脉
欲产之妇脉离经。离经者，离乎经常之谓也，非《难经》一呼三至之比。脉虽离经而腰不痛者，未
产也；若腹连腰痛甚者，即欲产也。诊其尺脉转急，如切绳转珠者，即产出之脉也。
证
临产之初，宜脱平常所穿之衣，以笼罩头及罩口，则易产。切不可喧闹，宜选一善熟稳婆及得力家人，
无使挥霍张皇，致令产妇惊恐，惟当餐软饭稀粥之类。若腹中痛，且令扶行，或痛或止，名曰弄痛。不可使
试水手探，亦不可屈腰眠卧。如连腰引痛，眼中如见火光，此是儿转，又须扶策徐徐行。起若艰难，即凭物立。
须臾直至腰腹相引，频频阵痛，难以行立，然后坐草。切勿太早，恐儿在腹中难以转侧，及胞浆先破，子
道干涩，皆至难产。若心中热闷，可用生鸡子一枚打破吞服。抱腰之人，不得倾斜，则儿顺自然产。若临事
仓惶，用力失宜，遂有难产之恙。是故有逆产者，则先露足；有横生者，则先露手；坐产者，则先露臂，此
皆用力太早之过。夫当脐腹疼痛之初，儿身才转而未顺，用力一逼，遂至横
逆。若手足先露者，用细针刺儿手足心一二分深，三四刺之，以盐涂其上，轻轻送入，儿得其痛，惊转一缩，
即顺生矣。或儿脚先下者，谓之踏莲花生，急以盐涂儿脚底，又可急搔之，并以盐擦母腹上，则正生矣。若
产讫先饮童便一盏，或入酒少许同服。勿便睡，且令闭目而坐，顷之，方可扶上床仰卧，立膝勿令伸足，
熟睡，宜频唤醒。亦不可以得男为喜，喜则伤心，恐生红汗之证；亦不可以得女为忧，恐致败血伤心之患。宜
常淬醋烟，以防晕闷。逡巡，少进白粥，母令过饱。其有破水之后，经日而不产者，即当随证细
辨∶身重体热，作寒，面黑，舌青，及舌上冷，子母俱死，面赤舌青，母活子死；面青舌赤，口沫出者；母
死子活；唇口俱青，吐沫，母子俱死。仓卒之间，不可不详细审视，预与病家言之。若胞衣不下者，停待
少久，非惟使产母疲倦，是血流入胞中，为血所胀，上冲心胸，喘急疼痛，必致危殆。宜急断脐带，以物
坠住，尤宜用意拴缚，然后截断。不尔，则胞上掩心而死。须臾其血不潮入胞中，则胞衣自当痿缩而下，纵
淹延数日，亦不致害人。惟欲产母心怀舒畅，则自下矣。不可妄用手法，因此致殂。五七日不可强力下床，
或忧虑用性，一月之内，或伤于房事，以致变生证候。类此难治，最宜谨慎。外此有外感内伤，及诸杂证，
与男子等。但当加理血药为助，临治之际，宜以意消息之而参用焉。
方
黄金散（秘方）〔批〕（按此方催生圣药，如产月未足，又能安之） 治生产一二
日难分娩者，服之如神。因屡验不敢自私，广以济人，人得之者，亦弗自私，庶施者愈广矣。
真金箔大者五片，小者七片，以小瓷钟将水少许，去纸，入金
在内，用指研匀，后再添水至半钟。一面先令扶产妇虚坐，又令一
妇人用两手，将大指按定产母两肩上肩井穴，前药温服，其胎即下。如产月未足，又能安之。
济生汤 治难产，须一二日不产者宜服，自然转动降生。
当归（三钱） 川芎（二钱） 香附（一钱半，炒） 枳壳（三钱，麸炒） 苏叶（八分）
大腹皮（姜汁洗，一钱半） 甘草（七分） 加白芷（一钱）
上锉一剂，水煎，腰痛甚，服之即产。
自生饮（云林制）〔批〕（按此方活血顺气平和之剂） 治临产生育艰难。
当归（三钱） 川芎（二钱） 枳壳（炒，二钱） 益母草（一钱） 白芷（六分） 火麻
（炒去壳，一钱）
上锉一剂，水煎，空心温服。
催生立应散（王柏泉传） 治难产，及横生逆产。
车前子（一两） 当归（一两） 冬葵子（三钱） 牛膝（二钱） 白芷（三钱） 大腹
皮（二钱） 枳壳（二钱） 川芎（二钱） 白芍（一钱）
上锉，水煎熟，入酒少许，服之立产。
夺命丸 治妇人小产，下血至多，子死腹中，其人憎寒，手指、唇口、爪甲青黑，或胎上抢心，则闷绝欲
死，冷汗自出，喘满不食，或食毒物，或误服草药，动胎气下血不止，胎尚未损，服之可安；已损，服之可下。
桃仁（麸炒，去皮尖） 赤芍 官桂 白茯苓 牡丹皮（各等分）
上为末，蜜丸弹子大。每一丸，细嚼，淡醋汤下，速进两丸。至胎腐烂腹中，危甚，立可取出。
〔批〕（按此法治难产属热者） 治难产沥浆胞干，胎不得下，用香油、蜂蜜各一碗，和匀，入铜锅
内慢火煎一二沸，掠去沫，调白滑石末一两，重搅匀顿服。外以油蜜于母腹脐上下摩之。
降生散 治临产生育艰难，痛阵尚疏，三两日不生，或产母气乏羡顿，产道干涩，致令难产，才
觉腹痛，但破水后，便可服此药，即生矣，如死胎亦下；未经破水，不宜服之。
苍术（制，二钱） 枳壳 桔梗 陈皮 杨芍 白芷 川芎 当归（各一钱） 肉桂 干姜
浓朴 半夏 茯苓 木香 杏仁 麻黄 甘草
（各五分）
上为末，每服二钱，顺流水温暖送下。若觉热闷，蜜汤调，或锉散，姜枣顺流水煎服。其杨芍、肉桂，
能开通子宫，饮药助气，关窍自通，麻黄内通阳气，甚则血行即产矣。冬月用之，甚为的当。
隆暑之时，恐难轻服。但以五苓散，用葵子灯心煎汤调下。
香桂散 治坐产涩滞，心腹大痛，死胎不能下者，急用之。
香白芷（三钱） 肉桂（三钱） 麝香（三分）
上为末，童便酒调下，即产。
催生丹〔批〕（按此方治难产属寒者） 治生理不顺，或横或逆。
母丁香（一钱，另研） 香乳（一钱，另研） 麝香（一字，另研） 腊月兔脑（去皮膜，研如泥）
上为末，以兔脑和为丸，如鸡头实大，辰砂一钱为衣，阴干，
油纸密封。每服一丸，温水送下，即产。男左女右手握出其丸，神效。药用瓷罐盛，黄蜡封口。
催生符式
生九天大力魔军速降威灵摄天生急急如律令敕。
上用朱砂细研，用新汲水浓调匀，将新笔蘸朱砂，于清晨未食时，至诚念∶九天大力魔军速降威灵摄
天生急急如律令敕。至“生”字，急写“生”字，却于生字下面一画下，左绕匝心，想胎元被笔推
转，令急急如律令敕气一笔推下，须是随笔一句念，令笔咒俱尽，候干剪切，折作一丸，用黄蜡丸之，朱
砂为衣，浓煎木香汤送下，待痛频时服，乳香汤亦可。
如神丹 治难产，兼胞衣不大，及死胎。
巴三萆七脱衣裳，细研如泥入麝香，捏作饼儿脐下贴，须臾母子便分张。
灸法 治难产，及胞衣不下。
于左脚小指尖头上，即至阴穴，灸之，炷如小麦大，三五壮
立产。
催生遇仙丹
朱砂（一钱半） 雄黄（一钱半） 蛇蜕（一尺， ） 蓖麻子（十四粒）
上为末，粥糊为丸，如弹子大。临产先用椒水洗净脐穴，纳药
一丸于脐中，仍用油纸数重覆药上，封固，软帛拴系，立效。
