妇人孕子如鸡覆卵相似，雏在卵壳中临出雏乃自家破卵壳而出。儿在胞胎中临生，
乃儿自吮开胞衣而生，其有艰难延久者，多为胞衣太浓，胎气肥大故也。如孕子者，勿
过安逸，勿浓奉养，勿多淫欲，自然胞衣不浓，胎气不肥，产自不难，且于子嗣有益。
妇人以血为主，惟气顺则血和，胎安则产顺，今富贵之家，过于安逸，以致气滞而
胎不转，过多交合，使精血聚于胞中，皆致难产也，生化汤主之。
有产累日不下，服催生药不验，此必坐草太早，心惧而气结不行也。《经》云∶恐
则气下，恐则精怯，怯则上焦闭，闭则气还，还则下焦胀气乃不行，宜温补气血，壮而行之。
胞浆先破，恶水来多，胎干不得下，先与四物，佐以四君，补养气血，次煎浓葱
汤，令稳婆洗产户，使气上下通畅，更用酥油、滑石涂产门，次服催生保产万全汤。
难产有因母气盛；胎肥而难产者，有因母气弱血枯而难产者，悉是平时不善调摄，
或七八月而犯房室，致污浊凝滞，不得顺生，大法以顺气和血为主。如浆干不下者，
滋润为主。污血阻滞者，逐瘀为主。加坐草用力太早，胞水干者，滑胎散、神应散，连
进大剂，如鱼得水自顺矣。
难产治法，或开滑子宫，或通调上下之气，或滋养气血，当随机应变，若胎死腹
中，惟有下法，平胃散加朴硝以下秽水。如肢体倦怠，急以四君、四物加姜桂调补之，
更宜去川芎加牛膝、红花、益母尤妙。
立斋曰∶交骨不开，产门不闭，子宫不
收三证，皆由元气素弱，胎前缺于调理，致气血不能运用而然。交骨不开者，阴血虚
也，佛手散加发灰、龟板。产门不闭者，气血虚也，十全大补汤，加五味子收之。子宫
不闭者，补中益气，加醋炒白芍、五味。如初产肿胀痛而不闭者，加味逍遥散。若肿既
消而不闭者，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，板则交错相解，故用之。又有开骨膏、明乳香
一两，五月五日研细，猪血为丸，如鸡豆大，朱砂为衣，加味佛手散送下。单养贤
曰∶产后见此三证，总服生化汤，如交骨不开，加龟板一枚，生化汤者，芎、归、桃
仁、黑姜、炙草，善化恶血，骤生新血而得名，为产后圣药。《经疏》云∶临产交骨不
开，惟浓者梓木枝汤饮之自开。（梓木俗名一叶一刺，其木枝干直上，每一叶下必发一刺者是也。）
盘肠生是母气血虚弱，因而下脱，当用补气血之药，兼以升提，则肠自收，大剂参
归芎加升麻主之。有以醋水喷面，使妇人惊寒，则气提而肠缩，恐惊则气散，寒则血
凝，愈难收而致病矣。不若皂角末吹鼻，嚏作自上也。
生者，言欲产时，儿头至产门，方服药催之。或经日久，产母困倦难生，宜服
药以助血气，令儿速生也。大法滑以通滞涩，苦以驱逐闭塞，温以调幔诸经，香以开
窍逐血，胞浆先破，气滞血干者，滋补精血以行之，然妇人气弱无力，或日久困倦，而
不能送子出产门者，须倍服人参，此药能兼治横生、倒产，催生保生之第一药也。
妇女怀胎如同母鸡孵蛋，雏鸟在蛋壳中，临近孵化时自然啄破蛋壳而出。胎儿在胞胎中，临产时也是胎儿自己吮开胞衣而出生。那些分娩艰难、拖延时间久的，大多是因为胞衣太厚，胎儿过大所致。如果孕妇能注意：不要过于安逸，不要过度进补营养，不要纵欲，自然胞衣不会太厚，胎儿不会过大，生产就不会困难，而且对生育后代也有益处。
妇女以血为本，只有气机顺畅则血液调和，胎元安稳则生产顺利。如今富贵人家，过于安逸，导致气机阻滞而胎位不转；过多行房事，使精血聚积于胞宫，都会导致难产，可用生化汤治疗。
有的产妇劳累数日胎儿仍不下，服用催生药无效，这一定是因为坐草（上产床待产）太早，心中恐惧导致气结而不行。《黄帝内经》说：“恐则气下，恐则精怯”，精气怯弱则上焦闭塞，闭塞则气还归，还归则下焦胀满，气机因此不行。适宜温补气血，壮盛正气以推动运行。
如果胞浆先破，羊水流出过多，胎儿干燥无法下行，先给予四物汤，配合四君子汤，补养气血；随后煎煮浓葱汤，让接生婆清洗产道，使气机上下通畅；再用酥油、滑石涂抹产门；最后服用催生保产万全汤。
难产有因母体气盛、胎儿肥大而难产的，有因母体气弱、血枯而难产的，这都是平时不善调养，或在怀孕七八个月时犯房事，导致污浊凝滞，不能顺产。大法以顺气和血为主。如羊水干涸胎儿不下者，以滋润为主。污血阻滞者，以逐瘀为主。加上坐草用力太早，胞水干涸者，用滑胎散、神应散，连续服用大剂量，如鱼得水般自然顺产。
难产的治疗方法，或开通润滑子宫，或通调上下之气，或滋养气血，应当随机应变。如果胎死腹中，唯有使用下法，用平胃散加朴硝以下除秽浊之水。如果肢体倦怠，急用四君子汤、四物汤加生姜、肉桂调补；更宜去掉川芎，加入牛膝、红花、益母草，效果更佳。
薛立斋说：交骨不开、产门不闭、子宫不收这三种证候，都是因为元气素来虚弱，产前缺乏调理，导致气血不能运用所致。交骨不开，是阴血虚，用佛手散加发灰、龟板。产门不闭，是气血虚，用十全大补汤，加五味子收敛。子宫不收，用补中益气汤，加醋炒白芍、五味子。如果是初产肿胀疼痛且不闭者，用加味逍遥散。如果肿胀已消但不闭者，用补中汤加半夏、茯苓以健脾，使元气恢复而诸病自愈，切忌使用寒凉药剂。又说：交骨不开，是阴气虚，龟为至阴之物，龟板纹理交错相解，所以用它。又有开骨膏，明乳香一两，五月五日研细，猪血为丸，如鸡豆大小，朱砂为衣，用加味佛手散送服。单养贤说：产后出现这三种证候，总服生化汤，如交骨不开，加龟板一枚。生化汤由川芎、当归、桃仁、黑姜、炙甘草组成，善于化除恶血，迅速生成新血而得名，是产后圣药。《医宗金鉴·医疏》说：临产交骨不开，只喝梓木枝汤自然会开。（梓木俗名一叶一刺，其木枝干直上，每一叶下必发一刺的是它。）
盘肠生是因为母体气血虚弱，因而子宫下垂脱出，当用补气血的药物，兼以升提，则肠自会收回，用大剂量人参、当归、川芎加升麻主治。有人用醋水喷脸，使妇人惊惧受寒，则气提而肠缩，但恐怕惊则气散，寒则血凝，更难收回而致病。不如用皂角末吹入鼻中，打喷嚏后自然上升收回。
