临产时最戒用力太早，《脉诀》云∶夜半觉痛应分娩，来朝日午定知生。由此观之
则腹痛半日后恰当产也。但产之难易，人各不同，时亦有异，有素易产，有素难产
者，有先难后易，先易后难者，俱无一定。如临产腹痛不生，非是难生，还是子未出
胎，产母切勿惧怕，即一日二日至三五日无妨，安心定气，任其自然，勉强忍痛，进其
饮食，要坐则坐，要行则行，要睡则睡，保养精神为第一，莫听稳婆逼迫，用力太早，
自己亦勿求速于离身，傍人亦勿多言恐惧，以乱其心，时至自然分娩，譬如登厕，未急
则难，时急自易，此理虽俗，知此免患。盖
稳婆逼迫有二，有不知时候逼迫者，有急完此家复往他家者，极误大事。
一未产前几固时辰，子亦要出产户，转身至手，被母用力一逼，即手先出，转身至
脚，母力一逼，即脚先出，横生倒生，皆因错于用力，其实无手足先出之理，故腹痛数
日而不生者，不宜慌忙。今人见其一日半日不产，即谓难生，老少惊惶，求神许愿，产
妇见之，必生忧恐一有忧恐之心，自然无胆气，无精力，难饮食，不审此非难生，乃是
时候未至，惟宜忍痛候时，若乃悯其痛甚，急欲离身，稳婆傍人强之用力，时候未到，
用力太早，关系母子性命，胡不明理，一至此哉！斯时稳婆以意推度，产妇以意审详，
切不可轻易催迫用力，必俟脐腹痛极，腰间重痛，眼中如火，谷道迸急，胞水或血惧
下，脉见离经，或沉细滑，此时子已出胎，产母方用努力，庶不误事。如数候未见，切
不可性急乱为，以致神气早疲，临产却无精力，不能运送出外，并致产后多虚矣。故将
产，宜浓煎人参汤时饮，补接助之。
一有用力太早，致令水衣先破，被风所吹，因而产户肿胀干湿狭小，最令难产者，
只多几个时辰，从容俟之无妨。又有稳婆无知害人，私以手指掐破水衣者，极要关防。
将产最戒曲身眠卧，虽甚腹痛，宜强为站立，散步房中，或免凡立，切戒挛腰，以助
儿转舒寻路也。盖产母畏痛，不肯直身行动，多爱曲腰眠卧，以致胎元转动不顺，儿
子寻到产门，被母曲腰遮闭，再转又再闭，则子必无力，而不能动，决至难产。人见其
不动，则谓胎死，其实因无力而非死也。此时恁有良方妙药，不能令子有力而动，只要
补接产母元气，更要心安气和，调理精神，胎元胜复，可保无虞。又有胞水已下，子忽
不动，停一二日三五日者有之，调补气血之外，切戒惊恐，忧惧暴性，盖惊则神散，忧
则气结，暴则气不顺，血必妄行，多致昏闷，知此善调，自然无恙。
一将产时，须迸饮食，戒喧闹。盖进饮食，则气充胆壮，免致饥渴虚乏无力，戒喧
闹，则神静自安，切勿烦躁，静则神藏，躁则消亡也。其食宜觅母鸡煮汁作粳米稀粥与
食，不可食鸡及诸肉食，常令稍饥为佳，盖饥则气下，气下则产速，若多食肉食，则碍
于上焦，气不得下，故产难。产后亦令勿食过饱，致生疾病。
一临产腹痛而腰不甚痛，产未急也。须扶起直身而行。若行不得，则倚物而立，
盖产自有时，如果熟香飘，瓜熟蒂落，不可仓皇鲁莽，反致有害也。痛时稍放裙带，以
便儿在腹中，转舒有余地也。
一临产时，凡丧孝秽浊人，尼姑孤寡不洁人，莫令入房，致产不利。惟老成解事，
曾经生长者，二三人足矣。俗忌人知，多亦难产，多一人入房，则多一时迟延，此亦当忌。
一产时以饮食为本，有等妇人临产不能饮食者，则精气不壮，何以用力？须未产
前，预买好人参四五钱，如虚极者，及向有产晕者，一二两任用，待将产时，煎汁一钟
听用，审是儿将来时，以此服之，大助精力，胜于肉食百倍。产后人参不可乱投，若
果系虚症，必兼温暖药用，如黑干姜之类。如一产后，以人参五钱，当归二钱，煎汤，
冲入童便，产下即服，元补诸虚，兼却产后百病。（张）常用于极虚之人，产后犹如未产之健旺。
一产后渐进玉米饮，取糠气能降虚火也。白粥宜极稀，以渐调理为上，三朝内不
可食荤及鸡子，及粘硬之物，六七日上胃强者，可少与母鸡、牛肉、鲫鱼作清羹，少少食之。
一将产救生法。凡手先出名曰横生，足先出名曰倒生，相传手出者曰觅盐生，此亦
