《便产须知》曰∶盘肠生者，临产子肠先
出，然后产子则肠不收，名曰盘肠产。稳婆以醋水各半盏，默喷产妇之面，肠即收上。又古方用蓖麻子仁四十九
粒，研涂产母头顶，肠即收上，急洗去。其肠若干不收，以磨刀水少许温润之。若以水喷面，恐惊则气散，愈
难收也。肠干者，浓煎黄 汤，浸其肠于漆盘中，温暖熏之即上。
李太素按∶盘肠生，是必母气血虚弱，因而下脱。当用补气补血之药，兼以升提，则肠自收矣。大剂参、
、芎、归，加升麻。
慎斋按∶以上二条，序交骨不开，盘肠生，是难产中之见证也。难产不止此二证，横逆产法，在稳婆妙手，
其用药亦不外后条诸法。
杨子建曰∶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，下部不可脱去棉
衣，并不可坐卧寒处，使满房围炉，常有暖气，令产母背身向火，脐下腿膝间常暖。血得热则散，儿易生也。
杨子建曰∶热产者，盛夏之月，产妇要温凉得所。不可恣意取凉，伤损胎气。不可人多，热气逼袭，产母
心烦，热血沸腾，有郁冒冲晕之患。
慎斋按∶杨子建有十产论，俱不可不知。但八条悉属产母与稳婆之事，故不尽录。其冻产热产二条，唯在医
者用药调护，因节取之。予谓古方临产用药最多。丹溪云∶只用佛手散最稳当，又效捷。后读单养贤《产宝
新书》有生化汤一方，为产后加减，今当以二方为主。如寒月冻产，多加肉桂、乳香。夏月热产，多加辰砂、益
元散，均用童便半盏冲入。人参，量产妇元气虚实，多寡加之可也。
《便产须知》记载：所谓“盘肠生”，是指产妇临产时子宫先脱出，然后才娩出胎儿，之后子宫无法回纳，这种情况称为“盘肠产”。接生婆用醋和水各半盏，默默喷在产妇脸上，子宫即可回纳。另外古方使用四十九粒蓖麻子仁，研磨后涂抹在产妇头顶，子宫即可回纳，需立即洗去。如果子宫仍然不能回纳，用少许磨刀水湿润它。如果用喷水喷脸，恐怕因惊吓导致气机散乱，更难回纳。如果子宫干燥，将黄芩汤浓煎，把子宫浸泡在漆盘中，用温暖之气熏蒸即可回纳。
李太素按语：盘肠生，必然是因为母体气血虚弱，从而导致下脱。应当使用补气补血的药物，兼用升提之法，子宫自然就会回纳。可用大剂量人参、[缺字]、川芎、当归，加入升麻。
慎斋按语：以上两条，叙述了交骨不开、盘肠生，这是难产中的证候。难产不止这两种证候，横位或逆位的分娩方法，在于接生婆的巧妙手法，其用药也不外乎后面几条所述的方法。
杨子建说：冻产，是指在冬季天气寒冷时，产妇经血遇冷则凝结，导致胎儿不能娩出，这种危害最深。所以冬季分娩者，下部不可脱下棉衣，也不可坐卧在寒冷之处，要使满屋围炉，常有暖气，让产妇背部和身体面向火源，脐下及腿膝间常保持温暖。血液得热则流通，胎儿容易出生。
杨子建说：热产，是指在盛夏月份，产妇要调节得温凉适宜。不可肆意贪凉，损伤胎气。不可人多拥挤，热气逼迫侵袭，导致产妇心烦，热血沸腾，有郁闭昏冒冲晕的祸患。
慎斋按语：杨子建有《十产论》，都不可不知道。但其中八条全属于产妇与接生婆的事情，所以不全部收录。关于冻产和热产这两条，只在于医生用药调护，因此节选记录。我认为古方中临产用药最多。朱丹溪说：只用佛手散最稳妥，又见效快。后来读到单养贤的《产宝新书》中有生化汤一方，作为产后加减的基础，现在应当以这两个方子为主。如果是寒月冻产，多加肉桂、乳香。夏月热产，多加辰砂、益元散，都用童便半盏冲入服用。人参，根据产妇元气的虚实情况，酌情增减用量即可。
*Bi Chan Xu Zhi* records: The condition known as "Pan Chang Sheng" (Plaited Intestine Birth) refers to a situation where the uterus prolapses before the delivery of the fetus. After the fetus is delivered, the uterus fails to retract, a condition termed "Pan Chang Chan" (Prolapsed Uterus Birth). Midwives may use half a cup of vinegar mixed with half a cup of water, silently spraying it onto the mother's face, which causes the uterus to retract. Another ancient prescription uses forty-nine kernels of *Ricini Semen* (Castor Bean), ground and applied to the crown of the mother's head; the uterus will then retract, and the substance must be washed off immediately. If the uterus still does not retract, moisten it slightly with water used for sharpening knives. Spraying water on the face should be avoided, as fear may cause Qi to scatter, making retraction more difficult. If the uterus is dry, decoct *Scutellariae Radix* (Huang Qin) strongly, immerse the uterus in a lacquered basin, and apply warm steam until it retracts.
