加味八珍汤 星连二陈汤 七珍散
产后不语分虚实，痰热乘心败血冲，气血两虚神郁冒，实少虚多要辨明。虚用八珍藤菖志，痰热星
连入二陈，败血冲心七珍散，芎地辛防朱蒲参。
【注】产后不语，须分虚实治之。有痰热乘心者，有败血冲心者，有气血两虚而郁冒
神昏者，大抵产后属虚者多，而实者少也。虚宜八珍汤加钩藤、菖蒲、远志，痰热宜二陈
汤加胆星、黄连，败血冲心宜七珍散，即川芎、生地、细辛、防风、朱砂、菖蒲、人参
也。
八珍汤（方见首卷） 二陈汤（方见三卷）
茯神散 加味归脾汤
产后血虚心气弱，惊悸恍惚不安宁，养心须用茯神散，参 地芍桂茯神，琥珀龙齿归牛膝。忧思归脾砂齿灵。
【注】产后血虚，心气不守，神志怯弱，故令惊悸恍惚不宁也。宜用茯神散，其方乃
人参、黄 、熟地、白芍、桂心、茯神、琥珀、龙齿、当归、牛膝也。若因忧愁思虑伤
心脾者，宜归脾汤加朱砂、龙齿治之。
归脾汤（方见首卷）
妙香散
产后谵狂见鬼神，败血冲心小调经。心虚闷乱妙香散，二茯参 远志辰，甘桂木麝山药末，归地
煎调效如神。
【注】产后败血冲心，狂乱见鬼，谵言妄语者，宜服小调经散。若因心血虚，神不守
舍而闷乱者，则用妙香散，即茯苓、茯神、人参、黄 、远志、辰砂、甘草、桔梗、木香、
麝香、山药为散，以当归、熟地煎汤。调服即愈，其效如神。
Jiawei Bazhen Decoction (Modified Eight-Treasure Decoction), Xinglian Erchen Tang (Arisaema and Coptis Modified Two-Aged Decoction), Qizhen San (Seven-Treasure Powder).
Postpartum mutism should be differentiated into deficiency and excess patterns. Etiologies include phlegm-heat harassing the Heart or failing blood rushing to the Heart. If caused by deficiency of both Qi and Blood leading to mental depression and faintness, the pattern is predominantly deficiency with little excess, which must be clearly distinguished. For deficiency patterns, use Bazhen Decoction (Eight-Treasure Decoction) added with Gouteng (Uncaria Ramulus cum Uncis), Shichangpu (Acori Tatarinowii Rhizoma), and Yuanzhi (Polygalae Radix). For phlegm-heat patterns, add Dansheng (Arisaematis Cum Bile) and Huanglian (Coptidis Rhizoma) to Erchen Tang (Two-Aged Decoction). For failing blood rushing to the Heart, use Qizhen San, composed of Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdi (Rehmanniae Radix), Xixin (Asari Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Zhusha (Cinnabaris), Shichangpu (Acori Tatarinowii Rhizoma), and Renshen (Ginseng Radix et Rhizoma).
[Note] Postpartum mutism requires treatment differentiation between deficiency and excess. There are cases of phlegm-heat harassing the Heart, cases of failing blood rushing to the Heart, and cases of mental confusion due to Qi and Blood deficiency causing depression and faintness. Generally, postpartum conditions are predominantly deficient rather than excessive. Deficiency patterns are suitable for Bazhen Decoction added with Gouteng (Uncaria Ramulus cum Uncis), Shichangpu (Acori Tatarinowii Rhizoma), and Yuanzhi (Polygalae Radix); phlegm-heat patterns are suitable for Erchen Tang (Two-Aged Decoction) added with Dansheng (Arisaematis Cum Bile) and Huanglian (Coptidis Rhizoma); failing blood rushing to the Heart is suitable for Qizhen San, consisting of Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdi (Rehmanniae Radix), Xixin (Asari Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Zhusha (Cinnabaris), Shichangpu (Acori Tatarinowii Rhizoma), and Renshen (Ginseng Radix et Rhizoma).
Bazhen Decoction (Formula seen in Volume 1) Erchen Tang (Formula seen in Volume 3)
Fushen San (Poria Spiritus Powder), Jiawei Guipi Tang (Modified Spleen-Restoring Decoction).
Postpartum Blood deficiency leads to weak Heart Qi, resulting in palpitations,恍惚 (mental vagueness/unsteadiness), and restlessness. To nourish the Heart and calm the spirit, Fushen San should be used, containing Renshen (Ginseng Radix et Rhizoma), Dihuang (Rehmanniae Radix), Baishao (Paeoniae Radix Alba), Guixin (Cinnamomi Cortex), Fushen (Poria cum Radice), Hupo (Succinum), Longchi (Dentis Fossum), Danggui (Angelicae Sinensis Radix), and Niuxi (Achyranthis Bidentatae Radix). If caused by worry and overthinking injuring the Heart and Spleen, Guipi Tang (Spleen-Restoring Decoction) added with Zhusha (Cinnabaris) and Longchi (Dentis Fossum) is indicated.
[Note] Postpartum Blood deficiency causes Heart Qi to fail to remain within, leading to timid spirit and symptoms of palpitations, mental vagueness, and restlessness. It is appropriate to use Fushen San, whose formula consists of Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Shudi (Rehmanniae Radix Preparata), Baishao (Paeoniae Radix Alba), Guixin (Cinnamomi Cortex), Fushen (Poria cum Radice), Hupo (Succinum), Longchi (Dentis Fossum), Danggui (Angelicae Sinensis Radix), and Niuxi (Achyranthis Bidentatae Radix). If injured by sorrow and overthinking affecting the Heart and Spleen, it is appropriate to treat with Guipi Tang (Spleen-Restoring Decoction) added with Zhusha (Cinnabaris) and Longchi (Dentis Fossum).
Guipi Tang (Formula seen in Volume 1)
Miaoxiang San (Wonderful Fragrance Powder).
Postpartum delirium, mania, and seeing ghosts are often due to failing blood rushing to the Heart, treated with Xiaotiaojing San (Minor Regulating Menses Powder). If caused by Heart Blood deficiency leading to chest stuffiness and mental disturbance, Miaoxiang San (Wonderful Fragrance Powder) is used, containing Fu Ling (Poria), Fushen (Poria cum Radice), Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Yuanzhi (Polygalae Radix), Chen Sha (Cinnabaris), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Muxiang (Aucklandiae Radix), Shexiang (Moschus), and Yamu (Dioscoreae Rhizoma) powdered, mixed with decoction of Danggui (Angelicae Sinensis Radix) and Shudi (Rehmanniae Radix Preparata). The effect is miraculous.
[Note] When failing blood rushes to the Heart postpartum, causing madness, seeing ghosts, and delirious speech, Xiaotiaojing San (Minor Regulating Menses Powder) is appropriate. If chest stuffiness and mental disturbance result from Heart Blood deficiency where the Shen (Spirit) fails to reside in its abode, then Miaoxiang San (Wonderful Fragrance Powder) is used. This powder consists of Fu Ling (Poria), Fushen (Poria cum Radice), Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Yuanzhi (Polygalae Radix), Chen Sha (Cinnabaris), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Muxiang (Aucklandiae Radix), Shexiang (Moschus), and Dioscoreae Rhizoma, taken as a powder mixed with a decoction of Danggui (Angelicae Sinensis Radix) and Shudi (Rehmanniae Radix Preparata). Recovery is swift and effective.