一曰正产，妇人怀胎，十月满足，忽腰腹作阵疼痛，相次胎气顿陷，至于脐腹痛甚，乃至腰
间重痛，谷道挺进，继之浆破出血，儿子遂生，此名正产。
二曰伤产，妇人怀胎，未产一月之前，忽然脐腹疼痛，有如欲产之状，仍却无事，是名试月
，非正产也。但一切产母未有正产之候，即不可令人抱腰，亦不可令产母乱动用力。若儿身
未顺，才方转动，便教产母虚乱用力，使儿错落，忽横忽倒，不能正生，皆缘产母用力未当
，用力之所致也。直待儿身顺，临逼产门，方始用力一送，令儿下生，此名伤产。
三曰催产，孕妇欲产，浆破血下，已见是正产候，但却未服药不生，即可服催生药试之。或
有经及数日而不产，则产母困倦，亦可服药，助产母之正气，令儿速生，此名催生。
四曰冻产，乃冬月寒冷，产母经血得冷则凝，以至儿不能生下，此害最深。若冬月生者，下
部切不可脱棉衣，并不可坐卧寒处，当满房着火，常有暖气，令产母背身向火，令脐下腿膝
间尝暖，血得热则流行，儿便易生，名曰冻产。
五曰热产，时当夏令，威焰酷烈，产妇要温凉得所，亦不恣意取凉，伤损胎气，又不可房中
人多，热气逼袭产母，使产母血沸，发热头疼面赤，昏昏如醉，乃至人事不省，此名热产。
六曰横产，儿先露手，或先露臂，此由产母未当用力，而先用力故也，儿身未顺，用力一逼
，遂致身横，不能生下，当令产母安然仰卧，然后推儿，
徐徐先推其手，令人直上，渐渐逼身，以中指摩其肩，推上而正之，或以指攀其耳
而正之，必须产母仰卧，以便推儿正之，候其儿身正，煎催生药一盏服之，方可用力，令儿
下生，此名横产。
七曰倒产，产母胎气不足，关键不牢，用力太早，致令儿不能回转，便直下先露儿足，当令
产母仰卧，令稳婆推其足，渐渐入内，不可令产母用分毫力，亦不得令其惊恐，务必安慰，
使儿自顺，名曰倒产。
八曰偏产，儿身未正，产母用力一逼，致令儿偏柱左腿，或偏柱右腿，故头先露偏柱一半，
不能生下，当令产母仰卧，次令看生之妇，轻轻推儿近上，以手正儿头，令看生之人，以绵
烘热，裹手于谷道外旁，轻轻推儿头端正，便令产母用力一送，儿即下也，此名偏产。
九曰碍产，儿身已顺而露正顶，不能生下。盖因儿身回转，脐带攀其肩，因此露顶，而不能
生下。当令产母仰卧，令看生之妇，轻轻推上，徐徐引手，以中指按儿肩下，拨其肚带，仍
须候儿身正顺，方令产母用力一送，儿即生下，此名碍产。
愚按∶大凡横产、倒产、偏产、碍产四法，若非稳婆精良妙手，不可根据用此法，恐恣其愚蠢
，以伤人命也。今世之倒产者，往往随其倒足生下，名曰踏莲花生，并无后患，子母双全，
不必根据前条推足上法亦可。如碍产者，往往肚带有缠在儿头顶上，而儿头自出在产户外，稳
婆以指拨其肚带，从儿头顶过下之者。又有肚带缠住头顶一匝，而儿与胞衣一齐同下者，倘
漫用前法推入产门，转恐误事也。
十曰坐产，言欲临产时，高处系一手巾，令产母以手攀之，轻轻屈足坐定，令儿生下，非坐
在物上也，此名坐产。
昔有赵都运恭人，每产则大肠先出，然后则产，产后则大肠仍露，甚为苦之，名曰盘肠生。
医不能疗，偶在建昌，得一良法，而可收之。用醋半盏，新汲冷水七分调匀， 产母面，每
一收缩，三 收尽，是良法也。
产母肠不收，用香油五斤，煎热盛盆，候温坐油盆上，约坐至半时，以皂角末次入鼻中，嚏
作立收。（《斗门方》） 又法∶用半夏末搐鼻中，则肠立收上。又纸捻蘸香油点灯吹灭，以
烟熏产母鼻中，肠亦立上。
丹溪曰∶胎前毋滞，产后毋虚，产后一切皆不可发表，产后不可早用白芍，以其酸寒，克伐
生发之气故也。大凡产后，不可食物过多，恐成积滞。若未盈月，不可强起离床，不宜多言
喜笑，及惊恐忧惶，悲思怒恼，不宜久坐久立，及作针工，恐盈月之后，即成蓐劳，并油腻
鱼肉之类，皆不可犯。凡产后百日之外，方可交合，不尔，百病滋长，慎之。凡妇人患风气
脐下虚冷，莫不皆早行房之故也。
或曰∶新产之妇，好血已亏，污血或留，彼黑神散非要药乎?
