一产时门户俱正。儿已露顶而不下。此因儿转身。脐带绊其肩也。名曰碍产。治法令母仰卧。轻轻推儿向上。以手指轻
按儿肩。去其脐带。候儿顺正。扶挟起身。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。审是偏左偏右。以手扶其头
顶端正。用力送下。又有头之后骨偏柱谷道。儿乃露额。名曰枨后。治法于谷道外旁。轻轻推儿头令正。然后用力送下。
或用膝头令产母抵住亦可。三产之难。皆母曲腰坐卧用力太早致之。三手法。必历练有分晓者。不可轻易。一儿出户时。
人即以两手轻抱产母胸前。产母自亦以两手紧抱肚脐。令胎衣下坠。如胎衣来迟。只管断脐洗儿。但先用软绢物。系住
脐带。然后断脐。系时宜轻巧牢固。此带极脆。要用心拿定。若血流入衣中。血胀不下。治之少缓。胀满以次上冲心胸。
疼痛喘急者。难治。但服夺命丹。以速去衣中之血。血散胀消即下。回生丹最妙。服至三丸。无不下者。如无。牛膝汤
亦可。济生汤亦可。用滚酒服失笑散亦可。若腹痛。手按稍缓。此气虚不能送出也。用无忧散、回生丹妙。益母丸亦妙。
有用便捷方。
以草纸烟熏产母鼻。令气内纳即下。或以滚水一杯。磨好墨一二匙冲服即下。一盘肠生者。未产肠先盘出。其治法。急
将净盆盛温水。寒天即热水。少入香油养润。待儿并胞衣下时。产母略仰卧。自己吸气上升。稳婆香油涂手。徐徐送入。
一法以磁石煎汤服之。即收上。磁石须阴阳家用过有验者。又一法。蓖麻仁四十九粒研涂产母头顶。肠收上。急洗去。
迟则有害。又一法。半夏末搐鼻中。肠自上。又一法。以麻油润大纸捻。点火吹灭。以烟薰鼻。肠即上。又一法。肠出
盛以洁净水。浓煎黄 汤浸之。肠即上。此法最佳。唯服大剂补中益气汤更妙。又有儿并胞衣下后。膀胱壅出产户者。
同前法送入。此皆用力太早之故。送入后。宜服安五内药。一闷脐生者。儿粪门有一膜。闭住儿气。故不能出声。以手
微拍之。则膜破而能哭矣。如拍之不破。须女人轻巧者。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。出声而苏。一产后产门不闭。乃血气虚也。服加味芎归
汤。总以补气血为相宜。
达生篇说 亟斋居士曰。临产有六字真言。一曰睡。二曰忍痛。三曰慢临盆。又曰。或问临盆服药。有益无损
否。曰。安得无损。鼠兔二丸。大耗气而兼损血。回生丹大破血而兼损气。盖鼠兔例用香窜之药。产时百脉解散。气血
亏虚。服此散气药。儿已出而香未消。其损多矣。且令毛窍开张。招风入内。祸不可言。回生丹以大黄、红花为君。其
余亦多消导之品。血已耗而又大破之。多致产后发热等病。遗患无穷。都只谓产后失调。谁复归咎于药。按此数方。古
人称为神灵奇宝者。尚然如此。其他可知。或又问总无可用之药乎。曰。有。只须加味芎归汤、佛手散二方用之不尽矣。
盖胎时全要血足。血一足如舟之得水。何患不行。二方皆大用芎归。使宿血顿去。新血骤生。药味随地皆有。且使身体
壮
健。产后无病。真正有益无损。此皆先贤洞明阴阳之理。制此神方。以利济后世。奈何人只求奇怪之药。不论损益。岂
不可叹。
临产逐条要论 医宗金鉴坐草条曰。凡产妇坐草。最要及时。不可太早。若儿身未顺。宁可迟迟。宽心以待。
又临盆条曰。凡儿之生。自有其时。时至则儿身转顺。头顶正当产门。胞浆大来。腰重腹痛。谷道挺迸。产母中指中节
或本节跳动。此方为正产之时。方可临盆用力送儿。自顺生矣。又曰。临产之家。必用收生婆。须预择老成历练。明白
经事之人。无故切勿令其先使手法。如试水探浆等事。但嘱令宽心宁耐可也。又惊生条曰。产室之内。不可多人。人多
则语声喧哗。产母之心必惊。惊则心气虚怯。至产时多致困乏。号曰惊生。有如此者。须急急摒出。只留服役一二人。
使寂静而无嘈杂之声。则母心始安。安则其心亦宁静矣。又产室条曰。产室之内。四时俱要寒温适中。若大热大寒。均
不相宜。夏月必须清凉。勿使炎热。致产母中暑晕迷。冬月必须温暖。勿令寒冷。以致血凝难产。又曰。妊娠月数未足
时。或腹中痛。痛定如常者。此名试胎。宜养血以安其胎。若月数未足。腹痛或作或止。腰不痛者。此名弄胎。不宜轻