有理，人未讲明，盖盐主收敛紧缩。又腌螫肌肉疼痛，儿手得盐，且痛且缩，自然转身
顺下，觅盐之名，本于此也。其治法如手足
先出者，急令产母仰卧，略以盐涂儿手心足心，仍以香油抹之，轻轻送入，即便自转顺
生，不可任其久出，久则手足青而子伤，难以送入，亦不可妄用催生方药，盖手足之
出，非药可治。又切勿误听凶妇，用力断手，一断子必腹中乱搅而伤母矣。屡见死
胎，人不慌忙逼迫，亦迟迟生下，而不伤母。夫死胎亦生者，何也？盖人腹中极热，
食物则入内俱化，其胎虽死，人不忙迫，产母安心饮食，腹内热气熏蒸，胎自柔软腐
化，亦生而不伤母。但所出秽气，令人难闻，可见死胎不必用力，况活胎乎？屡见无
知稳婆，轻令用力，动伤两命，特此谆谆。又见有怪胎，人不惊慌，亦自然生下，但勿
令产母知之。又产母危急时，当看面舌，面以候母，舌以候子，面青母伤，舌青子伤，
面赤舌青，子死母活，面舌俱赤，子母无恙，面舌俱青，口中吐沫者，子母难保。（张
秘授一方，专救难产及死胎，交骨不开，神验。用广猴血钱余，酒化服下，立产。）
一将产救生手法，如门户俱正，儿亦露顶而不下，此必因儿转身肚带攀其肩也，名
曰碍产。治法令母仰卧，轻轻推儿向上，以手中指按儿肩，去其肚带，候儿顺正，用力
送下。又有生路未正，被母用力一逼，令儿偏柱左右腿畔，儿头在产户不下，但云，
儿已露顶，非顶也，乃额角也，名曰偏产。治法亦令产母仰卧，轻轻推儿近上，以手扶
其额顶端正，用力一逼即下。又有头之后骨，偏柱谷道，儿乃露顶，名曰HT 后。治法
以绵衣裹手，急于谷道外傍，轻轻推儿头令正，然后用力一逼即下，或用膝头令产母抵
住亦可。三产之难，皆母曲腰眠卧，用力太早致之。三手之法，非历练有分晓稳婆，不可轻易。
一子出户时，人即以两手抱产母胸前，产母亦自以手紧抱肚腹，令胎衣下坠，如胎
衣来迟，切勿慌忙，以草纸烧烟熏鼻即下。再迟则急断脐带洗儿，仍用软帛物系坠脐
带，系时尤宜轻巧牢固，然后截断。此带极脆，若不便断脐带，恐血反潮入胞中，胀而
不下，攻心则伤。如稳婆诸事者，能以手指取下甚便。有产母胎衣久不下，一方用黑牛
粪，略焙带润，以布裹之，束于腹上即下。
一恚音闷脐生，相传有呼父乳名，手拍儿股者，此理亦未讲明，盖儿粪门有一膜，
闷住儿气，故不能出声，拍之则膜破而能叫哭。如拍之犹不破，须用女人轻巧者，以银
簪脚轻轻挑破甚便。或不能挑急，用暖衣紧包，勿令散放，以热水浸其胞衣，寒天则加
火热之，久则热气内鼓，其膜自破，膜破则出声而苏矣。
一妇人有盘肠生者，未产肠先盘出，其治法急将净盆一温水，冬则热水，入香油养
润，侍儿并胞衣俱下，产母吸气上升，稳婆香油涂手，徐徐送入。有醋水喷面，令产妇
惊寒气提，虽可收肠，常多误事，不可用也。又有儿并胞衣下后，膀胱（即尿胞）
壅出产户者，同前法送入。此皆用力太早，五内动摇之故。送入后宜服安脏调补药。
薛立斋曰∶欲产时，觉腹内转动，即当正身仰卧，待儿转身向下，其时作痛，试捏
产母手中指中节，或本节跳动，方临盆即产。或未产而水频下，此胞衣已破，血水先
干，必有逆生难产之患。若胞衣破，不得分娩，用保生无忧散，以固其血。如血已耗
损，八珍汤加益母草浓煎，时饮之。凡孕妇止腹痛，未产也。连腰痛者，将产也。肾候
于腰，胞系于肾故也。凡孕有生息不顺，宜嘱稳婆，只说未产。或遇双胎，只说胞衣，
恐惊则气散，愈难生息，大抵难产多患郁闷，安佚富贵之家，治法虽云胎前顺气，产
后补血，不可专执。若脾胃不实，气血不充，宜预调补之。
冻产者，冬月天冷，产母经血得冷则凝，致儿不能下，此害最深，故冬月产者，
下部不可脱去绵衣，并不可坐卧寒处，务使满房闱炉，常有暖气，令产母背身向火，脐
下腿膝间常暖，血得热则行，儿易生也。
热产者，盛夏产妇要温凉得所，不可过凉，反增疾病，不可人多，热气逼袭，令产
母心烦，热血沸腾，有郁冒冲晕之患。
