急以物牢扎脐带，坠住，使不上升，然后将脐带
剪断，使血不入胞，萎缩易下。若未系先断，胞升凑心，必死。
徐蔼辉曰∶《保生录》云∶觉胎衣不下，产妇用自己头发塞口中，打一恶心即下。切须放心，不可惊恐，不可
听稳婆妄用手取，多致伤生。又以草纸烧烟熏鼻，即下。
芒硝三钱，童便冲服，立效。俞邃良先生目睹。
松郡一老稳婆，包医是证。自带白末药一包，买牛膝二两，同煎去渣，冲童便半杯服，立下。
沈尧封曰∶白末药定是玄明粉，玄明粉即制朴硝也。
一老妪云∶产后被侍者挟落腰子使然。用乌梅肉二个，煎汤服，立效。嘉郡钱邻哉目睹。
轻则艾叶及夺命散；重则无极丸；寒凝者，肉桂、
红花等药，并花蕊石散。
王孟英按∶产后苟无寒证的据，一切辛热之药皆忌。恶露不来，腹无痛苦者，勿乱投药饵，听之可也；
如有疼胀者，只宜丹参、丹皮、玄胡、滑石、益母草、山楂、泽兰、桃仁、归尾、通草之类为治。慎毋妄施
峻剂。生化汤最弗擅用。
《汇补》云∶九窍出血，死证恒多。惟产后瘀血妄行，九窍出血，有用逐瘀之药而得生者，不可遽断其必
死。此是阅历后之言，不可忽略！虽无方药，其法已具。
立即用结实的物品紧紧扎住脐带，使其下坠固定，防止其向上回缩，然后将脐带剪断，使血液不进入胞宫，促使胞宫萎缩从而容易排出。如果在未扎紧之前就剪断脐带，胞衣会上提凑近心脏，必然导致死亡。
徐蔼辉说：《保生录》记载，感觉胎衣不下时，产妇可用自己的头发塞入口中，引发恶心感，胎衣即可排出。务必保持心情放松，不可惊恐，也不可听信接生婆胡乱用手去取，这往往会导致伤亡。又可以用草纸燃烧产生的烟雾熏鼻子，胎衣即可排出。
芒硝三钱，用童子尿冲服，立刻见效。俞邃良先生亲眼目睹过这一案例。
松江郡有一位老练的接生婆，专门治疗这种病症。她自带一包白色粉末药，购买牛膝二两，同煎后去渣，加入半杯童子尿服用，立刻见效。
沈尧封说：那包白色粉末药肯定是玄明粉，玄明粉就是经过炮制的朴硝。
一位老妇人曾说：产后因侍者搀扶不当导致腰部受挫所致。使用乌梅肉两个，煎汤服用，立刻见效。嘉郡的钱邻哉亲眼目睹过。
伏龙肝二两，煎汤澄清后，将阿胶一两溶化在其中服用。如果无效，再加入人参。
病情轻的用艾叶及夺命散；病情重的用无极丸；寒凝阻滞的，用肉桂、红花等药物，配合花蕊石散。
王孟英按语：产后如果没有寒证的依据，一切辛热性质的药物都应禁忌。恶露不来，腹部没有痛苦感的，不要乱投药物，顺其自然即可；如果有疼痛胀满感的，只适宜用丹参、丹皮、玄胡、滑石、益母草、山楂、泽兰、桃仁、归尾、通草这类药物治疗。千万不要妄用峻猛的药物。生化汤最不应该滥用。
《汇补》记载：九窍出血，死证通常很多。只有产后瘀血妄行导致的九窍出血，有用逐瘀药物而获救存活的，不能立刻断定必死无疑。这是经过临床实践后的言论，不可忽视！虽然这里没有列出方药，但治疗方法已经具备。
Immediately tie the umbilical cord tightly with a firm object to keep it lowered and prevent upward retraction, then cut the cord. This prevents blood from entering the uterus (Zang Fu organ), causing it to shrink and facilitating its expulsion. If the cord is cut before being tied, the placenta may ascend towards the heart, which will certainly lead to death.
Xu Aihui stated: *Bao Sheng Lu* records that if one feels the placenta is not descending, the parturient woman can insert her own hair into her mouth to induce nausea, after which the placenta will be expelled. One must remain calm and not panic, nor should one listen to midwives who blindly attempt manual extraction, as this often leads to injury or death. Alternatively, smoke from burning straw paper can be used to fumigate the nose, which will also cause the placenta to descend.
Three qian of Mangxiao (Natrii Sulfas) taken with Tongbian (Urine of a healthy young boy) yields immediate results. Mr. Yu Suiliang witnessed this case personally.
An experienced midwife in Songjun specialized in treating this condition. She carried a packet of white powder medicine herself, purchased two liang of Niuxi (Achyranthis Bidentatae Radix), decocted them together, strained the residue, and administered half a cup of Tongbian mixed with the decoction, resulting in immediate effect.
Shen Yaofeng remarked: The white powder medicine must be Xuanmingfen (Prepared Natrii Sulfas), which is processed Puxiao (Raw Natrii Sulfas).
An old woman claimed: This was caused by postpartum lumbar injury due to improper support by attendants. Two Wu Mei Rou (Semen Mume) were decocted in water and taken orally, yielding immediate results. Qian Linzai from Jiajun witnessed this.
Two liang of Fulonggan (Caulis Longan Arborescentis Carbonized) was decocted in water, clarified, and one liang of Ejiao (Colla Corii Asini) was dissolved into it for administration. If there is no response, add Renshen (Ginseng Radix et Rhizoma).
For mild cases, Ai Ye (Artemisiae Argyi Folium) and Duoming San (Life-Restoring Powder) are used; for severe cases, Wuji Wan (Wuji Pill); for cold stagnation, Rougui (Cinnamomi Cortex), Honghua (Carthami Flos), and other herbs, combined with Huarui Shi San (Stibnite Powder).
Wang Mengying added notes: In the postpartum period, unless there is clear evidence of cold syndromes, all acrid-warm medicines should be contraindicated. If lochia does not come and there is no abdominal pain, do not administer drugs indiscriminately; let nature take its course. If there is pain and distension, treatment should only involve herbs such as Danshen (Salviae Miltiorrhizae Radix), Danpi (Moutan Cortex), Yuanhu (Corydalis Rhizoma), Shishi (Talcum), Yimucao (Leonuri Herba), Shanzha (Crataegi Fructus), Zelan (Lycopus Herba), Taoren (Persicae Semen), Guiwei (Angelicae Sinensis Radix), and Tongcao (Tetrapanacis Medulla). Do not recklessly use harsh purgatives. Shenghua Tang (Decoction for Generating New Blood) should be used with extreme caution and is often misapplied.
*Hui Bu* states: Bleeding from the nine orifices is frequently a fatal syndrome. However, in cases where bleeding from the nine orifices is caused by postpartum chaotic flow of blood stasis, survival is possible using blood-invigorating and stasis-resolving medicines; one cannot hastily declare it inevitably fatal. This is a statement derived from clinical experience and should not be overlooked. Although no specific prescriptions are listed here, the therapeutic principles are already established.