产后中风噤者,是血气虚,而风入于领颊夹口之筋也。手三阳之筋结,入于颔颊。产
则劳损腑脏,伤动筋脉,风乘之者。其三阳之筋偏虚,则风偏搏之,筋得风冷则急,故令口
噤也。
产后中风痉者,因产伤动血脉,脏腑虚竭,饮食未复,未满日月。荣卫虚伤,风气得入
五脏,伤太阳之经,复感寒湿,寒搏于筋则发痉。其状,口急噤,背强直,摇头马鸣,腰为
反折,须臾十发,气急如绝,汗出如雨,手拭不及者,皆死。
柔风者,四肢不收,或缓或急,不得俯仰也。由阴阳俱虚,风邪乘之,风入于阳则表缓
,四肢不收也;入于阴则里急,不得俯仰也。产则血气皆损,故阴阳俱虚,未得平复,而风
邪乘之故也。
产后腑脏伤动,经络虚损。日月未满,未得平复,而起早劳动,风邪乘虚入。邪搏于阳
经者,气行则迟,机关缓纵,故令不随也。
产后血气俱虚,受风邪,入并于阴,则癫忽发,卧地吐涎,口 目急,手足缭左,
又无所觉知,良久乃苏是也。邪入并于阳则狂,发则言语倒错,或自高贤,或骂詈不避尊卑
是也。产则伤损血气,阴阳俱虚,未平复者,为风邪所乘,邪乘血气,乍并于阳,乍并于阴
,故癫狂也。
手太阳、少阴之经,主下为月水。太阳小肠之经,少阴心之经也,心主血脉。因产伤动
血气,其后虚损未复,而为风冷客于经络,冷搏于血,则血凝涩,故令月水不利也。
产后出现中风导致牙关紧闭(口噤)的症状,是因为气血虚弱,风邪侵入连接下颌、面颊和口部的筋脉所致。手三阳经的筋脉汇聚结于下颌和面颊部位。分娩时劳损了脏腑,损伤了筋脉,风邪便趁虚而入。由于手三阳经的筋脉偏于虚弱,风邪便偏盛地搏结于此,筋脉受到风冷侵袭就会拘急收缩,从而导致牙关紧闭。
产后出现中风导致的痉挛(痉病),是因为分娩损伤了血脉,脏腑空虚衰竭,饮食尚未恢复,未满产褥期。营卫之气虚弱受损,风气得以侵入五脏,伤害太阳经,又感受寒湿之邪,寒气与筋脉相搏结从而引发痉挛。其症状表现为:牙关紧急紧闭,背部僵硬挺直,头部摇动并发出类似马嘶的声音,腰部向后反折如弓状,短时间内发作多次,呼吸急促仿佛断绝,出汗如雨,用手擦拭都来不及,这些情况都属于死证。
柔风症,表现为四肢松弛无力无法收持,有时松弛有时拘急,身体不能前俯后仰。这是由于阴阳两虚,风邪乘虚而入。风邪侵入阳分则体表弛缓,导致四肢无力;侵入阴分则体内拘急,导致身体不能俯仰。分娩使气血均受损伤,所以阴阳俱虚,在未能平复恢复之际,风邪乘虚而入所致。
产后脏腑受伤扰动,经络虚弱受损。若未满产褥期,身体尚未平复恢复,就过早起床劳作,风邪便乘虚侵入。邪气搏结于阳经,导致气行迟缓,关节弛缓纵缓,因此导致肢体运动不灵活。
产后气血俱虚,感受风邪,若邪气并入阴分,则突然发作癫证,患者倒卧在地吐涎沫,口眼拘急,手足向左侧扭转抽搐,且失去知觉,许久才能苏醒,这就是癫证。若邪气并入阳分则发为狂证,发作时言语错乱颠倒,或自认为高贵贤能,或辱骂他人不分尊卑,这就是狂证。分娩损伤血气,导致阴阳俱虚,未得平复时,被风邪所乘,邪气随气血变化,时而并入阳分,时而并入阴分,因此导致癫狂。
手太阳经和手少阴经,主管下部的月经(月水)。手太阳经是小肠经,手少阴经是心经,心主血脉。因分娩损伤血气,之后虚损未恢复,风冷之邪客居于经络,寒气与血液相搏结,导致血液凝滞涩涩不畅,因此导致月经不通利。
Postpartum wind-stroke with trismus (lockjaw) occurs due to deficiency of blood and qi, allowing wind pathogen to invade the sinews connecting the jaw, cheeks, and mouth. The sinews of the three hand-yang meridians converge at the jaw and cheeks. Childbirth damages the zang-fu organs and injures the sinews and vessels; when wind takes advantage of this, it attacks the relatively deficient sinews of the three yang meridians. When sinews are affected by wind-cold, they become tense and contracted, causing trismus.
Postpartum wind-stroke with spasms (spasm disease) results from childbirth damaging the blood vessels, leaving the zang-fu organs empty and exhausted, with diet not yet restored and the confinement period not yet complete. Ying and Wei qi are deficient and injured, allowing wind pathogen to enter the five zang organs, damaging the Taiyang meridian, and further contracting cold-dampness. Cold combats with the sinews, triggering spasms. Symptoms include: tight trismus, stiff and straight back, head shaking with sounds resembling a horse's neigh, opisthotonos (body bent backward like a bow), multiple episodes in a short time,急促 breathing as if cut off, profuse sweating like rain, so severe that wiping is insufficient; all these indicate death.
Roufeng (soft wind) presents with flaccid limbs unable to hold themselves, alternating between flaccidity and tension, and inability to bend forward or backward. This is caused by dual deficiency of yin and yang, where wind pathogen takes advantage. Wind entering the yang aspect causes exterior flaccidity and limb weakness; entering the yin aspect causes interior tension and inability to flex or extend. Childbirth damages both blood and qi, resulting in dual deficiency of yin and yang; when wind pathogen invades before recovery, Roufeng occurs.
After childbirth, zang-fu organs are disturbed and damaged, and meridians are weak and depleted. If one rises and labors early before the confinement period ends and before recovery, wind pathogen invades via the deficiency. When evil combats the yang meridians, qi movement becomes slow, joints become lax and relaxed, leading to motor impairment.
Postpartum blood and qi are both deficient; upon contracting wind pathogen, if the evil merges into the yin aspect, Dian syndrome (epilepsy-like disorder) suddenly erupts: the patient falls to the ground, salivates, has tight mouth and eyes, limbs twist to the left, loses consciousness, and only recovers after a long time—this is Dian. If the evil merges into the yang aspect, Kuang syndrome (mania) erupts: speech is disordered and inverted, self-aggrandizement occurs, or cursing happens without regard for seniority or status—this is Kuang. Childbirth damages blood and qi, causing dual deficiency of yin and yang; before recovery, wind pathogen invades, combining with blood and qi, alternately merging into yang and yin, thus causing Dian and Kuang.
The Hand-Taiyang and Hand-Shaoyin meridians govern menstruation (Yueshui). The Hand-Taiyang meridian belongs to the Small Intestine, and the Hand-Shaoyin meridian belongs to the Heart, which governs blood vessels. Due to childbirth damaging blood and qi, subsequent deficiency remains unrecovered; when wind-cold lodges in the meridians, cold combats with blood, causing blood coagulation and stagnation, thus leading to dysmenorrhea or irregular menstruation.