〔《大》〕夺命丹 治血入胎衣,衣为血胀不得下。
附子(炮,半两) 牡丹(一两) 干漆(一分,碎之,炒尽烟)
上为末,以酽酷一升,大黄末一两,熬成膏,和药丸如桐子大。温酒吞五七丸,不拘时。此药逐
去胞中之血,血散胀消,胞衣自下矣。
花蕊石散 治产后气欲绝。缘败血不尽,血迷血晕,恶血奔心,胎死腹中,胎衣不下至死者。但心头暖,
急以童便调一钱,取下恶血如猪肝,终身无血风血气疾。膈上有血,化为黄水,即吐出,或从小便出也。
(方见跌扑伤损。)
黑龙丸治胞衣不下,神效。(方见产后血不下。)
黑神散治恶露不快,胞衣不下。(方见产通用。)
牛膝汤 治胞衣不出,脐腹坚胀,急痛即杀人。服此药胞即烂下,死胎亦下。
牛膝 瞿麦(各四两) 当归(三两) 通草(六两) 滑石(八两) 葵子(五两)
上 咀,以水九升,煮三升,分三服。若衣不下,腹满,即杀人。推其源皆胞衣有血奔心,是以不出,服
此药衣即烂出。
治胞衣不出。牛膝一两,葵子一合,以水一升,煮半升,去渣,分二服。
〔《千》〕备急丹 治产后恶血冲心,胎衣不下,腹中血块。
以锦纹大黄一两为细末,用酽醋半升,同煎如膏,丸如桐子大,患者用醋七分盏,化五丸至七丸
服之,须臾血下即愈。
〔《保》〕治胎衣不下,或子死腹中,或血冲上昏闷,或血暴下,及胎干不能生产,半夏汤主之。
(见前催生条。)
下胎丸
半夏 白蔹(各半两)
上细末,丸如桐子大。食后半夏汤下三十丸,渐加至五十丸。如未效者,须广大其药,榆白皮散
主之;又不效,大圣散主之;有宿热者,宜服人参荆芥散。
〔《大》〕治胞衣不下,惟有花蕊石散一件,最为要紧。若乡居药局远者,仓卒无之,今采得胡氏
方一妙法。若产讫胞衣不下,稍久则血流胞中,为血所胀,上冲心胸,喘急疼痛,必致危笃。若有此
证,宜急断脐带,以少物系带,必用力牢固系之,然后截断,使其子血脉不潮入胞中,则胞衣自当痿
缩而下。纵淹延数日,亦不害人。只要产母心怀安泰,终自下矣,累试有验。治胞衣不下,以蛇蜕炒
为细末,酒下二钱。如圣膏(方见胎前催生,即蓖麻子法。)若胞衣不下,腹胀则杀人。黑豆一合,
炒熟,入醋一盏,煎,去豆分三服。胞衣不下。取灶内黄土一寸,研碎,同醋调匀,纳于脐中,续
煎甘草汤三四合,服之出。
〔《山》〕胞衣不下。用取初洗儿汤,服下一盏,勿令产母知。
〔《集》〕胞衣不下∶三阴交、中极(各泻之。)
〔标幽〕又法∶照海、内关。
〔《甲》〕女子字难,若胞不出,昆仑主之。
【《太平惠民和剂局方》】夺命丹:治疗因血液进入胎衣,导致胎衣被血胀满而无法排出的情况。
附子(炮制,半两) 牡丹皮(一两) 干漆(一分,捣碎,炒至烟尽)
以上药物研为细末,用浓醋一升,加入大黄末一两,熬制成膏状,与药末混合制成如梧桐子大小的丸剂。每次温酒送服五至七丸,不限具体时间。此药能驱逐胞宫中的瘀血,瘀血消散、胀满消除后,胎衣自然排出。
花蕊石散:治疗产后气息将绝之症。缘由败血未尽,导致血迷血晕,恶血攻心,或胎死腹中、胎衣不下直至死亡的情况。只要患者心头尚暖,立即用童便调服一钱药粉,可排出如猪肝状的恶血,此后终身不再患血风、血气疾病。若膈上有瘀血,会化为黄水,通过呕吐或从小便排出。
(该方见“跌扑伤损”章节。)
黑龙丸:治疗胎衣不下,疗效显著。(该方见“产后血不下”章节。)
黑神散:治疗恶露排出不畅、胎衣不下。(该方见“产通用”章节。)
牛膝汤:治疗胎衣不出,脐腹部坚硬胀满,剧烈疼痛甚至危及生命。服用此药后,胎衣即腐烂脱落排出,死胎亦随之排出。
牛膝 瞿麦(各四两) 当归(三两) 通草(六两) 滑石(八两) 冬葵子(五两)
以上药物切碎,用水九升,煮取三升药液,分三次服用。如果胎衣不下,腹部胀满,就会危及生命。推究其根源,皆因胞衣中有血上冲于心,导致无法排出,服用此药后胎衣即腐烂而出。
治疗胎衣不出的另一法:牛膝一两,冬葵子一合,用水一升,煮取半升,去渣,分两次服用。
【《备急千金要方》】备急丹:治疗产后恶血冲心、胎衣不下、腹中血块。
以锦纹大黄一两研为细末,用浓醋半升,共同煎煮成膏状,制成如梧桐子大小的丸剂。患者用七分醋盏,化开五至七丸服用,须臾间瘀血下行即可痊愈。
【《妇人大全良方》】治疗胎衣不下,或子死腹中,或血冲上致昏闷,或血暴下,以及胎干不能生产,主用半夏汤。
(见前文“催生”条。)
下胎丸
半夏 白蔹(各半两)
