凡产妇胎未顺而胞先破者，其因有二∶盖一有母质薄弱，胞衣不固，因儿转动，随触而破者，此气血之虚
也；一有儿身未转以坐草太早，用力太过而胞先破者，此举动之伤也。若胞破久而水血干，产道涩则儿难下，
宜急用大料四物汤或五物煎、滑胎煎、五福饮、当归汤之类，助其气血，并浓煎葱汤熏洗产户，使其暖而气
达，则自当顺下。若持久力乏，血已耗涸，则甚危矣。当用八珍汤料一斤、益母草四两，水数碗，煎熟，不时
饮之，亦有得生者。或以黄 、芎、归数斤，以大釜煎，药气氤氲满室，使产母口鼻俱受其气，亦良法也。
四物汤（见经不调）
五物煎（见血寒论外方）
滑胎煎（见滑胎）
五福饮（见血热经早）
当归汤（见胎气上逼）
八珍汤（见经不调）
大抵产难之证，多患于郁闷、安佚、富贵之家，治法虽云胎前清气，产后补血，然不可拘泥。若脾胃不
健，气血不充，必当预为调补，不然，临产必多患难。
产难经日不下，别无危证者，宜用脱花煎催之，极妥极妙。
脱花煎（见催生）
一医宿客店，治店妇临产数日不生，下体俱冷，无药，甚窘。令取椒、橙叶、茱萸，共煎汤一盆，令产妇
以小凳坐盆内，熏洗良久，小腹皆暖，气温血行，遂产。
一方以紫苏煎汤熏洗。大抵遇严寒时月，产久伤冷，气血必凝。此熏洗之法，亦要法也。外以淋汤，内
以羊肉汤必效。
一方令产妇以自己发梢含于口中，令其恶心作呕，即下。亦治胞衣不出。
凡是产妇胎儿尚未转正而胞衣先破裂的情况，其成因主要有两种：一种是母亲体质虚弱，胞衣不坚固，因胎儿转动，触碰即破，这是气血虚弱的表现；另一种是胎儿身体未转正就过早临产，用力过猛导致胞衣先破，这是动作不当造成的损伤。如果胞衣破裂时间过长，羊水血液干枯，产道干涩，胎儿难以产出，应当立即使用大剂量的四物汤或五物煎、滑胎煎、五福饮、当归汤等方剂，以补益气血，并浓煎葱汤熏洗产门，使局部温暖且气机通达，胎儿自然顺利下行。如果拖延日久导致体力耗尽，血液枯竭，情况就非常危险了。此时应当使用八珍汤料一斤、益母草四两，加水数碗，煎煮成熟，不时让产妇饮用，也有能够存活下来的案例。或者用黄芪、川芎、当归数斤，用大锅煎煮，药气弥漫满屋，让产妇的口鼻都吸入药气，这也是很好的方法。
总的来说，难产这一病症，多发生在情绪抑郁、生活安逸、富贵人家中。治疗方法虽然常说产前宜清利气机，产后宜补血，但不可拘泥不变。如果脾胃功能不强健，气血不充足，必定应当预先进行调理补益，否则，临产时必然多有艰难困苦。
难产经过多日仍无法分娩，且没有其他危急症状的，适宜使用脱花煎来催产，非常稳妥巧妙。
有一位医生投宿在旅店，治疗一位店主妇人临产数天未能生下，下身全部冰冷，手中无药，处境十分窘迫。他让人取花椒、橙叶、吴茱萸，共同煎成一盆汤，让产妇坐在小凳上，将下体置于盆内熏洗很久，小腹变得温暖，气温升高血行通畅，于是顺利生产。
另一个方子是用紫苏煎汤熏洗。总的来说，遇到严寒时节，产程长久受寒，气血必定凝滞。这种熏洗的方法，也是重要的疗法。外部淋洗热汤，内部服用羊肉汤，必定有效。
还有一个方子是让产妇将自己头发梢含在口中，引发恶心呕吐感，胎儿随即娩出。这也用于治疗胞衣不下。
In cases where the membranes rupture before the fetus is in a proper position for delivery, there are two main causes: First, the mother's constitution is weak, and the membranes are not secure; as the fetus moves, it touches and ruptures them. This is due to deficiency of Qi and Blood. Second, the fetus has not yet turned into the correct position, but the mother goes to deliver too early and exerts excessive force, causing the membranes to rupture prematurely. This is an injury caused by improper movement. If the membranes have been ruptured for a long time, leading to dryness of amniotic fluid and blood, and the birth canal becomes rough, the fetus will find it difficult to descend. In such cases, one should urgently administer large doses of Siwu Tang (Four Substance Decoction), or Wuwu Jian (Five-Ingredient Decoction), Huatai Jian (Slippery Fetus Decoction), Wufu Yin (Five Blessings Drink), Danggui Tang (Angelica Sinensis Decoction), etc., to assist Qi and Blood. Additionally, decoct green onion soup at high concentration to fumigate and wash the vulva, so that warmth reaches the area and Qi flows smoothly, allowing the fetus to descend naturally. If the condition persists until strength is exhausted and blood is depleted, the situation becomes critical. One should then use eight zhen Tang (Eight Treasures Decoction) ingredients totaling one jin (approx. 500g), along with four liang (approx. 200g) of Motherwort Herb (Yimucao), add several bowls of water, boil until ready, and allow the parturient to drink intermittently. There are cases where this results in survival. Alternatively, use several jin of Astragalus Root (Huangqi), Szechuan Lovage Rhizome (Chuanxiong), and Angelica Sinensis Root (Danggui), decoct in a large cauldron until the medicinal vapor fills the room, ensuring the parturient inhales the vapor through both mouth and nose. This is also an excellent method.
Generally speaking, dystocia often affects those who are prone to depression, live in leisure, or belong to wealthy families. Although treatment principles generally suggest clearing Qi during pregnancy and nourishing Blood after delivery, these rules should not be applied rigidly. If the Spleen and Stomach are not robust and Qi and Blood are insufficient, preventive regulation and tonification must be undertaken beforehand; otherwise, difficulties during labor are inevitable.
For dystocia lasting several days without other critical symptoms, Tuohua Jian (Expel Flower Decoction) should be used to induce labor. It is extremely safe and effective.
A physician staying at an inn treated a shopkeeper's wife who had been in labor for several days without delivering. Her lower body was completely cold, and she had no medicine, leaving her in great distress. The physician instructed someone to gather Sichuan Pepper (Huajiao), Orange Leaf (Chengye), and Chinese Cornelian Cherry Fruit (Zhuyu), decoct them together in a basin of water, and have the parturient sit on a small stool over the basin to fumigate and wash for a long time. Her lower abdomen became warm, Qi temperature rose, and Blood circulation improved, resulting in successful delivery.
Another prescription uses Perilla Leaf (Zisu) decocted in water for fumigation and washing. Generally, during severe cold months, prolonged exposure to cold during labor causes Qi and Blood to coagulate. Therefore, this fumigation and washing method is also a crucial technique. External application of hot water infusion combined with internal consumption of Mutton Soup yields definite efficacy.
Another method involves having the parturient hold the tip of her own hair in her mouth to induce nausea and vomiting, which facilitates delivery. This is also used to treat retained placenta.