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*Bi Chan Xu Zhi* records: The condition known as "Pan Chang Sheng" (Plaited Intestine Birth) refers to a situation where the uterus prolapses before the delivery of the fetus. After the fetus is delivered, the uterus fails to retract, a condition termed "Pan Chang Chan" (Prolapsed Uterus Birth). Midwives may use half a cup of vinegar mixed with half a cup of water, silently spraying it onto the mother's face, which causes the uterus to retract. Another ancient prescription uses forty-nine kernels of *Ricini Semen* (Castor Bean), ground and applied to the crown of the mother's head; the uterus will then retract, and the substance must be washed off immediately. If the uterus still does not retract, moisten it slightly with water used for sharpening knives. Spraying water on the face should be avoided, as fear may cause Qi to scatter, making retraction more difficult. If the uterus is dry, decoct *Scutellariae Radix* (Huang Qin) strongly, immerse the uterus in a lacquered basin, and apply warm steam until it retracts.

Li Taisu commented: "Pan Chang Sheng" is inevitably caused by deficiency of Qi and Blood in the mother, leading to downward prolapse. Treatment should employ herbs that tonify Qi and Blood, combined with methods to lift and raise, so that the uterus naturally retracts. A large dose of *Ren Shen* (Ginseng Root), [missing character], *Chuanxiong Rhizoma* (Chuan Xiong), and *Dang Gui Radix* (Dang Gui), added with *Sheng Ma* (Cimicifugae Rhizoma), is indicated.

Shen Zhai commented: The above two items describe "Jiao Gu Bu Kai" (Failure of the Pubic Symphysis to Separate) and "Pan Chang Sheng," which are manifestations of dystocia. Dystocia is not limited to these two conditions. For transverse or malpositioned births, the method relies on the skill of the midwife, and the medication used does not exceed the methods described in the subsequent sections.

Yang Zijian stated: "Dong Chan" (Cold Birth) occurs when the weather is cold in winter; the mother's menstrual blood coagulates due to cold, preventing the fetus from descending. This harm is the most severe. Therefore, in winter births, the lower body must not be stripped of cotton clothing, nor should one sit or lie in cold places. The room should be surrounded by stoves to maintain warmth, with the mother facing the fire, keeping the area below the navel, legs, and knees constantly warm. When blood is warmed, it circulates freely, facilitating easier birth.

Yang Zijian also stated: "Re Chan" (Hot Birth) occurs during the height of summer. The mother must maintain a balance of warmth and coolness. One must not indulge in cooling measures, damaging fetal Qi. Crowds should be avoided to prevent heat oppression, which can cause maternal irritability, boiling blood, and risks of stagnation, fainting, or vertigo.

Shen Zhai commented: Yang Zijian's *Ten Types of Birth* theory should all be known. However, eight of the ten items concern only the mother and midwife, so they are not fully recorded. Regarding "Dong Chan" and "Re Chan," care depends on the physician's medication and nursing, so these are excerpted. I believe ancient prescriptions for labor contain many medications. Zhu Danxi said: Using only *Fo Shou San* (Buddha's Hand Powder) is the safest and most effective. Later, reading Shan Yangxian's *Chan Bao Xin Shu* (New Book of Obstetric Treasures), I found the formula *Sheng Hua Tang* (Invigorating Blood Decoction), which serves as a basis for postpartum modifications. Currently, these two formulas should be primary. For cold winter births, add more *Rou Gui* (Cinnamon Bark) and *Ru Xiang* (Frankincense). For hot summer births, add more *Zhu Sha* (Cinnabar) and *Yi Yuan San* (Benefit Origin Powder), all taken with half a cup of child's urine (*Tong Bian*). *Ren Shen* dosage should be adjusted according to the deficiency or excess of the mother's Yuan Qi.