产难子死腹中者，多因惊动太早，或触犯禁忌，致令产难，胞浆已破，无血养胎，枯
涸而死故也。须验产母舌，若青黑，其胎死矣，当下之。大法∶寒者热以行之，热者凉
以行之，燥者滑以润之，危急者毒药下之。
〔热剂〕
乌金散 治难产热病，胎死腹中，或因颠仆，或从高坠下，或房室惊搐，或临产惊
动太早，触犯禁忌，或产时未到，经血先下，恶露已尽，致胎干子死，身冷不能自出。但
视产妇面赤舌青，是其候也。面青舌赤，母死子活。唇青吐沫，子母俱毙。又有双胎，或
一死一活，其候难知，临时观变可也。
熟地黄（洗，切，焙干，酒炒） 真蒲黄 大当归 交趾桂 杨芍药 军姜（去皮） 粉草（各一
两） 小黑豆（四两） 百草霜（五钱）
上为末，每用二钱，米醋半合许，沸汤六七分浸起温服。疑二之际，且进佛手散，酒
水合煎二三服探之。若未死子母俱安，若胎已死，立便逐下。的知其胎死，进此药后更
进香桂散，须臾如手推下。常用催生，更加好滑石末半两，葵子五十粒捶碎，黄柞叶七
八片，葱白二寸，顺流水煎汤调下。盖滑石
能利小便，柞叶行气逐血，葱白内通阳气，气盛血行即产矣。
〔大全〕下死胎方 桂枝（二钱） 麝香当门子（一个） 同研，暖酒服，须臾如手推下。（一
名桂香散。）
此药比之用水银等不损血气。（赵和叔传）一方单用桂末一钱，痛时童便调下，名救苦
散。
一稳婆之女，勤苦负重，妊娠，腹中阴冷重坠，口中甚秽。余意其胎必死，令视其
舌，果青黑。与朴硝半两许服之，随下秽水而愈。一妇胎死，服朴硝而下秽水，肢体
倦怠，气息奄奄。用四君为主，佐以四物、姜、桂调补而愈。
〔寒剂〕
治妊娠三五个月，胎死在腹内不出。
大腹子 赤芍药 榆白皮（各三两） 当归（一两，炒） 滑石末（七钱半） 瞿麦 葵子（炒）
茯苓 粉草 子芩（各半两）
上为粗末，每服四钱，水一盏，煎至七分，去滓，不拘时温服。
邓知县传，疗死胎不出。朴硝半两研细，以温童便调服屡效。
治死胎不下，指甲青，舌青胀闷，口中作屎臭。先以平胃散一帖，作两服，每服酒
水各一盏，煎至一盏，却投朴硝末半两，再煎三五沸温服，其胎化血水下。
〔本〕治子死腹中不出。用辰砂一两，水煮四五沸，末之，然后取酒调服，立出。
〔外〕疗子死腹中。真珠二两为末，酒调服尽，立出。
〔滑剂〕
《千金》治小儿死腹中。葵子末酒服方寸匕。若口噤不开，格口灌之，药下即活。
疗妊娠胎死腹中，或母疾欲下胎。榆白皮煮汁服二升。
〔大〕治子死腹中，或半生不下，或半着脊骨，在草不产，血气上荡母心，面无颜
色，气欲绝。
猪脂（一斤） 白蜜（一升） 醇酒（二升）
上三味，合煎取二升，分温二服。不能饮，随所能服之。
〔妇人良方〕一字神散 治子死胎不下，胞破不生。此方屡效，救人无量。
鬼臼（黄色者，不以多少，去毛，碾为末，极细如粉，不用罗，以手指捻之）
上每服二钱，用无灰酒一盏，同煎至八分，通口服，立效如神。
〔世〕治生产不顺，胎死腹中，胞衣不下，临产危急，妙。
蛇蜕（一条，全者，香油灯上烧，研） 麝香（少许）
上为末，童便、酒各半盏，调一服即生，效。
杨氏疗有孕月数未足，子死腹中，母欲闷绝。取大豆（一方黑豆。）三升，醋煮浓汁三升，
顿服立效。
《本事》治妊娠热病，胎死腹中。鹿角屑一两，水一盏，葱五茎，豆豉半合，同煎至
六分，去滓温分二服。
又方 取死胎，乌鸡一支，去尾细切，以水三升，煮取二升，去鸡，通手用衣帛蘸，摩
脐下，胎自出。
Dystocia with fetal death in utero is often caused by excessive early agitation or violation of taboos, leading to difficult labor. By the time the amniotic fluid has ruptured, there is no blood to nourish the fetus, causing it to wither and die. It is necessary to examine the mother's tongue; if it is cyanotic and black, the fetus is dead, and purgative therapy should be employed. The general principle is: for cold patterns, use hot herbs to promote expulsion; for heat patterns, use cool herbs to promote expulsion; for dryness patterns, use slippery/lubricating herbs to moisten and promote expulsion; in critical situations, toxic drugs are used to purge.
