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Difficult labor should be waited for calmly; one must strictly avoid manual intervention. Use Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Paeoniae Alba), Niu Xi (Radix Achyranthis Bidentatae), Ren Shen (Radix Ginseng), Wu Wei Zi (Fructus Schisandrae Chinensis), Huang Qin (Scutellariae Radix), Xing Ren (Semen Armeniacae Amarum), Bei Mu (Fritillariae Bulbus), Zhi Mu (Rhizoma Anemarrhenae), and Huang Bo (Phellodendri Cortex), each 0.8 fen, decocted with ginger and water. If blood and fluids stagnate, the fetus will move upon receiving moisture. If the pubic symphysis (Jiao Gu) fails to open, use Xiong Gui Tang plus a tuft of hair and one turtle shell.

Nan Chan San: Ren Shen and Pao Jiang (Roasted Ginger) decocted in water. If the fetus is malpositioned downwards, apply salt to the soles of the feet, have the midwife gently support with her hand, and instruct the parturient woman to inhale deeply once, after which the fetus will be delivered. Another method: Use one rabbit bone marrow, 3 fen of She Xiang (Musk), one Mu Ding Xiang (Clove), and 3 fen of Ru Xiang (Olibanum), grind into powder, form pills, dry in shade, and take one pill with wine at the time of labor. Another prescription: Stir-fry 5 qian of Yu Jiao (Fish Maw) until it forms beads, stir-fry 2 qian of Chuan Shan Jia (Pangolin Scales, from the dorsal ridge) until it forms beads, grind into powder, and take with boiling wine. The parturient woman must not lie down; suspend both flanks with cloth strips to facilitate delivery. Before labor, regular movement is beneficial. Use 1 liang of Fu Long Gan (Vermilion Dragon Liver/Calcined Soil), 2.5 qian of Ren Shen, 5 fen of Ru Xiang, and 5 fen of Mo Yao, grind into powder. For a 15-year-old, take 1.5 qian mixed with wine; for a 20-year-old, take 1.6 qian; add 4 li for every additional year of age. Excessive dosage is ineffective. To expel a dead fetus, take 1 liang of Fu Long Gan adjusted with Gan Cao (Licorice Root) decoction. For retained placenta, mix with vinegar and apply to the umbilicus, while internally administering Jia Wei Xiong Gui Tang.

If the fetus dies in the womb, the pubic symphysis fails to open, or it remains undelivered for five to six days with critical condition, use 1 liang of Dang Gui and 1 liang of Chuan Xiong (Szechwan Lovage Rhizome), a handful of hair from a living man or woman calcined to retain its properties, and one shell from a naturally dead turtle. Grind together into powder. Take 1 liang of this powder, decoct in water for a long time, and drink. This works for both living and dead fetuses.

Case Record: A woman had a retained placenta. She was given Sha Ren (Amomum Fruit) powder, approximately 1 qian, washed down with Ren Shen decoction, two to three times a day. After three to four days, the placenta rotted and was expelled; the woman remained healthy.

Postpartum care should primarily focus on major tonification and warming. When blood is lost, Qi must be supplemented; warmth promotes blood circulation. Tonifying and regulating Qi and Blood prioritizes strengthening the Spleen, with blood-nourishing herbs as secondary. Various complications are numerous and need not all be treated individually. For lower abdominal distension and pain, use Yi Mu Cao (Motherwort), Rou Gui (Cinnamon Bark), Mu Xiang (Aucklandiae Radix), and Yan Hu Suo (Corydalis Rhizome); these are also effective for dysmenorrhea. If using Dan Pi (Moutan Cortex) and Hong Hua (Carthami Flos), Rou Gui is suitable for extreme heat, and cold-inducing herbs for extreme cold. Alternating chills and fever indicate deficiency of both Qi and Blood; use Shi Quan Da Bu Tang. For general weakness, use Bao Yuan Tang added with Pao Jiang and Rou Gui.

