临产切不可慌忙，
十月气足，胎元壮健者，忽然腹痛，或只腰痛，须臾产下，何俟于催？此易生天然之妙喜，服单益母膏，
免产后之患。中间有体弱性
急者，腹痛或作或止，名弄痛；浆水淋沥来少，名试水。虽脐腹俱痛，发动露顶，而腰不痛者，切莫怆惶，切
禁洗母动手于腹上揣摩。直待日子已到，腹痛阵密，破水以后，并腰痛，眼中如火，方可坐草；须待儿头直顺
且正，逼近产门，方可用力一送。如坐草太早，用力太过，产母困倦，及至迟滞，乃用催生之药。凡难产皆孕
后纵欲，及骄恣全不运动；又是生冷硬物凝滞∶或矮石女子，交骨不开；或腹大甚，胎水未尽；或临产闲杂之人
惊恐产妇。恐则精怯，精怯则上焦闭，闭则气还，下焦胀而不行，紫苏饮最妙。气实者，瘦胎枳甘散；气弱者，
达生散。
活血安胎未破浆；
如腹痛浆水未破，只宜用古芎归汤，以活其血，或浆水已破而少痛，虽痛而不密，宜安胎饮或达生散，
以固胎元。切不可轻用峻药，徒渗水道，反伤胎气而产愈难。产母亦听其眠食自如，但不可过眠过饱耳。
破浆已久犹难下，
破水多则血干涩，必用古黑神散，血虚者，古芎归汤下，名芎归黑神散；气弱者，四君子汤下，名四君
黑神散；横逆侧产，每加麝一厘。此时，如舟坐砂上，须涌水而后可通。服此药后，外用葱二斤，捣烂铺于小
腹上，用急水滩头沙一斗，炒热，将布袱于葱上，轻轻略揉。
滑利迅速要相当。
催生有露顶顺正，而生犹迟滞者，恐外感风冷寒暑所阻。夏月热产，则气散血沸，宜五苓散加葵子，或三
退六一散；冬月冻产，则血凝滞，常令房中火暖，宜催生五积散。有水道干涩不能下，及服黑神涩药又多者，
用清油、白蜜等分，猪肝煮汁调服；或六一散七钱，加葵子五钱为末，每二钱热服。有产难日久水干，及触犯恶
气，心烦躁闷者，兔脑丸；腰痛心烦者，用人参、乳香各二钱，辰砂五分，为末，鸡子清调姜汁化开，冷服。
以上正产艰难之法，以下横逆侧碍等法。
横生露手逆露足，徐徐推上任洗娘；
横者，儿先露手。原因腹痛儿身未转，产母用力一逼，遂致横来。当令产母安然仰卧，洗母轻手徐徐推
儿稍上，渐渐以中指摩其肩推上，又攀其耳而正之。服芎归黑神散，固血生血；须待儿身正直，且顺临门，服
阿胶、滑石、葵子为末，温酒入蜜搅匀服之，然后方可用力送下。逆者，先露其足。因母气乏，关键不牢，用力
太早，致儿逆来。当令产母安然仰卧，洗母徐徐推足入去，分毫不得惊恐。服芎归黑神散，固血活血，候儿自顺。
若经久不生，却令洗母轻缓用手推足，令就一边直上，令儿头一边渐渐顺下；多服芎、归等药，直待儿身转，
门路正当，然后用三退散调服，方可用力送下。
坐产露臀高攀手，
坐者，先露其臀。当高处牢系手巾一条，令产母以手攀之；服固血药，轻轻屈足良久，儿即顺生。
面贴顶救盘肠；
盘肠者，小肠先出。急用热水浸软旧布，盖住其肠，不可包扎；外用醋半盏，新汲水七分碗，调停 产
母面，每一 ，令一缩，三 三缩，当收尽为度。又以如圣膏贴产母头顶中心，肠上即拭去。内兼服芎、归、参、
大补之药，加升麻、防风以提之，未有不收者。又有久而为风吹干不能收者，用磨刀水少许，火上温过以润
其肠，后用好磁石煎汤一盏服之，其肠自收。
碍产儿肩脐带绊，
碍者，因儿身翻转脐带绊住其肩，虽露正顶，而不能生。当令产母仰卧，洗母轻轻推儿近上，徐徐引手，
以中指托起儿头，下其脐带，服固血药，仍须候儿身正顺，方可用力送下。
露额侧来坠腿尻。
侧者，因儿方转身，被产母用力一逼，以致儿头偏坠左腿，忽偏坠右腿，或露左额角，
或露右额角，儿头偏坠一畔。多服芎归黑神散；令产母仰卧，洗母轻轻推儿近上，以手正其头，直向人门，然
后用力送下。若是儿顶后骨偏坠谷道，即令儿只露额，当令洗母以绵衣炙令温暖，用手于谷道外畔轻按，推儿
头上而正之；服催生药后，即令产母用力送下。此非洗母轻手巧妙不能。
伤产蓦然口翻噤，
当产误用催生峻药，伤母气血，急用安胎，过月而产。有经一年、二年至四年、五年而产者，尽皆怆惶
用力太早之过，或因子欲生时，儿枕先破，败血裹住，宜盐豉一两，以青布包了，烧存性，入麝香一钱为末，
用秤锤烧红，淬酒调服一盏，仓卒只以新汲水磨京墨服之，墨水裹儿身出；或芎、归、益母草，葵心皆能逐瘀以
开产路。有坐草之时，蓦然目翻口噤吐沫者，霹雳丹。有矮石女子交骨不开难产者，龟壳散，或古芎归汤。通用
无忧散、来苏散、兔脑丸。
胎死母舌黑非常；
外证指甲青黑、胀闷不食、口中极臭，用平胃散加朴硝五钱，水酒煎服，其胎化成血水而下。便闭脉实者，
大黄备急丸，或单鹿角为末，葱豉煎汤调服；昏沉脉微者，养正丹，浓煎乳香汤下一百二十丸；血干或有寒者，
