难产宜静以待之，切忌动手。用当归、白芍、牛膝、人参、五味、黄芩、杏仁、贝母、
知母、黄 各八分，姜、水煎服。若血水歇，儿得水必动。交骨不开，芎归汤加发一团，龟
板一枚。
难产散∶人参、炮姜、肉桂、水煎。胎逆下，用盐涂脚心，收生妇手略托，令产
妇吸气一口
而出。又方∶用兔骨髓一个，麝香三分，母丁香一粒，乳香三分，共末，丸，阴干，临产酒
服一丸。又用鱼胶五钱炒成珠，穿山甲（用背脊）二钱，炒成珠，为末，滚酒下。产妇不可睡
倒，用布挂起两胁即产。未产常宜运动，用伏龙肝一两，人参二钱五分，乳香、没药各五分
为末。十五岁起用一钱五分，酒调服；二十岁，一钱六分，余一岁加四厘，加多不效。下死
胎，伏龙肝一两，甘草汤调服。胞衣不下，醋调纳脐中，内服加味芎归汤。
胎死腹中，交骨不开，或五六日不下，垂危者，用当归、川芎各一两，生男妇头发一握
，烧存性，自死龟壳一个，共末。每一两，水煎良久服。不问生死胎，皆下。
验案
一妇胞衣不下，用人参汤送下砂仁末钱许，一日二三次，三四日胞衣烂出，其妇无恙。
产后宜大补温暖为主，血脱益气，温暖则血行也。调补气血，理脾而血药次之。杂证多
端，不必治也。小腹胀，用益母草、肉桂、木香、延胡索，行经作痛亦效。若服丹皮、红花等
药
肉桂大热可用，大寒可用。寒热交作，气血两虚也，十全大补汤；虚弱，保元汤加炮姜、肉
产后但见吐泻，俱属脾胃，一、二月间有病，宜保元、四君加姜、桂；腹胀痛，血不行
，加吴萸少许；有痰不必理痰，大补温暖则痰自化。
产后腿痛甚者，四物汤共一两，加羌活、肉桂二钱，煎服。
产后前阴脱，宜温中。人参、肉桂、延胡各一钱，炮姜、甘草各八分，血得暖则行，调
理十全大补汤。若作泻后阴脱，保元汤加炮姜。切忌寒凉。
遗尿不禁，龙骨、文蛤各一两为末，人参汤服。阴户不闭，十全大补汤加五味敛之。子
宫不收，补中益气汤加醋炒白芍、半夏升提之。
产后昏晕，不知人事，痰盛。川乌、归身、肉桂、人参煎服，血下自愈。调理十全大补
妇人分娩，半产漏下，昏冒不醒，瞑目无所知觉。因血暴亡，心去血，神无所养。心与
包络
，不能镇抚也。若用寒凉，是血虚泻气，阴亏泻阳，两伤之也。宜补血生血，心得血养，神
不昏矣。红花三分，蔓荆、细辛各五分，生地、熟地各一钱， 本、川芎各一钱五分，防风
、羌活、甘草、当归各二钱，白芍三钱，共末，每服五钱，水煎服。
凡妇人乳不至，系胆虚不足，用通草二钱，穿山甲一钱，木馒头一枚，三味共末，入猪
蹄汤内煮烂吃；再不至，加急性五钱必效。
验案
一妇三朝即洗浴，六脉浮大数而左更甚，用补中益气汤加防风、羌活，未全愈。此里虚
表实也，改用保元汤加归、芍、炮姜而愈。
一妇产后二日，血止腹痛，痛而欲按。用人参三钱，同肉桂、炮姜、吴萸煎服，瘀血自
难产应当安静等待分娩时机，切忌随意动手干预。使用当归、白芍、牛膝、人参、五味子、黄芩、杏仁、贝母、知母、黄柏各八分，加生姜和水煎服。如果血水停滞，胎儿得到水分滋润必然活动。若耻骨联合（交骨）不开，使用芎归汤加入头发一团、龟板一枚。
难产散：用人参、炮姜，加水煎服。若胎位不正向下压迫，用盐涂抹产妇脚心，接生婆的手轻轻托举，令产妇吸气一口后胎儿即可产出。另一方法：使用兔骨髓一个、麝香三分、母丁香一粒、乳香三分，共研为末，制成丸剂，阴干，临产时酒送服一丸。又一方：使用鱼胶五钱炒成珠状，穿山甲（取背脊部分）二钱炒成珠状，研为细末，用滚开的酒送服。产妇不可躺倒，用布带悬挂起两侧胁肋部即可生产。未生产前常宜运动，使用伏龙肝一两、人参二钱五分、乳香、没药各五分研为细末。十五岁产妇每次服用一钱五分，酒调服；二十岁服用一钱六分，每增加一岁加四厘，加多则无效。下死胎，使用伏龙肝一两，甘草汤调服。胞衣不下，用醋调药敷于脐中，内服加味芎归汤。
