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The *Daquan* states: Postpartum patients may exhibit inverted speech, or delirious talking and rambling, even appearing to see ghosts and spirits. The etiology is diverse; therefore, careful differentiation of syndromes (Bian Zheng) must be conducted before administering medication.

If the condition is postpartum convulsion (Jing Feng), characterized by confused speech, hallucinations of seeing ghosts and spirits, and mental instability, grind high-quality Cinnabar (Zhusha) and administer Longhu Dan (Dragon-Tiger Pill) with wine (see formula in *Ju Fang*, three pills taken at once). This should be combined with the administration of Hupo Dihuang Wan (Amber and Rehmannia Pill). (Note that none of the preceding sections mention Phlegm).

First, if it is due to postpartum Heart deficiency, with stagnant blood accumulating and disturbing the Heart, leading to manic speech and muttering alone, one should refer to the section on "Suddenly Seeing Ghosts and Spirits" for treatment.

Second, if it is due to postpartum Zang-Fu deficiency, causing Heart spirit fright palpitations, unstable will, confused speech without self-awareness, and restless mind, one should refer to the section on "Fright Palpitations" for treatment.

Third, if there is a pre-existing wind-toxin condition, exacerbated by postpartum Heart deficiency and Qi weakness, resulting in stiffness and rigidity of the waist and back, or alternating singing and crying, anger and laughter, and confused speech, it should be treated as Wind Spasm (Feng Jing). One should refer to the section on "Heart Fright and Stroke" for treatment.

Fourth, if it is postpartum Heart deficiency complicated by Wind Strike (Zhong Feng), with vague Heart spirit and confused speech, one should refer to the section on "Stroke and Vagueness" for treatment.

Fifth, postpartum cases are often caused by stagnant blood confusing the Heart meridian, leading to mania and epilepsy, irregular confused speech, or fainting and oppression. One should refer to the "Blood Syncope" category in this volume for treatment.

Sixth, if it is due to contracting Wind-Cold after childbirth, with lochia suddenly stopping, aversion to cold and fever resembling malaria, clarity during the day but delirium at night resembling visions of ghosts, it should be treated as Heat Entering the Blood Chamber (Re Ru Xue Shi). It is suitable to use Hupo Dihuang Wan and Siwu Tang (Four Substance Decoction), using equal parts of Sheng Gan Di Huang (Dried Raw Rehmannia Root) and Bei Chai Hu (Northern Bupleurum Root) decocted together. If symptoms do not subside, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) adding Sheng Gan Di Huang in an amount equal to Huang Qin (Scutellaria Root), decocted and taken until cured.

Although so, generally speaking, antenatal and postpartum conditions have their own specialized and fixed methods. Even a slight difference matters. For postpartum cases, one must first expel stagnant blood and generate new blood, then carefully differentiate the disease syndrome. One must not arbitrarily create new names or ideas, nor casually modify formulas and herbs. The most important aspect is matching the prescription to the syndrome and treating according to ancient methods; there will be no lack of safety and stability.

Xue Ji stated: For the aforementioned conditions, the primary approach should be to consolidate Stomach Qi, assisted by herbs addressing the specific manifestations. If one solely attacks Phlegm, it would be a mistake.

A parturient was extremely fatigued and frequently experienced delirium. After using Baizi San (Seed of Biota Powder) with slight improvement, she was cured using Jiawei Guipi Tang (Modified Spleen-Restoring Decoction). Later, due to anger, she again exhibited manic speech, hypochondriac pain, and hematuria. She was treated with Jiawei Xiaoyao San (Modified Free Wanderer Powder) to clear Liver Fire and nourish Liver Blood, resulting in immediate recovery. She was then stabilized with Jiawei Guipi Tang.

Yiling Sansheng San (One-Spirit Three-Holy Decoction): Treats postpartum stagnant blood rushing to the Heart, fever, delirious talk, running about, and a deficient-large pulse.
Ingredients: Ganye He Ye (Dry Lotus Leaf), Sheng Gan Di Huang (Dried Raw Rehmannia Root), Mudan Pi (Tree Peony Bark), Sheng Puhuang (Fresh Pollen Typhae, separately ground, each 2 qian).
Usage: Decoct the first three ingredients strongly to make a soup, mix in the Puhuang powder. One dose brings calm.

