产后妄言、妄见,由气血两虚而神魂无所根据也。轻则睡中呢喃,重则不睡妄言。或因痰客上焦,十二官各失
其职,视听言动皆有虚妄,毋认鬼邪。治法当论产期新久,块痛有无,以为缓急。如块痛者,宜服宁神生化汤。
块痛已除,宜服益荣安神汤。
宁神生化汤
川芎(二钱) 当归(四钱) 茯苓 枣仁 柏仁(各一钱) 桃仁(十粒) 炮姜 炙草(各五分)
红枣(二枚去皮)
水煎服。虚加人参。
益荣安神汤
川芎(一钱) 当归(三钱) 茯神 枣仁 柏仁(各一钱) 橘红 甘草(各五分) 人参(一钱) 龙眼肉
(八个) 竹肉(一丸) 大枣(二枚)
渴,加麦冬、五味。汗多,加参、 、麻黄根。痰,加竹沥、姜汁。泻,加茯苓、白术。便闭,加苁蓉、麻仁。
产后忧、惊、劳倦、去血过多,心中烦动不宁,谓之怔忡。如惕然而惊,心中怯怯,若人捕之之状,谓之惊
悸。二症当调和脾胃,补养心血,使气宁神足,气舒心安,以加减养荣汤,其病自愈。
加减养荣汤
川芎(八分) 当归(二钱) 枣仁 茯苓 人参 麦冬 远志 白术 黄 (各一钱) 陈皮 炙草(各
五分) 龙眼肉(八个) 姜(二片)
水煎。虚烦,加竹茹。痰,加竹沥、姜汁。
此方可加丹参、柏仁。
安神丸
黄连 生地(酒乳九蒸九晒) 当归(各二钱) 炙草(八分)
作饼,为丸如豆大,朱砂为衣,每服四十丸。此与前药并服。
Postpartum incoherent speech and visual hallucinations arise from deficiency of both Qi and Blood, causing the Hun (Ethereal Soul) and Shen (Spirit) to lack a foundation. Mild cases manifest as muttering in sleep, while severe cases involve insomnia with incoherent speech. It may also be due to Phlegm lodging in the Upper Jiao, causing dysfunction of the Twelve Officials (Zang-Fu organs), resulting in false perceptions and actions in vision, hearing, speech, and movement; do not mistake this for demonic influence. The treatment method should consider the duration since delivery and the presence or absence of abdominal pain due to blood stasis, to determine the urgency. If there is pain due to blood stasis, it is appropriate to take Ningshen Shenghua Decoction. Once the pain due to blood stasis has subsided, it is appropriate to take Yirong Anshen Decoction.
Ningshen Shenghua Decoction (Soothing Spirit and Generating Life Decoction)
Chuanxiong Rhizome (2 qian) Angelicae Sinensis Radix (4 qian) Poria (1 qian) Semen Ziziphi Spinosae (1 qian) Semen Platycladi (1 qian) Persicae Semen (10 grains) Prepared Ginger (0.5 qian) Honey-fried Licorice Root (0.5 qian)
Red Dates (2 pieces, skin removed)
Decoct in water and take orally. Add Ginseng Radix et Rhizoma if deficient.
Yirong Anshen Decoction (Nourishing Glory and Calming Spirit Decoction)
Chuanxiong Rhizome (1 qian) Angelicae Sinensis Radix (3 qian) Poria Cum Ramo (1 qian) Semen Ziziphi Spinosae (1 qian) Semen Platycladi (1 qian) Exocarpium Citri Reticulatae (0.5 qian) Glycyrrhizae Radix et Rhizoma (0.5 qian) Ginseng Radix et Rhizoma (1 qian) Longan Aril (8 pieces) Bamboo Shavings (1 pill) Jujubae Fructus (2 pieces)
For thirst, add Ophiopogonis Radix and Schisandrae Fructus. For excessive sweating, add Ginseng Radix et Rhizoma, [missing character, likely Astragali Radix], and Ephedrae Radix et Rhizoma root tips (Mahuang Gen). For Phlegm, add Bamboo Juice and Ginger Juice. For diarrhea, add Poria and Atractylodis Macrocephalae Rhizoma. For constipation, add Cynomorii Herba and Cannabis Semen.
Postpartum palpitations (Zhongchong) refer to mental restlessness and agitation caused by worry, fright, fatigue, and excessive blood loss. Palpitations with fright (Jingji) refer to a state of sudden fearfulness and timidity, as if being pursued. Both conditions should be treated by harmonizing the Spleen and Stomach and nourishing Heart Blood, so that Qi becomes tranquil and Shen sufficient; when Qi flows smoothly, the mind is at peace, and the disease will heal spontaneously using Jiayang Yangrong Decoction.
Jiayang Yangrong Decoction (Modified Nourishing Glory Decoction)
Chuanxiong Rhizome (8 fen) Angelicae Sinensis Radix (2 qian) Semen Ziziphi Spinosae (1 qian) Poria (1 qian) Ginseng Radix et Rhizoma (1 qian) Ophiopogonis Radix (1 qian) Polygalae Radix (1 qian) Atractylodis Macrocephalae Rhizoma (1 qian) Astragali Radix (1 qian) Exocarpium Citri Reticulatae (0.5 qian) Honey-fried Licorice Root (0.5 qian) Longan Aril (8 pieces) Fresh Ginger (2 slices)
Decoct in water. For deficiency-heat irritability, add Bamboo Shavings. For Phlegm, add Bamboo Juice and Ginger Juice.
Salvia Miltiorrhiza Radix et Rhizoma and Semen Platycladi can be added to this formula.
Anshen Pill (Calming Spirit Pill)
Coptidis Rhizoma (2 qian) Rehmanniae Radix Preparata (2 qian, steamed and dried nine times with wine and milk) Angelicae Sinensis Radix (2 qian) Honey-fried Licorice Root (0.8 fen)
Form into cakes, grind into pills the size of beans, coat with Cinnabar, and take 40 pills per dose. This is taken concurrently with the previous medicines.