〔大〕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，言语颠错，医人不识，呼为风邪，如此治疾，必不
得愈，但服调经散，每服加龙脑一捻，得睡即安。
〔薛〕前证若败血停滞，用调经散。若血虚发热，用八珍加炮姜。若心血虚损，用
柏子仁散。大抵此证皆心脾血少所致，但调补胃气，则痰清而神自安矣。若果系鬼祟所
附，即灸鬼哭可愈。其或不起者，多因豁痰降火，攻伐之过也。一产妇患前证，或用
调经散，愈而复作，仍服前药，益甚，痰涎上涌，朝寒暮热。余朝用八珍散，夕用加味
归脾汤，各五十余剂而愈。
云岐治产后发热狂言奔走，脉虚大者，四物汤加柴胡；如不愈，加甘草、柴胡、生地
黄等分煎服亦可。
《广济》治产后血晕，心闷不识人，神言鬼语，气急欲绝。（见血晕。）
调经散
没药 琥珀（并细研） 桂心（各一钱） 芍药 当归（各二钱半） 麝香（研） 细辛（各半钱）
上为末，每服半钱，生姜汁、温酒各少许调服。
茯神散 治产后血邪，心神恍惚，言语失度，睡卧不安。
茯神（一两，去皮木） 人参 龙齿（研） 虎珀（研） 赤芍药 黄 牛膝（各七钱半）
生地黄（一两半） 桂心（半两）
上为末，每服三钱，水一盏，煎至七分，不拘时，去渣温服。
治方产一日，言语颠倒，用苏合香丸一钱，以童便调服即苏。
柏子仁散 治产后狂言乱语，皆因内虚，败血挟邪气攻心。
柏子仁 远志（去心） 人参 桑寄生 防风 琥珀（别研） 当归（焙） 生地黄（焙）
甘草（各等分）
上为粗末，先用白羊心一个切片，以水一大盏半，先煮至九分，去羊心，入药末五
钱，煎至六分，去渣无时服。
与前颠狂谵语门参看。
【大论】心主宰身体的血脉。因分娩损伤耗损了血脉，导致心气虚弱，于是败血（产后未能排出的瘀血）停滞积聚，向上干扰心脏。心脏无法承受这种干扰，从而导致心中烦躁，坐卧不安，突然看见鬼神，言语错乱颠倒。医生如果不认识这是病机，误称为风邪，这样治疗疾病，必定不能痊愈。只需服用调经散，每次服药时加入一捻量的龙脑（冰片），若能入睡则病情安定。
【薛己按语】上述证候如果是败血停滞所致，使用调经散。如果是血虚发热，使用八珍汤加炮姜。如果是心血虚损，使用柏子仁散。大抵这类证候都是由于心脾血液不足所致，只要调理补益胃气，那么痰浊自清，神志自然安宁。如果确实是鬼祟附体，即可艾灸鬼哭穴而愈。那些不能治愈的，大多是因为过度使用豁痰降火、攻伐正气的药物所致。有一位产妇患上述证候，有人用调经散治疗，病愈后又复发，再次服用前药，病情反而加重，出现痰涎上涌，早晨恶寒傍晚发热的症状。我早上给她服用八珍散，晚上服用加味归脾汤，各服五十多剂后痊愈。
云岐治疗产后发热、胡言乱语、奔跑躁动，脉象虚大的患者，使用四物汤加柴胡；如果无效，再加甘草、柴胡、生地黄等量煎服也可以。
《广济方》治疗产后血晕，心胸闷塞、不认识人，说神说鬼的话，气息急促近乎断绝。（详见“血晕”条。）
调经散
没药、琥珀（均细研）、桂心（各一钱）、芍药、当归（各二钱半）、麝香（研）、细辛（各半钱）。
以上药物研为末，每次服用半钱，用生姜汁和温酒少许调和服用。
茯神散 治疗产后血邪侵扰，心神恍惚，言语失去节制，睡卧不安。
茯神（一两，去皮木）、人参、龙齿（研）、虎珀（即琥珀，研）、赤芍药、黄芩、牛膝（各七钱半）、生地黄（一两半）、桂心（半两）。
以上药物研为末，每次服用三钱，用水一盏，煎至七分，不拘时候，去渣温服。
治疗方：产妇产后一日，言语颠倒错乱，用苏合香丸一钱，以童子尿调和服用即可苏醒。
柏子仁散 治疗产后胡言乱语，都是因为内部虚弱，败血挟带邪气攻心所致。
柏子仁、远志（去心）、人参、桑寄生、防风、琥珀（另研）、当归（焙干）、生地黄（焙干）、甘草（各等分）。
以上药物制成粗末，先用一个白羊心切片，加水一大盏半，先煮至九分，去掉羊心，放入药末五钱，煎至六分，去渣，随时服用。
与前文“颠狂谵语”门参看。
[Da Lun] The Heart governs the blood vessels of the body. Due to the injury and depletion of blood vessels during childbirth, Heart Qi becomes deficient. Consequently, "defeated blood" (stagnant postpartum blood) accumulates and interferes upward with the Heart. The Heart cannot tolerate this interference, leading to mental restlessness, inability to sit or lie down comfortably, hallucinations of seeing ghosts and spirits, and disordered speech. If physicians fail to recognize the pathogenesis and mistakenly attribute it to Wind Evil, treatment will inevitably fail. One should simply administer Tiaojing San (Regulate Menses Powder), adding a pinch of Longnao (Borneol) to each dose; if sleep is achieved, the condition will stabilize.
