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[Da] For women postpartum exhibiting inverted speech, or delirious rambling and incoherent speech, even seeing ghosts and spirits, the etiology is diverse. One must carefully differentiate the syndrome before administering medication. If it is postpartum convulsion (Jing Feng) causing chaotic speech, as if seeing ghosts and spirits, with unsettled spirit, grind high-quality Cinnabar (Zhusha), mix with wine, and administer Longhu Dan (Dragon-Tiger Pill; see *Ju Fang*). Take three pills per dose, concurrently administering Hupo Dihuang Wan (Amber Rehmannia Pill).

The first scenario arises from postpartum Heart Qi deficiency with stagnant blood accumulating and disturbing the Heart, leading to delirious solitary talking. Seek treatment under the section "Suddenly Seeing Ghosts and Spirits." The second scenario involves postpartum Zang-Fu deficiency, causing Heart Spirit fright palpitations and unstable will, resulting in disordered speech without self-awareness and restless thoughts. Seek treatment under the section "Fright Palpitations." The third scenario involves pre-existing wind-toxicity; due to postpartum Heart deficiency and weak Qi, presenting with stiffness of the waist and back, or singing, crying, anger, and laughter, with chaotic speech. Treat as Wind Spasm (Feng Jing) and seek guidance under "Heart Fright Stroke." The fourth scenario is postpartum Heart deficiency with stroke causing vague Heart Spirit and disordered speech. Seek guidance under "Stroke Vagueness." The fifth scenario is postpartum, often due to stagnant blood confusing the Heart Meridian, leading to mania, erratic speech, or fainting. Seek guidance under "Blood Syncope" in this volume.

The sixth scenario occurs when postpartum exposure to wind-cold causes lochia to abruptly cease, accompanied by aversion to cold and fever resembling malaria. The patient is lucid during the day but delirious at night, as if seeing ghosts. Treat as Heat Entering the Blood Chamber (Re Ru Xue Shi). Suitable formulas include Hupo Dihuang Wan and Siwu Tang. Use Sheng Gan Di Huang (Dried Raw Rehmannia Root) and Bei Chai Hu (Bupleurum Root) in equal proportions for decoction. If symptoms persist, use Xiaochai Hu Tang (Minor Bupleurum Decoction) adding Sheng Gan Di Huang in an amount equal to Huang Qin (Scutellaria Root), decocted and taken orally. Although these syndromes vary, prenatal and postpartum conditions generally have specific, fixed protocols that differ slightly. Postpartum treatment should first focus on expelling stasis and generating new blood, then carefully differentiate the disease. Do not arbitrarily create new names or modify prescriptions based on personal ideas. It is best to treat according to ancient methods matched to the syndrome, ensuring safety.

[Xue] The aforementioned syndromes should primarily be treated by consolidating Stomach Qi, assisted by herbs addressing the specific manifestations. If one focuses solely on attacking phlegm, it would be a mistake. A certain puerpera was extremely fatigued and occasionally experienced delirium. After using Baizi San (Seed-of-Catalpa Powder) with slight improvement, she recovered completely after taking Jiawei Guipi Tang (Modified Restore the Spleen Decoction). Later, due to anger, she again exhibited delirious speech, hypochondriac pain, and hematuria. She was treated with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) to clear Liver Fire and nourish Liver Blood, resulting in immediate recovery, followed by Jiawei Guipi Tang to stabilize her condition.

Yunqi Duoming San (Cloud-岐 Life-Seizing Powder) [for Blood Syncope]: Treats postpartum stagnant blood rushing to the Heart, causing fever, delirious speech, running about, and a deficient-large pulse.
Ingredients: Dried Lotus Leaf (Gan He Ye), Dried Raw Rehmannia Root (Sheng Gan Di Huang), Moutan Cortex (Mudan Pi) in equal parts.
Preparation: Decoct the three ingredients into a strong soup, mix with 2 qianbi of raw Polygonum multiflorum powder (Sheng Puhuang). One dose brings calm.

*Ju Fang* Miaoxiang San (Wonderful Fragrance Powder): Treats postpartum inverted Heart Spirit, disordered speech, as if seeing ghosts and spirits.
Usage: Decoct Dried Raw Rehmannia Root (Sheng Gan Di Huang) and Angelica Sinensis (Dang Gui) in water to take orally; effects are immediate.

Wujin San (Black Gold Powder): Treats sudden delirious speech and hallucinations of gods and spirits occurring 3-5 days or half a month after childbirth.
Ingredients: Dang Gui (2 qian), Yuanzhi Rou (2 qian), Chuan Xiong (2 qian), Suanzaoren (2 qian), Baizhu (2 qian), Chi Shaoyao (2 qian), Xiangfuzi (2 qian), Zhensha (Cinnabar, ground separately), Shu Dihuang (2 qian), Qianghuo (2 qian), Fangfeng (2 qian), Fushen (2.5 qian), Banxia (3 qian), Quanxie (1 qian), Maimendong (1 qian), Renshen (1 qian), Niuxi (1 qian), Tianma (1 qian), Gancao (0.9 qian), Chenpi (1.5 qian), Baizhi (1.5 qian).
Preparation: Coarsely crush into powder, divide into two doses. Decoct with 1.5 zhong of water, 3 slices of ginger, 3 sprigs of green onion, and gold/silver pieces until reduced to one bowl. Take warm at any time.

Siwu Buxin Tang (Four Substances Heart-Nourishing Decoction): Treats postpartum vague speech, inverted and disordered cognition.
Ingredients: Dang Gui (5 qian), Chuan Xiong (4 qian), Sheng Dihuang (4 qian), Baishao Yao (4 qian), Fushen (4 qian), Banxia (4 qian), Jiegeng (4 qian), Baizhu (4 qian), Chenpi (3 qian), Gancao (1 qian).
Preparation: Coarsely crush into powder, divide into six doses. For each dose, decoct with 1 zhong of water and 3 slices of ginger until reduced to 70%. Take warm on an empty stomach. Re-decoct the dregs. Add 2 qian of alcohol-fried Huanglian (Coptis Rhizome) if heat is present; omit if no heat.