[Heat-Resolving Agents]
Wujin San (Black Gold Powder): Treats dystocia complicated by febrile disease and fetal death in utero; or resulting from falls, jumping from heights, sexual activity-induced convulsions, or premature agitation/violation of taboos before labor; or premature bleeding/lochia exhaustion before term, leading to fetal desiccation and death, with a cold body unable to expel the fetus spontaneously. The sign is a red face and cyanotic tongue. If the face is cyanotic and the tongue is red, the mother dies while the fetus lives. If the lips are cyanotic and froth is vomited, both mother and fetus die. In cases of twins, one may be dead and the other alive, making the prognosis difficult; observation at the time is required.
Ingredients: Shudihuang (Prepared Rehmanniae Radix, washed, sliced, dried, wine-fried), Zhen Puhuang (Authentic Typhae Pollen), Da Danggui (Large Angelicae Sinensis Radix), Jiaozhi Gui (Cinnamon Twig from Jiaozhi), Yang Shaoyao (Paeoniae Radix), Jun Jiang (Zingiberis Rhizoma, peeled), Fencao (Glycyrrhizae Radix et Rhizoma) (each 1 liang), Xiaoheidou (Black Soybeans, 4 liang), Baicaoshuang (Soot from hundred herbs, 5 qian).
Grind all ingredients into fine powder. Take 2 qian each time, soak in approximately half a he of rice vinegar with boiling water (filling 60-70% of the vessel), warm, and drink. If uncertain whether the fetus is dead, first administer Foshou San (Buddha's Hand Powder), decocted with wine and water, two to three doses as a probe. If the fetus is alive, both mother and child remain safe; if the fetus is dead, it will be expelled immediately. Once fetal death is confirmed, after taking this medicine, administer Xianggui San (Fragrant Cinnamon Powder); within moments, the fetus will be expelled as if pushed out by hand. This formula is commonly used for inducing labor; adding Banxia Shi (Halloysitum Rubrum, 0.5 liang), Kuizi (Abutili Semen, 50 grains crushed), Huangzha Ye (Rhamni Frondis Folium, 7-8 leaves), and Congbai (Allii Fistulosi Bulbus, 2 cun), decocted in flowing water, enhances efficacy. Halloysitum Rubrum promotes urination, Rhamni Frondis Folium moves qi and dispels blood stasis, and Allii Fistulosi Bulbus unites internal yang qi; when qi is abundant and blood flows, delivery occurs.
[Daqan Formula for Expelling Dead Fetus]: Guizhi (Cinnamon Twig, 2 qian) and Muxiang Dangmenzi (Moschus, 1 unit), ground together, taken with warm wine. Within moments, the fetus is expelled as if pushed out. (Also known as Guixiang San.)
This formula does not damage qi and blood like mercury-based preparations do. (Transmitted by Zhao Heshu.) Another prescription uses only 1 qian of Guizhi powder, taken with fresh urine during pain, named Jiuku San (Save from Suffering Powder).
A midwife's daughter, who worked hard carrying heavy loads, became pregnant and felt coldness and heaviness in her abdomen, with foul breath. I suspected fetal death and had her check her tongue; it was indeed cyanotic and black. She was given Xiaoshi (Natrii Sulfas, approx. 0.5 liang), after which foul fluids were discharged, and she recovered. Another woman with a dead fetus took Xiaoshi and discharged foul fluids, but suffered from limb fatigue and faint breathing. She was treated with Sijunzi Tang (Four Gentlemen Decoction) as the main formula, supplemented with Siwu Tang (Four Substances Decoction), Shengjiang (Zingiberis Rhizoma Recens), and Rougui (Cinnamomi Cortex) to regulate and tonify, resulting in recovery.
[Cold-Resolving Agents]
Treats fetal death in utero between the third and fifth months of pregnancy, unable to be expelled.