胎儿死于腹中，耻骨联合不开，或五六天仍未产出，病情垂危者，使用当归、川芎各一两，生男妇头发一握烧存性，自死的龟壳一个，共研为末。每一两药末，加水久煎后服用。无论生死胎儿，皆可排出。
验案：一位妇女胞衣不下，用人参汤送下砂仁末约一钱，一日二三次，三四日后胞衣腐烂排出，该妇女安然无恙。
产后调理应以大补温暖为主，血脱则益气，温暖则血液运行通畅。调理补益气血，以健脾为主，补血药物为辅。杂症繁多，不必一一治疗。小腹胀痛，使用益母草、肉桂、木香、延胡索，经行作痛也有效。若服用丹皮、红花等药，肉桂大热可用，大寒也可用。寒热交替发作，是气血两虚的表现，使用十全大补汤；身体虚弱，使用保元汤加炮姜、肉桂。
产后只要出现呕吐腹泻，都属于脾胃问题，一两个月间有病，宜用保元汤、四君子汤加生姜、肉桂；若腹胀痛，因血行不畅，加少许吴茱萸；有痰不必专门治痰，大补温暖则痰自然化解。
产后前阴脱垂，宜温中。人参、肉桂、延胡索各一钱，炮姜、甘草各八分，血得暖则运行，调理使用十全大补汤。若泻痢后后阴脱垂，使用保元汤加炮姜。切忌使用寒凉药物。
遗尿不禁，龙骨、文蛤各一两研为末，人参汤送服。阴户不闭合，使用十全大补汤加五味子收敛。子宫不收，使用补中益气汤加醋炒白芍、半夏升提。
产后昏晕，不知人事，痰盛。川乌、当归身、肉桂、人参煎服，血下行后自愈。调理使用十全大补汤。
妇人分娩，半产漏下，昏冒不醒，闭目无知觉。因血液暴亡，心失去血液滋养，神无所养。心与心包络不能镇抚。若使用寒凉药物，是血虚导致气泄，阴亏导致阳泄，造成两伤。宜补血生血，心得血养，神志就不会昏乱。红花三分，蔓荆子、细辛各五分，生地、熟地各一钱，藁本、川芎各一钱五分，防风、羌活、甘草、当归各二钱，白芍三钱，共研为末，每次服用五钱，加水煎服。
凡妇人乳汁不来，系胆虚不足，使用通草二钱，穿山甲一钱，木馒头一枚，三味共研为末，放入猪蹄汤内煮烂吃；若仍不来，加急性子五钱必效。
验案：一位妇女产后三天即洗浴，六脉浮大数而左侧更甚，使用补中益气汤加防风、羌活，未全愈。这是里虚表实，改用保元汤加当归、白芍、炮姜而痊愈。
Difficult labor should be waited for calmly; one must strictly avoid manual intervention. Use Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Paeoniae Alba), Niu Xi (Radix Achyranthis Bidentatae), Ren Shen (Radix Ginseng), Wu Wei Zi (Fructus Schisandrae Chinensis), Huang Qin (Scutellariae Radix), Xing Ren (Semen Armeniacae Amarum), Bei Mu (Fritillariae Bulbus), Zhi Mu (Rhizoma Anemarrhenae), and Huang Bo (Phellodendri Cortex), each 0.8 fen, decocted with ginger and water. If blood and fluids stagnate, the fetus will move upon receiving moisture. If the pubic symphysis (Jiao Gu) fails to open, use Xiong Gui Tang plus a tuft of hair and one turtle shell.
