〔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〕妇女产后出现言语颠倒，或胡言乱语、神志不清，甚至看见鬼神幻象的，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，同时兼服琥珀地黄丸。
第一种情况是因为产后心气虚弱，败血停滞积聚，上扰心神而导致胡言独语的，应当在“乍见鬼神”条文中寻求治法。第二种情况是产后脏腑虚弱，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”条文中寻求治法。第三种情况是素有风毒，因生产导致心虚气弱，腰背强直，或歌哭嗔笑无常，言语错乱的，应当按“风痉”治疗，并应在“心惊中风”条文中寻求治法。第四种情况是产后心虚，中风导致心神恍惚，言语错乱的，应当在“中风恍惚倏忽”条文中寻求治法。第五种情况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，应当在本卷“血晕”类中寻求治法。
第六种情况是因产后感受风寒，恶露突然停止不行，憎寒发热如疟疾状，白天神志清楚，傍晚则胡言乱语如见鬼状，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量煎服；如果症状不退，则用小柴胡汤加入生干地黄，用量同黄芩，煎服即可痊愈。虽然以上诸证，大体上胎前产后自有专门固定的法则，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，最宜对症根据古法施治，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，再次出现胡言乱语、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。
药材：干荷叶、生干地黄、牡丹皮（等分）。
制法用法：将上述三味药浓煎成汤，调入生蒲黄末二钱匕，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。
制法用法：用生干地黄、当归两味药，煎汤调服，立竿见影。
乌金散：治疗产后三五天或半个月之间，忽然胡言乱语，目见神鬼等证。
药材：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）。
制法用法：将上述药物锉散，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。
药材：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）。
制法用法：将上述药物锉为散剂，分为六次服用。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 women postpartum exhibiting inverted speech, or delirious rambling and incoherent speech, even seeing ghosts and spirits, the etiology is diverse. One must carefully differentiate the syndrome before administering medication. If it is postpartum convulsion (Jing Feng) causing chaotic speech, as if seeing ghosts and spirits, with unsettled spirit, grind high-quality Cinnabar (Zhusha), mix with wine, and administer Longhu Dan (Dragon-Tiger Pill; see *Ju Fang*). Take three pills per dose, concurrently administering Hupo Dihuang Wan (Amber Rehmannia Pill).
The first scenario arises from postpartum Heart Qi deficiency with stagnant blood accumulating and disturbing the Heart, leading to delirious solitary talking. Seek treatment under the section "Suddenly Seeing Ghosts and Spirits." The second scenario involves postpartum Zang-Fu deficiency, causing Heart Spirit fright palpitations and unstable will, resulting in disordered speech without self-awareness and restless thoughts. Seek treatment under the section "Fright Palpitations." The third scenario involves pre-existing wind-toxicity; due to postpartum Heart deficiency and weak Qi, presenting with stiffness of the waist and back, or singing, crying, anger, and laughter, with chaotic speech. Treat as Wind Spasm (Feng Jing) and seek guidance under "Heart Fright Stroke." The fourth scenario is postpartum Heart deficiency with stroke causing vague Heart Spirit and disordered speech. Seek guidance under "Stroke Vagueness." The fifth scenario is postpartum, often due to stagnant blood confusing the Heart Meridian, leading to mania, erratic speech, or fainting. Seek guidance under "Blood Syncope" in this volume.
The sixth scenario occurs when postpartum exposure to wind-cold causes lochia to abruptly cease, accompanied by aversion to cold and fever resembling malaria. The patient is lucid during the day but delirious at night, as if seeing ghosts. Treat as Heat Entering the Blood Chamber (Re Ru Xue Shi). Suitable formulas include Hupo Dihuang Wan and Siwu Tang. Use Sheng Gan Di Huang (Dried Raw Rehmannia Root) and Bei Chai Hu (Bupleurum Root) in equal proportions for decoction. If symptoms persist, use Xiaochai Hu Tang (Minor Bupleurum Decoction) adding Sheng Gan Di Huang in an amount equal to Huang Qin (Scutellaria Root), decocted and taken orally. Although these syndromes vary, prenatal and postpartum conditions generally have specific, fixed protocols that differ slightly. 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 prescriptions based on personal ideas. It is best to treat according to ancient methods matched to the syndrome, ensuring safety.
[Xue] The aforementioned syndromes should primarily be treated by consolidating Stomach Qi, assisted by herbs addressing the specific manifestations. If one focuses solely on attacking phlegm, it would be a mistake. A certain puerpera was extremely fatigued and occasionally experienced delirium. After using Baizi San (Seed-of-Catalpa Powder) with slight improvement, she recovered completely after taking Jiawei Guipi Tang (Modified Restore the Spleen Decoction). Later, due to anger, she again exhibited delirious speech, hypochondriac pain, and hematuria. She was treated with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) to clear Liver Fire and nourish Liver Blood, resulting in immediate recovery, followed by Jiawei Guipi Tang to stabilize her condition.
Yunqi Duoming San (Cloud-岐 Life-Seizing Powder) [for Blood Syncope]: Treats postpartum stagnant blood rushing to the Heart, causing fever, delirious speech, running about, and a deficient-large pulse.
Ingredients: Dried Lotus Leaf (Gan He Ye), Dried Raw Rehmannia Root (Sheng Gan Di Huang), Moutan Cortex (Mudan Pi) in equal parts.
Preparation: Decoct the three ingredients into a strong soup, mix with 2 qianbi of raw Polygonum multiflorum powder (Sheng Puhuang). One dose brings calm.
*Ju Fang* Miaoxiang San (Wonderful Fragrance Powder): Treats postpartum inverted Heart Spirit, disordered speech, as if seeing ghosts and spirits.
Usage: Decoct Dried Raw Rehmannia Root (Sheng Gan Di Huang) and Angelica Sinensis (Dang Gui) in water to take orally; effects are immediate.
Wujin San (Black Gold Powder): Treats sudden delirious speech and hallucinations of gods and spirits occurring 3-5 days or half a month after childbirth.
Ingredients: Dang Gui (2 qian), Yuanzhi Rou (2 qian), Chuan Xiong (2 qian), Suanzaoren (2 qian), Baizhu (2 qian), Chi Shaoyao (2 qian), Xiangfuzi (2 qian), Zhensha (Cinnabar, ground separately), Shu Dihuang (2 qian), Qianghuo (2 qian), Fangfeng (2 qian), Fushen (2.5 qian), Banxia (3 qian), Quanxie (1 qian), Maimendong (1 qian), Renshen (1 qian), Niuxi (1 qian), Tianma (1 qian), Gancao (0.9 qian), Chenpi (1.5 qian), Baizhi (1.5 qian).
Preparation: Coarsely crush into powder, divide into two doses. Decoct with 1.5 zhong of water, 3 slices of ginger, 3 sprigs of green onion, and gold/silver pieces until reduced to one bowl. Take warm at any time.
Siwu Buxin Tang (Four Substances Heart-Nourishing Decoction): Treats postpartum vague speech, inverted and disordered cognition.
Ingredients: Dang Gui (5 qian), Chuan Xiong (4 qian), Sheng Dihuang (4 qian), Baishao Yao (4 qian), Fushen (4 qian), Banxia (4 qian), Jiegeng (4 qian), Baizhu (4 qian), Chenpi (3 qian), Gancao (1 qian).
Preparation: Coarsely crush into 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. Re-decoct the dregs. Add 2 qian of alcohol-fried Huanglian (Coptis Rhizome) if heat is present; omit if no heat.