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。又或因痰
客于上焦,以致十二官各失其职,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。
安神生化汤∶川芎二钱,当归四钱,茯神、枣仁、柏仁各一钱,桃仁十粒,炮姜、炙甘
草各五分,红枣二枚,去皮。水煎。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,竹油一丸大,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;便秘另苁蓉、麻仁。
产后忧惊劳倦,去血过多,心中烦动不宁,为之怔忡。如惕然而惊,心中怯惧,若人捕
之之状,为之惊悸。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、白术一钱,黄
一钱,陈皮、炙甘草各五分,龙眼肉八个,姜三片,水煎服。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。当归各三钱,炙甘草八分,作饼为丸如豆大,朱
砂为衣。每服四十丸。此与前药并服。
产后出现胡言乱语、幻视症状,是由于气血两虚导致神魂失去依附的根本。轻症表现为睡眠中喃喃自语,重症则彻夜不眠且胡言乱语。此外,也可能是因为痰邪客居在上焦,致使十二脏腑(指心、肺、肝、脾、肾、胆、胃、大肠、小肠、膀胱、三焦)各自功能失常,使得视、听、言、动等行为都出现虚妄之象,切勿误认为是鬼邪作祟。治疗法则应当根据产后的时间长短、是否有瘀血块及疼痛情况,来制定治疗的缓急方案。如果有瘀血块疼痛者,适宜服用宁神生化汤。如果瘀血块已消除,适宜服用益荣安神汤。
安神生化汤:川芎二钱,当归四钱,茯神、酸枣仁、柏子仁各一钱,桃仁十粒,炮姜、炙甘草各五分,红枣二枚(去皮)。加水煎煮。体质虚弱者加人参。
益荣安神汤:川芎一钱,当归三钱,茯神、酸枣仁、柏子仁各一钱,橘红、甘草各五分,人参一钱,龙眼肉八个,竹油一丸大小,大枣二枚。口渴者加麦冬、五味子;出汗多者加人参、黄芪、麻黄根;有痰者加竹沥、姜汁;腹泻者加茯苓、白术;便秘者另加肉苁蓉、火麻仁。
产后因忧愁惊恐、劳累倦怠,加上失血过多,导致心中烦乱躁动不安,这称为怔忡。如果表现为突然惊惧,心中胆怯恐惧,好像被人追捕一样的状态,这称为惊悸。这两种病症应当调和脾胃,补养心血。使气机安宁、神志充足,气顺则心安,通过服用加减养荣汤,疾病自然痊愈。
加减养荣汤:川芎八分,当归二钱,酸枣仁、茯苓、人参、麦冬、远志、白术各一钱,黄芪一钱,陈皮、炙甘草各五分,龙眼肉八个,生姜三片,加水煎服。虚烦者加竹茹,有痰者加竹沥、姜汁。此方还可以加入丹参、柏子仁。
安神丸:黄连、生地黄、酒制乳香(经过九次蒸、九次晒)、当归各三钱,炙甘草八分,制成饼状并研磨成丸,如豆粒大小,用朱砂作为包衣。每次服用四十丸。此药与前文药物同时服用。
Postpartum delirium and 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 and delirious speech. Alternatively, phlegm may lodge in the Upper Jiao (Upper Burner), causing the Twelve Officials (referring to the Zang-Fu organs: Heart, Lung, Liver, Spleen, Kidney, Gallbladder, Stomach, Large Intestine, Small Intestine, Bladder, and Sanjiao) to lose their respective functions, resulting in false perceptions and actions in vision, hearing, speech, and movement. One must not mistake this for demonic influence. The treatment method should consider the duration since childbirth and the presence or absence of blood stasis masses and pain to determine the urgency. If there are painful masses (blood stasis), Ning Shen Sheng Hua Tang (Soothing Spirit and Invigorating Blood Decoction) is appropriate. Once the masses have cleared, Yi Rong An Shen Tang (Nourishing Prosperity and Calming Spirit Decoction) is indicated.
