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Fetus retained in the uterus (Zisi Fuzhong) is mostly caused by being startled too early, or violating taboos, or being hugged around the waist too heavily, or frequently testing the amniotic fluid, causing the fetal membranes to rupture first and the blood and water to drain out completely, leading to the fetus drying up and dying. The signs are that if both the lips and tongue of the mother turn black, both mother and child die. If the tongue turns black or distension and oppression are severe, although the fetus has already died. First, administer Pingwei San (Calm the Stomach Powder) 1 liang, decocted with half wine and half water, then add Puxiao (Mirabilite) 0.5 liang, and immediately take the hot-melted skin mirabilite, or use 1 liang of mirabilite mixed with urine from a healthy boy, which is also excellent.

Clinical Cases:
A daughter of a midwife worked hard carrying heavy loads; during pregnancy, she felt coldness and heaviness/dragging in the abdomen, and her breath was very foul. I suspected the fetus must be dead, asked her to check her tongue, which was indeed greenish-black. She took about 0.5 liang of Puxiao (Mirabilite), subsequently discharged foul fluids, and recovered safely.
Another woman had a dead fetus; after taking Puxiao (Mirabilite), she discharged foul fluids. Her limbs were fatigued, and her breathing was faint. Using Sijunzi Tang (Four Gentlemen Decoction) as the main formula, assisted by Siwu Tang (Four Substances Decoction), Shengjiang (Fresh Ginger Rhizome), and Rongui (Cinnamon Bark), she recovered through regulation and tonification.

Some cases involve lochia entering the membranes, causing distension preventing expulsion; others involve deficiency of Yuanqi (Primary Qi) preventing expulsion. In cases where lochia flows into the membranes, there is abdominal distension and pain; use Duoming Dan (Life-Restoring Pill) or Shixiao San (Pain-Relieving Powder) to resolve blood stasis; delay will result in untreatable conditions. In cases where Yuanqi (Primary Qi) cannot expel, there is no abdominal distension or pain; use Baosheng Wuyou San (Protect Life and Ensure Safety Powder) to tonify and secure Yuanqi (Primary Qi). Alternatively, use 1 liang of Ricini Semen (Bibingzi/Ricinus communis seed flesh), finely ground into a paste, applied to the sole of the mother's right foot. Once the placenta is expelled, wash it off immediately; if delayed, the intestines may prolapse. If the intestines do not retract, apply this paste to the vertex of the head, and the intestines will naturally return. Yimu Wan (Motherwort Pill) is also effective. According to the Baoqing method, when the placenta has not yet been expelled, if one wishes to cut the umbilical cord, first tie a small weight to it, then cut it; otherwise, the uterus may retract upwards covering the heart, leading to death.

Clinical Cases:
The wife of a family member had an unexpelled placenta, with chest and abdominal distension and pain, unable to bear touch. This was due to blood stasis. One dose of Shixiao San (Pain-Relieving Powder) was administered with hot wine, and the lochia and placenta were expelled together.
A postpartum woman had an unexpelled placenta, without abdominal distension or pain, but slight relief of pain upon pressure. This was due to Qi deficiency failing to expel it. Wuyou San (Safety Powder) was used for expulsion. Regarding previous symptoms, I consulted midwives who suggested taking Yimucao Wan (Motherwort Pill), or inducing vomiting by placing the parturient's hair in her mouth, which would cause the placenta to expel naturally; failure to expel leads to death. The aforementioned methods proved very effective.