以上研为细末,制成如梧桐子大小的丸剂。饭后用半夏汤送服三十丸,逐渐增加至五十丸。如果无效,需用更广泛的药物,主用榆白皮散;若仍无效,主用大圣散;若有宿热者,宜服用人参荆芥散。
【《太平惠民和剂局方》】治疗胎衣不下,唯有花蕊石散这一种最为关键。如果在乡村居住且药局遥远,仓促间没有此药,现采集胡氏的一则妙法。如果分娩后胎衣不下,稍久则血流积聚在胞中,被血所胀,向上冲撞心胸,出现喘息急促、疼痛,必然导致危重病情。如果有此证候,应立即剪断脐带,用少量物品系住脐带,必须用力牢固地系紧,然后截断,使胎儿的血液不逆流进入胞中,则胎衣自然会萎缩而下。即使拖延数日,也不会伤害人。只要产妇心境安宁,最终胎衣自会排出,多次试验均有验证。治疗胎衣不下,可用蛇蜕炒为细末,酒送服二钱。如圣膏(该方见“胎前催生”,即蓖麻子用法)。如果胎衣不下,腹胀则会危及生命。黑豆一合,炒熟,加入醋一盏,煎煮,去豆渣,分三次服用。治疗胎衣不下,取灶内黄土一寸,研碎,同醋调匀,填入脐中,随后煎甘草汤三四合,服用后可使胎衣排出。
【《山居方》】胎衣不下。用初洗婴儿的汤水,让产妇喝下一盏,不要让产妇知道。
[Tai Ping Hui Min He Ji Ju Fang] Duoming Dan: Treats the condition where blood enters the placenta, causing it to swell with blood and preventing expulsion.
Fuzi (Prepared Aconiti Lateralis Radix, half tael) Mudanpi (Moutan Cortex, one tael) Ganqi (Dried Resin of Toxicodendron, one fen, crushed, stir-fried until smoke ceases)
The above ingredients are ground into fine powder. Using one sheng of strong vinegar and one tael of Dahuang powder, boil into a paste, mix with the medicine to form pills the size of paulownia seeds. Swallow five to seven pills with warm wine at any time. This drug expels blood stasis from the uterus; once the blood disperses and swelling subsides, the placenta will naturally descend.
Huarishi San: Treats postpartum breathlessness approaching cessation. The cause is incomplete expulsion of lochia and blood stasis, leading to blood confusion and fainting, evil blood rushing to the heart, fetal death in utero, or retained placenta leading to death. As long as the patient's heart area remains warm, immediately administer one qian of powder mixed with child's urine to expel evil blood resembling pig liver. Thereafter, the patient will never suffer from blood wind or blood qi disorders. If blood stasis exists above the diaphragm, it transforms into yellow fluid, which is expelled via vomiting or urination.
