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Dystocia with uterine prolapse (Pan Chang Chan) refers to a condition where the uterus prolapses (Zi Chang) and emerges before the fetus during delivery, followed by the birth of the fetus. The uterus may not retract immediately; apply forty-nine crushed castor seeds (Bì Mǎn Zǐ, Ricini Semen) on the vertex of the head. Once the uterus retracts, wash it off immediately; delaying this may cause harm. Another method uses only forty peeled castor seeds ground into a paste, applied to the center of the vertex. Wipe it off as soon as retraction occurs.

Difficult labor (Nan Chan) is caused by the separation of the pubic symphysis (Jiao Gu Bu Kai), preventing delivery. Administer Jiawei Xiong Gui Tang (Modified Ligusticum and Angelica Decoction); the fetus will be delivered after a short while.
Xiao Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1 liang) Dang Gui (Angelica Sinensis Radix, 1 liang) Bie Jia (Testudinis Carapax et Plastrum, one piece, prepared with wine) Fa Hui (Capilli Cinis, one handful)
Decoct with one zhong of water until reduced to seventy percent, then take orally.
Verse: When the pubic symphysis fails to separate, labor becomes difficult;
Prepare Testudo shell with wine, combined with Dang Gui and Chuan Xiong.
Add a handful of hair ash, decoct and take;
The fetus leaves the jade palace upon ingestion.

Fetal death in utero (Si Chan) indicates the fetus has died inside the womb. Verification involves observing a bluish-black tongue in the mother, confirming fetal death. First, administer Ping Wei San (Calm the Stomach Powder) once, decocted with equal parts water and wine to eighty percent volume. Add Mang Xiao (Mirabilite) and decoct again to facilitate expulsion. Using fresh urine from a healthy child (Tong Bian) is also effective, followed by restorative tonics for recovery.
Verse: Fetal death in the womb is called Si Chan;
A bluish-black tongue in the mother allows for decisive judgment.
Ping Wei San is decocted with water and wine together;
Then add Mang Xiao to expel the fetal remains.

Retained placenta (Bao Yi Bu Xia) can be treated by administering Shixiao San (Wu Ling Zhi and Pu Huang Powder) with hot wine, or Yi Mu Wan (Motherwort Pill), or sending Lu Jiao Hui (Deer Horn Ash) with Sheng Hua Tang (Invigorate Blood Decoction). Alternatively, induce vomiting by having the mother ingest her own hair, which will expel the placenta. In cases of Qi deficiency failing to expel the placenta, abdominal distension and pain occur; use Sheng Hua Tang alone.
Quan Dang Gui (Angelica Sinensis Radix, 1 liang) Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 3 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Xiang Fu (Cyperi Rhizoma, 1 qian)
Adding Ren Shen (Ginseng Radix, 3 qian) yields better results; decoct with water and take orally.
Another prescription uses two liang of castor seeds and two qian of Xiong Huang (Realgar), ground into a paste and applied to Yong Quan (KI1, Bubbling Spring) acupoint on the sole. Wash off immediately after the placenta is expelled.
Ping Wei San (Calm the Stomach Powder)
Nan Cang Zhu (Atractylodis Macrocephalae Rhizoma, soaked in rice water and stir-fried) Hou Po (Magnoliae Officinalis Cortex, stir-fried with ginger) Chen Pi (Citri Reticulatae Pericarpium) Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata, each 2 qian)
Grind into coarse powder. Decoct with water or wine. When nearly done, add two qian of Mang Xiao (Mirabilite), boil for one or two more boils, and take warm.
Shixiao San (Wu Ling Zhi and Pu Huang Powder)
Wu Ling Zhi (Trogopterori Faeces) and Pu Huang (Typhae Pollen) are both ground into fine powder. Take three qian per dose, administered with hot wine.