曰∶《内经》及后贤论脉皆繁而难学，惟普明子简便可从。普明子云∶《经》云∶妇人有孕者，身有病而无邪脉也。
有病，谓经闭；无邪脉，谓脉息如常，不断绝也。《经》又云∶“手少阴脉动甚者，孕子也”。少阴心也，心主血脉，心脉
旺则血旺，而为孕子之兆。《经》又云∶“阴搏阳别，谓之有子”。言二尺脉旺，与两寸迥别，亦为有孕。以上三者，但得
其一，即为孕脉。分而占之，合而推之，而孕脉无遁情矣。或为流利雀啄，亦为孕脉，何也？
答曰∶流利者，血正旺；雀啄者，经脉闭塞不行。故脉疾而歇，至此数月之胎也。不知者断为病脉，则令人耻笑。
或为孕有男女，何以脉而知之乎？
答曰∶左寸为太阳，脉浮大知为男也；右寸为太阴，脉沉实知为女也；若两寸皆浮大，主生二男；两尺皆沉实，主
生二女。凡胎孕弦、紧、滑、利为顺，沉、细、微、弱为逆也。
门人问曰∶妊娠有食忌、药忌，当以谁氏为主？
曰∶此一定之板法。《达生篇》及《妇人良方》、《女科大成》、《济阴纲目》等书，皆互相沿习，今以普明子所定为主。
普明子云∶“有孕之后，凡忌食之物，切宜戒食。”
一食鸡子糯米，令子生寸白虫；一食羊肝，令子多疾；一食鲤鱼，令子成疳；一食犬肉，令子无声；一食兔肉，令
子缺唇；一食鳖肉，令子项短；一食鸭子，令子心寒；一食螃蟹，多致横生；一食雀肉，令子多淫；一食豆酱，令子发
哮；一食野兽肉，令子多怪疾；一食生姜，令子多指；一食水鸡、鳝鱼，令子生癞；一食骡、马肉，延月难生。如此之
类，无不验者，所当深戒。
又云∶娠孕药忌歌，凡数十种，推之尚不止此。然药中如斑蝥、水蛭、蛇蜕、蜈蚣、水银、信砒等药，皆非恒用之
品，姑不论。兹特选其易犯者约纂数语，俾医者举笔存神，免致差误。其他怪异、峻险之品，有在孕时，自应避忌，不
待言也。
歌曰∶乌头附子与天雄，牛黄巴豆并桃仁；芒硝大黄牡丹桂，牛膝藜芦茅茜根；槐角红花与皂角，三棱莪术薏苡仁；
干漆 茹瞿麦穗，半夏南星通草同；干姜大蒜马刀豆，延胡常山麝莫闻。此系妇人胎前忌，常须记念在心胸。
（长孙心典）按∶上药忌犯似矣。然安胎止呕有用半夏者，娠孕热病有用大黄者，娠孕中寒有用干姜、桂、附者，
是何说也？昔黄帝问于岐伯曰∶“妇人重身，毒之何如？”岐伯对曰∶“有故无殒，亦无殒也。大积大聚，其可犯也，衰
其大半而止。”有故者，谓有病；无殒者，无殒乎胎也；亦无殒者，于产母亦无殒也。盖有病则病当之，故毒药无损乎胎
气。然大积大聚，病势坚强，乃可以投之；又须得半而止，不宜过剂，则慎之又慎矣！用药者，可不按岐黄之大法耶？
门人问曰∶临产将护及救治之法何如？
曰∶《达生篇》一书，发挥详尽，一字一珠，不必再赘。凡男人遇本妇怀孕，宜执此书，日与讲论三、四页，不过半
月也，可令全书熟记。较日夜与之博弈，或闲谈消遣，孰得孰失？请一再思之。余又于《达生篇》所未及者补之∶凡验
产法，腰痛腹不痛者未产；腹痛腰不痛者未产；必腰腹齐痛甚紧时，此真欲产也。如遇迟滞，以药投之则得矣。盖天之
生人，原造化自然之妙，不用人力之造作，但顺其性之自然而已。
（次男元犀）按∶凡新产之妇，其脏气坚固，胞胎紧实，产前宜服保生无忧散二、三剂，撑开道路，则易生。此方
于浆水未行时服之，若浆水既行，迟滞不产，劳倦神疲，宜十全大补汤以助其力。且恐浆水太过，血伤而胎不灵活，急
宜当归补血汤，或加肉桂，或加附子随宜。此高鼓峰之心法，余屡用屡效。或交骨不开，或阴门不闭、子宫不收，三者
皆元气不足。交骨不开者，前人传有加味归芎汤，张石顽立论诋之。谓每见服此，恶血凝滞，反成不救。惟大剂人参、
童便入芎、归剂中，助其气血，立效。阴门不闭者，十全大补汤倍参、桂，补而敛之。子宫不收者，补中益气汤加酒芍
一钱、肉桂五分，补而举之。其实张石顽之论，亦未免矫枉过正。即如加味芎归汤，谓为力量不大则可，谓为留血增病
则不可。至于前人所传试验之丸，催生有华佗顺生丹、如神散，胞衣不下有失笑散、花蕊石散，业是道者不可不备。又
难产，灸产妇右足小趾尖，艾炷如小豆大，三五炷立产，不可不预讲其法。
