催生汤（见上卷胎不长养门，又名补血行滞汤。） 胎产金丹达生散 保产无忧散 滑胎散
（以上俱见本卷保产门预服易产诸方。） 救逆汤（见本卷临产须知。） 紫苏饮（见上卷安
胎门。） 脱花煎（见本卷子死腹中门。） 丹溪佛手散（见上卷诸痛门，附佛手散下。）
凡孕妇胞衣未下，急于胎之未生。子死腹中，急于胎之未下。盖胞衣未下，子与母气尚通呼吸。若
子死腹中，则躯形已冷，胞脏气寒，胎血凝冱，气不升降。
欲下死胎，若以至寒之药用之，不惟无益，而害母命多矣。所以古人有用附子汤，使胞脏温暖，凝血流
动，以附子能破寒气堕胎也。又有因患伤寒、热病、温疟之类，胎受邪热，毒瓦斯内外交攻，因致胎死，
留于胞脏。古人深虑胎受毒瓦斯，必然胀大，故用朴硝水银 砂之药，不惟使胎不胀，又能使胎形化烂。
再副以行血顺气之药，死胎即下。此古人立方之意，后人遵意仿而行之，所以有立候下胎散一方。然药
味俱多峻厉，且有烂肉之能，即遇壮实村妇，予犹未敢轻用，又何敢施于富贵弱质之体哉。况予屡见死
胎，人不慌迫，亦能迟迟生下，并不伤母，其故何也？盖人腹中极热，食物入内俱化，其胎虽死，若产
母不惊恐，能安心饮食，腹内热气熏蒸，胎自柔软腐化。亦生而不伤母，但所出秽气，令人难闻耳。予
每治胎死不下，用胎产金丹一粒服下，顷刻即生。但子死在腹，其故多端，要不过急去其死胎以安产
母。如胎气薄弱，不成而殒。如产母久病胎萎而死。如胎肥气滞，恶露已尽，致胎干子死身冷不能出。如
临产孕妇护痛，两足不开，夹住儿头以致子死。如KT KT 忍耐，当值之人不善扶持，紧抱其腰，伤胎
而死。如生路不顺，逆侧等证，稳婆蠢厉，用手莽撞，伤子
而死。如脐带缠项，气绝而死。如儿头到门，交骨不开，久而不下，以致子死。如孕至五七个月，胎漏、
跌仆、时证等类，伤胎而死。用乌金散、脱花煎、香桂散、牛膝、琥珀等丸，新法下胎、神柞饮类，
择其宜服者服之，死胎自下。又有双躯一死一生者，不可不知。但双躯之脉，三阳俱盛。如少阴肾脉
微紧，血即凝浊，经养不周，胎即偏夭，或因难产，一死一生，不去其死，害母失胎，千金神造散
主之。但恐虚弱人下胎，或有贫富不等，医药一时未便，予故又择诸书内丸散及简易单方，开载于后，以
备选用。然下胎最宜谨慎，必先验明产母，面赤舌青，腹中阴冷重坠，口秽气喘的确，方可用下。若见
紫黑血块血缕，犹为确候。亦必先固妊妇本元，补气养血而后下之。予故重佛手散、香桂散、滑胎煎为
下死胎之王道药也。倘孕妇遇有不安，医者未能审详，遽用峻厉攻伐，难免不测之祸。慎之慎之。
立候下胎散 治临产或横逆，或血海干涸，或胎死不下，死在顷刻。
皮硝（一钱，少壮者一钱五分） 大附子（体弱者，加三五分。煨，去皮。壮者不用）
如寒天，亦加附子三五分，煨去皮，用黄酒半钟，煎一二沸，温服立下。
乌金散（《局方》名黑神散，《灵苑》名肉桂散。） 治产难，或热病胎死腹中，或因颠仆，或从高坠
下，或房室惊搐，或临产惊动太早，触犯禁忌，或产时未到，经行先下，恶露已尽，致胎干子死身冷不能出。
熟地（酒焙干） 蒲黄 当归 交趾桂 芍药 军姜（即炮姜去皮） 粉草（各一两） 小黑豆
（二两，炒） 百草霜（五钱）
上为末，每用二钱，米醋半合许，沸汤六七分浸起温服。疑贰之际，且进佛手散，酒水合煎二三服
探之。若未死，子母俱安。若胎已死，立便逐下。如的知其胎已死，进此药后，更进香桂散，须臾如手推下。常
用催生，更加好滑石末半两，葵子五十粒捶碎，黄柞叶七八皮，葱白二寸，顺流水煎汤调下。盖滑石能利小便，
柞叶行气逐血，葱白能通阳气，气盛血行即产矣。查《局方》黑神散，无百草霜，用童便、酒各半，调服二
钱。《良方》黑神散。有炮附子半两，无蒲黄。《简易方》黑神散，止用百草霜一味。又有加乳、没、血
竭之黑神散。《纲目》用熟地一斤，生姜半斤，同炒干为末，乌梅汤下二钱，为治产后块痛之黑神散。俱各有证治，
录此以别黑神散之方不一。
脱花煎 凡将产者，宜先服此药催生最佳。并治产难经日，或死胎不下俱妙。
当归（七八钱，或一两） 肉桂心（一二钱，或三钱） 川芎 牛膝（各二钱） 车前子（一钱五分）
红花（一钱，催生者不用此味亦可）
水二钟，煎八分，热服。或服后饮酒数杯亦妙。若胎死腹中，或坚滞不下者，加朴硝一二钱即下。若
气虚困剧者，加人参随宜。若阴虚者，加熟地三五钱。
香桂散（一名桂香散。附救苦散。） 治胎死腹中不下，简便而最效。
桂心（三钱） 麝香（三分，一方五分）
为末，葱汤调服，死胎即出。温童便、酒调亦可。加生川乌三钱，为下私胎猛剂。一方单用桂末一钱，
童便调下，名救苦散。或童便酒调亦可。
牛膝丸 下死胎。
杜牛膝（三两） 紫金藤（即紫木香） 蜀葵根（各七钱） 当归（四钱） 肉桂（二钱） 麝香（五分）
上为末，米糊为丸如梧子大，朱砂为衣。每服五十丸，乳香汤送下。
琥珀丸 治妇人或老少，或产前产后百病，及疗三十六种诸病，七疝八瘕，心腹刺
痛，卒中瘫痪，半身不遂，八风十二痹，手足酸疼，乳中结核结毒，怀胎惊动
伤犯不安，死胎不下。
琥珀 朱砂（各另研） 沉香 阿胶（炒珠） 附子（制） 川芎 肉桂 五味子 石斛（各五钱） 牛
膝（酒浸） 当归 肉苁蓉（酒洗，去泥，晒） 人参 熟地 续断 木香 没药（各一两）
上炼蜜为丸，弹子大，每服一丸。空心食前午后，温酒化开服。一方有牛黄、珍珠、乳香、元胡
各一两，共二十一味，为丸备服。凡服法，或姜汤或米汤，或酒或灯心汤，随证用引。若伤寒中风，
角弓反张，用麻黄汤送下。孕妇临月，宜一日一服，至产顺利，不觉疼痛。凡妇人服至五服十服之后，
日倍饮食，其功不能尽述，服者当自觉也。
新法下胎方（即平胃散之变局，比平胃散稳妥。）治胎死腹中最妙，或有用半剂者。
当归（一两） 浓朴（三钱） 陈皮（二钱）
酒水各一钟，煎至一钟，入朴硝或一钱或二钱，再煎十余沸，去渣，热温服。死胎自下，或化水而出。
或止用脱花煎更妙，脱花煎方见前。或用佛手散，以酒调服亦妙。
千金神造散 如妊娠双躯，一死一生，服此生者安，死者出矣。
蟹爪（一升） 阿胶（二两） 甘草（二钱）
以流水先煮蟹爪、甘草，去滓，纳阿胶烊化服之。血凝不下，加桂心三钱。此方用蟹爪以去其
死，阿胶以安其生，甘草和药性。
扶羸短剧方 虚弱人欲下胎，宜用此。
人参 粉草 川芎 肉桂 干姜 桃仁 黄芩 蟹爪
上等分，每服一两，水二钟，煎八分，空心服。未动，再服。
