Library

Some parturients experience vaginal bleeding prior to labor, leading to dryness of the Zang organs (specifically the uterus); some have latent pathogenic factors such as rashes (referring to internal heat toxins or skin-related pathogens) in the Zi Zang (uterus); some initially feel abdominal pain, followed by fright and premature discharge of turbid blood, causing the birth canal to become dry and slippery, and the mother to become exhausted; all these conditions lead to dystocia. Transverse presentation and breech presentation are both caused by exerting force too early, before the fetus has completed turning. If the lochia is exhausted while the fetus remains transverse and dry, the fetus cannot be delivered and will inevitably die in the abdomen. The formulas for expelling the fetus in such cases mainly consist of herbs like Epimedii Herba (Qumai) and Plantaginis Semen (Cheqian). To moisten dryness, beef su (Niusu, clarified butter from cow's milk) and white honey (Baimi) are used. Furthermore, ancient formulas for expelling dead fetuses employ both cold and hot medicines, implying a specific therapeutic intent. This may occur when excessive bleeding leads to fetal death, or when trauma causes fetal death, or when prolonged illness results in fetal atrophy and subsequent death. In such cases, if the Qi of the Zang-Fu organs is cold, causing fetal blood to coagulate and obstruct the dead fetus, preventing the ascent and descent of Qi, thus resulting in dystocia, it is appropriate to use Fuzi Tang (Aconite Decoction) to warm the interior, while simultaneously applying external heat compresses to the umbilicus, abdomen, waist, and hypochondrium to gradually activate the stasis. Since Aconiti Lateralis Radix Preparata (Fuzi) breaks cold and induces abortion, the fetus will be expelled. Alternatively, in cases of febrile diseases or warm malaria where the fetus is affected by heat toxicity, with internal and external attacks causing dystocia, Chengqi Tang (Gut-Draining Decoction) is indicated.

There are five types of dystocia that are considered untreatable: 1. No pain felt at the base of the abdomen; 2. Holding the feet with drooping, powerless legs; 3. The disease persists, and the whole body is not warm; 4. Continuous vomiting of clear saliva and foam due to Zang-Fu dysfunction; 5. Flaccidity and weakness of the neck tendons. All these conditions are untreatable. When a dead fetus and blood coagulate, the abdomen must be distended. It is appropriate to use Natrii Sulfas (Xiaoshi), Hydrargyrum (Shuiyin), and Ammonium Chloridum (Naosha). The nature and flavor of these three drugs not only decompose the fetus but, assisted by their ability to move blood and regulate Qi, will ensure expulsion.

Women who consume rich and fatty foods often develop internal heat. Consequently, the Yin water of the Kidney is insufficient to nourish the fetus, leading to fetal atrophy and weak movement. Thus, Yin deficiency with Yang hyperactivity occurs, and if Qi does not descend, the fetus cannot be delivered. Additionally, excessive leisure, prolonged sitting, or lying down can damage Qi, leading to Qi deficiency and blood stagnation. Therefore, the mother's deficient Qi cannot push the fetus, and the weak fetal Qi cannot turn, making delivery difficult. Sadness, grief, and emotional distress cause Qi stagnation. Since Blood follows Qi, Qi stagnation leads to Blood stasis, also resulting in difficulty. Medicines for expelling the fetus must differentiate between Qi stagnation and Qi-Blood deficiency for treatment. Whenever I encounter women accustomed to rich diets and sedentary lifestyles who have no other symptoms during labor, I invariably use Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Ligusticum Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Glycyrrhizae Radix et Rhizoma (Gancao), Paeoniae Radix Alba (Baishao), Scutellariae Radix (Huangqin), and Arecae Pericarpium (Dafupi). For those with severe Qi deficiency, this formula strengthens the Qi of both mother and child. At term, adding Leonurus Japonicus Herba (Yimucao) and administering one or two doses prevents other sequelae. For those with severe sadness, grief, Qi stagnation, or depression, add Aurantii Fructus (Zhike), Amomi Fructus Rotundus (Sharen), and Cyperi Rhizoma (Xiangfu). Generally, ensuring the smooth circulation of Qi and Blood in both mother and fetus not only facilitates rapid delivery but also prevents postpartum deficiency syndromes. Furthermore, if insufficiency of Middle Qi in the Spleen and Stomach prevents the Chong and Ren meridians (which govern Qi and Blood) from receiving the essence of food and drink, leading to dystocia, supplementation with Qi- and Blood-tonifying herbs like Renshen and Baizhu promotes the flow of Ying and Wei Qi derived from food and drink, making delivery easier. Is it merely about adhering rigidly to the pathology of dystocia and indiscriminately using abortifacient drugs?