〔《脉诀》〕欲产之妇脉离经，沉细而滑也同名。夜半觉时应分诞，来辰日午定知生。（《难经》云∶
脉一呼三至曰离经，一呼一至曰离经。《脉经》云∶妇人欲产，其脉离经，夜半觉，日中则生也。）身
重体热寒又频，舌下之脉黑复青，及舌上冷子当死，腹中须遣母归冥。面赤舌青细寻看，母活子死定
难应；唇舌俱青沫又出，子母俱死总高KT ；面青舌赤沫出频，母死子活定知真。不信若能看应验，寻
之贤哲不虚陈。
〔《大》〕十产论 一曰正产者，妇人怀胎，十月满足，忽腰腹作阵疼痛，相次胎气顿陷，至于脐腹，痛
极，乃至腰间重痛，谷道挺迸，继之浆破血出，儿子遂生，此名正产。
二曰伤产者，妇人怀胎，未产一月以前，忽然脐腹痛疼，有如欲产，仍却无事，是名试月，非正产也。但
一切产母未有正产之候，即不可令人抱腰，亦不可令产母妄乱用力。若儿身未顺，才方转动，便教
产母虚乱用力，使儿子错落，忽横忽倒，不能正生，皆缘产母用力于未当用力之所致也。直待儿子身顺，
临逼门户，方始用力一送，令儿下生。此名伤产。
上伤产一法，最为切要，慎勿轻忽也。凡十月未足，临产腹痛，或作或止，或痛不甚者，名曰
弄痛，非正产之候。或腹虽痛甚而腰不甚者，非正产之候。胎高未陷下者，非正产之候。谷道未挺迸者，
非正产之候。水浆未破血未出者，非正产之候。浆血虽出而腹不痛者，非正产之候。凡未有正产候，且
令扶行熟忍，如行不得，或凭物坐之，或安卧之，或服安胎药一二服得安即止，慎勿妄服催生药饵。
怆惶，致令产母忧恐而挫其志，务要产母宽心存养调停，亦令坐婆先说解谕之。如觉心中烦闷，可取白
蜜一匙，新汲水调下，切勿妄乱用力，先困其母。直待子逼门户，腰重痛极，眼中如火，谷道挺迸时，
是正产候，方可用力，并服催生药也。予男妇于未产一月以前，腰腹俱痛，全似将产，其痛至甚，但遇巳
牌稍止。如此者将十余日，计无所出，因阅此条遂与安胎药，加参、术数服，间与肉味养之，由是平
复不痛。又二十余日，始产一男。是时若妄动乱用力，并服催生等药，立见危亡矣。
三曰催产者，若妇欲产，浆破血下，已见是正产候，但却未生，即可服催生药以催之。忽有经及
数日，产母困苦，亦可服药助产母之正气，令儿速生，此名催生。
四曰冻产者，冬月天冷，产母经血得冷则凝，以致儿子不能生下，此害最深。若冬月产者，下部不
可脱去绵衣，并不可坐卧寒处。当满房着火，常有暖气。令产母背身向火，令脐下腿膝间常暖，血得热
则流散，使儿易生，此名冻产。
五曰热产者，盛夏之月，产妇要温凉得所，不可恣意取凉，伤损胎气。亦不可人多，热气逼袭产母，使产
母血沸，而有发热，头痛，面赤，昏昏如醉，乃至不知人事，此名热产。
六曰横产者，儿先露手，或先露臂，此由产母未当用力而用之过也。儿身未顺，用力一逼，遂
至身横不能生下，当令产母安然仰卧，后令看生之人，先推其手令入直上，渐渐逼身，以中指摩其肩，推
上而正之，或以指攀其耳而正之。须是产母仰卧，然后推儿徐徐正之。候其身正，煎催生药一盏，吃
了方可用力，令儿下生，此名横产。
七曰倒产者，产母胎气不足，关键不牢，用力太早，致令儿子不能回转，便直下，先露其足。当
令产母仰卧，令看生之人，推其足入去，不可令产母用分毫力，亦不得惊恐，使儿自顺云。
八曰偏产者，儿身未正，产母用力一逼，致令儿头偏拄左腿，或偏拄右腿，故头虽露，偏拄一畔，
不能生下。当令产母仰卧，次令看生之人轻轻推儿近上，以手正其头，令儿头顶端正，然后令产母用
力一送，即便生下。若是小儿头后骨偏拄谷道，只露其额，当令看生之人以绵衣炙温裹手，于谷道外方
轻轻推儿头令正，便令产母用力送儿生也，此名偏产。
九曰碍产者，儿身已顺而露正顶，不能生下。盖因儿身回转，肚带攀其肩，以此露正顶而不能生。
当令产母仰卧，令看生之人轻推儿近上，徐徐引手，以中指按儿肩下，拨其肚带，仍须候儿身正顺，
方令产母用力一送，使儿生下，此名碍产。