临产时最忌讳过早用力。《脉诀》说：“半夜感到疼痛，第二天中午必定分娩。”由此看来，腹痛半天后应当分娩。但是生产的难易，每个人各不相同，时间也有差异，有的素来容易生产，有的素来难产，有先难后易的，有先易后难的，都没有一定的规律。如果临产时腹痛但不分娩，并不是难产，而是胎儿尚未产出母体，产妇千万不要害怕，即使是一两天到三五天也没有妨碍，安心定气，顺其自然，勉强忍受疼痛，进食饮食，想坐就坐，想走就走，想睡就睡，保养精神是第一位的，不要听信稳婆（接生婆）逼迫，过早用力，自己也不要急于脱离身体，旁人也不要多言制造恐惧，以扰乱她的心神，时机到了自然分娩，就像上厕所一样，不紧急则困难，紧急了自然容易，这个道理虽然通俗，但懂得这个就能避免祸患。
因为稳婆逼迫有两种情况：有一种是不懂时候而逼迫的，有一种是急着结束这一家又要去另一家的，这极容易误大事。
一种情况是产前还没到时辰，胎儿也要出产户，转身到手的位置，被母亲用力一逼，就是手先出来；转身到脚的位置，母亲用力一逼，就是脚先出来，横生倒生，都是因为错误地用力，其实没有手脚先出来的道理，所以腹痛几天而不生的，不宜慌忙。现在的人看见他一天半天不生产，就说难产，老少惊慌，求神许愿，产妇看见了，必然产生忧恐，一有忧恐之心，自然没有胆气和精力，难以进食，不明白这不是难产，而是时候未到，只宜忍痛等待时机，如果怜悯她痛苦甚重，急于脱离身体，稳婆和旁人强迫她用力，时候未到，用力太早，关系到母子性命，为什么不明白道理，竟然到了这种地步！这时稳婆凭心意推测，产妇凭心意审察，切不可轻易催迫用力，必须等到脐腹疼痛至极，腰部沉重疼痛，眼中如火烧，肛门迸急，胞水或血液惧下，脉象出现离经之脉，或沉细滑，此时胎儿已出胎，产妇方才用努力，才不会误事。如果几个时辰未见动静，切不可性急乱为，以致神气早疲，临产时却没有精力，不能运送胎儿出来，并导致产后多虚证。所以在将产时，宜浓煎人参汤时时饮用，补益接续助产。
另一种情况是用力太早，致使水衣（胎膜）先破，被风所吹，因而产户肿胀干湿狭小，最令难产的，只是多几个时辰，从容等待没有妨碍。又有稳婆无知害人，私自用手指掐破水衣的，极要防范。
将产时最忌讳曲身眠卧，即使很腹痛，宜强作站立，在房中散步，或者避免凡立（此处疑为“烦立”或特定姿势，意指保持直立舒展），切戒挛腰，以帮助胎儿转动舒展寻找产路。因为产妇畏惧疼痛，不肯直身行动，多爱曲腰眠卧，以致胎元转动不顺，胎儿寻到产门，被母亲曲腰遮闭，再转又再闭，那么胎儿必无力，而不能动，决至难产。人看见他不活动，就说胎死，其实是因为无力而非死亡。这时纵有良方妙药，不能让胎儿有力而动，只要补接产妇元气，更要心安气和，调理精神，胎元胜复，可保无虞。又有胞水已下，胎儿忽然不动，停一二天到三五天的情况，除了调补气血之外，切戒惊恐、忧惧暴怒，因为惊则神散，忧则气结，暴怒则气不顺，血必妄行，多导致昏闷，知道这些善于调理，自然无恙。
将产时，须进食饮食，戒喧闹。因为进食饮食，则气充胆壮，免致饥渴虚乏无力，戒喧闹，则神静自安，切勿烦躁，静则神藏，躁则消亡也。食物宜找母鸡煮汁做粳米稀粥给吃，不可食鸡肉及诸肉食，常令稍饿为佳，因为饥饿则气下，气下则产速，如果多吃肉食，则碍于上焦，气不得下，故产难。产后也让勿食过饱，以致生疾病。
临产腹痛而腰不甚痛，生产未急。须扶起直身而行。如果行不得，则倚物而立，因为生产自有其时，如果果实熟香飘，瓜熟蒂落，不可仓皇鲁莽，反致有害也。痛时稍放裙带，以便胎儿在腹中，转舒有余地也。
临产时，凡是丧孝秽浊人，尼姑孤寡不洁人，不要让进入房间，导致生产不利。只有老成解事，曾经生育过的，两三个人足够了。俗忌人知，人多也难产，多一人入房，则多一时迟延，这也应当忌讳。
