横产者,以儿方转身,产母用力太早,以致儿身未顺,而先露手臂,名曰觅盐生。但见儿手略有出意,即
令产母宽心仰卧,轻轻送入弗令多出。盖出少则易入,未久则易入,如出多而久难入。略以盐半分涂儿手心,
以麻油抹儿满手,轻轻推入,或以手指轻轻抓儿手心亦可,切不可用刀截断,仍待儿身转正即生。
倒产者,因儿未及转身,产母努力一逼,致令儿先露足,名曰踏盐生。亦令产母宽心仰卧,轻轻扶入,若
未得入,略以盐半分涂儿足心,或以手指轻轻抓儿足心,仍以麻油抹儿满足,轻轻推入,静候转正即生。
坐产者,因儿将产,其母疲倦久坐椅褥,抵其生路不能正生,而先露臀。须用手巾一条拴系高处,令产
母以手攀之,轻轻屈足舒伸,以开生路,儿即顺生。
偏产者,因儿未顺生路,产母努力一逼,儿头偏柱边傍,虽若露顶实额角也。亦令产母正身仰卧,稳婆轻
手扶正头顶即生。若儿头后骨偏柱谷道傍边,令稳婆以绵衣烘热裹手,急向谷道外傍轻轻托上,或用膝头抵住,
令儿头正即生。
碍产者,因儿转身时产母用力太早,致儿脐带绊肩。虽儿身已正门路,已顺儿头,已露犹不能生。须令产
母仰卧,稳婆轻轻推儿向上,以中指按儿肩,拨去脐带,静候片时即生。
盘肠产者,因产母平日气虚,及临产时用力努挣,周身气血下注,以致肠随儿下。治法以洁净不破损漆器
盛之,浓煎黄 汤,待温浸之,以润其肠,待儿胞衣俱下,产母仰卧自己吸气上升。稳婆以麻油涂手徐徐送上。
宜服大剂补中益气汤(方见后膀胱落下条中)。一法以蓖麻子(十九粒去壳,捣烂),涂母头顶,待肠收上,
急以水洗去。又法以醋半盏,新汲水七分调匀,忽 产母之面,或背即收。每一 一缩,三 三缩,肠已收尽
矣(此法但恐惊则气散,反致他疾,须慎用之)。如肠头为风吹干不能收入,以磨刀水微温润肠,另煎活磁石
汤一杯,产母饮之,其肠自收。
横产,是指胎儿正在转身时,产妇过早用力,导致胎儿身体未顺产道,手臂先露出,这种情况称为“觅盐生”。只要看到胎儿的手有稍微露出的迹象,就立即让产妇宽心仰卧,轻轻将手推回,不要让它露出太多。因为露出少就容易推入,时间短就容易推入;如果露出多且时间长,就很难推入。可以用半份量的盐涂在胎儿手心,用麻油涂抹满胎儿的手,轻轻推入,或者用手指轻轻抓挠胎儿手心也可以,切不可用刀截断,仍要等待胎儿身体转正后自然分娩。
倒产,是因为胎儿尚未转身,产妇努力一逼,导致胎儿脚先露出,这种情况称为“踏盐生”。同样让产妇宽心仰卧,轻轻扶入。如果未能推入,可以用半份量的盐涂在胎儿足心,或者用手指轻轻抓挠胎儿足心,再用麻油涂抹满胎儿的脚,轻轻推入,静候胎儿转正后自然分娩。
坐产,是因为胎儿即将出生时,产妇疲倦久坐于椅子或褥垫上,阻碍了产道,不能正常分娩,臀部先露出。需要用一条手巾拴系在高处,让产妇用手攀住,轻轻屈足伸展,以打开产道,胎儿即可顺产。
偏产,是因为胎儿未顺产道,产妇努力一逼,胎儿头部偏向一侧,虽然看似露出头顶,实际上是额角。同样让产妇端正身体仰卧,接生婆轻手扶正胎儿头顶即可分娩。如果胎儿后脑勺偏向肛门旁边,让接生婆用绵衣烘热包裹双手,急忙向肛门外侧轻轻托起,或者用膝盖抵住,使胎儿头部端正即可分娩。
碍产,是因为胎儿转身时产妇用力太早,导致胎儿脐带绊住肩膀。虽然胎儿身体已正对产道,头位也顺,虽已露出但仍不能分娩。须让产妇仰卧,接生婆轻轻将胎儿向上推,用中指按压胎儿肩膀,拨开脐带,静候片刻即可分娩。
盘肠产,是因为产妇平日气虚,加上临产时用力努挣,周身气血下注,导致肠道随胎儿一起脱出。治疗方法是用洁净且不破损的漆器盛装脱出的肠子,浓煎黄芪汤,待温度适宜后浸泡肠子,以滋润肠道,待胎儿胎盘全部娩出后,产妇仰卧自行吸气上升。接生婆用麻油涂手徐徐将肠子送回去。宜服用大剂量的补中益气汤(方剂见后文膀胱落下条中)。另一种方法是用蓖麻子(十九粒去壳,捣烂),涂在产妇头顶,待肠子收回后,急忙用水洗去。又一种方法是用半盏醋,加七分新汲水调匀,突然喷在产妇面部或背部,肠子就会收缩。每喷一次缩一下,喷三次缩三次,肠子就完全收回了(这种方法只担心惊吓导致气散,反而引起其他疾病,必须慎用)。如果肠头被风吹干无法收回,用磨刀水微微润湿肠子,另煎活磁石汤一杯,让产妇喝下,肠子自然会收回。
Transverse presentation refers to the situation where the fetus is turning, and the mother exerts effort too early, causing the fetal body to be unaligned with the birth canal, resulting in the arm presenting first. This condition is named "Mi Yan Sheng" (Seeking Salt Birth). As soon as it is observed that the fetal hand has a tendency to emerge, the mother should be instructed to relax her mind and lie supine. The hand should be gently pushed back without allowing excessive protrusion. This is because less protrusion makes reinsertion easier, and shorter duration facilitates reinsertion; conversely, if protrusion is extensive and prolonged, reinsertion becomes difficult. A small amount of salt (half a portion) may be applied to the palm of the fetal hand, and sesame oil should be rubbed over the entire hand before gently pushing it back. Alternatively, one may gently scratch the fetal palm with fingers. It is strictly forbidden to cut off the limb with a knife. One must wait for the fetal body to turn into the correct position before delivery occurs naturally.
Breech presentation occurs when the fetus has not yet turned, and the mother exerts forceful pressure, causing the feet to present first. This condition is named "Ta Yan Sheng" (Treading on Salt Birth). Similarly, the mother should be instructed to relax her mind and lie supine, and the feet should be gently guided back. If they do not retract easily, a small amount of salt (half a portion) may be applied to the sole of the fetal foot, or the sole may be gently scratched with fingers. Sesame oil should then be rubbed over the entire foot before gently pushing it back. Delivery will occur naturally once the fetus turns into the correct position.