四物汤下古桂香丸；气弱者，催生五积散，加麝一厘。双胎一死一活者，用蟹爪一盏，甘草二两，东流水十盏，
煎至三盏，去渣，入阿胶三两，分二三次顿服，能令生者安，死者出。通用霹雳丹、夺命丸。外用如圣膏贴足
心，仍服催生药及通关散吹鼻，即下。
胞衣不下因血胀，消瘀和气信古方。
皆因用力太早，产下不能更用力送出胞衣，停久被外冷所乘，则血涩胀胞而不出，腹满冲胸，喘急疼痛者
危，急将脐带以少物系坠，然后截断，不然则胞上抱心而死。只要产母心安，不可轻信洗母用手，宜内服牛膝
汤、催生五积散，或用真血竭为末，酒调服。甚者，夺命丹，外用如圣膏贴脚心。昏晕危甚，八味黑神散、黑
龙丹。
临产时切不可惊慌忙乱。
若孕妇足月（十月），气血充足，胎儿健壮，突然感到腹痛，或者仅感腰痛，不久即可自然分娩，何必急于催产？这是顺应自然的顺产之喜，服用单味益母膏，可避免产后疾病。
期间若有体质虚弱、性情急躁者，腹痛时作时止，称为“弄痛”；羊水淋漓量少，称为“试水”。
即使脐腹部都疼痛，宫口已开（露顶），但腰部不痛的，切勿惊慌，严禁接生婆在产妇腹部上揉搓按摩。
必须等到预产期已到，腹痛阵发密集，破水之后，且伴有腰痛，眼中感觉如火烧般燥热，方可上床待产（坐草）；必须等到胎头位置直正且端正，逼近产门，方可用力推送。
如果上床待产太早，用力过度，导致产母困倦乏力，以及产程迟滞，这时才使用催生药物。
凡是难产，多因孕期纵欲，以及骄奢放纵、完全不运动所致；或是生冷坚硬之物导致气机凝滞；或者是骨盆狭窄（矮石女子），耻骨联合不开；或是腹部过大，羊水未排尽；或是临产时闲杂人等惊恐产妇。
恐惧则精气怯弱，精气怯弱则上焦闭塞，闭塞则气机还逆，下焦胀满而产道不通，此时用紫苏饮最为巧妙。
气实者，用瘦胎枳甘散；气弱者，用达生散。
活血安胎，适用于羊水未破之时；
如腹痛但羊水未破，只宜用古芎归汤，以活血行血；或羊水已破但疼痛轻微，虽然疼痛但不密集，宜用安胎饮或达生散，以固护胎元。
切不可轻易使用峻猛药物，徒然渗利水道，反而损伤胎气，使生产更加困难。
产母也应听任其睡眠饮食自如，只是不可过眠过饱罢了。
破水已久仍然难以产出，
破水过多则血液干涩，必须用古黑神散；血虚者，用古芎归汤送服古黑神散，名为芎归黑神散；气弱者，用四君子汤送服，名为四君黑神散；若是横位或倒位，每剂加麝香一厘。
此时，如同船搁浅在沙上，必须涌出水流后方可通行。
服用此药后，外用葱二斤，捣烂铺于小腹上，用急水滩头的沙子一斗，炒热，将布包放在葱上，轻轻略微揉按。
滑利迅速，要掌握适当时机。
催生需待宫口全开、胎位顺正，而生殖仍迟滞的，恐怕是外感风冷寒暑所阻。
夏季炎热生产，则气散血沸，宜用五苓散加冬葵子，或三退六一散；
冬季寒冷生产，则血凝滞，常令产房温暖，宜用催生五积散。
有水道干涩不能下行，及服用黑神散等收敛药物过多的，用清油、白蜜各半，猪肝煮汁调服；或六一散七钱，加冬葵子五钱研为末，每次二钱热服。
有产程艰难日久羊水干涸，及触犯秽恶之气，心中烦躁闷乱的，用兔脑丸；腰痛心烦者，用人参、乳香各二钱，辰砂五分，研为末，用鸡蛋清调姜汁化开，冷服。
以上是正常分娩艰难的方法，以下是横位、逆位、侧位阻碍等方法。
横生露手、逆位露足，徐徐推回任洗母处理；
横位，指胎儿先露出手。原因是腹痛时胎儿身体尚未转动，产母过早用力逼迫，遂致横位。
应当让产母安然仰卧，接生婆轻手徐徐将胎儿稍向上推，渐渐用中指摩挲其肩部推上，又牵引其耳朵使其转正。
服用芎归黑神散，以固血生血；必须等到胎儿身体正直，且顺向产门，服用阿胶、滑石、冬葵子研为末，温酒调入蜂蜜搅匀服下，然后方可用力送下。
逆位，指先露出其足。因母体气乏，关键部位不牢固，用力太早，致使胎儿逆位而来。
应当让产母安然仰卧，接生婆徐徐将脚推入，丝毫不得惊恐。
服用芎归黑神散，以固血活血，等待胎儿自然顺位。
若经久不生，却令接生婆轻缓用手推脚，令其偏向一边直立，令胎儿头部一边渐渐顺下；多服川芎、当归等药，直待胎儿身体转动，产门正当，然后用三退散调服，方可用力送下。
坐产露臀，高攀手辅助；
坐位，指先露出其臀部。应当在高处牢固系一条手巾，令产母以手攀握；服用固血药，轻轻屈足良久，胎儿即顺产。
面贴头顶，救治盘肠（小肠脱出）；
盘肠，指小肠先出。急用热水浸软旧布，盖住其肠，不可包扎；外用醋半盏，新汲水七分碗，调和后敷于产母面部，每一敷，令肛门收缩一次，敷三次缩三次，当收缩完全为止。
