〔大〕心主身之血脉，因产伤耗血脉，心气虚则败血停积，上干于心，心不受触，遂
致心中烦躁，卧起不安，乍见鬼神，言语颠错，医人不识，呼为风邪，如此治疾，必不
得愈，但服调经散，每服加龙脑一捻，得睡即安。
〔薛〕前证若败血停滞，用调经散。若血虚发热，用八珍加炮姜。若心血虚损，用
柏子仁散。大抵此证皆心脾血少所致，但调补胃气，则痰清而神自安矣。若果系鬼祟所
附，即灸鬼哭可愈。其或不起者，多因豁痰降火，攻伐之过也。一产妇患前证，或用
调经散，愈而复作，仍服前药，益甚，痰涎上涌，朝寒暮热。余朝用八珍散，夕用加味
归脾汤，各五十余剂而愈。
云岐治产后发热狂言奔走，脉虚大者，四物汤加柴胡；如不愈，加甘草、柴胡、生地
黄等分煎服亦可。
《广济》治产后血晕，心闷不识人，神言鬼语，气急欲绝。（见血晕。）
调经散
没药 琥珀（并细研） 桂心（各一钱） 芍药 当归（各二钱半） 麝香（研） 细辛（各半钱）
上为末，每服半钱，生姜汁、温酒各少许调服。
茯神散 治产后血邪，心神恍惚，言语失度，睡卧不安。
茯神（一两，去皮木） 人参 龙齿（研） 虎珀（研） 赤芍药 黄 牛膝（各七钱半）
生地黄（一两半） 桂心（半两）
上为末，每服三钱，水一盏，煎至七分，不拘时，去渣温服。
治方产一日，言语颠倒，用苏合香丸一钱，以童便调服即苏。
柏子仁散 治产后狂言乱语，皆因内虚，败血挟邪气攻心。
柏子仁 远志（去心） 人参 桑寄生 防风 琥珀（别研） 当归（焙） 生地黄（焙）
甘草（各等分）
上为粗末，先用白羊心一个切片，以水一大盏半，先煮至九分，去羊心，入药末五
钱，煎至六分，去渣无时服。
与前颠狂谵语门参看。
[Da Lun] The Heart governs the blood vessels of the body. Due to the injury and depletion of blood vessels during childbirth, Heart Qi becomes deficient. Consequently, "defeated blood" (stagnant postpartum blood) accumulates and interferes upward with the Heart. The Heart cannot tolerate this interference, leading to mental restlessness, inability to sit or lie down comfortably, hallucinations of seeing ghosts and spirits, and disordered speech. If physicians fail to recognize the pathogenesis and mistakenly attribute it to Wind Evil, treatment will inevitably fail. One should simply administer Tiaojing San (Regulate Menses Powder), adding a pinch of Longnao (Borneol) to each dose; if sleep is achieved, the condition will stabilize.
[Xue Ji's Commentary] For the aforementioned syndrome caused by stagnant defeated blood, use Tiaojing San. For fever due to Blood deficiency, use Bazhen Tang (Eight Treasures Decoction) with Paojiang (Charred Ginger). For damage to Heart Blood, use Baiziren San (Seed of Biota Seed Powder). Generally, these syndromes are caused by insufficient Blood in the Heart and Spleen. By regulating and tonifying Stomach Qi, phlegm will clear, and the Spirit will naturally settle. If it is indeed possession by evil spirits, moxibustion at Guiku (Ghost Cry, EX-HN21) can cure it. Cases that do not recover are often due to excessive use of herbs that resolve phlegm, descend fire, and attack/evacuate the body. A puerperal patient suffered from the aforementioned syndrome; after using Tiaojing San, she recovered but relapsed. Re-administering the previous medicine worsened her condition, causing phlegm-saliva to surge upward and alternating chills in the morning and heat in the evening. I administered Bazhen San (Eight Treasures Powder) in the morning and Jiawei Guipi Tang (Modified Tonify the Spleen Decoction) in the evening. After taking more than fifty doses of each, she recovered.
Yun Qi treated a postpartum patient with fever, delirious speech, and running about restlessly, presenting with a deficient and large pulse. He used Siwu Tang (Four Substances Decoction) plus Chaihu (Bupleurum Root). If ineffective, adding Gancao (Licorice Root), Chaihu, and Shengdihuang (Rehmannia Root) in equal parts for decoction is also acceptable.
Guangji Fang treats postpartum Xueyun (Blood Fainting), characterized by chest oppression, inability to recognize people, speaking as if possessed by spirits, and rapid breathing nearing cessation. (See entry on Xueyun.)
Tiaojing San (Regulate Menses Powder)
Moyao (Myrrha Resina), Hupo (Electrum), Guixin (Cinnamomi Cortex), Shaoyao (Paeoniae Radix), Danggui (Angelicae Sinensis Radix), Shexiang (Moschus), Xixin (Asari Radix et Rhizoma).
Process: Grind Moyao and Hupo finely. Use Guixin, Shaoyao, and Danggui (each 1 qian), Shexiang and Xixin (each 0.5 qian). Grind all into powder. Dosage: 0.5 qian per administration. Mix with a small amount of fresh ginger juice and warm wine.
Fushen San (Poria Cocos Powder)
Indications: Postpartum Blood-Evil invasion causing vague spirit, loss of verbal control, and restless sleep.
Ingredients: Fushen (Poria Cum Radice, 1 liang, remove woody core), Renshen (Ginseng Radix), Longchi (Draconis Os), Hupo (Electrum), ChiShaoyao (Paeoniae Radix Rubra), Huangqin (Scutellariae Radix), Niuxi (Achyranthis Bidentatae Radix) (each 7.5 qian), Shengdihuang (Rehmanniae Radix, 1.5 liang), Guixin (Cinnamomi Cortex, 0.5 liang).
Process: Grind into powder. Dosage: 3 qian per administration. Decoct with one cup of water until reduced to 0.7 cup. Strain and take warm at any time.
Treatment Formula: For a postpartum woman on the first day exhibiting inverted/disordered speech, use Suhexiang Wan (Styrax Pill), 1 qian, mixed with urine from an uncircumcised boy (Tongbian) to induce recovery.
Baiziren San (Biota Seed Powder)
Indications: Postpartum delirium and chaotic speech, caused by internal deficiency where defeated blood carries evil qi to attack the Heart.
Ingredients: Baiziren (Biota Semen), Yuanzhi (Polygalae Radix, remove heart), Renshen (Ginseng Radix), Sangjisheng (Taxilli Herba), Fangfeng (Saposhnikoviae Radix), Hupo (Electrum, processed separately), Danggui (Angelicae Sinensis Radix, roasted), Shengdihuang (Rehmanniae Radix, roasted), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Process: Make into coarse powder. Take one white sheep's heart, slice it, and decoct with 1.5 cups of water until reduced to 0.9 cup. Remove the heart. Add 5 qian of the herbal powder and decoct until reduced to 0.6 cup. Strain and take at any time.
Refer to the section on Diankuang Zhanyu (Mania, Delirium, and Confabulation) for comparison.