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The *Daquan* records: To treat postpartum mania and unconsciousness caused by fright leading to "defeated blood" (stagnant blood) rushing to the heart, where the patient appears possessed by spirits, it is appropriate to use *Dasheng Zelan San* (Great Sage Mugwort Powder) from the *Ju Fang*. Add high-quality Chen Sha (Cinnabar), ground extremely fine. For each dose, add approximately one "yi" (a traditional small weight unit) of Chen Sha. Decoct Suan Zao Ren Tang (Ziziphus Decoction) and mix with the powder. One dose can bring calm.

Xue Ji stated: The aforementioned syndrome results from Blood deficiency causing the Shen (Spirit) to lose its residence. It cannot be treated without tonifying Yuan Qi (Primal Qi). Refer to the mutually applicable formulas in subsequent chapters.

A postpartum woman suffered from the aforementioned syndrome and was cured using Da Ze Lan Tang (Large Mugwort Decoction). Later, she developed palpitations and delirious speech, with excessive phlegm. She was treated with Fu Shen San (Poria Cocos Powder) to tonify Heart deficiency, resulting in immediate recovery. Subsequently, Ba Zhen San (Eight Treasures Powder) was used with Yuan Zhi (Polygala Root) and Fu Shen (Poria Cocos with Wood Removed) to nourish Qi and Blood, leading to her convalescence.

Another postpartum woman suffered from this condition. Treatment with phlegm-resolving and spirit-calming herbs exacerbated the illness, causing severe depletion of mental energy. I diagnosed it as insufficiency of Qi and Blood in the Heart and Spleen. I administered a large dose of Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Chuan Xiong (Szechwan Lovage Rhizome), Dang Gui (Angelica Sinensis), Fu Shen, and Suan Zao Ren (Ziziphus Seed), totaling over four jin, which stabilized her. She was then cured after taking Gui Pi Tang (Restore the Spleen Decoction) for more than fifty doses.

**Dasheng Zelan San** (Great Sage Mugwort Powder): Treats cold deficiency in the Blood Sea (Uterus) in women, long-term infertility, postpartum defeated blood rushing to the heart, stroke with jaw lock, fetal death in utero (administered via forced feeding, the fetus is delivered shortly after, ensuring safety). Treats miscarriage, stabbing abdominal pain, breech presentation, retained placenta, syncope due to blood loss, blood stasis masses, hemorrhage, blood entering the limbs, any disorders of the blood organs and wind syndromes, or cold-heat alternating patterns from Shang Han (Cold Damage) with vomiting and coughing, widespread skin sores, headache, nausea, irregular menstruation, red and white leukorrhea, foul odor from breasts, cold deficiency of the fetal organ, recurrent miscarriages, indefinite metrorrhagia, phlegm formation due to these causes, and amenorrhea in unmarried women. All are suitable for this formula. Regular use warms the uterus, harmonizes Qi and Blood, beautifies complexion, dispels wind-cold, eliminates myriad diseases, and treats male five labors and seven injuries, and deficiency wasting syndromes.

Ingredients: Ze Lan Ye (Mugwort Leaf), Shi Gao (Gypsum Fibrosum, ground, 2 liang each), Sheng Di Huang (Rehmannia Root, 1.5 liang), Dang Gui (Angelica Sinensis), Chuan Xiong (Szechwan Lovage Rhizome), Shao Yao (Peony Root), Wu Yi (Chaulmoogra Seed), Gan Cao (Licorice Root, roasted, 1 liang 7 qian 5 fen each), Rou Gui (Cinnamon Bark, 1 liang 2 qian 5 fen), Hou Po (Magnolia Bark, stir-fried with ginger juice), Bai Fu Ling (Poria Cocos with Wood Removed), Fang Feng (Saposhnikovia Root), Xi Xin (Asarum), Wu Zhu Yu (Evodia Fruit, washed seven times in hot water), Juan Bai (Selaginella Tamariscina), Bai Zi Ren (Biota Seed, lightly stir-fried), Jie Geng (Platycodon Root, 1 liang each), Huang Qi (Astragalus Root), Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Dan Shen (Salvia Miltiorrhiza), Wu Wei Zi (Schisandra Berry), Chuan Jiao (Sichuan Pepper, remove eyes and closed ones, lightly stir-fried), Chuan Wu Tou (Aconitum Carmichaelii Lateral Root, processed, peel and navel removed), Gan Jiang (Dried Ginger, processed), Ben Lu (Ligusticum Wallichii Rhizome, remove seedlings), Bai Zhi (Angelica Dahurica Root, 7 qian 5 fen each), Bai Wei (Cynanchum Atratum Root), E Jiao (Donkey-hide Gelatin, crushed, fried until dry, 0.5 liang each).

