产难子死腹中者，多因惊动太早，或触犯禁忌，致令产难，胞浆已破，无血养胎，枯
涸而死故也。须验产母舌，若青黑，其胎死矣，当下之。大法∶寒者热以行之，热者凉
以行之，燥者滑以润之，危急者毒药下之。
〔热剂〕
乌金散 治难产热病，胎死腹中，或因颠仆，或从高坠下，或房室惊搐，或临产惊
动太早，触犯禁忌，或产时未到，经血先下，恶露已尽，致胎干子死，身冷不能自出。但
视产妇面赤舌青，是其候也。面青舌赤，母死子活。唇青吐沫，子母俱毙。又有双胎，或
一死一活，其候难知，临时观变可也。
熟地黄（洗，切，焙干，酒炒） 真蒲黄 大当归 交趾桂 杨芍药 军姜（去皮） 粉草（各一
两） 小黑豆（四两） 百草霜（五钱）
上为末，每用二钱，米醋半合许，沸汤六七分浸起温服。疑二之际，且进佛手散，酒
水合煎二三服探之。若未死子母俱安，若胎已死，立便逐下。的知其胎死，进此药后更
进香桂散，须臾如手推下。常用催生，更加好滑石末半两，葵子五十粒捶碎，黄柞叶七
八片，葱白二寸，顺流水煎汤调下。盖滑石
能利小便，柞叶行气逐血，葱白内通阳气，气盛血行即产矣。
〔大全〕下死胎方 桂枝（二钱） 麝香当门子（一个） 同研，暖酒服，须臾如手推下。（一
名桂香散。）
此药比之用水银等不损血气。（赵和叔传）一方单用桂末一钱，痛时童便调下，名救苦
散。
一稳婆之女，勤苦负重，妊娠，腹中阴冷重坠，口中甚秽。余意其胎必死，令视其
舌，果青黑。与朴硝半两许服之，随下秽水而愈。一妇胎死，服朴硝而下秽水，肢体
倦怠，气息奄奄。用四君为主，佐以四物、姜、桂调补而愈。
〔寒剂〕
治妊娠三五个月，胎死在腹内不出。
大腹子 赤芍药 榆白皮（各三两） 当归（一两，炒） 滑石末（七钱半） 瞿麦 葵子（炒）
茯苓 粉草 子芩（各半两）
上为粗末，每服四钱，水一盏，煎至七分，去滓，不拘时温服。
邓知县传，疗死胎不出。朴硝半两研细，以温童便调服屡效。
治死胎不下，指甲青，舌青胀闷，口中作屎臭。先以平胃散一帖，作两服，每服酒
水各一盏，煎至一盏，却投朴硝末半两，再煎三五沸温服，其胎化血水下。
〔本〕治子死腹中不出。用辰砂一两，水煮四五沸，末之，然后取酒调服，立出。
〔外〕疗子死腹中。真珠二两为末，酒调服尽，立出。
〔滑剂〕
《千金》治小儿死腹中。葵子末酒服方寸匕。若口噤不开，格口灌之，药下即活。
疗妊娠胎死腹中，或母疾欲下胎。榆白皮煮汁服二升。
〔大〕治子死腹中，或半生不下，或半着脊骨，在草不产，血气上荡母心，面无颜
色，气欲绝。
猪脂（一斤） 白蜜（一升） 醇酒（二升）
上三味，合煎取二升，分温二服。不能饮，随所能服之。
〔妇人良方〕一字神散 治子死胎不下，胞破不生。此方屡效，救人无量。
鬼臼（黄色者，不以多少，去毛，碾为末，极细如粉，不用罗，以手指捻之）
上每服二钱，用无灰酒一盏，同煎至八分，通口服，立效如神。
〔世〕治生产不顺，胎死腹中，胞衣不下，临产危急，妙。
蛇蜕（一条，全者，香油灯上烧，研） 麝香（少许）
上为末，童便、酒各半盏，调一服即生，效。
杨氏疗有孕月数未足，子死腹中，母欲闷绝。取大豆（一方黑豆。）三升，醋煮浓汁三升，
顿服立效。
《本事》治妊娠热病，胎死腹中。鹿角屑一两，水一盏，葱五茎，豆豉半合，同煎至
六分，去滓温分二服。
又方 取死胎，乌鸡一支，去尾细切，以水三升，煮取二升，去鸡，通手用衣帛蘸，摩
脐下，胎自出。
难产且胎儿死于腹中的情况，多因受惊动得太早，或者触犯禁忌，导致产程困难。此时胞浆已经破裂，没有血液滋养胎儿，致使胎儿干枯而死。必须检查产妇的舌头，如果舌色青黑，说明胎儿已死，应当使用下胎法治疗。基本法则：寒证用热药推动排出，热证用凉药推动排出，燥证用滑润药滋润排出，危急情况用毒药攻下。
【热剂】
乌金散：治疗难产伴热病、胎儿死于腹中；或因跌倒、从高处坠落；或房事时受惊抽搐；或临产前过早受惊动、触犯禁忌；或未到产期经血先下、恶露已尽，导致胎儿干枯死亡，身体冰冷无法自行产出。只要观察产妇面色红赤、舌色青黑，就是这种征候。若面色青黑、舌色红赤，则是母死子活。若嘴唇青紫、吐白沫，则母子双亡。又有双胞胎的情况，可能一死一活，其征候难以判断，需根据当时情况灵活变通。
配方：熟地黄（清洗、切片、焙干、酒炒）、真蒲黄、大当归、交趾桂、杨芍药、军姜（去皮）、粉草（各一两）、小黑豆（四两）、百草霜（五钱）。
