缪仲淳曰∶有产后六朝发狂,持刀杀人,此阴血暴崩,肝虚火炎故也。用泽兰、归、地、牛膝、茯神、远
志、枣仁,加童便。
《大全》曰∶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,言语错乱。医人不识,呼为风邪,如此治必不愈。但服调经散,加龙脑,得睡即安。
郭稽中曰∶产后乍见鬼神者何?曰∶肝藏血,心主血。因产去耗其血,劳动肝心,败血奔冲,邪淫于心,
所以乍见鬼神,言语颠倒,非风邪也。但服调经散、黑龙丹。
薛立斋曰∶产后乍见鬼神,若败血停滞,用调经散;若心血虚损,用柏子仁散。此证皆心脾血少所致。但
调补脾胃之气,则痰清而神自安。若果系鬼祟所附,即灸鬼穴可愈。其或不起,多因豁痰降火攻伐之过也。
慎斋按∶以上五条,序产后有发狂见鬼之证也。夫心所主者血也,心生血,肝藏血。产后阴血暴亡,则心
失所养,肝火得以上炎。肝藏魂,心藏神,血虚则神魂不守,有发狂见鬼诸证。此皆虚火上乘之病,立斋但主
补虚,而未之论及。缪仲淳一条,乃发前人未发。
单养贤曰∶产后失血,心神失守,妄言见邪,宜服生化汤,加茯神、枣仁、远志。慎
不可作痰火论,用消痰降火药,信师巫以惊产母。
缪仲淳说:有产后六天出现发狂,持刀杀人的症状,这是因为阴血突然大量流失,导致肝虚火旺的缘故。治疗使用泽兰、当归、地黄、牛膝、茯神、远志、酸枣仁,加入童便(童子尿)。
《妇人大全良方》说:心主宰身体的血脉,因为分娩损伤耗伤了血脉,心气虚弱,则败血(瘀血)停滞积聚,向上干扰心脏,心脏不能承受这种冲击,于是导致心中烦躁,卧起不安,偶尔看见鬼神,言语错乱。医生如果不认识这是病机,误称为风邪,这样治疗必定不会痊愈。只需服用调经散,加入龙脑(冰片),能够入睡即能安宁。
郭稽中说:产后偶尔看见鬼神是怎么回事?回答说:肝藏血,心主血。因为分娩失去并耗伤了血液,劳累了肝和心,败血奔冲,邪气淫溢于心,所以偶尔看见鬼神,言语颠倒错乱,这并不是风邪。只需服用调经散、黑龙丹。
薛立斋说:产后偶尔看见鬼神,如果是败血停滞,用调经散;如果是心血虚损,用柏子仁散。这个证候都是由于心脾血少所导致的。只要调理补益脾胃之气,那么痰浊自清而神志自然安宁。如果确实是鬼祟附体,艾灸鬼穴即可痊愈。如果病情没有好转,多是因为过度使用豁痰降火攻伐药物的缘故。
慎斋按语:以上五条,叙述了产后有发狂、见鬼的证候。心所主宰的是血,心生血,肝藏血。产后阴血突然亡失,则心失去滋养,肝火得以向上炎升。肝藏魂,心藏神,血虚则神魂不能守舍,出现发狂、见鬼等各种证候。这都是虚火上逆的疾病,薛立斋只主张补虚,而没有论及这一点。缪仲淳的这一条论述,是阐发了前人未曾发掘的道理。
单养贤说:产后失血,心神失守,胡言乱语、看见邪祟,适宜服用生化汤,加入茯神、酸枣仁、远志。千万不要将其当作痰火来论述,使用消痰降火的药物,相信巫师巫婆以惊吓产妇。
Miu Zhongchun stated: There are cases of mania appearing six days postpartum, where the patient holds a knife and kills people; this is due to sudden massive loss of Yin blood, resulting in Liver deficiency with flaming fire. The treatment uses Zelan (Drynariae Rhizoma), Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), Niuxi (Achyranthis Bidentatae Radix), Fushen (Poria Cum Radix), Yuanzhi (Polygalae Radix), Zaoren (Ziziphi Spinosae Semen), added with Tongbian (Child's Urine).
The *Daquan* (Complete Good Prescriptions for Women) states: The Heart governs the blood vessels of the body. Due to childbirth injuring and depleting the blood vessels, Heart Qi becomes deficient, causing敗血 (retained blood/stasis) to stagnate and accumulate, ascending to interfere with the Heart. The Heart cannot tolerate this disturbance, leading to restlessness in the chest, inability to sleep or rise calmly, occasional visions of ghosts and spirits, and disordered speech. If physicians fail to recognize this and misdiagnose it as Wind Evil, such treatment will certainly not cure the disease. One should merely administer Tiaojing San (Regulate Menses Powder) with Longnao (Borneolum Syntheticum); if sleep is achieved, peace follows.
Guo Jizhong asked: What causes occasional visions of ghosts and spirits postpartum? He answered: The Liver stores Blood, and the Heart governs Blood. Because childbirth involves loss and depletion of blood, exhausting the Liver and Heart, retained blood rushes forward, and evil influences overflow into the Heart. Therefore, there are occasional visions of ghosts and spirits, and inverted or disordered speech; this is not Wind Evil. One should merely administer Tiaojing San (Regulate Menses Powder) and Heilong Dan (Black Dragon Pill).
Xue Lizhai stated: For occasional visions of ghosts and spirits postpartum, if caused by retained blood stagnation, use Tiaojing San (Regulate Menses Powder); if caused by Heart Blood deficiency and damage, use Baiziren San (Biota Seed Powder). These conditions are all caused by insufficient Blood in the Heart and Spleen. By regulating and tonifying the Qi of the Spleen and Stomach, phlegm clears naturally and the Spirit becomes tranquil. If indeed possessed by demonic entities, moxibustion on Guixue (Ghost Acupoints) can lead to recovery. If the condition does not improve, it is often due to excessive use of phlegm-resolving and fire-draining attacking methods.
Shenzhen commented: The above five passages describe syndromes of mania and seeing ghosts postpartum. The Heart governs Blood; the Heart generates Blood, and the Liver stores Blood. Postpartum sudden loss of Yin Blood causes the Heart to lose its nourishment, allowing Liver Fire to flare upward. The Liver stores the Hun (Ethereal Soul), and the Heart stores the Shen (Spirit); when Blood is deficient, the Hun and Shen fail to reside within, leading to various symptoms such as mania and seeing ghosts. These are all diseases of deficient fire surging upward. Xue Lizhai only emphasized tonifying deficiency and did not discuss this aspect. Miu Zhongchun’s passage elucidates insights previously unexplored by earlier scholars.
Shan Yangxian stated: Postpartum blood loss leads to the Heart Spirit losing its residence, resulting in妄言 (delirious speech) and seeing evil spirits. It is appropriate to consume Shenghua Tang (Generate the New Decoction) with added Fushen (Poria Cum Radix), Zaoren (Ziziphi Spinosae Semen), and Yuanzhi (Polygalae Radix). One must strictly avoid diagnosing this as Phlegm-Fire and using phlegm-resolving and fire-draining herbs, nor should one rely on shamans and witches to frighten the parturient woman.