郭稽中曰∶产后汗出多而变痉者，因产后血虚，腠理不密，故多汗出，遇风邪搏之，则变
痉也。痉者，口噤不开，背强而直，如发痫状，摇头马嘶，身反折，须臾又发，气息如绝，宜速
斡口灌小续命汤，稍缓即汗出如雨，手摸空者，不可治也。
薛氏曰∶产后发痉，因去血过多，元气亏极，或外邪相搏，以致牙关紧急，四肢痉强，或
腰背反张，肢体抽搐。若有汗而不恶寒者曰柔痉，无汗而恶寒者曰刚痉，由亡血过多，筋无
所养而致，故伤寒汗下过多，溃疡脓血大泄多患之，乃败证也，急以十全大补汤大补血气，
如下应，急加附子，或保无虞，若攻风邪，死无疑矣。
夷坚志云∶杜壬治郝质子妇产四日， 戴眼，弓背反张，壬以为痉病，与大豆紫汤、独
活汤而愈。政和间，余妻方分娩，犹在蓐中，忽作此症；头足反接，相去几二尺，家人惊骇，以
数婢强拗之不直，适记所云，而药草有独活，乃急为之，召医未至，连进三剂，遂能直，医至
即愈矣，更不须用大豆紫汤。古人处方，神验屡矣。
陈临川曰∶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，以分刚柔阴阳而治，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。
按《素问》有痉字而无 字，仲景太阳经有痉病而无痉方，则今书中 字乃痉字传写
之误也，夫劲痉二字，谐体谐声，而痉之病状，有项背劲急反张之相，则从痉字无疑，若 字
于义莫解，故当以痉字为正。且寒主收引，风寒在太阳经而项背强直者，太阳筋病也，诸方
皆主续命，从仲景论矣。郭氏不问产后虚实，邪之有无，而概宗之，似乎一偏。至薛氏又
谓产后亡血过多，非急用十全大补不可，若
攻风邪，死无疑矣，又一见也。及《夷坚志》案，以大豆紫汤、独活汤而愈者，则又主于风矣。
是续命亦不为妄，但本方有麻黄、附子，于气血两虚之人不可轻用，而郭氏论又有速灌之
说，稍缓即汗出如雨，反不以麻黄为忌，何其语之切也。二说均不可废，临证之际，详之可也。
小续命汤 治产后汗多变痉，口噤首强，或摇头马嘶，不时举发，气息如绝。
方见前中风。
陈临川云∶陈无择评曰∶产后汗出多变痉，亦令服小续命汤，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，《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，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。
大豆紫汤 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。
方见前中风。
大豆汤 治产后卒中风发 ，倒闷不知人，及妊娠挟风，兼治在蓐诸疾。
大豆（五升，炒令微焦） 葛根 独活（各一两） 防己（六两）（防己行十二经，虚者忌用，今分两且
独多，宜斟酌）
上 咀，每服五钱，酒二盏煎至一盏半，去渣温服，不拘时，日三服。
一方 治产后中风，诸体疼痛，自汗出者，及余百疾。
独活（八两） 当归（四两）
上 咀，以酒八升煮取四升，去滓，分四服，日三夜一，取微汗。若上气者，加桂心二
两，不瘥更作。
羚羊角饮子 治产后气实，腹中坚硬，两胁胀满，心中烦热，渴欲饮水，欲成刚 ，中风之疾。
羚羊角（半两，镑） 防风 羌活 桔梗（并去芦） 败酱（各八钱）（败酱近无识者，不知当以何物
代之） 桂心 柴胡 大黄（酒浸过煨，各一两二钱）
上 咀，每服五钱，水一大盏半同煎至一盏，去渣温服，不拘时，更服地黄酒，（地黄酒
妙甚）用地黄切一升，炒令黑，瓷瓶中下热酒三升，密封口，煮令减半，任意服之。
