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，多因受惊动胎过早，或触犯禁忌，导致产程艰难。此时胞浆已破，缺乏血液滋养胎儿，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，应当使用下法排出死胎。基本治疗原则是：寒证用热药以推动气血运行，热证用凉药以清热下行，燥证用滑润药以滋润肠道，危急重症则用有毒药物攻下。
〔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；或未到产期却先见经血（恶露）流尽，导致胎儿干枯死亡、身体冰冷无法自行娩出。观察指征为：产妇面色红赤、舌色青黑，这是胎儿死亡的征兆。若面色青黑、舌色红赤，则是母死子活。若嘴唇青紫、吐白沫，则母子俱亡。还有双胎的情况，可能一死一活，症状难以辨别，需根据当时情况灵活判断。
配方：熟地黄（洗净、切片、焙干、酒炒）、真蒲黄、大当归、交趾桂（肉桂的一种）、杨芍药（白芍）、军姜（炮姜，去皮）、粉草（甘草，各一两）、小黑豆（四两）、百草霜（五钱）。
制法与用法：将上述药材研为细末。每次服用二钱，用米醋半合许，注入沸水六七分满浸泡至温热后服用。在胎儿生死未卜之际，可先服用佛手散，用酒和水混合煎煮二三服以试探。若胎儿未死，母子均安；若胎儿已死，立即排出。确知胎儿死后，服用此药后可再进香桂散，片刻间胎儿即可如被手推般娩出。常用于催生，若加入好滑石末半两、葵子五十粒捣碎、黄柞叶七八片、葱白二寸，顺流水煎汤调服效果更佳。因为滑石能通利小便，柞叶行气逐瘀，葱白内通阳气，气盛血行则分娩顺利。
〔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，片刻间胎儿即可娩出。（又名桂香散。）
此药相比用水银等药物，不损伤气血。（赵和叔传授）另一单方仅用桂末一钱，疼痛时用童子尿调服，名为救苦散。
曾有一位稳婆的女儿，勤劳辛苦负重，怀孕后腹部感觉阴冷沉重下坠，口中气味秽浊。我推测其胎儿必死，让她查看舌头，果然青黑。给予朴硝约半两服用，随后排出污秽液体而痊愈。另一位妇女胎儿死亡，服用朴硝后排出污秽液体，但肢体倦怠，气息微弱。以四君子汤为主方，佐以四物汤、生姜、肉桂进行调理补益而痊愈。
〔寒剂〕
治疗妊娠三至五个月，胎儿死于腹内无法排出。
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（黄芩，各半两）。
制法与用法：将上述药材制成粗末。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：治疗死胎不下。朴硝半两研细，用温热的童子尿调服，屡见奇效。
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，分为两服，每服用酒和水各一盏，煎至一盏量，然后投入朴硝末半两，再煎三五沸，温服，死胎化为血水下排。
〔本草/方书〕治疗胎儿死于腹中不出。用辰砂一两，水煮四五沸，研为粉末，然后用酒调服，胎儿立即产出。
〔外台〕治疗胎儿死于腹中。真珠二两研为粉末，用酒调服尽，胎儿立即产出。
〔滑剂〕
《千金方》治疗小儿死于腹中。葵子末用酒送服一方寸匕。若牙关紧闭不开，撬开灌入，药下即活。
治疗妊娠胎死腹中，或母亲患病欲下胎。榆白皮煮汁服用二升。
〔大全〕治疗胎儿死于腹中，或半生不下来，或卡在脊骨处，或在草丛中生产（指难产），血气上冲扰动母心，面无血色，气息将绝。
配方：猪脂（一斤）、白蜜（一升）、醇酒（二升）。
制法与用法：将这三味药合煎取二升，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。此方屡获奇效，救人无数。
配方：鬼臼（黄色者，用量不限，去毛，碾为极细粉末，过筛不用，用手指捻之）。
制法与用法：每次服用二钱，用无灰酒一盏，同煎至八分，一次性口服，效力如神。
〔世医〕治疗生产不顺，胎死腹中，胞衣不下，临产危急，妙方。
配方：蛇蜕（一条，完整的，在香油灯上烧焦，研磨）、麝香（少许）。
制法与用法：研为细末，用童子尿、酒各半盏调服一服，即可生出，有效。
杨氏疗法：治疗怀孕月数未满，胎儿死于腹中，母亲昏闷欲绝。取大豆（一方用黑豆）三升，用醋煮成浓汁三升，一次顿服，立见奇效。
《本事方》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，分两次温服。
又一方：取死胎，用乌鸡一只，去尾细切，加水三升，煮取二升，去掉鸡肉，用手拿着衣帛蘸取药液，摩擦脐下，胎儿自然排出。
Dystocia with fetal death in utero is often caused by premature disturbance of the fetus or violation of taboos, leading to difficult labor. At this stage, the amniotic sac has ruptured, and there is insufficient blood to nourish the fetus, causing it to wither and die. It is necessary to examine the mother's tongue; if it appears cyanotic or black, the fetus is dead, and purgative methods should be employed to expel the dead fetus. The general principles are: for cold patterns, use hot herbs to promote circulation; for heat patterns, use cool herbs to clear heat and descend; for dryness patterns, use slippery/lubricating herbs to moisten; for critical emergencies, use toxic drugs to purge.
