（中风口噤、角弓反张附）
论曰∶产后汗出多而变 者何？答曰∶产后血虚，肉理不密，故多汗，因遇风邪搏之则
变。 者，口噤不开，背强而直，如发痫状，摇头马鸣，身反折，须臾十发，气息如绝。
宜速斡口灌小续命汤，稍缓即汗出。如两手拭不及者，不可治也。
治中风及刚柔二 。及香港脚痹弱，不能转侧，兼治小儿惊风。
麻黄（制，可去，加葛根） 桂心 甘草（各半两） 防风（三钱三字） 芍药 白术 人
参川芎 附子 防己 黄芩（各一分）
上 咀，每服五钱。水一盏半，煎至一盏，去滓，取八厘清汁；入生姜汁再煎一、二沸
，温服，日三服，夜二服。若柔 自汗者，去麻黄；夏间及病有热者，去附子，减桂一半；
冬及初春去黄芩。（第三卷虽有，然其中有杏仁，无白术。）虽然陈无择评曰∶产后汗出多变
，亦令服续命汤，此又难信。既汗多如何更服麻黄、官桂、防己、黄芩辈？不若大豆紫汤
为佳。太医局方大圣散亦良药也。愚观朱奉议云∶凡刚柔二 ，小续命汤并可加减与之。若
柔自汗者，有去麻黄加葛根之说。朱奉议必有所据。虽大豆紫汤、大圣散良，亦不可偏见
曲说，有妨古人之意。
治中风头眩，恶风自汗，吐冷水及产后百病。或中风痱，痉，背强口噤，直视，烦热。
脉紧大者不治。《短剧方》主产后中风困笃，背强口噤，或但烦躁，或头身皆重，或身重痒
剧，呕吐直视者。（《指迷方》名独活汤）
川独活（两半） 大豆（半升） 酒（三升）
上先以酒浸独活煎一、二沸，别炒大豆极焦，烟出、急投酒中密封，候冷去豆。每服一
、二合许，得少汗则愈，日十服。此药能去风、消血结，如妊娠折伤，胎死腹中，服此得瘥
。凡产后口噤，腰背强直，角弓反张，皆名曰痉，又名曰 。古人察有汗、无汗以分刚柔、
阴阴而治。今《产宝》诸书有中风口噤一门，又有角弓反张一门，其实一也。如憎寒发热有
类伤寒，皆不论及，岂可只以一、二药治之？愚今取《百问》中方论，已详备前篇。（见三
卷第二论）庶几览者，如指诸掌。
论述说：产后出汗多而变生他病的原因是什么？回答说：产后血虚，腠理不密，所以容易出汗，如果遇到风邪侵袭搏结，就会发生病变。痉病（指以项背强直、四肢抽搐、甚至口噤不开、角弓反张为主要表现的病证），表现为口噤不开，背部僵硬挺直，像发作癫痫的样子，摇头发出马鸣般的声音，身体向后反折，片刻间发作十次，气息微弱如同断绝。应当迅速撬开口腔灌服小续命汤（由麻黄、桂心、甘草等组成的方剂，具有祛风散寒、益气养血功效），稍加缓和后就会出汗。如果双手擦拭都来不及（形容病情危急或患者无力配合），则不可治愈。
治疗中风以及刚痉、柔痉两种病症。以及脚气痹弱，不能翻身转动，兼治小儿惊风。
麻黄（炮制，可去掉节，加入葛根） 桂心 甘草（各半两） 防风（三钱三分） 芍药 白术 人参 川芎 附子 防己 黄芩（各一分）
以上药物捣碎成粗末，每次服用五钱。用水一盏半，煎煮至一盏，滤去药渣，取得八厘澄清药汁；加入生姜汁再煮沸一两次，温服，每日三次，夜间两次。如果是柔痉自汗者，去掉麻黄；夏季及患病有热者，去掉附子，减少桂心一半用量；冬季及初春去掉黄芩。（第三卷中虽有此方，但其中有杏仁，没有白术。）虽然陈无择评价说：产后出汗多变生他病，也让人服用续命汤，这又难以令人相信。既然已经出汗很多，为何还要服用麻黄、官桂、防己、黄芩这类药物？不如大豆紫汤更好。太医局方的大圣散也是良药。我观察朱奉议说：凡是刚痉、柔痉，小续命汤都可以加减使用。如果是柔痉自汗者，有去掉麻黄加入葛根的说法。朱奉议必定有所依据。虽然大豆紫汤、大圣散很好，也不可偏执片面之见，以免妨碍古人的本意。
治疗中风头晕目眩，怕风自汗，吐出冷水以及产后各种疾病。或者中风痱（肢体痿废不用）、痉病，背部僵硬口噤，直视，烦热。脉象紧大者属不治之症。《短剧方》主治产后中风危重，背部僵硬口噤，或者只是烦躁，或者头身皆沉重，或者身体沉重瘙痒剧烈，呕吐直视者。（《指迷方》称为独活汤）
川独活（一两半） 大豆（半升） 酒（三升）
以上先用酒浸泡独活，煎煮一两次沸，另外将大豆炒至极焦，冒出烟时，迅速投入酒中密封，待冷却后去掉豆。每次服用一、二合左右，得到少量汗出即痊愈，每日十次。此药能祛风、消除血结，如妊娠期间跌打损伤，胎死腹中，服用此药可得痊愈。凡是产后口噤，腰背强直，角弓反张，都称为痉病，也称为 。古人通过察看病人的有汗、无汗来区分刚痉、柔痉，从而分别施治。现在《产宝》等书中设有中风口噤一门，又有角弓反张一门，其实是一回事。如果憎寒发热类似伤寒，都不在此讨论，难道只用一、二种药就能治疗吗？我现在选取《百问》中的方论，已经在前篇详细备述。（见第三卷第二论）希望读者阅读时，能像看手掌上的纹路一样清楚明白。
(Attached: Lockjaw and Opisthotonos in Stroke)
The discussion states: What is the reason for excessive sweating after childbirth leading to other diseases? The answer is: After childbirth, blood deficiency causes the interstices (pores/skin texture) to be loose, resulting in profuse sweating. If wind pathogen invades and combats with this condition, pathological changes occur. Jing disease (a syndrome characterized by neck stiffness, limb spasms, lockjaw, and opisthotonos), manifests as lockjaw where the mouth cannot open, back stiffness and straightness, resembling an epileptic seizure, shaking of the head, sounds like a horse neighing, body bending backward, occurring ten times in a short period, with breath appearing as if cut off. One should quickly pry open the mouth and administer Xiao Xuming Tang (Cinnamon Twig and Ephedra Decoction, a formula for dispelling wind and cold while tonifying qi and blood). Once slightly relieved, sweating will occur. If the patient is too weak to even wipe themselves (indicating critical illness or inability to cooperate), it is incurable.