答曰∶至哉坤元，万物资生，理之常也。初产之妇，好血未必尽亏，污血未必尽积，脏腑未
必寒。何以药为?饮食起居，勤加保护，何病之有?诚有污血体怯而寒，与之几剂，亦自简便
。或有他病，当求病起何因，病在何经，对症投剂，何用杂药乱投，诚有性急形瘦易怒火多
者，夏月坐蓐，时行火令，姜桂皆为禁药。至于保护之法，尤为悖理。肉汁发阴经之火，易
成内伤之病，先定有训戒，何胡为羊鸡浓汁作糜，而又服当归丸、四顺理中丸之类，虽是补
药，并是偏热。若脏腑无寒，何处消受，若夫儿子初生，母腹顿宽，思食鸡子，而不思鸡子
难化，辗转生病，每见产母无疾者，却去黑神丹，不可与鸡子肉食，且与之白粥干菜，间以
少些白鲞，半月方与别物，大能养胃却疾。彼富贵之家，骄恣之妇，卒有白带头风气痛，膈
满
痰逆口干，经事不调等症，皆是阳盛阴虚之病。天生血气，本自和平，又乌知其有此等谬迷
，有以兆之耶?
一曰正产：妇女怀孕，十月期满，忽然腰腹部阵发性疼痛，接着胎气下陷，直到脐腹剧烈疼痛，甚至腰部沉重疼痛，肛门有下坠感（挺进），随后羊水破裂出血，婴儿随即出生，这叫做正产。
二曰伤产：妇女怀孕，未满月之前，忽然脐腹疼痛，好像要生产的样子，但过后又没事了，这叫试月，不是正产。但是，所有产妇在没有出现正产的征兆之前，不可让人抱住腰部，也不可使产妇乱动用力。如果胎儿身体未顺位，刚刚转动，就教产妇胡乱用力，导致胎儿错位，忽横忽倒，不能正常出生，都是因为产妇用力不当，是用力造成的后果。一直等到胎儿身体顺位，临近产门，才开始用力一送，让胎儿降生，这叫做伤产。（注：此处原文逻辑似有误，通常“伤产”指因过早用力导致的难产，而描述中“直待儿身顺...方始用力”实为正确做法，但依原文翻译如下：若因错误用力导致难产，需纠正；若指正确接生时机，则为避免伤产。）*更正理解：原文此处定义“伤产”似乎是指因处理不当（如过早用力）导致的异常分娩过程，或者是对“试月”后错误处理的警示。根据上下文，“此名伤产”紧接在“皆缘产母用力未当...所致也”之后，意指这种因错误用力导致的难产状态称为伤产。*
三曰催产：孕妇想要生产，羊水破裂出血，已经见到是正产的征兆，但却没有服药就不生，就可以服用催生药试试。或者有的过了几天还不生产，那么产妇困倦，也可以服药，帮助产妇的正气，让胎儿快速出生，这叫做催生。
四曰冻产：这是冬天寒冷，产妇的经血遇到冷则凝固，以至于胎儿不能生下，这种危害最深。如果是冬天出生的，下部切不可脱去棉衣，也不可坐卧在寒凉之处，应当满屋生火，常有暖气，让产妇背向火源，使脐下腿膝间经常温暖，血液得热则流通，胎儿便容易出生，名叫冻产。
五曰热产：正值夏令，气候酷烈，产妇要温凉适宜，也不要肆意贪凉，损伤胎气，也不可在房中人多，热气逼迫袭扰产妇，使产妇血液沸腾，发热头痛面赤，昏昏沉沉像喝醉了一样，甚至人事不省，这叫做热产。
六曰横产：胎儿先露出手，或先露出臂，这是由于产妇用力不当，过早用力的缘故，胎儿身体未顺位，用力一逼，致使身体横置，不能生下，应当让产妇安然仰卧，然后推扶胎儿，慢慢先推其手，使其进入直上位置，渐渐推扶身体，用中指摩擦其肩膀，向上推扶并矫正它，或者用手指牵拉其耳朵来矫正它，必须让产妇仰卧，以便推扶胎儿矫正，等到胎儿身体端正，煎好一盏催生药服下，才可以用力，让胎儿降生，这叫做横产。
七曰倒产：产妇胎气不足，关键部位（宫颈口等）不牢固，用力太早，致使胎儿不能回转，便直接向下先露出胎儿脚，应当让产妇仰卧，让稳婆（接生婆）推其脚，渐渐纳入体内，不可让产妇用分毫力气，也不得让其惊恐，务必安慰，使胎儿自然顺位，名叫倒产。
八曰偏产：胎儿身体未端正，产妇用力一逼，致使胎儿偏靠在左腿，或偏靠在右腿，所以头先露出偏靠一半，不能生下，应当让产妇仰卧，其次让看生的妇人，轻轻推胎儿靠近上方，用手端正胎儿头，让看生的人，用绵布烘热，包裹手在肛门外侧旁，轻轻推扶胎儿头端正，便令产妇用力一送，胎儿即降生，这叫做偏产。
九曰碍产：胎儿身体已顺位且露出正顶（头顶），但不能生下。大概是因为胎儿身体回转时，脐带攀附其肩，因此露出头顶，而不能生下。应当让产妇仰卧，让看生的妇人，轻轻推扶向上，慢慢引手，用中指按压胎儿肩下，拨开脐带，仍然须等候胎儿身体正顺，才令产妇用力一送，胎儿即降生，这叫做碍产。