上横产、倒产、偏产、碍产四法，若看生之人非精良妙手，不可根据用此法，恐恣其愚以伤人命也。
按倒产者，今世往往随其倒足生下，并无后患，子母双全，不必根据推足上之法亦可。又碍产者，往往
肚带有缠在儿顶上，而儿头自出在产门外，看生之人，以手拨其肚带，从儿头顶过而下之者，又有
肚带缠在顶上一匝，而儿与胞衣自然同下者，皆无妨。不必以此碍产法入产门里拨下之也。
十曰坐产者，言欲临产时，高处系一手巾，令产母以手攀之，轻轻屈足坐身，令儿生下，非坐在
物上也，此名坐产。
十一曰盘肠产者，赵都运恭人，每产则大肠先出，然后产子，产后其肠不收，甚以为苦，名曰盘肠产。医
不能疗。偶在建昌，得一坐婆施一法而收之，其法以醋半盏，新汲冷水七分，调停 产母面，每 一缩，三
收尽，此良法也。
〔丹〕产后肠不收。香油五斤，煎热盛盆，俟温，坐油盆中，约一顿食时，以皂角末吹入鼻中，嚏作
立上，妙。（《斗门》）
〔《大》〕半夏为末，搐鼻中，则肠上矣。又方。以大纸捻蘸香油，点灯吹灭，以烟熏产母鼻中，
肠即上矣。又方，以蓖麻子十四粒，去壳，研如膏，贴产母头顶中心，肠上，即减去。
【《脉诀》】即将临产的妇女，其脉象表现为离经之脉，即沉细而兼滑。若在半夜感觉到这种脉象变化，应当在此时分娩；若到中午时分，则确定会生产。（《难经》说：脉搏一呼跳动三次称为离经，一呼跳动一次也称为离经。《脉经》说：妇人将要生产，脉象离经，如果在半夜感觉到，到日中时就会生产。）如果身体沉重、发热且频繁发冷，舌下脉络呈现黑色兼青色，以及舌上发冷，胎儿将会死亡，母亲也会陷入冥界（死亡）。面色赤红而舌色青紫，仔细审视，可知母亲存活而胎儿死亡，这很难应对；如果嘴唇和舌头都发青，且有泡沫流出，则母子俱死，总是难以挽救；如果面色青紫而舌色赤红，泡沫频频流出，则母亲死亡而胎儿存活，这是确定的真相。如果不相信，若能观察这些征验，寻找贤哲的论述，是不会虚假空谈的。
【《大》】十种产法论：第一种叫正产，指妇人怀胎十月满足，忽然腰腹部阵痛，接着胎气突然下降，直到脐腹部位，疼痛达到极点，甚至腰部重痛，肛门挺出迸裂，随后羊水破裂、血液流出，儿子随即出生，这叫正产。
第二种叫伤产，指妇人怀孕未满一个月以前，忽然脐腹疼痛，好像要生产，但过后又没事了，这叫试月，不是正产。但是，所有产妇在没有出现正产征兆之前，不可让人抱住腰部，也不可让产妇胡乱用力。如果胎儿身体尚未顺位，刚刚转动，就教产妇虚弱混乱地用力，导致胎儿错位，忽横忽倒，不能正常出生，这都是因为产妇在不该用力的时候用力的缘故。必须等到胎儿身体顺位，临近产门，才开始用力一送，让胎儿生下。这叫伤产。
上述关于伤产的处理方法，最为关键重要，千万不要轻视。凡是十月未满，临产腹痛，或作或止，或疼痛不严重的，名叫弄痛，不是正产的征兆。或者腹部虽然疼痛剧烈但腰部不重的，不是正产的征兆。胎位高未下沉的，不是正产的征兆。肛门未挺出的，不是正产的征兆。羊水未破、血未出的，不是正产的征兆。羊水血液虽出但腹部不痛的，不是正产的征兆。凡是没有正产征兆的，暂且让产妇扶行并忍耐，如果无法行走，可依靠物体坐着，或安静躺卧，或服用一两服安胎药，得到安宁就停止，千万不要胡乱服用催生药物。惊慌失措，导致产妇忧恐而挫伤意志，务必让产妇宽心存养、调理停当，也让接生婆先解释开导她。如果觉得心中烦闷，可取白蜜一匙，用新汲水调服，千万不要胡乱用力，先使母亲困乏。必须等到胎儿逼近产门，腰部重痛至极，眼中如火，肛门挺出迸裂时，才是正产征兆，才可以用力，并服用催生药物。我的男妇亲属在产前一月以前，腰腹俱痛，完全像是要生产，疼痛非常剧烈，但每到巳牌时稍作停止。像这样的情况持续了十余天，无计可施，于是查阅此条内容，便给予安胎药，加入人参、白术数服，偶尔给予肉味滋养，因此平复不再疼痛。又过了二十多天，才生下一个男孩。当时如果妄动乱用力，并服用催生等药，立刻就会见到危险灭亡。