An Shen Sheng Hua Tang (Calming Spirit and Invigorating Blood Decoction): Chuanxiong Radix (2 qian), Danggui Radix (4 qian), Fushen Poria with Hostwood (1 qian), Zao Ren Semen Ziziphi Spinosae (1 qian), Bai Ren Semen Platycladi (1 qian), Tao Ren Semen Persicae (10 grains), Pao Jiang Rhizoma Zingiberis Preparatum (0.5 qian), Zhi Gancao Radix Glycyrrhizae Preparata (0.5 qian), Hongzao Fructus Jujubae (2 pieces, peeled). Decoct in water. Add Renshen Radix Ginseng for deficiency.
Yi Rong An Shen Tang (Nourishing Prosperity and Calming Spirit Decoction): Chuanxiong Radix (1 qian), Danggui Radix (3 qian), Fushen Poria with Hostwood (1 qian), Zao Ren Semen Ziziphi Spinosae (1 qian), Baidoukou Pericarpium Tsaoko? No, Ju Hong Exocarpium Citri Reticulatae (0.5 qian), Gancao Radix Glycyrrhizae (0.5 qian), Renshen Radix Ginseng (1 qian), Longyan Rou Arillus Longan (8 pieces), Zhuyou Bamboo Sap (one pill-sized amount), Dazao Fructus Jujubae (2 pieces). For thirst, add Maidong Herba Ophiopogonis and Wuweizi Fructus Schisandrae; for excessive sweating, add Renshen Radix Ginseng, Huangqi Radix Astragali, and Mahuanggen Radix Ephedrae; for phlegm, add Zhuli Bamboo Juice and Jiangjiang Ginger Juice; for diarrhea, add Fuling Poria and Baizhu Rhizoma Atractylodis Macrocephalae; for constipation, separately add Rongsheng Cistanche and Haren Semen Cannabis.
Postpartum忧惊劳倦 (worry, fright, fatigue, and overwork), combined with excessive blood loss, leads to inner restlessness and agitation, termed Zhengchong (Palpitations/Anxiety). If accompanied by sudden fear, timidity, and a sensation as if being pursued, it is termed Jingji (Startle Palpitations). Both conditions require harmonizing the Spleen and Stomach and nourishing Heart Blood. By calming Qi and enriching Shen, ensuring smooth Qi flow and peaceful Spirit, the disease will heal spontaneously through the use of Jiajian Yang Rong Tang (Modified Nourishing Prosperity Decoction).
Jiajian Yang Rong Tang (Modified Nourishing Prosperity Decoction): Chuanxiong Radix (0.8 fen), Danggui Radix (2 qian), Zao Ren Semen Ziziphi Spinosae, Fuling Poria, Renshen Radix Ginseng, Maidong Herba Ophiopogonis, Yuanzhi Radix Polygalae, Baizhu Rhizoma Atractylodis Macrocephalae (each 1 qian), Huangqi Radix Astragali (1 qian), Chenpi Pericarpium Citri Reticulatae, Zhi Gancao Radix Glycyrrhizae Preparata (each 0.5 qian), Longyan Rou Arillus Longan (8 pieces), Shengjiang Rhizoma Zingiberis Recens (3 slices). Decoct in water and take. For empty heat/restlessness, add Zhuru Bamboo Juice Prepared; for phlegm, add Zhuli Bamboo Juice and Jiangjiang Ginger Juice. Danshen Radix Salviae Miltiorrhizae and Bai Ren Semen Platycladi can be added to this formula.
An Shen Wan (Calming Spirit Pill): Huanglian Rhizoma Coptidis, Shengdiheng Radix Rehmanniae Preparata, Jiuru Ru Xiang Resina Olibani Preparata (steamed nine times, sun-dried nine times), Danggui Radix (each 3 qian), Zhi Gancao Radix Glycyrrhizae Preparata (0.8 fen). Form into cakes, grind into pills the size of beans, coat with Zhusha Cinnabaris. Take forty pills per dose. This is taken concurrently with the previous medicines.