动。二者均非正产之时。切勿躁扰疑惑。惟宜宁静以待其时。
体元子借地法 东借十步。西借十步。南借十步。北借十步。上借十步。下借十步。壁方之中。四十余步。安
产借地。或有秽污。或有东海神王。或有西海神王。或有南海神王。或有北海神王。或有日游将军。白虎夫人。远去
十丈。轩辕招摇。举高十丈。天符地轴。入地十丈。令地空闲。产妇某氏安居。无所妨碍。无所畏忌。诸神拥护。百邪
速去。急急如律令敕。此借地法。于入月第一日朱书一幅。贴产妇房内墙壁上。更不须避忌诸神煞也。
一、难产情况之一：门户端正，儿头已露但不下。这是因为胎儿转身时，脐带缠绕住了肩膀。这种情况称为“碍产”。治疗方法是让产妇仰卧，轻轻将胎儿向上推，用手指轻按胎儿肩部以解开脐带，待胎儿位置顺正后，扶起产妇身体，用力将胎儿送出。
二、难产情况之二：产道未正，因产妇过早用力，导致胎儿偏斜卡在左右腿旁。此时胎儿头部在产门处下不来，虽然看起来像露出了头顶，但实际上并非头顶，而是额角。这种情况称为“偏产”。治疗方法也是让产妇仰卧，轻轻将胎儿推近上方，仔细辨别是偏左还是偏右，用手扶正胎儿头顶，然后用力送出。
三、难产情况之三：胎儿后脑勺偏斜抵住谷道（肛门），胎儿露出的是额头。这种情况称为“枨后”（枕后位）。治疗方法是在谷道外侧轻轻推正胎儿头部，然后再用力送出。或者用膝盖抵住产妇背部也可以。
四、上述三种难产，都是因为产妇弯腰坐卧、过早用力所致。这三种手法必须由经验丰富、操作熟练的人执行，不可轻易尝试。
五、胎儿娩出时，旁人应用双手轻抱产妇胸前，产妇自己应用双手紧抱肚脐，促使胎盘（胎衣）下行。如果胎盘下来得慢，只管剪断脐带清洗婴儿。但在剪断脐带前，必须先用柔软的绢布系住脐带，然后再剪断。系结时要轻巧且牢固，因为脐带非常脆弱，需要用心拿捏固定。如果血液流入胎盘内，导致血胀而胎盘不下，治疗稍慢，胀满之气会依次上冲心胸，引起疼痛、气喘急促，这就难以治疗了。此时只需服用夺命丹，以迅速排出胎盘内的积血，血散胀消后胎盘自然落下。回生丹效果最好，服用三丸，没有不下的。如果没有这些药，牛膝汤也可以；济生汤也可以；用滚酒送服失笑散也可以。
六、如果产后腹痛，用手按压感觉稍缓，这是气虚不能推动排出所致。使用无忧散、回生丹效果妙；益母丸也有效。还有一个便捷方：用草纸烟熏产妇鼻子，使烟气吸入体内，胎盘即可落下；或者用一杯滚水，磨入一两匙好墨汁冲服，胎盘也可落下。
七、有一种情况叫“盘肠生”，即未分娩时直肠先脱出体外。治疗方法是：急忙准备一个干净的盆盛温水，天冷则用热水，加入少许香油润滑。待胎儿和胎盘都出来后，产妇稍微仰卧，自己吸气向上提肛，接生婆手上涂香油，慢慢将直肠送入。另一种方法是用磁石煎汤服用，直肠即可收回。磁石必须是经过风水师验证有效的。再一种方法是将四十九粒蓖麻仁研碎涂抹在产妇头顶，直肠收回后立即洗去，迟了会有害处。再一种方法是将半夏末吹入鼻中，直肠会自动上升。再一种方法是用麻油润湿大纸捻，点火吹灭，用烟熏鼻，直肠即会上收。再一种方法是将脱出的直肠盛在洁净水中，浓煎黄芪汤浸泡它，直肠即会上收，此法最佳。如果能服用大剂量的补中益气汤更妙。
八、还有一种情况是胎儿和胎盘出来后，膀胱膨出到产门外。处理方法同上，将其送入。这都是因为用力过早造成的。送入后，宜服用调理五脏的药物。
九、有一种情况叫“闷脐生”，即胎儿肛门处有一层膜封闭住气息，所以不能出声。用手轻轻拍打这层膜，膜破即可哭出声来。如果拍不破，需由手脚轻巧的女性，用银簪脚轻轻挑破也很方便。如果不能挑破，急忙用暖衣紧紧包裹，不要让它散开，用热水浸泡其胎盘，天冷则加热，时间久了热气内鼓，那层膜自然会破，胎儿出声苏醒。
十、产后产门不闭合，是因为气血虚弱。应服用加味芎归汤。总体原则是以补益气血为宜。
