产后胞衣不下，为血入胞中，上冲心胸，气血胀闷，不出欲死。必须逐其血，用红花、茜草
酒煎服，或朴硝散，甚则夺命丹。如再不下，脐坚胀急痛欲死者，牛膝汤。
妊娠努力，跌仆伤胎，腰腹疼痛，或胎上抢心去血，胶艾丸或从高坠下，或努力被重物所压
，触伤胎气，腹痛下血，胃虚呕逆，砂仁二钱，炒为末，酒调下，或佛手散。
胞衣先破之由有二∶或因母体素弱，气血两虚，胞衣故薄，儿身转动，随触而破。有因儿未
转动，坐草或早，用力过多，以致胞破。如已破久，则血水干，产路遂涩，儿难下也。急用
大剂加味芎归汤，加熟蜜一两助气，而兼润滑
，自当儿即顺下。
娄全善曰∶胞衣不下，惟花蕊散取效独妙。若乡居药肆，仓卒无之，今采得胡氏一法甚妙。
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。若有此患
，宜急断脐带，以少物系带必用力牢固系之，然后截断，使其子血不流入胞中。则胞衣自当
痿缩而下，纵淹延数日，亦不能有害。惟以产母心怀安泰，终自可下，累试有验。
花蕊散 治产后败血不尽，血迷血晕，恶阻，败血奔心。
胎死腹中，胞衣不下，至死者，但心头稍缓，急以童便调一钱服之，取下恶血或如猪肝，产
妇从此可无血气血风之症矣。如膈上有血，亦化为黄水，即口中吐出，或从小便下也。
牛膝汤
牛膝 瞿麦（各四两） 当归（三两） 通草（六两） 滑石（八两） 葵子（五两）
上药 咀为末，以水九升，煎至三升，分为三服。
产后胞衣不下，是因为血液进入胞宫，向上冲逆至心胸部位，导致气血壅滞胀闷，胞衣无法排出，产妇痛苦欲死。必须驱逐瘀血，使用红花、茜草用酒煎煮后服用，或者服用朴硝散，严重时使用夺命丹。如果仍然不排出，出现脐部坚硬、胀满急痛、痛苦欲死的症状，使用牛膝汤。
妊娠期间因用力过度或跌仆导致伤胎，出现腰腹部疼痛，或者胎气上冲心胸并伴有出血；如果是从高处置坠下，或者因用力被重物压迫，触伤了胎气，出现腹痛和下血，且胃气虚弱导致呕吐逆乱，可用砂仁二钱，炒成粉末，用酒调服，或者使用佛手散。
胞衣先破的原因有两个：一是因为母亲体质素来虚弱，气血两虚，导致胞衣变薄，胎儿在宫内转动时，随触碰而破裂。二是因为胎儿尚未转动，过早临盆（坐草），用力过多，导致胞衣破裂。如果胞衣破裂时间较长，则血水干涸，产道变得涩滞，胎儿难以产出。此时急需使用大剂量的加味芎归汤，加入一两熟蜂蜜以辅助补气，并兼有润滑作用，胎儿自然顺利产出。
娄全善说：产后胞衣不下，只有花蕊散取效最为奇妙。如果在乡村药铺中，仓促间没有此药，现在采纳胡氏的一种方法也非常奇妙。分娩结束后，胞衣不下，稍久则血液流入胞中，被血液胀满，向上冲逆至心胸，引起喘息急促和疼痛，必然导致病情危重。如果有这种病患，应当立即剪断脐带，用少量物品系住脐带，务必用力牢固地系紧，然后截断，使胎儿的血液不流入母体胞宫中。这样胞衣自然会萎缩而下，即使拖延数日，也不会造成危害。只要让产妇心情安定平和，最终胞衣自然可以排出，多次尝试都有验证。
胎死腹中，胞衣不下，甚至导致产妇死亡的情况，只要心头尚有一丝微弱气息，急忙用童便调服一钱花蕊散，可排出恶血，状如猪肝，产妇从此便可避免血虚、气虚及风邪等病症。如果膈上有瘀血，也会化为黄水，从口中吐出，或者从小便排出。
牛膝汤
牛膝、瞿麦（各四两）、当归（三两）、通草（六两）、滑石（八两）、葵子（五两）。
以上药物切碎成末，用水九升，煎煮至三升，分三次服用。
Postpartum retention of the placenta occurs when blood enters the uterus, rushing upward to the chest and heart, causing Qi and Blood stagnation, distension, and oppression. The placenta fails to expel, leaving the woman in extreme distress, on the verge of death. It is necessary to drive out the blood using Honghua (Safflower) and Qiancao (Madder Root), decocted with wine for oral administration, or administer Puxiao San (Mirabilite Powder). In severe cases, Duoming Dan (Life-Rescuing Pill) should be used. If it still does not expel, and symptoms include hardness, distension, and acute pain around the umbilicus, bringing the patient to the brink of death, Niuxi Tang (Achyranthes Decoction) is indicated.