[Hot Agents]
Wujin San (Black Gold Powder): Treats dystocia accompanied by febrile disease and fetal death in utero; or caused by falls, jumping from heights, sexual activity inducing convulsions, premature disturbance before labor, violation of taboos, or vaginal bleeding (lochia) occurring before term, exhausting fluids and causing fetal desiccation and death, with a cold body unable to deliver spontaneously. Clinical signs include a red face and cyanotic tongue, indicating fetal death. A cyanotic face with a red tongue indicates maternal death with fetal survival. Cyanotic lips with foaming at the mouth indicate death of both mother and child. In twin pregnancies, one may be alive and the other dead, making diagnosis difficult; observe changes dynamically.
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 Alba), Jun Jiang (Prepared Zingiberis Rhizoma, peeled), Fencao (Glycyrrhizae Radix et Rhizoma, each 1 liang), Xiaoheidou (Small Black Soybeans, 4 liang), Baicaoshuang (Soot from burning hundred herbs, 5 qian).
Preparation and Administration: Grind all ingredients into fine powder. Take 2 qian per dose, mix with approximately half he of rice vinegar, add boiling water to fill six or seven parts, let stand until warm, then drink. If the status of the fetus is uncertain, first administer Foshou San (Buddha's Hand Powder), decocted with wine and water, two or 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 to induce labor. For better lubrication, add Banliang of high-quality Huashi (Talcum) powder, 50 crushed Kuizi (Abutili Semen), 7-8 leaves of Huangzuo Ye (Toxicodendron vernicifluum leaf), and 2 cun of Congbai (Scallion White). Decoct in flowing water and take with the liquid. Huashi promotes urination, Huangzuo Ye moves qi and dispels blood stasis, and Congbai unblocks yang qi internally; when qi is vigorous and blood flows, delivery occurs smoothly.
[Daquan] Formula for Expelling Dead Fetus: Guizhi (Cinnamon Twig, 2 qian), Muxiang Dangmenzi (Musk, 1 piece). Grind together and take with warm wine. The fetus will be expelled within moments. (Also known as Guixiang San.)
This formula does not damage qi and blood like mercury-based preparations do. (Transmitted by Zhao Heshu.) Another single herb prescription uses only 1 qian of Guimo (Cinnamon Bark powder), taken with urine from an uncircumcised boy during pain, named Jiuku San (Save Suffering Powder).
Case: 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 asked her to show her tongue; it was indeed cyanotic and black. She was given Banliang of Xiaomiao (Mirabilite) orally, after which foul fluid was discharged, and she recovered. Another woman had a dead fetus; after taking Xiaomiao, foul fluid was discharged, but she suffered from limb fatigue and faint breathing. She was treated primarily with Sijunzi Tang (Four Gentlemen Decoction), supplemented with Siwu Tang (Four Substances Decoction), Shengjiang (Fresh Ginger), and Rougui (Cinnamon Bark) to regulate and tonify, resulting in recovery.
[Cold Agents]
Treats fetal death in utero between the third and fifth months of pregnancy, unable to be expelled.
