世传产书甚多，《千金》《外台》《会王产宝》、马氏、王氏、崔氏皆有产书，巢安世
有《卫生宝集》《子母秘录》等。备则备矣，但仓卒之间，未易历试。惟李师圣序郭稽中《
产科经验保庆集》二十一篇，凡十八方，用之颇效。但其间叙论，未为至当，始用料理简辨
于诸方之下，以备识者，非敢好辨也。
第一论曰∶热病胎死腹中者何?答曰∶因母患热病，至六七日以后，脏腑极热，熏煮其
胎，是以致死，缘儿身死，冷不能自出。但服黑神散暖其胎，须臾胎气暖即自出。何以知其
胎之已死?但看产妇舌色青者是其候也。
桂心 当归 芍药 甘草(炙) 生干地黄 干姜(炮，各一两） 黑豆(炒，去皮，二两） 附
子(炮去皮脐，半两)
上为末。每服二钱，空心温酒调下。一法，无附子，有蒲黄。
评曰∶夫妊娠，谓之重身，二命系焉。将理失宜，皆能损胎，不特病熏煮所致。或因顿
仆惊恐，出入触冒，及素有 瘕积聚，坏胎最多。候其舌青，即知子死。《养胎论》云
∶面青舌赤，母死子生；唇青吐涎，子母俱毙。又有双怀二胎，或一死一活，其候尤难知，
自非临歧观变，未易预述，不可不备学也。然以黑神散温胎，未若补助产母，使其气正，免
致虚乏困顿，胎自下矣，催生汤殊胜黑神散。
催生汤 治胎死腹中，或产母气乏委顿，产道干涩。(方见产难门)
第二论曰∶难产者何?答曰∶胎侧有成形块，为儿枕，子欲生时枕破，与败血裹其子，
故难产，但服胜金散逐其败血即自生矣，逆生横生并皆治之。
世间流传的产科书籍非常多，《千金方》《外台秘要》《会王产宝》、马氏、王氏、崔氏都有产科著作，巢元方有《卫生宝集》《子母秘录》等。内容虽然详尽完备，但在紧急仓促的情况下，不容易逐一尝试验证。只有李师圣为郭稽中《产科经验保庆集》所作的序言中提到二十一篇内容，共十八个方剂，使用效果颇为显著。但是其中的论述，并非完全恰当，因此我在各个方剂之下简要整理辨析，以备有识之士参考，并非敢于好争辩。
第一篇论述说：热病导致胎儿死于腹中的情况是怎样的？回答说：因为母亲患有热病，到了六七天以后，脏腑极度发热，熏烤煮灼胎儿，从而导致死亡，由于胎儿身体已死，寒冷之气使其不能自行排出。只需服用黑神散温暖胎气，片刻间胎气回暖即可自然产出。如何知道胎儿已经死亡？只要观察产妇舌色发青，就是这一征候。
桂心（Cinnamon Twig）、当归（Angelicae Sinensis Radix）、芍药（Paeoniae Radix）、甘草（Glycyrrhizae Radix et Rhizoma，炙/roasted）、生干地黄（Rehmanniae Radix，raw and dried）、干姜（Zingiberis Rhizoma，炮/prepared）、黑豆（Sojae Semen Nigrum，炒/stir-fried, peeled, two liang）、附子（Aconiti Lateralis Radix Praeparata，炮去皮脐/prepared, peeled, half a liang）。
以上药物研为细末。每次服用二钱，空腹时用温酒调服。另一种方法，不用附子，改用蒲黄（Typhae Pollen）。
评述说：妊娠，称为重身，两条性命系于一身。调理失当，都能损伤胎儿，不仅仅是因为热病熏烤所致。或者因为突然跌倒惊恐，外出接触冒犯风寒，以及素有癥瘕积聚（pathological masses），最容易损坏胎儿。观察舌色发青，就知道胎儿死亡。《养胎论》说：面青舌赤，母亲死胎儿生；唇青吐涎，母子俱亡。又有双胎怀两孩，或一死一活，其征候尤其难以知晓，除非在临产时观察变化，否则不易预先陈述，不可不预备学习。然而用黑神散温暖胎儿，不如补助产母，使其正气端正，避免导致虚乏困顿，胎儿自然就会娩出，催生汤（parturition-promoting decoction）胜过黑神散。
催生汤：治疗胎儿死于腹中，或产母气力匮乏委顿，产道干涩。（方剂见难产章节）
第二篇论述说：难产的情况是怎样的？回答说：胎儿侧面有成形块状物，称为儿枕（fetal pillow），胎儿将要出生时儿枕破裂，与败血（stagnant blood）包裹住胎儿，所以难产，只需服用胜金散驱逐败血即可自然分娩，至于逆生（breech presentation）、横生（transverse lie）也都治疗。
There are many obstetric books circulating in the world. *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold), *Waitai Miyao* (Secret Essentials of the Outer Cabinet), *Huiwang Chanbao*, as well as works by Masters Ma, Wang, and Cui all contain obstetric treatises. Chao Yuanfang has *Weisheng Baoji* (Health Treasure Collection) and *Zimu Bilu* (Secret Records of Mother and Child), among others. Although they are comprehensive, it is not easy to test them one by one in emergencies. Only Li Shisheng, in his preface to Guo Jizhong's *Chanke Jingyan Baoqing Ji* (Collection of Experienced and Auspicious Obstetric Prescriptions), mentions twenty-one discussions and eighteen formulas, which have proven quite effective. However, the discussions therein are not entirely appropriate. Therefore, I have briefly organized and analyzed the formulas below for the reference of knowledgeable practitioners, not out of a desire to argue.