Li Taisu commented: "Pan Chang Sheng" is inevitably caused by deficiency of Qi and Blood in the mother, leading to downward prolapse. Treatment should employ herbs that tonify Qi and Blood, combined with methods to lift and raise, so that the uterus naturally retracts. A large dose of *Ren Shen* (Ginseng Root), [missing character], *Chuanxiong Rhizoma* (Chuan Xiong), and *Dang Gui Radix* (Dang Gui), added with *Sheng Ma* (Cimicifugae Rhizoma), is indicated.
Shen Zhai commented: The above two items describe "Jiao Gu Bu Kai" (Failure of the Pubic Symphysis to Separate) and "Pan Chang Sheng," which are manifestations of dystocia. Dystocia is not limited to these two conditions. For transverse or malpositioned births, the method relies on the skill of the midwife, and the medication used does not exceed the methods described in the subsequent sections.
Yang Zijian stated: "Dong Chan" (Cold Birth) occurs when the weather is cold in winter; the mother's menstrual blood coagulates due to cold, preventing the fetus from descending. This harm is the most severe. Therefore, in winter births, the lower body must not be stripped of cotton clothing, nor should one sit or lie in cold places. The room should be surrounded by stoves to maintain warmth, with the mother facing the fire, keeping the area below the navel, legs, and knees constantly warm. When blood is warmed, it circulates freely, facilitating easier birth.
Yang Zijian also stated: "Re Chan" (Hot Birth) occurs during the height of summer. The mother must maintain a balance of warmth and coolness. One must not indulge in cooling measures, damaging fetal Qi. Crowds should be avoided to prevent heat oppression, which can cause maternal irritability, boiling blood, and risks of stagnation, fainting, or vertigo.
Shen Zhai commented: Yang Zijian's *Ten Types of Birth* theory should all be known. However, eight of the ten items concern only the mother and midwife, so they are not fully recorded. Regarding "Dong Chan" and "Re Chan," care depends on the physician's medication and nursing, so these are excerpted. I believe ancient prescriptions for labor contain many medications. Zhu Danxi said: Using only *Fo Shou San* (Buddha's Hand Powder) is the safest and most effective. Later, reading Shan Yangxian's *Chan Bao Xin Shu* (New Book of Obstetric Treasures), I found the formula *Sheng Hua Tang* (Invigorating Blood Decoction), which serves as a basis for postpartum modifications. Currently, these two formulas should be primary. For cold winter births, add more *Rou Gui* (Cinnamon Bark) and *Ru Xiang* (Frankincense). For hot summer births, add more *Zhu Sha* (Cinnabar) and *Yi Yuan San* (Benefit Origin Powder), all taken with half a cup of child's urine (*Tong Bian*). *Ren Shen* dosage should be adjusted according to the deficiency or excess of the mother's Yuan Qi.