仙传保命丹（一名安禳丸，又名夺命丹。） 凡孕妇下血不止，或小产下血，及子死腹中。其人
憎寒，手指甲黑，唇青，面色黄黑，胎上攻心，冷汗自出，闷绝欲死。或食恶物毒药，伤动胎气，下血
不止，胎尚未死，服之可安。胎若已死，服之自下。此方得之仙传，与黑龙丹媲美，皆产科之圣药也。
丹皮 赤芍 桂心 桃仁 白茯苓（各等分）
上为细末，蜜丸弹子大，每服一丸。细嚼，淡醋汤下，连进三丸神效。
官桂散 治产妇面赤舌青，子死母活者。或面青舌赤沫出，母死子活者。或唇舌俱
青黑沫出，子母俱死者。此方下死胎如神。
官桂（五钱，去皮） 丹皮 川芎 葵子（各一钱五分）
为末，葱白煎汤调下三钱。
黑神散 凡临产血多，胎为血裹，以致难产，宜弃子救母。横生逆产，子死腹中，以及胎衣不下，
血迷心窍，头晕眼花，败血乘虚流散，四肢浮肿，口渴舌燥，乍寒乍热，烦躁发狂，言语错乱，其状如
癫。或月内饮冷，败血凝聚，大便艰难，小便闭涩。或血流小肠，小便出血。或恶露未尽，误食酸物
收敛，因而崩漏。或肺败鼻中气黑，或败血冲心，喉口气急。或血滞脾胃，心腹胀满呕吐，亦似翻
胃，服之神效。
当归 熟地 白芍（炒） 肉桂 炙草（各一两） 棕灰 蒲黄 没药 血竭（各五分） 乳香
（三钱） 赤芍（八钱）
为细末，每服二钱，温酒调下。
鸡熨下死胎法
乌鸡（一只）
去毛，细切，水煎二三升。候汤通手，用衣帛蘸摩腹中，胎自出。
下胎单方
牛粪（不拘多少）
上牛粪炒极热，入醋半盏，以青布包裹，于母脐上下熨之，立下。
千金榆皮汤 治胎死腹中，或母有疾，欲下胎。
榆白皮（一握）
上白皮煮汁服之，自下。
返魂丹 治生产诸证，并死胎恶血，胎衣不下，横生逆产。产前清热养血，产后推陈致新。
野天麻（一名益母草，四五月采花叶子，阴干，半斤） 赤芍（六钱） 当归（七钱） 木香（五钱）
为末，蜜丸弹子大，或童便、酒，或薄荷汤，或米饮，或桂枝汤，或枣汤，或秦艽汤，随证酌
汤，化下一丸。
胎产金丹 滑胎煎（俱见本卷保产门易产方。） 神柞饮（见本卷催生门。） 佛手散
（见上卷诸痛门。）
催生汤（见上卷胎不长养门，又名补血行滞汤。） 胎产金丹达生散 保产无忧散 滑胎散
（以上俱见本卷保产门预服易产诸方。） 救逆汤（见本卷临产须知。） 紫苏饮（见上卷安
胎门。） 脱花煎（见本卷子死腹中门。） 丹溪佛手散（见上卷诸痛门，附佛手散下。）
凡是孕妇胞衣未下，情况比胎儿未出生时更紧急。若是子死腹中，则比胞衣未下更加危急。因为胞衣未下时，胎儿与母体的气息尚且相通。如果胎儿死于腹中，那么躯壳已经变冷，子宫气机寒凝，胎血凝结冻结，气机不能升降。
想要排出死胎，如果使用极寒性质的药物，不仅没有益处，反而会严重危害母亲的生命。所以古人有用附子汤的，使子宫温暖，让凝固的血流流动起来，因为附子能破除寒气、堕下死胎。又有因患伤寒、热病、温疟等疾病，胎儿受到邪热侵袭，毒气内外交攻，导致胎死，滞留于子宫内。古人深深担忧胎儿受毒气后必然胀大，所以使用朴硝、水银、硇砂等药物，不仅能使胎儿不胀大，还能使胎儿形体化烂。再配合行血顺气的药物，死胎即可排出。这是古人立方的用意，后人遵循此意仿制施行，所以有了立候下胎散一方。然而药味大多峻猛猛烈，且有烂肉的功效，即使遇到身体壮实的农村妇女，我也不敢轻易使用，又怎敢施用于富贵而体质虚弱的人身上呢？况且我多次见到死胎，人若不惊慌紧迫，也能慢慢生下，并不伤害母亲，这是什么原因呢？大概是因为人腹中极热，食物进入体内都会消化，胎儿虽然死了，但如果产妇不惊恐，能安心饮食，腹内热气熏蒸，胎儿自然会柔软腐化。也是生而不伤母体，只是排出的秽气，让人难以闻罢了。我每次治疗胎死不下，用胎产金丹一粒服用，顷刻间即生出。但子死在腹中的原因很多端绪，总归不过是急去其死胎以安顿产妇。如胎气薄弱，不成形而殒落。如产妇久病导致胎萎而死。如胎儿肥盛气滞，恶露已尽，导致胎干子死身冷不能出。如临产孕妇护痛，两脚不开，夹住儿头以致子死。如产妇忍耐，接生人员不善扶持，紧抱其腰，伤胎而死。如生路不顺，胎位不正等证，稳婆愚笨粗暴，用手莽撞，伤子而死。如脐带缠颈，气绝而死。如儿头到门，交骨不开，久而不下，以致子死。如怀孕至五七个月，胎漏、跌仆、时病等类，伤胎而死。用乌金散、脱花煎、香桂散、牛膝、琥珀等丸，新法下胎、神柞饮之类，选择适宜者服用，死胎自然排出。又有双胎一死一生者，不可不知。但双胎之脉，三阳脉俱盛。如少阴肾脉微紧，血即凝浊，经养不周，胎儿即偏夭折，或因难产，一死一生，不去其死胎，会害母失胎，千金神造散主治。但恐怕虚弱之人下胎，或有贫富不等，医药一时不便，所以我又从各书中选取丸散及简易单方，记载于后，以备选用。然而下胎最宜谨慎，必须先验明产妇面赤舌青，腹中阴冷重坠，口秽气喘的确切征象，方可使用下胎药。若见到紫黑血块血缕，更是确切的征候。也必先固护妊妇本元，补气养血而后下之。所以我重视佛手散、香桂散、滑胎煎为下死胎的王道药物。倘若孕妇遇有不安，医者未能审详，遽用峻厉攻伐，难免不测之祸。慎之又慎。
立候下胎散 治疗临产或横位逆位，或血海干涸，或胎死不下，死在顷刻。
皮硝（一钱，少壮者一钱五分） 大附子（体弱者，加三五分。煨，去皮。壮者不用）
如遇寒天，也加附子三五分，煨去皮，用黄酒半钟，煎一二沸，温服立下。
乌金散（《局方》名黑神散，《灵苑》名肉桂散。） 治疗产难，或热病胎死腹中，或因颠仆，或从高坠下，或房室惊搐，或临产惊动太早，触犯禁忌，或产时未到，经行先下，恶露已尽，致胎干子死身冷不能出。
熟地（酒焙干） 蒲黄 当归 交趾桂 芍药 军姜（即炮姜去皮） 粉草（各一两） 小黑豆
（二两，炒） 百草霜（五钱）
以上研为末，每用二钱，米醋半合许，沸汤六七分浸起温服。怀疑之际，暂进佛手散，酒水合煎二三服试探。若未死，子母俱安。若胎已死，立即逐下。如确实知道胎已死，进此药后，再进香桂散，片刻如手推下。常用催生，更加好滑石末半两，葵子五十粒捶碎，黄柞叶七八皮，葱白二寸，顺流水煎汤调下。盖滑石能利小便，柞叶行气逐血，葱白能通阳气，气盛血行即产矣。查《局方》黑神散，无百草霜，用童便、酒各半，调服二钱。《良方》黑神散。有炮附子半两，无蒲黄。《简易方》黑神散，止用百草霜一味。又有加乳、没、血竭之黑神散。《纲目》用熟地一斤，生姜半斤，同炒干为末，乌梅汤下二钱，为治产后块痛之黑神散。俱各有证治，录此以别黑神散之方不一。