（陈念祖）说：《内经》以及后世医家对脉象的论述繁杂难学，只有普明子的论述简明易从。普明子说：《黄帝内经》记载：“怀孕的妇女，身体虽有病状表现，但脉象没有邪气。”所谓“有病”，是指月经停止；所谓“无邪脉”，是指脉搏呼吸如常，没有断绝之象。《黄帝内经》又说：“手少阴心经的脉动特别明显的，是怀孕的征兆。”少阴对应心脏，心主血脉，心脉旺盛则血液充盈，这是怀孕的征兆。《黄帝内经》还说：“尺部阴脉搏动有力，与寸部阳脉截然不同，这叫做有孕。”意思是两尺脉旺盛，与两寸脉明显不同，也是怀孕的迹象。以上三种情况，只要具备其中一种，就是妊娠脉象。分别占测，综合推演，那么妊娠脉象就无所遁形了。或者脉象流利如雀啄食，也是妊娠脉象，为什么呢？
（陈念祖）回答说：脉象流利，说明气血正旺盛；脉象如雀啄，说明经脉闭塞不通。所以脉来急疾而有间歇，到了此时已是数月之胎。不懂的人将其断定为病脉，就会令人耻笑。
有人问：如何从脉象判断胎儿性别呢？
（陈念祖）回答说：左寸脉属太阳，若脉象浮大，可知怀的是男孩；右寸脉属太阴，若脉象沉实，可知怀的是女孩；如果两寸脉都浮大，主生两个男孩；两尺脉都沉实，主生两个女孩。凡是胎孕脉象呈现弦、紧、滑、利为顺证，呈现沉、细、微、弱为逆证。
门人问道：妊娠期有饮食禁忌和药物禁忌，应当以谁的说法为主？
（陈念祖）说：这是一定的固定法则。《达生篇》及《妇人良方》、《女科大成》、《济阴纲目》等书，都是互相沿袭，现在以普明子所定的内容为主。普明子说：“怀孕之后，凡是忌食之物，务必戒除食用。”
一是吃鸡蛋和糯米，会使孩子出生后患寸白虫（绦虫病）；一是吃羊肝，会使孩子多病；一是吃鲤鱼，会使孩子患上疳积；一是吃狗肉，会使孩子失声；一是吃兔肉，会使孩子唇裂；一是吃鳖肉，会使孩子颈短；一是吃鸭子，会使孩子心寒；一是吃螃蟹，容易导致难产横位；一是吃雀肉，会使孩子多淫欲；一是吃豆酱，会使孩子发作哮喘；一是吃野兽肉，会使孩子多患怪病；一是吃生姜，会使孩子手指过多；一是吃田鸡、鳝鱼，会使孩子生癞疮；一是吃骡马肉，会导致过期难产。像这样的禁忌，无不灵验，应当深深戒除。
普明子又说：妊娠用药禁忌歌诀，有几十种，推究起来还不止这些。然而药物中如斑蝥、水蛭、蛇蜕、蜈蚣、水银、信砒等药，都不是常用之品，暂且不谈。这里特意挑选那些容易误犯的，简要编纂几句，使医生提笔时精神集中，避免差错。其他怪异、峻烈危险的药品，在怀孕期间自然应当避忌，不用多说。
歌诀说：乌头、附子与天雄，牛黄、巴豆并桃仁；芒硝、大黄、牡丹皮、桂枝，牛膝、藜芦、茅根、茜草根；槐角、红花与皂角，三棱、莪术、薏苡仁；干漆、姜茹、瞿麦穗，半夏、南星、通草同用；干姜、大蒜、马刀豆，延胡索、常山、麝香莫闻。这些都是妇女妊娠前的禁忌，必须时刻记在心中。
（长孙心典）按语：上述药物的禁忌似乎是对的。然而安胎止呕有用半夏的时候，妊娠热病有用大黄的时候，妊娠中寒有用干姜、桂枝、附子的时候，这是什么道理呢？昔日黄帝问岐伯说：“妇人重身（怀孕），使用毒药会怎样？”岐伯回答说：“有病故无殒，亦无殒也。大积大聚，其可犯也，衰其大半而止。”所谓“有故”，是指有病；所谓“无殒”，是指不伤胎；所谓“亦无殒”，是指对产妇也不伤害。大概是因为有病则病邪承受药力，所以毒药不会损伤胎气。但是遇到大积大聚，病势强盛，才可以投用此类药物；而且需要病势消退大半就停止，不宜过量，这就更加谨慎了！用药的人，能不遵循岐黄的大法吗？
门人问道：临产时的护理及救治方法怎么样？
（陈念祖）说：《达生篇》一书，发挥详尽，一字千金，不必再赘述。凡是男子遇到本妇怀孕，应当拿着这本书，每天与她讲解三四页，不过半个月，就可以让全书熟记。这与日夜与她赌博，或闲谈消遣相比，孰得孰失？请再三思考。我又补充《达生篇》所未涉及的内容：凡是验证分娩的方法，腰痛而腹部不痛的，尚未分娩；腹痛而腰部不痛的，尚未分娩；一定要腰腹同时疼痛且非常紧迫时，这才是真正要分娩了。如果遇到产程迟滞，用药干预即可顺利生产。因为上天生成人类，原本具有造化自然的奥妙，不需要人为造作，只需顺应其自然本性即可。