[Xue Ji's Commentary] For the aforementioned syndrome caused by stagnant defeated blood, use Tiaojing San. For fever due to Blood deficiency, use Bazhen Tang (Eight Treasures Decoction) with Paojiang (Charred Ginger). For damage to Heart Blood, use Baiziren San (Seed of Biota Seed Powder). Generally, these syndromes are caused by insufficient Blood in the Heart and Spleen. By regulating and tonifying Stomach Qi, phlegm will clear, and the Spirit will naturally settle. If it is indeed possession by evil spirits, moxibustion at Guiku (Ghost Cry, EX-HN21) can cure it. Cases that do not recover are often due to excessive use of herbs that resolve phlegm, descend fire, and attack/evacuate the body. A puerperal patient suffered from the aforementioned syndrome; after using Tiaojing San, she recovered but relapsed. Re-administering the previous medicine worsened her condition, causing phlegm-saliva to surge upward and alternating chills in the morning and heat in the evening. I administered Bazhen San (Eight Treasures Powder) in the morning and Jiawei Guipi Tang (Modified Tonify the Spleen Decoction) in the evening. After taking more than fifty doses of each, she recovered.
Yun Qi treated a postpartum patient with fever, delirious speech, and running about restlessly, presenting with a deficient and large pulse. He used Siwu Tang (Four Substances Decoction) plus Chaihu (Bupleurum Root). If ineffective, adding Gancao (Licorice Root), Chaihu, and Shengdihuang (Rehmannia Root) in equal parts for decoction is also acceptable.
Guangji Fang treats postpartum Xueyun (Blood Fainting), characterized by chest oppression, inability to recognize people, speaking as if possessed by spirits, and rapid breathing nearing cessation. (See entry on Xueyun.)
Tiaojing San (Regulate Menses Powder)
Moyao (Myrrha Resina), Hupo (Electrum), Guixin (Cinnamomi Cortex), Shaoyao (Paeoniae Radix), Danggui (Angelicae Sinensis Radix), Shexiang (Moschus), Xixin (Asari Radix et Rhizoma).
Process: Grind Moyao and Hupo finely. Use Guixin, Shaoyao, and Danggui (each 1 qian), Shexiang and Xixin (each 0.5 qian). Grind all into powder. Dosage: 0.5 qian per administration. Mix with a small amount of fresh ginger juice and warm wine.
Fushen San (Poria Cocos Powder)
Indications: Postpartum Blood-Evil invasion causing vague spirit, loss of verbal control, and restless sleep.
Ingredients: Fushen (Poria Cum Radice, 1 liang, remove woody core), Renshen (Ginseng Radix), Longchi (Draconis Os), Hupo (Electrum), ChiShaoyao (Paeoniae Radix Rubra), Huangqin (Scutellariae Radix), Niuxi (Achyranthis Bidentatae Radix) (each 7.5 qian), Shengdihuang (Rehmanniae Radix, 1.5 liang), Guixin (Cinnamomi Cortex, 0.5 liang).
Process: Grind into powder. Dosage: 3 qian per administration. Decoct with one cup of water until reduced to 0.7 cup. Strain and take warm at any time.
Treatment Formula: For a postpartum woman on the first day exhibiting inverted/disordered speech, use Suhexiang Wan (Styrax Pill), 1 qian, mixed with urine from an uncircumcised boy (Tongbian) to induce recovery.
Baiziren San (Biota Seed Powder)
Indications: Postpartum delirium and chaotic speech, caused by internal deficiency where defeated blood carries evil qi to attack the Heart.
Ingredients: Baiziren (Biota Semen), Yuanzhi (Polygalae Radix, remove heart), Renshen (Ginseng Radix), Sangjisheng (Taxilli Herba), Fangfeng (Saposhnikoviae Radix), Hupo (Electrum, processed separately), Danggui (Angelicae Sinensis Radix, roasted), Shengdihuang (Rehmanniae Radix, roasted), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Process: Make into coarse powder. Take one white sheep's heart, slice it, and decoct with 1.5 cups of water until reduced to 0.9 cup. Remove the heart. Add 5 qian of the herbal powder and decoct until reduced to 0.6 cup. Strain and take at any time.
Refer to the section on Diankuang Zhanyu (Mania, Delirium, and Confabulation) for comparison.