杨子建曰∶催生者,言欲产时,儿头至产门,方服药催之。或经日久,产母困倦难生,宜服药以助血气,
令儿速生也。
《大全》曰∶大法,滑以流通滞涩,苦以驱逐闭塞,香以开窍逐血。气滞者行气,胞浆先破血干者,固血。
慎斋按∶《大全》云∶滑以流通滞涩者,如车前、滑石、凤仙子、蜀葵子、麻油、香油、白蜜、牛乳、猪脂
之属,皆滑剂也。苦以驱逐闭塞者,如桃仁、干姜、赤芍、浓朴、朴硝、大黄之属,皆苦剂也。香以开窍者,
如乳香、麝香、白芷、肉桂之属,皆香剂也。气滞,则香附、枳壳、陈皮、乌药、青皮,皆顺气之剂也。血干,
则当归、川芎、益母、红花、丹参之属,皆固血之剂也。
《女科正宗》曰∶催生多用滑利迅速之药,古方有兔脑、蛇蜕、笔尖、弩牙、急性子之类,皆一时妙用。唯佛
手散为至当不易。至如手握石燕,足贴蓖麻,子道干涩则用葵子、榆白皮、猪脂、葱油、蜜、牛乳以润之。天
寒风冷,使气血凝滞,则用乳香、麝香之类,以香能开窍逐污也。
慎斋按∶以上三条,序催生用药之大略也。催生,古方甚多,有不甚稳者,概删之。
叔和曰∶产后寸口洪疾不调者死,沉微附骨不绝者生。又曰∶沉小滑者生,实大坚弦急者死。
朱丹溪曰∶胎前脉当洪数,既产而脉仍洪数者死。又曰∶胎前脉细小,产后脉洪大者多死。
杨子建说:所谓“催生”,是指胎儿头部到达产门时,才给产妇服药以促使分娩。如果产程拖延日久,产妇疲惫困倦难以生产,应当服用药物来辅助气血,使胎儿迅速娩出。
《妇人大全良方》说:基本法则是,用滑利药来疏通滞涩,用苦味药来驱逐闭塞,用香燥药来开窍并推动血液运行。气机阻滞的,使用行气药;胞浆先破、血枯干涸的,使用固摄血液的药。
慎斋按语:《妇人大全良方》所说的“用滑利药疏通滞涩”,例如车前子、滑石、凤仙花子、蜀葵子、麻油、香油、白蜜、牛乳、猪脂等,都属于滑利剂。所说的“用苦味药驱逐闭塞”,例如桃仁、干姜、赤芍、厚朴、朴硝、大黄等,都属于苦味剂。所说的“用香燥药开窍”,例如乳香、麝香、白芷、肉桂等,都属于香燥剂。气机阻滞,则用香附、枳壳、陈皮、乌药、青皮等,这些都是顺气理气的药剂。血枯干涸,则用当归、川芎、益母草、红花、丹参等,这些都是固摄养血(注:此处原文语境为针对血干之治法,虽言固血,实指补血养营以润燥)的药剂。
《女科正宗》说:催生多使用滑利且作用迅速的药材,古方中有兔脑、蛇蜕、笔尖(指毛笔头,喻其尖锐通利)、弩牙(弓弩发射机关,喻其弹射之力)、急性子(凤仙花种子)之类,都是一时的巧妙应用。唯有佛手散是最恰当且不可更改的良方。至于手握石燕、足底贴敷蓖麻子,若产道干涩则使用葵子、榆白皮、猪脂、葱油、蜂蜜、牛乳等来滋润它。天气寒冷,导致气血凝滞,则使用乳香、麝香之类,因为香气能够开窍并驱除污浊。
慎斋按语:以上三条,叙述了催生用药的大致原则。催生的古方非常多,其中有不甚稳妥的,一概删去。
叔和(王叔和)说:产后寸口脉象洪大急疾且不调和的,预后不良(主死);脉象沉微但按之至骨仍有根不绝的,预后良好(主生)。又说:脉象沉小滑利的,预后良好(主生);脉象实大坚弦急的,预后不良(主死)。
朱丹溪说:妊娠期间脉象应当洪数,如果分娩后脉象仍然洪数的,预后不良(主死)。又说:妊娠期间脉象细小,分娩后脉象反而洪大的,大多预后不良(主死)。
Yang Zijian stated: "Cui Sheng" (labor induction) refers to administering medication only when the fetal head has reached the birth canal. If labor is prolonged and the mother is exhausted and unable to deliver, medications should be taken to assist Qi and Blood, enabling the rapid delivery of the infant.