【达生篇说】亟斋居士说：临产有六个字的真言诀要。一是睡，二是忍痛，三是慢临盆（不要过早用力）。又有人问：临盆服药，只有益处没有损害吗？回答说：怎么可能没有损害？鼠兔丸，极大耗损气并兼损伤血；回生丹，极大破血并兼损伤气。因为鼠兔丸通常使用香窜类药物，生产时百脉解散，气血亏虚，服用这种散气药，胎儿已经出生而药效未消，损害很大。而且会使毛孔开张，招致风邪入体，祸患不可言说。回生丹以大黄、红花为主药，其余也多属消导之品，血已消耗却又大力破血，多导致产后发热等疾病，遗患无穷。人们都只说是产后调养不当，谁又会归咎于药物呢？按这几张方子，古人称为神灵奇宝的，尚且如此，其他的可想而知。又有人问：难道完全没有可以用的药吗？回答说：有。只需要加味芎归汤、佛手散这两张方子，用之不竭。因为怀孕期间全赖血足，血充足就像船有了水，还担心行不通吗？这两张方子都大量使用川芎、当归，使宿血顿去，新血骤生。药材各地都有，且能使身体健壮，产后无病，真正有益无损。这些都是先贤洞察阴阳之理，制定这些神方，以利益后世。奈何世人只求奇怪的药物，不论损益，岂不可叹。
【临产逐条要论】《医宗金鉴·坐草条》说：凡是产妇开始用力分娩，最要及时，不可太早。如果胎儿身体尚未顺正，宁可迟缓等待，宽心以待。
又《临盆条》说：凡是胎儿出生，自有其时机。时机到了，胎儿身体转顺，头顶正当产门，胞浆大量流出，腰部沉重腹痛，肛门挺迸感，产妇中指中节或本节跳动，这才是正产的时机，才可以临盆用力送儿，自然顺产。
又说：临产的家庭，必须使用接生婆，须预先选择老成历练、明白经事的人，无故切勿让她先施展手法，如试水探浆等事情。只嘱咐她宽心忍耐即可。
又《惊生条》说：产房之内，不可多人。人多则语声喧哗，产妇的心必受惊吓。惊则心气虚怯，到生产时多导致困乏，这叫“惊生”。有这种情况的，须急急将闲杂人等摒除，只留服役的一二人，使环境寂静而无嘈杂之声，产妇的心才能安定。心安则心亦宁静。
又《产室条》说：产房之内，四季都要寒温适中。若大热大寒，均不相宜。夏天必须清凉，勿使炎热，导致产妇中暑晕迷；冬天必须温暖，勿令寒冷，以致血凝难产。
又说：妊娠月数未满时，如果腹中痛，痛定之后如常者，这名叫“试胎”，宜养血以安其胎。如果月数未满，腹痛或作或止，腰不痛的，这名叫“弄胎”，不宜轻动。这两种情况均非正产之时，切勿躁扰疑惑，惟宜宁静以待其时。
【体元子借地法】东借十步，西借十步，南借十步，北借十步，上借十步，下借十步。墙壁方圆之中，四十余步。安产借地，若有秽污，或有东海神王，或有西海神王，或有南海神王，或有北海神王，或有日游将军、白虎夫人，远去十丈；轩辕、招摇，举高十丈；天符、地轴，入地十丈。令地空闲，产妇某氏安居，无所妨碍，无所畏忌。诸神拥护，百邪速去。急急如律令敕。此借地法，于入月第一日朱书一幅，贴产妇房内墙壁上，更不须避忌诸神煞也。
I. Normal presentation with obstructed descent: The birth canal is correctly aligned, and the fetal vertex has emerged but fails to descend further. This occurs because the fetus turns, and the umbilical cord becomes entangled around its shoulder. This condition is termed "Obstructed Birth" (Ai Chan). The treatment requires instructing the mother to lie supine. Gently push the fetus upward, and use fingers to lightly press on the fetal shoulder to release the entangled umbilical cord. Once the fetus is in a normal position, assist the mother to rise slightly and exert force to deliver the baby.
