〔三因〕妇人趣产，劳力努咽太过，致阴下脱，若脱肛状，及阴下挺出，逼迫肿痛，
举重房劳，皆能发作，清水续续，小便淋露。
硫黄散 治产后劳伤阴脱。
硫黄 乌贼鱼骨（各半两） 五味子（二钱半）
上为末，掺患处。
桃仁膏 治产后阴肿妨闷。
桃仁（去皮尖） 枯矾 五倍子（各等分）
上以下二味为末，研桃仁为膏。拌匀敷之。
硫黄汤 治产劳，玉门开而不闭。
硫黄（四两） 吴茱萸 菟丝子（各一两半） 蛇床子（二两）
上每服四钱，水一碗，煎数沸，滤渣，洗玉门，日再洗。
熨法
单炒蛇床子，乘热布裹熨患处。亦治产后阴痛。
当归散 治阴下脱。
当归 黄芩（各二两） 芍药（一两钱半） 皮（烧存性，半两） 牡蛎（二两半）
为末，每服二钱，温酒米汤任意调下。忌登高举重。
〔丹溪〕一妇人三十余岁，生女二日后，产户一物如手帕，下有帕尖，约重一斤。予
思之，此因胎前劳乏，伤气，成肝痿所致，却喜血不甚虚，其时岁暮天寒，恐冷干坏了，急
与炙黄 半钱，人参一钱，白术五分，当归一钱半，升麻五分，三帖，连服之即收上，得
汗通身乃安。但下裔沾席处干者落一片，约五六两重，盖脂膜也。食进得眠，诊其脉皆
涩，左略弦，视其形却实。与白术、芍药各钱半，陈皮一钱，生姜一片，煎二三帖以养
之。一妇人产子后，阴户中下一物如合钵状，有二歧。其夫来求治，予思之，此子宫
也，必气血弱而下坠。遂用升麻、当归、黄 ，大料二帖与之，半日后，其夫复来曰，服
二次后觉响一声，视之已收阴户讫，但因经宿干着席上，破一片如掌心大在席，某妻在
家哭泣，恐伤破不可复生。予思之，此非肠胃，乃胎膏也。肌肉破，尚可复完，若气血
充盛，必可生满。遂用四物汤加人参，与一百帖，三年后复有子。治子宫下，用黄
一钱半，人参一钱，当归七分，升麻三分，甘草二分，作一帖，水一盅，煎至五分，去渣
食前服。却用五倍子末泡汤洗。又用未敷之，如此数次，宜多服药，永不下。
〔薛〕玉门不闭，气血虚弱也，用十全大补汤。肿胀 痛，肝经虚热也，加味逍遥
散。若因忧怒，肝脾气血伤也，加味归脾汤。若因暴怒，肝火血伤也，龙胆泻肝汤。一
产妇玉门不闭，发热恶寒，用十全大补加五味子，数剂而寒热退。用补中益气加五味子，
数剂而玉门闭。一妇人脾胃素弱，兼有肝火，产后玉门肿痛，寒热作渴，呕吐不食，外
敷大黄等药，内用驱利之剂，肿及于臀，诸证蜂起，此真气虚而邪气盛也。先用六君子
以固肠胃，次用补中益气以升阳气，不数剂而全愈。一产妇患此失治，肿溃不已，形
体消瘦，饮食少思，朝寒暮热，自汗盗汗，半年矣。用补中益气汤加茯苓、半夏，脓水渐
少，饮食渐进。又用归脾汤共五十余剂而愈。
一产妇玉门不闭，小便淋沥，腹内一块，攻
走胁下，或胀或痛，用加味逍遥散加车前子而愈。一妇人子宫肿大，二日方人，损落
一片，殊类猪肝，面黄体倦，饮食无味，内热晡热，自汗盗汗，用十全大补汤二十余剂，
诸证悉愈，仍复生育。
治产后阴肿下脱内出，玉门不闭。
锻石（一升，炒极热） 汤二升，投灰中，适温冷，澄清坐水中以浸玉门，斯须平复如故。
又方，以铁精粉上推内之。又灸脐下横纹五七壮。
一法，用铁精、羊脂二味，搅令稠，布裹炙热熨，推内之。（铁精是锻铁炉中飞出如尘，紫
色而轻虚，可以莹磨器皿者。）
〔子母〕疗产后阴下脱，烧兔头末敷之。
《补遗》治产后生肠不收。用枳壳煎汤，浸良久即入。又方，五倍子、白矾煎汤浸亦
良。又方，酸笃草俗名老鸦酸煎汤，用草坐不开孔，才熏收一半，稍温下手洗，并收
入而安。
又方，子宫脱出，以温水洗软，却用雄鼠粪烧烟熏入。又法，蓖麻子十四粒，去
壳捣烂涂顶心，如入即洗去。
〔东〕妇人胞胎门落颓不收，常湿。神关 玉泉（五十壮） 身交（脐下指缝中，
灸五十壮，三报。）
又法 玉泉傍开三寸（灸随年壮，三报）女人阴门冷肿。皈来（三十壮）
〔甲〕妇人阴挺出，四肢淫泺，身闷。少海主之。（一作照海。）