“生”字，意指临产时，胎儿头部到达产门，才服药催产。或者经过日子太久，产母困倦难以生产，宜服药以助血气，令胎儿速生。大法：滑以利通滞涩，苦以驱逐闭塞，温以调幔诸经，香以开窍逐血。胞浆先破，气滞血干者，滋补精血以推动之。然而妇人气弱无力，或日久困倦，而不能送子出产门者，须加倍服用人参，此药能兼治横生、倒产，是催生保生的第一要药。
Pregnancy in women is like a hen incubating an egg; the chick, inside the shell, pecks its way out naturally when ready to hatch. Similarly, the fetus, within the amniotic sac, breaks through the membranes on its own at the time of birth. Cases of difficult or prolonged labor are mostly due to the amniotic sac being too thick or the fetus being too large. If pregnant women avoid excessive leisure, over-nourishment, and sexual indulgence, the amniotic sac will not be overly thick, nor will the fetus become excessively large, making delivery easier and benefiting future offspring.
Women's health is primarily based on blood; only when Qi flows smoothly does blood harmonize, and only when the fetus is secure is delivery smooth. Nowadays, wealthy families often indulge in excessive comfort, leading to Qi stagnation and fetal immobility, or engage in frequent intercourse, causing essence and blood to accumulate in the uterus, all resulting in dystocia (difficult childbirth). The Shenghua Tang (Blood-Generating Decoction) is indicated.
In cases where labor has dragged on for days without delivery despite taking parturition-inducing medicines, it is likely because the woman went to bed too early, and fear caused Qi to knot and cease moving. The Classic states: "Fear causes Qi to sink, and fear makes essence timid." Timidity leads to closure of the Upper Jiao (Upper Burner), which causes Qi to return, leading to distension in the Lower Jiao (Lower Burner) and cessation of Qi movement. It is appropriate to warm and tonify Qi and Blood, strengthening the body's vital energy to promote movement.
If the amniotic fluid breaks prematurely with excessive leakage, causing the fetus to dry out and fail to descend, first administer Siwu Tang (Four Substances Decoction) combined with Sijunzi Tang (Four Gentlemen Decoction) to tonify Qi and Blood. Then, decoct a strong scallion water for the midwife to wash the vaginal opening, ensuring the free flow of Qi up and down. Apply sesame butter and talcum powder to the vulva, followed by administering the Cui Sheng Bao Chan Wan Quan Tang (Ten Thousand Complete Parturition-Inducing and Protection Decoction).
