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Postpartum retention of the placenta occurs when blood enters the uterus, rushing upward to the chest and heart, causing Qi and Blood stagnation, distension, and oppression. The placenta fails to expel, leaving the woman in extreme distress, on the verge of death. It is necessary to drive out the blood using Honghua (Safflower) and Qiancao (Madder Root), decocted with wine for oral administration, or administer Puxiao San (Mirabilite Powder). In severe cases, Duoming Dan (Life-Rescuing Pill) should be used. If it still does not expel, and symptoms include hardness, distension, and acute pain around the umbilicus, bringing the patient to the brink of death, Niuxi Tang (Achyranthes Decoction) is indicated.

During pregnancy, excessive effort or falling may injure the fetus, resulting in lower back and abdominal pain, or fetal Qi rushing upward to the heart accompanied by bleeding. If injured by a fall from height, or by being pressed by heavy objects due to excessive straining, damaging the fetal Qi, leading to abdominal pain and vaginal bleeding, combined with Spleen/Stomach deficiency causing vomiting and nausea, use 2 qian of Ren (Amomum Fruit), stir-fried into powder, taken with wine, or use Foshou San (Buddha's Hand Powder).

There are two causes for premature rupture of the membranes: First, due to the mother's inherent weakness and deficiency of both Qi and Blood, the membranes become thin; as the fetus moves, contact causes them to rupture. Second, if the fetus has not yet rotated, and labor begins too early with excessive pushing, the membranes may rupture. If the membranes have been ruptured for a long time, the amniotic fluid dries up, making the birth canal slippery and difficult, hindering the fetus's descent. In such cases, urgently administer a large dose of Jiawei Xionggui Tang (Modified Angelica and Ligusticum Decoction), adding 1 liang of cooked honey to tonify Qi and provide lubrication, allowing the fetus to descend smoothly.

Lou Quanshan stated: For postpartum retention of the placenta, only Huari San (Flower Stamen Powder) yields unique and excellent results. If one resides in the countryside and cannot obtain this medicine in an emergency, I now adopt a method from Mr. Hu which is also very effective. After delivery, if the placenta is retained, and after a short while blood flows into the uterus, causing distension and rushing upward to the chest and heart, leading to panting, urgency, and pain, the condition will inevitably become critical. If this occurs, one should immediately cut the umbilical cord. Tie the cord firmly with a small object, ensuring it is tightly bound, then cut it off. This prevents fetal blood from flowing into the maternal uterus. Consequently, the placenta will naturally shrink and descend. Even if delayed for several days, it will cause no harm. As long as the parturient woman maintains a calm and peaceful mind, the placenta will eventually expel naturally; this has been verified through repeated trials.

Huari San: Treats incomplete expulsion of lochia after childbirth, blood confusion and fainting, severe nausea/vomiting during pregnancy, and lochia rushing to the heart.

In cases where the fetus dies in the womb, the placenta is retained, and even leads to the death of the mother, provided there is still a slight warmth at the heart region, urgently administer 1 qian of Huari San mixed with child's urine. This will expel the foul blood, resembling pig liver. From then on, the parturient woman can avoid symptoms of Blood deficiency, Qi deficiency, and Wind pathogens. If there is blood above the diaphragm, it will transform into yellow fluid, either vomited from the mouth or discharged via urination.

Niuxi Tang
Niuxi (Radix Achyranthis Bidentatae), Qumai (Herba Dianthi) (each 4 liang); Danggui (Radix Angelicae Sinensis) (3 liang); Tongcao (Medulla Tetrapanacis) (6 liang); Huashi (Talcum) (8 liang); Kuizi (Fructus Abutilonis) (5 liang).
Grind the above herbs into coarse powder. Add 9 sheng of water, decoct until reduced to 3 sheng. Divide into three doses.