生产时以饮食为本，有些妇人临产不能饮食的，则精气不壮，何以用力？须在未产前，预先买好人参四五钱，如虚极者，以及向来有产晕者，一两二两随意使用，待将产时，煎汁一杯听用，审察是胎儿将要来时，以此服用，大助精力，胜于肉食百倍。产后人参不可乱投，如果确实是虚症，必兼温暖药用，如黑干姜之类。如一例产后，用人参五钱，当归二钱，煎汤，冲入童便，产下即服，元补诸虚，兼却产后百病。（张氏）常用于极虚之人，产后犹如未产时的健旺。
产后渐进玉米饮，取糠气能降虚火也。白粥宜极稀，以渐调理为上，三朝内不可食荤及鸡蛋，及粘硬之物，六七日上胃强者，可少与母鸡、牛肉、鲫鱼作清羹，少量食用。
将产救生法。凡是手先出名曰横生，足先出名曰倒生，相传手出的曰觅盐生，这也有道理，人们未讲明，大概盐主收敛紧缩。又腌肉肌肉疼痛，胎儿手得盐，且痛且缩，自然转身顺下，觅盐之名，本于此也。其治法如手足先出者，急令产妇仰卧，略以盐涂儿手心足心，仍以香油抹之，轻轻送入，即便自转顺生，不可任其久出，久则手足青而子伤，难以送入，也不可妄用催生方药，大概手足之出，非药可治。又切勿误听凶妇，用力断手，一断子必腹中乱搅而伤母矣。屡见死胎，人不慌忙逼迫，亦迟迟生下，而不伤母。夫死胎亦生者，何也？大概人腹中极热，食物则入内俱化，其胎虽死，人不忙迫，产妇安心饮食，腹内热气熏蒸，胎自柔软腐化，亦生而不伤母。但所出秽气，令人难闻，可见死胎不必用力，何况活胎呢？屡见无知稳婆，轻令用力，动伤两命，特此谆谆告诫。又见有怪胎，人不惊慌，亦自然生下，但不要令产妇知道。又产妇危急时，当看面舌，面以候母，舌以候子，面青母伤，舌青子伤，面赤舌青，子死母活，面舌俱赤，子母无恙，面舌俱青，口中吐沫者，子母难保。（张氏秘授一方，专救难产及死胎，交骨不开，神验。用广猴血钱余，酒化服下，立产。）
将产救生手法，如门户俱正，胎儿也露顶而不下，这必因胎儿转身肚带攀其肩也，名曰碍产。治法令母仰卧，轻轻推儿向上，以手中指按儿肩，去其肚带，候儿顺正，用力送下。又有生路未正，被母用力一逼，令儿偏柱左右腿畔，儿头在产户不下，只说，儿已露顶，非顶也，乃额角也，名曰偏产。治法亦令产妇仰卧，轻轻推儿近上，以手扶其额顶端正，用力一逼即下。又有头之后骨，偏柱谷道，胎儿乃露顶，名曰HT后（此处原文可能有误，通常指臀位或枕后位等，依文意保留）。治法以绵衣裹手，急于谷道外傍，轻轻推儿头令正，然后用力一逼即下，或用膝头令产妇抵住亦可。三种生产之难，皆因母亲曲腰眠卧，用力太早所致。这三种手法，非历练有分晓的稳婆，不可轻易尝试。
胎儿出户时，人即以两手抱产妇胸前，产妇也自以手紧抱肚腹，令胎衣下坠，如果胎衣来迟，切勿慌忙，以草纸烧烟熏鼻即下。再迟则急断脐带洗儿，仍用软帛物系坠脐带，系时尤宜轻巧牢固，然后截断。此带极脆，若不便断脐带，恐血反潮入胞中，胀而不下，攻心则伤。如果稳婆诸事者，能以手指取下甚便。有产妇胎衣久不下，一方用黑牛粪，略焙带润，以布裹之，束于腹上即下。
恚音闷脐生（此处疑为新生儿窒息或啼哭不畅），相传有呼父乳名，手拍儿股者，这道理也未讲明，大概胎儿粪门有一膜，闷住儿气，故不能出声，拍之则膜破而能叫哭。如果拍之犹不破，须用女人轻巧者，以银簪脚轻轻挑破甚便。或不能挑急，用暖衣紧包，勿令散放，以热水浸其胞衣，寒天则加火热之，久则热气内鼓，其膜自破，膜破则出声而苏矣。
妇人有盘肠生者，未产肠先盘出，其治法急将净盆一温水，冬则热水，入香油养润，侍儿并胞衣俱下，产妇吸气上升，稳婆香油涂手，徐徐送入。有醋水喷面，令产妇惊寒气提，虽可收肠，常多误事，不可用也。又有儿并胞衣下后，膀胱（即尿胞）壅出产户者，同前法送入。这都是用力太早，五内动摇的缘故。送入后宜服安脏调补药。
薛立斋说：欲产时，觉腹内转动，即当正身仰卧，待儿转身向下，其时作痛，试捏产妇手中指中节，或本节跳动，方临盆即产。或未产而水频下，这是胞衣已破，血水先干，必有逆生难产之患。如果胞衣破，不得分娩，用保生无忧散，以固其血。如血已损耗，八珍汤加益母草浓煎，时饮之。凡是孕妇止腹痛，未产也。连腰痛者，将产也。肾候于腰，胞系于肾故也。凡是孕有生息不顺，宜嘱稳婆，只说未产。或遇双胎，只说胞衣，恐惊则气散，愈难生息，大概难产多患郁闷，安佚富贵之家，治法虽云胎前顺气，产后补血，不可专执。如果脾胃不实，气血不充，宜预调补之。
