产后发痉，阴血大亏也。其证则腰背反张，戴眼直视，或四肢强劲，身体抽搐。在伤寒虽有刚痉、柔痉之
辨，总之无非血枯血燥之病，而实惟足太阳与少阴主之。盖膀胱与肾为表里，肾主精血，而太阳之脉络于头目
项背，是以病痉。若其发痉之由，则凡如伤寒误为大汗以亡液，大下以亡阴，或溃疡脓血大泄之后，乃有此证。
故产后亦惟去血过多，或大汗大泻而然，其为元气虚极，血液枯败也。可知治宜察其阴阳，大补气血，宜大补
元煎，或十全大补汤（方见上恶露不止条中）。若认为风痰而用发散消导等剂，必死无疑矣。
大补元煎
人参（一二钱） 山药（炒，二钱） 熟地黄（二三钱） 杜仲（炒，一钱） 当归 枸杞（各二三钱）
山茱萸 炙甘草（各一钱）
水煎，食前温服。
元阳不足而多寒者，加附子、肉桂、炮姜之类；气分偏虚者，加黄 、白术（胃口多滞者，不必用）；血
滞者去山茱萸，加川芎（一钱）；滑泄者去当归，加五味子、破故纸之类。
新产血虚多汗喜中风，故病痉；亡血复汗寒多，故令郁冒；亡津液胃燥、故大便难，三者虽不同而实相因。
如新产胃虚不食，往往昏冒而神不清，或厥，是郁冒也。宜白薇汤。郁冒则多汗必致病痉，宜钩藤汤。且多汗
必液少而大便秘，至五七日、七八日之久，宜养荣血，肠自润矣。宜苏麻粥。
白薇汤
白薇 当归（各三钱） 人参（一钱五分） 甘草（七分）
水煎服。
钩藤汤
钩藤钩 茯神 当归 人参（各一钱） 桔梗（一钱五分） 桑寄生（五分）
水煎服。烦热加石膏。
苏麻粥
苏子 麻子（各等分，去壳）
同捣烂，和水滤取汁，入粳米末少许，同煮作粥。
产后出现痉挛，是由于阴血大量亏损所致。其症状表现为腰背向后反张（角弓反张），眼球上翻直视，或者四肢强直有力，身体发生抽搐。在伤寒病中，虽然有刚痉和柔痉的区分，但总之无非是血液枯竭、血液干燥的病证，实际上主要由足太阳膀胱经和足少阴肾经所主。因为膀胱与肾互为表里，肾主管精血，而太阳经脉循行联络于头、目、项、背，所以会导致痉挛病症。至于导致痉挛的原因，凡是像伤寒误用大汗法导致津液亡失，或误用峻下法导致阴气亡失，或者溃疡后脓血大量流失之后，才会出现这种证候。因此，产后也只有在失血过多，或者大汗、大泻的情况下才会发生，这属于元气极度虚弱，血液枯败的表现。可知治疗应当考察阴阳虚实，以大补气血为主，适宜使用大补元煎，或者十全大补汤（方剂见上文恶露不止条中）。如果误认为是风痰而使用发散、消导等药剂，必定死亡无疑。
大补元煎
人参（一至二钱） 山药（炒制，二钱） 熟地黄（二至三钱） 杜仲（炒制，一钱） 当归 枸杞子（各二至三钱）
山茱萸 炙甘草（各一钱）
加水煎煮，饭前温服。
若元阳不足且畏寒多冷者，加入附子、肉桂、炮姜之类；气分偏虚者，加入黄芪、白术（胃口多有停滞者，不必使用）；血滞者去掉山茱萸，加入川芎（一钱）；滑泄者去掉当归，加入五味子、破故纸之类。
新近生产后血虚、多汗、容易感受风邪，所以发生痉挛；失血后又发汗，寒气较多，所以导致郁冒；津液亡失导致胃燥，所以大便困难。这三种情况虽然不同，但实际上是相互关联的。
如新产后胃气虚弱不能进食，往往出现昏沉冒昧而神志不清，或者四肢厥冷，这就是郁冒。适宜使用白薇汤。郁冒则多汗必然导致痉挛，适宜使用钩藤汤。而且多汗必然导致津液减少而大便秘结，到了五七日、七八日之久，应当滋养营血，肠道自然就会润泽。适宜食用苏麻粥。
白薇汤
白薇 当归（各三钱） 人参（一钱五分） 甘草（七分）
加水煎煮服用。
Spasm occurring after childbirth is caused by a severe deficiency of Yin and blood. The symptoms include opisthotonos (backward arching of the back), eyes staring upward, or rigid limbs and convulsions of the body. Although in *Shanghan* (Cold Damage) there is a distinction between Gang Jing (Stiff Spasm) and Rou Jing (Flexible Spasm), essentially these are all diseases of blood depletion and dryness, primarily governed by the Foot-Taiyang Bladder Meridian and the Foot-Shaoyin Kidney Meridian. Since the Bladder and Kidney are interior-exteriorly related, and the Kidney governs essence and blood, while the Taiyang meridians connect to the head, eyes, neck, and back, spasms result. Regarding the causes of such spasms, they occur after errors in treating *Shanghan*, such as inducing excessive sweating leading to fluid loss, or aggressive purging leading to Yin loss, or following ulceration with massive discharge of pus and blood. Therefore, postpartum spasms also occur only due to excessive blood loss, or excessive sweating and purging, representing an extreme deficiency of Yuan Qi (Original Qi) and exhaustion of blood. Thus, treatment should assess Yin and Yang, employing major tonification of Qi and Blood. Da Bu Yuan Jian (Great Tonify Origin Decoction) or Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) [see formula for continuous lochia above] are appropriate. If mistakenly treated as Wind-Phlegm using dispersing and resolving agents, death is inevitable.