以上药物研为细末，每次服用二钱，用米醋半合左右，用沸水六七分浸泡至温热后服用。在怀疑胎儿是否死亡的犹豫之际，可以先服用佛手散，用酒和水混合煎煮二三服以试探。如果胎儿未死，母子均安；如果胎儿已死，立即排出。确知胎儿已死后，服用此药后再进香桂散，片刻间胎儿如被手推下般排出。常用于催生，可再加好滑石末半两、葵子五十粒捣碎、黄柞叶七八片、葱白二寸，用顺流水煎汤调服。因为滑石能利小便，柞叶行气逐血，葱白内通阳气，气盛血行即可分娩。
【大全】下死胎方：桂枝（二钱）、麝香当门子（一个），共同研磨，用温酒送服，片刻间胎儿如被手推下。（又名桂香散。）
此药比用水银等药物不损伤气血。（赵和叔传授）另一方单用桂末一钱，疼痛时用童便调服，名为救苦散。
有一位稳婆的女儿，勤劳辛苦负重，怀孕后腹部感觉阴冷重坠，口中气味很臭。我推测胎儿必死，让她查看舌头，果然青黑。给予朴硝半两左右服用，随即排出秽水而痊愈。另一位妇女胎儿已死，服用朴硝后排出秽水，肢体倦怠，气息微弱。用四君子汤为主方，佐以四物汤、生姜、肉桂调理补益而痊愈。
【寒剂】
治疗妊娠三到五个月，胎儿死于腹内无法产出。
配方：大腹子、赤芍药、榆白皮（各三两）、当归（一两，炒）、滑石末（七钱半）、瞿麦、葵子（炒）、茯苓、粉草、子芩（各半两）。
以上药物制成粗末，每次服用四钱，加水一盏，煎至七分，去渣，不拘时候温服。
邓知县传授，治疗死胎不出。朴硝半两研细，用温热的童便调服，屡见疗效。
治疗死胎不下，指甲青紫，舌青胀闷，口中散发屎臭味。先用平胃散一帖，分成两服，每服用酒和水各一盏，煎至一盏，然后投入朴硝末半两，再煎三五沸后温服，胎儿化为血水下排。
【本】治疗胎儿死于腹中无法产出。用辰砂一两，水煮四五沸，研为细末，然后用酒调服，胎儿立即产出。
【外】治疗胎儿死于腹中。真珠二两研为细末，用酒调服完，胎儿立即产出。
【滑剂】
《千金》治疗小儿死于腹中。葵子末用酒送服方寸匕。如果牙关紧闭不开，撬开嘴巴灌入，药下去即活。
治疗妊娠胎儿死于腹中，或母亲患病想要下胎。榆白皮煮汁服用二升。
【大】治疗胎儿死于腹中，或半生不下来，或卡在脊骨上，在草丛中生产不出，血气上冲扰动母心，面无血色，气欲绝。
配方：猪脂（一斤）、白蜜（一升）、醇酒（二升）。
以上三味药，合煎取二升，分两次温服。不能饮酒者，按其所能承受的量服用。
【妇人良方】一字神散：治疗胎儿死胎不下，胞衣破裂不生。此方屡见疗效，救人无数。
配方：鬼臼（黄色者，不限多少，去毛，碾为极细粉末，不用筛，用手指捻之）。
每次服用二钱，用无灰酒一盏，同煎至八分，一次性口服，效果立竿见影。
【世】治疗生产不顺，胎儿死于腹中，胞衣不下，临产危急，效果奇妙。
配方：蛇蜕（一条，完整的，在香油灯上烧焦，研磨）、麝香（少许）。
以上研为细末，用童便、酒各半盏调服一服即生，有效。
杨氏治疗怀孕月数不足，胎儿死于腹中，母亲想要闷绝。取大豆（一方用黑豆）三升，用醋煮成浓汁三升，一次服下立效。
《本事》治疗妊娠热病，胎儿死于腹中。鹿角屑一两，水一盏，葱五茎，豆豉半合，同煎至六分，去渣温分两次服。
又一方：取死胎，用乌鸡一只，去尾细切，用水三升，煮取二升，去掉鸡肉，用手拿着衣帛蘸取药液，摩擦脐下，胎儿自然产出。
Dystocia with fetal death in utero is often caused by excessive early agitation or violation of taboos, leading to difficult labor. By the time the amniotic fluid has ruptured, there is no blood to nourish the fetus, causing it to wither and die. It is necessary to examine the mother's tongue; if it is cyanotic and black, the fetus is dead, and purgative therapy should be employed. The general principle is: for cold patterns, use hot herbs to promote expulsion; for heat patterns, use cool herbs to promote expulsion; for dryness patterns, use slippery/lubricating herbs to moisten and promote expulsion; in critical situations, toxic drugs are used to purge.
