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Failure of the pubic symphysis to open is caused by deficiency of Yuan Qi (Original Qi), lack of proper care during pregnancy, resulting in the inability of Qi and Blood to circulate and reach the necessary areas. Immediately instruct the patient to rest quietly. Internally administer Jiawei Xionggui Tang (Cinnamon Twig and Angelica Decoction with Additions; see "Medication for Childbirth" section above). Externally, mix Talcum Powder (Hua Shi) with Sesame Oil and apply it to the vaginal opening to facilitate dilation.

When the fetus is being delivered, the midwife should gently support the mother's chest with both hands, while the mother herself should tightly embrace her navel with both hands to encourage the descent of the retained placenta. If the placenta fails to descend, this is also due to premature labor. During normal delivery, the pelvic joints open; robust individuals' joints close within a few days, while frail individuals may take a month to close. Now, if the fetus is forcibly expelled before the joints have opened, the bony aperture closes immediately after the fetus emerges, causing the placenta to be unable to exit in time. One should use Foshou San (Buddha's Hand Powder; see "Dystocia" section above), adding Achyranthes Root (Niu Xi) and Dianthera Herb (Qu Mai) (each 2 qian), and Talcum Powder (Hua Shi) (1 qian), decocted in water and taken orally. If necrotic blood flows into the uterus, the uterus will become distended and fail to expel the placenta; if treatment is delayed slightly, the distension fills the abdomen, rushes upward to the heart and chest, causing pain, panting, and urgency. In such cases, one must urgently cut the umbilical cord to prevent blood from entering the uterus, avoiding further distension. However, the umbilical cord is extremely fragile and must be handled with great care. First, tie the cord firmly with soft silk or coarse hemp thread, then fold the cord double and tie another knot, weighting it down with a scale weight to prevent retraction, and then cut it. After three to five days, it will naturally wither, dry up, shrink, and fall off. Do not indiscriminately administer medication or perform manual interventions. If blood enters the placenta causing distension and retention, and treatment is delayed, it will inevitably lead to abdominal distension, subsequently rushing upward to the heart and chest, causing pain and respiratory distress; in such cases, Niu Xi Tang (Achyranthes Decoction) should be administered. If the condition is due to Qi and Blood deficiency failing to propel the placenta downward, and the mother only feels fatigue without other distending pain, Jiawei Xionggui Tang (see "Dystocia" section above) is appropriate. If abdominal pain is relieved by pressure, it indicates a deficiency-type pain. Baosheng Wuyou San (Life-Preserving Fearless Powder) should be used to treat this comprehensively. For retained placenta, suspend the mother's hair, and urgently probe the throat with the hair tip to induce vomiting; once vomiting occurs, the placenta will descend.

Niu Xi Tang (Achyranthes Decoction)
Corydalis Rhizome (Yan Hu Suo) (5 qian)
Achyranthes Root (Niu Xi)
Complete Angelica Sinensis Root (Quan Dang Gui) (each 3 qian)
Decoct in water and take orally.

Baosheng Wuyou San (Life-Preserving Fearless Powder)
Angelica Sinensis Root (Dang Gui) (soaked in wine)
Bitter Orange (Zhi Ke) (stir-fried with salt)
Sichuan Lovage Rhizome (Chuan Xiong)
Costus Root (Mu Xiang)
White Peony Root (Bai Shao)
Prepared Licorice Root (Zhi Gan Cao) (each 1.5 qian)
Scorched Hair (Xue Yu Tan) (separately ground)
Frankincense (Ru Xiang) (separately ground, each 0.5 fen)
Decoct in water, add the powders of Scorched Hair and Frankincense, and take orally.