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[From *Mai Jue* (Pulse Resolution)] For a woman about to give birth, the pulse is "Li Jing" (pulse deviating from the normal pattern), characterized as deep, fine, and slippery. If this pulse change is felt at midnight, delivery should occur then; if it persists until noon, birth is certain. (*Nan Jing* states: A pulse rate of three beats per exhalation is called Li Jing, and one beat per exhalation is also called Li Jing. *Mai Jing* states: When a woman is about to deliver, her pulse becomes Li Jing; if felt at midnight, she will deliver by midday.) If the body feels heavy, there is fever with frequent chills, the veins under the tongue are blackish-green, and the tongue feels cold, the fetus will die, and the mother will perish. If the face is red but the tongue is cyanotic, careful examination reveals that the mother survives while the fetus dies, a situation difficult to manage; if both lips and tongue are cyanotic and froth is expelled, both mother and fetus will die, generally incurable; if the face is cyanotic but the tongue is red, and froth flows frequently, the mother dies while the fetus survives, which is definitive. If one does not believe this, observing these signs according to the teachings of sages proves they are not empty talk.

[From *Da Yi Jing Cui*] Discussion on Ten Types of Delivery:
1. **Zheng Chan** (Normal Delivery): When a woman has carried the fetus for ten months, suddenly experiencing paroxysmal pain in the lower back and abdomen, followed by a sudden descent of fetal Qi down to the umbilical and abdominal regions. The pain reaches its peak, causing heavy pain in the waist and protrusion/bursting sensation in the anus. Subsequently, the amniotic sac ruptures and blood flows, and the infant is born. This is called Normal Delivery.

2. **Shang Chan** (Injurious Delivery): Occurs when a woman, less than one month before term, suddenly experiences umbilical and abdominal pain resembling labor, but then nothing happens. This is called "Shi Yue" (Testing Month) and is not true labor. However, before any signs of normal labor appear, no one should hold the mother's waist, nor should the mother exert force recklessly. If the fetus is not yet in position and merely shifting, instructing the mother to exert weak, chaotic force causes the fetus to dislocate, becoming transverse or inverted, unable to be born normally. This results from the mother exerting force at the wrong time. One must wait until the fetus is in position and approaching the cervix before exerting force to push the baby out. This scenario is termed Injurious Delivery.

The above method regarding Injurious Delivery is crucial and must not be neglected. If ten months are not complete, and there is labor-like pain that comes and goes or is mild, it is called "Nong Tong" (Play Pain), not a sign of normal labor. Severe abdominal pain without severe lower back pain is not a sign of normal labor. A high fetal position not yet descended is not a sign of normal labor. No anal protrusion is not a sign of normal labor. No rupture of membranes or bleeding is not a sign of normal labor. Bleeding/fluid discharge without abdominal pain is not a sign of normal labor. In the absence of normal labor signs, allow the mother to walk and endure patiently. If she cannot walk, let her sit leaning on something, lie down quietly, or take one or two doses of Fetal-Calming Decoction until relieved. Do not recklessly administer Labor-Inducing Medicines. Panic causes fear and discouragement. Ensure the mother remains calm and composed, and have the midwife explain this clearly. If feeling stifled, mix one spoonful of white honey with fresh cool water and drink it. Do not exert force recklessly, exhausting the mother first. Only when the fetus presses against the cervix, causing extreme lower back heaviness/pain, a burning sensation in the eyes, and anal protrusion, is it the sign of normal labor, at which point force may be used and Labor-Inducing Medicine taken. I had a female relative who experienced severe lower back and abdominal pain resembling labor more than a month before delivery, stopping slightly during the Si hour (9-11 AM). This persisted for over ten days. Having exhausted other options, I consulted this text and prescribed Fetal-Calming Decoction supplemented with Ginseng and Atractylodes Macrocephala Rhizome for several doses, along with meat broth for nourishment. She recovered and ceased hurting. Twenty days later, she delivered a healthy boy. Had she exerted force recklessly or taken labor-inducing drugs then, she would have faced immediate danger and death.

3. **Cui Chan** (Accelerated Delivery): If a woman is in labor, membranes have ruptured, and bleeding has started, indicating normal labor signs, but the baby has not yet been born, administer Accelerating Medicine to hasten birth. If menstruation occurs or the mother is distressed after several days, medicine can be given to boost the mother's Zheng Qi (Upright Qi) to facilitate rapid birth. This is called Accelerated Delivery.

