〔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，导致阴道脱出，状如脱肛，或阴道内组织挺出，伴有压迫性肿痛。举重、房事劳累等因素均可诱发此病，表现为阴道持续流出清水，小便淋漓不尽。
硫黄散：治疗产后因劳伤导致的阴道脱出。
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：治疗产后阴道肿胀不适。
药材：桃仁（去皮尖）、枯矾、五倍子（各等分）。
制法与用法：将枯矾和五倍子研为细末，将桃仁研磨成膏状，两者拌匀后外敷。
硫黄汤：治疗产后因劳损导致的外阴口开张不闭合。
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：每次取药四钱，加水一碗，煮沸数次，滤去药渣，用汤汁清洗外阴口，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道疼痛。
当归散：治疗阴道脱出。
药材：当归、黄芩（各二两）、芍药（一两半）、[皮]（烧至存性，半两）、牡蛎（二两半）。
*注：原文“皮”前缺字，据《证治准绳》及上下文推测可能指某种树皮或特定药材，此处保留原文“皮”。*
制法与用法：将上述药物研为细末，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】一位三十多岁的妇人，生下女儿两天后，产户中脱出一物状如手帕，下方有手帕的尖角，重量约一斤。我思考认为，这是因为产前劳累乏力，损伤了气机，导致肝痿所致。幸好其血虚不严重。当时正值岁末天寒，担心寒冷使组织干枯坏死，于是急用炙黄芪半钱、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，全身出汗后病情安定。但脱出部分接触席子干燥脱落的一片，约重五六两，那是脂膜。患者饮食增加并能安睡，诊脉皆涩，左脉略弦，视其形体却显得充实。随后给予白术、芍药各一钱半，陈皮一钱，生姜一片，煎服二三帖以调养身体。
另一位妇人生子后，阴道中脱出一物状如合钵，分为两歧。其丈夫来求治，我思考认为这是子宫脱出，必定是因为气血虚弱而下坠。于是使用升麻、当归、黄芪，大剂量两帖给予她。半天后，其丈夫再次前来说，服药两次后听到一声响，查看发现已收纳入阴道内，但因隔了一夜干粘在席子上，破了一片如掌心大小在席子上，妻子在家哭泣，担心破损后无法再生。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，如果气血充盛，必定能重新生长充满。于是使用四物汤加人参，给予一百帖。三年后该妇人又生育了孩子。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，去渣饭后服用。同时用五倍子末泡汤清洗。再用未敷过的药粉外敷，如此多次，宜多服药，可防止再次下脱。
【薛己医案】外阴口不闭合，是气血虚弱所致，使用十全大补汤。肿胀疼痛，是肝经虚热所致，使用加味逍遥散。若因忧怒导致肝脾气血受损，使用加味归脾汤。若因暴怒导致肝火伤血，使用龙胆泻肝汤。一位产妇外阴口不闭合，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，数剂后外阴口闭合。一位妇人脾胃素来虚弱，兼有肝火，产后外阴肿痛，寒热发作口渴，呕吐不能进食，外用大黄等药，内服驱利之剂，导致肿胀蔓延至臀部，各种症状蜂拥而起，这是真气虚弱而邪气亢盛。先用六君子汤以固护肠胃，次用补中益气汤以提升阳气，不数剂即痊愈。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，饮食逐渐恢复。又用归脾汤共五十余剂而痊愈。
一位产妇外阴口不闭合，小便淋漓，腹内有块状物，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，两天才入腹，脱落一片，极像猪肝，面色黄形体疲倦，饮食无味，内热午后潮热，自汗盗汗，使用十全大补汤二十余剂，所有症状悉愈，后来恢复了生育能力。
治疗产后阴道肿胀下脱内出，外阴口不闭合。
煅石（一升，炒至极热）加入水二升，投入灰中，待温度适宜冷暖适中，澄清后坐浴浸泡外阴口，片刻即可平复如初。
又一方，用铁精粉推入阴道内。又一方，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，推入阴道内。（铁精是锻铁炉中飞出的如尘般的物质，紫色且轻虚，可以用来磨光器皿。）
【子母秘录】治疗产后阴道脱出，烧兔头研末敷之。
《补遗》治疗产后直肠脱出不收。用枳壳煎汤，浸泡良久即可回纳。又一方，五倍子、白矾煎汤浸泡也良效。又一方，酸笃草俗名老鸦酸，煎汤，用无孔草垫坐，刚熏到收一半时，稍温时下手清洗，并协助收入而安。
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，去壳捣烂涂于头顶心，如已回纳即洗去。
【东垣医案】妇人胞胎门下垂不收，常感潮湿。神阙穴、玉泉穴（灸五十壮）；身交穴（脐下指缝中，灸五十壮，需重复三次）。
又法：玉泉穴旁开三寸（灸随年壮，需重复三次）。女人阴门冷肿。归来穴（灸三十壮）。
【甲乙经】妇人阴挺出，四肢湿冷，身体困闷。少海穴主治。（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。先服用失笑散数次，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。一天一夜收缩大半，两天即完全回纳。再服用失笑散、芎归汤调理。如果肉线断裂则不可治了。
[Sanyin Fang] When women exert excessive force during labor, it may cause the vagina to prolapse, resembling rectal prolapse, or tissue within the vagina protrudes externally, accompanied by a sensation of pressure and swelling pain. Heavy lifting and sexual fatigue can also trigger this condition, presenting with continuous discharge of clear fluid from the vagina and dribbling urination.