防风当归散
防风 川芎 当归 地黄（各五钱）
上锉，每服一两，水三盏煎至二盏，温服。
楼氏曰∶续命汤、大豆紫汤、举卿古拜散，太阳厥阴药也，邪实，脉浮弦有力者固宜，但
产后血气大虚之人，不宜轻发其表，但用防风当归散治之为妙。
郭稽中说：产后出汗多而转变为痉病的，是因为产后血虚，腠理（皮肤毛孔及皮下组织）不紧密，所以容易出汗，遇到风邪侵袭搏结，就会变成痉病。所谓痉病，是指牙关紧闭不能张开，背部僵硬挺直，像发作癫痫的样子，摇头如马嘶鸣，身体向后反折，片刻后又发作，气息微弱好像要断绝一样，应当迅速撬开口腔灌服小续命汤，如果病情稍缓却出现大汗淋漓如雨、手在空中摸索的症状，就无法治疗了。
薛氏说：产后发生痉病，是因为失血过多，元气极度亏损，或者外邪相搏结，导致牙关紧急，四肢痉挛强直，或者腰背向后反张，肢体抽搐。如果有汗且不恶寒的称为柔痉，无汗且恶寒的称为刚痉，这是由于亡血过多，筋脉失去滋养所致，所以伤寒病中发汗或攻下过多，以及溃疡脓血大量流失的患者容易患此病，属于败坏危重的证候，急需使用十全大补汤来大补气血，如果服药后脉象应指有力，急加附子，或许可以保全性命；如果去攻伐风邪，必定死亡无疑。
《夷坚志》记载：杜壬治疗郝质子之妻，生产四天后，出现眼睛上翻，背部弓起反张，杜壬认为是痉病，给予大豆紫汤、独活汤治疗后痊愈。政和年间，我的妻子刚刚分娩，还在产床上，忽然出现这种症状；头和脚向后反接，相距近二尺，家人惊恐骇异，让几个婢女强行掰正也掰不直，恰好记得书上说的情况，而且药草中有独活，于是急忙为她煎药，医生还没到，连续服用三剂，身体就能伸直了，医生到了也就痊愈了，更不需要用大豆紫汤。古人开方，神效屡见不鲜。
陈临川说：凡是产后牙关紧闭，腰背强直，角弓反张，都名叫痉，又名叫痓。古人观察有汗无汗，以此区分刚柔阴阳而进行治疗，现在《产宝》等书中设有“中风牙关紧闭”一门，又有“角弓反张”一门，其实是一回事，比如憎寒发热，类似伤寒，都不加以论述，怎么可以用一两种药来治疗呢？
按《素问》中有“痉”字而没有“痓”字，张仲景在太阳经篇中有痉病却没有专门的痉病方剂，那么现在书中的“痓”字乃是“痉”字传抄书写时的错误。劲、痉二字，字形相近读音相同，而痉病的症状，有项背强劲紧急、身体反张的表现，所以用“痉”字毫无疑问，若用“痓”字在意义上无法解释，所以应当以“痉”字为正。况且寒性主收敛牵引，风寒在太阳经导致项背强直的，是太阳经筋的病，各方剂都主张用续命汤，这是遵循张仲景的理论。郭氏不问产后体质的虚实、邪气的有无，而一概宗奉它，似乎有些偏颇。至于薛氏又说产后亡血过多，非急用十全大补不可，如果去攻伐风邪，必定死亡无疑，这又是另一种片面见解。等到《夷坚志》的案例，用大豆紫汤、独活汤治愈的，则是侧重于治风。这样看来，续命汤也不算妄用，但本方含有麻黄、附子，对于气血两虚的人不可轻易使用，而郭氏的论述中又有迅速灌服的說法，如果稍慢就会大汗如雨，反而不把麻黄作为禁忌，他的话多么急切啊。这两种说法都有可取之处，不可废弃，临床时详细斟酌即可。
小续命汤 治疗产后出汗多变生痉病，牙关紧闭，头颈强直，或者摇头如马嘶鸣，不时发作，气息微弱好像要断绝。
方剂见前文中风章节。
陈临川说：陈无择评价道：产后出汗多变生痉病，也让服用小续命汤，这又难以让人相信，既然已经汗多，怎么还能再服用麻黄、官桂、防己、黄芩这类药物呢？不如大豆紫汤为好，《局方》中的大圣散也是良药。我观察朱奉议说：凡是刚柔二种痓病，小续命汤都可以加减后给予，如果是柔痓自汗的，去掉麻黄加上葛根的说法，朱奉议一定有依据，虽然大豆紫汤、大圣散很好，也不可持有偏见曲解原意，妨碍古人的本意。
