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Huisheng Dan (Resurrection Pill) [Gynecology 66], Xia Sitai Fang (Decoction for Expelling Dead Fetus) [Gynecology 59], Guixiang San (Cassia and Sandalwood Powder) [Gynecology 55], Hupo Wan (Amber Pill) [Gynecology 134].

Failure of the pubic symphysis to open and failure of the vaginal orifice to close are due solely to deficiency of Yin Qi. When Yin is deficient, Yang Qi cannot penetrate, thus the orifice remains closed. If it does not open, childbirth will inevitably be difficult. It is appropriate to use Jiawei Xionggui Tang (Modified Angelica and Ligusticum Decoction) to tonify and open the passage, which yields remarkable effects. Alternatively, Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) may also be used.

Failure of the vaginal orifice to close results from severe deficiency of Yin Qi, leading to an inability to retain; or it may be caused by the downward flow of Deficient Fire (Yin Huo). Consequently, symptoms may include prolapse of the vagina (Yinting), swelling, or dribbling dysuria with incontinence. If both Qi and Blood are deficient, Shiquan Dabu Tang added with Wuweizi (Schisandra Fruit) should be used to tonify and astringe. If there is pain accompanied by a sensation of heat, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is suitable. If worry and overthinking damage the Spleen causing Blood Heat, Jiawei Guipi Tang (Modified Heart-Spleen Tonic Decoction) is indicated. If sudden anger damages the Liver stirring up Fire, Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) is prescribed.

For uterine prolapse where the uterus fails to retract and descends outward, Buzhong Yiqi Tang (Middle-Boosting Qi-Invigorating Decoction) added with Chao Shaoyao (Vinegar-fried White Peony Root) should be taken to lift and raise the prolapse. Alternatively, external fumigation and washing with Huangbai (Phellodendron Bark) decoction is also excellent. Or, fumigate and wash with Liuhuang Tang (Sulfur Decoction) and apply Liuhuang San (Sulfur Powder) externally.

Another prescription: For postpartum uterine atony, fumigate and wash with decoction of Jingjie (Schizonepeta), Huoxiang (Patchouli), and Chun Gen Bai Pi (Toona Root Bark), yielding miraculous effects.

Another prescription: For postpartum rectal or vaginal prolapse, fumigate and wash externally with decoction of Zhike (Aurantii Fructus), Hezi (Chebula Fruit), Wubeizi (Chinese Gall), and Baifan (Alumen). If it does not retract, moxa several cones on Baihui GV20 (Hundred Convergences) on the vertex will cause it to rise.

Another prescription: For uterine prolapse, grind fourteen seeds of Biren Ren (Castor Bean) into a paste and apply to the vertex. Wash off immediately after retraction occurs.

Another prescription: For postpartum vaginal prolapse, place stir-fried hot Chuangzi (Cnidium Fruit) in a silk bag and apply as a warm compress; this also treats vulvar pain. Another method: Boil five taels of Chuangzi (Cnidium Fruit) and fourteen sour plums (Wumei) in water, and wash externally five to six times daily.

Syndromes of spontaneous abortion vary in severity, timing, constitutional predisposition, and iatrogenic factors. Those arising from constitutional predisposition are mostly due to weakness. Those arising from iatrogenic factors are mostly due to injury. Normal full-term delivery occurs naturally when mature; spontaneous abortion occurs due to damage and forced termination, which is why it must not be neglected. If one's age and vigor have declined and childbearing has been frequent, expecting recovery and stability is naturally difficult. In such cases, preserving the mother's Qi is the best outcome. If a young person suffers spontaneous abortion due to carelessness, regulation and conditioning are most crucial; otherwise, subsequent pregnancies may also miscarry, leading to repeated losses and difficulty conceiving, which is significant. Methods for stabilizing pregnancy are detailed in previous sections on recurrent miscarriage. Postpartum conditioning methods are similar to those for full-term delivery. See the postpartum section for details, and apply accordingly.

First, women entering middle age with weak fetal roots often suffer from inability to carry the fetus to term or recurrent spontaneous abortion with fainting. This is due to the decline of Qi and Blood. Once Qi and Blood are weakened, after spontaneous abortion, the uterus may continue to descend even after the fetus is expelled. If another pregnancy occurs simultaneously, this descent is not due to the fetus but to uterine sinking caused by Qi deficiency. The mother, unaware, may panic, but there is no need for concern. Treatment with Shoupi Jian (Longevity Spleen Decoction), Bazhen Tang (Eight Treasure Decoction), Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction), or Xionggui Buzhong Tang (Angelica and Ligusticum Middle-Boosting Decoction) will ensure safety.

Furthermore, spontaneous abortions vary in timing: those occurring in the second or third month are considered "near," while those in the fifth or sixth month are "far." Abortions shortly after conception are milder in presentation, while those later in gestation are heavier, which is common knowledge. There is an even earlier type: continuous miscarriage throughout pregnancy. Among families struggling with infertility, five or six out of ten suffer from this. The root cause is invariably excessive sexual indulgence. Although people are often unaware and unwilling to believe this, I write this to illuminate the path for others, hoping to benefit future generations. Please listen carefully. At the initial stage of conception, the embryo is like dew in the first month; like peach blossoms in the second month; blood vessels and form are established by the third and fourth months; bones, muscles, and hair grow by the fifth and sixth months. Initially, it is merely a drop of profound essence. At this stage, the fetal root lacks foundation and stability; if consolidated, it remains firm; if breached, it flows away. Therefore, after conception, one must strictly abstain from sex to prevent seminal overflow. Yet youths indulge without fear. Even if the fetal root is initially stable, preservation is often compromised. Those with strong constitutions may rely on their strength, fail, and then resume intercourse. At this time, while the body desires rest, desire does not cease. Like a madman banging on doors, driven by watery nature and fiery passion, who would not open the door and let the flow pass? At such moments, falling flowers fly with butterflies, and fire dates escape with pear blossoms; mixing with filth and flowing together, one does not realize that pregnancy conceived yesterday resulted in birth today. Conceived on the first day, born by the fifteenth; continuous miscarriage leaves no trace. Obvious miscarriages involve formed fetuses and are felt; hidden miscarriages involve the fetus dissolving into fluid, passing unnoticed. Thus, prostitutes rarely have full-term births because they experience so many hidden miscarriages. Men marrying prostitutes often have children because their partners' uteri are "slippery" and accustomed to early loss. I have seen men seeking prescriptions for infertility who claim potent sexual performance and complete mastery, yet lament having no children. Do they not realize that what others experience as obvious birth, they experience as hidden loss? Additionally, women who miscarry repeatedly in the third or fifth months, though common among frail women, are mostly due to uncontrolled sexual indulgence damaging maternal Qi. Therefore, those who rely on excessive virility often remain childless due to mutual destruction of strength and weakness; those who indulge without restraint often remain infertile because they steal and damage the fetal Qi. Is this entirely the woman's fault? Those seeking my prescriptions should read this section first; understanding this concept constitutes half the treatment.