（次男陈元犀）按语：凡是刚生产的妇女，脏腑之气坚固，胞胎紧实，产前宜服用保生无忧散二至三剂，以撑开产道，则易于生产。此方在羊水未破时服用，如果羊水已破，产程迟滞不产，且劳倦神疲，宜用十全大补汤以助其力。并且担心羊水过多，导致血伤而胎动不灵活，急需使用当归补血汤，或加肉桂，或加附子，视情况而定。这是高鼓峰的诊疗心法，我屡次使用屡见疗效。如果是交骨不开，或阴门不闭、子宫不收，这三者都是元气不足所致。对于交骨不开者，前人传有加减芎归汤，张石顽立论诋毁它。认为常见服用此药后，恶血凝滞，反而造成不可挽救的后果。只有大剂量人参、童便加入芎归剂中，辅助气血，才能立即见效。对于阴门不闭者，用十全大补汤倍加人参、桂枝，以补益收敛。对于子宫不收者，用补中益气汤加酒炒白芍一钱、肉桂五分，以补益升举。其实张石顽的言论，也不免矫枉过正。就像加减芎归汤，说它力量不大还可以，说它留血增病则不可取。至于前人流传的经验丸药，催生有华佗顺生丹、如神散，胞衣不下有失笑散、花蕊石散，作为专业人士不可不准备。另外对于难产，灸产妇右足小趾尖，艾炷如小豆大小，三五壮即可立即分娩，不可不预先讲授这种方法。
(Chen Nianzu) stated: The discussions on pulse diagnosis in the *Neijing* (Inner Canon of the Yellow Emperor) and by later experts are complex and difficult to learn, whereas the teachings of Pu Mingzi are concise and easy to follow. Pu Mingzi said: The *Jing* (Canon) states, "In pregnant women, there may be symptoms of illness, but the pulse will not show signs of pathogenic factors." "Symptoms of illness" refers to amenorrhea; "no signs of pathogenic factors" means the pulse rhythm is normal and uninterrupted. The *Jing* also states, "When the pulse of the Hand-Shaoyin meridian beats vigorously, it indicates pregnancy." Shaoyin corresponds to the Heart, which governs blood vessels. When the Heart pulse is vigorous, blood is abundant, signaling pregnancy. The *Jing* further states, "When the Yin pulse at the cun position beats strongly, distinct from the Yang pulse, it is called having a child." This means that when the pulses at both chi positions (distal radial artery) are vigorous and significantly different from those at both cun positions (proximal radial artery), it also indicates pregnancy. Among these three indicators, possessing any one constitutes a pregnancy pulse. By analyzing them separately and synthesizing them comprehensively, the signs of pregnancy become unmistakable. Alternatively, a pulse that flows smoothly like a sparrow pecking at food is also a sign of pregnancy. Why?