又以如圣膏贴于产母头顶中心，肠管上即拭去残留物。内兼服川芎、当归、人参等大补之药，加升麻、防风以提举，没有不收纳的。
又有久而被风吹干不能收回的，用磨刀水少许，火上温过以润湿其肠，后用上好磁石煎汤一盏服下，其肠自收。
碍产，因儿肩被脐带绊住；
碍产，因胎儿身体翻转，脐带绊住其肩膀，虽露正顶，而不能生出。
应当让产母仰卧，接生婆轻轻推胎儿近上，徐徐引手，以中指托起胎儿头，放下其脐带，服用固血药，仍须候胎儿身体正顺，方可用力送下。
露额侧来，坠腿尻部；
侧位，因胎儿正在转身，被产母用力一逼，以致胎儿头偏坠左腿，忽偏坠右腿，或露左额角，或露右额角，胎儿头偏坠一侧。
多服芎归黑神散；令产母仰卧，接生婆轻轻推胎儿近上，以手正其头，直向产门，然后用力送下。
若是胎儿枕骨偏坠谷道（肛门），即令胎儿只露额头，当令接生婆以绵衣炙令温暖，用手于谷道外畔轻按，推胎儿头上而正之；服用催生药后，即令产母用力送下。这非接生婆轻手巧妙不能做到。
伤产，蓦然口噤目翻；
当产时误用催生峻药，损伤母体气血，急用安胎法，过月而产。
有经一年、二年至四年、五年而产者，尽皆是惊慌用力太早之过，或因胎儿欲生时，儿枕（胎盘/瘀血块）先破，败血裹住，宜用盐豉一两，以青布包了，烧存性，入麝香一钱研为末，用秤锤烧红，淬酒调服一盏，仓促间只以新汲水磨京墨服之，墨水包裹胎儿身出；或川芎、当归、益母草、葵心皆能逐瘀以开产路。
有上床待产之时，蓦然目翻口噤吐沫者，用霹雳丹。
有骨盆狭窄女子耻骨联合不开难产者，用龟壳散，或古芎归汤。通用无忧散、来苏散、兔脑丸。
胎死，母舌黑非常；
外证指甲青黑、胀闷不食、口中极臭，用平胃散加朴硝五钱，水酒煎服，其胎化成血水而下。
便闭脉实者，用大黄备急丸，或单鹿角为末，葱豉煎汤调服；昏沉脉微者，用养正丹，浓煎乳香汤下一百二十丸；血干或有寒者，用四物汤送服古桂香丸；气弱者，用催生五积散，加麝香一厘。
双胎一死一活者，用蟹爪一盏，甘草二两，东流水十盏，煎至三盏，去渣，入阿胶三两，分二三次顿服，能令生者安，死者出。通用霹雳丹、夺命丸。外用如圣膏贴足心，仍服催生药及通关散吹鼻，即下。
胞衣不下，因血胀；消瘀和气信古方。
皆因用力太早，产下后不能更用力送出胞衣，停久被外冷所乘，则血涩胀胞而不出，腹满冲胸，喘急疼痛者危，急将脐带以少物系坠，然后截断，不然则胞上抱心而死。
只要产母心安，不可轻信接生婆用手操作，宜内服牛膝汤、催生五积散，或用真血竭为末，酒调服。
甚者，用夺命丹，外用如圣膏贴脚心。昏晕危甚，用八味黑神散、黑龙丹。
During labor, one must absolutely not panic or act in haste.
If the pregnancy has reached full term (ten months), with sufficient Qi and blood, and the fetus is robust, sudden abdominal pain, or merely lower back pain, will lead to delivery shortly thereafter; why rush to induce? This is the natural joy of spontaneous delivery. Taking single-ingredient Motherwort Paste (Yimu Gao) can prevent postpartum complications.
In the interim, for those with weak constitutions and impatient temperaments, abdominal pain that comes and goes is called "playing pain" (Nong Tong); if amniotic fluid drips sparingly, it is called "trial water" (Shi Shui).
Even if both the umbilical and abdominal areas are painful, and the cervix is dilated (Lu Ding), but there is no lower back pain, do not be alarmed. Strictly forbid the midwife from rubbing or massaging the mother's abdomen.