Nan Chan San: Ren Shen and Pao Jiang (Roasted Ginger) decocted in water. If the fetus is malpositioned downwards, apply salt to the soles of the feet, have the midwife gently support with her hand, and instruct the parturient woman to inhale deeply once, after which the fetus will be delivered. Another method: Use one rabbit bone marrow, 3 fen of She Xiang (Musk), one Mu Ding Xiang (Clove), and 3 fen of Ru Xiang (Olibanum), grind into powder, form pills, dry in shade, and take one pill with wine at the time of labor. Another prescription: Stir-fry 5 qian of Yu Jiao (Fish Maw) until it forms beads, stir-fry 2 qian of Chuan Shan Jia (Pangolin Scales, from the dorsal ridge) until it forms beads, grind into powder, and take with boiling wine. The parturient woman must not lie down; suspend both flanks with cloth strips to facilitate delivery. Before labor, regular movement is beneficial. Use 1 liang of Fu Long Gan (Vermilion Dragon Liver/Calcined Soil), 2.5 qian of Ren Shen, 5 fen of Ru Xiang, and 5 fen of Mo Yao, grind into powder. For a 15-year-old, take 1.5 qian mixed with wine; for a 20-year-old, take 1.6 qian; add 4 li for every additional year of age. Excessive dosage is ineffective. To expel a dead fetus, take 1 liang of Fu Long Gan adjusted with Gan Cao (Licorice Root) decoction. For retained placenta, mix with vinegar and apply to the umbilicus, while internally administering Jia Wei Xiong Gui Tang.
If the fetus dies in the womb, the pubic symphysis fails to open, or it remains undelivered for five to six days with critical condition, use 1 liang of Dang Gui and 1 liang of Chuan Xiong (Szechwan Lovage Rhizome), a handful of hair from a living man or woman calcined to retain its properties, and one shell from a naturally dead turtle. Grind together into powder. Take 1 liang of this powder, decoct in water for a long time, and drink. This works for both living and dead fetuses.
Case Record: A woman had a retained placenta. She was given Sha Ren (Amomum Fruit) powder, approximately 1 qian, washed down with Ren Shen decoction, two to three times a day. After three to four days, the placenta rotted and was expelled; the woman remained healthy.
Postpartum care should primarily focus on major tonification and warming. When blood is lost, Qi must be supplemented; warmth promotes blood circulation. Tonifying and regulating Qi and Blood prioritizes strengthening the Spleen, with blood-nourishing herbs as secondary. Various complications are numerous and need not all be treated individually. For lower abdominal distension and pain, use Yi Mu Cao (Motherwort), Rou Gui (Cinnamon Bark), Mu Xiang (Aucklandiae Radix), and Yan Hu Suo (Corydalis Rhizome); these are also effective for dysmenorrhea. If using Dan Pi (Moutan Cortex) and Hong Hua (Carthami Flos), Rou Gui is suitable for extreme heat, and cold-inducing herbs for extreme cold. Alternating chills and fever indicate deficiency of both Qi and Blood; use Shi Quan Da Bu Tang. For general weakness, use Bao Yuan Tang added with Pao Jiang and Rou Gui.