Treats stroke, as well as Gang-Jing (Stiff Spasm) and Rou-Jing (Soft Spasm). Also treats Jiaoqi (foot weakness/numbness) with bi-syndrome (obstruction) and weakness, inability to turn over, and concurrently treats infantile convulsions.
Mahuang (Ephedrae Herba, processed, nodes may be removed, add Gegen) Guixin (Cinnamomi Cortex) Gancao (Glycyrrhizae Radix et Rhizoma) (each half liang) Fangfeng (Saposhnikoviae Radix) (3 qian 3 fen) Shaoyao (Paeoniae Radix) Baizhu (Atractylodis Macrocephalae Rhizoma) Renshen (Ginseng Radix) Chuanxiong (Ligustici Chuanxiong Rhizoma) Fuzi (Aconiti Lateralis Radix Praeparata) Fangji (Stephaniae Tetrandrae Radix) Huangqin (Scutellariae Radix) (each 1 fen)
The above herbs are crushed into coarse powder. Each dose is 5 qian. Add 1.5 zhan of water, decoct until 1 zhan remains, filter out the dregs, obtain 8 li of clear liquid; add Shengjiangzhi (Fresh Ginger Juice), boil one or two more times, take warm. Take three times daily, twice at night. For Rou-Jing with spontaneous sweating, remove Mahuang; in summer or when heat is present in the disease, remove Fuzi, reduce Guixin by half; in winter and early spring, remove Huangqin. (Although this formula appears in Volume 3, it contains Xingren but lacks Baizhu.) Although Chen Wuyue commented: "Postpartum sweating leading to various changes can also be treated with Xuming Tang," this is hard to believe. Since there is already profuse sweating, why use Mahuang, Guan Gui (Official Cinnamon), Fangji, and Huangqin? It is better to use Dadou Zi Tang (Black Soybean Purple Decoction). Daisheng San (Great Sage Powder) from the Imperial Medical Bureau is also a good medicine. I observe that Zhu Fengyi said: "For both Gang-Jing and Rou-Jing, Xiao Xuming Tang can be used with modifications." For Rou-Jing with spontaneous sweating, there is a method of removing Mahuang and adding Gegen. Zhu Fengyi must have had basis for this. Although Dadou Zi Tang and Daisheng San are excellent, one should not hold biased views or make distorted interpretations that hinder the original intent of the ancients.
Treats stroke with dizziness, aversion to wind, spontaneous sweating, vomiting cold water, and various postpartum diseases. Or stroke fei (limb flaccidity/paralysis), jing (spasm), back stiffness, lockjaw, staring eyes, irritability, and heat. Pulse being tight and large indicates an untreatable condition. "Duanju Fang" mainly treats severe postpartum stroke with back stiffness and lockjaw, or merely irritability, or heaviness of head and body, or severe itching and heaviness of body, vomiting, and staring eyes. ("Zhimifang" calls it Duhuo Tang)
Chuan Duhuo (Angelicae Pubescentis Radix) (1.5 liang) Dadou (Black Soybean) (0.5 sheng) Jiu (Wine) (3 sheng)
First, soak Duhuo in wine and boil one or two times. Separately, stir-fry Dadou until extremely scorched and smoking. Immediately throw the hot soybeans into the wine, seal tightly, wait for it to cool, then remove the beans. Each dose is about 1-2 he. Recovery occurs when slight sweating is achieved. Take ten times daily. This medicine can dispel wind and resolve blood stasis. It is effective for traumatic injuries during pregnancy, intrauterine fetal death, etc., where taking this medicine leads to improvement. Any postpartum lockjaw, waist and back stiffness, and opisthotonos are all named Jing disease, also called . The ancients distinguished between Gang-Jing and Rou-Jing by observing the presence or absence of sweating, treating them accordingly. Current books like "Chanbao" have separate sections for stroke lockjaw and opisthotonos, but they are essentially the same. Conditions resembling Taiyang disease with chills and fever are not discussed here. How can such conditions be treated with only one or two medicines? I now select the formulas and discussions from "Baiwen," which are detailed in the previous chapter. (See Volume 3, Discussion 2) May readers understand this clearly as if looking at their own palms.