脱花煎 凡将产者，宜先服此药催生最佳。并治产难经日，或死胎不下俱妙。
当归（七八钱，或一两） 肉桂心（一二钱，或三钱） 川芎 牛膝（各二钱） 车前子（一钱五分）
红花（一钱，催生者不用此味亦可）
水二钟，煎八分，热服。或服后饮酒数杯亦妙。若胎死腹中，或坚滞不下者，加朴硝一二钱即下。若
气虚困剧者，加人参随宜。若阴虚者，加熟地三五钱。
香桂散（一名桂香散。附救苦散。） 治疗胎死腹中不下，简便而最效。
桂心（三钱） 麝香（三分，一方五分）
研为末，葱汤调服，死胎即出。温童便、酒调亦可。加生川乌三钱，为下私胎猛剂。一方单用桂末一钱，
童便调下，名救苦散。或童便酒调亦可。
牛膝丸 下死胎。
杜牛膝（三两） 紫金藤（即紫木香） 蜀葵根（各七钱） 当归（四钱） 肉桂（二钱） 麝香（五分）
以上研为末，米糊为丸如梧子大，朱砂为衣。每服五十丸，乳香汤送下。
琥珀丸 治疗妇人或老少，或产前产后百病，及疗三十六种诸病，七疝八瘕，心腹刺
痛，卒中瘫痪，半身不遂，八风十二痹，手足酸疼，乳中结核结毒，怀胎惊动
伤犯不安，死胎不下。
琥珀 朱砂（各另研） 沉香 阿胶（炒珠） 附子（制） 川芎 肉桂 五味子 石斛（各五钱） 牛
膝（酒浸） 当归 肉苁蓉（酒洗，去泥，晒） 人参 熟地 续断 木香 没药（各一两）
以上炼蜜为丸，弹子大，每服一丸。空心食前午后，温酒化开服。一方有牛黄、珍珠、乳香、元胡
各一两，共二十一味，为丸备服。凡服法，或姜汤或米汤，或酒或灯心汤，随证用引。若伤寒中风，
角弓反张，用麻黄汤送下。孕妇临月，宜一日一服，至产顺利，不觉疼痛。凡妇人服至五服十服之后，
日倍饮食，其功不能尽述，服者当自觉也。
新法下胎方（即平胃散之变局，比平胃散稳妥。）治疗胎死腹中最妙，或有用半剂者。
当归（一两） 浓朴（三钱） 陈皮（二钱）
酒水各一钟，煎至一钟，入朴硝或一钱或二钱，再煎十余沸，去渣，热温服。死胎自下，或化水而出。
或止用脱花煎更妙，脱花煎方见前。或用佛手散，以酒调服亦妙。
千金神造散 如妊娠双躯，一死一生，服此生者安，死者出矣。
蟹爪（一升） 阿胶（二两） 甘草（二钱）
以流水先煮蟹爪、甘草，去滓，纳阿胶烊化服之。血凝不下，加桂心三钱。此方用蟹爪以去其
死，阿胶以安其生，甘草和药性。
扶羸短剧方 虚弱人欲下胎，宜用此。
人参 粉草 川芎 肉桂 干姜 桃仁 黄芩 蟹爪
上等分，每服一两，水二钟，煎八分，空心服。未动，再服。
仙传保命丹（一名安禳丸，又名夺命丹。） 凡孕妇下血不止，或小产下血，及子死腹中。其人
憎寒，手指甲黑，唇青，面色黄黑，胎上攻心，冷汗自出，闷绝欲死。或食恶物毒药，伤动胎气，下血
不止，胎尚未死，服之可安。胎若已死，服之自下。此方得之仙传，与黑龙丹媲美，皆产科之圣药也。
丹皮 赤芍 桂心 桃仁 白茯苓（各等分）
以上为细末，蜜丸弹子大，每服一丸。细嚼，淡醋汤下，连进三丸神效。
官桂散 治疗产妇面赤舌青，子死母活者。或面青舌赤沫出，母死子活者。或唇舌俱
青黑沫出，子母俱死者。此方下死胎如神。
官桂（五钱，去皮） 丹皮 川芎 葵子（各一钱五分）
研为末，葱白煎汤调下三钱。
黑神散 凡临产血多，胎为血裹，以致难产，宜弃子救母。横生逆产，子死腹中，以及胎衣不下，
血迷心窍，头晕眼花，败血乘虚流散，四肢浮肿，口渴舌燥，乍寒乍热，烦躁发狂，言语错乱，其状如
癫。或月内饮冷，败血凝聚，大便艰难，小便闭涩。或血流小肠，小便出血。或恶露未尽，误食酸物
收敛，因而崩漏。或肺败鼻中气黑，或败血冲心，喉口气急。或血滞脾胃，心腹胀满呕吐，亦似翻
胃，服之神效。
当归 熟地 白芍（炒） 肉桂 炙草（各一两） 棕灰 蒲黄 没药 血竭（各五分） 乳香
（三钱） 赤芍（八钱）
研为细末，每服二钱，温酒调下。
鸡熨下死胎法
乌鸡（一只）
去毛，细切，水煎二三升。候汤通手，用衣帛蘸摩腹中，胎自出。
下胎单方
牛粪（不拘多少）
上牛粪炒极热，入醋半盏，以青布包裹，于母脐上下熨之，立下。
千金榆皮汤 治疗胎死腹中，或母有疾，欲下胎。
榆白皮（一握）
以上白皮煮汁服之，自下。
返魂丹 治疗生产诸证，并死胎恶血，胎衣不下，横生逆产。产前清热养血，产后推陈致新。
野天麻（一名益母草，四五月采花叶子，阴干，半斤） 赤芍（六钱） 当归（七钱） 木香（五钱）
研为末，蜜丸弹子大，或童便、酒，或薄荷汤，或米饮，或桂枝汤，或枣汤，或秦艽汤，随证酌
汤，化下一丸。
胎产金丹 滑胎煎（俱见本卷保产门易产方。） 神柞饮（见本卷催生门。） 佛手散
（见上卷诸痛门。）
Cui Sheng Tang (Labor-Inducing Decoction) (See Volume I, Section on Failure of Fetal Growth and Nourishment, also known as Bu Xue Xing Zhi Tang.) Tai Chan Jin Dan Da Sheng San Bao Chan Wu You San Hua Tai San
(Above all are seen in this volume, Section on Prenatal Care, Pre-administration Formulas for Easy Delivery.) Jiu Ni Tang (See this volume, Knowledge for Labor.) Zi Su Yin (See Volume I, Section on Calming the Fetus.) Tuo Hua Jian (See this volume, Section on Dead Fetus in the Womb.) Dan Xi Fo Shou San (See Volume I, Section on Various Pains, attached below Fo Shou San.)