脱衣散 治胞衣不下。
牛膝（三钱） 归尾（二钱） 木通（三钱） 滑石（四钱） 冬葵子（二钱半） 加枳壳（三钱）
上锉，水煎，温服。
有胞衣不下，因产母元气虚薄者，用芎、归倍桂以温之，自下。
一方 下死胎
平胃散一剂，水、酒各一碗，煎一二沸，入朴硝五钱，再煎，倾出候温服，其胎化为水而下。
一方 治坐草三四日不下者，即刻下。
蜜、香油、好酒各一钟，三味合入煎，产妇面东服。
一方 治横逆不顺，子死腹中。
伏龙肝为细末，温酒调服二三钱，其儿带土而下。
一方 催生下胎
鱼胶七寸，麻油灯烧过为末，酒调服。
Pulse
For a woman about to give birth, the pulse deviates from the regular pattern. "Deviating from the meridian" (Li Jing) refers to the pulse departing from its usual state, which is different from the description in *Nan Jing* of three beats per breath. If the pulse has deviated but there is no lower back pain, labor has not yet truly begun; if there is severe pain connecting the abdomen and lower back, delivery is imminent. Palpating the Chi (尺) position of the pulse, if it feels rapid and tense, like cutting a turning rope or beads rolling, this is the pulse indicating imminent delivery.
Symptoms
At the beginning of labor, one should remove ordinary clothing and cover the head and mouth with a cloth sheet, which facilitates easy delivery. One must strictly avoid noise and commotion. It is advisable to select an experienced, steady midwife and capable family members to prevent the mother from becoming panicked or flustered, which could cause fright. The mother should only consume soft rice and thin porridge. If abdominal pain occurs, the mother may be assisted to walk; the pain comes and goes, known as "false labor pains" (Nong Tong). Do not allow unqualified attendants to examine, nor let the mother lie down with her waist bent. If the lower back pain radiates to the abdomen and the mother sees flashes of light in her eyes, this indicates the fetus is rotating its position; she should be supported to walk slowly. If rising is difficult, she should stand leaning on objects. After a while, when the waist and abdomen pull together and contractions become frequent, making walking and standing difficult, then she should ascend the birthing stool (Zuo Cao). Do not exert force too early, lest the fetus cannot rotate within the womb, or the amniotic sac ruptures prematurely, causing the birth canal to become dry, all leading to dystocia. If the chest feels hot and stifled, one broken raw egg can be swallowed. The person supporting the mother's waist must not lean, so that the fetus delivers naturally according to its position. If panic sets in during labor and effort is misapplied, dystocia will result. Therefore, in breech presentation (Ni Chan), feet appear first; in transverse presentation (Heng Sheng), hands appear first; in seated presentation (Zuo Chan), arms appear