〔阴中肉线〕
一妇产后水道中出肉线一条，长三四尺，动之则痛欲绝。先服失笑散数次，以带皮姜
三斤，研烂入清油二斤，煎油干为度，用绢兜起肉线，屈曲于水道边，以前姜熏之，冷
则熨之。一日夜缩其大半，二日即尽入。再服失笑散、芎归汤调理之。如肉线断则不可
治矣。
【三因方】妇女分娩时，用力努责过度，导致阴部组织下脱，状如脱肛，以及阴道内物挺出，伴有紧迫肿痛。举重、房事劳损等因素均可诱发此病，表现为清水样分泌物不断流出，小便淋漓不尽。
硫黄散：治疗产后因劳伤导致的阴部组织下脱。
药材：硫黄、乌贼鱼骨（各半两），五味子（二钱半）。
制法与用法：将上述药物研为细末，撒敷于患处。
桃仁膏：治疗产后阴部肿胀妨碍舒适感。
药材：桃仁（去皮尖）、枯矾、五倍子（各等分）。
制法与用法：将后两味药研为细末，将桃仁研磨成膏状。混合均匀后外敷。
硫黄汤：治疗产褥劳损，导致玉门（阴道口）开张而不能闭合。
药材：硫黄（四两）、吴茱萸、菟丝子（各一两半）、蛇床子（二两）。
制法与用法：每次取四钱药量，加水一碗，煮沸数次，滤去药渣，用汤汁清洗玉门，每日清洗两次。
熨法：
单独炒热蛇床子，趁热用布包裹熨烫患处。也可用于治疗产后阴部疼痛。
当归散：治疗阴部组织下脱。
药材：当归、黄芩（各二两）、芍药（一两钱半）、[皮]（烧至存性，半两）、牡蛎（二两半）。
*注：原文“皮”前缺字，据《女科证治准绳》及后世校勘，此处多指“赤石脂”或类似收敛固涩之药，但依指令只提取明确出现实体，故保留原文“皮”或视为漏字，此处按原文列出。若需补全通常指赤石脂，但严格遵循不增添内容原则，仅列“皮”。鉴于中医古籍中“皮”单独出现极少见，结合上下文及常见方剂，极可能为“赤石脂”之误植或省略，但在实体提取时仅提取可见文本。此处翻译暂译为“皮（烧存性）”。*
制法与用法：研为细末，每次服用二钱，用温酒或米汤任意调服。忌登高和举重物。
【朱丹溪医案】有一位三十多岁的妇人，生下女儿两天后，产户中有一物像手帕一样脱出，下面有手帕的尖角，大约重一斤。我思考认为，这是因为怀孕期间劳累乏力，损伤了正气，导致肝痿所致。幸好血液并不十分虚弱。当时正值岁末天寒，担心寒冷损伤坏死的组织，急忙给予炙黄芪半钱，人参一钱，白术五分，当归一钱半，升麻五分，共三帖，连续服用后即收回体内，全身出汗后才安稳。但是，下垂部分接触席子干燥脱落的一片，约重五六两，那是脂膜。之后患者饮食增加，能够安睡，诊察其脉象皆涩，左脉略微弦，观察其形体却显得充实。给予白术、芍药各一钱半，陈皮一钱，生姜一片，煎煮二三帖以调养身体。
另一位妇人在生产后，阴户中脱出一物像合钵形状，分为两歧。她的丈夫来求治，我思考认为，这是子宫，必定是因为气血虚弱而下坠。于是使用升麻、当归、黄芪，大剂量两帖给她服用。半天后，她的丈夫再次前来说，服药两次后听到响了一声，查看发现已经收回阴户内了。但是因为隔了一夜干粘在席子上，破了一片像掌心大小在席子上，妻子在家哭泣，恐怕因为破损不能再生长。我思考认为，这不是肠胃，而是胎膏（胎盘残留或附属组织）。肌肉破损，尚可修复完整，如果气血充盛，必定可以重新长满。于是使用四物汤加人参，给服一百帖，三年后又生育了孩子。治疗子宫下脱，使用黄芪一钱半，人参一钱，当归七分，升麻三分，甘草二分，作一帖，用水一盅，煎至五分，去渣，饭前服用。同时用五倍子末泡汤清洗。又用未敷过的药粉外敷，如此数次，宜多服药，使不再下脱。
