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Pang Anchang treated a woman who was about to give birth. Seven days passed, yet the child remained undelivered, and all treatments proved ineffective. Pang examined her and instructed her family to warm her waist and abdomen with hot water, while he personally performed upper and lower massage on her abdomen. The pregnant woman felt slight pain in her intestines and stomach, and amidst groaning, she delivered a male infant. Her family was both surprised and delighted but did not know the reason. Pang said, "The fetus has already exited the amniotic sac, but one hand mistakenly grasped the mother's intestine and could not release it. Therefore, this cannot be resolved by medicine alone. I palpated the location of the fetal hand through the abdominal wall and acupunctured its 'tiger mouth' (Hegu, LI4). The pain caused the hand to retract, which is why delivery occurred rapidly. There is no other technique." Upon examining the infant, needle marks were indeed found on the right tiger mouth area.

Another woman had been unable to deliver for several consecutive days, and parturition-inducing medicines were ineffective. Pang said, "This must be due to preparing for labor too early, causing fear in the heart, leading to qi stagnation and failure to move. This is not malposition. As stated in *Suwen*: 'Fear causes qi to sink.' Generally, fear makes the spirit timid; timidity causes closure of the Upper Jiao; closure leads to qi rebellion; rebellion causes distension in the Lower Jiao, so qi fails to move." He then administered Zisu Yin (Perilla Decoction), and after one dose, she delivered smoothly. For women experiencing "Zixuan" (Fetal Distension) at six or seven months of pregnancy, this formula is also often effective.

Yu Zhen commented: Su Dongpo once wrote to Pang Anchang discussing the meanings of "Wang, Zhen, Meng, Qiu, Ming" from Yang Xiong's *Tai Xuan Jing*, praising him by saying, "Anchang reads extensively and excels at exploring the principles of things; his insights often make me ponder." Such high regard for Pang Anchang. Observing these two cases further confirms that his reputation is well-deserved.

Zhu Danxi said: Difficult labors in the world often occur among people who are depressed and live in leisure, specifically those from wealthy families enjoying luxurious lifestyles; they are rarely seen among the poor and hardworking. Medical texts only discuss "Shoutai Yin" (Fat-Reducing Decoction), but this formula was created for Princess Huyang and does not represent the ultimate theory. Why? Because seeing its use, difficult labors persisted. My clan sister suffered greatly from difficult labor and would terminate pregnancies whenever she conceived, which deeply pitied me. Observing her obese physique but diligence in female crafts, I pondered for ten days and realized: "This is exactly opposite to Princess Huyang's case. Those living in luxury likely have excess qi; consuming their qi to bring it to balance facilitates easy delivery. Now, her obesity indicates qi deficiency, and prolonged sitting indicates stagnant qi movement, making qi even weaker. Furthermore, prolonged sitting causes the uterus to follow the mother's stagnant qi. We should tonify the mother's qi, so the fetus becomes robust and delivery is easy." She was prescribed Zisu Yin supplemented with qi-tonifying herbs during the fifth to sixth month of pregnancy, taking over ten doses, resulting in a smooth delivery of a son with great relief. Thereafter, based on this formula, adjusting according to each person's physique and constitution, and considering seasonal changes, it proved universally effective. Thus, the formula was named "Da Dasheng San" (Great Delivery Powder).

Yu Zhen commented: Reading ancient texts and reversing their approach while adhering to reason is something only superior scholars can do. Since the emergence of Da Dasheng San, countless mothers and infants have enjoyed safety. Zhu Danxi's contribution to society was immense.

Wang Shishan treated a woman who frequently experienced transverse or breech presentations, having had seven or eight pregnancies, none of which survived. Wang diagnosed the pulse as fine, soggy, and slightly wiry, stating, "This is a combination of dual deficiency of qi and blood with internal heat." Someone asked, "Only when qi and blood are sufficient can pregnancy form; if qi and blood are deficient, how can one conceive?" Wang replied, "Her tall and thin physique with fine and soggy pulses indicates dual deficiency of qi and blood; her bluish complexion and wiry pulse indicate frequent flaring of Liver Fire. The floating and slippery pulses at the Cunkou position suggest blood deficiency is mild, while qi deficiency is severe." It is suitable to use Buyin Wan (Tonify Yin Pill), removing Chenpi (Tangerine Peel), doubling the dosage of Xiangfu (Cyperus Rhizome), Renshen (Ginseng), and Baizhu (Atractylodes Macrocephala Rhizome), formed into honey pills, taken continuously. After more than a year, she finally delivered a son smoothly at term.

Yu Zhen commented: The principle of preserving pregnancy and facilitating easy delivery presented here is correct. Because maternal weakness results in lack of strength, the fetus within the abdomen cannot rotate its body, leading to transverse or inverted presentations. If ginseng is taken frequently before term, maternal qi becomes vigorous, ensuring smooth delivery. This has been verified repeatedly.