first. These are all faults caused by pushing too early. When umbilical and abdominal pain first begins, the fetal body has just turned but is not yet aligned; forcing it leads to transverse or inverted positions. If hands or feet appear first, use a fine needle to prick the palms or soles of the fetus to a depth of one or two fen, pricking three or four times, and apply salt to them, gently inserting the limb. The pain and shock will cause the fetus to contract and turn, resulting in a normal delivery. If the feet come out first, it is called "Treading Lotus Flower"; immediately apply salt to the soles, scratch them quickly, and rub salt on the mother's abdomen, and the fetus will deliver normally. After delivery, drink a cup of child's urine, or mix with a little wine. Do not sleep immediately; sit with eyes closed for a moment, then lie supine on the bed with knees flexed, not extending the legs. Wake the mother frequently from deep sleep. Do not rejoice at having a boy, as joy injures the heart and may cause "red sweat" (postpartum hemorrhage); do not grieve over having a girl, as sorrow may lead to blood stasis injuring the heart. Constantly fumigate with vinegar smoke to prevent fainting. After a while, take small amounts of white porridge, avoiding overeating. If water breaks but delivery does not occur after a day, carefully differentiate based on symptoms: heavy body, fever, chills, black face, cyan tongue, and cold tongue indicate death of both mother and fetus; red face and cyan tongue indicate living mother and dead fetus; blue face, red tongue, and foaming at the mouth indicate dead mother and living fetus; blue lips and mouth with foaming indicate death of both. In emergencies, careful examination is essential, and the prognosis must be communicated to the family beforehand. If the placenta fails to descend, waiting too long not only exhausts the mother but also allows blood to fill the placental sac, distending it and rushing upward to the chest and heart, causing panting, urgency, and pain, leading to danger. The umbilical cord should be cut immediately, secured with a weight, and firmly tied before cutting. Otherwise, the placenta may rise and compress the heart, causing death. Soon, if blood ceases to surge into the placental sac, the placenta will naturally shrink and descend; even if delayed for days, it will not be fatal. A calm mind in the mother ensures natural descent. Do not use manual manipulation recklessly, as this may cause death. For five to seven days postpartum, do not force oneself out of