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A woman suffers from abdominal pain for several days and cannot deliver. People assume it is due to Qi deficiency and weakness, unable to push the fetus out of the birth canal. Little do they know that it is actually Blood deficiency causing stagnation; with no Blood in the womb, the fetus finds it difficult to turn. The formation of the fetus stems from Kidney Essence (Jing), while its nourishment relies half on the Blood of the Zang-Fu organs. Therefore, when Blood is abundant, childbirth is easy; when Blood is deficient, childbirth is difficult. Thus, before labor, one must tonify Blood. Although Blood is hard to generate rapidly, tonifying Qi is precisely the method to generate Blood. However, if one only tonifies Qi without simultaneously tonifying Blood, Yang will become excessively vigorous while Yin/Blood becomes insufficient. The harm of such imbalance fears a condition of ascending without descending. Hence, it is appropriate to tonify both Qi and Blood. Qi can push, and Blood can support it, making the amniotic fluid ample for turning, avoiding concerns of stagnation. Use Songzi Dan (Child-Delivering Decoction) to treat this.

Huangqi (Astragali Radix, 1 liang), Danggui (Angelicae Sinensis Radix, 1 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma, 3 qian), Shudi (Rehmanniae Radix Praeparata, 5 qian), Maidong (Ophiopogonis Radix, 1 liang). Decoct in water and take orally. After two doses, the child is born, without complications of transverse or breech presentation.

This formula consists of herbs that tonify Qi and Blood. Comparing the two, tonifying Blood is heavier than tonifying Qi; among them, only Huangqi tonifies Qi, while the rest are all Blood-tonifying substances. Whether Qi and Blood are balanced, or Yin and Yang interact harmoniously, childbirth becomes easy. When Blood is abundant relative to Qi, the interior of the gestational sac is filled with Blood. It is like a boat encountering shallow waters; despite using all human effort, it is difficult to move forward. Suddenly, spring floods arrive, allowing the boat to move on its own, and with a following wind, does it not sail swiftly without raising sails? Blood is like water, Qi is like wind. Without water, what good is a favorable wind? Therefore, tonifying Qi must include tonifying Blood.

Using Maidong Shengma Tang (Ophiopogon and Cimicifuga Decoction) is also effective.

Maidong (Ophiopogonis Radix, 4 liang), Shengma (Cimicifugae Rhizoma, 2 qian). Decoct in water and take orally. The fetal body turns immediately, facilitating rapid delivery.

In cases where a woman’s fetus has reached the birth canal but cannot be delivered, it is a critical moment of life and death. People attribute this to the premature rupture of membranes and lack of amniotic fluid to push. Little do they know that the issue lies in the failure of the pubic symphysis (Jiaogu) to open. Above the birth canal, there are originally two bones that interlock. Before labor, these bones remain closed; at the onset of labor, they naturally open. Thus, the pubic symphysis acts as the gatekeeper of the fetal passage and the key to the female genital opening. Its ability to open and close is governed by Qi and Blood. Without Blood, the passage closes itself; without Qi, it fails to open. To achieve opening and closing, the pubic symphysis must be smooth, which necessitates major tonification of Qi and Blood. Closing is easy, but opening is difficult. The reason for non-opening is often pre-natal indulgence in sexual activity, leading to excessive essence loss, severe depletion of Qi and Blood, and adhesiveness/stagnation of the pubic symphysis. Therefore, to open the pubic symphysis, one must use herbs that open it within the context of Qi and Blood tonification. Treating both together allows the fetus to descend rapidly without forced pushing. Use Jiangzi San (Child-Descending Powder):

Danggui (Angelicae Sinensis Radix, 1 liang), Renshen (Ginseng Radix, 5 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 5 qian), Honghua (Carthami Flos, 1 qian), Niuxi (Achyranthis Bidentatae Radix, 3 qian), Zuomuzhi (Ramulus Ziziphus Spinosae, 1 liang). Decoct in water and take orally. After one dose, a loud sound is heard from the birth canal, the bones seem to separate, and the fetus descends straight down.

This formula uses Renshen to tonify Qi, Danggui and Chuanxiong to tonify Blood, Honghua to invigorate Blood, Niuxi to guide downward, and Zuomuzhi to open the joints. The Sovereign, Minister, Assistant, and Envoy herbs work in concert, yielding miraculous effects by employing opening methods within tonification. Although Zuomuzhi alone can open the bones, without Qi and Blood tonification, the opening may not seal properly. An unsealed birth canal risks wind invasion. It is superior to use this formula which allows both opening and closing. If the fetus has not yet reached the canal, one must absolutely avoid using Zuomuzhi prematurely to open the passage. However, Jiangzi San is safe because it tonifies Qi and Blood. If using only Zuomuzhi, one must wait until the fetal head reaches the canal.

Using Tumen San (Aperture-Opening Powder) is also effective.

