妊娠至临月，当安神定虑，时常步履，不可多睡、饱食、过饮、酒醴、杂药。欲产时，不可多人喧
闹怆惶。若见浆水，腰间痛甚，是胎已离经，方可用药催生、坐草。不可早服催生药、早坐草。
临蓐切忌饮酒。酒性多热，口鼻出血，多致不救，急与二四汤加行血药、入童便治之。
凡儿在腹，男负阳背阴，女负阴背阳，首上足下，临产侧转顺出。其有横生逆产之患者，因产母忍
痛，曲腰眠卧，不肯舒伸行动，倒运不转故也。坐草不宜太早，须再扶行运动，方免祸患。徒及气血不足，
则误矣！若产顿迟难者，此方可归罪于气血也。
临产切戒惊吓，致产妇恐怖气怯，上闭下胀，气乃不行，不候时至，妄乱用力，逼儿错路，以取前
祸。譬如登厕，时候未至，用力何益。急用紫苏饮以宽气。
临产腹痛，而不甚痛者，产未至也，切勿使稳婆探候。虽脐腹痛，犹当熟忍，扶挟而行，凭物而
立，须候腰腹痛极不已，谷道如挺并，目中火生，胞水已破，尺脉切如绳珠之状，盒饭顺产。若有横逆倒
生，皆由先期动手，风入产户，以致肿胀，门户狭小干涩故也。脐带系于命门，儿将育时，两手动荡，使
带脱落，然后得出，安得不痛乎？谚曰“瓜熟蒂落，栗熟自出”，此喻最善。若夏时之盛暑，宜深屋宇，
多贮清水，预防血晕不省之患。若值盛寒，多宜闭户，生火向暖，下部宜浓衣覆裹，庶免贻寒血结之患矣。
凡临月忽然腹痛，或作或止，或三四日，或数日，胎水下而痛不急者，名曰弄胎，非产也，不必药治。
妊娠临产，胞水未破而血先下，此是伤胎。腹不痛者，八物汤与安胎饮治之。若胞水已破，此是欲
产，宜服紫苏饮，以生其气血也。
妊娠，或足月，忽然腹痛，似欲生产，却又无事，名曰试产，非产也。不问胎水来与不来，但宽心
等候时至，服紫苏饮加枳壳理之。
临蓐胎水放尽而胎不下，以无忧散加紫苏服之。或胎肥气逆，母瘦血少，亦宜用此方。
凡妇有十产之症，子母须臾者为生，收生不可不慎也。月满、腰痛、谷道挺并、浆破、血下，用药
攻催，谓之催生。
严寒天气，血凝产道，儿不能生，谓之冻产；盛暑时月，热气逼蒸，昏晕如醉，而不能生者，谓之热
产；月份不足谓之半产；有胎即堕，谓之小产；坐草太早，努力过多，儿身倒运不转，先露足者，谓之逆
产；先露手者，谓之横产；儿头或注一边者，谓之偏产；若脐带绊住儿肩，谓之凝产；倘子肠先出，名盘
肠产；或腹痛时作时止，浆水淋漓，名曰试产；临产坐着一物，抵住儿头，不能生动，谓之坐产。此皆不
明生育之理，临产仓皇，致有此等，保产者能不预为讲明乎？
偷生与村姑等妇，无难产者，有妊时运动不惜，临产又不能不忍故也。
《金匮要略》曰∶新产妇人有三病∶一者病痉，二者病郁冒，三者大便难。皆因气血虚耗，内亡津液，肠
胃干涸，故有此症。其脉微弱，呕不能食，大便坚，头汗出。如此者，血虚而厥上，故冒；冒欲解，故大
汗出；以血虚下厥，孤阳上出，故头汗出。所以产妇喜汗出者，亡阴，血虚阳盛，故当汗出；阳盛阴虚，
所以大便坚，呕而不能食也。
难产者，以白芷散治之。甚者，不过再服。
【白芷散】百草霜 白芷
为末，用童便、酒煎，热服。
凡交骨不开，产门不闭，子宫不收三证，皆由元气素弱，胎前失于调理，致血气不能运耳。然交骨
不开者，阴血虚也，佛手散加龟版；产门不闭者，气血虚也，十全大补汤加五味子收之；子宫不收者，补
中益气加醋炒白芍、五味子。
如初产，肿胀，痛而不闭者，补中汤加半夏、茯苓以健脾，使元气复而诸疾自愈，切忌寒凉之剂。
又曰，交骨不开者，阴气虚也。龟为至阴，则交错相解，故用之。
妊娠到了临近预产期的时候，应当安定心神、消除顾虑，经常散步走动，不可多睡、饱食、过量饮水、饮酒或服用杂药。将要分娩时，不可让多人喧闹惊慌。如果见到羊水流出（浆水），腰部疼痛剧烈，这是胎儿已经脱离经络位置（胎已离经），才可以用药催产、上产床待产。不可过早服用催产药、过早躺上产床。临产时切忌饮酒。酒性多热，若导致口鼻出血，大多难以救治，急需给予二四汤加入行血药物，并兑入童便来治疗。
凡是胎儿在腹中，男婴背负阳气而背部朝阴，女婴背负阴气而背部朝阳，头部向上脚部向下，临产时侧身转动顺产出世。如果有横生逆产等难产情况，是因为产妇忍受疼痛，弯腰蜷卧睡觉，不肯舒展身体活动，导致胎位倒转无法转动之故。上产床不宜太早，必须再搀扶行走运动，才能避免祸患。若是等到气血不足时才处理，那就误事了！如果产程突然迟缓困难，这就可以归咎于气血虚弱了。
临产时切戒惊吓，以免产妇恐惧气怯，导致上部闭塞下部胀满，气机运行不畅，不等待时机到来就胡乱用力，逼迫胎儿走错路径，从而招致前面的祸患。譬如上厕所，时候未到，用力有什么益处？急需使用紫苏饮来宽理气机。
临产腹痛，但疼痛并不剧烈的，说明生产尚未真正开始，切勿让接生婆探视检查。即使是脐腹部疼痛，也应当忍耐，搀扶挟持着行走，靠着物体站立，必须等到腰腹部疼痛极度不止，肛门有下坠挺出感，眼中似有火生，羊水已破，尺脉切之如绳珠般紧实圆滑的样子，才应当顺产。如果有横生、逆生、倒生，都是因为提前动手干预，风邪侵入产户，导致肿胀，门户狭小干涩之故。脐带系于命门，胎儿即将孕育成熟时，两手晃动，使脐带脱落，然后才能出来，怎么能不痛呢？谚语说“瓜熟蒂落，栗子熟了自然掉落”，这个比喻最好。如果是夏季盛暑时节，宜住在深屋宇内，多储备清水，预防血晕昏迷的祸患。如果遇到严寒，多宜关闭门窗，生火取暖，下部宜穿厚衣覆盖包裹，以免遗留寒凝血结的祸患。
凡是临近预产期忽然腹痛，或作或止，或持续三四天，或几天，胎水下流但疼痛不急迫的，名叫弄胎，不是真正的生产，不必用药治疗。
妊娠临产，羊水未破而血先流出，这是伤胎。腹部不痛的，用八物汤与安胎饮治疗。如果羊水已破，这是将要生产，宜服用紫苏饮，以滋生其气血。
妊娠，或者足月，忽然腹痛，似乎要生产，却又无事发生，名叫试产，不是真正的生产。不问胎水来与不来，只要放宽心等候时机到来，服用紫苏饮加枳壳调理。