第三种叫催产，如果妇人想要生产，羊水破裂、血液下行，已经看到是正产征兆，但却未生出，即可服用催生药来催促它。如果有月经来潮及数日，产妇困苦，也可服药帮助产妇的正气，让胎儿快速出生，这叫催生。
第四叫冻产，冬季天气寒冷，产妇经血遇冷则凝结，导致胎儿不能生下，这种危害最深。如果是冬季生产，下部不可脱去棉衣，也不可以坐卧在寒冷处。应当在满屋生火，常有暖气。让产妇背身面向火，让脐下腿膝间常暖，血液得热则流动散开，使胎儿容易出生，这叫冻产。
第五叫热产，盛夏月份，产妇要温凉适宜，不可肆意贪凉，损伤胎气。也不可人数过多，热气逼迫袭击产妇，使产妇血液沸腾，而有发热、头痛、面赤、昏昏如醉，甚至不知人事，这叫热产。
第六叫横产，胎儿先露出手，或先露出臂，这是由于产妇在不该用力的时候过度用力所致。胎儿身体未顺，用力一逼，致使身体横置不能生下，应当让产妇安然仰卧，然后让接生的人，先推其手使其进入，直上，渐渐逼近身体，以中指摩擦其肩部，推上并矫正它，或以手指攀拉其耳朵并矫正它。必须是产妇仰卧，然后推儿徐徐矫正。等到身体端正，煎好一盏催生药，吃下后方可用力，让胎儿生下，这叫横产。
第七叫倒产，产妇胎气不足，关键不牢固，用力太早，导致胎儿不能回转，便直接向下，先露出其足。应当让产妇仰卧，让接生的人，推其足进去，不可让产妇用分毫力气，也不能惊恐，使胎儿自然顺位。
第八叫偏产，胎儿身体未正，产妇用力一逼，导致胎儿头偏拄左腿，或偏拄右腿，故头虽露出，偏拄一边，不能生下。应当让产妇仰卧，其次让接生的人轻轻推儿靠近上方，用手正其头，让胎儿头顶端正，然后让产妇用力一送，即便生下。如果是小儿头后骨偏拄肛门，只露出额头，应当让接生的人用绵衣炙温包裹手，在肛门外方轻轻推儿头令其端正，便令产妇用力送儿出生，这叫偏产。
第九叫碍产，胎儿身体已顺而露出正顶，不能生下。大概是因为胎儿身体回转，肚带攀住其肩，以此露出正顶而不能生。应当让产妇仰卧，让接生的人轻推儿靠近上方，徐徐引手，以中指按在儿肩下，拨动其肚带，仍须等待胎儿身体正顺，方才让产妇用力一送，使胎儿生下，这叫碍产。
上述横产、倒产、偏产、碍产四种方法，如果接生的人不是精良妙手，不可根据使用此法，恐怕放纵愚昧而伤害人命。按倒产者，当今世界往往随着倒足生下，并无后患，母子双全，不必根据推足上的方法也可以。又有碍产者，往往肚带有缠在儿顶上，而儿头自出在产门外，接生的人，以手拨开其肚带，从儿头顶过而下之的，又有肚带缠在顶上一匝，而儿与胞衣自然同下的，都没有妨碍。不必以此碍产法进入产门里拨下来的。
第十叫坐产，说想要临产时，在高处系一条手巾，让产妇以手攀之，轻轻屈足坐身，让胎儿生下，并非坐在物体上，这叫坐产。
第十一叫盘肠产，赵都运恭人，每次生产则大肠先出，然后产子，产后其肠不收，非常痛苦，名叫盘肠产。医生不能治疗。偶然在建昌，得到一个接生婆施加一种方法而收回它，其法是用醋半盏，新汲冷水七分，调和涂于产妇面部，每收缩一次，收三次尽，这是良法。
【丹】产后肠不收。香油五斤，煎热盛盆，待温，坐油盆中，约一顿饭的时间，以皂角末吹入鼻中，打喷嚏立起，妙。（《斗门》）
【《大》】半夏为末，搐鼻中，则肠上矣。又方。以大纸捻蘸香油，点灯吹灭，以烟熏产妇鼻中，肠即上矣。又方，以蓖麻子十四粒，去壳，研如膏，贴产妇头顶中心，肠上，即减去。