[Heat-Resolving Agents]
Wujin San (Black Gold Powder): Treats dystocia complicated by febrile disease and fetal death in utero; or resulting from falls, jumping from heights, sexual activity-induced convulsions, or premature agitation/violation of taboos before labor; or premature bleeding/lochia exhaustion before term, leading to fetal desiccation and death, with a cold body unable to expel the fetus spontaneously. The sign is a red face and cyanotic tongue. If the face is cyanotic and the tongue is red, the mother dies while the fetus lives. If the lips are cyanotic and froth is vomited, both mother and fetus die. In cases of twins, one may be dead and the other alive, making the prognosis difficult; observation at the time is required.
Ingredients: Shudihuang (Prepared Rehmanniae Radix, washed, sliced, dried, wine-fried), Zhen Puhuang (Authentic Typhae Pollen), Da Danggui (Large Angelicae Sinensis Radix), Jiaozhi Gui (Cinnamon Twig from Jiaozhi), Yang Shaoyao (Paeoniae Radix), Jun Jiang (Zingiberis Rhizoma, peeled), Fencao (Glycyrrhizae Radix et Rhizoma) (each 1 liang), Xiaoheidou (Black Soybeans, 4 liang), Baicaoshuang (Soot from hundred herbs, 5 qian).
Grind all ingredients into fine powder. Take 2 qian each time, soak in approximately half a he of rice vinegar with boiling water (filling 60-70% of the vessel), warm, and drink. If uncertain whether the fetus is dead, first administer Foshou San (Buddha's Hand Powder), decocted with wine and water, two to three doses as a probe. If the fetus is alive, both mother and child remain safe; if the fetus is dead, it will be expelled immediately. Once fetal death is confirmed, after taking this medicine, administer Xianggui San (Fragrant Cinnamon Powder); within moments, the fetus will be expelled as if pushed out by hand. This formula is commonly used for inducing labor; adding Banxia Shi (Halloysitum Rubrum, 0.5 liang), Kuizi (Abutili Semen, 50 grains crushed), Huangzha Ye (Rhamni Frondis Folium, 7-8 leaves), and Congbai (Allii Fistulosi Bulbus, 2 cun), decocted in flowing water, enhances efficacy. Halloysitum Rubrum promotes urination, Rhamni Frondis Folium moves qi and dispels blood stasis, and Allii Fistulosi Bulbus unites internal yang qi; when qi is abundant and blood flows, delivery occurs.
[Daqan Formula for Expelling Dead Fetus]: Guizhi (Cinnamon Twig, 2 qian) and Muxiang Dangmenzi (Moschus, 1 unit), ground together, taken with warm wine. Within moments, the fetus is expelled as if pushed out. (Also known as Guixiang San.)
This formula does not damage qi and blood like mercury-based preparations do. (Transmitted by Zhao Heshu.) Another prescription uses only 1 qian of Guizhi powder, taken with fresh urine during pain, named Jiuku San (Save from Suffering Powder).
A midwife's daughter, who worked hard carrying heavy loads, became pregnant and felt coldness and heaviness in her abdomen, with foul breath. I suspected fetal death and had her check her tongue; it was indeed cyanotic and black. She was given Xiaoshi (Natrii Sulfas, approx. 0.5 liang), after which foul fluids were discharged, and she recovered. Another woman with a dead fetus took Xiaoshi and discharged foul fluids, but suffered from limb fatigue and faint breathing. She was treated with Sijunzi Tang (Four Gentlemen Decoction) as the main formula, supplemented with Siwu Tang (Four Substances Decoction), Shengjiang (Zingiberis Rhizoma Recens), and Rougui (Cinnamomi Cortex) to regulate and tonify, resulting in recovery.
