交骨不开者，阴血虚也。或年幼受胎，阴气不足，阴不足则气不达，所以不开。或年大方嫁，脉络长
成，或元气虚弱，胎前失调，皆有此证。用参便佛手散，补而开之。或十全大补汤亦可，古法用
加味芎归汤。每见服此药者，恶血凝滞，反成不救。惟大剂人参童便，入于芎归剂中，助其气血开阖之功，
立效也。证见切牙昏晕，急以热小便灌之，稍迟则无济矣。若元气不虚者，只用佛手散入小便服之，人参不
必用也。又有用开骨膏，以参便佛手散煎汤送下。予谓又不如用加味神柞饮，开交骨如神也。予曾治彭姓
女，初次生产，经日不下，交骨不开，神柞饮并诸催生药，服之无效，用人参三钱，煎服立下。
参便佛手散 治临产交骨不开，其验如神。
当归（三钱） 川芎（一钱） 人参（三五钱，去血过多，加至一两）
水煎，临服入童便半盏，续续进之。质壮气实者，但加童便，其参不用可也。
加味芎归汤 治交骨不开，并死胎不下。
川芎 当归（各一两） 龟版（一个，自死者，酥炙） 妇人发（五钱，曾生子者，烧存性）
上共为末，每服一两，水煎服。
开骨膏 治交骨不开。（即催生方乳朱丹，彼兼治难产，此独开交骨。）
明乳香（一两）
五月五日研细，猪血为丸如鸡头大，朱砂为衣。凉酒化服一丸。
十全大补汤（见上卷胎不长养门。） 佛手散（见上卷诸痛门。） 加味神柞饮
（见本卷子死腹中门。） 独参汤催生（见本卷催生门。）
交骨不开（分娩时骨盆耻骨联合分离不足导致产道狭窄），是由于阴血亏虚所致。有的是因为年幼怀孕，阴气不足，阴气不足则阳气不能通达，所以交骨无法打开。有的是因为年长才出嫁，脉络已经长成定型，或者是元气虚弱，产前调养不当，都会出现这种证候。使用参便佛手散，通过补益气血来促使交骨开启。或者使用十全大补汤也可以，古法中使用加味芎归汤。但我常见服用这些药物的人，反而导致恶露凝滞，最终造成无法救治的后果。只有用大剂量的人参和童便，加入芎归剂中，以辅助其调理气血开阖的功效，才能立即见效。如果症状表现为咬紧牙关、昏厥晕倒，急需灌服热的小便，稍微延迟就无济于事了。如果元气不虚的产妇，只需用佛手散加入小便服用即可，不必用人参。又有使用开骨膏的，是用参便佛手散的煎汤送服开骨膏。我认为这不如使用加味神柞饮，开启交骨的效果如神一般灵验。我曾治疗一位姓彭的女子，初次生产，经过一天孩子仍不下来，原因是交骨不开，使用了神柞饮及其他催生药物，服用后无效，后来用了三钱人参煎服，胎儿立刻生下。
参便佛手散：治疗临产时交骨不开，效果验证如神。
当归（三钱） 川芎（一钱） 人参（三至五钱，若失血过多，加至一两）
加水煎煮，临服用时加入半盏童便，分次慢慢服用。体质强壮、气血充实者，只需加入童便，可以不用人参。
加味芎归汤：治疗交骨不开，以及死胎不下。
川芎 当归（各一两） 龟版（一个，取自自然死亡的乌龟，用酥油炙烤） 妇人发（五钱，必须是生过孩子的妇女头发，烧存性）
以上共同研成细末，每次服用一两，加水煎煮后服用。
开骨膏：治疗交骨不开。（即催生方中的乳朱丹，该方兼治难产，此方专门用于开启交骨。）
明乳香（一两）
在五月五日研磨成细粉，用猪血制成如鸡头大小的丸药，外裹朱砂衣。用凉酒化开服用一丸。
Jiaogu Bukai (failure of the pubic symphysis to separate during labor) is caused by a deficiency of Yin and Blood. In some cases, pregnancy occurs at a young age when Yin Qi is insufficient; insufficiency of Yin leads to an inability of Yang Qi to penetrate, thus preventing the opening of Jiaogu. In other cases, marriage occurs at an older age when the meridians have fully matured and solidified, or due to weak Yuan Qi (Original Qi) and improper regulation before delivery, all of which can result in this syndrome. One may use Shenbian Foshou San (Ginseng and Human Urine Hand-Holding Powder), which tonifies and thereby opens the passage. Shiquan Dabu Tang (Complete Ten Tonifying Decoction) is also effective. The ancient method utilizes Jiawei Xionggui Tang (Modified Ligusticum and Angelica Decoction). However, I often observe that patients taking these medicines suffer from stagnation of lochia (postpartum discharge), which can lead to untreatable conditions. Only by using a large dose of Renshen (Ginseng) and Tongbian (Child's Urine) added to the Xionggui formula can one assist the mechanism of Qi and Blood opening and closing, resulting in immediate efficacy. If the symptoms include teeth grinding and fainting, hot urine must be administered immediately; any delay will render treatment useless. For those whose Yuan Qi is not deficient, simply administering Foshou San mixed with urine is sufficient; Renshen is not necessary. Another method involves using Kaigu Gao (Bone-Opening Paste), delivered via a decoction of Shenbian Foshou San. I believe this is inferior to using Jiawei Shenzuo Yin (Modified Camptotheca Decoction), which opens Jiaogu with miraculous effect. I once treated a female patient surnamed Peng who was experiencing her first delivery. After a day had passed without progress due to Jiaogu Bukai, neither Shenzuo Yin nor other parturition-inducing medicines were effective. Upon administering three qian of Renshen in a decoction, the fetus was delivered immediately.
Shenbian Foshou San: Treats Jiaogu Bukai during labor; its efficacy is verified as miraculous.
Danggui (Angelicae Sinensis Radix) (3 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma) (1 qian) Renshen (Panacis Ginseng Radix) (3–5 qian; increase to 1 liang if blood loss is excessive)
Decoct in water. Before administration, add half a cup of Tongbian (Child's Urine). Administer gradually. For individuals with robust constitution and abundant Qi and Blood, only Tongbian needs to be added; Renshen may be omitted.
Jiawei Xionggui Tang: Treats Jiaogu Bukai and retained dead fetus.
Chuanxiong (Rhizoma Ligustici Chuanxiong) Danggui (Radix Angelicae Sinensis) (each 1 liang) Guiban (Testudinis Carapax et Plastrum) (one unit, from a naturally deceased turtle, roasted with butter) Renfa (Capilli Humani) (5 qian, from a woman who has given birth, charred but retaining substance)
Grind all ingredients into powder. Take 1 liang per dose, decoct in water, and drink.
Kaigu Gao: Treats Jiaogu Bukai. (This is equivalent to Rushu Dan in the parturition-inducing formulas; that formula treats difficult labor generally, whereas this specifically targets Jiaogu.)
Ming Ruxiang (Boswelliae Resina) (1 liang)
On the fifth day of the fifth lunar month, grind finely. Form pills the size of a chicken head using pig blood, coated with Zhusha (Cinnabaris). Dissolve one pill in cool wine and ingest.
Shiquan Dabu Tang (See Volume Upper, Section on Failure of Fetal Growth). Foshou San (See Volume Upper, Section on Various Pains). Jiawei Shenzuo Yin (See Volume This, Subsection on Retained Dead Fetus). Dushen Tang for Inducing Labor (See Volume This, Section on Parturition Induction).