凡临产时,亟斋已有六字真言,一曰睡,二曰忍痛,三曰慢临盆。诚为保产金丹,今又有飞霞曰“未
离经三字,谁与行医者言,然产家亦不可不知,较六字真言,更为亲切,能根据此言保全
甚多,如为医临产家诊视,无论脉之滑,痛之紧,但曰胎未离经,尚未到正产时候,且诊得脉气舒徐定然
安吉,惟嘱产母加餐稳卧,候其时至可也。此何意,盖生产全赖母气为主,产妇闻脉,未离
经知时未到,不敢望其速下,惟安心耐之而已。产妇一安,举室皆安,庶无仓惶扰攘之患。天下原无难产之
事,凡难产而致死者,总由时候未至,仓惶逼迫害之也。始则家长惊张,不能镇定,继
则产妇娇怯,不能忍痛,或弄产、或转胞,稍有腹痛,随即声扬,无知稳婆便称是产。而试水坐草,一任
胡为,岂知七候未临,胎气未足,子在胞中安然不动,欲令其产焉可得乎,因其久而不下,
产妇则惊惧忧疑,饮食不纳,渐至气怯神昏,因而异症百出,活活做成难产,常有未生而毙者矣。凡遇是
症,惟以大剂甘温之药服之,如八珍汤,十全大补汤之类,助其产母之元气,服后若果
正产,则腹痛阵紧,一阵痛急自下。倘非正产,则腹痛渐减渐缓,
胎元得暖而安矣。屡见稳婆谓头已平门,而诊得脉未离经,用固胎暖药而安之。
有迟至一月半月而产者,岂有头已平门,而能倒悬一月半月之理,即此可知,稳婆之不足信,观
亟斋有曰∶凡邪淫之妇,私胎并无难产,总因胎起于私,怕人知觉,只得极力忍痛痛到极熟
之时,则脱然而出,此岂有稳婆分掐,妙药催生乎。
凡产能耐心耐痛,听其自然,则万举万全,谓药能催生,予
则未敢许也。至催生之法,为产时胞浆已下一二时辰,七候确备不生者,方可佐药力以助之。
盖浆乃养儿之物,浆干不产,必胎元无力,愈迟则愈干,力必愈乏,不得不以大补气血之药,助
其母力,又惟人参为至圣,其次则脱花煎、芎归汤皆可。然亦须子已出胞平门,交骨即开门户
已,一方为有益若止,凭产妇腹痛之言,稳婆头至之说,妄用催
生怪异方药,不惟无济,反速其毙,慎之,戒之。
凡是遇到临产的时候,亟斋先生已经有六字真言:一是睡,二是忍痛,三是慢临盆。这确实是保胎生产的金丹妙法。现在又有飞霞氏提出“未离经”三字,虽然行医者未必常与之言,但产妇家属也不可不知晓,这比六字真言更为切近实际,若能依据此言,能保全许多生命。
如果作为医生去诊视临产的产妇,无论脉象是滑利还是疼痛紧迫,都只说“胎未离经”,说明还没有到正产的时刻。并且诊察发现脉气舒缓从容,必定是安吉之兆,只需嘱咐产妇多吃东西、安稳躺卧,等待时候到了再生产即可。这是什么意思呢?因为生产完全依赖母体的元气为主,产妇听到医生说“胎未离经”,知道时候未到,就不敢期望胎儿迅速降生,只能安心忍耐罢了。产妇一旦心安,全家也就安定了,从而避免惊慌忙乱的危害。天下原本没有难产这回事,凡是因为难产而致死的,总归是因为时候未到,因惊慌逼迫而害了性命。
起初是家长惊慌失措,不能镇定;接着产妇娇弱胆怯,不能忍受疼痛;或者被弄产(不当处理导致产程异常)、转胞(胎位或膀胱位置异常),稍有腹痛就大声呼号。无知的稳婆(接生婆)便声称是正在生产。于是试水坐草,任由其胡作非为。哪里知道七候(临产的七个征象)尚未到来,胎气不足,胎儿在胞宫中安然不动,想要让它生出来怎么可能呢?
因为时间久了胎儿不下,产妇就会惊惧忧虑,饮食不进,逐渐导致气虚神昏,因而各种异症百出,硬生生造成难产,常有还没生下来就死去的案例。凡是遇到这种情况,只有用大剂量的甘温药物服用,如八珍汤、十全大补汤之类,来助长产妇的元气。服药后如果真的正产,那么腹痛阵发紧促,一阵剧痛自然胎儿就下来了。如果不是正产,那么腹痛会逐渐减轻变缓,胎元得到温暖而安定了。
多次见到稳婆说胎头已经平抵骨盆入口(平门),但诊察发现脉象仍未离经,使用固胎暖宫的药物而使情况安定。有的迟至一个月半个月才生产,哪里有胎头已经平抵骨盆入口,却能倒悬一个月半个月的道理?由此可知,稳婆的话不可信。观察亟斋曾说:凡是行为不正的妇女,私通怀孕并无难产,总因为胎儿起于私情,怕被人发觉,只得极力忍受疼痛,等到痛到极致熟悉之时,则自然脱落而出,这哪里有什么稳婆的分掐手法、妙药催生的事呢?