Duoming San (Life-Rescuing Powder): Treats postpartum blood entering the Heart meridian, manic speech, forgetfulness, and loss of will.
See the previous Blood Syncope section for the formula.

Tiaojing San (Regulating Menses Powder): Treats Blood and Qi deficiency, Yin deficiency with fever, or stagnant blood causing Heart spirit irritability, visions of ghosts and spirits, or delirious speech.
Ingredients: Moyao (Myrrh), Hupo (Amber, both finely ground), Guixin (Cinnamon Heart, each 1 qian), Chishao (Red Peony Root, stir-fried), Danggui (Angelica Sinensis Root, soaked in wine, each 1 qian), Xixin (Asarum, 2.5 qian), Shexiang (Musk, a small amount).
Usage: Grind into fine powder. Take 0.5 qian per dose, mixed with a little Ginger Juice and warm wine. (This formula focuses on treating stagnant blood, not Yin deficiency fever, hence the use of Guixin and Shexiang). Alternatively, take 1 qian of Suhexiang Wan (Styrax Pill), mixed with child's urine (Tongbian) to awaken the patient. (Using Suhexiang in postpartum cases may be too aromatic and dispersing of True Qi; using Tongbian demonstrates clever application).

Baiziren San (Biota Seed Powder): Treats postpartum Yuan Qi weakness, stagnant blood, delirious speech, and sudden visions of ghosts and spirits.
Ingredients: Baiziren (Biota Seed), Yuanzhi (Polygala Root), Sheng Dihuang (Raw Rehmannia Root, baked), Renshen (Ginseng Root), Danggui (Angelica Sinensis Root), Sangjisheng (Taxillus Branch, treats postpartum residual ailments and benefits blood vessels), Fangfeng (Saposhnikovia Root), Hupo (Amber, separately ground), Gancao (Licorice Root, honey-fried, all in equal proportions).
Usage: Grind into coarse powder. First, slice one White Sheep Heart, boil in three bowls of water to obtain seven-tenths of clear juice. Add five qian of the herb powder, decoct to six-tenths, and take.

Miaoxiang San (Wonderful Fragrance Powder): Treats postpartum inverted Heart spirit, confused speech, and visions of ghosts and spirits.
Ingredients: Ganshan Yao (Dried Chinese Yam), Bai Fuling (White Poria), Fushen (Poria with Hostwood, remove wood), Huangqi (Astragalus Root), Yuanzhi (Polygala Root, remove heart, each 1 liang), Renshen (Ginseng Root), Jiegeng (Platycodon Root), Gancao (Licorice Root, each 5 qian), Chensha (Cinnabar, 3 qian), Shexiang (Musk, 1 qian), Muxiang (Costus Root, 2.5 qian).
Usage: Grind into powder. Take 2 qian per dose, mixed with warm wine.
Another method: Use Sheng Gan Di Huang (Dried Raw Rehmannia Root) and Danggui (Angelica Sinensis Root) decocted in soup to mix and take, yielding immediate effect.