When a pregnant woman's placenta has not been delivered, the situation is more urgent than before the fetus is born. If the fetus dies in the womb, it is even more critical than when the placenta remains undelivered. This is because when the placenta is undelivered, the fetus and mother's qi still share respiration. If the fetus dies in the womb, the body becomes cold, the uterine qi becomes cold and stagnant, fetal blood coagulates and freezes, and qi fails to ascend and descend.
To expel a dead fetus, if extremely cold-natured medicines are used, not only will they be ineffective, but they will also greatly endanger the mother's life. Therefore, ancient practitioners sometimes used Fu Zi Tang (Aconite Decoction) to warm the uterus, allowing coagulated blood to flow, because Fu Zi (Prepared Aconite Root) can break cold qi and induce abortion. In cases where the mother suffered from Shang Han (Cold Damage), Re Bing (Heat Disease), or Wen Nue (Warm Malaria), the fetus was affected by pathogenic heat, with toxic factors attacking from inside and outside, leading to fetal death and retention in the uterus. Ancient physicians deeply worried that the fetus would inevitably swell due to toxic factors; thus, they used medicines like Po Xiao (Mirabilite), Shui Yin (Mercury), and Niao Sha (Sal Ammoniac). These not only prevented fetal swelling but also caused the fetal form to rot and disintegrate. Combined with herbs that promote blood circulation and regulate qi, the dead fetus would be expelled. This reflects the intent of ancient formulas. Later generations followed this intent and imitated them, resulting in the creation of Li Hou Xia Tai San (Li Hou Formula for Expelling the Fetus). However, these formulas contain many harsh and potent ingredients with flesh-rotting capabilities. Even for robust rural women, I dare not use them lightly, let alone for wealthy individuals with weak constitutions. Moreover, I have often observed that when a dead fetus is retained, if the person does not panic, the fetus can be delivered slowly without harming the mother. Why is this? It is likely because the human abdomen is extremely hot, and food ingested is digested. Although the fetus is dead, if the mother does not panic and maintains a calm diet, the internal heat steams and softens the fetus, causing it to decompose naturally. Thus, it is delivered without harming the mother, although the foul odor is unpleasant. Whenever I treat retained dead fetuses, I administer one pill of Tai Chan Jin Dan (Pregnancy and Childbirth Golden Pill), and the fetus is delivered almost instantly. However, there are many causes for fetal death in the womb, which generally boil down to the urgent need to remove the dead fetus to secure the mother's safety. For example, weak fetal qi leads to failure