In the postpartum period, any vomiting or diarrhea belongs to Spleen and Stomach disorders. In the first one or two months, if illness occurs, use Bao Yuan Tang or Si Jun Zi Tang added with Sheng Jiang (Fresh Ginger) and Rou Gui. For abdominal distension and pain due to stagnant blood, add a small amount of Wu Zhu Yu (Evodiae Fructus). Phlegm does not require specific treatment; major tonification and warming will resolve it spontaneously.
For severe leg pain postpartum, use Si Wu Tang totaling 1 liang, added with Qiang Huo (Notopterygii Rhizoma et Radix) and Rou Gui 2 qian, decocted and taken.
For prolapse of the anterior vulva postpartum, warm the Middle Jiao. Use Ren Shen, Rou Gui, and Yan Hu Suo each 1 qian, Pao Jiang and Gan Cao each 0.8 fen. Warmth allows blood to circulate; regulate with Shi Quan Da Bu Tang. For posterior prolapse following diarrhea, use Bao Yuan Tang added with Pao Jiang. Strictly avoid cold and cooling herbs.
For involuntary urination, use Long Gu (Fossilized Bones) and Wen Ge (Clam Shell), each 1 liang, ground into powder, taken with Ren Shen decoction. For incomplete closure of the vaginal introitus, use Shi Quan Da Bu Tang added with Wu Wei Zi to astringe. For uterine inversion/prolapse, use Bu Zhong Yi Qi Tang added with Vinegar-processed Bai Shao and Ban Xia to lift and raise.
For postpartum syncope and unconsciousness with abundant phlegm, use Chuan Wu (Aconiti Lateralis Radix Praeparata), Dang Gui Shen (Dang Gui root tip), Rou Gui, and Ren Shen decocted and taken; self-healing occurs as blood discharges. Regulate with Shi Quan Da Bu Tang.
When women experience miscarriage or prolonged bleeding leading to coma, unresponsiveness, and loss of sensation, it is due to sudden massive blood loss. The Heart loses its blood nourishment, and the Spirit has no support. The Heart and Pericardium cannot stabilize. Using cold and cooling herbs causes Qi leakage due to blood deficiency and Yang leakage due to Yin deficiency, resulting in dual injury. One should tonify and generate blood. Once the Heart is nourished by blood, the Spirit will not be confused. Use Hong Hua 3 fen, Man Jing Zi (Vernoniae Fructus) and Xi Xin (Asari Radix et Rhizoma) each 5 fen, Sheng Di Huang (Rehmanniae Radix) and Shu Di Huang (Prepared Rehmanniae Radix) each 1 qian, Gao Ben (Ligustici Rhizoma et Radix) and Chuan Xiong each 1.5 qian, Fang Feng (Saposhnikoviae Radix), Qiang Huo, Gan Cao, and Dang Gui each 2 qian, and Bai Shao 3 qian. Grind into powder, take 5 qian per dose, decoct in water, and drink.
Failure of lactation in women is due to Gallbladder deficiency. Use Tong Cao (Tetrapanacis Medulla) 2 qian, Chuan Shan Jia 1 qian, and Mu Man Tou (Artocarpis Hypargyreus Fruit) 1 piece. Grind these three into powder, boil in pig trotter soup until soft, and eat. If lactation still does not occur, add Ji Xing Zi (Strychnos Nux-vomica Seed) 5 qian for effectiveness.
Case Record: A woman bathed three days after delivery. Her pulse was floating, large, and rapid, more pronounced on the left side. Bu Zhong Yi Qi Tang added with Fang Feng and Qiang Huo was used but did not fully cure. This indicated interior deficiency and exterior excess. The prescription was changed to Bao Yuan Tang added with Dang Gui, Bai Shao, and Pao Jiang, which resulted in recovery.
A woman experienced cessation of bleeding and abdominal pain two days postpartum, with pain relieved by pressure. Ren Shen 3 qian was decocted with Rou Gui, Pao Jiang, and Wu Zhu Yu; the blood stasis expelled itself.