大豆紫汤 治疗中风头晕目眩，恶风自汗，吐冷水以及产后各种疾病，或者中风引起的痱病、痉病，背部强直，牙关紧闭，直视烦热，脉象紧大的，属不治之症。
方剂见前文中风章节。
大豆汤 治疗产后突然中风引发痓病，昏倒闷乱不知人事，以及妊娠期间挟带风邪，兼治在产床期间的各种疾病。
大豆（五升，炒至微焦） 葛根 独活（各一两） 防己（六两）（防己通行十二经络，虚弱者忌用，如今分量且特别重，宜斟酌使用）
以上药材捣碎成粗末，每次服用五钱，用酒两盏煎至一盏半，去渣温服，不拘时间，每日三次。
另一方案 治疗产后中风，全身疼痛，自汗出的，以及其余各种疾病。
独活（八两） 当归（四两）
以上药材捣碎成粗末，用酒八升煮取四升，去滓，分四次服用，白天三次晚上一次，以求微微出汗。如果气逆上冲的，加桂心二两，不好再制作。
羚羊角饮子 治疗产后气实，腹部坚硬，两胁胀满，心中烦热，想喝水，快要形成刚痓，中风类的疾病。
羚羊角（半两，镑成片） 防风 羌活 桔梗（均去芦头） 败酱（各八钱）（败酱近期无人认识，不知道用什么东西替代） 桂心 柴胡 大黄（酒浸过后煨制，各一两二钱）
以上药材捣碎成粗末，每次服用五钱，用水一大盏半同煎至一盏，去渣温服，不拘时间，再服用地黄酒，（地黄酒非常妙），用地黄切一升，炒至黑色，放入瓷瓶中倒入热酒三升，密封瓶口，煮至减半，任意服用。
防风当归散
防风 川芎 当归 地黄（各五钱）
以上药材切碎，每次服用一两，用水三盏煎至二盏，温服。
楼氏说：续命汤、大豆紫汤、举卿古拜散，都是针对太阳经和厥阴经的药物，邪气实盛，脉象浮弦有力的固然适宜，但产后气血大虚的人，不宜轻易发散其表邪，只用防风当归散治疗才是妙法。
Guo Jizhong stated: When excessive sweating after childbirth transforms into Jing disease (spasm), it is due to blood deficiency postpartum, where the Cou Li (skin pores and interstitial spaces) are not tight, leading to profuse sweating. Upon encountering wind pathogen invasion and binding, Jing disease occurs. Jing disease refers to trismus (lockjaw) where the mouth cannot open, back stiffness and straightness, resembling an epileptic seizure, with head shaking and sounds like a horse neighing, opisthotonos (body arching backward), recurring in moments, with breath appearing as if cut off. One should quickly pry open the mouth and administer Xiao Xuming Tang (Minor Cinnamon Twig Decoction). If the condition slightly relieves but presents with sweat pouring like rain and picking at empty air (carphologia), it is incurable.
