〔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。
【《大全》】产后出现心中烦热闷乱、气逆上冲，进而转变为香港脚（即脚气病）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，因此附着成为香港脚。其症状表现为烦热闷乱、肢体牵引抽搐、惊恐心悸、心烦意乱、呕吐及气逆上冲，这些都是该病的征候。可以服用小续命汤（方剂见杂病中风篇），服用两三剂必定痊愈。如果医生错误地使用逐瘀败血的药物来攻伐，那么血液耗损而疾病会更加加重。
陈无择评论说：香港脚固然是一种常见疾病，但未曾听说产后能转变为这种病的。人们往往阅读《千金方》时，看到书中说产妇多有此疾的语句，便据此推断出此证，这是文辞损害了原意，由此可见。假设确实是烦热闷乱、气逆上冲，怎么能立即服用续命汤呢？此药原本主治少阳经的中风，并非普遍治疗各经的香港脚，必须根据香港脚的方论，按照阴阳经络进行调理。这涉及专门领域，不容易轻易议论，既然不是产后的主要疾病，就不再繁复引用。
虽然陈无择有上述言论，然而对小续命汤进行加减化裁后使用，没有不奏效的。所以《百问》中说：寒邪中伤三阳经，所患之症必然偏冷，用小续命汤主治。（加入生姜汁效果更快。）暑邪中伤三阴经，所患之症必然偏热，用小续命汤。（去掉附子，减少桂枝用量的一半。）若出现极度烦躁者，紫雪是最良的选择。（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，可用真薄荷煎煮冷水送服。（娄全善说：各方书都主张与小续命汤各半量配合服用。）
【薛己】前述证候应当以补益气血为主，佐以小续命汤、寄生汤。如果无效，使用大防风汤。一位产妇患有前述证候，有人用独活寄生汤而痊愈。后来复发，服用前一方，出汗如水，更加出现牙关紧闭、吐痰的症状。我用十全大补汤来培养气血，逐渐好转。后来饮食日渐减少，身体日渐消瘦，吐痰如涌。这是命门火衰，脾土虚寒，使用八味丸及加味归脾汤，各种症状逐渐消退，肌肉逐渐生长。
独活寄生汤 治疗肝肾虚弱，或者久处湿冷之地，或者洗脚时当风受寒，湿毒内攻，导致两小腿松弛无力，挛急疼痛、麻木虚弱，或者皮肉紫暗破损，足膝拘挛沉重。又专门治疗产后香港脚。
川独活（三两） 桑寄生（如果没有，可以用续断代替） 杜仲（炒制） 牛膝（去除芦头，酒浸） 细辛 官桂（不经过火烤） 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，用水煎煮，温服。
[Daquan] What is the reason for postpartum heat, oppression, and rising qi transforming into Hongxiangjiao (Jiaogqi/Foot Qi)? The answer is: After childbirth, lying in bed causes blood deficiency generating internal heat. Furthermore, due to excessive cooling during spring and summer, the steaming dampness of the earth enters through the feet upon walking, thus attaching to become Hongxiangjiao. Its manifestations include heat and oppression, pulling and twitching, fright, palpitations, mental restlessness, vomiting, and rising qi; these are all its signs. One may take Xiao Xuming Tang (Formula see Miscellaneous Diseases Stroke) for two or three doses, and it will surely heal. If physicians mistakenly use drugs that expel stasis and blood to attack it, the blood will be depleted and the disease will increase further.
Chen Wuyue commented: Hongxiangjiao is indeed a common disease, but I have never heard of it transforming from postpartum conditions. People often read *Qianjin Fang* and see statements that many women after childbirth suffer from this disease, so they deduce this syndrome. This shows how literary expressions can harm the intended meaning. Suppose there is heat, oppression, and rising qi; how can one immediately take Xuming Tang? This drug originally treats wind-stroke of the Shaoyang channel, not all channels' Hongxiangjiao uniformly. It is necessary to regulate according to the formulas and theories of Hongxiangjiao based on Yin-Yang and meridians. This involves specialized knowledge and is not easy to discuss lightly. Since it is not a critical postpartum disease, it is not cited extensively.
Although Chen Wuyue has this argument, adding and subtracting ingredients from Xiao Xuming Tang when used yields no failure in efficacy. Thus, *Baiwen* states: Cold invading the Three Yang channels results in cold ailments, treated by Xiao Xuming Tang. (Adding ginger juice acts faster.) Heat invading the Three Yin channels results in hot ailments, treated by Xiao Xuming Tang. (Remove Fuzi, reduce Guizhi by half.) For those with extreme irritability, Zixue (Purple Snow) is best. (I selected the modification methods from *Baiwen* so that later generations may receive treatment.) If Zixue is unavailable, decoct fresh Bohe (Menthae Haplocalycis Herba) in cold water and chew/swallow. (Lou says: Various formularies suggest taking half the dose of Siwu Tang together.)
[Xue Ji] The aforementioned syndromes should primarily be supplemented with Qi and Blood, assisted by Xiao Xuming Tang and Jisheng Tang. If ineffective, use Dafangfeng Tang. A puerperal patient suffered from the aforementioned syndrome; someone cured her using Duhuo Jisheng Tang. Later it relapsed; she took the previous formula, sweated profusely like water, and developed trismus and expectoration. I used Shiquan Dabu Tang to nourish Qi and Blood, leading to gradual improvement. Later, food intake decreased daily, the body became thinner daily, and expectoration surged. This indicated decline of Mingmen Fire and deficiency-cold of Spleen Earth. Using Bawei Wan (Eight-Ingredient Pill) and Jiawei Guipi Tang, various symptoms gradually receded, and muscle mass gradually regenerated.
Duhuo Jisheng Tang Treats Liver and Kidney deficiency, or long-term exposure to damp-cold places, or washing feet while exposed to wind, causing damp-toxin to attack internally. Symptoms include flaccidity and weakness of both calves, cramping pain, numbness, and weakness, or purple/broken skin and flesh, and cramping heaviness of feet and knees. It also specifically treats postpartum Hongxiangjiao.
Chuan Duhuo (Radix Angelicae Pubescentis) (3 liang) Sangjisheng (Visci Ramulus et Fructus) (If unavailable, substitute with Xu Duan [Radix Dipsaci]); Duzhong (Cortex Eucommiae) (stir-fried); Niuxi (Radix Achyranthis Bidentatae) (remove rhizome, soak in wine); Xixin (Radix et Rhizoma Asari); Guan Gui (Cinnamomi Cortex) (do not expose to fire); Bai Fuling (Poria); Fangfeng (Radix Saposhnikoviae); Chuanxiong (Rhizoma Chuanxiong); Danggui (Radix Angelicae Sinensis); Renshen (Radix Ginseng); Shu Dihuang (Radix Rehmanniae Preparata) (wash with wine); Shaoyao (Radix Paeoniae Alba); Qinjiao (Radix Gentianae Macrophyllae) (each 2 liang); Gancao (Radix Glycyrrhizae Preparata) (roasted, 1 liang).
Grind the above into coarse powder. Each dose is 4 qian, add 5 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct with water, and take warm.