to develop and miscarriage. Prolonged maternal illness causes fetal atrophy and death. Excessive fetal fatness and qi stagnation, after lochia has ceased, lead to a dry, dead, cold fetus unable to exit. During labor, if the mother guards against pain by keeping legs closed, clamping the fetal head, it may cause fetal death. If the mother endures pain and the attendant fails to support properly, tightly holding her waist, it may injure the fetus. If the birth canal is obstructed or the fetus is malpositioned, and the midwife is ignorant and rough, using hands clumsily, it may injure the fetus. If the umbilical cord wraps around the neck, causing suffocation, the fetus dies. If the fetal head reaches the cervix but the pubic symphysis does not open, prolonged retention may lead to fetal death. At five to seven months of pregnancy, conditions such as vaginal bleeding, falls, or seasonal diseases may injure the fetus. Use Wu Jin San (Black Gold Powder), Tuo Hua Jian, Xiang Gui San, Niu Xi (Achyranthes Root), Hu Po Wan (Amber Pills), Xin Fa Xia Tai (New Method for Expelling Fetus), Shen Zuo Yin, etc., selecting appropriate ones to take, and the dead fetus will naturally be expelled. There is also the case of twins, one dead and one alive, which must be known. The pulse for twins shows excess in the three Yang channels. If the Shao Yin Kidney pulse is slightly tight, blood becomes turbid, nourishment is insufficient, and the fetus may die prematurely. Due to difficult labor, one may die while the other lives. If the dead one is not removed, it harms the mother and loses the living fetus. Qian Jin Shen Zao San (Thousand Years Divine Creation Powder) is indicated. However, fearing that expelling the fetus in weak individuals, or due to disparities in wealth making medical care inconvenient, I have selected various pills, powders, and simple single prescriptions from other books, listed below for reference. Yet, expelling a fetus requires utmost caution. One must first verify signs such as a red face and blue tongue, cold and heavy sensation in the abdomen, foul breath, and panting. Seeing purple-black blood clots or threads confirms the diagnosis. One must first consolidate the pregnant woman's original qi, tonify qi and nourish blood, and then expel the fetus. Therefore, I emphasize Fo Shou San (Buddha's Hand Powder), Xiang Gui San, and Hua Tai Jian as the "royal way" medicines for expelling dead fetuses. If a pregnant woman experiences discomfort and the physician fails to examine carefully, rashly using harsh attacking methods invites unpredictable disasters. Be cautious! Be cautious!