冻产者，冬月天冷，产妇经血得冷则凝，致儿不能下，此害最深，故冬月产者，下部不可脱去绵衣，并不可坐卧寒处，务使满房闱炉，常有暖气，令产妇背身向火，脐下腿膝间常暖，血得热则行，儿易生也。
During labor, it is most taboo to exert force too early. The *Mai Jue* (Pulse Classic) states: "If pain is felt at midnight, delivery will surely occur by noon the next day." From this, it can be seen that delivery should occur half a day after abdominal pain begins. However, the difficulty of childbirth varies from person to person and time to time; some are naturally easy to deliver, some are naturally difficult, some are difficult first then easy, and some are easy first then difficult, with no fixed rule. If there is abdominal pain during labor but no delivery, it is not dystocia (difficult childbirth), but rather the fetus has not yet exited the womb. The mother must not be afraid; even if it takes one or two days to three or five days, there is no harm. She should calm her mind and spirit, let nature take its course, endure the pain as best she can, eat and drink, sit when she wishes, walk when she wishes, sleep when she wishes, and preserving her spirit is the priority. She must not listen to midwives urging her to exert force too early, nor should she herself seek to hasten the separation from her body, nor should bystanders speak much in fear to disturb her heart. When the time comes, delivery will happen naturally. It is like using the toilet: if not urgent, it is difficult; if urgent, it is easy. Although this logic is common, understanding it prevents disaster.