临产时胎水流尽而胎儿不下，用无忧散加紫苏服用。或者是胎儿肥胖气逆，母亲瘦弱血少，也适宜用此方。
凡是妇女有十种产症，母子片刻之间出生的为正常生产，接生不可不谨慎。月份已满、腰痛、肛门挺并、羊水破裂、见血，用药攻逐催生，叫做催生。
严寒天气，血液凝滞产道，胎儿不能生出，叫做冻产；盛暑时节，热气逼蒸，昏晕如醉而不能生出的，叫做热产；月份不足而生下的叫做半产；有胎即堕落的叫做小产；上产床太早，努力过多，胎儿身体倒转无法转动，先露出脚的，叫做逆产；先露出手的，叫做横产；胎儿头偏向一边的，叫做偏产；如果脐带绊住胎儿肩膀，叫做凝产；倘若子肠先出来，名叫盘肠产；或者腹痛时作时止，浆水淋漓，名叫试产；临产时坐着一物，抵住胎儿头，不能移动，叫做坐产。这都是不明白生育的道理，临产时仓皇失措，导致有此等情况，保产的人能不预先讲明吗？
偷生（指民间俗语中的轻松生产）与村姑等妇女，没有难产的，是因为怀孕时运动不惜力，临产时又不能不忍痛坚持的缘故。
《金匮要略》说：新产妇人有三病：一是病痉，二是病郁冒，三是大便难。都是因为气血虚耗，体内津液亡失，肠胃干涸，所以有此症状。其脉微弱，呕吐不能进食，大便坚硬，头部出汗。像这样的情况，是血虚导致厥逆上行，所以出现郁冒；郁冒想要解除，所以大汗出；因为血虚下部厥冷，孤阳上出，所以头部出汗。所以产妇喜欢汗出的，是因为亡阴，血虚阳盛，所以应当汗出；阳盛阴虚，所以大便坚硬，呕吐而不能进食。
研为细末，用童便、酒煎煮，热服。
凡是交骨不开、产门不闭、子宫不收这三证，都是由元气素来虚弱，胎前失于调理，导致血气不能运化所致。然而交骨不开的，是阴血虚，佛手散加龟版；产门不闭的，是气血虚，十全大补汤加五味子收敛；子宫不收的，用补中益气汤加醋炒白芍、五味子。
如果是初产，肿胀，痛而不闭的，用补中汤加半夏、茯苓以健脾，使元气恢复而诸疾自愈，切忌寒凉之剂。
又说，交骨不开的，是阴气虚。龟为至阴之物，则交错相解，所以使用它。
When pregnancy reaches the term near delivery, one should calm the mind and eliminate anxiety, walking frequently. One must avoid excessive sleep, overeating, drinking too much water, consuming alcohol (Jiu), or taking miscellaneous medicines. When labor is imminent, there should be no noise or panic from many people. If amniotic fluid (Yang Shui) appears and severe lower back pain occurs, this indicates that the fetus has detached from its meridian position (Tai Yi Li Jing), at which point medication to induce labor and lying on the birthing bed can be used. One must not take labor-inducing drugs too early nor lie on the birthing bed prematurely. Drinking alcohol is strictly forbidden during labor. Alcohol has a hot nature; if it causes bleeding from the mouth and nose, it is often incurable. Urgently administer Er Si Tang with blood-activating herbs and add child's urine (Tong Bian) for treatment.
Generally, while in the womb, male fetuses carry Yang energy on their backs facing Yin, and female fetuses carry Yin energy on their backs facing Yang, with heads up and feet down. During delivery, they turn sideways to exit smoothly. Difficulties such as transverse or breech presentations occur because the mother endures pain by bending her waist and sleeping curled up, refusing to stretch and move, causing the fetal position to invert and fail to rotate. Lying on the birthing bed should not be done too early; one must continue to walk and move under support to avoid disaster. If action is delayed until Qi and Blood are depleted, it is already too late! If labor suddenly becomes slow and difficult, this can be attributed to deficiency of Qi and Blood.