Liuhuang San (Sulfur Powder): Treats vaginal prolapse due to labor injury postpartum.
Ingredients: Liuhuang (Sulfur), Wuzuiyu Gu (Cuttlefish Bone) (each 0.5 liang), Wuweizi (Schisandra Fruit) (2.5 qian).
Preparation and Administration: Grind the above ingredients into fine powder and apply locally to the affected area.
Taoren Gao (Peach Kernel Ointment): Treats vaginal swelling and discomfort postpartum.
Ingredients: Taoren (Peach Seed, peeled and core removed), Kufan (Alum), Wubeizi (Chinese Gallnut) (equal parts).
Preparation and Administration: Grind Kufan and Wubeizi into powder, grind Taoren into paste, mix evenly, and apply externally.
Liuhuang Tang (Sulfur Decoction): Treats patulous vulva (Yumen open and not closing) due to labor strain postpartum.
Ingredients: Liuhuang (Sulfur) (4 liang), Wuzhuyu (Evodia Fruit), Tusizi (Dodder Seed) (each 1.5 liang), Shechuangzi (Cnidium Fruit) (2 liang).
Preparation and Administration: Take 4 qian of the mixture per dose, add one bowl of water, boil several times, filter the dregs, and wash the Yumen (vulva) with the liquid. Wash twice daily.
Moxibustion/Warming Method:
Stir-fry Shechuangzi (Cnidium Fruit) alone until hot, wrap in cloth while hot, and apply as a warm compress to the affected area. This method is also effective for postpartum vaginal pain.
Danggui San (Angelica Sinensis Powder): Treats vaginal prolapse.
Ingredients: Danggui (Angelica Sinensis Root), Huangqin (Scutellaria Root) (each 2 liang), Shaoyao (Peony Root) (1.5 qian), [Pi] (Bark, charred to retain efficacy, 0.5 liang), Muli (Oyster Shell) (2.5 liang).
*Note: The character before "Pi" is missing in the original text; retained as "Pi".*
Preparation and Administration: Grind the above ingredients into powder. Take 2 qian per dose, mixed with warm wine or rice soup as desired. Avoid climbing heights and lifting heavy objects.
[Case by Zhu Danxi] A woman in her thirties, two days after delivering a daughter, had an object protruding from the vagina resembling a handkerchief with a pointed tip at the bottom, weighing approximately one jin. I reasoned that this was caused by pre-natal fatigue and Qi deficiency leading to Liver Wei (Liver Flaccidity). Fortunately, blood deficiency was not severe. Given the cold weather at year-end, I feared cold damage causing necrosis. I urgently prescribed Zhi Huangqi (Prepared Astragalus Root) 0.5 qian, Renshen (Ginseng Root) 1 qian, Baizhu (Atractylodes Macrocephala Rhizome) 0.5 qian, Danggui (Angelica Sinensis Root) 1.5 qian, and Shengma (Cimicifuga Rhizome) 0.5 qian. After three doses taken consecutively, the prolapse retracted. General sweating followed, and she stabilized. However, a piece of the protruding tissue, which had dried against the mat, fell off, weighing about 5-6 liang; this was adipose membrane. Her appetite improved, and she slept well. Pulse diagnosis showed all pulses were choppy (Se), with the left pulse slightly wiry (Xuan). Her physical appearance appeared robust. Subsequently, I prescribed Baizhu (Atractylodes Macrocephala Rhizome) and Shaoyao (Peony Root) each 1.5 qian, Chenpi (Tangerine Peel) 1 qian, and Shengjiang (Fresh Ginger) one slice, decocted and taken for 2-3 doses to nourish her.
In another case, a woman had an object resembling a lidded pot with two lobes protruding from the vagina after delivery. Her husband sought treatment. I reasoned this was uterine prolapse due to weak Qi and Blood sinking. I prescribed Shengma (Cimicifuga Rhizome), Danggui (Angelica Sinensis Root), and Huangqi (Astragalus Root) in large doses for two packets. Half a day later, the husband returned, stating that after two doses, he heard a sound, and upon inspection, the uterus had retracted into the vagina. However, a piece the size of a palm had broken off and stuck to the mat overnight. His wife was weeping, fearing irreparable damage. I reasoned this was not intestine but placental residue (Tai Gao). Muscle tissue can heal; if Qi and Blood are sufficient, it will regenerate. I prescribed Siwu Tang (Four Substance Decoction) plus Renshen (Ginseng Root) for 100 doses. Three years later, she gave birth again. For treating uterine prolapse, use Huangqi (Astragalus Root) 1.5 qian, Renshen (Ginseng Root) 1 qian, Danggui (Angelica Sinensis Root) 0.7 qian, Shengma (Cimicifuga Rhizome) 0.3 qian, Gancao (Licorice Root) 0.2 qian. Decoct one packet in one cup of water until reduced to half, filter, and take before meals. Also wash with Wubeizi (Chinese Gallnut) powder infusion. Apply external powder multiple times. Long-term medication prevents recurrence.