Ingredients: Dafuzi (Arecae Semen, 3 liang), Chi Shaoyao (Red Peony Root, 3 liang), Yubaipi (Ulmus Alba Cortex, 3 liang), Danggui (Angelicae Sinensis Radix, fried, 1 liang), Huashi Mo (Halloysiti Rubrum Powder, 7.5 qian), Qumai (Diantherae Herba), Kuizi (Abutili Semen, fried), Fuling (Poria), Fencao (Glycyrrhizae Radix et Rhizoma), Ziqin (Scutellariae Radix, 0.5 liang each).
Grind into coarse powder. Take 4 qian each time, add one zhan of water, decoct to 0.7 zhan, strain, and take warm at any time.
Transmitted by County Magistrate Deng for treating retained dead fetus. Xiaoshi (Natrii Sulfas, 0.5 liang) is finely ground and taken with warm fresh urine; it is frequently effective.
For retained dead fetus with cyanotic nails, cyanotic tongue, abdominal distension and oppression, and fecal odor in the mouth: First administer Pingwei San (Powder for Maintaining Stability) in one dose, divided into two servings. Each serving is decocted with one zhan of wine and one zhan of water until reduced to one zhan. Then add 0.5 liang of Xiaoshi powder, boil for three to five boils, and take warm. The fetus will transform into bloody fluid and discharge.
[Ben Cao] For fetal death in utero not being expelled: Use Zhensha (Cinnabaris, 1 liang), boiled in water for four to five boils, ground into powder, then taken with wine. The fetus is expelled immediately.
[Wai Ke] For fetal death in utero: Zhenzhu (Margarita, 2 liang) ground into powder, taken with wine until finished. The fetus is expelled immediately.
[Slippery/Lubricating Agents]
Qianjin Fang treats fetal death in utero. Abutili Semen powder taken with wine using a square-inch measure. If trismus (lockjaw) prevents opening the mouth, force it open and pour the medicine in; life is restored upon ingestion.
For fetal death in utero during pregnancy, or when maternal illness necessitates expulsion: Decoct Yubaipi (Ulmus Alba Cortex) and drink 2 sheng.
[Da Yi Zong Lu] For fetal death in utero, or partial birth failure, or fetus stuck on the spine, inability to deliver in grassy areas, blood and qi rushing up to disturb the heart, pallor, and impending collapse of qi.
Ingredients: Zhuzhi (Porci Adeps, 1 jin), Baimi (Mel, 1 sheng), Chunjiu (Pure Wine, 2 sheng).
Decoct the three ingredients together to obtain 2 sheng. Divide into two warm doses. If unable to drink wine, take according to tolerance.
[Furen Liangfang] Yizi Shensan (One-Character Divine Powder): Treats retained dead fetus and ruptured membranes without delivery. This formula is highly effective and saves countless lives.
Ingredient: Jiujiao (Podophylli Fructus, yellow variety, amount unspecified, remove hairs, grind to extremely fine powder like flour, do not sieve, rub with fingers).
Take 2 qian each time, decoct with one zhan of non-fermented wine until reduced to 0.8 zhan, take orally in one dose. Effect is miraculous and immediate.
[Shi Yi De Xiao Fang] For difficult labor, fetal death in utero, retained placenta, and critical labor conditions.
Ingredients: Shetui (Ophichthidis Cutis Coriacea, one whole piece, burned over sesame oil lamp, ground), Shexiang (Moschus, small amount).
Grind into powder. Take one dose mixed with half a zhan of fresh urine and half a zhan of wine. Immediate delivery ensues.
Yang Shi treats premature fetal death in utero with maternal syncope. Take Douda (Sojae Semen Album, or alternatively Heidou/Black Soybean) 3 sheng, decoct in vinegar to obtain 3 sheng of thick juice, take in one dose for immediate effect.
[Benshi Fang] For febrile disease in pregnancy with fetal death in utero: Lujiaoxie (Cornu Cervi Deglutatum, 1 liang), water 1 zhan, Congbai (Allii Fistulosi Bulbus, 5 stalks), Chidouchi (Fermented Sojae Semen, 0.5 he). Decoct together to 0.6 zhan, strain, and take warm in two divided doses.
Another prescription: Obtain the dead fetus, take one Wuji (Gallus Domesticus, tail removed, finely chopped), decoct in 3 sheng of water to obtain 2 sheng. Remove the chicken. Dip cloth into the liquid and massage the lower umbilical region with the hand; the fetus will naturally be expelled.