Chen Liangfu treated a woman at seven months of pregnancy who returned from a long journey and suddenly experienced fetal qi rushing up to the heart causing pain, restlessness in sitting and lying down. Two physicians failed to treat her and declared the fetus dead. Castor bean paste mixed with musk had already been applied below the navel to induce abortion, creating a critical situation. Chen examined her and found the pulses at the Chi position (Kidney position) absent, while other pulses were peaceful. Chen asked the physicians what diagnosis they had made. They answered, "Dead fetus." Chen asked, "How do you know?" They replied, "The Chi pulses are deep and absent." Chen said, "Incorrect. This is 'Zixuan' (Fetal Distension). If the fetus were dead, there would be distinguishing signs: red face and blue tongue indicate dead fetus and living mother; blue face and red tongue indicate dead mother and living fetus; blue lips and mouth indicate death of both. Currently, the face is not red, and the tongue is not blue, indicating the fetus is alive. This is fetal qi pressing against the heart, suitable for treatment with Zisu Yin." After ten doses, the fetal qi descended.

Yu Zhen commented: Absent Chi pulses are easily mistaken for a dead fetus in the womb. Without Chen's diagnostic method, how could one avoid mistakenly killing two lives?

Hua Borén treated a woman with difficult labor who had not lactated for seven days and ate very little. Hua examined her and provided a bowl of cool porridge, grinding maple leaves to decoct in water, mixing them together for her to drink. Lactation resumed shortly. When questioned about the rationale, Hua said, "This woman eats very little; without grain qi, lactation is impossible. Maple leaves shed leaves after bearing fruit/flowers (implying a specific natural order or property), hence using them in decoction."

Wu Jiaoshan treated a woman with difficult labor where the fetus had not descended for three days. Blood-breaking and menstruation-promoting medicines were ineffective. Wu formulated a prescription with Cheqianzi (Plantago Seed) as the sovereign herb, Dongkuizi (Malva Seed) as the minister herb, and Baizhi (Angelica Dahurica Root) and Zhike (Bitter Orange Fruit) as assistant and envoy herbs. The patient delivered at noon after taking the medicine. Other physicians were astonished. Wu explained, "*Bencao* states these herbs are sovereign for inducing labor; *Shijing* mentions preventing difficult labor."

Wei Yun added: Fresh Cheqianzi is superior.

Liu Fuzhen encountered the daughter of a Prefectural Judge who died due to obstructed labor. Liu boiled Honghua (Safflower) strongly, supported the woman on a stool, dipped cotton cloth in the decoction, and wiped her body, continuously pouring warm water over the cloth. After a long time, she revived and subsequently delivered a male infant. This was because it was severe winter, causing blood to congeal and stagnate; warmth promoted circulation and delivery. His insight was miraculous.

A doctor staying at an inn found the innkeeper's wife unable to deliver for several days, with cold lower extremities and no medicine available, leaving him in distress. He decocted Sichuan pepper, orange leaves, and Evodia fruit. When the temperature was suitable, he washed her umbilical area, abdomen, and perineum with the liquid. The warmth promoted qi and blood flow, resulting in successful delivery.

Yu Zhen commented: There are many parturition-inducing formulas, some effective, others not, with no fixed outcome. The key lies in precise application. These few cases merely demonstrate flexibility. Only by learning the thought process of Sun Dongsu in the following case can one achieve the skill of a giant god splitting mountains.

A woman who previously delivered easily faced excessive bleeding and an unopened cervix during her fortieth pregnancy. One dose of Jiawei Xionggui Tang (Modified Ligusticum and Angelica Decoction) was given, along with a large amount of Wuyou San (Carefree Powder), decocted and sipped frequently to nourish blood and facilitate delivery.

Sun Dongsu said: My nephew Yuansu's wife suffered from difficult labor in midsummer. Inquiring about her condition, she said, "Delivery has reached the threshold [cervix fully dilated/fetus low], but cannot descend. Straining causes a sensation of something rushing up in the chest and diaphragm, unbearable pain." I pondered for a moment and said, "This must be twins. The sacs have separated, one above and one below. The lower one wants to deliver, while the upper one rushes upward due to straining. Because it presses against the chest and diaphragm, there is pain. This is dangerous. Unfortunately, obstetric texts do not discuss methods for this. After careful consideration of treatment, I realized we must calm the upper part so the lower part can exert force effectively." I took Yiyuan San (Yi Yi Yuan San / Talc and Coix Seed Powder), one tael, administered with Zisu Tang (Perilla Decoction). Perilla calms the fetus and directs qi downward; Talc lubricates orifices. Both are excellent for inducing labor. After the medicine entered the stomach, chest pain ceased. Within less than an hour, twin daughters were born, and the mother was unharmed.