(See section on "Traumatic Injuries".)
Heilong Wan: Treats retained placenta with miraculous efficacy. (See section on "Postpartum Failure of Blood Expulsion".)
Heishen San: Treats sluggish lochia discharge and retained placenta. (See section on "General Postpartum Formulas".)
Niuxi Tang: Treats retained placenta, characterized by hard and distended umbilical/abdominal region, severe pain that can be fatal. After taking this medicine, the placenta rots and descends, and dead fetuses are also expelled.
Niuxi Quma (each four taels) Danggui (three taels) Tongcao (six taels) Huashi (eight taels) Kuiziren (five taels)
The above ingredients are chopped. Boil in nine sheng of water until three sheng remain, divide into three doses. If the placenta does not descend and the abdomen becomes full, it is fatal. Investigating the source, all cases stem from blood rushing to the heart due to the retained placenta, preventing expulsion. Taking this medicine causes the placenta to rot and exit.
Another method for retained placenta: Niuxi one tael, Kuiziren one he. Boil in one sheng of water until half a sheng remains, strain, and divide into two doses.
[Bei Ji Qian Jin Yao Fang] Beiji Dan: Treats postpartum evil blood rushing to the heart, retained placenta, and abdominal blood masses.
Grind one tael of Jinwen Dahuang into fine powder. Use half a sheng of strong vinegar, boil together into a paste, and form pills the size of paulownia seeds. The patient dissolves five to seven pills in seven-tenths of a cup of vinegar and takes them. Within a short time, blood descends and recovery occurs.
[Fu Ren Da Quan Liang Fang] For retained placenta, fetal death in utero, blood rushing upward causing faintness, sudden heavy bleeding, or dried placenta preventing delivery, primarily use Banxia Tang.
(See previous section on "Inducing Labor".)
Xiatai Wan
Banxia Bailian (each half tael)
Grind into fine powder and form pills the size of paulownia seeds. Take thirty pills after meals with Banxia Tang, gradually increasing to fifty pills. If ineffective, use broader-acting medicines, primarily Yubai Pi San; if still ineffective, use Dasheng San; for those with chronic heat, Renshen Jingjie San is suitable.
[Tai Ping Hui Min He Ji Ju Fang] To treat retained placenta, only Huarishi San is most critical. If living in rural areas far from pharmacies and lacking this medicine in haste, here is a wonderful method from Mr. Hu. If the placenta fails to descend after birth, and after some time blood flows into the uterus, causing swelling that rushes upward to the chest and heart, resulting in panting, urgency, and pain, it leads to critical danger. In such cases, immediately cut the umbilical cord, tie it securely with a small object, then sever it completely, preventing fetal blood from flowing back into the uterus. Consequently, the placenta will naturally shrink and descend. Even if delayed for several days, it will not harm the person. As long as the mother remains calm, the placenta will eventually descend. This has been tested repeatedly with success. To treat retained placenta, stir-fry shed snake skin into fine powder and take two qian with wine. Rushing Holy Paste (see "Antenatal Induction", i.e., Ricinus communis method). If the placenta does not descend and the abdomen swells, it is fatal. Take one he of black beans, roast until cooked, add one cup of vinegar, boil, remove beans, and divide into three doses. For retained placenta, take one cun of yellow earth from the hearth, grind finely, mix with vinegar, apply to the navel, then decoct and drink three to four he of Gancao Tang to facilitate expulsion.
[Shan Ju Fang] Retained placenta: Administer one cup of the water used for washing the newborn for the first time to the mother, without her knowledge.
[Zhen Jiu Ji Cheng] Retained placenta: Needle Sanyinjiao (SP6), Zhongji (CV3) using reducing method.
[Biao You Fu] Another method: Zhaohai (KI6), Neiguan (PC6).
[Jia Yi Jing) Difficult childbirth in women, specifically when the placenta does not descend, Kunlun (BL60) is indicated.