II. Oblique presentation: The birth path is not yet straight. Due to premature exertion by the mother, the fetus is forced obliquely, lodging against the lateral sides of the legs. The fetal head remains at the vaginal opening without descending. Although it appears that the vertex has emerged, it is actually the frontal angle (forehead). This condition is termed "Oblique Birth" (Pian Chan). The treatment also involves having the mother lie supine, gently pushing the fetus upward, carefully determining whether it is deviated to the left or right, using hands to correct the fetal vertex to a central position, and then exerting force to deliver.
III. Occiput posterior position: The occipital bone of the fetus is deviated and presses against the anus (Gudao), while the forehead emerges. This is termed "Cheng Hou". The treatment involves gently pushing the fetal head into alignment from the side of the anus, followed by exerting force for delivery. Alternatively, placing knees against the mother's back may assist.
IV. Difficulties in these three types of difficult labor are all caused by the mother bending her waist, sitting or lying down, and exerting force too early. These manual techniques must be performed by experienced and skilled practitioners; they should not be attempted lightly.
V. Upon fetal expulsion, assistants should gently hold the mother's chest with both hands, while the mother tightly holds her own navel area with both hands to facilitate the descent of the placenta (Tai Yi). If the placenta is delayed, proceed with cutting the umbilical cord and cleaning the infant. However, before cutting, securely tie the umbilical cord with soft silk cloth. The knot must be light yet firm, as the cord is fragile and requires careful handling. If blood flows into the placenta causing distension and retention, delaying treatment allows the distension to ascend to the heart and chest, causing pain, panting, and urgency, which is difficult to treat. In such cases, administer Du Ming Dan (Life-Restoring Pill) to rapidly expel blood from the placenta. Once the blood disperses and distension subsides, the placenta will pass naturally. Hui Sheng Dan (Revival Pill) is most excellent; three pills usually ensure passage. Alternatives include Niuxi Tang (Achyranthes Decoction), Jisheng Tang (Assist Life Decoction), or Shixiao San (Instant Pain-Relieving Powder) taken with boiling wine.
VI. If postpartum abdominal pain is relieved by pressure, it indicates Qi deficiency failing to expel retained products. You Wu San (Worry-Free Powder) and Hui Sheng Dan are effective; Yi Mu Wan (Motherwort Pill) is also beneficial. A convenient method involves smoking the mother's nose with burning straw paper to induce inhalation and expulsion, or administering one to two spoons of ink ground in boiling water orally.
VII. "Coiled Intestine Birth" (Pan Chang Sheng): The rectum prolapses before delivery. Treatment: Immediately prepare a clean basin with warm water (hot water in cold weather), adding a little sesame oil for lubrication. After the fetus and placenta are delivered, have the mother lie slightly supine and inhale deeply to lift the pelvic floor. The midwife, with hands coated in sesame oil, should slowly reduce the prolapsed rectum. Another method: Administer a decoction of Cishi (Magnetitum); the rectum will retract. Use Magnetitum verified by Feng Shui masters. Another method: Grind 49 seeds of Ricinus communis (Bixia Ren) and apply paste to the mother's vertex; wash off immediately after reduction to avoid harm. Another method: Snuff Banxia powder (Pinelliae Rhizoma) into the nose to raise the rectum. Another method: Smoke the nose with a paper wick soaked in sesame oil and extinguished. Another method: Immerse the prolapsed rectum in clean water and soak with a strong decoction of Huangqi (Astragali Radix); this is optimal. Administering a large dose of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is even better.