I reply: A smooth flowing pulse indicates that blood and qi are flourishing; a sparrow-pecking pulse indicates obstruction of the menstrual channels. Thus, the pulse comes rapidly with intermittent pauses, indicating a fetus of several months' gestation. Those who do not understand this may mistakenly diagnose it as a pathological pulse, which would be laughable.
Someone asked: How can one determine the gender of the fetus through pulse diagnosis?
I reply: The left cun position corresponds to Taiyang; if the pulse is floating and large, it indicates a male fetus. The right cun position corresponds to Taiyin; if the pulse is deep and solid, it indicates a female fetus. If both cun positions are floating and large, it suggests twins boys; if both chi positions are deep and solid, it suggests twin girls. Generally, for pregnancy, a string-tight (Xian), tight (Jin), slippery (Hua), or free-flowing pulse is considered favorable (Shun), whereas a deep (Chen), fine (Xi), minute (Wei), or weak (Ruo) pulse is considered unfavorable (Ni).
A disciple asked: Regarding dietary and medicinal taboos during pregnancy, whose authority should be primarily followed?
I say: This is a fixed standard. Books such as *Dasheng Pian*, *Furen Liangfang*, *Nuke Dacheng*, and *Jiyin Gangmu* all follow similar traditions. However, I shall take the regulations established by Pu Mingzi as the primary guide. Pu Mingzi said: "After conception, one must strictly avoid consuming prohibited foods."
First, eating chicken eggs and glutinous rice may cause the child to develop tapeworms (Cunbai Chong) after birth. Second, eating lamb liver may make the child prone to illnesses. Third, eating carp may lead to infantile malnutrition syndrome (Gan Ji). Fourth, eating dog meat may cause the child to lose their voice. Fifth, eating rabbit meat may result in a cleft lip. Sixth, eating soft-shelled turtle meat may cause a short neck. Seventh, eating duck may induce heart coldness in the child. Eighth, eating crab often leads to dystocia or breech presentation. Ninth, eating sparrow meat may predispose the child to excessive lust. Tenth, eating bean paste may trigger asthma in the child. Eleventh, eating wild beast meat may cause rare diseases. Twelfth, eating ginger may result in polydactyly. Thirteenth, eating frogs and eels may cause leprosy-like skin conditions. Fourteenth, eating mule or horse meat may prolong labor beyond the due date. Such prohibitions are all effective and should be deeply observed.
Pu Mingzi also added: There are dozens of songs detailing medicinal taboos during pregnancy, and the list extends even further. However, substances such as Mylabris (Banmao), Leech (Shuizhi), Snake Slough (Shetui), Centipede (Wugong), Mercury (Shuiyin), and Arsenic (Xinpi) are rarely used in daily practice and need not be discussed here. I have selected only those commonly encountered to compile a few verses, so that physicians may remain vigilant and avoid errors. Other bizarre or highly toxic substances should naturally be avoided during pregnancy without needing explicit mention.
The verse reads: Avoid Aconitum (Wutou), Prepared Aconite Root (Fuzi), and Lateral Root of Aconite (Tianxiong); Realgar (Niuhuang), Croton Seed (Badou), and Peach Kernel (Taoren); Mirabilite (Mangxiao), Rhubarb (Dahuang), Peony Root (Mudanpi), and Cinnamon Twig (Guizhi); Achyranthes Root (Niuxi), Veratrum (Lilu), Imperata Rhizome (Maogen), and Madder Root (Qiancaogen); Sophora Fruit (Huaijiao), Safflower (Honghua), and Gleditsia Sinensis (Zaojiao); Burreed Tuber (Sanleng), Curcuma Zedoaria (Ezhu), and Coix Seed (Yiyiren); Dried Lacquer (Ganqi), Ginger (Ru), and Lygodium Spore (Qumai Sui); Pinellia Tuber (Banxia), Star Fennel (Nanxing), and Thoroughwort Stem (Tongcao); Dried Ginger (Ganjiang), Garlic (Dasuan), and Horse Bean (Madoudou); Corydalis Rhizome (Yanhusu), Oldenlandia (Changshan), and Musk (She) should never be heard of. These are the taboos for women before childbirth; keep them constantly in mind.