Xue Shi stated: Postpartum Jing disease arises from excessive blood loss causing extreme depletion of Yuan Qi (Original Qi), or interaction with external pathogens, resulting in urgent jaw clenching, spastic rigidity of the four limbs, or opisthotonos of the waist and back, and limb convulsions. Those with sweating but no aversion to cold are called Rou Jing (Soft Spasm); those without sweating and with aversion to cold are called Gang Jing (Hard Spasm). This is caused by excessive blood loss leaving the sinews without nourishment. Thus, patients who have undergone excessive sweating or purgation in Shanghan diseases, or those with massive discharge of pus and blood from ulcers, often suffer from this; it is a critical syndrome. Urgently use Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) to greatly tonify blood and Qi. If the pulse responds favorably, urgently add Fuzi (Prepared Aconite Root); survival may be ensured. If one attacks the wind pathogen, death is inevitable.
The Yijian Zhi records: Du Ren treated the wife of Hao Zizhi, four days postpartum, presenting with eyes rolling upward and opisthotonos. Du Ren diagnosed it as Jing disease and administered Da Dou Zi Tang (Soybean Purple Decoction) and Duhuo Tang (Angelica Pubescens Decoction), resulting in recovery. During the Zhenghe era, my wife had just given birth and was still in bed when she suddenly developed this symptom; her head and feet bent backward towards each other, nearly two chi apart. Family members were terrified; several maids tried forcibly to straighten her body but failed. Recalling the text, and finding Duhuo among the herbs, I hastily prepared it. Before the physician arrived, three doses were administered consecutively, allowing her body to straighten. The physician's arrival coincided with full recovery, making Da Dou Zi Tang unnecessary. Ancient prescriptions proved effective repeatedly.
Chen Linchuan stated: Any postpartum case involving trismus, back stiffness, and opisthotonos is named Jing (Spasm), also referred to as Chi (Stiffness). Ancients distinguished between Gang (Hard) and Rou (Soft) types based on the presence or absence of sweating to guide treatment according to Yin-Yang principles. Current texts such as Chanbao include sections on "Stroke with Trismus" and "Opisthotonos," which are essentially the same entity. Symptoms like aversion to cold and fever resemble Shanghan, yet these are often overlooked. How can such conditions be treated with only one or two remedies?
According to Suwen, the character for Jing exists, but Chi does not. Zhang Zhongjing discussed Jing disease in the Taiyang channel chapter but did not provide a specific formula for it. Therefore, the character Chi in current texts is likely a transcription error for Jing. The characters Jin and Jing share similar forms and sounds. Given that Jing disease manifests with stiff neck and back and opisthotonos, using Jing is undoubtedly correct, whereas Chi lacks clear semantic meaning. Cold governs contraction and pulling; wind-cold in the Taiyang channel causing neck and back stiffness indicates a Taiyang sinew pathology. Most formulas advocate Xuming Tang, following Zhongjing’s theory. Guo’s approach, ignoring postpartum deficiency/excess and the presence/absence of pathogens, blindly adheres to this method, showing bias. Conversely, Xue’s assertion that postpartum blood loss requires urgent Shiquan Dabu Tang and forbids attacking wind pathogens is another form of one-sidedness. The Yijian Zhi case, cured with Da Dou Zi Tang and Duhuo Tang, emphasizes treating wind. Thus, Xuming Tang is not entirely baseless, but it contains Mahuang (Ephedra Herb) and Fuzi, which should not be used lightly in patients with dual Qi and Blood deficiency. Guo’s advice to administer it rapidly, warning that delay causes profuse sweating (contradicting the caution against Mahuang), seems overly hasty. Both perspectives have merit and should be carefully considered clinically.
Xiao Xuming Tang treats postpartum sweating transforming into Jing disease, characterized by trismus, neck stiffness, head shaking resembling horse neighing, intermittent attacks, and breathlessness.
Formula see previous Stroke section.