[Case by Xue Ji] Patulous vulva (Yumen not closing) is due to Qi and Blood deficiency; treat with Shiquan Dabu Tang (Ten Ingredient Great Tonifying Decoction). Swelling and pain indicate deficient heat in the Liver Meridian; treat with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If caused by worry and anger damaging Liver and Spleen Qi and Blood, use Jiaweigui Pi Tang (Modified Heart-Spleen Tonifying Decoction). If caused by sudden anger damaging Liver Fire and Blood, use Longdan Xiegan Tang (Gentian Decoction to Drain the Liver). A postpartum patient with patulous vulva, fever, and chills was treated with Shiquan Dabu Tang (Ten Ingredient Great Tonifying Decoction) plus Wuweizi (Schisandra Fruit); fever and chills subsided after several doses. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Wuweizi (Schisandra Fruit) closed the vulva after several doses. A woman with inherent weak Spleen and Stomach and Liver Fire presented with postpartum vulvar swelling and pain, chills, fever, thirst, vomiting, and anorexia. External application of Dahuang (Rhubarb Root) and internal purgatives caused swelling to spread to the buttocks and various symptoms to arise, indicating true Qi deficiency and pathogenic excess. First, Liu Jun Zi Tang (Six Gentlemen Decoction) was used to stabilize the intestines and stomach, followed by Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to raise Yang Qi; she recovered in a few doses. A postpartum patient with untreated prolapse suffered persistent swelling and ulceration, emaciation, poor appetite, morning chills, evening fevers, spontaneous and night sweats for six months. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fuling (Poria) and Banxia (Pinellia Tuber) gradually reduced pus and improved diet. Guipi Tang (Heart-Spleen Tonifying Decoction) for over 50 doses led to recovery.
A postpartum patient with patulous vulva, dribbling urination, and abdominal mass radiating to the hypochondrium causing distension and pain was cured with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) plus Cheqianzi (Plantago Seed). A woman with uterine enlargement took two days to retract, shedding a piece resembling pig liver. With sallow complexion, fatigue, anorexia, internal heat, afternoon tidal fever, and sweating, she was treated with Shiquan Dabu Tang (Ten Ingredient Great Tonifying Decoction) for over 20 doses; all symptoms resolved, and fertility was restored.
Treatment for postpartum vaginal swelling, prolapse, and patulous vulva:
Duanshi (Calcined Stone) (1 sheng, stir-fried until very hot) added to 2 sheng of water, poured into ash. When temperature is suitable, clarify and sit in the water to soak the Yumen (vulva). It will recover quickly.
Another prescription: Push Tie Jing Fen (Iron Essence Powder) into the vagina.
Another prescription: Moxa five to seven moxibustions on the horizontal crease below the umbilicus.
Another method: Mix Tie Jing (Iron Essence) and Yangzhi (Sheep Fat) until thick, wrap in cloth, heat, and apply as a warm compress to push inside. (Tie Jing is dust-like substance flying from the iron forging furnace, purple, light, and porous, used for polishing vessels.)
[Zimu Milu] To treat postpartum vaginal prolapse, burn rabbit head to ash and apply.
[Buyi] To treat postpartum rectal prolapse: Decoct Zhike (Aurantii Fructus) and soak for a long time to facilitate reduction. Another prescription: Soak in decoction of Wubeizi (Chinese Gallnut) and Baifan (Alum). Another prescription: Decoct Suanducao (Old Crow Acid Grass), sit on a non-perforated grass pad, fumigate until partially retracted, then wash gently when warm and assist retraction.
Another prescription: For uterine prolapse, wash with warm water to soften, then fumigate with smoke from burning Xiong Shufen (Male Rat Feces) to induce retraction. Another method: Crush 14 Castor Seeds (Bibanzi) without shell, apply to Baihui (GV20) on the vertex. Wash off once retracted.
[Dong Yuan] For prolapsed womb not retracting with constant dampness: Moxa Shenque (CV8) and Yuquan (50 moxibustions); Shenjiao (midway between umbilicus and pubic symphysis, 50 moxibustions, repeated three times).
Another method: Moxa point 3 cun lateral to Yuquan (moxibustion according to age, repeated three times). For cold swelling of female genitalia: Moxa Guilai (ST29) (30 moxibustions).
[Jia Yi Jing] For vaginal prolapse with wet limbs and body heaviness: Shaohai (HT3) is indicated. (Alternatively, Zhaohai (KI6)).
[Fleshy Cord in Vagina]
A postpartum patient had a fleshy cord emerging from the urinary/vaginal 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, crush it, add 2 jin of clear oil, and boil until oil is dry. Use silk to hold the fleshy cord, place it curved beside the tract, fumigate with the remaining ginger. Warm compress if cool. After one day and night, it shrinks significantly; fully retracts in two days. Regulate with Shixiao San (Stop Pain Powder) and Xionggui Tang (Ligusticum and Angelica Decoction). If the fleshy cord breaks, it is incurable.