【难产生死歌】欲产之妇脉离经，沉细而滑腹又疼，定知半夜应分娩，脉法由来载《内经》
。大凡临产应如此，产妇安然切勿惊。身重寒热痛频频，唇甲之色黑复青，子死腹中从此验
，舌青冰冷母归阴。面赤舌青须细看，母活子死定分明。唇口俱青白沫出，子母俱亡自可凭
。面青舌赤沫又出，母死子生定知真。临症过来俱应验，方知前哲不虚陈。
难产之症，宜服童便，磨神仙聚宝丹服之。或有不顺者，用蓖麻子肉十四粒，朱砂雄黄各五
分，蛇壳尺许烧灰，加麝香一分，共为末，将水和作一丸，用川椒汤淋产妇脐内，次将丸药
纳脐中，用绵纸数层覆其上，再用阔布缚住，待胎下即去其药。推肠生者，若肠不收，用新
汲水入醋少许，三喷其面，即自缩而上矣。若肠下时，须用温汤洗湿，米筛盛之。若沾染尘
垢，及着干物，即不肯上，且粘住断绝，而母命不保矣。又法∶将产妇顶心发分开，用蓖麻
子肉捣烂，敷于颠顶，将肠温水养之，其肠即收，则母命全矣。又有横生逆产，手足先出者
，用细针连刺儿手足，将盐擦其刺处，即便缩上，俗谓讨盐生也。
有头胎生，曾二三个月随堕，嗣后第二三胎，仍前复堕，名曰滑胎，不可复安矣。必须于有
胎之后，曾有正产一次，后无此患矣。
按紫苏饮一药，能治临产惊恐气怯，累日不下，乃妊娠之要剂也。
壬午年间，曾有某室怀孕，十月满足，忽然腹中大痛，即唤稳婆守候，稳婆欲图大望，假意
探胎消息，将指摘破胞衣，水流不止，胞水流干，胎元干搁，不能转运，日夜无眠，痛亦不
已，约四五日矣。邀余往视，诊其脉，六脉离经，或曰六脉已散，命将危矣。余察其舌色鲜
红，毫无青色，谓曰不妨，将临盆矣。或曰胞浆已干，有何生理?答曰∶古有急开支河之法
，即大剂四物人参，加入车前五钱，柞枝一两，煎汤代水煎服。房中稳婆三个，议论纷纷，
或欲早用钩割，以全母命。余曰∶各人不可动手，瓜熟蒂落，可保子母两全。服过药后，少
顷，腹中大痛，唤人扶掖走动，儿即堕地。今已十二岁矣。
【难产生死歌】即将分娩的孕妇，其脉象表现为离经之脉（指脉象与平时不同，预示临产），若脉象沉细而滑，且腹部疼痛，可以断定在半夜就会分娩。这种脉法早在《黄帝内经》中就有记载。大凡临产时情况大致如此，产妇应保持安然，切勿惊慌。如果身体沉重，伴有寒热交替，疼痛频繁，嘴唇和指甲颜色发黑又转青，这是胎儿死于腹中的征象，可以通过此法验证；若舌色青紫、四肢冰冷，则母亲将死亡。面色赤红而舌色青紫，需要仔细辨别，这是母亲存活而胎儿死亡的明确征兆。嘴唇和口部都发青，且有白色泡沫流出，这是母子双亡的凭据。面色青紫而舌色赤红，又有泡沫流出，这是母亲死亡而胎儿存活的确定事实。临床诊治过来的人都应验了这些说法，才知道前人的论述并非虚言。
对于难产的症状，适宜服用童便（童子尿），并磨服神仙聚宝丹。如果有不顺的情况，可用蓖麻子肉十四粒，朱砂、雄黄各五分，蛇蜕约一尺长烧成灰，加入麝香一分，共同研为细末，用水调和做成一个药丸。用川椒汤淋洗产妇的肚脐内部，然后将药丸纳入脐中，用多层绵纸覆盖在上面，再用宽布带缚紧固定，等到胎儿娩出后立即去掉药物。如果是胎衣不下或肠脱出的情况，如果肠子不收纳，用新汲取的冷水加入少许醋，向产妇面部喷三次，肠子就会自动缩回体内。如果肠子已经脱出，必须用温水洗净润湿，放在米筛上盛放。如果沾染了灰尘污垢，或者接触到干燥物体，肠子就不肯缩回，并且会粘连断裂，导致母亲性命不保。另一种方法：将产妇头顶心的头发分开，用蓖麻子肉捣烂，敷在头顶百会穴处，用温水养护脱出的肠子，肠子就会收回，这样母亲的生命就能保全。又有横生逆产，即手脚先出来的情况，用细针连续刺儿的手脚，将盐擦在针刺的地方，手脚就会立刻缩回，俗称“讨盐生”。
如果是第一胎顺利生产，但后来怀孕两三个月就自然流产，此后第二、第三胎仍然重复发生这种情况，称为滑胎（习惯性流产），这种情况很难再安胎成功。必须在有过一次正常足月分娩之后，以后才不会再有这种祸患。
按语：紫苏饮这一方药，能够治疗临产时因惊恐导致的气怯无力，致使多日无法分娩，是妊娠期间的要方。
壬午年间，曾有一位女子怀孕，十月期满，忽然腹部剧烈疼痛，于是叫来稳婆（接生婆）守候。稳婆为了博取高额报酬，假装探查胎儿情况，用手指戳破了胞衣（羊膜），羊水不断流出，直到羊水流干，胎儿因失去羊水润滑而干枯停滞，无法转动下降，日夜无法入睡，疼痛不止，大约过了四五天的时间。邀请我去诊治，诊察其脉象，六脉呈现离经之象，有人说六脉已散乱，生命垂危。我观察她的舌色鲜红，毫无青色，对她说不要紧，快要分娩了。有人说羊水已经干了，还有什么生机？我回答说：古代有“急开支河”的治疗方法，即用大剂量的四物汤合人参，加入车前子五钱、柞枝一两，煎汤代替水来煎煮药物服用。房中的三个稳婆议论纷纷，有的主张尽早使用钩割手段以保全母亲性命。我说：各位不可动手，瓜熟蒂落，可以保证母子双全。服药后不久，腹部剧烈疼痛，叫人搀扶走动，婴儿随即落地。如今孩子已经十二岁了。
[Song on Life and Death in Difficult Labor] The pulse of a woman about to give birth shows the "Li Jing" pulse (a pulse distinct from the usual pattern, indicating impending labor); if the pulse is deep, fine, and slippery, accompanied by abdominal pain, it can be known that delivery will occur at midnight. This pulse method has been recorded since the *Huangdi Neijing* (Yellow Emperor's Inner Canon). Generally, this is how it should be during labor; the parturient should remain calm and must not be alarmed. If the body feels heavy, with alternating chills and fever, and frequent pain, while the lips and nails turn black then cyan, this verifies that the fetus has died in the womb; if the tongue is cyan and the limbs are cold, the mother will die. If the face is red and the tongue is cyan, careful observation is required; this clearly indicates the mother survives while the fetus dies. If both the lips and mouth are cyan with white foam emerging, this confirms the death of both mother and child. If the face is cyan and the tongue is red with foam emerging, it is certain that the mother dies while the fetus lives. These observations have proven accurate in clinical practice, confirming that the statements of former sages were not empty talk.
