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[Da] For postpartum women presenting with inverted speech, or delirious and incoherent rambling, even hallucinating spirits and ghosts, the etiology varies. One must carefully differentiate the syndrome before administering medication. If it is postpartum convulsion (Jing Feng) causing chaotic speech, hallucinations, and unsettled spirit, grind high-quality Cinnabar (Zhusha), mix with wine, and administer Longhu Dan (Dragon-Tiger Pill; see *Ju Fang*). Three pills per dose, taken concurrently with Hupo Dihuang Wan (Amber Rehmannia Pill).

First, if the cause is postpartum Heart Qi deficiency with stagnant blood accumulating and disturbing the Heart, leading to manic talking and muttering, refer to the section on "Suddenly Seeing Spirits and Ghosts." Second, if it is due to postpartum Zang-Fu deficiency, causing Heart Spirit fright palpitations and mental unrest, where speech is disordered without self-awareness, refer to the section on "Palpitations." Third, if there is a pre-existing wind-toxin condition, exacerbated by postpartum Heart deficiency and weak Qi, manifesting as stiffness of the waist and back, or inappropriate laughing/crying/anger, treat as Wind Spasm (Feng Jing); refer to the section on "Heart Fright and Stroke." Fourth, if postpartum Heart deficiency leads to external wind-stroke affecting the Heart Spirit, causing恍惚 (trance-like state) and disordered speech, refer to the section on "Stroke Trance." Fifth, if postpartum stasis confuses the Heart Meridian leading to mania, erratic speech, or fainting, refer to the "Blood Syncope" category in this volume.

Sixth, if caused by postpartum contraction of wind-cold, sudden cessation of lochia, aversion to cold and fever resembling malaria, clear during the day but delirious at night as if seeing ghosts, treat as Heat Entering the Blood Chamber (Re Ru Xue Shi). Use Hupo Dihuang Wan and Si Wu Tang (Four Substances Decoction), using only Sheng Gan Di Huang (Raw Dried Rehmannia) and Bei Chai Hu (Bupleurum) in equal proportions decocted and taken. If symptoms persist, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) adding Sheng Gan Di Huang in the same dosage as Huang Qin (Scutellaria), decocted and taken. Although these syndromes differ, generally, antenatal and postnatal periods have specific, fixed treatment protocols. Postpartum treatment should first focus on expelling stasis and generating new blood, then carefully differentiate the disease. Do not arbitrarily create new names or modify formulas without basis. Adhering strictly to ancient methods according to the syndrome ensures safety.

[Xue] The aforementioned syndromes should primarily be treated by consolidating Stomach Qi, supplemented by herbs addressing the specific manifestations. Treating solely by attacking phlegm would be erroneous. A patient with extreme fatigue and intermittent delirium improved slightly with Baizi San (Seed of Biota Powder) and was cured with Jiawei Guipi Tang (Modified Spleen-Invigorating Decoction). Later, due to anger, she experienced 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, followed by Jiawei Guipi Tang for stabilization.

Yunqi Dueming San (Cloud-岐 Life-Seizing Powder) [for Blood Syncope]: Treats postpartum stasis rushing to the Heart, causing fever, manic speech, running about, and a deficient-large pulse.
Dried Lotus Leaf, Raw Dried Rehmannia, Moutan Cortex (equal parts).
Decoct these three ingredients strongly, mix with 2 qianbi of raw Polygonum multiflorum powder, take once to settle symptoms.

Ju Fang Miaoxiang San (Wonderful Fragrance Powder from the Bureau Formulary): Treats postpartum mental inversion, disordered speech, hallucinations.
Use Raw Dried Rehmannia and Angelica Sinensis, decoct in water and take for immediate effect.

Wujin San (Black Gold Powder): Treats sudden manic speech, visual hallucinations occurring 3-5 days or half a month after childbirth.
Angelica Sinensis, Polygala Root, Ligusticum Chuanxiong, Sour Jujube Seed, Atractylodes Macrocephala, Red Peony Root, Cyperus Rotundus, Cinnabar (separately ground and added), Prepared Rehmannia, Notopterygium Root, Saposhnikovia Root (each 2 qian), Poria Cocos with Hostwood (2.5 qian), Pinellia Tuber (3 qian), Scorpion, Ophiopogon Tuber, Ginseng, Achyranthes Bidentata, Gastrodia Elata (each 1 qian), Licorice Root (0.9 qian), Tangerine Peel, Bai Zhi (Angelica Dahurica) (each 1.5 qian).
Grind into coarse powder, divide into two doses. Decoct with 1.5 zhong of water, 3 slices of ginger, 3 sprigs of scallion, and gold/silver pieces until one bowl remains. Take warm at any time.

Si Wu Buxin Tang (Four Substances Heart-Nourishing Decoction): Treats postpartum vague speech, mental inversion, and disordered language.
Angelica Sinensis (5 qian), Ligusticum Chuanxiong, Raw Rehmannia, White Peony Root, Poria Cocos with Hostwood, Pinellia Tuber, Platycodon Root, Atractylodes Macrocephala (each 4 qian), Tangerine Peel (3 qian), Licorice Root (1 qian).
Grind into coarse powder, divide into six doses. For each dose, decoct with 1 zhong of water and 3 slices of ginger until reduced to 70%. Take warm on an empty stomach. Decoct the dregs again. Add 2 qian of alcohol-fried Coptis Chinensis if heat is present; omit if no heat.