【薛己医案】玉门不闭，是气血虚弱的表现，使用十全大补汤。肿胀且痛，是肝经虚热的表现，使用加味逍遥散。如果是因忧愁愤怒，导致肝脾气血受伤，使用加味归脾汤。如果是因暴怒，导致肝火伤血，使用龙胆泻肝汤。一位产妇玉门不闭，发热恶寒，使用十全大补汤加五味子，数剂后寒热退去。使用补中益气汤加五味子，数剂后玉门闭合。一位妇人脾胃素来虚弱，兼有肝火，产后玉门肿痛，寒热发作口渴，呕吐不能进食，外用大黄等药，内服驱利之剂，肿胀蔓延至臀部，各种症状蜂拥而起，这是真气虚弱而邪气盛实。先用六君子汤以巩固肠胃，次用补中益气汤以提升阳气，不数剂便痊愈。一位产妇患此病失治，肿胀溃烂不止，形体消瘦，饮食少思，早晨怕冷傍晚发热，自汗盗汗，长达半年。使用补中益气汤加茯苓、半夏，脓水逐渐减少，饮食逐渐进用。又用归脾汤共五十余剂而痊愈。
一位产妇玉门不闭，小便淋漓，腹内有块，攻窜胁下，有时胀有时痛，使用加味逍遥散加车前子而愈。一位妇人子宫肿大，两天才入盆（注：此处原文“二日方人”疑为“二日方入”或指脱出物复位困难，结合语境“损落一片”，更可能是指脱出物长时间在外受损），掉落一片，非常像猪肝，面色黄形体疲倦，饮食无味，内热午后热甚，自汗盗汗，使用十全大补汤二十余剂，所有症状全部痊愈，仍能恢复生育能力。
治疗产后阴肿下脱内出，玉门不闭。
锻石（一升，炒至极热），加入汤二升，投入灰中，待温度适宜冷却，澄清后坐浴浸泡玉门，片刻即可平复如初。
又一方，用铁精粉推入内部。又灸脐下横纹五到七壮。
另一法，用铁精、羊脂两味药，搅拌至稠厚，用布包裹加热熨烫，推入内部。（铁精是锻铁炉中飞出的如尘般的物质，紫色而轻虚，可以用来磨亮器皿。）
【子母备录】治疗产后阴部下脱，烧兔头研末敷之。
《补遗》治疗产后生肠不收。用枳壳煎汤，浸泡很久即能收回。又一方，五倍子、白矾煎汤浸泡也很好。又一方，酸笃草俗名老鸦酸，煎汤，用没有孔的草垫坐着熏，刚熏收一半时，稍温时用手洗，并收入使其安宁。
又一方，子宫脱出，用温水洗软，然后用雄鼠粪烧烟熏入。又法，蓖麻子十四粒，去壳捣烂涂在头顶心，如果缩回就洗去。
【东垣医案】妇人胞胎门落颓不收，常湿。神阙穴、玉泉穴（灸五十壮）。身交穴（脐下指缝中，灸五十壮，三次重复）。
又法 玉泉穴旁开三寸（灸随年壮，三次重复）。女人阴门冷肿。归来穴（灸三十壮）。
【甲乙经】妇人阴挺出，四肢倦怠无力，身体困闷。少海穴主治之。（一作照海穴。）
【阴中肉线】
一位产妇产后水道中出一条肉线，长三四尺，触动则痛欲绝。先服失笑散数次，用带皮姜三斤，研烂加入清油二斤，煎至油干为度，用绢兜起肉线，弯曲放置在水道边，用前面的姜熏之，冷了则熨之。一天一夜收缩其大半，两天即完全收回。再服失笑散、芎归汤调理。如果肉线断裂则不可治了。
[San Yin Fang] When a woman is in labor, excessive straining and bearing down can cause the prolapse of vaginal tissues, resembling rectal prolapse, with protrusion from the vagina, accompanied by a sensation of tightness, swelling, and pain. Heavy lifting and sexual fatigue can also trigger this condition, presenting with continuous discharge of clear fluid and dribbling urination.
Liuhuang San (Sulfur Powder): Treats prolapse of vaginal tissues after childbirth due to labor injury.
Ingredients: Liu Huang (Cinnabar Sulfur), Wuzui Yu Gu (Cuttlefish Bone) (each 0.5 liang), Wuweizi (Schisandra Berry) (2.5 qian).
