麝香(一钱) 盐豉(一两,旧青布裹了,烧令红,急以乳捶研细)
上为末。取秤捶烧红,以酒淬之,调下一钱。
评曰∶产难,不只胎侧有儿枕破与败血裹凝,随其胎息因缘,自有难易。其如横逆,多
因坐草太早,努力过多,儿转未逮,或已破水,其血必干,致胎难转。若先露脚谓之逆,先
露手谓之横。法当以微针刺之,使自缩入,即服神应黑散,以固其血,必自转生。《养生方
》云∶仓皇之间,两命所系,不可不广传。盖赞黑散之功也。或以盐涂儿脚底,抓搔之。
治横生、逆生、难产。
百草霜 香白芷(各等分)
上为细末。每服二钱,童子小便、好醋各一茶脚许,调匀,更以沸汤浸四五分服,止一
服见功,甚者再服,已分免矣。一名乌金散。
第三论曰∶胎衣不下者何?答曰∶母生子讫,血流入衣中,衣为血所胀,是故不得下。
治之稍缓,胀满腹中,以次上冲心胸,疼痛喘急者,但服夺命丹,以逐去衣中之血,血散胀
消,胎衣自下,而无所患;更有牛膝汤,用之甚效,录以附行。
附子(半两,炮,去皮脐) 牡丹皮(一两) 干漆(一分,捣碎,炒烟尽)
上为末,酽醋一升、大黄末一两,同熬成膏,和药,梧子大。温酒下五七丸,不以时服。
治产儿已出,胞衣不下,脐腹坚,胀急痛甚;及子死腹中,不得出。
牛膝(酒浸) 瞿麦(各四两) 滑石(八两) 当归(酒浸) 木通(各六两) 葵子(五两)
上为锉散。每服三钱,水两盏,煎七分,去滓,不以时服。
第四论曰∶产后血晕者何?答曰∶产后气血暴虚,未得安静,血随气上,迷乱心神,故
眼前生花;极甚者,令人闷绝不知人,口噤神昏气冷。医者不识,呼为暗风,若作此治之,
病必难愈,但服清魄散自瘥。
麝香(一钱) 盐豉(一两,用旧青布包裹,烧至通红,迅速用乳汁研磨成细末)
以上药物研为粉末。取秤锤烧红,用酒淬火,取淬后的药液调服一钱药粉。
评述说:难产,不仅仅是因为胎位不正有“儿枕”(产后瘀血积聚形成的包块)破裂或败血凝结,随着胎儿呼吸因缘的不同,自然有难易之分。至于横位、逆位,多因坐草(临产准备)太早,用力过多,胎儿转动不及,或者羊水已破,血液必然干枯,导致胎位难以转动。如果先露出脚部称为逆产,先露出手部称为横产。治疗方法应当用微针刺之,使其自行缩回,随即服用神应黑散,以固摄血液,胎儿自然会转动出生。《养生方》说:在仓皇紧急之间,关系到两条性命,不可不广泛传播。这是称赞神应黑散的功劳。也有人用盐涂抹婴儿脚底,抓挠刺激它。
治疗横生、逆生、难产。
百草霜 香白芷(各等分)
以上研为细末。每次服用二钱,用童子小便、好醋各约茶脚许的量,调匀,再用沸汤浸泡四五分钟服用,通常一服见效,严重者再服,胎儿已分出者即可免除困难。又名乌金散。
第三论说:什么是胎衣不下?回答说:母亲分娩完毕后,血液流入胎衣中,胎衣被血液胀大,所以不能排出。治疗如果稍慢,胀满腹中,依次向上冲撞心胸,出现疼痛、气喘急促等症状时,只需服用夺命丹,以驱逐胎衣中的血液,血液消散、胀满消除,胎衣自然排出,就没有祸患了;另有牛膝汤,使用非常有效,记录在此附于行间。
附子(半两,炮制,去皮和脐) 牡丹皮(一两) 干漆(一分,捣碎,炒至烟尽)
以上研为粉末,用浓醋一升、大黄末一两,共同熬制成膏,混合药物,做成梧桐子大小的丸剂。温酒送服五七丸,不拘时候服用。
治疗胎儿已产出,但胞衣不下,脐腹部坚硬,胀急疼痛严重;以及胎儿死于腹中,无法产出。
牛膝(酒浸) 瞿麦(各四两) 滑石(八两) 当归(酒浸) 木通(各六两) 葵子(五两)
以上锉散。每次服用三钱,水两盏,煎至七分,去渣,不拘时候服用。
第四论说:什么是产后血晕?回答说:产后气血突然虚弱,未能得到安静,血液随气上逆,迷乱心神,所以眼前出现眼花;极严重的,使人闷绝不知人事,牙关紧闭,神志昏迷,气息冷。医生如果不认识,称之为暗风,如果按照此法治疗,病必定难以痊愈,只需服用清魄散自然痊愈。
Musk (1 qian) Salted Fermented Soybeans (1 liang, wrapped in old green cloth, burned until red-hot, then quickly ground into fine powder with milk)
The above are processed into powder. Take a weighing hammer, heat it until red-hot, quench it in wine, and take 1 qian of the powder mixed with this quenched liquid.
