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[San Yin Fang] When a woman is in labor, excessive straining and bearing down can cause the prolapse of vaginal tissues, resembling rectal prolapse, with protrusion from the vagina, accompanied by a sensation of tightness, swelling, and pain. Heavy lifting and sexual fatigue can also trigger this condition, presenting with continuous discharge of clear fluid and dribbling urination.

Liuhuang San (Sulfur Powder): Treats prolapse of vaginal tissues after childbirth due to labor injury.
Ingredients: Liu Huang (Cinnabar Sulfur), Wuzui Yu Gu (Cuttlefish Bone) (each 0.5 liang), Wuweizi (Schisandra Berry) (2.5 qian).
Preparation and Administration: Grind the above ingredients into fine powder and apply to the affected area.

Taoren Gao (Peach Kernel Ointment): Treats postpartum vaginal swelling causing discomfort.
Ingredients: Taoren (Peach Seed, peeled and removed of tips), Kufan (Alum), Wubeizi (Chinese Gallnut) (equal parts).
Preparation and Administration: Grind the latter two ingredients into powder, grind the peach seeds into an ointment/paste. Mix evenly and apply externally.

Liuhuang Tang (Sulfur Decoction): Treats uterine/vaginal prolapse after childbirth labor, where the Yumen (vaginal opening) remains open and does not close.
Ingredients: Liu Huang (Sulfur) (4 liang), Wu Zhu Yu (Evodia Fruit), Tusizi (Dodder Seed) (each 1.5 liang), Shechuangzi (Cnidium Fruit) (2 liang).
Preparation and Administration: Take 4 qian per dose, add one bowl of water, boil for several times, filter out the dregs, and wash the Yumen with the liquid. Wash twice daily.

Moxibustion/Fomentation Method:
Stir-fry Shechuangzi (Cnidium Fruit) alone until hot, wrap in cloth while hot, and foment the affected area. This method also treats postpartum vaginal pain.

Danggui San (Angelica Powder): Treats vaginal tissue prolapse.
Ingredients: Danggui (Angelica Sinensis), Huangqin (Scutellaria Root) (each 2 liang), Shaoyao (Peony Root) (1.5 qian), Pi [Note: Text implies a bark or specific herb, likely missing character like Chishizhi, but strictly translated as 'Pi'] (burned to retain charred nature, 0.5 liang), Muli (Oyster Shell) (2.5 liang).
Preparation and Administration: Grind into powder. Take 2 qian per dose, mix with warm wine or rice soup as desired. Avoid climbing heights and lifting heavy objects.

[Zhu Danxi's Case] A woman in her thirties, two days after delivering a daughter, had a mass protruding from the birth canal resembling a handkerchief with a pointed tip, weighing approximately one jin. I reasoned that this was caused by fatigue during pregnancy damaging the Qi, leading to Liver Wei (Liver Flaccidity). Fortunately, her Blood was not severely deficient. Given the cold weather at year-end, fearing cold damage to the necrotic tissue, I urgently prescribed Zhi Huangqi (Processed Astragalus Root) 0.5 qian, Renshen (Ginseng Root) 1 qian, Baizhu (Atractylodes Macrocephala Rhizome) 0.5 qian, Danggui (Angelica Sinensis) 1.5 qian, Shengma (Cimicifuga Rhizome) 0.5 qian, for three doses. Continuous administration resulted in retraction, followed by whole-body sweating and relief. However, a piece of the protruding part that had dried against the mat fell off, weighing about 5-6 liang, which was adipose membrane. Subsequently, her appetite improved, and she slept well. Her pulse was wiry-choppy (Se), slightly wiry on the left, yet her physical constitution appeared robust. I prescribed Baizhu and Shaoyao (Peony Root) each 1.5 qian, Chenpi (Tangerine Peel) 1 qian, and Shengjiang (Fresh Ginger) one slice, decocted for 2-3 doses to nourish her.

Another woman, after childbirth, had a mass protruding from the vagina resembling a covered bowl with two lobes. Her husband sought treatment. I reasoned this was the uterus, prolapsed due to weak Qi and Blood. I prescribed large doses of Shengma (Cimicifuga Rhizome), Danggui (Angelica Sinensis), and Huangqi (Astragalus Root) for two doses. Half a day later, the husband returned saying that after two doses, there was a popping sound, and the mass had retracted into the vagina. However, a palm-sized piece had adhered to and torn from the mat overnight. The wife was weeping, fearing the tear prevented regeneration. I reasoned this was not intestine but placental residue/fat. Muscle tears can heal if Qi and Blood are sufficient. I prescribed Siwu Tang (Four Substance Decoction) plus Renshen (Ginseng Root) for 100 doses. Three years later, she conceived again. For treating uterine prolapse, use Huangqi (Astragalus Root) 1.5 qian, Renshen (Ginseng Root) 1 qian, Danggui (Angelica Sinensis) 0.7 qian, Shengma (Cimicifuga Rhizome) 0.3 qian, Gancao (Licorice Root) 0.2 qian, as one dose. Decoct in one cup of water to half volume, strain, and take before meals. Also wash with Wubeizi (Chinese Gallnut) powder infusion. Apply unprocessed powder externally multiple times. Encourage prolonged medication to prevent recurrence.