During pregnancy, excessive effort or falling may injure the fetus, resulting in lower back and abdominal pain, or fetal Qi rushing upward to the heart accompanied by bleeding. If injured by a fall from height, or by being pressed by heavy objects due to excessive straining, damaging the fetal Qi, leading to abdominal pain and vaginal bleeding, combined with Spleen/Stomach deficiency causing vomiting and nausea, use 2 qian of Ren (Amomum Fruit), stir-fried into powder, taken with wine, or use Foshou San (Buddha's Hand Powder).
There are two causes for premature rupture of the membranes: First, due to the mother's inherent weakness and deficiency of both Qi and Blood, the membranes become thin; as the fetus moves, contact causes them to rupture. Second, if the fetus has not yet rotated, and labor begins too early with excessive pushing, the membranes may rupture. If the membranes have been ruptured for a long time, the amniotic fluid dries up, making the birth canal slippery and difficult, hindering the fetus's descent. In such cases, urgently administer a large dose of Jiawei Xionggui Tang (Modified Angelica and Ligusticum Decoction), adding 1 liang of cooked honey to tonify Qi and provide lubrication, allowing the fetus to descend smoothly.
Lou Quanshan stated: For postpartum retention of the placenta, only Huari San (Flower Stamen Powder) yields unique and excellent results. If one resides in the countryside and cannot obtain this medicine in an emergency, I now adopt a method from Mr. Hu which is also very effective. After delivery, if the placenta is retained, and after a short while blood flows into the uterus, causing distension and rushing upward to the chest and heart, leading to panting, urgency, and pain, the condition will inevitably become critical. If this occurs, one should immediately cut the umbilical cord. Tie the cord firmly with a small object, ensuring it is tightly bound, then cut it off. This prevents fetal blood from flowing into the maternal uterus. Consequently, the placenta will naturally shrink and descend. Even if delayed for several days, it will cause no harm. As long as the parturient woman maintains a calm and peaceful mind, the placenta will eventually expel naturally; this has been verified through repeated trials.
Huari San: Treats incomplete expulsion of lochia after childbirth, blood confusion and fainting, severe nausea/vomiting during pregnancy, and lochia rushing to the heart.
In cases where the fetus dies in the womb, the placenta is retained, and even leads to the death of the mother, provided there is still a slight warmth at the heart region, urgently administer 1 qian of Huari San mixed with child's urine. This will expel the foul blood, resembling pig liver. From then on, the parturient woman can avoid symptoms of Blood deficiency, Qi deficiency, and Wind pathogens. If there is blood above the diaphragm, it will transform into yellow fluid, either vomited from the mouth or discharged via urination.
Niuxi Tang
Niuxi (Radix Achyranthis Bidentatae), Qumai (Herba Dianthi) (each 4 liang); Danggui (Radix Angelicae Sinensis) (3 liang); Tongcao (Medulla Tetrapanacis) (6 liang); Huashi (Talcum) (8 liang); Kuizi (Fructus Abutilonis) (5 liang).
Grind the above herbs into coarse powder. Add 9 sheng of water, decoct until reduced to 3 sheng. Divide into three doses.