There are two reasons why midwives urge prematurely: one is due to ignorance of the timing, and the other is rushing to finish with one family to go to another, which greatly misleads major matters.
One scenario is before the proper time, when the fetus turns towards the hand, and the mother exerts force, causing the hand to emerge first; when it turns towards the foot, and the mother exerts force, the foot emerges first. Breech presentation (Heng Sheng / Dao Sheng) all result from incorrect use of force. In reality, there is no principle for hands or feet to emerge first. Therefore, if there is abdominal pain for several days without delivery, one should not panic. Nowadays, people see that delivery has not occurred after half a day and declare it dystocia, causing panic among the young and old, seeking gods and making vows. Seeing this, the parturient woman inevitably becomes worried and fearful. Once there is worry and fear, there is naturally no courage or energy, and eating becomes difficult. Not realizing that this is not dystocia but simply that the time has not arrived, she should only endure the pain and wait for the right moment. If pitying her severe pain and wanting her to deliver quickly, midwives and bystanders force her to exert effort, but since the time has not arrived, exerting force too early relates to the lives of both mother and child. Why do people not understand reason and reach such a state? At this time, the midwife should judge by intuition, and the parturient woman should examine carefully. One must not easily urge or force effort. One must wait until the umbilical abdominal pain is extreme, the waist feels heavy and painful, the eyes feel like burning fire, the anus feels urgent and protruding, amniotic fluid or blood is about to flow down, the pulse shows a Li Jing (Departing from the Channel) pattern, or is deep, fine, and slippery. Only at this point has the fetus exited the womb, and the mother should exert effort, so as not to cause mistakes. If several hours pass without seeing results, one must not act rashly out of impatience, leading to early exhaustion of spirit and energy, leaving no strength for delivery, and resulting in postpartum deficiency. Therefore, just before delivery, it is advisable to brew strong Ren Shen Tang (Ginseng Decoction) and drink it occasionally to tonify and assist.
Another scenario is exerting force too early, causing the water bag (amniotic sac) to break first. Exposed to wind, the birth canal may swell, become dry, narrow, and small, leading to difficult childbirth. This merely requires waiting a few more hours calmly, which is harmless. There are also ignorant midwives who harm people by privately puncturing the water bag with their fingers; this must be strictly guarded against.
Just before delivery, bending the body while lying down is most taboo. Even with severe abdominal pain, one should try to stand and walk around the room, or avoid standing stiffly, and definitely avoid curling the waist, to help the fetus turn and find the path. Because the mother fears pain and refuses to keep her body straight, preferring to lie curled up, the fetal movement becomes obstructed. When the fetus reaches the birth canal, it is blocked by the mother's curved waist. Turning again and being blocked again, the fetus loses strength and cannot move, inevitably leading to dystocia. People see it not moving and think the fetus is dead, but it is actually due to lack of strength, not death. At this time, even with good prescriptions and miraculous medicines, one cannot make the fetus strong and move. One must only tonify and connect the mother's Yuan Qi (Original Qi), ensure peace of mind and harmonious Qi, regulate the spirit, and restore the fetal vitality, ensuring safety. There are cases where amniotic fluid has flowed, but the fetus suddenly stops moving, lasting one or two days to three or five days. Besides regulating and tonifying Qi and Blood, one must strictly avoid fright, worry, and sudden anger. Fright scatters the spirit, worry knots the Qi, and sudden anger makes Qi unsmooth, causing Blood to move recklessly, often leading to fainting. Knowing this and regulating well ensures health.
Just before delivery, one must eat and drink, and avoid noise. Eating fills Qi and strengthens courage, preventing weakness from hunger and thirst. Avoiding noise keeps the spirit quiet and calm, preventing irritability. Quietness stores the spirit; agitation destroys it. Food should preferably be a thin rice porridge made from chicken broth and jujube rice. Chicken meat and other meats should be avoided. Being slightly hungry is best because hunger causes Qi to descend, and descending Qi speeds up delivery. Eating too much meat obstructs the Upper Jiao (Upper Burner), preventing Qi from descending, thus causing difficult childbirth. After delivery, one should also avoid overeating to prevent disease.