VIII. Postpartum bladder prolapse into the vaginal opening occurs after delivery of the fetus and placenta. Reduce it using the same method described above. This results from premature exertion. After reduction, administer herbs to calm the Zang-Fu organs.
IX. "Stifled Umbilicus Birth" (Men Qi Sheng): A membrane closes the fetal anus, preventing crying. Gently tap the membrane until it breaks and the infant cries. If tapping fails, a dexterous woman should gently pierce it with the tip of a silver hairpin. If piercing is impossible, wrap the infant warmly to prevent heat loss, and immerse the placenta in hot water (heat it in cold weather). The internal heat generated will eventually rupture the membrane, allowing the infant to cry and revive.
X. Failure of the vaginal introitus to close postpartum is due to Blood and Qi deficiency. Administer Jiawei Xionggui Tang (Modified Chuanxiong and Angelica Decoction). The general principle is to tonify Blood and Qi.
[Da Sheng Pian Commentary] Jizhai Jushi states there are six essential words for labor: Sleep, Endure Pain, and Delay Bearing (do not push prematurely). Regarding medication during labor: Is it beneficial without harm? No. Shu Tu Wan consumes Qi and damages Blood. Hui Sheng Dan breaks Blood and damages Qi. Shu Tu Wan uses aromatic, penetrating herbs; during labor, when meridians are open and Qi/Blood are deficient, these herbs dissipate Qi excessively, causing harm even after birth, and open pores inviting Wind. Hui Sheng Dan uses Dahuang (Rhei Radix et Rhizoma) and Honghua (Carthami Flos) as chief ingredients, along with other draining agents, further damaging already depleted Blood, leading to postpartum fever and other issues. People blame poor postpartum care rather than the medicine. Even formulas revered as miraculous can cause harm. Are there safe medicines? Yes. Jiawei Xionggui Tang and Foshou San are sufficient. During pregnancy, sufficiency of Blood is crucial; like a boat needing water, sufficient Blood ensures smooth delivery. These formulas use large doses of Xionggui to remove stagnant Blood and generate new Blood, strengthening the body and preventing postpartum illness. They are truly beneficial without harm, created by sages understanding Yin-Yang. It is lamentable that people seek strange remedies without considering pros and cons.
[Essential Discussions on Labor from Yizong Jinjian]
On Sitting for Delivery: Timing is critical; do not start too early. If the fetus is not yet in position, wait patiently with a relaxed mind.
On Bearing Down: Birth has its proper time. When the time comes, the fetus aligns, the vertex enters the birth canal, amniotic fluid gushes, the lower back feels heavy and painful, the anus protrudes, and the middle joint or proximal joint of the mother's middle finger throbs. Only then should she bear down for natural delivery.
On Selecting Midwives: Choose experienced, knowledgeable women. Do not allow them to perform unnecessary manipulations like testing waters. Advise them to remain calm and patient.
On Fearful Birth: Keep the delivery room quiet. Noise frightens the mother, causing Qi deficiency and exhaustion, termed "Fearful Birth." Remove bystanders, keeping only one or two servants, to ensure silence and peace.
On Delivery Room Environment: Maintain moderate temperature year-round. Summer should be cool to prevent heatstroke; winter should be warm to prevent blood stasis and dystocia.
On False Labor: Before full term, intermittent abdominal pain that resolves normally is "Test Fetal Movement" (Shi Tai); nourish Blood to calm the fetus. Intermittent pain without lower backache is "Playing Fetus" (Nong Tai); do not intervene. Both are not true labor; remain calm and wait.
[Tiyuanzi Borrowing Earth Method]
Borrow ten steps East, West, South, North, Up, and Down. Within the square of the walls, over forty steps. For safe delivery, if there is filth, or deities of the East, West, South, and North Seas, or General Riyou, Lady Baihu, move ten zhang away; Xuanyuan and Zhaoyao move ten zhang high; Tianfu and Dizhou move ten zhang underground. Let the earth be empty. May产妇 [Mother] reside safely without obstruction or fear. May all deities protect and evil spirits depart swiftly. Execute immediately according to law. Write this method in vermilion ink on the first day of the ninth month and paste it on the wall of the delivery room, avoiding all taboo deities and sha energies.