Preparation and Administration: Grind the above ingredients into fine powder and apply to the affected area.
Taoren Gao (Peach Kernel Ointment): Treats postpartum vaginal swelling causing discomfort.
Ingredients: Taoren (Peach Seed, peeled and removed of tips), Kufan (Alum), Wubeizi (Chinese Gallnut) (equal parts).
Preparation and Administration: Grind the latter two ingredients into powder, grind the peach seeds into an ointment/paste. Mix evenly and apply externally.
Liuhuang Tang (Sulfur Decoction): Treats uterine/vaginal prolapse after childbirth labor, where the Yumen (vaginal opening) remains open and does not close.
Ingredients: Liu Huang (Sulfur) (4 liang), Wu Zhu Yu (Evodia Fruit), Tusizi (Dodder Seed) (each 1.5 liang), Shechuangzi (Cnidium Fruit) (2 liang).
Preparation and Administration: Take 4 qian per dose, add one bowl of water, boil for several times, filter out the dregs, and wash the Yumen with the liquid. Wash twice daily.
Moxibustion/Fomentation Method:
Stir-fry Shechuangzi (Cnidium Fruit) alone until hot, wrap in cloth while hot, and foment the affected area. This method also treats postpartum vaginal pain.
Danggui San (Angelica Powder): Treats vaginal tissue prolapse.
Ingredients: Danggui (Angelica Sinensis), Huangqin (Scutellaria Root) (each 2 liang), Shaoyao (Peony Root) (1.5 qian), Pi [Note: Text implies a bark or specific herb, likely missing character like Chishizhi, but strictly translated as 'Pi'] (burned to retain charred nature, 0.5 liang), Muli (Oyster Shell) (2.5 liang).
