Library

9. The intestines prolapse before the delivery of the placenta, or remain outside after the infant is delivered. Apply a paste of Ricinus communis seed (Bì Mǎn Rén) to the Baihui acupoint (Dùnníng, GV20) on the vertex, and administer internal decoctions that tonify and raise Qi. If the prolapsed tissue is dry, lubricate it with ghee (Nǎi Sū Yóu) to facilitate reduction.

[Annotation] In pregnant women experiencing "pan chang sheng" (prolapse of the uterus or rectum during labor), the intestines may protrude before delivery and fail to retract even after the infant is born. In such cases, apply crushed Ricinus communis seeds to the center of the vertex (Baihui acupoint). Internally, administer formulas that lift and tonify Qi, such as Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), or Bajun Tang (Eight Treasures Decoction) and Shiquan Dabu Tang (Ten Significant Tonifying Decoction) with added Chishengma (Radix Bupleuri et Rhizoma Cimicifugae, often referring to Chaihu in this context for lifting action). This will naturally cause the prolapse to retract.
The prescriptions for Buzhong Yiqi Tang and Shiquan Dabu Tang are found in the first volume of this book.

10. The causes of dystocia (difficult labor) are manifold: excessive comfort and sleepiness during pregnancy, fright and timidity at labor, premature pushing, rupture of the amniotic sac with blood stasis, and depletion of amniotic fluid.

[Annotation] The causes of dystocia in pregnancy are not singular. Some women prefer comfort and cannot endure physical labor during pregnancy, or sleep excessively, all of which can lead to stagnation of Qi and difficult labor. Others experience fright and Qi deficiency at the onset of labor, or push too early, leading to maternal exhaustion and difficult labor. Some suffer from injury to the amniotic sac with bleeding, causing blood stasis obstructing the birth canal; others have premature rupture of membranes with drying up of amniotic fluid and blood. All these can result in dystocia. Clinicians must carefully examine these factors.

11. Retained placenta in primiparas may be due to fatigue from excessive effort, cold-dampness coagulating blood, excessive postpartum bleeding causing dryness of the birth canal, or blood entering the placenta causing abdominal distension and pain. Urgently administer Duoming Shejie San (Life-Restoring Myrrh and Dragon's Blood Powder) to prevent evil qi from rushing to the heart and chest, causing panting and fullness. Instruct the midwife to remove the placenta along with the fetus. Do not alarm the mother, nor let her hear about it, to avoid fear exacerbating the condition.

[Annotation] When a parturient experiences retained placenta, it may be due to fatigue from excessive effort during first childbirth, combined with interference from wind-cold causing blood stasis and coagulation. Or it may be due to excessive postpartum hemorrhage leading to blood depletion and dryness of the birth canal. Or blood may enter the placenta, causing distension and pain, preventing its expulsion. In all cases, urgently use Duoming San (Life-Restoring Powder), which consists of Myrrha (Mò Yào) and Xuejie (Sanguis Draconis, Dragon's Blood) ground into powder. This prevents the pathogenic factor from attacking the heart and chest, causing distension, fullness, and急促 breathing, which would be harmful. Furthermore, instruct the midwife to remove the placenta following the delivery of the infant. Do not let the mother hear about it, as fear may make expulsion even more difficult.