Huangqi (Astragali Radix, 2 liang), Baiguiban (Testudinis Carapax et Plastrum, one piece, crushed), Niuxi (Achyranthis Bidentatae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma, each 5 qian), Fuzi (Aconiti Lateralis Radix Praeparata, 3 fen). Decoct in water and take orally. After one dose, the birth canal opens, and the child is born. Adding Danggui is acceptable; adding Renshen is even more effective.

In childbirth, some present feet-first, others hands-first. People consider this transverse or breech presentation, a critical condition. Little do they know it is actually a disease of severe Qi and Blood deficiency. In the womb, the fetus sits upright: males face inward, females face outward. At birth, the head must rotate before delivery, a marvel of nature beyond human coercion. Although innate constitution and acquired constitution operate in harmony, heavenly mechanisms require human effort to assist. This "human effort" refers not to the mother's physical exertion, but to her Qi and Blood. Sufficient Qi and Blood ensure a smooth fetus; deficient Qi and Blood lead to abnormal presentations. Since Qi and Blood are deficient, the mother is weak, and the fetus cannot be strong. The fetus becomes timid and weak, lacking strength to turn, thus breaking the membrane and emerging with limbs visible first. At this time, urgently prick the fetal limbs with needles to cause retraction, then urgently use Zhuantian Tang (Heaven-Turning Decoction) to rescue.

Renshen (Ginseng Radix, 1 liang), Danggui (Angelicae Sinensis Radix, 2 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma, 5 qian), Shengma (Cimicifugae Rhizoma, 4 fen), Niuxi (Achyranthis Bidentatae Radix, 3 qian), Fuzi (Aconiti Lateralis Radix Praeparata, 1 fen). Decoct in water and take orally. After one dose, the fetus turns. Urgently take two more doses for natural smooth delivery.

This formula uses Renshen, Danggui, and Chuanxiong to tonify deficient Qi and Blood, which everyone understands. The use of Shengma, Niuxi, and Fuzi might be less obvious. Since the fetus is tilted, lifting agents are needed to turn the head. Once the head turns, descending agents are needed for rapid body descent. Using both requires Fuzi to ensure unobstructed meridian flow, enabling Qi and Blood to rush and push the fetus out.

Using Zhuanqi Cuisheng Tang (Qi-Turning Labor-Inducing Decoction) is also miraculous.

Renshen (Ginseng Radix, 2 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma, 5 qian), Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Guigao (Tartarum Testudinis, each 1 liang), Shengma (Cimicifugae Rhizoma), Xuanfuhua (Inulae Flos, each 1 qian). Decoct in water and take orally. After one dose, the fetus turns and is born.

In cases where a woman has labored for three or four days, the fetus has reached the canal, the pubic symphysis will not open, the child is dead, but the mother survives, and remedies to open the pubic symphysis fail, there is a risk of death. Fortunately, survival is possible because the death of the fetus means the membranes have ruptured, separating mother and child. The mother's Qi recovers and does not perish with the child. The treatment should focus solely on saving the mother, ignoring the dead fetus. However, a dead fetus blocking the canal is dangerous. One should still tonify Blood and Qi to make both abundant, allowing the dead fetus to exit. If one merely uses purgative or expulsive agents to force the fetus out, the fetus may not pass, but the mother may collapse first. Use Jiumu Dan (Mother-Saving Pill):

Danggui (Angelicae Sinensis Radix, 2 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma, 1 liang), Renshen (Ginseng Radix, 1 liang), Jingjie (Schizonepetae Spica, 3 qian), Yimucao (Leonuri Herba, 1 liang), Chishizhimo (Halloysit Rubra, 1 qian). Decoct in water and take orally. After one dose, the fetus is expelled.

This formula uses Chuanxiong and Danggui to tonify Blood, and Renshen to tonify Qi. With abundant Qi and Blood, there is ascending and descending, pushing and sending, eliminating obstruction. Moreover, Leonuri Herba excels at expelling dead fetuses, and Halloysit Rubra resolves blood stasis, ensuring simultaneous expulsion.

Using Niuxi Yimu Tang (Achyranthus and Motherwort Decoction) is also effective.

Niuxi (Achyranthis Bidentatae Radix, 3 liang), Yimucao (Leonuri Herba, 1 liang). Decoct in water and take orally. After one dose, the dead fetus drops immediately. Subsequently, administer Renshen and Danggui (each 1 liang), Chuanxiong (5 qian), and Rougui (Cinnamomi Cortex, 1 qian) to prevent complications.

