大全云∶产后脏虚，心神惊悸者，由体虚心气不足，心之经为风邪所乘也，或恐惧忧
迫，令心气受于风邪，邪搏于心，则惊不自安，若惊不已，则悸动不定，其状目睛不转而不能
动，诊其脉动而弱者，惊悸也，动则为惊，弱则为悸矣。
薛氏曰∶按人之所主者心，心之所主者血，心血一虚，神气不守，此惊悸所由作也，当
补气血为主。
一产妇患前证，二度服琥珀地黄丸《局方》妙香散，随效，再患服之，其证益甚，而脉
浮大，按之如无，发热恶寒，此血气俱虚，用十全大补加味归脾二汤各百余剂而愈，后遇惊
恐劳怒复作，仍服前药而安。
加味四物汤 治产后血少，怔忡无时。
当归 川芎 白芍（炒） 熟地（酒洗） 茯神（去木，各一钱） 远志（去心） 枣仁（炒，各七分）
上 咀，水煎，食远服。
白茯苓散 治产后心神惊悸，言语失常。
白茯苓 人参 熟地黄（各一两半） 黄 当归 白芍药 远志（去心） 麦门冬（去心）
桂心 甘草（炙，各一两） 石菖蒲 桑寄生（各七钱半）
上 咀，每服八钱，水一大盏半，生姜五片，枣三枚，竹叶三七片，煎至一大盏，去滓，
温服无时。
熟干地黄散 治产后心神惊悸，神思不安。
熟干地黄（二两） 黄 白薇 龙齿（另研，各一两） 茯神（去木） 人参 羌活 远志肉（各七
钱） 桂心 防风 甘草（炙，各半两）
上 咀，每服五钱，水一大盏半，生姜五片，枣三枚，煎至一大盏，去滓，温服不拘时。
（以气血药为主，似矣，而以羌活为佐者，岂果有风邪乘之耶）一方无黄 ，有荆芥。
产乳七宝散 初产后服之，调和血气，补虚，安心神，镇惊悸。
当归 川芎 人参 白茯苓 桂心 羚羊角（烧存性） 朱砂（水飞，各二钱） 干姜（一钱）
上为细末，每服一钱，用羌活豆淋酒调下，不饮酒者，用清米饮调下（凡产后方，古人
喜用热药，今人仍古方者亦十之九。此方以芎归姜桂为主，似太热矣，为之温血行血则可，
若谓其能调和血气，安神镇惊，则未可也，临症者悉再详之）。如觉心烦热闷，以麦门冬去
心煎汤调下；若心下烦闷而痛，用童便调下；若觉心胸烦热，即减姜桂，心寒却加之；腹痛，
加当归；心闷，加羚羊角；心虚气怯，加桂心；不思饮食，或恶心，加人参；虚烦，加茯苓。以
意斟酌，日二夜一，服之。
人参散 治产后脏腑虚，心怔惊悸，言语
错乱。
人参 麦冬（去心，各八钱） 茯神 远志（去心） 独活 防风 生地黄 甘草（炙） 天竺黄（另
研） 龙齿（另研） 朱砂（水飞，各四钱） 牛黄（另研） 白薇（各一钱） 龙脑（另研） 麝香
（另研，各一钱）
上为细末，每服二钱，薄荷酒调下，不拘时。（此方清凉，气血并补，而治痰不用燥剂，
清心不入苦寒，可补辛热之未备，而独活防风又治风，升举之法，须察之）
琥珀散 治血虚，惊悸少寐，及产后败血停留，少腹作痛。
辰砂（另研） 没药 琥珀（并研细） 当归（等分）
上为细末，每服二钱，空心日午临卧白汤调下。
茯苓散 治产后狂语，志意不定，精神昏乱，心气虚，风邪所致。
茯苓（一方用茯神） 生地黄（各三两） 远志 白薇 龙齿（各二两五钱） 人参 防风 独活（各
二两）
上为末，以银一斤（妙在用银一斤），水一斗五升，煮取七升，下诸药煮取三升，温分三
服，忌菘菜、猪肉、生冷。一方加荆芥二两，甘草一两二钱半。
一方 治产后多虚羸弱，若大汗利，皆至于死，此重虚故也，若中风语谬，昏闷不知人
者，宜服此。
人参 茯苓 羌活 远志 大枣（各二两） 竹沥（一升）
上用水六升煮取二升，下竹沥，更煎二升半，分三服。（既不宜大汗，何以用羌活二两，
所未信也。下竹沥一升，妙甚）
归脾汤 治产后血气大虚，心神惊悸，怔忡不寐，或心脾伤痛，嗜卧少食，或忧思伤脾，
血虚发热。
人参 黄 （蜜炒） 白术（土炒） 白茯苓 龙眼肉 当归 远志（去心） 酸枣仁（炒，各一钱）
木香 甘草（各五分）
上加姜枣，煎服。加柴胡、牡丹皮，名加味
归脾汤。
远志丸 治产后脏虚不足，心神惊悸，志意不安，腹中急痛，或时怕怖，夜卧不宁。
远志（去心） 麦门冬（去心） 黄 当归（炒） 人参 白术 独活（去芦） 白茯苓 桂心 柏
子仁 山茱萸 石菖蒲 熟地黄 钟乳粉 阿胶（碎炒，各一两）
上为细末，炼蜜和，捣五七百下，丸如桐子大，每服三十丸，温酒送下，不拘时，日进三服。
白茯苓丸 治产后心虚惊悸，神志不安。
白茯苓 熟地黄（各一两） 人参 桂心 远志（去心） 石菖蒲 柏子仁 琥珀（另研，各半两）
上为细末，炼蜜和，捣二三百下，丸如桐子大，每服三十丸，不拘时，粥饮送下。（此温
补法，于虚寒者宜之，然心虚则热收于内，用热药又当斟酌）
The *Daquan* states: Postpartum visceral deficiency, with the heart spirit startled and palpitations, arises from physical weakness and insufficient Heart Qi, where the meridians of the Heart are invaded by Wind pathogen. Alternatively, due to fear or distress, the Heart Qi is affected by Wind pathogen; when the pathogen clashes with the Heart, one experiences startle and unease. If the startle persists, palpitations and instability occur. The presentation includes fixed eyes that cannot move. Palpation reveals a pulsating yet weak pulse, indicating Startle-Palpitation (Jing Ji). A "moving" pulse indicates Startle, while a "weak" pulse indicates Palpitation.
