〔大〕夫产后语言颠倒，或狂言谵语，如见鬼神者，其源不一，须仔细辨证用药治
疗。产后惊风，言语乱道，如见鬼神，精神不定者，研好朱砂，酒调下龙虎丹（方见《局
方》）。三丸，作一服，兼琥珀地黄丸服之。一则因产后心虚败血停积，上干于心而狂言
独语者，当在乍见鬼神条求之。二则产后脏虚，心神惊悸，志意不安。言语错乱不自
觉知，神思不安者，当在惊悸条求之。三则宿有风毒，因产心虚气弱，腰背强直，或
歌哭嗔笑，言语乱道，当作风痉治疗，当在心惊中风条求之。四则产后心虚，中风心
神恍惚，言语错乱，当在中风恍惚倏求之。五则产后多因败血迷乱心经而颠狂，言语错
乱无常，或晕闷者，当于本卷血晕类中求之。
六则因产后感冒风寒，恶露斩然不行，憎寒发热如疟，昼日明了，暮则谵语如见鬼状，
当作热入血室治之。宜琥珀地黄丸及四物汤，只用生干地黄加北柴胡等分煎服；如不退者，
以小柴胡汤加生干地黄如黄芩分两，煎服愈。虽然以上诸证，大抵胎前产后，自有专门一
定之法，毫发不同。如产后首当逐散生新，然后仔细详辨疾证，不可妄立名色，自生新意，
加减方药，大宜对证根据古法施治，未有不安者也。
〔薛〕前证当固胃气为主，而佐以见证之药。若一于攻痰，则误矣。一产妇形体
甚倦，时发谵语，用柏子散稍愈，又用加味归脾汤而愈。又因怒，仍狂言胁痛，小便下
血，用加味逍遥散，以清肝火、养肝血，顿瘥，又佐以加味归脾汤而安。
云岐夺命散 （血晕） 治产后败血冲心，发热狂言奔走，脉虚大者。
干荷叶 生干地黄 牡丹皮（等分）
上三味，浓煎汤，调生蒲黄末二钱匕，一服即定。
《局方》妙香散 治产后心神颠倒，语言错乱，如见鬼神。
用生干地黄、当归二味，煎汤调服立效。
乌金散 治产后三五日或半月之间，忽狂言乱语，目见神鬼等证。
当归 远志肉 川芎 酸枣仁 白术 赤芍药 香附子 辰砂（另研入） 熟地黄
羌活 防风（各二钱） 茯神（二钱半） 半夏（三钱） 全蝎 麦门冬 人参 牛膝 天麻（各一钱）
甘草（九分） 陈皮 白芷（各一钱五分）
上锉散作二服，水一盅半，姜三片，葱三枝，入金银同煎一碗，不拘时温服。
四物补心汤 治产后言语恍惚，颠倒错乱。
当归（五钱） 川芎 生地黄 白芍药 茯神 半夏 桔梗 白术（各四钱）
陈皮（三钱） 甘草（一钱）
上锉为散，分作六服，每服用水一盅，姜三片，煎至七分，空心温服，滓再煎服。有
热加酒炒黄连二钱，无热不用。
【大】产后出现语言颠倒，或胡言乱语、神志不清，甚至像看见鬼神一样的人，其病因不一，必须仔细辨证后用药治疗。若是产后惊风，导致言语错乱，如见鬼神，精神不定的，可将优质朱砂研细，用酒调服龙虎丹（方剂见《太平惠民和剂局方》）。每次三丸，作为一次服用量，同时兼服琥珀地黄丸。
其一，是因为产后心气虚弱，败血停滞积聚，上扰于心而导致狂言独语的，应当在“乍见鬼神”条目下寻求治法。其二，是产后脏腑虚弱，心神受惊悸动，意志不安，言语错乱而不自知，神思不宁的，应当在“惊悸”条目下寻求治法。其三，是素来有风毒宿疾，因生产导致心虚气弱，出现腰背强直，或歌哭嗔笑无常，言语错乱的，应当按“风痉”治疗，并在“心惊中风”条目下寻求治法。其四，是产后心虚，感受中风邪气，导致心神恍惚，言语错乱的，应当在“中风恍惚倏忽”条目下寻求治法。其五，是产后多因败血迷乱心经而导致癫狂，言语错乱无常，或伴有晕厥闷绝的，应当在本书卷次“血晕”类中寻求治法。
其六，是因产后感受风寒，恶露突然停止不行，憎寒发热如疟疾状，白天神志清楚，傍晚则谵语如见鬼状，应当按“热入血室”治疗。适宜使用琥珀地黄丸及四物汤，仅用生干地黄与北柴胡等分煎服；如果症状不退，用小柴胡汤加入生干地黄，剂量同黄芩，煎服即可痊愈。虽然以上诸证，大致上前孕期和后产期自有专门固定的治疗方法，毫厘不同。如产后首先应当逐去瘀血、生成新血，然后仔细详细辨别疾病证候，不可随意创立名目，自创新意，加减方药，最宜对证依据古法施治，没有不安全的。
【薛】上述证候应当以固护胃气为主，辅以针对见证的药物。如果一味攻伐痰浊，那就错了。有一位产妇形体非常疲倦，时常发作谵语，使用柏子散后稍有好转，又使用加味归脾汤而痊愈。后来因为发怒，再次出现狂言、胁痛，小便下血，使用加味逍遥散，以清肝火、养肝血，顿时痊愈，又辅以加味归脾汤而安定。
云岐夺命散（用于血晕）：治疗产后败血冲心，发热狂言奔走，脉象虚大的。
干荷叶、生干地黄、牡丹皮（等分）
以上三味药，浓煎成汤，调服生蒲黄末二钱匕，一服即定。
《局方》妙香散：治疗产后心神颠倒，语言错乱，如见鬼神。
用生干地黄、当归两味药，煎汤调服，立见功效。
乌金散：治疗产后三五天或半个月之间，忽然狂言乱语，目见神鬼等证候。
当归、远志肉、川芎、酸枣仁、白术、赤芍药、香附子、辰砂（另研入）、熟地黄、羌活、防风（各二钱），茯神（二钱半），半夏（三钱），全蝎、麦门冬、人参、牛膝、天麻（各一钱），甘草（九分），陈皮、白芷（各一钱五分）。
以上锉散分为两次服用，用水一盅半，生姜三片，葱三枝，加入金银同煎至一碗，不拘时候温服。
四物补心汤：治疗产后言语恍惚，颠倒错乱。
当归（五钱），川芎、生地黄、白芍药、茯神、半夏、桔梗、白术（各四钱），陈皮（三钱），甘草（一钱）。
以上锉为散，分作六次服用，每次用水一盅，生姜三片，煎至七分，空腹温服，药渣再煎服用。有热者加酒炒黄连二钱，无热者不用。
[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.