《大全》云∶娠妇人怀胎有七月八月而产者，有至九月十月而产者，有经一年二年乃至
四年而产者，各根据法治之。
薛氏曰∶先期欲产者凉血安胎，过期不产者补血行滞。
《大全》云∶妇人脏腑调和则气血充实，风邪鬼魅不能干之。若荣卫虚损则精神衰弱，
妖魅鬼精得入于脏，状如怀孕，故曰鬼胎也。
薛氏曰∶前症因七情相干，脾肺亏损，气血虚弱，行失常道，冲任乖违而致之者，乃元
气不
足、病气有余也。若见经候不调，就行调补，庶免此症。治法以补元气为主，而佐以雄黄丸
之类行散之。若脾经郁结气逆者，用加味归脾汤调补之。若脾虚血不足者，用六君芎归培
养之。肝火血耗者，用加味逍遥散滋抑之。肝脾郁怒者，用加味逍遥、归脾二药兼服。肾肝
虚弱者，用六味地黄丸。
立斋云∶欲临产之时，觉腹内转动，即当正身仰卧，待见转身向下(催生药切不可早，
若儿
未转顺身，宜以补血为主，而宽气有之)，腰腹痛甚者，将产也。盖肾候于腰，胞系于肾故
也。若但觉腹痛者，未产也，不可服催生滑胎等药，亦不可令人抱腰(抱腰则儿不能转身，
故不可)动手(稳婆之手)。产母亦不可妄乱用力，以致横生逆产。若未产而水频下，此胞衣
已破，血水先干，而不能分娩也，宜保生无忧散以固其血(固血之说宜玩，八珍益母配法服
治俱妙)，自然生息。如血过于耗损，八珍汤(料一斤)加益母草(半斤水数碗)煎熟，不时饮
之，亦有得生也。陈无择云∶是乃多因儿未转顺，坐草太早，或过于努力，以致胞衣破而血
水干、产路涩，而儿难下。宜服催生如神散，以固其血，自能润下。亦有因儿转身时将儿枕
破碎与胞中败血壅滞，儿身不能便利，是以难产。急服胜金以消其血，儿便得生。若未产一
月之前，忽然脐腹疼痛，如有欲产之状者，是名弄胎。又名试水。稳婆不悟，入手探胎，致
胞破浆干，儿身难转，亦难生矣。然贫贱妇人，生育极易者，以其劳役，胎气流动故也。富
贵
之家浓养安逸，身体肥壮，以致气滞而胎不转，故难产也。况妇人以血为主，血以气为主，
惟气顺而血和，胎安则产顺，故瘦胎饮一论专为奉养者设也。若多思多郁及藜藿之人，其体
虽
肥而内气必弱，儿在胞胎不能自运，宜用达生散以补母气，则儿健而易产矣。大概临产之际
，勿令饥渴以乏其力，亦勿令惊恐以散其气，法宜滑以流通涩滞。古以驱逐闭塞，香以开窍
逐血气。滞者行气，胞浆先破者固血(固血如闸水放舟，最为稳当)。盛夏之月倘若头晕血溢
，头痛面赤，昏昏如醉，不知人事，当清水益元解之(血晕血溢以水解之，在暑月尤宜，余
月亦无害，惟少吃之)。冬月天冷用火温暖下部，衣服尤当温浓，方免胎寒血结，则儿易生(
仲圭曰∶此语甚是，妇人志之)。
薛氏曰∶交骨不开，产门不闭，皆由元气素弱，胎前失于调摄，以致血气不能运达而然
也
。交骨不开，阴气虚也，加味芎归汤、补中益气汤。产门不闭，气血虚也，十全大补汤。
《准绳》云∶产难子死腹中者，因惊动太早或触犯禁忌，致令难产。胞浆已破，血无养
胎，
枯涸而死也。须验产母舌，若青黑，其胎必死，当下之。大法寒者热以行之，热者凉以行之
，燥者滑以润之，危急者毒药下之。
《产育宝庆集》中说：孕妇怀胎，有的七个月、八个月就分娩，有的到九个月、十个月才分娩，有的经过一年、两年甚至四年才分娩，都应根据具体病情依法治疗。
薛己说：预产期提前想要分娩的，应凉血安胎；过期未能分娩的，应补血行滞。
《产育宝庆集》中说：妇人脏腑功能调和，则气血充实，风邪鬼魅不能侵犯。如果营卫虚损，则精神衰弱，妖魅鬼精得以侵入脏腑，症状如同怀孕，所以称为“鬼胎”。
薛己说：上述病症是由于七情相互干扰，导致脾肺亏损，气血虚弱，运行失去常道，冲任二脉失调所致，这是元气不足而病气有余的表现。如果见到月经不调，就应及时进行调补，以免发生此症。治疗方法以补益元气为主，辅以雄黄丸等药物来行散瘀滞。如果是脾经郁结、气机上逆者，用加味归脾汤调补。如果是脾虚血不足者，用六君芎归汤培养气血。肝火旺盛耗伤阴血者，用加味逍遥散滋阴清热。肝脾郁怒者，将加味逍遥散和归脾汤两种药配合服用。肾肝虚弱者，用六味地黄丸。