凡是产妇能够耐心忍受疼痛,听其自然,则万事周全。如果说药物能催生,我则不敢苟同。至于催生的方法,只有在产时胞浆已破一两个时辰,七候确实具备却仍不生者,才可以借助药力来辅助。因为羊水是养育胎儿之物,羊水干涸而不生产,必然是胎元无力,越拖延羊水越干,力气必然越发匮乏,不得不使用大补气血的药物,来助长母体之力,其中惟有人参最为神圣,其次是脱花煎、芎归汤都可以。然而也必须胎儿已经出胞到达骨盆入口,交骨(耻骨联合)即开门户已定,一方为有益。如果只是凭借产妇腹痛之言、稳婆说胎头已到之说,妄用催生的怪异方药,不仅无济于事,反而加速死亡,务必谨慎,引以为戒。
When approaching labor, Ji Zhai already had the "Six-Character Mantra": first, sleep; second, endure pain; third, delay delivery. This is indeed a golden pill for preserving childbirth. Now, Fei Xia proposes the three characters "Not Yet Discharged from the Meridian" (Wei Li Jing). Although practitioners may not often discuss this with patients, the family of the parturient must know it. It is more practical than the Six-Character Mantra, and adhering to it can save many lives.
If a physician examines a woman in labor, regardless of whether the pulse is slippery or the pain is tight, one should only state that the "fetus has not yet discharged from the meridian," indicating that the time for normal delivery has not arrived. Furthermore, if the pulse qi is found to be slow and leisurely, it is certainly an auspicious sign. One should merely instruct the mother to eat well and lie down steadily, waiting for the proper time. What is the meaning of this? Childbirth relies entirely on the mother's Yuan Qi (Original Qi). Upon hearing the doctor say the fetus has not yet discharged, knowing the time is not ripe, she will not expect rapid delivery but will instead remain calm and endure. Once the mother is at peace, the whole household is at peace, thus avoiding panic and chaos. There are originally no cases of dystocia in the world. Those who die from difficult labor do so because the time has not arrived, and they are harmed by panic and coercion.
Initially, the family members are startled and cannot remain composed; subsequently, the mother, being delicate and timid, cannot endure the pain. Or, due to improper handling causing abnormal labor progression or uterine displacement, as soon as there is slight abdominal pain, she cries out loudly. Ignorant midwives then claim that labor has begun. They allow her to try water and sit on straw, acting arbitrarily. Who knows that the seven signs of impending labor have not yet appeared, and the fetal qi is insufficient? The fetus remains still and safe within the womb; how could it possibly deliver? Because the fetus does not come down after a long time, the mother becomes frightened, fearful, and worried, refusing food and drink. Gradually, this leads to deficient qi and confused spirit, causing various strange symptoms to emerge, artificially creating dystocia. There are often cases where the mother dies before giving birth.
In such cases, one must administer large doses of sweet and warm medicines, such as Bazhen Tang (Eight-Treasure Decoction) or Shiquan Dabu Tang (Ten Significant Tonifying Decoction), to assist the mother's Yuan Qi. If normal delivery occurs after taking the medicine, the abdominal pain will become paroxysmal and tight, and with each intense contraction, the fetus will naturally descend. If it is not normal delivery, the abdominal pain will gradually decrease and slow down, and the fetal origin will be warmed and settled.
It is frequently seen that midwives claim the fetal head has reached the pelvic inlet (Ping Men), but upon examination, the pulse indicates the fetus has not yet discharged from the meridian. Using herbs to secure the fetus and warm the uterus can stabilize the situation. Some deliveries are delayed by a month or half a month. How could the fetal head reach the pelvic inlet and yet hang upside down for a month or half a month? From this, we can see that midwives' words are unreliable. Observing Ji Zhai's statement: For women of loose morals who conceive out of wedlock, there is usually no difficulty in childbirth. This is because the pregnancy arises from illicit affairs, and fearing discovery, they strive to endure the pain until it reaches its peak familiarity, at which point the fetus falls out naturally. Where is there any need for a midwife's manual manipulation or miraculous drugs to induce labor?
If a woman can patiently endure pain and let nature take its course, everything will be complete and safe. Regarding the claim that drugs can induce labor, I dare not agree. As for methods of induction, they should only be used when the amniotic sac has ruptured for one or two hours, the seven signs are fully present, yet the baby has not been born. Only then can herbal power assist. Amniotic fluid is the substance that nourishes the fetus. If the fluid dries up and birth does not occur, it is necessarily because the fetal origin lacks strength. The longer the delay, the drier the fluid, and the weaker the strength. It is imperative to use large doses of herbs to tonify qi and blood to assist the mother's strength. Among these, Ren Shen (Ginseng Root) is the most sacred, followed by Tuohua Jian (Flower-Shedding Decoction) and Xiong Gui Tang (Ligusticum and Angelica Decoction). However, this is beneficial only if the fetus has exited the womb and reached the pelvic inlet, and the pubic symphysis (Jiao Gu) has opened. If one blindly uses strange and bizarre formulas to induce labor based solely on the mother's complaint of abdominal pain or the midwife's claim that the head has arrived, it will not only be ineffective but also accelerate death. Be cautious and beware.