Xue Ji stated: In the human body, the Heart is the master, and the Blood is what the Heart governs. Once Heart Blood becomes deficient, the Spirit (Shen) fails to reside securely, which is the origin of Startle-Palpitation. Treatment should primarily focus on tonifying Qi and Blood.
A postpartum woman suffered from the aforementioned condition. After taking *Hupo Dihuang Wan* (Amber Rehmannia Pill) and *Miaoxiang San* (Wonderful Incense Powder) from the *Ju Fang* twice, there was initial improvement. However, upon recurrence, re-administration worsened the symptoms. Her pulse was floating and large but empty upon deep pressure, accompanied by fever and aversion to cold. This indicated dual deficiency of Qi and Blood. She was cured after taking over one hundred doses each of *Jiawei Shiquan Dabu Tang* (Modified Ten Great Tonifying Decoction) and *Jiawei Guipi Tang* (Modified Spleen-Restoring Decoction). Later, when relapse occurred due to fright, fatigue, and anger, she stabilized again by taking the previous medicines.
**Jiawei Siwu Tang** (Modified Four Substances Decoction): Treats postpartum blood deficiency causing intermittent severe palpitations (Zheng Chong).
Ingredients: Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba, stir-fried), Shu Di Huang (Rehmanniae Radix Praeparata, wine-washed), Fu Shen (Poria with Hostwood, woody core removed, 1 qian each), Yuan Zhi (Polygalae Radix, heart removed), Zao Ren (Ziziphi Spinosae Semen, stir-fried, 0.7 qian each).
Usage: Coarsely crush the herbs, decoct in water, and take after meals.
**Bai Fuling San** (White Poria Powder): Treats postpartum heart spirit startle-palpitations and abnormal speech.
Ingredients: Bai Fuling (Poria, 1.5 liang each), Ren Shen (Ginseng Radix et Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix), Bai Shao Yao (Paeoniae Radix Alba), Yuan Zhi (Polygalae Radix, heart removed), Mai Men Dong (Ophiopogonis Radix, heart removed), Gui Xin (Cinnamomi Ramulus Cortex, 1 liang each), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 liang each), Shi Chang Pu (Acori Tatarinowii Rhizoma), Sang Ji Sheng (Taxilli Caulis, 0.75 liang each).
Usage: Coarsely crush the herbs. Take 8 qian per dose, add 1.5 da zhan of water, 5 slices of Sheng Jiang (Zingiberis Rhizoma Recens), 3 dates, and about 30 leaves of Zhu Ye (Bambusae Folium). Decoct until 1 da zhan remains, filter, and take warm at any time.