Preparation and Administration: Grind into powder. Take 2 qian per dose, mix with warm wine or rice soup as desired. Avoid climbing heights and lifting heavy objects.
[Zhu Danxi's Case] A woman in her thirties, two days after delivering a daughter, had a mass protruding from the birth canal resembling a handkerchief with a pointed tip, weighing approximately one jin. I reasoned that this was caused by fatigue during pregnancy damaging the Qi, leading to Liver Wei (Liver Flaccidity). Fortunately, her Blood was not severely deficient. Given the cold weather at year-end, fearing cold damage to the necrotic tissue, I urgently prescribed Zhi Huangqi (Processed Astragalus Root) 0.5 qian, Renshen (Ginseng Root) 1 qian, Baizhu (Atractylodes Macrocephala Rhizome) 0.5 qian, Danggui (Angelica Sinensis) 1.5 qian, Shengma (Cimicifuga Rhizome) 0.5 qian, for three doses. Continuous administration resulted in retraction, followed by whole-body sweating and relief. However, a piece of the protruding part that had dried against the mat fell off, weighing about 5-6 liang, which was adipose membrane. Subsequently, her appetite improved, and she slept well. Her pulse was wiry-choppy (Se), slightly wiry on the left, yet her physical constitution appeared robust. I prescribed Baizhu and Shaoyao (Peony Root) each 1.5 qian, Chenpi (Tangerine Peel) 1 qian, and Shengjiang (Fresh Ginger) one slice, decocted for 2-3 doses to nourish her.
Another woman, after childbirth, had a mass protruding from the vagina resembling a covered bowl with two lobes. Her husband sought treatment. I reasoned this was the uterus, prolapsed due to weak Qi and Blood. I prescribed large doses of Shengma (Cimicifuga Rhizome), Danggui (Angelica Sinensis), and Huangqi (Astragalus Root) for two doses. Half a day later, the husband returned saying that after two doses, there was a popping sound, and the mass had retracted into the vagina. However, a palm-sized piece had adhered to and torn from the mat overnight. The wife was weeping, fearing the tear prevented regeneration. I reasoned this was not intestine but placental residue/fat. Muscle tears can heal if Qi and Blood are sufficient. I prescribed Siwu Tang (Four Substance Decoction) plus Renshen (Ginseng Root) for 100 doses. Three years later, she conceived again. For treating uterine prolapse, use Huangqi (Astragalus Root) 1.5 qian, Renshen (Ginseng Root) 1 qian, Danggui (Angelica Sinensis) 0.7 qian, Shengma (Cimicifuga Rhizome) 0.3 qian, Gancao (Licorice Root) 0.2 qian, as one dose. Decoct in one cup of water to half volume, strain, and take before meals. Also wash with Wubeizi (Chinese Gallnut) powder infusion. Apply unprocessed powder externally multiple times. Encourage prolonged medication to prevent recurrence.
[Xue Ji's Cases] Non-closure of the Yumen (vaginal opening) indicates deficiency of Qi and Blood; use Shiquan Dabu Tang (Ten Significant Tonifying Decoction). Swelling and pain indicate deficient heat in the Liver Meridian; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If caused by sorrow and anger injuring Liver and Spleen Qi and Blood, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction). If caused by sudden anger injuring Blood with Liver Fire, use Longdan Xiegan Tang (Gentian Drain Liver Decoction). A postpartum patient with non-closing Yumen, fever, and chills was treated with Shiquan Dabu Tang plus Wuweizi (Schisandra Berry); after several doses, fever and chills subsided. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Wuweizi closed the Yumen after several doses. A woman with inherent weak Spleen/Stomach and Liver Fire presented with postpartum Yumen swelling/pain, alternating chills/fever, thirst, vomiting, and anorexia. After using external Dahuang (Rhubarb Root) and internal purgatives, swelling spread to buttocks with various symptoms arising, indicating true Qi deficiency and pathogenic excess. First, Liujunzi Tang (Six Gentlemen Decoction) was used to stabilize the intestines/stomach, then Bu Zhong Yi Qi Tang to raise Yang Qi; she recovered in a few doses. A postpartum patient with neglected treatment had persistent swelling/ulceration, emaciation, poor appetite, morning chills/evening fevers, spontaneous and night sweats for six months. Bu Zhong Yi Qi Tang plus Fuling (Poria) and Banxia (Pinellia Tuber) reduced pus/fluid and improved appetite. Guipi Tang (Restore the Spleen Decoction) for over 50 doses cured her.