If there is abdominal pain during labor but not significant lower back pain, delivery is not urgent. One should be helped to stand straight and walk. If walking is impossible, lean on something to stand. Delivery has its own time, like a ripe fruit falling or a melon detaching from the vine. Do not be hasty or reckless, or you may cause harm. During pain, loosen the skirt belt slightly to give the fetus room to turn and expand in the abdomen.
During labor, people involved in mourning or defiled, nuns, widows, and unclean persons should not enter the room, as this harms delivery. Only experienced, sensible women who have given birth themselves, two or three of them, are sufficient. Superstition forbids many people knowing; having too many people makes delivery difficult. Each additional person in the room delays the process, which should also be avoided.
Delivery relies on diet. Some women cannot eat during labor, meaning their Essence and Qi are not robust, so how can they exert force? Before labor, buy 4-5 qian of Ren Shen (Ginseng Root). For those extremely deficient or with a history of syncope during delivery, use 1-2 liang. Just before delivery, decoct a cup of juice for use. When it is determined that the baby is coming, take this to greatly boost energy, far surpassing meat. Ren Shen should not be used randomly after delivery. If it is indeed a deficiency syndrome, warm herbs like Hei Gan Jiang (Blackened Ginger Rhizome) should be added. For example, after delivery, decoct 5 qian Ren Shen and 2 qian Dang Gui (Angelica Sinensis Root) in soup, mix with Tong Bian (Child's Urine), and take immediately after delivery. It tonifies all deficiencies and cures hundreds of postpartum diseases. (Zhang) commonly uses this for extremely deficient people, making the postpartum state as vigorous as pre-pregnancy.
After delivery, gradually introduce corn silk drink, as the husk Qi can descend deficient Fire. White rice porridge should be very thin, adjusting gradually is best. Within three days, avoid meat, eggs, and sticky/hard foods. On the sixth or seventh day, if the stomach is strong, small amounts of clear soup made from hen, beef, or crucian carp can be taken.
Emergency rescue methods for delivery. Hand presenting first is called Heng Sheng (Transverse Lie); foot presenting first is called Dao Sheng (Breech Presentation). It is said that hand presentation is cured by "seeking salt," which has some logic, though not fully explained. Salt is astringent and contracting. Also, salted flesh hurts; if the baby's hand gets salt, it hurts and contracts, naturally turning to descend. Hence the name "Seeking Salt." Treatment for hand/foot presenting first: urgently lay the mother supine, lightly apply salt to the baby's palm and sole, then smear with Sesame Oil (Xiang You), and gently push back. It will naturally turn and deliver normally. Do not let it stay out long, or the limbs will turn blue and injure the child, making reinsertion difficult. Do not recklessly use催产 (induction) drugs, as limb presentation cannot be treated by medicine. Do not listen to wicked women suggesting cutting off the limb; doing so would cause chaos in the abdomen and injure the mother. I have often seen dead fetuses delivered slowly without panic or force, without injuring the mother. Why does a dead fetus deliver? The human abdomen is extremely hot, digesting food inside. Even if the fetus is dead, if people are not rushed, and the mother eats and drinks calmly, the internal heat steams the fetus, softening and decomposing it, allowing it to be born without injury. The foul smell is unpleasant, showing that dead fetuses need no force, let alone live ones. I have often seen ignorant midwives lightly urging force, killing both lives. This is earnestly stated. I have also seen monster fetuses delivered naturally if people do not panic, provided the mother does not know. When the mother is critical, check face and tongue: face reflects the mother, tongue reflects the child. Blue face indicates maternal injury; blue tongue indicates fetal injury. Red face and blue tongue indicate dead fetus and living mother. Red face and red tongue indicate both are safe. Blue face and blue tongue with foaming at the mouth indicate both are hard to save. (Zhang secretly taught a formula specifically for difficult labor and dead fetus, and open pelvis bones, highly effective. Use Guang Monkey Blood, worth a coin, dissolve in wine and take, delivering immediately.)