bed, nor worry or anger. Within a month, sexual indiscretion may cause other syndromes. Such cases are difficult to treat and require utmost caution. Aside from these, external invasions, internal injuries, and miscellaneous syndromes are similar to those in men. However, blood-regulating herbs should be added as assistance. During treatment, one should carefully consider and integrate these measures.
Formulas
Golden Leaf Powder (Secret Recipe) [Commentary] (Note: This is a sacred medicine for inducing labor; if used before full term, it can also secure the pregnancy.) Treats difficult delivery lasting one or two days; effects are miraculous. Having verified it repeatedly, I dare not keep it secret, but spread it to help others. Those who receive it should also not keep it secret, so that more people may benefit.
True gold leaf: large pieces 5, small pieces 7. Place in a small porcelain bell with a little water, remove paper lining, add gold leaf inside, grind evenly with finger, then add water to half the bell. Have the mother sit loosely on one side. Another woman uses both thumbs to press the Jianjing (GB21) acupoints on both shoulders of the mother. Take the prepared medicine warm; the fetus will descend. If before full term, it secures the pregnancy.
Jisheng Decoction Treats dystocia; suitable for those who have not delivered after one or two days, allowing the fetus to naturally rotate and descend.
Dang Gui (Angelicae Sinensis Radix) (3 qian) Chuan Xiong (Ligustici Chuanxiong Rhizoma) (2 qian) Xiang Fu (Cyperi Rhizoma) (1.5 qian, stir-fried) Zhi Ke (Aurantii Fructus) (3 qian, bran-fried) Su Ye (Perillae Folium) (0.8 fen) Da Fu Pi (Arecae Pericarpium) (washed with ginger juice, 1.5 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.7 fen) Add Bai Zhi (Angelicae Dahuricae Radix) (1 qian).
Crush into coarse powder for one dose, decoct in water. For severe lower back pain, taking it induces delivery.
Zisheng Yin (Made by Yunlin) [Commentary] (Note: This is a mild formula for activating blood and regulating qi.) Treats difficult labor at term.
Dang Gui (Angelicae Sinensis Radix) (3 qian) Chuan Xiong (Ligustici Chuanxiong Rhizoma) (2 qian) Zhi Ke (Aurantii Fructus) (stir-fried, 2 qian) Yi Mu Cao (Leonuri Herba) (1 qian) Bai Zhi (Angelicae Dahuricae Radix) (0.6 fen) Huo Ma Ren (Cannabis Fructus) (stir-fried, husked, 1 qian).
Crush into coarse powder for one dose, decoct in water, take warm on an empty stomach.
Cuisheng Liying San (Passed down by Wang Boquan) Treats dystocia, and transverse or inverted presentations.