Wujin San (Black Gold Powder): Treats sudden delirious speech and visual hallucinations of ghosts and spirits occurring 3-5 days or half a month after childbirth.
Ingredients: Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Rhizome), Chishao Yao (Red Peony Root), Shudihuang (Prepared Rehmannia Root), Baizhu (Atractylodes Macrocephala Rhizome), Yuanzhi Rou (Polygala Flesh), Fushen (Poria with Hostwood, remove wood), Qianghuo (Notopterygium Rhizome), Suanzaoren (Ziziphus Seed), Chensha (Cinnabar, separately ground and added), Fangfeng (Saposhnikovia Root), Xiangfuzi (Cyperus Rhizome, each 2 qian), Banxia (Pinellia Tuber, 3 qian), Baizhi (Angelica Dahurica Root), Chenpi (Citrus Reticulata Peel, each 1.5 qian), Renshen (Ginseng Root), Niuxi (Achyranthes Root), Maimendong (Ophiopogon Tuber), Tianma (Gastrodia Rhizome), Quanxie (Whole Scorpion, each 1 qian), Gancao (Licorice Root, 9 fen).
Usage: Cut into pieces for two doses. Add 3 slices of Ginger, 3 stalks of Scallion, and Silver (Gold/Silver leaf or wire) to decoct together. (*Neijing* states: The Heart is the monarch official, from which Shen (Spirit) emerges. Thus, Shen is not inherent to the Heart but endowed by Heaven. What Heaven endows is the pure, bright Qi. Therefore, if the Heart chamber is pure and clear, the will is governed and Shen resides therein. If evil invades slightly, Shen has no home, the will is unsettled, and diseases of delirious speech and false vision arise. Thus, the Heart chamber cannot be impure for a day, nor can Shen depart for a day. Qi generates Shen, Blood nourishes the Heart. When Qi and Blood are abundant, Shen is vigorous and thought is precise; when deficient, Shen declines and thought diminishes. In the period of 3-5 days or half a month postpartum, Qi and Blood are indeed deficient. If suddenly startled, the Spirit leaves the empty residence, Evil attacks the chamber, causing Shen to have no home and the Heart no master, thus generating confusion. The so-called Evil refers to Wind-Phlegm and Stagnant Blood. This formula uses Qianghuo, Baizhi, Quanxie, Tianma, and Banxia to remove Wind-Phlegm; Sizijunzi Tang and Siwu Tang to cultivate Qi and Blood; Niuxi and Chishao to move stagnant blood; Xiangfu and Chenpi to regulate stagnant Qi; Fushen and Zaoren to attract returning Shen; Chensha and Yuanzhi to calm the unsettled will; Maimendong is a key herb for clearing the Heart; Jin Yin (Silver/Gold) is a spiritual pill for calming; Scallion guides upwards to connect with Heavenly Qi; Ginger connects internally to illuminate Shen. The formulator must be one of complete Shen. 'Wujin' is a term of respect. Since Blood loss requires tonifying Qi, Blood-invigorating herbs are omitted. The excellence lies in forming a paste.)

Siwu Buxin Tang (Four-Substance Heart-Nourishing Decoction): Treats postpartum vague speech, inversion, and confusion.
Ingredients: Danggui (Angelica Sinensis Root, 5 qian), Chuanxiong (Ligusticum Rhizome), Baishaoyao (White Peony Root), Sheng Dihuang (Raw Rehmannia Root), Baizhu (Atractylodes Macrocephala Rhizome), Banxia (Pinellia Tuber), Jiegeng (Platycodon Root), Fushen (Poria with Hostwood, each 4 qian), Chenpi (Citrus Reticulata Peel, 3 qian), Gancao (Licorice Root, 1 qian).
Usage: Cut into pieces to make a powder, divided into six doses. Each dose is boiled with 3 slices of Ginger in water, taken on an empty stomach. If there is heat, add 2 qian of Jiu Chao Huanglian (Alcohol-fried Scutellaria Root); if no heat, do not use.

Ningshen Gao (Spirit-Calming Paste): Treats excessive blood loss, dull and oppressed Heart spirit, abnormal speech, and inability to sleep.
Ingredients: Chensha (Cinnabar), Ruxiang (Frankincense), Suanzaoren (Ziziphus Seed, stir-fried), Renshen (Ginseng Root), Fuling (Poria, each 1 liang), Hupo (Amber, 7.5 qian).
Usage: Grind into powder. Take 1 qian per dose, mixed with Dengxin Zaozi Jian Tang (Decoction of Juncus Effusus and Jujube). Or, make honey pills the size of a bullet, dissolve one pill in Mint Decoction.

Hupo Dihuang Wan (Amber and Rehmannia Pill): Treats Heart Blood deficiency leading to delirious speech.
Ingredients: Hupo (Amber, separately ground), Yanshusuo (Corydalis Rhizome, stir-fried with glutinous rice until red, remove rice), Danggui (Angelica Sinensis Root, each 1 liang), Puhuang (Pollens Typhae, stir-fried, 4 liang), Sheng Dihuang (Raw Rehmannia Root), Shengjiang (Fresh Ginger, each 2 jin).
Usage: Separate the juice and dregs from the Dihuang and Shengjiang. Stir-fry the Dihuang dregs with Shengjiang juice, and the Shengjiang dregs with Dihuang juice, drying each separately. Mix with the previous four ingredients, grind into powder, and refine with honey to make pills the size of bullets. Take one pill per dose, washed down with Danggui decoction.