(Changsun Xindian) noted: The above prohibitions seem correct. However, Banxia is sometimes used to calm the fetus and stop vomiting; Dahuang is used for febrile diseases during pregnancy; Ganjiang, Guizhi, and Fuzi are used for cold syndromes during pregnancy. What is the explanation for this? In ancient times, the Yellow Emperor asked Qibo: "If toxic medicines are used on a pregnant woman, what happens?" Qibo replied: "If there is an existing pathology, the medicine will not harm [the mother or fetus]. Large accumulations and masses may be attacked, but stop when half has subsided." "Existing pathology" means disease is present; "not harming" means the fetus is not injured; "also not harming" means the mother is not injured. Essentially, because the disease bears the brunt of the medication, toxic drugs do not damage fetal qi. However, this applies only when large accumulations and strong pathological forces exist. One must stop treatment once the condition improves by half and avoid overdosing, exercising extreme caution! Physicians must adhere to the great principles of Qibo and Huangdi.
A disciple asked: What are the methods for care and emergency treatment during labor?
I say: The book *Dasheng Pian* covers this topic in detail, with every word being valuable, so no further elaboration is needed. Any husband whose wife is pregnant should hold this book and discuss three to four pages with her daily. Within half a month, she can memorize the entire text. Is this not better than gambling or idle chatter to pass the time? Please reflect on this repeatedly. I will supplement what *Dasheng Pian* omitted: To verify impending labor, lower back pain without abdominal pain indicates labor has not started; abdominal pain without lower back pain also indicates labor has not started. Only when both lower back and abdomen hurt intensely and tightly is true labor beginning. If labor stalls, administering appropriate medication will facilitate delivery. Nature's creation of humans possesses miraculous spontaneity; human intervention should not force the process but merely follow its natural course.
(Chen Yuanxi, second son) noted: For women who have just given birth, their organ qi is robust, and the placental sac is firm. Before delivery, taking Baosheng Wuyou San (Baosheng Wuyou Powder) for two to three doses helps open the birth canal, making delivery easier. This formula should be taken before the rupture of membranes. If membranes have ruptured but labor is delayed, accompanied by fatigue and mental exhaustion, Shiquan Dabu Tang (Ten Significant Tonifying Decoction) should be used to boost strength. Furthermore, to prevent excessive amniotic fluid leading to blood deficiency and lack of fetal mobility, Danggui Buxue Tang (Angelica Tonifying Blood Decoction) should be administered urgently, optionally adding Cinnamon Bark (Rougui) or Prepared Aconite Root (Fuzi) as indicated. This is the clinical method of Gao Gufeng, which I have used successfully many times. For cases where the pubic symphysis does not separate (Jiaogu Bukai), or the vulva remains open, or the uterus fails to contract, these are all due to insufficiency of Yuan Qi (Original Qi). For non-separation of the pubic symphysis, predecessors recommended Jiawei Xiongui Tang (Modified Ligusticum and Angelica Decoction), but Zhang Shiwen criticized it, arguing that it causes blood stasis and worsens the condition. He advocated using large doses of Ginseng (Renshen) and Child's Urine (Tongbian) combined with Ligusticum (Xiong) and Angelica (Gui) to boost qi and blood, yielding immediate results. For the vulva remaining open, use Shiquan Dabu Tang with increased Ginseng and Cinnamon to tonify and astringe. For uterine inversion/prolapse, use Buzhong Yiqi Tang (Middle-Boosting Qi-Supplementing Decoction) with 1 qian of Wine-fried White Peony Root (Jiu Shaoyao) and 0.5 qian of Cinnamon Bark to tonify and lift. Actually, Zhang Shiwen's critique was somewhat overcorrecting. While it may be true that Jiawei Xiongui Tang lacks sufficient potency, claiming it causes blood stasis and worsens disease is incorrect. As for traditional pills tested over time, Huatuo's Shunsheng Dan (Smooth Birth Pill) and Rushen San (Miraculous Powder) for inducing labor, and Shixiao San (Laughing Off Powder) and Huarui Shi San (Flower and Pyrite Powder) for retained placenta, are essential preparations for any practitioner. Additionally, for dystocia, moxibustion on the tip of the right little toe of the parturient woman, using moxa cones the size of a small bean, three to five cones, can induce immediate delivery. This technique must be taught in advance.