薛己（立斋）说：临产之时，感觉腹内胎儿转动，就应当端正身体仰卧，等待胎儿转身向下（催产药切不可过早使用，如果胎儿尚未转顺，宜以补血为主，兼用宽气之法），腰部腹部疼痛剧烈者，即将分娩。因为肾对应腰部，胞宫系于肾的缘故。如果只是感到腹痛，说明尚未分娩，不可服用催生、滑胎等药物，也不可以让稳婆抱腰（抱腰会导致胎儿无法转身，所以不可行）或动手探查（稳婆的手）。产妇也不可胡乱用力，以致造成横生、逆产等难产情况。如果尚未分娩但羊水频繁流出，这说明胞衣已破，血水先干涸，导致无法分娩，宜服用保生无忧散以固护血液（固血的说法值得玩味，八珍益母汤的配伍方法服用治疗都很巧妙），胎儿自然能顺利出生。如果血液耗损过于严重，可用八珍汤（药材一斤）加入益母草（半斤，用水数碗煎煮）煎熟后，不时饮用，也有能够存活的情况。陈无择说：这大多是因为胎儿未转正，坐草太早，或者用力过猛，导致胞衣破裂而血水干涸、产道涩滞，胎儿难以产出。宜服用催生如神散，以固护血液，自然能润滑下行。也有因胎儿转身时将儿枕破碎，与胞中败血壅滞，阻碍胎儿身体活动，从而导致难产。此时急服胜金散以消散瘀血，胎儿便能得救。如果在分娩前一个月，突然脐腹部疼痛，有类似临产的症状，这叫“弄胎”，又名“试水”。稳婆如果不明白，伸手探胎，导致胞衣破裂、羊水干涸，胎儿身体难以转动，也就难以出生了。然而贫贱妇女生育容易的，是因为她们从事劳动，胎气流动的缘故。富贵人家生活安逸，身体肥壮，导致气机阻滞而胎儿不转动，所以难产。况且妇人以血为本，血又以气为主导，只有气顺则血和，胎安则产顺，所以瘦胎饮这一理论专门是为那些营养过度的人设立的。如果思虑过多、情绪抑郁以及饮食粗劣之人，虽然身体肥胖但体内元气必弱，胎儿在胞胎中不能自行运转，宜用达生散来补益母体之气，则胎儿健壮而易于分娩。大抵临产之际，不要让产妇饥渴以耗竭体力，也不要让产妇惊恐以散失正气，治法宜用滑利之品以流通涩滞。古人认为香燥之品可以驱逐闭塞，芳香之品可以开窍并推动血气运行。气滞者行气，胞浆先破者固血（固血就像闸门蓄水放舟一样，最为稳妥）。盛夏月份如果出现头晕、出血、头痛面赤、昏沉如醉、人事不知的血晕症状，当用天水散（清水益元散）解暑清热（血晕血溢用水法治疗，在暑月尤其适宜，其他月份也无害，只是要少吃）。冬季天气寒冷，应用火温暖下部，衣服尤其要穿得厚实，这样才能避免胎寒血结，使胎儿易于出生（仲圭说：这话很有道理，妇女们要记住）。
薛己说：交骨不开、产门不闭，都是由于元气素来虚弱，产前失于调养摄护，导致血气不能运达所致。交骨不开，是阴气虚，用加味芎归汤、补中益气汤。产门不闭，是气血虚，用十全大补汤。
《医学准绳六要》中说：难产且胎儿死于腹中的情况，是因为受惊动得太早或触犯禁忌，导致难产。胞浆已经破裂，血液无法滋养胎儿，枯涸而死。必须检查产妇舌头，如果舌色青黑，胎儿必定已死，当下胎。大法则是：寒证用热药行之，热证用凉药行之，燥证用滑润药润之，危急者用毒药下之。
The *Daquan* (Compendium) states: Pregnant women may deliver at seven or eight months, at nine or ten months, or even after one, two, up to four years. Each case should be treated according to the appropriate method.