愚按：大凡横产、倒产、偏产、碍产四种情况，如果不是稳婆精良妙手，不可依据使用这些方法，恐怕放纵其愚蠢，以致伤害人命。当今世上的倒产者，往往随着倒出的脚直接生下，名叫踏莲花生，并无后患，母子双全，不必依据前条推足向上的方法也可。至于碍产者，往往脐带有缠绕在胎儿头顶上，而胎儿头自己露出在产户外，稳婆用手指拨开脐带，从胎儿头顶过下即可。又有脐带缠住头顶一圈，而胎儿与胞衣一齐同下的，倘若漫用前法推入产门，反而恐怕误事。
十曰坐产：说是要临产时，在高处系一条手巾，让产妇用手攀着，轻轻屈足坐定，让胎儿降生，并不是坐在物体上，这叫做坐产。
过去有赵都运恭人，每次生产都是大肠先出来，然后才生产，产后大肠仍露在外面，非常痛苦，名叫盘肠生。医生不能治疗，偶然在建昌，得到一种良法，可以收摄回去。用醋半盏，新汲冷水七分调匀，喷在产妇脸上，每当子宫收缩一次，喷三次，收缩完毕，这是良法。
产妇肠不收，用香油五斤，煎热盛于盆中，候温坐在油盆上，约坐半小时，将皂角末吹入鼻中，打喷嚏立刻收回。（《斗门方》）又一种方法：用半夏末搐入鼻中，则肠立刻收回。还有用纸捻蘸香油点灯吹灭，用烟熏产妇鼻子，肠也立刻收回。
丹溪说：胎前毋滞，产后毋虚，产后一切皆不可发表（发汗解表），产后不可早用白芍，因为其性酸寒，克伐生发之气的缘故。大凡产后，不可食物过多，恐怕形成积滞。如果未满月，不可强起离床，不宜多言喜笑，及惊恐忧惶，悲思怒恼，不宜久坐久立，及作针线活，恐怕满月之后，即成蓐劳（产后虚弱劳损），以及油腻鱼肉之类，都不可触犯。凡产后百日之外，方可交合，不然，百病滋长，慎之。凡妇人患风气（风邪侵袭）、脐下虚冷，无不都是早行房事的缘故。
有人说：新生产的妇女，好血（阴血）已亏，污血（恶露）或留，黑神散不是必要的药吗？
回答说：至哉坤元，万物依靠它生长，这是常理。刚生产的妇女，好血未必尽亏，污血未必尽积，脏腑未必寒。为什么要用药呢？饮食起居，勤加保护，有什么病呢？确实有污血滞留、体弱怯懦而寒的，给它几剂药，也自简便。如果有其他病，应当探求病因，病在何经，对症投药，何必杂药乱投？确实有性急形瘦易怒火多的人，夏天坐月子，时令火旺，姜桂都是禁药。至于保护的方法，更是悖理。肉汁会引发阴经之火，容易成为内伤之病，先前已有训戒，为何还要用羊鸡浓汁做粥，而又服用当归丸、四顺理中丸之类，虽然是补药，都是偏热的。如果脏腑无寒，哪里受得了？至于儿子初生，母亲腹部顿宽，想吃鸡蛋，却不考虑鸡蛋难消化，辗转生病，常见产妇无疾者，却去掉黑神丹，不给吃鸡子肉食，且给白粥干菜，间以少许白鲞，半月后才给别物，大能养胃却疾。那些富贵之家，骄纵的妇女，突然有白带头风痛，膈满痰逆口干，经事不调等症状，都是阳盛阴虚的病。天生血气，本自和平，怎么知道有这样的谬误迷惑，是有原因导致的呢？
1. Normal Delivery (Zhengchan): When a woman's pregnancy reaches ten months, she suddenly experiences paroxysmal pain in the lower back and abdomen. Subsequently, the fetal Qi descends rapidly. The pain intensifies in the umbilical and abdominal regions, extending to severe heaviness and pain in the waist, with a sensation of prolapse in the anal region (Gudao). This is followed by the rupture of membranes and bleeding, after which the infant is born. This is called Normal Delivery.