[From *Mai Jue* (Pulse Resolution)] For a woman about to give birth, the pulse is "Li Jing" (pulse deviating from the normal pattern), characterized as deep, fine, and slippery. If this pulse change is felt at midnight, delivery should occur then; if it persists until noon, birth is certain. (*Nan Jing* states: A pulse rate of three beats per exhalation is called Li Jing, and one beat per exhalation is also called Li Jing. *Mai Jing* states: When a woman is about to deliver, her pulse becomes Li Jing; if felt at midnight, she will deliver by midday.) If the body feels heavy, there is fever with frequent chills, the veins under the tongue are blackish-green, and the tongue feels cold, the fetus will die, and the mother will perish. If the face is red but the tongue is cyanotic, careful examination reveals that the mother survives while the fetus dies, a situation difficult to manage; if both lips and tongue are cyanotic and froth is expelled, both mother and fetus will die, generally incurable; if the face is cyanotic but the tongue is red, and froth flows frequently, the mother dies while the fetus survives, which is definitive. If one does not believe this, observing these signs according to the teachings of sages proves they are not empty talk.
[From *Da Yi Jing Cui*] Discussion on Ten Types of Delivery:
1. **Zheng Chan** (Normal Delivery): When a woman has carried the fetus for ten months, suddenly experiencing paroxysmal pain in the lower back and abdomen, followed by a sudden descent of fetal Qi down to the umbilical and abdominal regions. The pain reaches its peak, causing heavy pain in the waist and protrusion/bursting sensation in the anus. Subsequently, the amniotic sac ruptures and blood flows, and the infant is born. This is called Normal Delivery.
