不可像尾生那样固执己见，至死不悟。
In my prefecture, Vice Prefect He was subsequently transferred to Gansu, while his family remained in the city. A female servant in his household, who was nine months pregnant, accidentally suffered from a headache. The physician treated it as an external contraction (exogenous pathogenic factor), but the pain intensified, accompanied by vomiting and profuse sweating. By the second watch of the night (approximately 11:00 PM to 1:00 AM), she suddenly became unconscious with limb convulsions, upward staring of the eyes, and locked jaw. The symptoms came and went intermittently. Mr. He’s younger son, Brother Liuji, sent someone urgently to summon me that evening. I arrived at his residence the next morning. Brother Liuji informed me of the critical condition. Upon examining the manifestations of the convulsions and feeling the pulse, which was deficient, wiry, forceful, and rapid, I said, “This is Eclampsia (a complication of pregnancy characterized by dizziness, headache, convulsions, and coma). Although the situation is dangerous, fortunately, it is in the early stage, so death should not occur.” Brother Liuji said, “Last night, in the panic, fearing your late arrival, I invited a gynecologist nearby, who also diagnosed it as Eclampsia. However, the medicine had no effect. What should we do?” He showed me the prescription, which was Lingyangjiao San (Antelope Horn Decoction). I said, “This is an ancient formula and is fundamentally correct, but one must understand the etiology of eclampsia. Because the fetus is in the womb, the mother suffers from Yin deficiency with vigorous fire, leading to loose meridians and collaterals. Essence and blood fail to nourish the Spirit and tendons, resulting in symptoms resembling Jue syndrome (syncope or cold extremities) and Xian syndrome (epilepsy/seizures), loss of control over the Hun and Shen spirits, and jerking of the limbs. The initial headache was a sign of internal wind stirring. The physician mistakenly attributed it to external wind and blindly administered dispersing agents, causing this transformation. Regarding Lingyangjiao San, only Antelope Horn enters the Liver to relax the tendons; Dang Gui (Angelica Sinensis Root) and Suan Zao Ren (Ziziphus Seed) tonify the Liver and enrich blood; Fu Shen (Poria with Hostwood) calms the Spirit; and Gan Cao (Licorice Root) moderates urgency. These match the syndrome. However, Fang Feng (Saposhnikovia Root), Du Huo (Angelica Pubescens Root), Mu Xiang (Aucklandia Root), and Xing Ren (Apricot Seed) all consume true Qi, and Yi Yi Ren (Coix Seed) may induce abortion; thus, they are largely inappropriate. One cannot simply use an ancient formula without careful examination.” Therefore, I retained the original formula but removed Fang Feng and Du Huo, adding Shu Di Huang (Prepared Rehmannia Root), Sha Shen (Glehnia Root), Mai Dong (Ophiopogon Tuber), E Jiao (Donkey-hide Gelatin), and Zhi Ma (Sesame Seed) to nourish Yin and moisten fluids. I added a small amount of Gou Teng (Uncaria Ramulus cum Uncis) and Sang Ji Sheng (Taxillus Caulis) to pacify the Liver and extinguish wind. After taking the first decoction, the convulsions gradually subsided. After taking the second decoction, the convulsions stopped, and the headache decreased. Brother Liuji was very pleased. I said, “The disease onset was violent. Although it has temporarily subsided, recurrence is still feared. I advise purchasing another dose and consuming it entirely tonight. If the convulsions do not recur again, then there will be no danger.” On the following day, upon re-examination, both the headache and convulsions had ceased. The patient’s spirit was clear, the pulse was calm, and she could eat without vomiting. I removed Gou Teng and Sang Ji Sheng from the prescription and added Bai Shao (White Peony Root), Yu Zhu (Polygonatum Odoratum Rhizome), Nu Zhen Zi (Ligustrum Lucidum Fruit), and Shi Hu (Dendrobium Stem). She delivered after one month, and both mother and child were safe.
An Bo’s commentary: In analyzing syndromes, one must always maintain mental agility and adapt to changing symptoms. One should not be rigid like Weisheng, remaining obstinate until death.