A postpartum patient with non-closing Yumen, dribbling urine, and abdominal masses moving to the hypochondrium causing distension/pain was cured with Jiawei Xiaoyao San plus Cheqianzi (Plantago Seed). A woman with uterine enlargement/prolapse, who had a piece torn off resembling pig liver, presented with sallow complexion, fatigue, anorexia, internal heat, afternoon tidal fever, and sweats. Shiquan Dabu Tang (Ten Significant Tonifying Decoction) for over 20 doses cured all symptoms and restored fertility.
Treatment for postpartum vaginal swelling, prolapse, and non-closing Yumen:
Duanshi (Calcined Limestone) (1 sheng, stir-fried until very hot), added to 2 sheng of water, mixed with ash, cooled to suitable temperature, clarified, and used for sitz baths to immerse the Yumen. Recovery occurs quickly.
Another formula: Push Tie Jing (Iron Essence/Powder) internally. Moxa 5-7 cones below the umbilical horizontal line.
Another method: Mix Tie Jing (Iron Essence) and Yang Zhi (Sheep Fat) until thick, wrap in cloth, heat, foment, and push inside. (Tie Jing is dust-like, purple, light, and porous material from iron forging furnaces, used for polishing vessels.)
[Zimu Beilu] For postpartum vaginal prolapse, burn rabbit heads to powder and apply.
[Bu Yi] For postpartum intestinal prolapse not retracting: Decoct Zhike (Bitter Orange) and soak for a long time to induce retraction. Another formula: Soak in Wubeizi (Chinese Gallnut) and Bai Fan (Alum) decoction. Another formula: Decoct Suanning Cao (Old Crow Acid/Oxalis species), sit on a non-perforated grass pad to fumigate; when halfway retracted and slightly warm, wash manually and assist retraction.
Another formula: For uterine prolapse, wash with warm water to soften, then fumigate with smoke from burning Xiong Shufen (Male Rat Feces). Another method: Mash 14 Castor Seeds (Bimazi) without shells, apply to Baihui (DU20) acupoint; wash off immediately upon retraction.
[Dong Yuan's Cases] Prolapse of the birth canal with constant dampness: Shenque (CV8), Yuquan (GV19) - Moxa 50 cones. Shenjiao (Intercranial space below umbilicus) - Moxa 50 cones, repeat three times.
Another method: 3 cun lateral to Yuquan (GV19) - Moxa age-in-cones, repeat three times. Cold swelling of female genitalia: Guilai (ST29) - Moxa 30 cones.
[Jia Yi Jing] Vaginal prolapse, limpness of four limbs, body heaviness/distress: Shaohai (HT3) controls it. (Alternative: Zhaohai, KI6).
[Yinzhong Rouxian]
A postpartum patient had a fleshy cord emerging from the urinary tract, 3-4 chi long, causing excruciating pain upon touch. First, administer Shixiao San (Stop Pain Powder) several times. Then, take 3 jin of ginger with skin, mash, add 2 jin of clear oil, boil until oil is dry. Use silk to hold the fleshy cord, place it curved beside the urethra, fumigate with the prepared ginger. Foment if cool. After one day and night, it shrinks significantly; fully retracts in two days. Regulate with Shixiao San and Xionggui Tang (Ligusticum and Angelica Decoction). If the fleshy cord breaks, it is incurable.