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[Song on Life and Death in Difficult Labor] The pulse of a woman about to give birth shows the "Li Jing" pulse (a pulse distinct from the usual pattern, indicating impending labor); if the pulse is deep, fine, and slippery, accompanied by abdominal pain, it can be known that delivery will occur at midnight. This pulse method has been recorded since the *Huangdi Neijing* (Yellow Emperor's Inner Canon). Generally, this is how it should be during labor; the parturient should remain calm and must not be alarmed. If the body feels heavy, with alternating chills and fever, and frequent pain, while the lips and nails turn black then cyan, this verifies that the fetus has died in the womb; if the tongue is cyan and the limbs are cold, the mother will die. If the face is red and the tongue is cyan, careful observation is required; this clearly indicates the mother survives while the fetus dies. If both the lips and mouth are cyan with white foam emerging, this confirms the death of both mother and child. If the face is cyan and the tongue is red with foam emerging, it is certain that the mother dies while the fetus lives. These observations have proven accurate in clinical practice, confirming that the statements of former sages were not empty talk.

For difficult labor, it is suitable to consume Tongbian (Child's Urine) and take Shenshen Jubao Dan (Divine Immortal's Treasure Pill). In cases of obstruction, use 14 grains of Castor Seed flesh (Ricini Semen), 5 fen each of Cinnabar (Zhusha) and Realgar (Xionghuang), burn approximately one chi of Snake Slough (Sheqiao) to ash, add 1 fen of Musk (Shexiang), grind all into powder, mix with water to form one pill. Pour Sichuan Pepper Decoction (Chuanjiao Tang) into the parturient's umbilicus, then insert the pill into the navel, cover with several layers of cotton paper, and bind tightly with a wide cloth. Remove the medicine immediately after the fetus is delivered. For prolapsed intestines: if the intestine does not retract, spray fresh well water mixed with a little vinegar onto the patient's face three times, and the intestine will spontaneously retract upward. If the intestine has already prolapsed, it must be washed wet with warm water and placed in a rice sieve. If contaminated with dust or exposed to dry objects, it will refuse to retract, may adhere and break off, endangering the mother's life. Another method: part the hair at the vertex (Baihui point) of the parturient, apply mashed Castor Seed flesh (Ricini Semen) to the vertex, and nourish the prolapsed intestine with warm water; the intestine will retract, preserving the mother's life. For transverse or breech presentation where hands or feet emerge first, prick the infant's hands and feet repeatedly with a fine needle, rub salt on the puncture sites, causing immediate retraction; this is colloquially called "begging for salt birth."

If the first pregnancy was term delivery, but subsequent pregnancies ending in miscarriage at two or three months recur in the second and third pregnancies, this is termed Huatai (Slippery Fetus/Habitual Abortion), which is difficult to stabilize. One must experience one normal term delivery before this condition ceases.

Note: Zisu Yin (Perilla Decoction) is a crucial formula for treating fear and qi deficiency during labor that results in prolonged retention of the fetus.

In the Renwu year, a certain woman reached full term (ten months) and suddenly suffered severe abdominal pain. A midwife was summoned. Seeking greater profit, the midwife feigned examining the fetus and punctured the Bao Yi (Placental Membrane/Amnion) with her finger. Amniotic fluid flowed incessantly until exhausted. Deprived of fluid lubrication, the fetus became dry and stuck, unable to descend. She slept neither day nor night, enduring continuous pain for about four to five days. I was invited to examine her. Her six pulses showed the "Li Jing" pattern. Some said the pulses were scattered and life was critical. I observed her tongue was bright red without any cyan hue, and told her there was no cause for alarm; she was near delivery. Others asked, "The amniotic fluid is dry; what hope is there?" I replied, "Ancient texts mention the method of 'urgently opening branch rivers.' Use a large dose of Siwu Tang (Four Substances Decoction) combined with Ginseng, adding Plantago Seed (Cheqianzi) 5 qian and Zha Zhi (Ramulus Quercus variabilis) 1 liang. Decoct these, using the liquid as water to decoct the main herbs." Three midwives in the room debated fiercely; some advocated early use of hooks or cutting to save the mother. I said, "Do not touch her. When the melon is ripe, it falls naturally; both mother and child can be preserved." After taking the medicine, shortly thereafter, severe abdominal pain occurred. With assistance walking, the infant was delivered. The child is now twelve years old.