[Xue Ji's Cases] Non-closure of the Yumen (vaginal opening) indicates deficiency of Qi and Blood; use Shiquan Dabu Tang (Ten Significant Tonifying Decoction). Swelling and pain indicate deficient heat in the Liver Meridian; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If caused by sorrow and anger injuring Liver and Spleen Qi and Blood, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction). If caused by sudden anger injuring Blood with Liver Fire, use Longdan Xiegan Tang (Gentian Drain Liver Decoction). A postpartum patient with non-closing Yumen, fever, and chills was treated with Shiquan Dabu Tang plus Wuweizi (Schisandra Berry); after several doses, fever and chills subsided. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Wuweizi closed the Yumen after several doses. A woman with inherent weak Spleen/Stomach and Liver Fire presented with postpartum Yumen swelling/pain, alternating chills/fever, thirst, vomiting, and anorexia. After using external Dahuang (Rhubarb Root) and internal purgatives, swelling spread to buttocks with various symptoms arising, indicating true Qi deficiency and pathogenic excess. First, Liujunzi Tang (Six Gentlemen Decoction) was used to stabilize the intestines/stomach, then Bu Zhong Yi Qi Tang to raise Yang Qi; she recovered in a few doses. A postpartum patient with neglected treatment had persistent swelling/ulceration, emaciation, poor appetite, morning chills/evening fevers, spontaneous and night sweats for six months. Bu Zhong Yi Qi Tang plus Fuling (Poria) and Banxia (Pinellia Tuber) reduced pus/fluid and improved appetite. Guipi Tang (Restore the Spleen Decoction) for over 50 doses cured her.

A postpartum patient with non-closing Yumen, dribbling urine, and abdominal masses moving to the hypochondrium causing distension/pain was cured with Jiawei Xiaoyao San plus Cheqianzi (Plantago Seed). A woman with uterine enlargement/prolapse, who had a piece torn off resembling pig liver, presented with sallow complexion, fatigue, anorexia, internal heat, afternoon tidal fever, and sweats. Shiquan Dabu Tang (Ten Significant Tonifying Decoction) for over 20 doses cured all symptoms and restored fertility.

Treatment for postpartum vaginal swelling, prolapse, and non-closing Yumen:
Duanshi (Calcined Limestone) (1 sheng, stir-fried until very hot), added to 2 sheng of water, mixed with ash, cooled to suitable temperature, clarified, and used for sitz baths to immerse the Yumen. Recovery occurs quickly.
Another formula: Push Tie Jing (Iron Essence/Powder) internally. Moxa 5-7 cones below the umbilical horizontal line.
Another method: Mix Tie Jing (Iron Essence) and Yang Zhi (Sheep Fat) until thick, wrap in cloth, heat, foment, and push inside. (Tie Jing is dust-like, purple, light, and porous material from iron forging furnaces, used for polishing vessels.)

[Zimu Beilu] For postpartum vaginal prolapse, burn rabbit heads to powder and apply.

[Bu Yi] For postpartum intestinal prolapse not retracting: Decoct Zhike (Bitter Orange) and soak for a long time to induce retraction. Another formula: Soak in Wubeizi (Chinese Gallnut) and Bai Fan (Alum) decoction. Another formula: Decoct Suanning Cao (Old Crow Acid/Oxalis species), sit on a non-perforated grass pad to fumigate; when halfway retracted and slightly warm, wash manually and assist retraction.
Another formula: For uterine prolapse, wash with warm water to soften, then fumigate with smoke from burning Xiong Shufen (Male Rat Feces). Another method: Mash 14 Castor Seeds (Bimazi) without shells, apply to Baihui (DU20) acupoint; wash off immediately upon retraction.

[Dong Yuan's Cases] Prolapse of the birth canal with constant dampness: Shenque (CV8), Yuquan (GV19) - Moxa 50 cones. Shenjiao (Intercranial space below umbilicus) - Moxa 50 cones, repeat three times.
Another method: 3 cun lateral to Yuquan (GV19) - Moxa age-in-cones, repeat three times. Cold swelling of female genitalia: Guilai (ST29) - Moxa 30 cones.

[Jia Yi Jing] Vaginal prolapse, limpness of four limbs, body heaviness/distress: Shaohai (HT3) controls it. (Alternative: Zhaohai, KI6).

[Yinzhong Rouxian]
A postpartum patient had a fleshy cord emerging from the urinary tract, 3-4 chi long, causing excruciating pain upon touch. First, administer Shixiao San (Stop Pain Powder) several times. Then, take 3 jin of ginger with skin, mash, add 2 jin of clear oil, boil until oil is dry. Use silk to hold the fleshy cord, place it curved beside the urethra, fumigate with the prepared ginger. Foment if cool. After one day and night, it shrinks significantly; fully retracts in two days. Regulate with Shixiao San and Xionggui Tang (Ligusticum and Angelica Decoction). If the fleshy cord breaks, it is incurable.