One must wait until the due date has arrived, abdominal pains become frequent and dense, after the waters have broken, accompanied by lower back pain, and a sensation of fire in the eyes, before getting into bed for delivery (Zuo Cao); only when the fetal head is straight, aligned, and approaching the birth canal, should one exert force to push.
If getting into bed too early and exerting excessive force leads to maternal exhaustion and delayed labor, then use labor-inducing medicines at that point.
All difficult labors are often caused by indulgence in sexual activity during pregnancy, as well as pampering and complete lack of exercise; or by the stagnation caused by raw, cold, hard foods; or by narrow pelvises (Ai Shi Nv Zi) where the pubic symphysis does not open; or by an excessively large abdomen with unexpelled amniotic fluid; or by bystanders startling the mother during labor.
Fear causes essence and Qi to weaken; weakness of essence and Qi causes closure of the Upper Jiao; closure leads to Qi rebounding, causing distension in the Lower Jiao and obstruction of the birth canal. In such cases, Perilla Decoction (Zisu Yin) is most effective.
For excess Qi patterns, use Fetus-Thinning Powder of Zhi Gan (Shoutai Zhigan San); for deficient Qi patterns, use Da Sheng San.
Invigorating blood and calming the fetus applies when membranes have not yet ruptured;
If there is abdominal pain but membranes have not ruptured, only Gu Xiong Gui Tang should be used to invigorate blood circulation; or if membranes have ruptured but pain is slight, though present but not dense, An Tai Yin or Da Sheng San should be used to secure the fetal origin.
One must absolutely not lightly use harsh medicines, which would merely drain the water passages, damaging fetal Qi and making delivery even more difficult.