Commentary: Dystocia is not only caused by malpresentation where the "Erzhen" (a mass formed by postpartum blood stasis) ruptures or by stagnant blood coagulation; depending on the circumstances of fetal respiration and positioning, there are naturally variations in difficulty. Regarding transverse or breech presentations, these often result from starting labor preparations too early or excessive pushing before the fetus has rotated sufficiently. If the membranes have already ruptured, the blood must dry up, making fetal rotation difficult. If the feet present first, it is called breech presentation; if the hands present first, it is called transverse presentation. The method should involve pricking with a fine needle to induce retraction, followed immediately by administering Shenying Heisan (Divine Response Black Powder) to consolidate the blood, after which the fetus will naturally rotate and be born. *Yangsheng Fang* states: In moments of panic, where two lives are at stake, this knowledge must be widely disseminated. This praises the efficacy of Shenying Heisan. Alternatively, some apply salt to the soles of the infant's feet and scratch them.
Treats transverse presentation, breech presentation, and dystocia.
Baicaoshuang (Soot from Hundred Herbs) Xiangbaizhi (Aucklandiae Radix, equal parts)
The above are ground into fine powder. Each dose consists of 2 qian, mixed with approximately one tea-foot amount of urine from an uncircumcised boy and good vinegar. Stir evenly, soak in boiling water for four to five minutes, and consume. Usually effective after one dose; for severe cases, administer a second dose. If the fetus has already emerged, delivery can proceed smoothly. Also known as Wujin San.
Third Treatise: What is retained placenta? Answer: After the mother gives birth, blood flows into the placenta, causing it to swell due to the blood, hence it cannot descend. If treatment is delayed, swelling fills the abdomen, rising successively to rush against the heart and chest, causing pain, panting, and urgency. One should simply administer Duoming Dan (Life-Stealing Pill) to expel the blood within the placenta. Once the blood disperses and swelling subsides, the placenta will naturally descend without complication. There is also Niuxi Tang (Achyranthes Decoction), which is very effective; it is recorded here for reference.
Fuzi (Prepared Aconite Root, half liang, processed, skin and umbilical scar removed) Mudanpi (Tree Peony Bark, 1 liang) Ganxi (Dried Resin of Toxicodendron, 1 fen, crushed, stir-fried until smoke ceases)
The above are ground into powder. Mix with one sheng of strong vinegar and one liang of Dahuang (Rhubarb) powder, boil together into a paste, combine with the medicinal powder, and form pills the size of a Chinese elm seed. Take five to seven pills with warm wine, administered at any time.
Treats cases where the infant has been delivered but the placenta remains, accompanied by hardness of the navel and abdomen, severe distension and pain; as well as cases of fetal death in utero preventing expulsion.
Niuxi (Achyranthis Bidentatae Radix, wine-soaked) Qumai (Herba Dianthi, each 4 liang) Huashi (Talcum, 8 liang) Danggui (Angelicae Sinensis Radix, wine-soaked) Mutong (Akebiae Caulis, each 6 liang) Kuizi (Abutilonis Fructus, 5 liang)
The above are cut into coarse pieces. Each dose is 3 qian, boiled in two zhan of water until reduced to seven-tenths, strain, and take at any time.
Fourth Treatise: What is postpartum syncope due to blood loss? Answer: After childbirth, qi and blood are suddenly deficient. Without rest, blood follows the ascending qi, confusing the spirit and mind, resulting in visual disturbances (seeing flowers). In extreme cases, it causes suffocation, unconsciousness, locked jaws, coma, and cold breath. If physicians do not recognize this condition and misdiagnose it as An Feng (Hidden Wind), treating it accordingly will make recovery difficult. One should simply administer Qingpo San (Clear Soul Powder) for spontaneous recovery.