In cases where a woman has labored for six or seven days, the amniotic fluid has broken, but the fetus has not descended, people assume it is dystocia. Little do they know the fetus has died in the abdomen. A living fetus near the canal can extend and retract its head; a dead fetus remains motionless. If alive, pulling the hair would cause retraction. If only the fetus is dead in the abdomen, the mother's face will show no black qi, and she will survive. If the mother shows black qi on her face, along with black lips and tongue, both mother and child die. Knowing the fetus is dead but the mother lives, failing to use medication to expel it is dangerous. Although seven days into labor, using harsh/expulsive drugs would deplete the already exhausted Qi and Blood, potentially killing the mother upon delivery. One must tonify the mother; tonifying the mother allows the fetus to exit naturally. Use Liaor San (Fetus-Curing Powder):

Renshen (Ginseng Radix, 1 liang), Danggui (Angelicae Sinensis Radix, 2 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma, 1 liang), Niuxi (Achyranthis Bidentatae Radix, 5 qian), Jiubai (Podophylli Peltati Rhizoma et Radix, 3 qian), Ruxiangmo (Boswelliae Resina, 2 qian). Decoct in water and take orally. After one dose, the dead fetus is expelled.

Normally, the fetus must turn its head at birth. Difficulty turning is due to Qi and Blood deficiency. People often use labor-inducing drugs, which consume the fetus's Qi and Blood, preventing passage and causing suffocation death. Such deaths are effectively physician-induced. Therefore, in dystocia, one must never lightly use labor-inducing drugs. Solely tonifying Qi and Blood can save countless infants. This formula saves the mother of a dead fetus by heavily tonifying Qi and Blood, addressing the root. Who knows that treating the root induces labor?

Using Shenqi Jiumu Tang (Ginseng and Astragalus Mother-Saving Decoction) is also miraculous.

Renshen (Ginseng Radix), Huangqi (Astragali Radix, each 1 liang), Danggui (Angelicae Sinensis Radix, 2 liang), Shengma (Cimicifugae Rhizoma, 5 fen), Guiban (Testudinis Carapax et Plastrum, one piece), Mudingxiang (Eugeniae Caryophyllatus Flos, 3 pieces). Decoct in water and take orally. After one dose, the dead fetus is born.

In cases where a woman has labored for several days without delivering, and labor-inducing drugs fail, previous sections mentioned difficulty opening the pubic symphysis. However, there is also the case of Qi stagnation and failure to move. While pubic symphysis non-opening causes dystocia, if the fetal head has reached the canal but cannot descend, it is indeed due to the pubic symphysis, and bone-opening agents are appropriate. But if the fetus has not reached the canal and is not delivering, it is not due to pubic symphysis issues. Opening the pubic symphysis prematurely would widen the birth canal, causing the fetal head to fail to turn and leading to unusual complications. One must absolutely avoid opening the birth canal lightly. Generally, during labor, sitting on the grass (beginning active pushing) too early is forbidden. If the fetus hasn't turned, sudden delivery is impossible. Sitting too early causes anxiety upon seeing no progress. Fear disperses Shen (Spirit), causing Qi to sink rather than ascend. Unascended Qi blocks the Upper Jiao, causing Qi rebellion. Upper Qi rebellion leads to Upper Jiao distension, making Qi movement harder. Qi obstruction between upper and lower levels makes labor-inducing drugs counterproductive, worsening Qi rebellion and fetal closure. The treatment is to promote Qi flow, not induce labor; the fetus will descend naturally. Use Shuqi Yin (Qi-Regulating Decoction):

Renshen (Ginseng Radix, 1 liang), Zisu (Perillae Folium, 3 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 5 qian), Danggui (Angelicae Sinensis Radix, 1 liang), Chenpi (Citri Reticulatae Pericarpium, 1 qian), Baishao (Paeoniae Radix Alba, 5 qian), Niuxi (Achyranthis Bidentatae Radix, 3 qian), Chaihu (Bupleuri Radix, 8 fen). Decoct in water. Add 7 cun of Congbai (Allii Fistulosi Bulbus) and decoct together. After one dose, the situation reverses, and the fetus is delivered.

This formula promotes Qi flow while实质上 tonifying Qi. Qi rebellion stems from Qi deficiency; deficiency leads to fear. Tonifying Qi stabilizes fear, and stabilized fear allows rebellious Qi to normalize naturally. Moreover, herbs like Perillae Folium, Bupleuri Radix, Paeoniae Radix Alba, and Achyranthis Bidentatae Radix soothe Liver and diffuse Lung. Assisted by Ginseng, Ligustici Chuanxiong Rhizoma, and Angelicae Sinensis Radix, they truly benefit tonification and regulation. Why bother opening the pubic symphysis unnecessarily?

Guishu Jiangbao Tang (Angelica and Atractylodes Uterus-Descending Decoction) can also be used.

Danggui (Angelicae Sinensis Radix, 2 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 2 liang), Chaihu (Bupleuri Radix, 1 qian), Niuxi (Achyranthis Bidentatae Radix, 3 qian), Danpi (Moutan Cortex, 3 qian), Honghua (Carthami Flos, 5 qian), Jingjie (Schizonepetae Spica, 3 qian), Yimucao (Leonuri Herba, 5 qian). Decoct in water and take orally. Delivery occurs after one dose, without harming the fetus.