Chen Linchuan cited Chen Wuyue’s evaluation: Allowing Xiao Xuming Tang for postpartum sweating-induced Jing disease is hard to believe. Since sweating is already excessive, how can one administer Mahuang, Guizhi (Cinnamon Twig), Fangji (Stephania Root), Huangqin (Scutellaria Root)? Da Dou Zi Tang is preferable. Dasheng San (Great Sage Powder) from Ju Fang is also a good medicine. Observing Zhu Fengyi’s statement: For both Gang and Rou Chi, Xiao Xuming Tang can be modified and administered. For Rou Chi with spontaneous sweating, removing Mahuang and adding Gegen (Kudzu Root) must have a basis. Although Da Dou Zi Tang and Dasheng San are excellent, one should not hold biased views that distort ancient intentions.
Da Dou Zi Tang treats stroke with dizziness, aversion to wind, spontaneous sweating, vomiting cold water, and various postpartum ailments. It also treats stroke-induced Fei (flaccidity) or Jing disease, back stiffness, trismus, staring gaze, irritability, and heat. If the pulse is tight and large, it is untreatable.
Formula see previous Stroke section.
Da Dou Tang treats sudden wind-stroke in postpartum women causing Chi disease, fainting and unconsciousness, as well as pregnancy complicated by wind, and various disorders during confinement.
Da Dou (Soybean, 5 sheng, stir-fried until slightly scorched), Gegen (Puerariae Radix), Duhuo (Angelicae Pubescentis Radix) (each 1 liang), Fangji (Stephaniae Tetrandrae Rhizoma) (6 liang). (Fangji circulates through the twelve meridians; contraindicated in deficiency. The dosage here is particularly high; use discretion.)
Crush the ingredients. Take 5 qian per dose, decoct with 2 zhan of wine to 1.5 zhan. Strain and take warm. No fixed time; three times daily.
Another prescription treats postpartum wind-stroke with generalized pain and spontaneous sweating, along with other ailments.
Duhuo (8 liang), Danggui (Angelicae Sinensis Radix) (4 liang).
Crush the ingredients. Decoct with 8 sheng of wine to obtain 4 sheng. Strain. Divide into four doses. Take three times during the day and once at night, aiming for mild sweating. If there is rebellious Qi, add Guixin (Cinnamomi Cortex) 2 liang. Repeat if ineffective.
Lingyang Jiao Yinzi treats postpartum excess Qi, abdominal hardness, distension in the hypochondrium, mental restlessness and heat, thirst for water, impending Gang Chi, and wind-stroke diseases.
Lingyang Jiao (Antelope Horn) (0.5 liang, sliced), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Jiegeng (Platycodonis Radix) (all remove rhizome), Baijiangcao (Patriniae Herba) (each 8 qian). (Baijiangcao is rarely recognized nowadays; substitute appropriately.) Guixin, Chaihu (Bupleuri Radix), Dahuang (Rhei Radix et Rhizoma) (soaked in wine and roasted) (each 1 liang 2 qian).
Crush the ingredients. Take 5 qian per dose, decoct with 1.5 zhan of water to 1 zhan. Strain and take warm. No fixed time. Also take Dihuang Jiu (Rehmannia Wine): Cut 1 sheng of Dihuang (Rehmanniae Radix Praeparata), stir-fry until black, place in a porcelain jar, add 3 sheng of hot wine, seal tightly, and boil until reduced by half. Drink as desired.
Fangfeng Danggui San
Fangfeng, Chuanxiong (Ligusticum Chuanxiong Rhizoma), Danggui, Dihuang (Rehmanniae Radix Praeparata) (each 5 qian).
Cut the ingredients. Take 1 liang per dose, decoct with 3 zhan of water to 2 zhan. Take warm.
Lou Shi stated: Xuming Tang, Da Dou Zi Tang, and Juqing Gubai San are medicines targeting the Taiyang and Jueyin channels. They are suitable for cases with excess pathogens and floating, wiry, forceful pulses. However, for postpartum women with severe Qi and Blood deficiency, one should not lightly induce diaphoresis to release the exterior. Using Fangfeng Danggui San is the superior approach.