Library

Pulse: During labor, if the pulse beats six times per cycle (indicating a change in rhythm), it is called "Li Jing" (pulse changing from the regular pattern); if the pulse is deep, fine, and slippery, birth is imminent. If the pulse is floating and large, difficult labor may occur; if accompanied by chills and fever, the prognosis is ominous. At this time, critical signs must be watched for urgently, especially facial color changes. Black or cyan colors on the face, cheeks, lips, and tongue are taboo. A red face suggests the mother may survive but the fetus will surely die; if the fetus remains in the womb, both mother and child may perish.

The difficulty of childbirth often arises because the woman has not previously learned about the principles of childbirth. In the moment of delivery, panic and improper exertion lead to dystocia. Thus, there is breech presentation where feet appear first; transverse presentation where hands appear first; and seated presentation where the buttocks appear first. These are all due to premature exertion. When abdominal pain first begins, the fetus has just started to turn but is not yet in position. Forcing effort at this stage causes transverse or inverted presentations. If hands or feet appear first, prick the soles of the feet or palms of the hands one to two fen deep, three or four times, and apply salt. Gently push them back. The pain and surprise cause the fetus to contract and turn into a normal position. If feet appear first, known as "Lotus Stepping," immediately apply salt to the soles, scratch them quickly, and massage the mother's abdomen with salt to correct the position for normal birth.

When the placenta fails to descend, it is because after the infant is born, blood enters the placenta, causing it to swell and preventing expulsion. If treatment is delayed, the swollen placenta fills the abdomen and rises toward the heart and chest, causing pain, panting, and potentially fatal conditions. If this occurs, tie and cut the umbilical cord immediately, weighing it down to prevent blood from flowing back into the uterus. The placenta will naturally shrink and descend; even if delayed for days, it is not harmful. The mother should remain calm and not trust midwives who use improper manual techniques, which often cause harm. For placental retention due to deficient Yuan Qi, use Xiong Gui Tang with doubled Guizhi to warm the body, allowing the placenta to descend naturally.

For pregnant women approaching labor, if contractions are sparse and no birth occurs after two or three days, or if the mother is exhausted and the birth canal is dry, leading to dystocia: once water breaks and abdominal pain is felt, take Wu Ji San plus seven Xingren (Apricot Seeds), Muxiang (Costus Root) ground into juice, Shun Liu Shui (flowing water), ginger, and jujube decocted together. Mix in one qian of Baicao Shuang (soot from hundred herbs) and take orally. Do not take before water breaks.

Knowing these ten signs can prevent unnecessary loss of life. Few practitioners possess excellent skills, often resulting in tragedy. I recount them out of sorrow:

1. Normal Labor (Zheng Chan): After ten months of pregnancy, when Yin and Yang energies are sufficient, sudden rhythmic pains begin. The fetus descends to the rectum, waters break, blood flows, and the baby is born normally.
2. Traumatic Labor (Shang Chan): Pregnancy is not full-term. Injury or disturbance causes sudden abdominal pain. Taking催产 drugs too early or pushing too early forces the fetus into an incorrect path. One must wait for the fetus to turn correctly, head facing the birth canal, before pushing.
3. Induction of Labor (Cui Sheng): When the fetal head reaches the birth canal, medication is used to induce birth. If the process is prolonged and the mother is exhausted, medicine is given to boost Qi and Blood for faster delivery.
4. Cold Labor (Dong Chan): In cold weather, maternal Qi and Blood stagnate, slowing birth. Keep clothes thick, the room warm, and the back covered to facilitate easy birth.
5. Hot Labor (Re Chan): In summer heat, temperature regulation is crucial. Excessive heat causes headache, red face, and fainting. Crowded rooms with stifling heat cause "Blood Fainting." Avoid drafts and rain in summer.
6. Transverse Presentation (Heng Chan): The fetus is turning, but maternal pushing forces it sideways. Let the mother lie supine. The midwife straightens the fetus, aligns the head with the birth canal, checks the shoulder with the middle finger to ensure the cord is not tangled, then uses medication and maternal effort for birth.
7. Inverted Presentation (Dao Chan): The fetus has not turned, caused by maternal pushing. Let the mother lie supine. The midwife pushes the fetus in and waits for natural alignment. If delayed, the midwife inserts a hand to guide the fetus toward the canal, then gives induction medicine and encourages pushing.
8. Oblique Presentation (Pian Chan): The fetus turns but does not align with the birth path. Maternal pushing forces the head to one side. Although the vertex appears, it is actually the forehead or ear. Let the mother lie supine. The midwife gently corrects the head position toward the canal, then encourages pushing. If the occiput is pushed toward the anus exposing the forehead, the midwife warms cotton-wrapped hands and gently pushes from outside the anus to correct position.
9. Obstructed Labor (Ai Chan): The fetus is aligned and the head is visible, but the umbilical cord wraps around the shoulder during turning. Let the mother lie supine. The midwife pushes the fetus up, presses the shoulder with the middle finger to free the cord, realigns the fetus, and encourages pushing.
10. Seated Presentation (Zuo Chan): To assist birth, tie a towel securely from a high place. The mother holds it and sits gently, bending knees. Do not sit directly against the birth path.
11. Prolapsed Intestine (Pan Chang Chan): Lady Zhao Gong would have her intestines prolapse before delivering the baby. The midwife uses half a cup of vinegar water, silently directing it towards the mother's face and back to retract the intestine. This method must be known.