**Shu Gan Di Huang San** (Prepared Dry Rehmannia Powder): Treats postpartum heart spirit startle-palpitations and mental unrest.
Ingredients: Shu Gan Di Huang (Prepared Dry Rehmannia Root, 2 liang), Huang Qi (Astragali Radix), Bai Wei (Cynanchi Atrati Radix), Long Chi (Dentis Longae, separately ground, 1 liang each), Fu Shen (Poria with Hostwood, woody core removed), Ren Shen (Ginseng Radix et Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Yuan Zhi Rou (Polygalae Radix flesh, 0.7 qian each), Gui Xin (Cinnamomi Ramulus Cortex), Fang Feng (Saposhnikoviae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 liang each).
Usage: Coarsely crush the herbs. Take 5 qian per dose, add 1.5 da zhan of water, 5 slices of Sheng Jiang, and 3 dates. Decoct until 1 da zhan remains, filter, and take warm at any time.
(Note: Primarily using Qi and Blood tonics seems appropriate, but why use Qiang Huo as an assistant? Is there truly a Wind pathogen invading?) Another formula excludes Huang Qi and includes Jing Jie.
**Chanru Qibao San** (Seven Treasures for Childbirth Powder): Taken immediately after childbirth to harmonize Qi and Blood, tonify deficiency, calm the spirit, and settle startle-palpitations.
Ingredients: Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Bai Fuling (Poria), Gui Xin (Cinnamomi Ramulus Cortex), Ling Yang Jiao (Saigae Tataricae Cornu, burnt to retain properties), Zhu Sha (Cinnabar, water-triturated, 2 qian each), Gan Jiang (Zingiberis Rhizoma Aridum, 1 qian).
Usage: Grind into fine powder. Take 1 qian per dose, mixed with Qiang Huo Dou Lin Jiu (Qiang Huo Bean-Leaven Wine). For those who do not drink alcohol, mix with clear rice water. (Postpartum formulas traditionally favor hot herbs; nine out of ten modern practitioners still follow ancient formulas. This formula relies heavily on Xiong, Gui, Jiang, and Gui, appearing too hot. It may warm and move blood, but claiming it harmonizes Qi/Blood and calms the spirit is questionable. Clinicians must deliberate carefully.) If feeling心烦热闷 (heart vexation and heat oppression), mix with Mai Men Dong decoction. If experiencing heart vexation, oppression, and pain, mix with Tong Bian (child's urine). If feeling chest heat, reduce Jiang and Gui; if feeling cold, increase them. For abdominal pain, add Dang Gui. For chest oppression, add Ling Yang Jiao. For heart deficiency and timidity, add Gui Xin. For poor appetite or nausea, add Ren Shen. For deficiency vexation, add Fuling. Adjust according to judgment. Take twice daily and once at night.
**Renshen San** (Ginseng Powder): Treats postpartum visceral deficiency, heart Zheng Chong and startle-palpitations, and disordered speech.
Ingredients: Ren Shen (Ginseng Radix et Rhizoma), Mai Dong (Ophiopogonis Radix, heart removed, 8 qian each), Fu Shen (Poria with Hostwood), Yuan Zhi (Polygalae Radix, heart removed), Du Huo (Angelicae Pubescentis Radix), Fang Feng (Saposhnikoviae Radix), Sheng Di Huang (Rehmanniae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Tian Zhu Huang (Calami Polyporus, separately ground), Long Chi (Dentis Longae, separately ground), Zhu Sha (Cinnabar, water-triturated, 4 qian each), Niu Huang (Bovis Calculus, separately ground), Bai Wei (Cynanchi Atrati Radix, 1 qian each), Long Nao (Borneolum Syntheticum, separately ground), She Xiang (Moschus, separately ground, 1 qian each).
Usage: Grind into fine powder. Take 2 qian per dose, mixed with Bo He Jiu (Mint Wine), at any time. (This formula is cooling, tonifies both Qi and Blood, treats phlegm without drying agents, clears the heart without bitter-cold herbs, supplementing the deficiencies of acrid-hot formulas. Du Huo and Fang Feng treat wind and lift yang; careful observation is required.)
**Hupo San** (Amber Powder): Treats blood deficiency causing startle-palpitations and insomnia, as well as postpartum retained lochia causing lower abdominal pain.
Ingredients: Chen Sha (Vermilion, separately ground), Mo Yao (Myrrhae Resina), Hu Po (Succinum, finely ground together), Dang Gui (Angelicae Sinensis Radix, equal parts).
Usage: Grind into fine powder. Take 2 qian per dose, mixed with plain warm water on an empty stomach, at noon, and before bed.