The mother should also be allowed to sleep and eat as she pleases, provided she does not overeat or oversleep.
If membranes have been ruptured for a long time and delivery remains difficult:
Excessive loss of amniotic fluid leads to dryness and stickiness of the blood; Gu Heishen San must be used. For blood deficiency, Gu Xiong Gui Tang is used to administer Gu Heishen San, named Xiong Gui Heishen San; for Qi deficiency, Si Junzi Tang is used, named Si Jun Heishen San. For transverse or breech presentations, add 1 li of Moschus (She Xiang) per dose.
At this time, it is like a boat stranded on sand; flow must surge before passage is possible.
After taking these medicines, externally apply two jin of scallions, mashed and spread on the lower abdomen. Use one dou of sand from a rapid stream, heated in a wok, wrapped in cloth, placed over the scallions, and gently kneaded.
Slippery and rapid delivery requires appropriate timing.
Induction should only occur when the cervix is fully dilated and the position is correct, yet delivery remains delayed, possibly due to external obstruction by wind, cold, heat, or cold.
In summer hot deliveries, Qi dissipates and blood boils; use Wu Ling San plus seeds of Abutilon (Kuizi), or San Tui Liu Yi San.
In winter cold deliveries, blood stagnates; keep the room warm, and use Cui Sheng Wu Ji San.
For dry water passages preventing descent, or after excessive use of astringent Heishen medicines, use equal parts of refined sesame oil and white honey, mixed with juice boiled from pig liver; or take seven qian of Liu Yi San plus five qian of Kuizi powder, taken hot in two qian doses.
For prolonged difficult labor with dried fluids, or exposure to foul qi causing mental restlessness and oppression, use Rabbit Brain Pill (Tunao Wan). For lower back pain and irritability, use two qian each of Ginseng Radix (Renshen) and Frankincense (Ruxiang), plus five fen of Cinnabar (Chensha), powdered, mixed with egg white and ginger juice, taken cold.
The above describes methods for difficult normal deliveries; below are methods for transverse, breech, and lateral obstructions.
Transverse presentation with hand protruding, or breech with feet protruding, should be slowly pushed back by the midwife;
Transverse presentation means the hand appears first. The cause is that the fetal body had not turned during abdominal pain, and the mother's premature pushing forced it sideways.
The mother should lie flat on her back calmly. The midwife should gently and slowly push the fetus slightly upward, gradually using the middle finger to massage the shoulder upwards, and pull the ear to align it.
Take Xiong Gui Heishen San to consolidate and generate blood; only when the fetal body is straight and facing the birth canal, take powder of Donkey-hide Gelatin (Ejiao), Talcum (Huashi), and Abutilon seeds (Kuizi), mixed with warm wine and honey, then exert force to push down.
Breech presentation means the feet appear first. This is due to maternal Qi deficiency and laxity of the pelvic joints, combined with premature pushing.
The mother should lie flat on her back calmly. The midwife should slowly push the feet back in, without any alarm.
Take Xiong Gui Heishen San to consolidate and invigorate blood, waiting for the fetus to naturally align.
If delivery is delayed for a long time, the midwife should gently push the feet to one side to straighten them, allowing the fetal head to gradually descend on that side; take more Chuanxiong and Angelica sinensis medicines, until the fetal body turns and the birth canal is aligned, then take San Tui San mixed, and exert force to push down.
Sitting presentation with buttocks protruding, assisted by holding onto a high strap;
Sitting presentation means the buttocks appear first. Tie a towel securely at a high place for the mother to hold; take blood-consolidating medicines, bend the legs gently for a long time, and the fetus will deliver smoothly.
Face pressed against the top of the head to rescue prolapsed intestines (Pan Chang);
"Prolapsed intestines" refers to the small intestine protruding first. Quickly soak an old cloth in hot water, cover the intestine, do not bandage it; externally, mix half a cup of vinegar with seven-tenths of a bowl of fresh water, apply to the mother's face. Each application induces one contraction; three applications induce three contractions, until fully retracted.
Apply Ru Sheng Gao to the center of the mother's crown; wipe off any residue from the intestine. Internally, take tonifying medicines including Chuanxiong, Danggui, Renshen, etc., plus Cimicifugae Rhizoma (Shengma) and Saposhnikoviae Radix (Fangfeng) to lift, ensuring successful retraction.
If dried out by wind for a long time and unable to retract, use a little whetstone water, warmed over fire to moisten the intestine, then drink one cup of decoction made from high-quality Magnetite (Cishi); the intestine will retract spontaneously.