During labor, one must strictly avoid fright, which causes fear and timidity in the mother, leading to upper blockage and lower distension, stagnation of Qi movement, and reckless exertion before the proper time. This forces the fetus onto the wrong path, causing previous disasters. It is like straining to defecate before the time is right; what good does it do? Urgently use Zi Su Yin to regulate Qi.
If there is abdominal pain during labor but it is not severe, true labor has not yet begun. Do not allow midwives to perform internal examinations. Even if there is umbilical abdominal pain, one should endure it patiently, walking with support, standing leaning against objects. One must wait until lower back and abdominal pain are extreme and unceasing, the anus feels protruding, eyes feel fiery, amniotic fluid has ruptured, and the Chi pulse feels tight and round like beads on a string, before proceeding with natural delivery. Transverse, inverted, or breech births are all due to premature intervention, allowing Wind pathogens to enter the birth canal, causing swelling and making the passage narrow and dry. The umbilical cord is tied to the Mingmen (Gate of Life). When the fetus is ready to be born, its hands move, causing the cord to detach, after which it emerges. How could this not be painful? As the proverb says, "When the melon is ripe, it falls off the vine; when the chestnut is ripe, it drops out naturally." This analogy is excellent. In the height of summer, one should stay in deep houses, store plenty of clean water, and prevent complications like blood syncope and unconsciousness. In severe cold, keep doors and windows closed, generate fire for warmth, and cover the lower body with thick clothing to avoid cold coagulating blood.
If sudden abdominal pain occurs near the term, intermittent, lasting three or four days or more, with amniotic fluid leaking but pain not urgent, it is called "Nong Tai" (Playing Fetus), not true labor, and requires no medication.
If vaginal bleeding occurs before the rupture of amniotic fluid during labor, it indicates fetal injury. If there is no abdominal pain, treat with Ba Wu Tang and An Tai Yin. If the amniotic fluid has ruptured, it indicates impending labor; take Zi Su Yin to nourish Qi and Blood.