4. **Dong Chan** (Frozen Delivery): In winter, cold weather causes maternal blood to coagulate upon exposure to cold, preventing the fetus from being born. This harm is profound. In winter deliveries, the lower body must not be stripped of cotton clothing, nor should the mother sit or lie in cold places. Fire should be lit throughout the room to maintain warmth. The mother should face away from the fire towards warmth, keeping the area below the navel, legs, and knees warm. Heat allows blood to flow freely, facilitating easier birth. This is called Frozen Delivery.

5. **Re Chan** (Hot Delivery): In midsummer, the parturient must maintain appropriate temperature balance, avoiding excessive cooling which damages fetal Qi. Also, avoid overcrowding, as heat oppression can cause the mother's blood to boil, leading to fever, headache, facial redness, drowsiness like drunkenness, and even loss of consciousness. This is called Hot Delivery.

6. **Heng Chan** (Transverse Delivery): The fetus presents a hand or arm first. This is due to the mother exerting force excessively when inappropriate. With the fetus malpositioned, forceful pushing causes the body to become transverse. The mother should lie supine. The attendant should gently push the presenting limb back up, guiding the body into alignment, using the middle finger to rub the shoulder and push it upright, or pulling the ear to correct position. The mother must remain supine while the attendant slowly corrects the fetus. Once aligned, administer a cup of Accelerating Medicine. After ingestion, the mother may exert force to deliver the baby. This is Transverse Delivery.

7. **Dao Chan** (Breech/Inverted Delivery): Due to insufficient fetal Qi and lax pelvic floor, combined with premature exertion, the fetus fails to turn and descends feet-first. The mother should lie supine. The attendant should gently push the feet back up. The mother must not exert any force, nor should she be frightened, allowing the fetus to naturally assume the correct position.

8. **Pian Chan** (Oblique/Lateral Delivery): The fetus is misaligned. Forceful pushing causes the head to press against the left or right thigh. Although the head is visible, it is stuck to one side. The mother should lie supine. The attendant should gently push the fetus upward, manually correcting the head so the vertex is centered. Then, the mother exerts force to deliver. If the occiput is pressed against the anus, exposing only the forehead, the attendant, wearing gloves warmed by heated cotton cloth, should gently push the head from outside the anus to align it, then the mother pushes. This is Oblique Delivery.

9. **Ai Chan** (Impeded Delivery): The fetus is in position, presenting the vertex, but cannot be born. This is often because the fetus turned, and the umbilical cord wrapped around the shoulder, impeding the vertex's passage. The mother should lie supine. The attendant should gently push the fetus upward, extend a hand, press the middle finger under the shoulder, and manipulate the cord. Wait until the fetus is properly aligned, then the mother exerts force to deliver. This is Impeded Delivery.

For the four methods above (Transverse, Breech, Oblique, Impeded), if the attendant is not highly skilled, do not attempt these manipulations, lest ignorance cause harm. Regarding Breech Delivery, nowadays babies are often born feet-first without sequelae, with both mother and child surviving; thus, manual correction of feet is not always necessary. Regarding Impeded Delivery, sometimes the cord wraps around the vertex, but the head emerges naturally outside the vulva; the attendant can simply clear the cord from over the head. Or the cord wraps once around the vertex, and the fetus and placenta descend together naturally. These cases pose no harm. There is no need to insert hands into the vagina to manipulate the cord in these instances.

10. **Zuo Chan** (Sitting Delivery): When nearing delivery, hang a towel from a high place. The mother holds onto it, bends her knees, and sits lightly to facilitate birth. This does not mean sitting on an object. This is Sitting Delivery.

11. **Pan Chang Chan** (Prolapsed Intestine Delivery): Lady Gong, wife of Zhao Duyun, experienced prolapse of the large intestine before the baby during each delivery. Postpartum, the intestine did not retract, causing great suffering. This is called Prolapsed Intestine Delivery. Physicians could not treat it. While in Jianchang, a midwife applied a method to reduce it: Mix half a cup of vinegar with seven parts fresh cool water. Apply this mixture to the mother's face. Each time the intestine protrudes, apply the remedy three times until reduced. This is an excellent method.

[Dan Xi] Postpartum intestinal prolapse. Boil five jin (approx. 2.5 kg) of sesame oil in a basin. When warm, have the patient sit in the oil basin for about the duration of one meal. Blow powdered Sophora Flavescens Root (Zao Jiao) into the nose to induce sneezing, which instantly reduces the prolapse. Excellent. (*Dou Men*)

[Da Yi Jing Cui] Powdered Pinellia Tuber (Ban Xia) insufflated into the nose causes the intestine to rise. Another prescription: Dip a large paper wick in sesame oil, light it, blow it out, and smoke the fumes into the mother's nose; the intestine rises. Another prescription: Take fourteen castor seeds (Bi Ma Zi), remove shells, grind into a paste, and apply to the center of the mother's vertex; the intestine rises and reduces.