交骨不开乃元气虚弱，胎前失于调养，以致气血不能运达而然也。急令安睡。内服加味芎归汤（方见前临产服药条
中），外以麻油调滑石末，涂其产门即开。
儿出胎时，稳婆宜以两手轻抱产母胸前，产母自己亦宜以两手紧抱肚脐，令胞衣下坠。如胞衣不下，亦是临
盆太早之故。盖正产时骨节开张，壮者数日而合，怯者弥月而合。今不待其开而强出之，故胎出骨眼随闭，以致
胞出不及耳。宜用佛手（方见前难产条中），加牛膝、瞿麦（各二钱），滑石（一钱），水煎服。若败血流入胞
中，胞即胀大，不得下，治之稍缓，胀满腹中，上冲心胸，疼痛喘急，宜急断脐带，使血不入胞中，免致胀满。
但脐带极脆，要细心拿定。先用软绢或粗麻线系住脐带，又将脐带双折再系一道，以秤锤坠之，防其缩入，然后
剪断。过三五日自痿缩干小而下。不可乱服药，乱动手。若血流入胞衣，血胀不下，治之少缓，必致胀满。以
次上冲心胸疼痛喘急者，宜服牛膝汤。若气血虚弱，不能传达而不下者，产母但觉乏力，别无胀痛，宜加味芎
归汤（方见前难产条中）。若腹痛手按稍缓是虚痛也。宜保生无忧散统治。胞衣不下，将产母头发吊起，急以
发梢探喉中，一呕即下。
牛膝汤
延胡索（五钱） 牛膝 全当归（各三钱）
水煎服。
保生无忧散
当归（酒浸） 枳壳（盐炒） 川芎 木香 白芍 炙甘草（各一钱半） 血余炭（另研） 乳香（另研，各五分）
水煎，入血余炭、乳香二末服。
交骨不开是由于元气虚弱，怀孕期间失于调养，导致气血无法运行到达所致。此时应让产妇立即安静入睡。内服加味芎归汤（方剂见前文“临产服药”条中），外用麻油调和滑石粉，涂抹于产门即可打开。
胎儿娩出时，接生婆应用双手轻扶产妇胸前，产妇自己也应用双手紧抱肚脐，促使胞衣下坠。如果胞衣不下，这也是因为临盆过早的缘故。因为在正常分娩时，骨节会张开，体质强壮者数日后骨节闭合，体质虚弱者一个月后才会闭合。现在不等待骨节张开就强行娩出胎儿，所以胎儿出来后骨眼随即闭合，导致胞衣未能及时排出。应当使用佛手散（方剂见前文“难产”条中），加入牛膝、瞿麦（各二钱），滑石（一钱），水煎服用。如果是败血流入胞中，胞衣就会胀大，无法排出；若治疗稍缓，血液胀满腹中，向上冲撞心胸，引起疼痛、气喘急促，应立即剪断脐带，使血液不再流入胞中，以免导致胀满。但脐带非常脆弱，操作时要小心拿稳。先用软绢或粗麻线系住脐带，再将脐带对折系一道，用秤锤坠住以防缩入，然后剪断。过三五天后，脐带自然会萎缩干枯变小并脱落。不可乱服药，也不可乱动手。如果血液流入胞衣，因血胀而无法排出，治疗稍缓，必然导致胀满，进而依次上冲心胸，引起疼痛、气喘急促者，宜服用牛膝汤。如果是气血虚弱，无法推动而致胞衣不下，产妇只感觉乏力，没有其他胀痛症状，宜服用加味芎归汤（方剂见前文“难产”条中）。如果腹痛且用手按压后疼痛稍减，这是虚痛。宜用保生无忧散统治。对于胞衣不下，可将产妇头发吊起，急用发梢探入喉咙催吐，一旦呕吐，胞衣即下。
保生无忧散
当归（酒浸） 枳壳（盐炒） 川芎 木香 白芍 炙甘草（各一钱半） 血余炭（另研） 乳香（另研，各五分）
水煎，加入血余炭、乳香两药粉末服用。
Failure of the pubic symphysis to open is caused by deficiency of Yuan Qi (Original Qi), lack of proper care during pregnancy, resulting in the inability of Qi and Blood to circulate and reach the necessary areas. Immediately instruct the patient to rest quietly. Internally administer Jiawei Xionggui Tang (Cinnamon Twig and Angelica Decoction with Additions; see "Medication for Childbirth" section above). Externally, mix Talcum Powder (Hua Shi) with Sesame Oil and apply it to the vaginal opening to facilitate dilation.
When the fetus is being delivered, the midwife should gently support the mother's chest with both hands, while the mother herself should tightly embrace her navel with both hands to encourage the descent of the retained placenta. If the placenta fails to descend, this is also due to premature labor. During normal delivery, the pelvic joints open; robust individuals' joints close within a few days, while frail individuals may take a month to close. Now, if the fetus is forcibly expelled before the joints have opened, the bony aperture closes immediately after the fetus emerges, causing the placenta to be unable to exit in time. One should use Foshou San (Buddha's Hand Powder; see "Dystocia" section above), adding Achyranthes Root (Niu Xi) and Dianthera Herb (Qu Mai) (each 2 qian), and Talcum Powder (Hua Shi) (1 qian), decocted in water and taken orally. If necrotic blood flows into the uterus, the uterus will become distended and fail to expel the placenta; if treatment is delayed slightly, the distension fills the abdomen, rushes upward to the heart and chest, causing pain, panting, and urgency. In such cases, one must urgently cut the umbilical cord to prevent blood from entering the uterus, avoiding further distension. However, the umbilical cord is extremely fragile and must be handled with great care. First, tie the cord firmly with soft silk or coarse hemp thread, then fold the cord double and tie another knot, weighting it down with a scale weight to prevent retraction, and then cut it. After three to five days, it will naturally wither, dry up, shrink, and fall off. Do not indiscriminately administer medication or perform manual interventions. If blood enters the placenta causing distension and retention, and treatment is delayed, it will inevitably lead to abdominal distension, subsequently rushing upward to the heart and chest, causing pain and respiratory distress; in such cases, Niu Xi Tang (Achyranthes Decoction) should be administered. If the condition is due to Qi and Blood deficiency failing to propel the placenta downward, and the mother only feels fatigue without other distending pain, Jiawei Xionggui Tang (see "Dystocia" section above) is appropriate. If abdominal pain is relieved by pressure, it indicates a deficiency-type pain. Baosheng Wuyou San (Life-Preserving Fearless Powder) should be used to treat this comprehensively. For retained placenta, suspend the mother's hair, and urgently probe the throat with the hair tip to induce vomiting; once vomiting occurs, the placenta will descend.
Niu Xi Tang (Achyranthes Decoction)
Corydalis Rhizome (Yan Hu Suo) (5 qian)
Achyranthes Root (Niu Xi)
Complete Angelica Sinensis Root (Quan Dang Gui) (each 3 qian)
Decoct in water and take orally.
Baosheng Wuyou San (Life-Preserving Fearless Powder)
Angelica Sinensis Root (Dang Gui) (soaked in wine)
Bitter Orange (Zhi Ke) (stir-fried with salt)
Sichuan Lovage Rhizome (Chuan Xiong)
Costus Root (Mu Xiang)
White Peony Root (Bai Shao)
Prepared Licorice Root (Zhi Gan Cao) (each 1.5 qian)
Scorched Hair (Xue Yu Tan) (separately ground)
Frankincense (Ru Xiang) (separately ground, each 0.5 fen)
Decoct in water, add the powders of Scorched Hair and Frankincense, and take orally.