If a pregnant woman, even at full term, suddenly experiences abdominal pain resembling labor but nothing happens, it is called "Shi Chan" (Trial Labor), not true labor. Regardless of whether amniotic fluid is present, wait calmly for the proper time and take Zi Su Yin with Zhi Qiao to regulate.
If amniotic fluid is exhausted but the fetus does not descend, use Wu You San with Zi Su. This formula is also suitable for cases where the fetus is large with rebellious Qi, or the mother is thin with scanty Blood.
There are ten types of deliveries described. Rapid delivery of mother and child within moments is normal birth; midwives must be cautious. When the month is full, with lower back pain, anal protrusion, ruptured membranes, and bleeding, using drugs to induce labor is called "Cui Chan".
In severe cold, blood coagulates in the birth canal, preventing the fetus from being born; this is called "Dong Chan" (Frozen Birth). In the heat of summer, steaming heat causes fainting and drunkenness, preventing birth; this is called "Re Chan" (Hot Birth). Birth before the full month is called "Ban Chan" (Half Birth). Abortion due to existing pregnancy is called "Xiao Chan" (Small Birth). Lying on the birthing bed too early, excessive straining, fetal inversion failing to rotate, presenting feet first, is called "Ni Chan" (Reverse Birth). Presenting hands first is called "Heng Chan" (Transverse Birth). Head presenting to one side is called "Pian Chan" (Lateral Birth). Umbilical cord entangling the fetal shoulder is called "Ning Chan" (Coagulated Birth). Prolapse of the uterus/intestine before the baby is called "Pan Chang Chan" (Placenta-like Intestine Birth). Intermittent abdominal pain with dripping fluids is "Shi Chan" (Trial Birth). Sitting on an object blocking the fetal head is called "Zuo Chan" (Sitting Birth). These result from ignorance of reproductive principles and panic during labor. Those who protect childbirth must explain these beforehand.
Easy births among village women occur because they exercise without sparing effort during pregnancy and endure pain persistently during labor.
The *Jin Gui Yao Lue* states: New mothers have three diseases: 1. Spasm (Jing), 2. Depression and Dizziness (Yu Mao), 3. Difficulty with bowel movements. These are due to depletion of Qi and Blood, loss of body fluids, and dryness of the stomach and intestines. The pulse is weak, vomiting prevents eating, stool is hard, and there is sweating only on the head. In such cases, Blood deficiency leads to Jue rebellion upwards, causing dizziness; as dizziness resolves, profuse sweating occurs; due to Blood deficiency causing lower Jue, solitary Yang rises, causing head sweating. Therefore, postpartum women welcome sweating because Yin is lost, Blood is deficient, and Yang is abundant, so sweating is expected; Yang abundance and Yin deficiency lead to hard stool and vomiting.
For difficult labor, treat with Bai Zhi San. Severe cases may require a second dose.
[Bai Zhi San] Bai Cao Shuang (Soot from Kitchen Chimney), Bai Zhi (Angelicae Dahuricae Radix)
Grind into powder. Decoct with child's urine (Tong Bian) and wine (Jiu), and take hot.
For three conditions: non-opening of the pubic symphysis (Jiao Gu Bu Kai), non-closing of the birth canal (Chan Men Bu Bi), and uterine prolapse (Zi Gong Bu Shou), all stem from inherent weakness of Yuan Qi and lack of regulation during pregnancy, leading to failure of Qi and Blood circulation. Non-opening of the pubic symphysis is due to Yin Blood deficiency; treat with Fo Shou San plus Gui Ban (Testudinis Carapax et Plastrum). Non-closing of the birth canal is due to Qi and Blood deficiency; treat with Shi Quan Da Bu Tang plus Wu Wei Zi (Schisandrae Chinensis Fructus) to astringe. Uterine prolapse is treated with Bu Zhong Yi Qi Tang plus Cu Chao Bai Shao (Vinegar-fried Paeoniae Radix Alba) and Wu Wei Zi.
For primiparas with swelling, pain but no closure, use Bu Zhong Tang plus Ban Xia (Pinelliae Rhizoma) and Fu Ling (Poria) to strengthen the Spleen, restoring Yuan Qi so diseases heal themselves. Strictly avoid cold-cooling agents.
It is also said that non-opening of the pubic symphysis is due to Yin Qi deficiency. Turtle (Gui) is of extreme Yin nature, thus resolving the interlocking; therefore, it is used.