Dystocia may result from maternal excess Qi and a large fetus, or from maternal deficiency Qi and depleted Blood. These are all due to poor daily regulation or engaging in intercourse during the seventh or eighth month of pregnancy, causing turbid stagnation that prevents natural delivery. The general principle is to soothe Qi and harmonize Blood. In cases of dried amniotic fluid preventing descent, moisten and lubricate. For obstruction by stagnant blood, expel stasis. If premature pushing dries the amniotic waters, use Hua Tai San (Slippery Fetus Powder) and Shen Ying San (Miraculous Response Powder), administered in large doses continuously, allowing the delivery to proceed as naturally as fish in water.
Treatment methods for dystocia include opening and lubricating the uterus, regulating Qi up and down, or nourishing Qi and Blood, adapting to circumstances. If the fetus is dead in the womb, purgative methods are necessary; use Pingwei San (Stomach-Ping Powder) with Mangxiao (Natrii Sulfas) to purge turbid fluids. If limbs are fatigued, urgently tonify with Sijunzi Tang and Siwu Tang plus Ginger and Cinnamon. It is better to remove Chuanxiong and add Niuxi (Achyranthes Root), Honghua (Safflower), and Yimucao (Motherwort Herb) for superior effect.
Xue Lizhai stated: The three syndromes of unopened pubic symphysis (Jiao Gu), non-closing vaginal introitus, and uterine prolapse are all caused by inherent weakness of Yuan Qi (Original Qi) and lack of prenatal regulation, leading to inability of Qi and Blood to function. Unopened pubic symphysis indicates Yin Blood deficiency; use Foshou San (Buddha's Hand Powder) with Fa Hui (Hair Ash) and Gui Ban (Tartar Testudinis). Non-closing vaginal introitus indicates Qi and Blood deficiency; use Shiquan Dabu Tang (Ten Thousand Great Tonifying Decoction) with Wuweizi (Schisandra Fruit) to astringe. Uterine prolapse requires Bu Zhong Yi Qi Tang (Center-Supplementing and Qi-Boosting Decoction) with Vinegar-fried Baishao (White Peony Root) and Wuweizi. For initial swelling and pain with non-closure, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If swelling subsides but closure fails, use Bu Zhong Tang with Banxia (Pinellia Tuber) and Fuling (Poria) to strengthen the Spleen, restoring Yuan Qi so diseases heal themselves; strictly avoid cold-cooling agents. He further stated: Unopened pubic symphysis is due to Yin Qi deficiency. The turtle is the ultimate Yin entity, and its shell's interlocking structure helps separate bones, hence its use. There is also Kaigu Gao (Bone-Opening Paste): 1 liang of Ming Ru Xiang (Frankincense), finely ground on the fifth day of the fifth lunar month, formed into pills the size of a soybean with pig blood, coated with Zhusha (Cinnabar), taken with Jiawei Foshou San. Shan Yangxian said: If these three syndromes appear postpartum, generally administer Shenghua Tang; for unopened pubic symphysis, add one Gui Ban. Shenghua Tang consists of Chuanxiong, Danggui, Taoren (Peach Kernel), Heijiang (Charred Ginger), and Zhi Gancao (Honey-fried Licorice); it is named for its ability to transform evil blood and rapidly generate new blood, making it the sacred medicine for postpartum care. The *Yi Shu* states: For unopened pubic symphysis at labor, drinking Zimu Zhi Tang (Catalpa Branch Decoction) will naturally open it. (Zimu, commonly known as 'one leaf one thorn', has straight-growing branches with a thorn emerging under each leaf.)
"Pan Chang Sheng" (Intestine Prolapse at Birth) occurs due to maternal Qi and Blood deficiency causing downward prolapse. Treatment requires tonifying Qi and Blood combined with lifting herbs, so the intestine retracts naturally. Use a large dose of Renshen (Ginseng), Danggui, Chuanxiong, and Shengma (Cimicifuga Rhizome). Some suggest spraying vinegar water on the face to startle and chill the woman, causing Qi to rise and the intestine to retract. However, startling scatters Qi, and chilling congeals Blood, making retraction harder and causing disease. It is better to blow Zaojiao Mo (Gleditsia Sinensis Powder) into the nose; the resulting sneeze naturally lifts the tissue upward.
The term "Sheng" (Birth/Generation) refers to administering drugs only when the fetal head reaches the vaginal introitus during labor. If labor is prolonged and the mother is exhausted, drugs should be given to boost Qi and Blood to facilitate rapid delivery. General principles: Slippery herbs unblock stagnation, bitter herbs drive away obstruction, warm herbs regulate the meridians, and aromatic herbs open orifices and expel blood. If amniotic fluid breaks early with Qi stagnation and Blood dryness, tonify Essence and Blood to promote movement. However, if the woman has weak Qi and no strength, or is exhausted after a long labor and cannot push the fetus out, Ren Shen (Ginseng) must be doubled. This herb can treat transverse lie and breech presentation, serving as the primary drug for inducing labor and protecting life.