Grind all ingredients into fine powder. Take 2 qian per dose, mixed with warm wine on an empty stomach or before bed. For urgent conditions, take at any time, three times daily.

**Ba Dan Wan** (Gallbladder-Charging Pill): Treats postpartum mania due to excessive fright, or mania occurring during menstruation.

Ingredients: Shui Yin (Mercurius, 2 liang), Hei Qian (Lead, 1.5 liang), Zhu Sha (Cinnabar, 1 liang, finely ground), Ru Xiang (Frankincense, 1 liang, finely ground).

First, melt the Lead in a crucible over fire. Add Mercurius and stir until it forms granules. Add Cinnabar and Frankincense. While hot, grind evenly with a willow wood pestle. Form pills the size of a chestnut. Take one pill per dose, with Bohe Tang (Mint Decoction) on an empty stomach. Ensure the patient sleeps without being startled; upon waking, they will be calm. (The human Spirit resides in the Heart. The liquid nature of Mercurius finds its residence in Cinnabar. The color of Cinnabar corresponds to the Heart, and the fluidity of Mercurius corresponds to the Spirit. The Spirit responds wondrously without obstruction; Mercurius flows roundly without stagnation. Both do not decay through ten thousand kalpas, hence they are combined by similarity. However, below the Fire of the Heart, Yin Essence must support it for peace. The flow of Mercurius is stabilized by True Lead. This is achieved by using True Water to control True Fire. In this formula, Ru Xiang unblocks Heart Qi, and Zhu Sha nourishes Heart Blood. Lead and Mercury interact between Heart and Kidneys in an instant, guiding the Spirit back to its residence. When the Spirit returns, sleep becomes peaceful.) Miao Xiang San (Wonderful Fragrance Powder) is also effective.

**Chen Sha Yuan Zhi Wan** (Cinnabar and Polygala Pill): Treats postpartum stroke with fright and mania, restlessness in sitting and lying, or surging phlegm-saliva.

Ingredients: Shi Chang Pu (Acorus Rhizome), Yuan Zhi (Polygala Root, remove heart), Ren Shen (Ginseng), Fu Ling (Poria Cocos, remove wood), Chen Sha (Cinnabar, 3 qian each), Chuan Xiong (Szechwan Lovage Rhizome), Shan Yao (Dioscorea Rhizome), Tie Fen (Iron Powder), Xi Xin (Asarum), Mai Men Dong (Ophiopogon Tuber, remove heart), Tian Ma (Gastrodia Rhizome), Ban Xia (Pinellia Tuber, soaked in hot water), Nan Xing (Arisaema Cum Bile), Bai Fu Zi (Typhonium Rhizome, 1 liang each).

Grind into powder. Cook with ginger juice and form pills with paste, sized like mung beans. Coat separately with Cinnabar. Take 30 pills per dose, with ginger tea before bed.

**Jia Wei Ba Zhen Tang** (Modified Eight Treasures Decoction): Postpartum mania and madness result from Blood deficiency causing the Spirit to lose its residence; tonifying Yuan Qi is essential. Use this formula, or Fu Shen San (Poria Cocos Powder), or Gui Pi Tang (Restore the Spleen Decoction). (The latter two formulas are found in the subsequent Palpitations chapter).

Ingredients: Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria Cocos), Gan Cao (Licorice Root, roasted), Dang Gui (Angelica Sinensis), Chuan Xiong (Szechwan Lovage Rhizome), Shao Yao (Peony Root), Shu Di Huang (Prepared Rehmannia Root), Yuan Zhi (Polygala Root), Fu Shen (Poria Cocos with Wood Removed, 2 qian each).

Cut into pieces. Decoct with Sheng Jiang (Fresh Ginger) and Da Zao (Jujube) in water. Take orally.