Li Hou Xia Tai San (Li Hou Formula for Expelling the Fetus) Treats difficult labor with malposition, depletion of the Blood Sea, or retained dead fetus dying instantaneously.
Xiao Shi (Mirabilite) (1 qian, 1.5 qian for young/robust individuals) Da Fu Zi (Large Prepared Aconite Root) (For weak individuals, add 3-5 fen. Roasted, peeled. Not for robust individuals.)
In cold weather, also add 3-5 fen of Fu Zi, roasted and peeled. Use half zhong of yellow wine, boil once or twice, and take warm to expel immediately.
Wu Jin San (Black Gold Powder) (Named Hei Shen San in Ju Fang, Rou Gui San in Ling Yuan.) Treats dystocia, fetal death in the womb due to heat disease, falls, jumping from heights, sexual activity-induced convulsions, premature labor disturbance, violation of taboos, or preterm bleeding exhausting lochia, leading to a dry, dead, cold fetus unable to exit.
Shu Di Huang (Prepared Rehmannia Root, dried with wine) Pu Huang (Typha Pollen) Dang Gui (Angelica Sinensis) Jiao Zhi Gui (Cinnamon Bark from Cochinchina) Bai Shao (White Peony Root) Jun Jiang (Prepared Ginger, peeled) Fen Cao (Licorice Root) (Each 1 liang) Xiao Hei Dou (Small Black Soybeans) (2 liang, stir-fried) Bai Cao Shuang (Soot from Hundred Herbs Stove) (5 qian)
Grind into powder. Take 2 qian each time, soak in half he of rice vinegar with boiling water (60-70% full), warm and drink. In cases of doubt, temporarily administer Fo Shou San, decocted with wine and water, two to three doses to test. If the fetus is alive, both mother and child are safe. If the fetus is dead, it will be expelled immediately. If certain the fetus is dead, after taking this medicine, further administer Xiang Gui San, and within moments, the fetus will be pushed out like by hand. For common labor induction, add 0.5 liang of fine Hua Shi (Talcum Powder), 50 crushed Kui Zi (Abutilon Seeds), 7-8 pieces of Huang Zuo Ye (Zelkova Leaf), and 2 cun of Cong Bai (Scallion White). Decoct with flowing water and mix with powder. Hua Shi promotes urination, Zuo Ye moves qi and expels blood, Cong Bai unblocks yang qi. When qi is abundant and blood flows, delivery occurs. Checking Ju Fang's Hei Shen San, it lacks Bai Cao Shuang, using Tong Bian (Child's Urine) and wine equally, mixed with 2 qian. Liang Fang's Hei Shen San contains 0.5 liang of Pao Fu Zi (Prepared Aconite) and lacks Pu Huang. Jian Yi Fang's Hei Shen San uses only Bai Cao Shuang. There is also a Hei Shen San added with Ru Xiang (Frankincense), Mo Yao (Myrrh), and Xue Jie (Dragon's Blood). Gang Mu uses 1 jin of Shu Di Huang and 0.5 jin of Sheng Jiang (Fresh Ginger), stir-fried until dry, ground, taken with Wumei Tang (Mume Decoction), 2 qian, for postpartum abdominal masses. All have specific indications. Recorded here to distinguish the various Hei Shen San formulas.
Tuo Hua Jian (Formula for Shedding Flowers) For those about to deliver, taking this beforehand is best for induction. Also excellent for prolonged dystocia or retained dead fetus.
Dang Gui (Angelica Sinensis) (7-8 qian or 1 liang) Rou Gui Xin (Cinnamon Twig Heart) (1-2 qian or 3 qian) Chuan Xiong (Ligusticum Chuanxiong) Niu Xi (Achyranthes Bidentata) (Each 2 qian) Che Qian Zi (Plantago Seed) (1.5 qian) Hong Hua (Carthamus Tinctorius) (1 qian, can be omitted for induction)
Add 2 zhong of water, decoct to 0.8 zhong, take hot. Drinking a few cups of wine afterwards is also good. If the fetus is dead in the womb or hard and stuck, add 1-2 qian of Po Xiao (Mirabilite) to expel it. If qi deficiency is severe, add Ren Shen (Ginseng) as appropriate. If yin deficiency, add 3-5 qian of Shu Di Huang (Prepared Rehmannia Root).