The first discussion states: What is the situation where a fetus dies in the womb due to febrile disease? The answer is: This occurs because the mother suffers from a febrile disease. After six or seven days, the zang-fu organs become extremely hot, scorching and boiling the fetus, leading to its death. Since the fetus is dead, the cold prevents it from expelling itself naturally. One should administer Heishen San (Black Divine Powder) to warm the fetal qi; once the fetal qi warms up after a moment, it will be expelled naturally. How can one know if the fetus has died? Observe the color of the parturient woman's tongue; if it is cyanotic, this is the sign.
Ingredients: Guixin (Cinnamomi Ramulus), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Shengdihuang (Rehmanniae Radix, raw and dried), Ganjiang (Zingiberis Rhizoma, prepared), Heidou (Sojae Semen Nigrum, stir-fried and peeled, 2 liang), Fuzi (Aconiti Lateralis Radix Praeparata, prepared, peeled, without skin and umbilicus, 0.5 liang).
Grind the above ingredients into powder. Take 2 qian per dose, mixed with warm wine on an empty stomach. Another method: omit Fuzi and use Puhuang (Typhae Pollen) instead.
Commentary: Pregnancy is referred to as "double body" (zhongshen), with two lives dependent on it. Improper management can damage the fetus, not only due to heat scorching. It may also result from sudden falls or fright, exposure to wind-cold during outings, or pre-existing zhengjia jiju (pathological accumulations and masses), which most frequently harm the fetus. Observing a cyanotic tongue indicates fetal death. The *Yangtai Lun* (Treatise on Nurturing the Fetus) states: "If the face is cyanotic and the tongue red, the mother dies but the child lives; if the lips are cyanotic and saliva is vomited, both mother and child perish." In cases of twin pregnancies, where one fetus dies and the other lives, the signs are particularly difficult to discern. Unless changes are observed at the time of delivery, it is hard to predict in advance; thus, one must prepare by studying this thoroughly. However, using Heishen San to warm the fetus is inferior to supporting the parturient woman, rectifying her qi, and preventing deficiency and exhaustion, so that the fetus is expelled naturally. Cuisheng Tang (Parturition-Promoting Decoction) is superior to Heishen San.
Cuisheng Tang: Treats fetal death in the womb, or parturient weakness and exhaustion, causing dryness and涩ness of the birth canal. (Formula see section on Difficult Labor).
The second discussion states: What is the situation of difficult labor? The answer is: There is a formed mass on the side of the fetus, called Erzhen (Fetal Pillow). When the fetus is about to be born, the Erzhen ruptures, and stagnant blood wraps around the fetus, causing difficult labor. Administer Shengjin San (Golden Victory Powder) to expel the stagnant blood, and natural delivery will occur. This also treats breech presentation (nixsheng) and transverse lie (hengsheng).