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[Sanyin Fang] When women exert excessive force during labor, it may cause the vagina to prolapse, resembling rectal prolapse, or tissue within the vagina protrudes externally, accompanied by a sensation of pressure and swelling pain. Heavy lifting and sexual fatigue can also trigger this condition, presenting with continuous discharge of clear fluid from the vagina and dribbling urination.

Liuhuang San (Sulfur Powder): Treats vaginal prolapse due to labor injury postpartum.
Ingredients: Liuhuang (Sulfur), Wuzuiyu Gu (Cuttlefish Bone) (each 0.5 liang), Wuweizi (Schisandra Fruit) (2.5 qian).
Preparation and Administration: Grind the above ingredients into fine powder and apply locally to the affected area.

Taoren Gao (Peach Kernel Ointment): Treats vaginal swelling and discomfort postpartum.
Ingredients: Taoren (Peach Seed, peeled and core removed), Kufan (Alum), Wubeizi (Chinese Gallnut) (equal parts).
Preparation and Administration: Grind Kufan and Wubeizi into powder, grind Taoren into paste, mix evenly, and apply externally.

Liuhuang Tang (Sulfur Decoction): Treats patulous vulva (Yumen open and not closing) due to labor strain postpartum.
Ingredients: Liuhuang (Sulfur) (4 liang), Wuzhuyu (Evodia Fruit), Tusizi (Dodder Seed) (each 1.5 liang), Shechuangzi (Cnidium Fruit) (2 liang).
Preparation and Administration: Take 4 qian of the mixture per dose, add one bowl of water, boil several times, filter the dregs, and wash the Yumen (vulva) with the liquid. Wash twice daily.

Moxibustion/Warming Method:
Stir-fry Shechuangzi (Cnidium Fruit) alone until hot, wrap in cloth while hot, and apply as a warm compress to the affected area. This method is also effective for postpartum vaginal pain.

Danggui San (Angelica Sinensis Powder): Treats vaginal prolapse.
Ingredients: Danggui (Angelica Sinensis Root), Huangqin (Scutellaria Root) (each 2 liang), Shaoyao (Peony Root) (1.5 qian), [Pi] (Bark, charred to retain efficacy, 0.5 liang), Muli (Oyster Shell) (2.5 liang).
*Note: The character before "Pi" is missing in the original text; retained as "Pi".*
Preparation and Administration: Grind the above ingredients into powder. Take 2 qian per dose, mixed with warm wine or rice soup as desired. Avoid climbing heights and lifting heavy objects.

[Case by Zhu Danxi] A woman in her thirties, two days after delivering a daughter, had an object protruding from the vagina resembling a handkerchief with a pointed tip at the bottom, weighing approximately one jin. I reasoned that this was caused by pre-natal fatigue and Qi deficiency leading to Liver Wei (Liver Flaccidity). Fortunately, blood deficiency was not severe. Given the cold weather at year-end, I feared cold damage causing necrosis. I urgently prescribed Zhi Huangqi (Prepared Astragalus Root) 0.5 qian, Renshen (Ginseng Root) 1 qian, Baizhu (Atractylodes Macrocephala Rhizome) 0.5 qian, Danggui (Angelica Sinensis Root) 1.5 qian, and Shengma (Cimicifuga Rhizome) 0.5 qian. After three doses taken consecutively, the prolapse retracted. General sweating followed, and she stabilized. However, a piece of the protruding tissue, which had dried against the mat, fell off, weighing about 5-6 liang; this was adipose membrane. Her appetite improved, and she slept well. Pulse diagnosis showed all pulses were choppy (Se), with the left pulse slightly wiry (Xuan). Her physical appearance appeared robust. Subsequently, I prescribed Baizhu (Atractylodes Macrocephala Rhizome) and Shaoyao (Peony Root) each 1.5 qian, Chenpi (Tangerine Peel) 1 qian, and Shengjiang (Fresh Ginger) one slice, decocted and taken for 2-3 doses to nourish her.

In another case, a woman had an object resembling a lidded pot with two lobes protruding from the vagina after delivery. Her husband sought treatment. I reasoned this was uterine prolapse due to weak Qi and Blood sinking. I prescribed Shengma (Cimicifuga Rhizome), Danggui (Angelica Sinensis Root), and Huangqi (Astragalus Root) in large doses for two packets. Half a day later, the husband returned, stating that after two doses, he heard a sound, and upon inspection, the uterus had retracted into the vagina. However, a piece the size of a palm had broken off and stuck to the mat overnight. His wife was weeping, fearing irreparable damage. I reasoned this was not intestine but placental residue (Tai Gao). Muscle tissue can heal; if Qi and Blood are sufficient, it will regenerate. I prescribed Siwu Tang (Four Substance Decoction) plus Renshen (Ginseng Root) for 100 doses. Three years later, she gave birth again. For treating uterine prolapse, use Huangqi (Astragalus Root) 1.5 qian, Renshen (Ginseng Root) 1 qian, Danggui (Angelica Sinensis Root) 0.7 qian, Shengma (Cimicifuga Rhizome) 0.3 qian, Gancao (Licorice Root) 0.2 qian. Decoct one packet in one cup of water until reduced to half, filter, and take before meals. Also wash with Wubeizi (Chinese Gallnut) powder infusion. Apply external powder multiple times. Long-term medication prevents recurrence.