Xiang Gui San (Fragrant Cinnamon Powder) (Also named Gui Xiang San. Includes Jiu Ku San.) Treats retained dead fetus in the womb, simple and most effective.
Gui Xin (Cinnamon Heart) (3 qian) She Xiang (Musk) (3 fen, some say 5 fen)
Grind into powder, mix with Scallion Decoction to take. The dead fetus will be expelled. Warm Child's Urine or Wine can also be used. Add 3 qian of Sheng Chuan Wu (Raw Aconitum Carmichaelii Root) for a strong formula to abort private pregnancies. Another formula uses only 1 qian of Gui Mo (Cinnamon Powder), taken with Child's Urine, named Jiu Ku San (Save Suffering Powder). Can also be taken with Wine.
Niu Xi Wan (Achyranthes Pills) Expels dead fetus.
Du Niu Xi (Wild Achyranthes Root) (3 liang) Zi Jin Teng (Purple Wood Fragrance/Polygonum Multiflorum Vine) Shu Kui Gen (Hollyhock Root) (Each 7 qian) Dang Gui (Angelica Sinensis) (4 qian) Rou Gui (Cinnamon Bark) (2 qian) She Xiang (Musk) (5 fen)
Grind into powder, make pills with rice paste the size of walnut seeds, coat with Zhu Sha (Cinnabar). Take 50 pills each time, washed down with Ru Xiang Tang (Frankincense Decoction).
Hu Po Wan (Amber Pills) Treats various diseases in women of all ages, before or after childbirth, including 36 types of diseases, 7 hernias and 8 masses, stabbing heart/abdominal pain, stroke paralysis, hemiplegia, 8 winds and 12 bi syndromes, limb soreness, breast nodules/toxins, fetal disturbance/injury causing anxiety, and retained dead fetus.
Hu Po (Amber) Zhu Sha (Cinnabar) (Each separately ground) Chen Xiang (Agarwood) E Jiao (Donkey-hide Gelatin) (Stir-fried to beads) Fu Zi (Prepared Aconite) Chuan Xiong (Ligusticum Chuanxiong) Rou Gui (Cinnamon Bark) Wu Wei Zi (Schisandra Berry) Shi Hu (Dendrobium Stem) (Each 5 qian) Niu Xi (Achyranthes Bidentata) (Soaked in wine) Dang Gui (Angelica Sinensis) Rou Cong Rong (Cistanche Stem) (Washed in wine, cleaned, dried) Ren Shen (Ginseng) Shu Di Huang (Prepared Rehmannia Root) Xu Duan (Dipsacus Root) Mu Xiang (Aucklandia Root) Mo Yao (Myrrh) (Each 1 liang)
Refine honey to make pills the size of quail eggs. Take one pill each time. On an empty stomach before meals or in the afternoon, dissolve in warm wine and take. Another formula adds Niu Huang (Calculus Bovis), Zhen Zhu (Pearl), Ru Xiang (Frankincense), and Yuan Hu (Corydalis Rhizome), each 1 liang, totaling 21 ingredients, made into pills for use. Administration methods: use Ginger Decoction, Rice Decoction, Wine, or Deng Xin Cao (Juncus Decoction) as guides according to syndrome. If Shang Han Zhong Feng (Cold Damage Wind Strike) with opisthotonos, use Ma Huang Tang (Ephedra Decoction) to wash down. Pregnant women near term should take one dose daily until smooth delivery without pain. Women taking this for five to ten doses will see their appetite double; its merits cannot be fully described, but users will feel it themselves.
Xin Fa Xia Tai Fang (New Method for Expelling Fetus Formula) (A variation of Ping Wei San, safer than Ping Wei San.) Excellent for retained dead fetus in the womb, or half-dose may be used.
Dang Gui (Angelica Sinensis) (1 liang) Nong Po (Magnolia Bark) (3 qian) Chen Pi (Citrus Reticulata Peel) (2 qian)
Use 1 zhong each of wine and water, decoct to 1 zhong. Add 1 or 2 qian of Po Xiao (Mirabilite), boil ten more times, strain, and take warm. The dead fetus will be expelled naturally or dissolved into water. Using only Tuo Hua Jian is better; see formula above. Or use Fo Shou San (Buddha's Hand Powder), taken with wine, also good.
Qian Jin Shen Zao San (Thousand Years Divine Creation Powder) For twin pregnancy, one dead and one alive. Taking this ensures the survival of the living and expulsion of the dead.
Xie Zhua (Crab Claws) (1 sheng) E Jiao (Donkey-hide Gelatin) (2 liang) Gan Cao (Licorice Root) (2 qian)
First decoct Crab Claws and Licorice Root in flowing water, strain, dissolve E Jiao in the liquid, and take. If blood coagulation prevents expulsion, add 3 qian of Gui Xin (Cinnamon Heart). This formula uses Crab Claws to remove the dead, E Jiao to protect the living, and Licorice Root to harmonize the properties.
Fu Lei Duan Ju Fang (Formula to Strengthen the Emaciated and Shorten the Illness) For weak individuals wishing to expel the fetus.
Ren Shen (Ginseng) Fen Cao (Licorice Root) Chuan Xiong (Ligusticum Chuanxiong) Rou Gui (Cinnamon Bark) Gan Jiang (Dried Ginger) Tao Ren (Peach Kernel) Huang Qin (Scutellaria Root) Xie Zhua (Crab Claws)
Equal parts. Take 1 liang each time, decoct in 2 zhong of water to 0.8 zhong, take on an empty stomach. If no effect, take again.