For difficult labor, it is suitable to consume Tongbian (Child's Urine) and take Shenshen Jubao Dan (Divine Immortal's Treasure Pill). In cases of obstruction, use 14 grains of Castor Seed flesh (Ricini Semen), 5 fen each of Cinnabar (Zhusha) and Realgar (Xionghuang), burn approximately one chi of Snake Slough (Sheqiao) to ash, add 1 fen of Musk (Shexiang), grind all into powder, mix with water to form one pill. Pour Sichuan Pepper Decoction (Chuanjiao Tang) into the parturient's umbilicus, then insert the pill into the navel, cover with several layers of cotton paper, and bind tightly with a wide cloth. Remove the medicine immediately after the fetus is delivered. For prolapsed intestines: if the intestine does not retract, spray fresh well water mixed with a little vinegar onto the patient's face three times, and the intestine will spontaneously retract upward. If the intestine has already prolapsed, it must be washed wet with warm water and placed in a rice sieve. If contaminated with dust or exposed to dry objects, it will refuse to retract, may adhere and break off, endangering the mother's life. Another method: part the hair at the vertex (Baihui point) of the parturient, apply mashed Castor Seed flesh (Ricini Semen) to the vertex, and nourish the prolapsed intestine with warm water; the intestine will retract, preserving the mother's life. For transverse or breech presentation where hands or feet emerge first, prick the infant's hands and feet repeatedly with a fine needle, rub salt on the puncture sites, causing immediate retraction; this is colloquially called "begging for salt birth."
If the first pregnancy was term delivery, but subsequent pregnancies ending in miscarriage at two or three months recur in the second and third pregnancies, this is termed Huatai (Slippery Fetus/Habitual Abortion), which is difficult to stabilize. One must experience one normal term delivery before this condition ceases.
Note: Zisu Yin (Perilla Decoction) is a crucial formula for treating fear and qi deficiency during labor that results in prolonged retention of the fetus.
In the Renwu year, a certain woman reached full term (ten months) and suddenly suffered severe abdominal pain. A midwife was summoned. Seeking greater profit, the midwife feigned examining the fetus and punctured the Bao Yi (Placental Membrane/Amnion) with her finger. Amniotic fluid flowed incessantly until exhausted. Deprived of fluid lubrication, the fetus became dry and stuck, unable to descend. She slept neither day nor night, enduring continuous pain for about four to five days. I was invited to examine her. Her six pulses showed the "Li Jing" pattern. Some said the pulses were scattered and life was critical. I observed her tongue was bright red without any cyan hue, and told her there was no cause for alarm; she was near delivery. Others asked, "The amniotic fluid is dry; what hope is there?" I replied, "Ancient texts mention the method of 'urgently opening branch rivers.' Use a large dose of Siwu Tang (Four Substances Decoction) combined with Ginseng, adding Plantago Seed (Cheqianzi) 5 qian and Zha Zhi (Ramulus Quercus variabilis) 1 liang. Decoct these, using the liquid as water to decoct the main herbs." Three midwives in the room debated fiercely; some advocated early use of hooks or cutting to save the mother. I said, "Do not touch her. When the melon is ripe, it falls naturally; both mother and child can be preserved." After taking the medicine, shortly thereafter, severe abdominal pain occurred. With assistance walking, the infant was delivered. The child is now twelve years old.