In the postpartum period, any vomiting or diarrhea belongs to Spleen and Stomach disorders. In the first one or two months, if illness occurs, use Bao Yuan Tang or Si Jun Zi Tang added with Sheng Jiang (Fresh Ginger) and Rou Gui. For abdominal distension and pain due to stagnant blood, add a small amount of Wu Zhu Yu (Evodiae Fructus). Phlegm does not require specific treatment; major tonification and warming will resolve it spontaneously.

For severe leg pain postpartum, use Si Wu Tang totaling 1 liang, added with Qiang Huo (Notopterygii Rhizoma et Radix) and Rou Gui 2 qian, decocted and taken.

For prolapse of the anterior vulva postpartum, warm the Middle Jiao. Use Ren Shen, Rou Gui, and Yan Hu Suo each 1 qian, Pao Jiang and Gan Cao each 0.8 fen. Warmth allows blood to circulate; regulate with Shi Quan Da Bu Tang. For posterior prolapse following diarrhea, use Bao Yuan Tang added with Pao Jiang. Strictly avoid cold and cooling herbs.

For involuntary urination, use Long Gu (Fossilized Bones) and Wen Ge (Clam Shell), each 1 liang, ground into powder, taken with Ren Shen decoction. For incomplete closure of the vaginal introitus, use Shi Quan Da Bu Tang added with Wu Wei Zi to astringe. For uterine inversion/prolapse, use Bu Zhong Yi Qi Tang added with Vinegar-processed Bai Shao and Ban Xia to lift and raise.

For postpartum syncope and unconsciousness with abundant phlegm, use Chuan Wu (Aconiti Lateralis Radix Praeparata), Dang Gui Shen (Dang Gui root tip), Rou Gui, and Ren Shen decocted and taken; self-healing occurs as blood discharges. Regulate with Shi Quan Da Bu Tang.

When women experience miscarriage or prolonged bleeding leading to coma, unresponsiveness, and loss of sensation, it is due to sudden massive blood loss. The Heart loses its blood nourishment, and the Spirit has no support. The Heart and Pericardium cannot stabilize. Using cold and cooling herbs causes Qi leakage due to blood deficiency and Yang leakage due to Yin deficiency, resulting in dual injury. One should tonify and generate blood. Once the Heart is nourished by blood, the Spirit will not be confused. Use Hong Hua 3 fen, Man Jing Zi (Vernoniae Fructus) and Xi Xin (Asari Radix et Rhizoma) each 5 fen, Sheng Di Huang (Rehmanniae Radix) and Shu Di Huang (Prepared Rehmanniae Radix) each 1 qian, Gao Ben (Ligustici Rhizoma et Radix) and Chuan Xiong each 1.5 qian, Fang Feng (Saposhnikoviae Radix), Qiang Huo, Gan Cao, and Dang Gui each 2 qian, and Bai Shao 3 qian. Grind into powder, take 5 qian per dose, decoct in water, and drink.

Failure of lactation in women is due to Gallbladder deficiency. Use Tong Cao (Tetrapanacis Medulla) 2 qian, Chuan Shan Jia 1 qian, and Mu Man Tou (Artocarpis Hypargyreus Fruit) 1 piece. Grind these three into powder, boil in pig trotter soup until soft, and eat. If lactation still does not occur, add Ji Xing Zi (Strychnos Nux-vomica Seed) 5 qian for effectiveness.

Case Record: A woman bathed three days after delivery. Her pulse was floating, large, and rapid, more pronounced on the left side. Bu Zhong Yi Qi Tang added with Fang Feng and Qiang Huo was used but did not fully cure. This indicated interior deficiency and exterior excess. The prescription was changed to Bao Yuan Tang added with Dang Gui, Bai Shao, and Pao Jiang, which resulted in recovery.

A woman experienced cessation of bleeding and abdominal pain two days postpartum, with pain relieved by pressure. Ren Shen 3 qian was decocted with Rou Gui, Pao Jiang, and Wu Zhu Yu; the blood stasis expelled itself.