Manual rescue techniques for delivery. If the opening is correct and the head is visible but not descending, it is likely due to the fetus turning and the umbilical cord catching its shoulder, called Ai Chan (Obstructed Labor). Treatment: lay the mother supine, gently push the fetus upward, press the shoulder with the middle finger to release the cord, wait for alignment, then exert force to push down. If the birth path is not straight and the mother forces it, the fetus may lean against the left or right leg, with the head stuck in the birth canal. Saying "the head is visible" is wrong; it is the forehead, called Pian Chan (Oblique Presentation). Treatment: lay the mother supine, gently push the fetus up, support the forehead with hand to align, then exert force to push down. If the occiput leans against the anus, and the head is visible, it is called HT Hou (Posterior Position - note: original text has typo). Treatment: wrap hand in cotton clothes, gently push the head from beside the anus to align, then exert force. Alternatively, use knees to prop the mother. These three difficulties all result from the mother lying curled and exerting force too early. These three manual methods should not be attempted lightly unless the midwife is experienced and knowledgeable.
When the baby exits, someone should hold the mother's chest with both hands, and the mother should hug her abdomen tightly to help the placenta descend. If the placenta is slow, do not panic; smoke burnt straw paper near the nose to induce expulsion. If still delayed, urgently cut the umbilical cord and wash the baby. Tie the cord with soft cloth, ensuring it is light yet secure, then cut. This cord is fragile. If the cord cannot be cut conveniently, fear blood reflux into the uterus, causing swelling and failure to descend, attacking the heart and causing injury. If the midwife is skilled, removing it by finger is convenient. For prolonged retention of placenta, one formula uses black cow dung, slightly roasted but moist, wrapped in cloth, and bound to the abdomen to induce expulsion.
For newborn suffocation/inability to cry, it is said calling the father's childhood name and patting the buttocks works. The logic is unclear, but likely there is a membrane blocking the anal opening, stifling the baby's Qi, preventing crying. Patting breaks the membrane, allowing crying. If patting doesn't work, a dexterous woman should gently pierce it with the end of a silver hairpin. If piercing is urgent and difficult, wrap warmly, do not let loose, soak the placenta in hot water (add heat in cold weather). Long-term internal heat pressure will break the membrane, allowing sound and revival.
A woman may have prolapsed intestines during delivery (Pan Chang Sheng), where intestines protrude before the baby. Treatment: urgently prepare a clean basin of warm water (hot in winter), add Sesame Oil for lubrication. Wait for baby and placenta to deliver. Mother inhales deeply to lift Qi. Midwife applies oil to hands and slowly pushes intestines back. Spraying vinegar water to startle and contract Qi might retract intestines but often causes errors and should not be used. Sometimes, after baby and placenta deliver, the bladder (Niao Bao) prolapses. Treat same as above. All these result from exerting force too early, disturbing the Five Zang organs. After reinsertion, take An Zang Tiao Bu Yao (Organ-Calming and Tonifying Medicine).
Xue Lizhai said: When feeling abdominal movement before delivery, lie supine straight. Wait for the fetus to turn downward. When pain starts, pinch the middle joint or proximal joint of the mother's middle finger. If it throbs, delivery is imminent. If water flows frequently before labor, the amniotic sac has broken, blood and fluids dried up, risking malpresentation and dystocia. If sac breaks but no delivery, use Bao Sheng Wu You San (Protect Life Fearless Powder) to stabilize blood. If blood is depleted, decoct Ba Zhen Tang (Eight Treasures Decoction) with Yi Mu Cao (Motherwort Herb) strongly and drink occasionally. Abdominal pain stopping means not yet in labor. Continuous lower back pain means approaching labor. Kidneys govern the waist, and the uterus connects to the kidneys. For any irregular pregnancy, instruct midwives to say "not yet in labor." Or if twins, say "placenta issues," fearing that fright scatters Qi and makes delivery harder. Generally, dystocia often involves depression. Wealthy families living in ease: although treatment claims regulating Qi before birth and tonifying Blood after, do not adhere rigidly. If Spleen and Stomach are weak and Qi/Blood insufficient, pre-regulate and tonify.
Dong Chan (Cold Birth): In winter, cold congeals menstrual blood, preventing descent. This is most harmful. Thus, in winter, do not remove woolens from the lower body, nor sit/lie in cold places. Ensure the room has stoves with constant warmth. Let the mother face the fire, keeping below the navel, legs, and knees warm. Heat moves Blood, making delivery easier.
Re Chan (Hot Birth): In midsummer, mothers must be neither too cool nor too hot. Overcooling increases disease. Too many people create oppressive heat, causing心烦 (Vexation), boiling Blood, and risks of Yu Mao Chong Yun (Depression/Fainting/Swooning).