Fetal Death in Utero: Often caused by premature excitement, violating taboos, heavy pressure on the waist, or frequent testing breaking the membranes prematurely, drying up amniotic fluid. Signs include black/cyan lips and tongue, indicating death of both mother and child. If the tongue is black or severe bloating occurs, the fetus is dead. First, decoct Ping Wei San (one liang) in equal parts wine and water, add Po Xiao (half liang), and take. Alternatively, take one liang of Po Xiao mixed with child's urine.

Ping Wei San
Cang Zhu (milled rice soaked) Chen Pi Zhen Mu Jiang Zhi Chao Gan Cao
Decoct one dose in wine and water, add Po Xiao, boil briefly, and take warm.

In case of dystocia or extreme cold, slowly cut the umbilical cord using a large oil-paper wick. Even if the fetus is dead, warming air entering the abdomen may revive it. Never use a knife.

Dystocia is often due to dryness and constriction. (Xiong Gui Tang is safest and most effective for induction.)

Cui Sheng Yin
Dang Gui Chuan Xiong Da Fu Pi Xi Zhi Ke Mai Chao Bai Zhi (equal parts)
Decoct one dose in water, take warm. These five ingredients induce birth immediately.

Zha Mu Yin: Induces labor, also treats transverse/inverted presentations and retained dead fetuses. Effective instantly.
Fresh Zha Mu branches (finger-thick, one handful), washed and chopped, leaves and thorns present everywhere. Gan Cao (five cun).
Decoct one large dose in 1.5 bowls of water in a clay pot sealed with double paper. Simmer until half remains. When abdominal pain is severe, drink one cup warm. Within one or two doses, heaviness indicates birth.

Cui Sheng Tang: Take when abdominal/lower back pain occurs and amniotic fluid breaks.
Tao Ren (fried, peeled) Chi Shao Mu Dan Pi Jing Guan Gui Bai Fu Ling Qu Pi (each one qian)
Decoct one dose in water, take hot.

Ru Shen San: Highly effective for induction, though mechanism is hard to explain. Practical results are miraculous.
Find one straw sandal on the road, burn the sole to ash, mix with warm wine, take three qian. Left foot implies boy, right foot girl, pair implies fetal death, single implies fright. Truly magical.

Cui Sheng San: Treats dystocia and retained placenta.
Bai Zhi Fu Long Gan Baicao Shuang Hua Shi (equal parts) Gan Cao (half amount)
Grind to fine powder. Mix with Xiong Gui Tang, wine, and a little child's urine. Take twice for immediate effect.

Tuo Yi San: Treats retained placenta.
Chuan Niu Xi (three qian) Gui Wei (two qian) Mu Tong (three qian) Hua Shi (four qian) Dong Kui Zi (two and a half qian) Add Zhi Ke (two qian)
Decoct one dose in water, take hot.

For retained placenta due to deficient Qi, use Dang Gui and Chuan Xiong with doubled Guizhi to warm and promote descent.

Supplementary Prescriptions
For Dystocia: She Tui (Snake Slough) one qian, roasted to retain properties, ground to powder, taken with yellow wine induces birth.
For Transverse/Inverted Presentation: If charms fail, moxa three cones on the tip of the right little toe, cone size like wheat grain.
For Retained Dead Fetus: She Xiang (five fen, separately ground) Guan Gui end (three qian). Mix, take with yellow wine. Fetus expelled quickly as if pushed by hand.
For Fetal Death with Unceasing Pain: Lu Jiao (Deer Antler) burned to ash, take three qian with warm yellow wine.

A pregnant woman had unopened crossing bones and an open birth canal, due to weak Yuan Qi and poor prenatal care, leading to failure of Qi and Blood circulation. Unopened crossing bones indicate Yin deficiency; use Jia Wei Xiong Gui Tang and Bu Zhong Yi Qi Tang. Open birth canal indicates Qi and Blood deficiency; use Shi Quan Da Bu Tang. (Jia Wei Xiong Gui Tang consists of Chuan Xiong and Dang Gui each one liang, plus one fried turtle shell from a naturally dead turtle and a handful of burnt human hair, ground to powder. Take five qian decocted in water. Birth occurs as fast as walking five li. Also works for dead fetuses. Burnt turtle shell is acceptable.)