2. **Shang Chan** (Injurious Delivery): Occurs when a woman, less than one month before term, suddenly experiences umbilical and abdominal pain resembling labor, but then nothing happens. This is called "Shi Yue" (Testing Month) and is not true labor. However, before any signs of normal labor appear, no one should hold the mother's waist, nor should the mother exert force recklessly. If the fetus is not yet in position and merely shifting, instructing the mother to exert weak, chaotic force causes the fetus to dislocate, becoming transverse or inverted, unable to be born normally. This results from the mother exerting force at the wrong time. One must wait until the fetus is in position and approaching the cervix before exerting force to push the baby out. This scenario is termed Injurious Delivery.
The above method regarding Injurious Delivery is crucial and must not be neglected. If ten months are not complete, and there is labor-like pain that comes and goes or is mild, it is called "Nong Tong" (Play Pain), not a sign of normal labor. Severe abdominal pain without severe lower back pain is not a sign of normal labor. A high fetal position not yet descended is not a sign of normal labor. No anal protrusion is not a sign of normal labor. No rupture of membranes or bleeding is not a sign of normal labor. Bleeding/fluid discharge without abdominal pain is not a sign of normal labor. In the absence of normal labor signs, allow the mother to walk and endure patiently. If she cannot walk, let her sit leaning on something, lie down quietly, or take one or two doses of Fetal-Calming Decoction until relieved. Do not recklessly administer Labor-Inducing Medicines. Panic causes fear and discouragement. Ensure the mother remains calm and composed, and have the midwife explain this clearly. If feeling stifled, mix one spoonful of white honey with fresh cool water and drink it. Do not exert force recklessly, exhausting the mother first. Only when the fetus presses against the cervix, causing extreme lower back heaviness/pain, a burning sensation in the eyes, and anal protrusion, is it the sign of normal labor, at which point force may be used and Labor-Inducing Medicine taken. I had a female relative who experienced severe lower back and abdominal pain resembling labor more than a month before delivery, stopping slightly during the Si hour (9-11 AM). This persisted for over ten days. Having exhausted other options, I consulted this text and prescribed Fetal-Calming Decoction supplemented with Ginseng and Atractylodes Macrocephala Rhizome for several doses, along with meat broth for nourishment. She recovered and ceased hurting. Twenty days later, she delivered a healthy boy. Had she exerted force recklessly or taken labor-inducing drugs then, she would have faced immediate danger and death.
3. **Cui Chan** (Accelerated Delivery): If a woman is in labor, membranes have ruptured, and bleeding has started, indicating normal labor signs, but the baby has not yet been born, administer Accelerating Medicine to hasten birth. If menstruation occurs or the mother is distressed after several days, medicine can be given to boost the mother's Zheng Qi (Upright Qi) to facilitate rapid birth. This is called Accelerated Delivery.
4. **Dong Chan** (Frozen Delivery): In winter, cold weather causes maternal blood to coagulate upon exposure to cold, preventing the fetus from being born. This harm is profound. In winter deliveries, the lower body must not be stripped of cotton clothing, nor should the mother sit or lie in cold places. Fire should be lit throughout the room to maintain warmth. The mother should face away from the fire towards warmth, keeping the area below the navel, legs, and knees warm. Heat allows blood to flow freely, facilitating easier birth. This is called Frozen Delivery.
5. **Re Chan** (Hot Delivery): In midsummer, the parturient must maintain appropriate temperature balance, avoiding excessive cooling which damages fetal Qi. Also, avoid overcrowding, as heat oppression can cause the mother's blood to boil, leading to fever, headache, facial redness, drowsiness like drunkenness, and even loss of consciousness. This is called Hot Delivery.