2. Injurious Delivery (Shangchan): If a woman experiences sudden pain in the umbilical and abdominal regions before the full month of pregnancy, resembling the onset of labor, but the symptoms subside without delivery, this is called "Trial Month" (Shiyue) and is not normal delivery. However, for any parturient who has not yet shown signs of normal delivery, one must not allow others to hold her waist, nor should the mother move or exert force randomly. If the fetus has not yet assumed a proper position and merely shifts, instructing the mother to exert force blindly may cause the fetus to dislocate, turning sideways or upside down, preventing normal birth. Such outcomes are due to improper exertion by the mother. One should wait until the fetus is in a proper position and approaches the birth canal before instructing the mother to exert force once to facilitate delivery. *Note: The text defines the scenario resulting from improper effort as Shangchan.*
3. Induced Delivery (Cui Chan): When a pregnant woman desires to deliver, and membranes have ruptured with bleeding, indicating signs of normal delivery, but no birth occurs without medication, one may administer parturifacient drugs to test their effect. If several days pass without delivery, causing the mother to become fatigued and exhausted, medication can be given to support the mother's Healthy Qi (Zheng Qi) and accelerate birth. This is called Induced Delivery.
4. Frozen Delivery (Dong Chan): This occurs in winter when coldness causes the mother's menstrual blood (lochia) to coagulate, hindering the birth of the infant. This is highly detrimental. For births occurring in winter, the lower body must not be exposed to cold; cotton garments should not be removed, and sitting or lying in cold places must be avoided. The room should be heated with fire to maintain warmth. The mother should face away from the heat source towards the fire, ensuring the area below the navel, legs, and knees remains warm. Heat promotes blood circulation, facilitating easier birth. This is called Frozen Delivery.
5. Hot Delivery (Re Chan): During summer, when heat is intense, the parturient must maintain appropriate temperature balance. She should not excessively seek coolness, which could damage Fetal Qi. Furthermore, the delivery room should not be overcrowded, as excessive heat may oppress the mother, causing blood to boil, leading to fever, headache, flushed face, drowsiness resembling intoxication, or even loss of consciousness. This is called Hot Delivery.
6. Transverse Presentation (Heng Chan): The fetus presents first with a hand or arm. This results from improper or premature exertion by the mother while the fetus is not yet aligned. Forceful pushing causes the fetus to lie transversely, preventing birth. The mother should lie supine. The attendant should gently guide the fetus, first pushing the limb upward into a vertical position, then gradually adjusting the body. Using the middle finger, rub the shoulder and push upwards to correct the position, or pull the ear to align it. The mother must remain supine to facilitate correction. Once the fetus is aligned, administer a cup of induced delivery decoction. Only then should the mother exert force to deliver the infant. This is called Transverse Presentation.
7. Breech Presentation (Dao Chan): Due to insufficient Fetal Qi and laxity of the cervix ("key"), premature exertion prevents the fetus from rotating, causing the feet to present first. The mother should lie supine. The midwife should gently push the feet back inside. The mother must not exert any force, nor should she be frightened; she must be comforted to allow the fetus to naturally assume a correct position. This is called Breech Presentation.
8. Oblique Presentation (Pian Chan): The fetus is misaligned, and forceful pushing causes the head to tilt against the left or right thigh, presenting obliquely and preventing birth. The mother should lie supine. The attendant should gently push the fetus upward and manually correct the head's position. Using a cloth warmed by heating, the attendant should place it near the anus and gently push the head into alignment. Then, the mother should exert force to deliver the infant. This is called Oblique Presentation.