Xian Chuan Bao Ming Dan (Immortal Transmitted Life-Preserving Pill) (Also named An Rang Wan, Duo Ming Dan.) For pregnant women with continuous bleeding, miscarriage bleeding, or fetal death in the womb. Symptoms include aversion to cold, black fingernails, blue lips, sallow-dark complexion, fetal pressure on the heart, spontaneous cold sweat, fainting desire to die. Or ingestion of bad substances/poisons injuring fetal qi, continuous bleeding, fetus not yet dead, taking this calms it. If fetus is dead, taking this expels it. This formula comes from immortal transmission, comparable to Hei Long Dan (Black Dragon Pill), both are sacred medicines in obstetrics.
Dan Pi (Moutan Bark) Chi Shao (Red Peony Root) Gui Xin (Cinnamon Heart) Tao Ren (Peach Kernel) Bai Fu Ling (Poria) (Equal parts)
Grind into fine powder, make honey pills the size of quail eggs. Take one pill each time. Chew finely, swallow with light vinegar water. Take three pills continuously for miraculous effect.
Guan Gui San (Official Cinnamon Powder) Treats postpartum red face and blue tongue (fetus dead, mother alive); or blue face and red tongue with foam (mother dead, fetus alive); or blue-black lips and tongue with foam (both mother and fetus dead). This formula expels dead fetuses miraculously.
Guan Gui (Official Cinnamon Bark) (5 qian, peeled) Dan Pi (Moutan Bark) Chuan Xiong (Ligusticum Chuanxiong) Kui Zi (Abutilon Seed) (Each 1.5 qian)
Grind into powder, mix with Scallion White Decoction, take 3 qian.
Hei Shen San (Black Divine Powder) For excessive bleeding during labor, fetus wrapped in blood causing dystocia, should abandon fetus to save mother. Malpresentation, fetal death in womb, retained placenta, blood confusing the mind, dizziness, blurred vision,敗血 (decayed blood) flowing freely due to deficiency, limb edema, thirst, dry tongue, alternating chills and fever, irritability, mania, confused speech, resembling madness. Or drinking cold liquids within the month, decayed blood coagulating, difficult defecation, urinary retention. Or blood flowing to small intestine, hematuria. Or lochia not finished, mistakenly eating sour astringent foods causing metrorrhagia. Or lung failure with black nasal gas, or decayed blood rushing to heart, throat qi urgency. Or blood stasis in spleen/stomach, abdominal distension/vomiting, resembling fan wei (regurgitation). Taking this is miraculous.
Dang Gui (Angelica Sinensis) Shu Di Huang (Prepared Rehmannia Root) Bai Shao (White Peony Root, stir-fried) Rou Gui (Cinnamon Bark) Zhi Cao (Honey-fried Licorice Root) (Each 1 liang) Zong Hui (Palm Frond Ash) Pu Huang (Typha Pollen) Mo Yao (Myrrh) Xue Jie (Dragon's Blood) (Each 5 fen) Ru Xiang (Frankincense) (3 qian) Chi Shao (Red Peony Root) (8 qian)
Grind into fine powder. Take 2 qian each time, mix with warm wine.
Ji Yun Xia Si Tai Fa (Chicken Compress Method for Expelling Dead Fetus)
Wu Ji (Black-bone Chicken) (One whole)
Remove feathers, cut finely, decoct in 2-3 sheng of water. When the liquid is hand-warm, dip silk cloth in it and rub the abdomen. The fetus will be expelled naturally.
Xia Tai Dan Fang (Single Prescription for Expelling Fetus)
Niu Fen (Cow Dung) (Any amount)
Stir-fry cow dung until extremely hot, add half zhan of vinegar, wrap in green cloth, compress above and below the mother's navel. Expels immediately.
Qian Jin Yu Pi Tang (Thousand Years Elm Bark Decoction) Treats fetal death in the womb, or maternal illness requiring fetus expulsion.
Yu Bai Pi (Elm White Bark) (One handful)
Decoct the white bark in water, take the juice. The fetus will be expelled naturally.
Fan Hun Dan (Soul-Returning Pill) Treats various labor syndromes, dead fetus and evil blood, retained placenta, malpresentation. Clears heat and nourishes blood before labor; pushes out old and generates new after labor.
Ye Tian Ma (Wild Gastrodia Rhizome, also named Yi Mu Cao Motherwort, flowers/leaves harvested Apr-May, shade-dried, 0.5 jin) Chi Shao (Red Peony Root) (6 qian) Dang Gui (Angelica Sinensis) (7 qian) Mu Xiang (Aucklandia Root) (5 qian)
Grind into powder, make honey pills the size of quail eggs. Take one pill dissolved in Child's Urine, Wine, Mint Decoction, Rice Drink, Gui Zhi Tang (Cinnamon Twig Decoction), Jujube Decoction, or Qin Jiao Tang (Gentiana Macrophylla Decoction) according to syndrome.
Tai Chan Jin Dan (Pregnancy and Childbirth Golden Pill) Hua Tai Jian (Slippery Fetus Decoction) (Both seen in this volume, Prenatal Care Section, Easy Delivery Formulas.) Shen Zuo Yin (Seen in this volume, Labor Induction Section.) Fo Shou San (Buddha's Hand Powder) (Seen in Volume I, Various Pains Section.)