[Cold-Resolving Agents]
Treats fetal death in utero between the third and fifth months of pregnancy, unable to be expelled.
Ingredients: Dafuzi (Arecae Semen, 3 liang), Chi Shaoyao (Red Peony Root, 3 liang), Yubaipi (Ulmus Alba Cortex, 3 liang), Danggui (Angelicae Sinensis Radix, fried, 1 liang), Huashi Mo (Halloysiti Rubrum Powder, 7.5 qian), Qumai (Diantherae Herba), Kuizi (Abutili Semen, fried), Fuling (Poria), Fencao (Glycyrrhizae Radix et Rhizoma), Ziqin (Scutellariae Radix, 0.5 liang each).
Grind into coarse powder. Take 4 qian each time, add one zhan of water, decoct to 0.7 zhan, strain, and take warm at any time.
Transmitted by County Magistrate Deng for treating retained dead fetus. Xiaoshi (Natrii Sulfas, 0.5 liang) is finely ground and taken with warm fresh urine; it is frequently effective.
For retained dead fetus with cyanotic nails, cyanotic tongue, abdominal distension and oppression, and fecal odor in the mouth: First administer Pingwei San (Powder for Maintaining Stability) in one dose, divided into two servings. Each serving is decocted with one zhan of wine and one zhan of water until reduced to one zhan. Then add 0.5 liang of Xiaoshi powder, boil for three to five boils, and take warm. The fetus will transform into bloody fluid and discharge.
[Ben Cao] For fetal death in utero not being expelled: Use Zhensha (Cinnabaris, 1 liang), boiled in water for four to five boils, ground into powder, then taken with wine. The fetus is expelled immediately.
[Wai Ke] For fetal death in utero: Zhenzhu (Margarita, 2 liang) ground into powder, taken with wine until finished. The fetus is expelled immediately.
[Slippery/Lubricating Agents]
Qianjin Fang treats fetal death in utero. Abutili Semen powder taken with wine using a square-inch measure. If trismus (lockjaw) prevents opening the mouth, force it open and pour the medicine in; life is restored upon ingestion.
For fetal death in utero during pregnancy, or when maternal illness necessitates expulsion: Decoct Yubaipi (Ulmus Alba Cortex) and drink 2 sheng.
[Da Yi Zong Lu] For fetal death in utero, or partial birth failure, or fetus stuck on the spine, inability to deliver in grassy areas, blood and qi rushing up to disturb the heart, pallor, and impending collapse of qi.
Ingredients: Zhuzhi (Porci Adeps, 1 jin), Baimi (Mel, 1 sheng), Chunjiu (Pure Wine, 2 sheng).
Decoct the three ingredients together to obtain 2 sheng. Divide into two warm doses. If unable to drink wine, take according to tolerance.
[Furen Liangfang] Yizi Shensan (One-Character Divine Powder): Treats retained dead fetus and ruptured membranes without delivery. This formula is highly effective and saves countless lives.
Ingredient: Jiujiao (Podophylli Fructus, yellow variety, amount unspecified, remove hairs, grind to extremely fine powder like flour, do not sieve, rub with fingers).
Take 2 qian each time, decoct with one zhan of non-fermented wine until reduced to 0.8 zhan, take orally in one dose. Effect is miraculous and immediate.
[Shi Yi De Xiao Fang] For difficult labor, fetal death in utero, retained placenta, and critical labor conditions.
Ingredients: Shetui (Ophichthidis Cutis Coriacea, one whole piece, burned over sesame oil lamp, ground), Shexiang (Moschus, small amount).
Grind into powder. Take one dose mixed with half a zhan of fresh urine and half a zhan of wine. Immediate delivery ensues.
Yang Shi treats premature fetal death in utero with maternal syncope. Take Douda (Sojae Semen Album, or alternatively Heidou/Black Soybean) 3 sheng, decoct in vinegar to obtain 3 sheng of thick juice, take in one dose for immediate effect.
[Benshi Fang] For febrile disease in pregnancy with fetal death in utero: Lujiaoxie (Cornu Cervi Deglutatum, 1 liang), water 1 zhan, Congbai (Allii Fistulosi Bulbus, 5 stalks), Chidouchi (Fermented Sojae Semen, 0.5 he). Decoct together to 0.6 zhan, strain, and take warm in two divided doses.
Another prescription: Obtain the dead fetus, take one Wuji (Gallus Domesticus, tail removed, finely chopped), decoct in 3 sheng of water to obtain 2 sheng. Remove the chicken. Dip cloth into the liquid and massage the lower umbilical region with the hand; the fetus will naturally be expelled.