三者皆元气不足，观诸治验，可见其交骨不开者，用芎归汤加发灰、龟板补而开之；阴门不
闭者，用十全大补加五味子补而敛之；子宫不收者，补中益气加醋炒芍药、半夏，补而举之，或助以外治之法。
治验
地官李孟卿，娶三十五岁稚女为继室，妊娠虑其难产，与加味芎归汤四剂备用，果产
门不开，服之顿然分娩。
西宾费怀德之室，下血甚多，产门不开，两日未生，服前药一剂，实时而产，已后育胎，并
无此症。怀德传与服者，无有不效。
一妇人分娩最易，至四十妊娠，下血甚多，产门不开，亦与前汤一剂，又用无忧散斤许一剂
，煎熟时时饮之，以助其血而产。
一产妇阴门不闭，发热恶寒，用十全大补加五味子数剂，而寒热悉退，又用补中益气加五味
子，数剂而敛。若初产肿胀，或 痛而不闭者，当用加味逍遥散。若肿既消而不闭者，当用
补中益气汤，切忌寒凉之剂。
一妇人脾胃素弱，兼有肝火，产后阴门肿痛，寒热作渴，呕吐不食，敷大黄等药，服驱利之
剂，肿及于臀，虚症蜂起，此真气虚而作，先用六君子以固脾胃，乃以补中益气汤升举，不数剂而消。
一产妇失治，肿溃不已，形体消瘦，饮食不思，朝寒暮热，自汗盗汗半年矣，用补中益气加
茯苓、半夏以健脾胃，脓水渐少，饮食渐进，用归脾汤以解脾郁，共五十余剂，元气复而疮亦愈矣。
一产妇阴门不闭，小便淋沥，腹内一物，攻动胁下，或胀或痛，用加味逍遥散加车前子而愈
一妇人子宫肿大，二日方入，损落一片，殊类猪肝，已而面黄体倦，饮食无味，内热晡热，
自汗盗汗，用十全大补汤二十余剂，诸症悉愈，仍复生育。血滞成痈方见后。
These three conditions (failure of the pubic symphysis to open, failure of the vulva to close, and uterine prolapse) are all caused by insufficiency of Yuan Qi (Original Qi). From various treatment cases, it can be observed that: for failure of the pubic symphysis to open, Xiong Gui Tang (Cnidium and Angelica Decoction) is used with added Fa Hui (Burnt Hair) and Gui Ban (Tortoise Shell), employing tonification to facilitate opening; for failure of the vulva to close, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) is used with added Wu Wei Zi (Schisandra Fruit), employing tonification to promote closure; for uterine prolapse, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is used with added Cu Chao Shao Yao (Vinegar-processed White Peony Root) and Ban Xia (Pinellia Rhizome), employing tonification to lift and raise, or auxiliary external treatments may be applied.
Treatment Cases:
Li Mengqing, an official, married a thirty-five-year-old young woman as his second wife. Fearing difficult labor, he prepared four doses of Jia Wei Xiong Gui Tang (Modified Cnidium and Angelica Decoction) in advance. Indeed, during delivery, the birth canal failed to open. After taking this medicine, she delivered smoothly and immediately.
The wife of Fei Huaide, a private tutor, suffered from excessive postpartum bleeding and failure of the birth canal to open, remaining undelivered for two days. After taking one dose of the aforementioned medicine, she delivered immediately. Subsequently, when pregnant again, she did not experience this symptom. Fei Huaide passed this prescription to others, and it was effective without exception.
A certain woman who had previously given birth easily, upon becoming pregnant at forty, suffered from excessive vaginal bleeding and failure of the birth canal to open. She was given one dose of the aforementioned decoction, along with one dose of Wu You San (Worry-Free Powder) exceeding one jin, boiled and taken frequently while warm, to assist blood and qi to facilitate delivery.
A parturient woman presented with failure of the vulva to close, accompanied by fever and aversion to cold. Several doses of Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) with added Wu Wei Zi (Schisandra Fruit) were administered, after which the chills and fever completely subsided. Subsequently, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Wu Wei Zi (Schisandra Fruit) was used for several doses, resulting in closure. If there is swelling after first-time delivery, or pain without closure, Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) should be used. If the swelling has subsided but closure has not occurred, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. Cold-natured agents must strictly be avoided.
A certain woman with inherently weak spleen and stomach, complicated by liver fire, presented with painful swelling of the vulva postpartum, accompanied by alternating chills and fever, thirst, vomiting, and inability to eat. After applying external herbs such as Da Huang (Rhubarb Rhizome) and taking purgative agents, the swelling spread to the buttocks, and deficiency symptoms arose profusely. This was due to deficiency of true qi. Liu Jun Zi Tang (Six Gentlemen Decoction) was first used to consolidate the spleen and stomach, followed by Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to lift and raise. The swelling subsided in less than a few doses.
A parturient woman, due to lack of timely treatment, suffered from persistent swelling and ulceration, emaciation, loss of appetite, morning chills, evening fevers, spontaneous sweating, and night sweats for half a year. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Fu Ling (Poria) and Ban Xia (Pinellia Rhizome) was used to strengthen the spleen and stomach. The pus and fluid gradually decreased, and appetite slowly improved. Then, Gui Pi Tang (Restore the Spleen Decoction) was used to resolve spleen depression. After a total of more than fifty doses, yuan qi (original qi) recovered, and the sores healed.
A parturient woman presented with failure of the vulva to close, dribbling urination, and a sensation of a mass inside the abdomen attacking into the hypochondrium, causing distension or pain. She was cured using Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) with added Che Qian Zi (Plantago Seed).
A certain woman presented with uterine enlargement, which only retracted after two days, accompanied by the expulsion of a piece of tissue resembling a pig's liver. Subsequently, she exhibited sallow complexion, physical fatigue, tastelessness in food, internal heat, afternoon tidal fever, spontaneous sweating, and night sweats. More than twenty doses of Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) were administered, after which all symptoms resolved, and fertility was restored. The formula for blood stasis forming abscesses is seen in the following text.