Che Qian Zi (Plantaginis Semen) (1 liang) Dang Gui (Angelicae Sinensis Radix) (1 liang) Dong Kui Zi (Malvae Semen) (3 qian) Niu Xi (Achyranthis Bidentatae Radix) (2 qian) Bai Zhi (Angelicae Dahuricae Radix) (3 qian) Da Fu Pi (Arecae Pericarpium) (2 qian) Zhi Ke (Aurantii Fructus) (2 qian) Chuan Xiong (Ligustici Chuanxiong Rhizoma) (2 qian) Bai Shao (Paeoniae Radix Alba) (1 qian).
Crush, decoct in water until cooked, add a little wine, take to induce immediate delivery.
Duoming Pill Treats miscarriage in women with excessive bleeding, fetus dead in the uterus, aversion to cold, cyanosis of fingers, lips, and nails, or fetal Qi rushing to the heart causing suffocation and near-death, cold sweats, panting, fullness, anorexia, or poisoning from food/herbs disturbing fetal Qi causing continuous bleeding. If the fetus is intact, it secures it; if damaged, it expels it.
Tao Ren (Persicae Semen) (bran-fried, skin and tip removed) Chi Shao (Paeoniae Radix Rubra) Guan Gui (Cinnamomi Ramulus) Bai Fu Ling (Poria) Mu Dan Pi (Moutan Cortex) (equal parts).
Grind into fine powder, make pills with honey the size of a bullet. Chew one pill finely, swallow with light vinegar water, quickly take two pills. Even if the fetus has decomposed in the uterus and the condition is critical, it can be extracted immediately.
[Commentary] (Note: This treats heat-type dystocia.) For dystocia due to premature rupture of membranes and dryness, mix 1 bowl of sesame oil and 1 bowl of honey, slow-boil in a copper pot for one or two boils, skim foam, mix with 1 liang of Bai Hua Shi (Talcum), stir well and take at once. Massage mother's abdomen above and below the navel with the oil-honey mixture externally.
Jiangsheng San Treats difficult labor at term, sparse contractions, failure to deliver after two or three days, or maternal Qi deficiency and exhaustion, dry birth canal causing dystocia. Take as soon as abdominal pain starts after water breaks; delivery will follow, even for dead fetuses. Not suitable before water breaks.
Cang Zhu (Atractylodis Rhizoma) (processed, 2 qian) Zhi Ke (Aurantii Fructus) Jie Geng (Platycodonis Radix) Chen Pi (Citri Reticulatae Pericarpium) Yang Shao (Paeoniae Radix Alba) Bai Zhi (Angelicae Dahuricae Radix) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Dang Gui (Angelicae Sinensis Radix) (each 1 qian) Rou Gui (Cinnamomi Cortex) Gan Jiang (Zingiberis Rhizoma) Hou Po (Magnoliae Officinalis Cortex) Ban Xia (Pinelliae Rhizoma) Fu Ling (Poria) Mu Xiang (Aucklandiae Radix) Xing Ren (Armeniacae Semen) Ma Huang (Ephedrae Herba) Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 0.5 fen).
Grind into powder, take 2 qian each time, swallow with warm running water. If feeling hot/stifled, mix with honey water, or decoct the powder with ginger and jujube in running water. Yang Shao and Rou Gui open the uterus; the medicine boosts Qi, opening orifices naturally. Ma Huang connects internal Yang Qi; when blood flows freely, delivery occurs. Very appropriate for winter. In summer, avoid using lightly. Use Wuling San instead, taken with decoction of Dong Kui Zi and Deng Xin Cao.
Xianggui San Treats seated presentation with stagnation, severe abdominal pain, and retained dead fetus. Use urgently.
Xiang Bai Zhi (Angelicae Dahuricae Radix) (3 qian) Rou Gui (Cinnamomi Cortex) (3 qian) She Xiang (Moschus) (0.3 fen).
Grind into powder, take mixed with child's urine and wine; delivery follows immediately.
Cuisheng Dan [Commentary] (Note: This treats cold-type dystocia.) Treats abnormal physiology, transverse or inverted presentations.
Mu Ding Xiang (Syzygii Aromatis Flos) (1 qian, separately ground) Xiang Ru (Olibanum) (1 qian, separately ground) She Xiang (Moschus) (1 zi, separately ground) Rabbit brain from December (skin and membrane removed, ground to paste).