Sitting presentation occurs when the mother, exhausted near the time of delivery, sits for a long period on a chair or cushion, obstructing the birth canal and preventing normal delivery, resulting in the buttocks presenting first. A towel should be tied to a high place, allowing the mother to hold onto it. She should gently bend her legs and stretch to open the birth canal, enabling the fetus to deliver smoothly.
Oblique presentation occurs when the fetus is not aligned with the birth canal, and the mother exerts forceful pressure, causing the fetal head to press against the side. Although the vertex appears to be presenting, it is actually the frontal angle. The mother should be instructed to lie supine with her body straightened. The midwife should gently adjust the fetal head to the correct position, after which delivery will occur. If the occiput presses against the side of the anus, the midwife should wrap her hands in heated cotton cloth and gently lift the head from the lateral side of the anus, or use her knee to support it, ensuring the fetal head is aligned correctly for delivery.
Impeded presentation occurs when the mother exerts effort too early during fetal turning, causing the umbilical cord to entangle the shoulder. Although the fetal body is aligned with the birth canal and the head is in the correct position, delivery cannot proceed despite partial emergence. The mother should lie supine, and the midwife should gently push the fetus upward. Using the middle finger to press on the fetal shoulder, the midwife should disengage the umbilical cord. After a brief pause, delivery will occur.
Prolapsed intestine during childbirth occurs due to the mother's chronic Qi deficiency and excessive straining during labor, causing Qi and Blood to sink downward, leading to the prolapse of the intestines along with the fetus. The treatment involves placing the prolapsed intestines in a clean, intact lacquerware vessel. A concentrated decoction of Huangqi Tang (Astragalus Decoction) should be prepared and allowed to cool to a warm temperature for soaking the intestines to moisten them. Once the placenta is fully expelled, the mother should lie supine and inhale deeply to draw Qi upward. The midwife, with hands coated in sesame oil, should slowly return the intestines to their proper position. It is advisable to administer a large dose of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (see formula under the section on Bladder Prolapse). Another method involves applying castor seeds (nineteen kernels, shelled and pounded into a paste) to the crown of the mother's head. Once the intestines have retracted, wash the area immediately with water. Yet another method uses half a cup of vinegar mixed with seven parts fresh well water, splashed suddenly onto the mother's face or back, which causes the intestines to contract. Each splash induces a contraction; three splashes result in three contractions, until the intestines are fully retracted. (Caution: This method risks dispersing Qi due to shock, potentially causing other ailments, and must be used with extreme care.) If the tip of the prolapsed intestine dries out due to wind exposure and cannot be retracted, moisten it slightly with water used for sharpening knives. Prepare a separate cup of Huo Cishi Tang (Live Magnetite Decoction) and have the mother drink it; the intestines will naturally retract.