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Miu Zhongchun stated: There are cases of mania appearing six days postpartum, where the patient holds a knife and kills people; this is due to sudden massive loss of Yin blood, resulting in Liver deficiency with flaming fire. The treatment uses Zelan (Drynariae Rhizoma), Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), Niuxi (Achyranthis Bidentatae Radix), Fushen (Poria Cum Radix), Yuanzhi (Polygalae Radix), Zaoren (Ziziphi Spinosae Semen), added with Tongbian (Child's Urine).

The *Daquan* (Complete Good Prescriptions for Women) states: The Heart governs the blood vessels of the body. Due to childbirth injuring and depleting the blood vessels, Heart Qi becomes deficient, causing敗血 (retained blood/stasis) to stagnate and accumulate, ascending to interfere with the Heart. The Heart cannot tolerate this disturbance, leading to restlessness in the chest, inability to sleep or rise calmly, occasional visions of ghosts and spirits, and disordered speech. If physicians fail to recognize this and misdiagnose it as Wind Evil, such treatment will certainly not cure the disease. One should merely administer Tiaojing San (Regulate Menses Powder) with Longnao (Borneolum Syntheticum); if sleep is achieved, peace follows.

Guo Jizhong asked: What causes occasional visions of ghosts and spirits postpartum? He answered: The Liver stores Blood, and the Heart governs Blood. Because childbirth involves loss and depletion of blood, exhausting the Liver and Heart, retained blood rushes forward, and evil influences overflow into the Heart. Therefore, there are occasional visions of ghosts and spirits, and inverted or disordered speech; this is not Wind Evil. One should merely administer Tiaojing San (Regulate Menses Powder) and Heilong Dan (Black Dragon Pill).

Xue Lizhai stated: For occasional visions of ghosts and spirits postpartum, if caused by retained blood stagnation, use Tiaojing San (Regulate Menses Powder); if caused by Heart Blood deficiency and damage, use Baiziren San (Biota Seed Powder). These conditions are all caused by insufficient Blood in the Heart and Spleen. By regulating and tonifying the Qi of the Spleen and Stomach, phlegm clears naturally and the Spirit becomes tranquil. If indeed possessed by demonic entities, moxibustion on Guixue (Ghost Acupoints) can lead to recovery. If the condition does not improve, it is often due to excessive use of phlegm-resolving and fire-draining attacking methods.

Shenzhen commented: The above five passages describe syndromes of mania and seeing ghosts postpartum. The Heart governs Blood; the Heart generates Blood, and the Liver stores Blood. Postpartum sudden loss of Yin Blood causes the Heart to lose its nourishment, allowing Liver Fire to flare upward. The Liver stores the Hun (Ethereal Soul), and the Heart stores the Shen (Spirit); when Blood is deficient, the Hun and Shen fail to reside within, leading to various symptoms such as mania and seeing ghosts. These are all diseases of deficient fire surging upward. Xue Lizhai only emphasized tonifying deficiency and did not discuss this aspect. Miu Zhongchun’s passage elucidates insights previously unexplored by earlier scholars.

Shan Yangxian stated: Postpartum blood loss leads to the Heart Spirit losing its residence, resulting in妄言 (delirious speech) and seeing evil spirits. It is appropriate to consume Shenghua Tang (Generate the New Decoction) with added Fushen (Poria Cum Radix), Zaoren (Ziziphi Spinosae Semen), and Yuanzhi (Polygalae Radix). One must strictly avoid diagnosing this as Phlegm-Fire and using phlegm-resolving and fire-draining herbs, nor should one rely on shamans and witches to frighten the parturient woman.