Xue Ji said: For those delivering prematurely, cool the blood and stabilize the fetus; for those overdue who do not deliver, tonify the blood and promote stagnation resolution.
The *Daquan* states: When a woman’s zang-fu organs are harmonious, her qi and blood will be abundant, preventing invasion by wind pathogens or malevolent spirits. If ying and wei (nutritive and defensive qi) are deficient and damaged, spirit and vitality weaken, allowing demonic essences to enter the zang organs. The presentation resembles pregnancy, hence it is called "Ghost Fetus" (Gui Tai).
Xue Ji said: The aforementioned condition arises from emotional disturbances interfering with each other, leading to deficiency of the Spleen and Lung, weakness of qi and blood, deviation from normal circulation, and disharmony of the Chong and Ren vessels. This results in insufficient primordial qi and excess pathogenic qi. If irregular menstruation is observed, timely regulation and tonification should be administered to prevent this condition. The treatment principle focuses on tonifying primordial qi, assisted by formulas such as Xionghuang Wan (Realgar Pill) to promote dispersion. In cases of Spleen meridian depression with rebellious qi, Jiawei Guipi Tang (Modified Return the Spleen Decoction) should be used for regulation and tonification. In cases of Spleen deficiency with insufficient blood, Liu Jun Xiong Gui Tang (Six Gentlemen with Ligusticum and Angelica Decoction) should be used to nourish. In cases of Liver fire consuming blood, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) should be used to nourish and suppress. In cases of Liver-Spleen depression and anger, Jiawei Xiaoyao San and Guipi Tang should be taken concurrently. In cases of Kidney-Liver deficiency, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) should be used.
Li Zhongzi (Zhai) stated: At the time of impending delivery, when internal fetal movement is felt, the mother should lie supine with her body straightened, waiting for the fetus to turn downward. (Parturifacient drugs must never be administered too early; if the fetus has not yet turned into a favorable position, the primary approach should be blood tonification, supplemented by methods to broaden qi.) Severe pain in the lower back and abdomen indicates imminent delivery. This is because the Kidneys manifest in the waist, and the uterus is connected to the Kidneys. If only abdominal pain is felt without other signs, delivery has not yet begun; parturifacient or slippery-pregnancy-inducing medicines should not be taken, nor should midwives embrace the waist (embracing the waist prevents the fetus from turning, thus it is contraindicated) or manually manipulate (midwives' hands). The mother should also avoid exerting force recklessly, which could lead to transverse or breech presentations. If amniotic fluid flows frequently before actual labor begins, this indicates the membranes have ruptured. If blood and fluids dry up first, delivery cannot occur. Baosheng Wuyou San (Baosheng Wuyou Powder) should be administered to secure the blood. (The concept of securing blood warrants careful consideration; the preparation and administration of Bazhen Yimu Tang [Eight-Tonics Motherwort Decoction] are both excellent.) The fetus will naturally be born safely. If blood loss is excessive, Bazhen Tang (Eight-Tonics Decoction, 1 jin of herbs) combined with Yi Mu Cao (Leonuri Herba, 0.5 jin, decocted in several bowls of water) should be prepared and drunk intermittently, which can also result in survival. Chen Wuze stated: This situation mostly occurs because the fetus has not turned into a favorable position, the mother sat on the birth mat too early, or she exerted herself excessively, causing membrane rupture, drying of blood and fluids, and lubricity obstruction in the birth canal, making fetal descent difficult. Shensheng Rushen San (Shensheng Rushen