[Case by Xue Ji] Patulous vulva (Yumen not closing) is due to Qi and Blood deficiency; treat with Shiquan Dabu Tang (Ten Ingredient Great Tonifying Decoction). Swelling and pain indicate deficient heat in the Liver Meridian; treat with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If caused by worry and anger damaging Liver and Spleen Qi and Blood, use Jiaweigui Pi Tang (Modified Heart-Spleen Tonifying Decoction). If caused by sudden anger damaging Liver Fire and Blood, use Longdan Xiegan Tang (Gentian Decoction to Drain the Liver). A postpartum patient with patulous vulva, fever, and chills was treated with Shiquan Dabu Tang (Ten Ingredient Great Tonifying Decoction) plus Wuweizi (Schisandra Fruit); fever and chills subsided after several doses. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Wuweizi (Schisandra Fruit) closed the vulva after several doses. A woman with inherent weak Spleen and Stomach and Liver Fire presented with postpartum vulvar swelling and pain, chills, fever, thirst, vomiting, and anorexia. External application of Dahuang (Rhubarb Root) and internal purgatives caused swelling to spread to the buttocks and various symptoms to arise, indicating true Qi deficiency and pathogenic excess. First, Liu Jun Zi Tang (Six Gentlemen Decoction) was used to stabilize the intestines and stomach, followed by Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to raise Yang Qi; she recovered in a few doses. A postpartum patient with untreated prolapse suffered persistent swelling and ulceration, emaciation, poor appetite, morning chills, evening fevers, spontaneous and night sweats for six months. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fuling (Poria) and Banxia (Pinellia Tuber) gradually reduced pus and improved diet. Guipi Tang (Heart-Spleen Tonifying Decoction) for over 50 doses led to recovery.

A postpartum patient with patulous vulva, dribbling urination, and abdominal mass radiating to the hypochondrium causing distension and pain was cured with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) plus Cheqianzi (Plantago Seed). A woman with uterine enlargement took two days to retract, shedding a piece resembling pig liver. With sallow complexion, fatigue, anorexia, internal heat, afternoon tidal fever, and sweating, she was treated with Shiquan Dabu Tang (Ten Ingredient Great Tonifying Decoction) for over 20 doses; all symptoms resolved, and fertility was restored.

Treatment for postpartum vaginal swelling, prolapse, and patulous vulva:
Duanshi (Calcined Stone) (1 sheng, stir-fried until very hot) added to 2 sheng of water, poured into ash. When temperature is suitable, clarify and sit in the water to soak the Yumen (vulva). It will recover quickly.
Another prescription: Push Tie Jing Fen (Iron Essence Powder) into the vagina.
Another prescription: Moxa five to seven moxibustions on the horizontal crease below the umbilicus.
Another method: Mix Tie Jing (Iron Essence) and Yangzhi (Sheep Fat) until thick, wrap in cloth, heat, and apply as a warm compress to push inside. (Tie Jing is dust-like substance flying from the iron forging furnace, purple, light, and porous, used for polishing vessels.)

[Zimu Milu] To treat postpartum vaginal prolapse, burn rabbit head to ash and apply.

[Buyi] To treat postpartum rectal prolapse: Decoct Zhike (Aurantii Fructus) and soak for a long time to facilitate reduction. Another prescription: Soak in decoction of Wubeizi (Chinese Gallnut) and Baifan (Alum). Another prescription: Decoct Suanducao (Old Crow Acid Grass), sit on a non-perforated grass pad, fumigate until partially retracted, then wash gently when warm and assist retraction.
Another prescription: For uterine prolapse, wash with warm water to soften, then fumigate with smoke from burning Xiong Shufen (Male Rat Feces) to induce retraction. Another method: Crush 14 Castor Seeds (Bibanzi) without shell, apply to Baihui (GV20) on the vertex. Wash off once retracted.

[Dong Yuan] For prolapsed womb not retracting with constant dampness: Moxa Shenque (CV8) and Yuquan (50 moxibustions); Shenjiao (midway between umbilicus and pubic symphysis, 50 moxibustions, repeated three times).
Another method: Moxa point 3 cun lateral to Yuquan (moxibustion according to age, repeated three times). For cold swelling of female genitalia: Moxa Guilai (ST29) (30 moxibustions).

[Jia Yi Jing] For vaginal prolapse with wet limbs and body heaviness: Shaohai (HT3) is indicated. (Alternatively, Zhaohai (KI6)).

[Fleshy Cord in Vagina]
A postpartum patient had a fleshy cord emerging from the urinary/vaginal 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, crush it, add 2 jin of clear oil, and boil until oil is dry. Use silk to hold the fleshy cord, place it curved beside the tract, fumigate with the remaining ginger. Warm compress if cool. After one day and night, it shrinks significantly; fully retracts in two days. Regulate with Shixiao San (Stop Pain Powder) and Xionggui Tang (Ligusticum and Angelica Decoction). If the fleshy cord breaks, it is incurable.