The *Da Quan* (General Principles, referring to *Furen Daquan Liang Fang*) states: The general principle is to use slippery agents to unblock stagnation and friction, bitter agents to expel obstruction, and aromatic agents to open orifices and drive blood circulation. For Qi stagnation, use Qi-moving agents; for premature rupture of membranes with dried-up Blood, use agents to consolidate Blood.
Shen Zhai commented: Regarding the *Da Quan*'s statement on using slippery agents to unblock stagnation, examples include Cheqian Zi (Plantago Seed), Huashi (Talcum), Fengxian Zi (Mandarin Orange Peel/Impatiens Seed), Shuhui Zi (Malva Seed), Sesame Oil, Sesame Oil, White Honey, Cow's Milk, and Pig Lard; these all belong to slippery agents. Regarding the use of bitter agents to expel obstruction, examples include Tao Ren (Peach Kernel), Gan Jiang (Dried Ginger), Chi Shao (Red Peony Root), Hou Po (Magnolia Bark), Puxiao (Mirabilite), and Dahuang (Rhubarb); these all belong to bitter agents. Regarding the use of aromatic agents to open orifices, examples include Ruxiang (Frankincense), Shexiang (Musk), Baizhi (Angelica Dahurica), and Rougui (Cinnamon Bark); these all belong to aromatic agents. For Qi stagnation, Xiangfu (Cyperus Rhizome), Zhike (Aurantii Fructus), Chenpi (Citrus Reticulata Peel), Wuyao (Lindera Root), and Qingpi (Green Citrus Peel) are used; these are all agents that regulate Qi smoothly. For dried-up Blood, Dang Gui (Angelica Sinensis), Chuanxiong (Ligusticum Chuanxiong), Yimucao (Motherwort), Honghua (Safflower), and Danshen (Salvia Miltiorrhiza) are used; these are all agents to consolidate and nourish Blood.
*Nuke Zhengzong* (Orthodox Gynecology) states: Labor induction mostly employs slippery and rapidly acting herbs. Ancient formulas include Rabbit Brain, Snake Slough, Brush Tip (metaphor for sharpness/penetration), Crossbow Trigger (metaphor for explosive force), and Jixingzi (Impatiens Seed); these represent clever applications for immediate effect. However, Foshou San (Buddha's Hand Powder) is the most appropriate and unchangeable formula. As for holding Shiyan (Flint) in the hand or applying Biba (Castor Bean) to the soles of the feet, if the vaginal passage is dry and astringent, use Kuizi (Malva Seed), Yubai Pi (Elm Bark), Pig Lard, Scallion Oil, Honey, and Cow's Milk to moisten it. In cold weather causing Qi and Blood stagnation, use Ruxiang (Frankincense) and Shexiang (Musk), as aroma can open orifices and expel turbidity.
Shen Zhai commented: The above three passages outline the general principles of medication for labor induction. There are many ancient formulas for this purpose, some of which are not very safe; they have been omitted.
He Chao (Wang Shuhe) stated: If the Cun Kou (radial pulse at the wrist) is洪疾 (surging and rapid) and irregular after childbirth, death ensues; if it is 沉微 (deep and faint) but continuous upon pressing to the bone, life is preserved. He also stated: A 沉小滑 (deep, small, and slippery) pulse indicates survival; a 实大坚弦急 (full, large, firm, wiry, and rapid) pulse indicates death.
Zhu Danxi stated: During pregnancy, the pulse should be 洪数 (surging and rapid). If the pulse remains surging and rapid after delivery, death ensues. He also stated: If the pulse is fine and small during pregnancy but becomes surging and large after delivery, death is likely.