Da Bu Yuan Jian (Great Tonify Origin Decoction)
Ren Shen (Ginseng Radix et Rhizoma, 1-2 qian) Shan Yao (Dioscoreae Rhizoma, stir-fried, 2 qian) Shu Di Huang (Rehmanniae Radix Praeparata, 2-3 qian) Du Zhong (Eucommiae Cortex, stir-fried, 1 qian) Dang Gui (Angelicae Sinensis Radix) Gou Qi Zi (Lycii Fructus, each 2-3 qian)
Shan Zhu Yu (Corni Fructus) Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata, each 1 qian)
Decoct in water, take warm before meals.
If Yuan Yang is insufficient with much cold, add Fu Zi (Aconiti Lateralis Radix Praeparata), Rou Gui (Cinnamomi Cortex), Pao Jiang (Zingiberis Rhizoma Preparatus), etc.; if Qi is predominantly deficient, add Huang Qi (Astragali Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) [not needed if stomach appetite is stagnant]; if blood is stagnant, remove Shan Zhu Yu and add Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1 qian); if there is slipping/diarrhea, remove Dang Gui and add Wu Wei Zi (Schisandrae Chinensis Fructus), Po Gu Zhi (Psoraleae Fructus), etc.
Newly postpartum women have deficient blood, excessive sweating, and susceptibility to Wind, hence spasm occurs; loss of blood followed by sweating leads to excess cold, hence Yu Mao (Depression and Dizziness) occurs; loss of Jin Ye (Body Fluids) causes Stomach dryness, hence difficulty in defecation. Although these three conditions differ, they are causally linked.
For example, newly postpartum women with weak Stomach Qi unable to eat often experience dizziness and clouded consciousness, or Jue (Cold Extremities); this is Yu Mao. Bai Wei Tang (Baiwei Decoction) is appropriate. Yu Mao with excessive sweating inevitably leads to spasm; Gou Teng Tang (Uncaria Decoction) is appropriate. Moreover, excessive sweating leads to fluid deficiency and constipation; after five to seven days or even longer, nourishing Ying Blood (Nutritive Blood) will naturally moisten the intestines. Su Ma Zhou (Perilla and Hemp Seed Porridge) is appropriate.
Bai Wei Tang (Baiwei Decoction)
Bai Wei (Cynanchi Atrati Radix) Dang Gui (Angelicae Sinensis Radix, each 3 qian) Ren Shen (Ginseng Radix et Rhizoma, 1.5 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.7 qian)
Decoct in water and take.
Gou Teng Tang (Uncaria Decoction)
Gou Teng Gou (Uncariae Ramulus cum Uncis) Fu Shen (Poria Cum Radix) Dang Gui (Angelicae Sinensis Radix) Ren Shen (Ginseng Radix et Rhizoma, each 1 qian) Jie Geng (Platycodonis Radix, 1.5 qian) Sang Ji Sheng (Taxilli Herba, 0.5 qian)
Decoct in water and take. Add Shi Gao (Gypsum Fibrosum) if there is vexing heat.
Su Ma Zhou (Perilla and Hemp Seed Porridge)
Su Zi (Perillae Fructus) Ma Zi (Cannabis Semen, equal parts, shell removed)
Grind together until pasty, mix with water, filter to extract juice, add a small amount of Jing Mi (Oryza Sativa Var. Glutinosa) powder, and cook into porridge.