Grind into powder, mix with rabbit brain to form pills the size of a corn kernel, coat with 1 qian of Chen Sha (Cinnabaris), dry in shade, seal in oil paper. Take one pill with warm water; delivery follows. Hold the pill in the left hand for boys, right for girls; miraculous effect. Store medicine in porcelain jar, seal with yellow wax.
Cuisheng Talisman Formula
Sheng Jiu Tian Da Li Mo Jun Su Jiang Wei Ling She Tian Sheng Ji Ji Ru Lü Ling Chi.
Grind Zhu Sha (Cinnabaris) finely, mix thickly with fresh drawn water. Dip a new brush in Zhu Sha. At dawn before eating, sincerely chant: "Jiu Tian Da Li Mo Jun Su Jiang Wei Ling She Tian Sheng Ji Ji Ru Lü Ling Chi." Upon reaching the character "Sheng" (Birth), hastily write the character "Sheng". Below the bottom stroke of the character, circle to the left towards the heart, visualizing the fetal origin being pushed and rotated by the brush, commanding the Qi to push down instantly. Chant along with the writing until the spell ends. Wait for it to dry, cut, fold into a pill, wrap in yellow wax, coat with Zhu Sha. Take with strong decoction of Mu Xiang (Aucklandiae Radix) when contractions are frequent. Ru Xiang (Olibanum) decoction is also acceptable.
Rushen Dan Treats dystocia, small placenta, and dead fetus.
Ba Dou (Semens Brunonellae) three, Bi Qi (Radix Stemonae) seven, strip clothes, grind fine like mud, add She Xiang (Moschus), shape into cakes, apply below navel, soon mother and child separate.
Moxibustion Method Treats dystocia and retained placenta.
On the tip of the little toe of the left foot, i.e., Zhiyin (BL67) acupoint, moxa. Moxa cone size of wheat grain, 3-5 moxibustions. Immediate delivery.
Cuisheng Yuxian Dan
Zhu Sha (Cinnabaris) (1.5 qian) Xiong Huang (Realgar) (1.5 qian) She Tui (Bombyx Batryticatus) (1 chi) Bi Ma Zi (Ricini Semen) (14 grains).
Grind into powder, bind with rice paste into pills the size of bullets. Before labor, wash the navel with pepper water, insert one pill into the navel, cover with several layers of oil paper, seal tightly, tie with soft cloth. Immediate effect.
Tuoyi San Treats retained placenta.
Niu Xi (Achyranthis Bidentatae Radix) (3 qian) Gui Wei (Angelicae Sinensis Radix - tail) (2 qian) Mu Tong (Akebiae Caulis) (3 qian) Hua Shi (Talcum) (4 qian) Dong Kui Zi (Malvae Semen) (2.5 qian) Add Zhi Ke (Aurantii Fructus) (3 qian).
Crush, decoct in water, take warm.
For retained placenta due to maternal Yuan Qi deficiency, use doubled Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Dang Gui (Angelicae Sinensis Radix) with Gui Zhi (Cinnamomi Ramulus) to warm, and it will descend naturally.
One Prescription Expel Dead Fetus
Pingwei San (Coptidis Rhizoma etc.) one dose, decoct with 1 bowl water and 1 bowl wine for one or two boils, add Piao Xiao (Natrii Sulfas) 5 qian, decoct again, pour out, wait for warmth, take. The fetus turns to water and descends.
One Prescription Treats failure to deliver after sitting on the grass for 3-4 days, expels immediately.
Honey, Sesame Oil, Good Wine each 1 zhong. Mix and decoct. Mother faces east and takes.
One Prescription Treats transverse/inverted malpresentation, fetus dead in uterus.
Fu Long Gan (Fodi Argilla) ground to fine powder, mix with warm wine, take 2-3 qian. The fetus descends carrying earth.
One Prescription Induce Delivery of Second Fetus
Yu Jiao (Colla Corii Asini) 7 cun, burn over sesame oil lamp, grind to powder, mix with wine and take.