**Zha Jian Shen Gui** (Suddenly Seeing Spirits/Ghosts) (Refer to the preceding Mania and Delirium chapter).

The *Daquan* records: The Heart governs the blood vessels of the body. Childbirth damages and depletes blood vessels, leading to Heart Qi deficiency. Defeated blood accumulates and interferes with the Heart. The Heart cannot tolerate this disturbance, resulting in inner irritability, restlessness in sleeping and rising, suddenly seeing spirits/ghosts, and disordered speech. If physicians fail to recognize this and diagnose it as Wind Evil, treatment will certainly fail. Simply administer Tiao Jing San (Regulate Menstruation Powder), adding one pinch of Long Nao (Borneol) per dose. Sleep indicates safety. (The subtlety lies in adding one pinch of Borneol).

Xue Ji said: For the aforementioned syndrome, if defeated blood is stagnant, use Tiao Jing San (Regulate Menstruation Powder); if there is Heat due to Blood deficiency, use Ba Zhen Tang (Eight Treasures Decoction) with Pao Jiang (Roasted Ginger); if there is Heart Blood deficiency, use Bai Zi Ren San (Biota Seed Powder). Generally, this syndrome is caused by insufficient Blood in the Heart and Spleen. By regulating and tonifying Stomach Qi, Phlegm clears and the Spirit naturally calms. (The previous discussion only mentioned blood stasis and did not mention Phlegm; this discussion mentions Phlegm but does not treat it directly, instead focusing on regulating Stomach Qi. If there is indeed Phlegm, one must observe the patient's courage or timidity to decide the approach). If it is truly possession by spirits, moxibustion on the Ghost Acupoints can cure it. If it fails, it is often due to excessive purging of Phlegm and descending of Fire.

A postpartum woman suffered from the aforementioned syndrome. Someone used Tiao Jing San (Regulate Menstruation Powder), and she recovered but relapsed. Continuing the previous medication worsened the condition, with surging phlegm-saliva and morning chills with evening fevers. I prescribed Ba Zhen San (Eight Treasures Powder) in the morning and Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction) in the evening. Each was taken for over fifty doses, leading to recovery.

Yun Qi treated postpartum fever with delirious speech and running about, with a deficient and large pulse. Use Si Wu Tang (Four Substances Decoction) plus Chai Hu (Bupleurum Root). (Note: Is it advisable to add Chai Hu when the pulse is deficient? However, treating according to symptoms is acceptable). If ineffective, equal parts of Gan Cao (Licorice Root), Chai Hu (Bupleurum Root), and Sheng Di Huang (Rehmannia Root) can be decocted and taken.

**Tiao Jing San** (Regulate Menstruation Powder): Formula seen in the preceding Delirious Speech section.

**Hu Po San** (Amber Powder): Treats postpartum blood stasis attacking the Heart, causing confusion, delirious speech, and seeing ghosts.

Ingredients: Ren Shen (Ginseng), Fu Shen (Poria Cocos with Wood Removed), Sheng Di Huang (Rehmannia Root), E Jiao (Donkey-hide Gelatin, 7.5 qian each), Zhu Sha (Cinnabar, 5 qian, ground separately), Gan Cao (Licorice Root), Hu Po (Amber), Tie Fen (Iron Powder, ground separately), She Xiang (Musk, ground separately, 1 qian each).

Grind into fine powder. Take 1 qian per dose, mixed with decoction of Gold and Silver.

**Fu Shen San** (Poria Cocos Powder): Treats postpartum Blood-Evil, causing vague mind, inappropriate speech, and restless sleep.

Ingredients: Fu Shen (Poria Cocos with Wood Removed, 1 liang), Ren Shen (Ginseng), Huang Qi (Astragalus Root), Chi Shao (Red Peony Root), Niu Xi (Achyranthes Root), Hu Po (Amber, ground), Long Chi (Dragon Teeth, ground, 7.5 qian each), Sheng Di Huang (Rehmannia Root, 1.5 liang), Gui Xin (Cinnamon Twig Center, 0.5 liang).

Grind into powder. Take 3 qian per dose, decocted in water.

**One Formula**: Treats postpartum blood syncope, mental confusion and mania, vagueness as if seeing ghosts. (All blood-stasis-dispelling herbs are typically aromatic and hot. This formula is neither aromatic nor hot; it is a sacred medicine for cooling, clearing Fire, and dispelling stasis, adapting to the season. Contraindicated for Qi deficiency).

Ingredients: Sheng Yi Mu Cao (Motherwort Herb, fresh, 3 he; roots also acceptable), Sheng Di Huang Zhi (Rehmannia Juice, 2 he), Tong Bian (Child Urine, 1 he), Ji Zi Qing (Egg White, 3 units).

Decoct together for three or four boils. Then add Egg Whites and stir evenly. Take as one dose.