Powder) should be taken to secure the blood, allowing natural lubrication and descent. Alternatively, if the fetus turns and breaks the "fetal pillow," causing stagnant blood in the uterus to obstruct the fetal body, making descent difficult, Shengjin San (Shengjin Powder) should be taken urgently to dissipate the blood, allowing the fetus to survive. If, one month before delivery, sudden umbilical and abdominal pain occurs resembling labor, this is named "Nong Tai" (Playing Fetus) or "Shi Shui" (Testing Water). If midwives fail to recognize this and insert their hands to probe the fetus, it causes membrane rupture and fluid drying, making fetal turning and delivery difficult. However, women of humble status often give birth easily because their physical labor keeps the fetal qi moving. Conversely, wealthy families live in comfort and ease, becoming obese, which leads to qi stagnation and failure of the fetus to turn, resulting in difficult labor. Furthermore, women are governed by blood, and blood is governed by qi. Only when qi is smooth does blood harmonize; when the fetus is secure, delivery proceeds smoothly. Therefore, the theory of Shaotai Yin (Fetus-Thinning Drink) was specifically designed for those who are overly nourished. For those who overthink, harbor depression, or consume coarse food, although their bodies may be fat, their internal qi is necessarily weak. The fetus in the uterus cannot move independently. Dasheng San (Dasheng Powder) should be used to tonify the mother's qi, making the fetus robust and delivery easy. Generally, during labor, do not let the mother go hungry or thirsty to exhaust her strength, nor allow fear or shock to scatter her qi. The method should utilize slippery agents to unblock stagnation. Ancient texts suggest using pungent aromatics to drive away blockage and open orifices to expel blood and qi. For qi stagnation, promote qi movement; for premature membrane rupture, secure the blood (securing blood is like holding back water to release a boat, which is most stable). In midsummer, if dizziness, bleeding, headache, red face, stupor like drunkenness, and unconsciousness occur due to blood晕 (blood晕), Qing Shui Yiyuan San (Tianshui San/Cool Water Yi Yuan Powder) should be used to resolve it. (Treating blood晕 and hemorrhage with water-based methods is especially suitable in summer months and harmless in others, though consumption should be moderate.) In winter, when the weather is cold, heat the lower body with fire, and wear thick clothing to avoid uterine cold and blood coagulation, facilitating easier delivery. (Zhonggui said: This statement is very sound; women should remember it.)
Xue Ji said: Failure of the pubic symphysis to open (Jiao Gu Bu Kai) and failure of the vaginal opening to close (Chan Men Bu Bi) are both caused by inherent weakness of primordial qi and lack of regulation during pregnancy, leading to an inability of blood and qi to circulate and reach the area. Jiao Gu Bu Kai is due to deficiency of yin qi; treat with Jiawei Xiong Gui Tang (Modified Ligusticum and Angelica Decoction) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Chan Men Bu Bi is due to deficiency of qi and blood; treat with Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction).
The *Zhunsheng* (Standard for Diagnosis) states: Difficult labor with a dead fetus in the uterus occurs due to premature disturbance or violation of taboos, leading to dystocia. Once the amniotic fluid has broken and blood fails to nourish the fetus, the fetus dies from desiccation. One must examine the mother's tongue; if it is blue-black, the fetus is certainly dead, and purgatives should be administered. The general principles are: for cold patterns, use hot agents to promote movement; for heat patterns, use cool agents to promote movement; for dryness patterns, use slippery agents to moisten; for critical conditions, use toxic agents to purge.