6. **Heng Chan** (Transverse Delivery): The fetus presents a hand or arm first. This is due to the mother exerting force excessively when inappropriate. With the fetus malpositioned, forceful pushing causes the body to become transverse. The mother should lie supine. The attendant should gently push the presenting limb back up, guiding the body into alignment, using the middle finger to rub the shoulder and push it upright, or pulling the ear to correct position. The mother must remain supine while the attendant slowly corrects the fetus. Once aligned, administer a cup of Accelerating Medicine. After ingestion, the mother may exert force to deliver the baby. This is Transverse Delivery.
7. **Dao Chan** (Breech/Inverted Delivery): Due to insufficient fetal Qi and lax pelvic floor, combined with premature exertion, the fetus fails to turn and descends feet-first. The mother should lie supine. The attendant should gently push the feet back up. The mother must not exert any force, nor should she be frightened, allowing the fetus to naturally assume the correct position.
8. **Pian Chan** (Oblique/Lateral Delivery): The fetus is misaligned. Forceful pushing causes the head to press against the left or right thigh. Although the head is visible, it is stuck to one side. The mother should lie supine. The attendant should gently push the fetus upward, manually correcting the head so the vertex is centered. Then, the mother exerts force to deliver. If the occiput is pressed against the anus, exposing only the forehead, the attendant, wearing gloves warmed by heated cotton cloth, should gently push the head from outside the anus to align it, then the mother pushes. This is Oblique Delivery.
9. **Ai Chan** (Impeded Delivery): The fetus is in position, presenting the vertex, but cannot be born. This is often because the fetus turned, and the umbilical cord wrapped around the shoulder, impeding the vertex's passage. The mother should lie supine. The attendant should gently push the fetus upward, extend a hand, press the middle finger under the shoulder, and manipulate the cord. Wait until the fetus is properly aligned, then the mother exerts force to deliver. This is Impeded Delivery.
For the four methods above (Transverse, Breech, Oblique, Impeded), if the attendant is not highly skilled, do not attempt these manipulations, lest ignorance cause harm. Regarding Breech Delivery, nowadays babies are often born feet-first without sequelae, with both mother and child surviving; thus, manual correction of feet is not always necessary. Regarding Impeded Delivery, sometimes the cord wraps around the vertex, but the head emerges naturally outside the vulva; the attendant can simply clear the cord from over the head. Or the cord wraps once around the vertex, and the fetus and placenta descend together naturally. These cases pose no harm. There is no need to insert hands into the vagina to manipulate the cord in these instances.
10. **Zuo Chan** (Sitting Delivery): When nearing delivery, hang a towel from a high place. The mother holds onto it, bends her knees, and sits lightly to facilitate birth. This does not mean sitting on an object. This is Sitting Delivery.
11. **Pan Chang Chan** (Prolapsed Intestine Delivery): Lady Gong, wife of Zhao Duyun, experienced prolapse of the large intestine before the baby during each delivery. Postpartum, the intestine did not retract, causing great suffering. This is called Prolapsed Intestine Delivery. Physicians could not treat it. While in Jianchang, a midwife applied a method to reduce it: Mix half a cup of vinegar with seven parts fresh cool water. Apply this mixture to the mother's face. Each time the intestine protrudes, apply the remedy three times until reduced. This is an excellent method.
[Dan Xi] Postpartum intestinal prolapse. Boil five jin (approx. 2.5 kg) of sesame oil in a basin. When warm, have the patient sit in the oil basin for about the duration of one meal. Blow powdered Sophora Flavescens Root (Zao Jiao) into the nose to induce sneezing, which instantly reduces the prolapse. Excellent. (*Dou Men*)
[Da Yi Jing Cui] Powdered Pinellia Tuber (Ban Xia) insufflated into the nose causes the intestine to rise. Another prescription: Dip a large paper wick in sesame oil, light it, blow it out, and smoke the fumes into the mother's nose; the intestine rises. Another prescription: Take fourteen castor seeds (Bi Ma Zi), remove shells, grind into a paste, and apply to the center of the mother's vertex; the intestine rises and reduces.