**Fuling San** (Poria Powder): Treats postpartum manic speech, unstable will, mental confusion, caused by Heart Qi deficiency and Wind pathogen.
Ingredients: Fu Ling (Poria, another version uses Fu Shen), Sheng Di Huang (Rehmanniae Radix, 3 liang each), Yuan Zhi (Polygalae Radix), Bai Wei (Cynanchi Atrati Radix), Long Chi (Dentis Longae, 2.5 liang each), Ren Shen (Ginseng Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix), Du Huo (Angelicae Pubescentis Radix, 2 liang each).
Usage: Grind into powder. Use 1 jin of Silver (the use of silver is ingenious), add 1.5 dou of water, boil down to 7 sheng. Add the herbs and boil down to 3 sheng. Divide into three warm doses. Avoid Song Cai (Chinese cabbage), pork, and raw/cold foods. Another version adds Jing Jie (Schizonepetae Spica, 2 liang) and Gan Cao (Licorice, 1.25 liang).
**Another Formula**: Treats extreme postpartum emaciation and weakness. Profuse sweating or diarrhea can lead to death due to double deficiency. If wind-stroke causes erroneous speech, coma, or unconsciousness, this formula is suitable.
Ingredients: Ren Shen (Ginseng Radix et Rhizoma), Fu Ling (Poria), Qiang Huo (Notopterygii Rhizoma et Radix), Yuan Zhi (Polygalae Radix), Da Zao (Jujubae Fructus, 2 liang each), Zhu Li (Bambusae Succus, 1 sheng).
Usage: Boil water (6 sheng) down to 2 sheng. Add Zhu Li and boil down to 2.5 sheng. Divide into three doses. (Since profuse sweating is contraindicated, why use 2 liang of Qiang Huo? This is unconvincing. Adding 1 sheng of Zhu Li is excellent.)
**Guipi Tang** (Spleen-Restoring Decoction): Treats severe postpartum Qi and Blood deficiency, heart spirit startle-palpitations, Zheng Chong insomnia, heart-spleen pain, lethargy, poor appetite, spleen injury from worry/thought, blood deficiency fever.
Ingredients: Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix, honey-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Bai Fu Ling (Poria), Long Yan Rou (Longan Aril), Dang Gui (Angelicae Sinensis Radix), Yuan Zhi (Polygalae Radix, heart removed), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried, 1 qian each), Mu Xiang (Aucklandiae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 fen each).
Usage: Add Sheng Jiang and Da Zao, decoct and take. Adding Chai Hu (Bupleuri Radix) and Mu Dan Pi (Moutan Cortex) creates *Jiawei Guipi Tang* (Modified Spleen-Restoring Decoction).
**Yuanzhi Wan** (Polygala Pill): Treats postpartum visceral deficiency, heart spirit startle-palpitations, mental unrest, acute abdominal pain, occasional fear, and restless sleep.
Ingredients: Yuan Zhi (Polygalae Radix, heart removed), Mai Men Dong (Ophiopogonis Radix, heart removed), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix, stir-fried), Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Du Huo (Angelicae Pubescentis Radix, de-rooted), Bai Fu Ling (Poria), Gui Xin (Cinnamomi Ramulus Cortex), Bai Zi Ren (Platycladi Semen), Shan Zhu Yu (Corni Fructus), Shi Chang Pu (Acori Tatarinowii Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata), Zhong Ru Fen (Concha Ostreae Pulveratum), E Jiao (Colla Corii Asini, crushed and stir-fried, 1 liang each).
Usage: Grind into fine powder, mix with refined honey, pound 500-700 times. Form pills the size of tung seeds. Take 30 pills per dose with warm wine, at any time, three times daily.
**Bai Fuling Wan** (White Poria Pill): Treats postpartum heart deficiency startle-palpitations and mental unrest.
Ingredients: Bai Fu Ling (Poria), Shu Di Huang (Rehmanniae Radix Praeparata, 1 liang each), Ren Shen (Ginseng Radix et Rhizoma), Gui Xin (Cinnamomi Ramulus Cortex), Yuan Zhi (Polygalae Radix, heart removed), Shi Chang Pu (Acori Tatarinowii Rhizoma), Bai Zi Ren (Platycladi Semen), Hu Po (Succinum, separately ground, 0.5 liang each).
Usage: Grind into fine powder, mix with refined honey, pound 200-300 times. Form pills the size of tung seeds. Take 30 pills per dose at any time, with congee drink. (This is a warming tonification method, suitable for deficiency-cold. However, heart deficiency leads to internal heat retention; caution is needed when using hot herbs.)