Ingredients: Dafuzi (Arecae Pericarpium), Chishaoyao (Red Peony Root), Yubaipi (Ulmus Alba Cortex, each 3 liang), Danggui (Angelicae Sinensis Radix, stir-fried, 1 liang), Huashi Mo (Talcum Powder, 7 qian 5 fen), Qumai (Diantherae Herba), Kuizi (Abutili Semen, stir-fried), Fuling (Poria), Fencao (Glycyrrhizae Radix et Rhizoma), Ziqin (Scutellariae Radix/Baical Skullcap Root, each half liang).
Preparation and Administration: Make into coarse powder. Take 4 qian per dose, add one zhan of water, decoct to seven parts, strain, and take warm at any time.
Transmission by County Magistrate Deng: For retained dead fetus. Xiaomiao (Mirabilite) half liang, ground fine, mixed with warm urine from an uncircumcised boy, taken orally, showing frequent efficacy.
For retained dead fetus with cyanotic nails, cyanotic tongue, abdominal distension and stuffiness, and fecal odor in the mouth. First, administer Pingwei San (Regulate the Stomach Powder) 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 Banliang of Xiaomiao Mo (Mirabilite Powder), boil for three to five boils, take warm. The dead fetus will transform into bloody fluid and discharge.
[Benzao/Fangshu] For fetal death in utero not being expelled. Use Chencha (Cinnabar) one liang, boil in water for four or five boils, grind into powder, then take with wine. The fetus will be expelled immediately.
[Waitai] For fetal death in utero. Zhenzhu (Pearl) two liang, ground into powder, take fully with wine. The fetus will be expelled immediately.
[Slippery Agents]
Qianjin Fang (Essential Prescriptions Worth a Thousand Gold) treats fetal death in utero. Take Kuizi Mo (Abutili Semen Powder) with wine, one fangcun bi (approx. 2-3 grams). If the jaw is locked and cannot open, pry it open and pour the medicine in; life will be restored upon ingestion.
For fetal death in utero during pregnancy, or when the mother is ill and wishes to expel the fetus. Boil Yubaipi (Ulmus Alba Cortex) in water and take two sheng.
[Daquan] For fetal death in utero, or partial birth failure, or the fetus stuck against the spine, or dystocia in grassy areas, with blood and qi rushing up disturbing the heart, pale complexion, and impending respiratory failure.
Ingredients: Zhizhi (Lard, one jin), Baimi (White Honey, one sheng), Chunjiu (Pure Wine, two sheng).
Preparation and Administration: Combine these three ingredients, decoct to obtain two sheng. Divide into two warm doses. If unable to drink wine, take according to tolerance.
[Furen Liangfang] Yizi Shensan (One-Character Divine Powder): For retained dead fetus and ruptured membranes failing to deliver. This formula has proven highly effective, saving countless lives.
Ingredient: Jiubai (Podophylli Fructus, yellow variety, amount unspecified, remove hairs, grind into extremely fine powder like flour, do not sieve, check texture with fingers).
Preparation and Administration: Take 2 qian per dose, decoct with one zhan of non-fermented wine (Wuhui Jiu) until reduced to eight parts. Take orally in one go. Effect is miraculous.
[Shiyi] For difficult labor, fetal death in utero, retained placenta, and critical labor conditions. Excellent.
Ingredients: Shetui (Snake Slough, one whole piece, burned over sesame oil lamp, ground), Muxiang (Musk, a small amount).
Preparation and Administration: Grind into powder. Mix with half zhan of urine from an uncircumcised boy and half zhan of wine. Take one dose. Effective.
Yang Shi's Therapy: For pregnancy less than full term with fetal death in utero, causing maternal syncope. Take Dasdou (Soybean, or Black Soybean in another version) three sheng, boil in vinegar to make a thick juice of three sheng. Take in one dose. Immediate effect.
[Benshi Fang] For febrile disease during pregnancy with fetal death in utero. Lujiaoxie (Deer Horn Chips) one liang, water one zhan, five stalks of Scallion, Douchi (Fermented Soybean Paste) half he. Decoct together to six parts, strain, and divide into two warm doses.
Another Prescription: Obtain the dead fetus, use one Utiji (Black-bone Chicken), remove tail, cut finely. Add three sheng of water, decoct to two sheng. Remove chicken meat. Dip cloth into the liquid and massage the area below the umbilicus with hands. The fetus will naturally be expelled.