Obstructed delivery due to fetal shoulder caught by umbilical cord;
Obstruction occurs when the fetal body turns and the umbilical cord catches the shoulder; although the vertex may be visible, delivery cannot proceed.
The mother should lie on her back. The midwife should gently push the fetus upward, slowly guide the hand, use the middle finger to support the fetal head, release the umbilical cord, take blood-consolidating medicines, and wait for the fetal body to align before exerting force to push down.
Forehead protruding laterally, leg and buttock drooping;
Lateral presentation occurs when the fetus is turning, and the mother's forceful pushing causes the fetal head to droop to the left leg, suddenly to the right leg, exposing either the left or right frontal angle, with the head tilted to one side.
Take more Xiong Gui Heishen San; have the mother lie on her back, the midwife gently pushes the fetus up, aligns the head with the hand towards the birth canal, then exerts force to push down.
If the occipital bone is drooping into the anus, causing only the forehead to show, the midwife should warm cotton clothing and gently press outside the anus to push the fetal head up and align it; after taking labor-inducing medicine, the mother should exert force to push down. This requires the midwife's skillful and gentle touch.
Injured delivery, sudden eye rolling and jaw locking;
If harsh labor-inducing medicines are mistakenly used during labor, damaging maternal Qi and blood, urgently use methods to calm the fetus and delay delivery until another month.
Some may deliver after one, two, four, or five years, all due to panic and premature pushing, or because the placenta/blood stasis broke prematurely when the fetus wanted to be born, trapping the fetus in bad blood. Use one liang of fermented soybeans (Yan Chi), wrapped in green cloth, charred but not burnt, mixed with one qian of Moschus (She Xiang), powdered, quenched in wine with a red-hot hammer, and taken in one cup. In emergencies, grind Jingmo ink with fresh water and take it; the ink wraps around the fetus as it exits; or Chuanxiong, Danggui, Motherwort (Yimucao), and Abutilon heart can all expel stasis to clear the birth path.
If during labor, sudden eye rolling, jaw locking, and foaming occur, use Pili Dan.
For women with narrow pelvises and non-opening pubic symphysis causing difficult labor, use Turtle Shell Powder (Gu Ke San) or Gu Xiong Gui Tang. Commonly use Wuyou San, Laisu San, and Tunao Wan.
Dead fetus, mother's tongue becomes unusually black;
External signs include blue-black fingernails, distension, anorexia, and extreme halitosis. Use Pingwei San plus five qian of Mirabilite (Piaoxiao), decocted in water and wine; the dead fetus will transform into bloody fluid and pass.
For constipation and excess pulse, use Dahuang Beijii Wan, or powder of Deer Antler (Lujiao) mixed with Scallion and Forsythia decoction.
For lethargy and faint pulse, use Yangzheng Dan, taken with strong Frankincense decoction, 120 pills.
For dry blood or cold patterns, take Gu Guixiang Wan with Siwu Tang.
For Qi deficiency, use Cui Sheng Wuji San plus 1 li of Moschus.
For twins where one is dead and one alive, use one cup of crab claws, two liang of Licorice Root (Gancao), and ten cups of east-flowing water, decocted to three cups, strained, mixed with three liang of Ejiao, taken in two or three doses. This can save the living fetus and expel the dead one. Commonly use Pili Dan and Duoming Wan. Externally apply Ru Sheng Gao to the soles of the feet, continue taking labor-inducing medicines, and blow Tongguan San into the nose for immediate expulsion.
Retained placenta due to blood distension; trust ancient formulas for resolving stasis and harmonizing Qi.
This is all due to premature pushing; after delivery, the mother cannot exert further force to expel the placenta. After staying in too long, external cold attacks, causing blood stagnation and placental distension, preventing expulsion. Full abdomen pressing on the chest, panting, and pain indicate danger. Urgently tie a small object to the umbilical cord to hang it, then cut it; otherwise, the placenta may rise to encircle the heart, causing death.
Ensure the mother remains calm; do not blindly trust the midwife to manually manipulate. Internally, take Niuxi Tang or Cui Sheng Wuji San, or take powder of true Dragon's Blood (Xuejie) mixed with wine.
For severe cases, use Duoming Dan; externally apply Ru Sheng Gao to the soles of the feet. For severe fainting and critical condition, use Bawei Heishen San or Heilong Dan.