9. Impeded Delivery (Ai Chan): The fetus is aligned and the vertex presents, but cannot be delivered. This is often caused by the umbilical cord wrapping around the shoulder during fetal rotation, trapping the vertex. The mother should lie supine. The attendant should gently push upward, guiding the hand to press below the shoulder and dislodge the cord. Wait until the fetus is fully aligned, then instruct the mother to exert force for delivery. This is called Impeded Delivery.
Commentary: For transverse, breech, oblique, and impeded presentations, these methods require skilled midwives. Unskilled application may harm life. Currently, many breech births occur naturally with the feet presenting first, known as "Lotus Stepping Birth," with no adverse effects on mother or child; thus, manual reduction of feet is not always necessary. For impeded delivery, if the cord wraps the vertex but the head emerges, the midwife can simply dislodge the cord over the head. If the cord encircles the vertex and the infant and placenta descend together, forcing them back into the birth canal may cause errors.
10. Sitting Delivery (Zuo Chan): This refers to a method where, upon imminent delivery, a towel is hung high. The mother holds onto it, bends her knees, and sits lightly to facilitate birth. It does not mean sitting on an object. This is called Sitting Delivery.
Historical Case: Lady Gong, wife of Zhao Duyun, suffered from "Intestine Prolapse Birth" (Panchang Sheng), where the large intestine prolapsed before and after delivery, causing great distress. Physicians could not cure it. While in Jianchang, a effective method was found: Mix half a cup of vinegar with seven parts fresh cold water. Spray this mixture on the mother's face. With each uterine contraction, spray three times. Upon completion of contractions, the intestine retracts. This is an effective method.
For postpartum intestinal prolapse: Boil five jin (approx. 2.5 kg) of sesame oil, pour into a basin, and let it cool to a warm temperature. Sit on the basin for about half an hour. Then, blow powdered Gleditsia sinensis (Zaojiao) into the nose to induce sneezing, which immediately retracts the intestine. (*Doumen Fang*) Another method: Use Pinellia ternata (Banxia) powder insufflated into the nose to retract the intestine. Alternatively, dip a paper wick in sesame oil, light it, extinguish it, and use the smoke to fumigate the mother's nose, which also retracts the intestine.
Danxi stated: During pregnancy, avoid stagnation; after delivery, avoid deficiency. Postpartum, all exterior-releasing methods (such as sweating) are contraindicated. Bai Shao (Radix Paeoniae Alba) should not be used early postpartum because its sour and cold nature suppresses the ascending and generating Qi. Generally, postpartum women should not overeat to prevent food stagnation. Within the first month, do not force oneself out of bed. Avoid excessive talking, laughing, fright, worry, sadness, anger, prolonged sitting or standing, and needlework. Failure to observe these may lead to "Chuilao" (postpartum consumptive disease) after the month ends. Greasy meats and fish should be avoided. Intercourse should only resume after one hundred days; otherwise, various diseases may arise. Women suffering from wind pathogens or coldness in the lower abdomen often do so due to early resumption of sexual activity.
Question: Since new mothers suffer from blood deficiency and potential lochia retention, is Hei Shen San (Black Divine Powder) an essential medicine?
Answer: The Earth element generates all things; this is the natural order. After childbirth, blood deficiency and lochia retention are not necessarily complete, nor is organ coldness guaranteed. Why use medicine? Proper care in diet and lifestyle prevents illness. If there is indeed lochia retention, weakness, and cold, a few doses of medicine are simple and effective. For other conditions, identify the cause and meridian involvement, and prescribe accordingly. Do not indiscriminately mix herbs. Those with irritable temperaments, thin bodies, and frequent anger should avoid ginger and cinnamon in summer due to the prevailing fire climate. Protective measures involving rich foods are unreasonable. Meat broths may ignite fire in the Yin meridians, leading to internal injury. As previously advised, avoid mutton and chicken broths and tonics like Dang Gui Wan or Si Shun Li Zhong Wan, which are too hot. If organs are not cold, they cannot tolerate such heat. When the abdomen feels empty after birth, cravings for eggs may arise, but eggs are hard to digest and may cause illness. It is common for healthy mothers to recover better by avoiding Hei Shen Dan, meat, and eggs, instead consuming white porridge, dried vegetables, and small amounts of salted fish for half a month, which nourishes Stomach Qi and prevents disease. Wealthy, indulgent women who suddenly develop headaches, chest fullness, phlegm, dry mouth, or irregular menstruation often suffer from Yang excess and Yin deficiency. Natural Qi and Blood are balanced; such disorders arise from misconceptions and improper practices.