答曰。将产坐卧。须顺四时方面。并避五行禁忌。若有触犯。多令产难。或因漏胎去血脏燥
。或子脏宿挟疹病。并触禁忌。或觉腹痛。产时未到。便即惊动。秽露下早。致子道干涩。
产妇力疲。又有横逆不顺者。皆难产也。或有子上逼心者。皆繇妊娠之人。失于将养也。大
抵临产之际。腹痛而腰不痛者。未产也。若腹痛连腰甚者即产。所以然者。肾候于腰。胞系
于肾。故也。诊其尺脉转大。如切绳转珠者。谓之离经。日中觉。夜半生。若腰痛甚者。即
产也。愚谓横生逆产者。皆因少母未经生育。将产之时。不肯忍痛。务欲逼下为妙。殊不知
时候未到。胎气未至。其子未能翻身。受逼不过。只得一任离胎迳下。以至倒生。其有横生
者。其子离胎。将欲翻身投下。半中之间。被母逼紧。转身不及。以至横下。古人云。瓜熟蒂
落。粟熟自出。自然之理。凡有横逆。皆繇母不能忍痛也。
乌金散。治横生难产。及催生。(此方救子母于顷刻)
百草霜 香白芷
上等分为细末。每服二钱。以童便醋各少许调。更以热汤化下。未愈再服。
乳香丸。治难产。
乳香(一两研为细末)
上用猪心血和作十丸。每服一丸。煎乳香汤化下。
出衣法。治妊娠胎死腹中。衣不出。及产后猝有别病。欲至野狼狈。
若胎衣未下腹满。宜水一盏半。煮猪脂一两。煎五七沸。和脂服下之。寤生丸。治难产。
枳实(六两一本枳壳) 桑白皮(干六两)
以上二味。入大铛内。以长河水煮半日许。候枳实透软。去桑白皮不用。取枳实去穣。薄切
作小片子。焙干。再入后药。
木香(半两) 甘草(炙半两)
上四件和为细末。炼蜜丸桐子大。晒干每日空心日午临卧。各用温米饮送下三十丸。加至五
七十丸。日三服。怀七个月后服。
回答说:分娩前的坐卧姿势,必须顺应四季的方向,并避开五行相克的禁忌。如果有触犯禁忌的情况,大多会导致难产。或者因为胎漏导致失血,使子宫干燥;或者子宫原本就夹杂有疹病等宿疾,又触犯了禁忌;或者感觉腹痛,但分娩时间未到,便惊慌躁动,导致羊水过早流出,致使产道干涩;产妇体力疲惫,又有胎儿横位或倒位不顺的情况,这些都是难产。或者有胎儿上逼心胸的情况,这都是因为孕妇在妊娠期间调养不当所致。
大体上,临产之际,如果只有腹痛而腰部不痛,说明尚未真正分娩;如果腹痛剧烈且牵连腰部,就是即将分娩。之所以这样,是因为肾气反映在腰部,胞宫系于肾脏的缘故。诊察其尺脉变得洪大,如同切按转动的绳索或珠子一样滑利,这叫做“离经”脉。如果在白天感觉到这种脉象,半夜就会分娩;如果腰痛剧烈,就会立即分娩。
我认为横生(胎儿横位)和逆产(胎儿倒位),都是因为母亲未曾生育过,在分娩时不肯忍受疼痛,一味想要用力向下推挤以图顺利。殊不知时候未到,胎气未至,胎儿无法翻身。由于承受不住逼迫,只能任由身体离开母体直接下降,从而导致倒生。那些横生的情况,是胎儿离开母体后,正欲翻身向下,在半途中被母亲用力挤压,转身不及,从而导致横位产出。古人说:“瓜熟蒂落,粟熟自出”,这是自然的道理。凡是出现横生或逆产,都是因为母亲不能忍受疼痛所致。
乌金散:治疗横位难产及催生。(此方能在顷刻间挽救母子性命)
百草霜、香白芷。
以上两味药上等分研为细末。每次服用二钱,用童便和醋各少许调匀,再用热汤送服。若未痊愈,可再次服用。
乳香丸:治疗难产。
乳香(一两,研为细末)。
用猪心血调和制成十丸。每次服用一丸,煎煮乳香汤化开服用。
出衣法:治疗妊娠期间胎死腹中,胎盘不下,以及产后突然患其他疾病,急需外出奔波的情况。
如果胎衣未下且腹部胀满,宜用水一盏半,煮猪脂一两,煎煮五到七沸,连同油脂一起服用。
寤生丸:治疗难产。
枳实(六两,有的版本用枳壳)、桑白皮(干品六两)。
以上两味药,放入大锅中,用长河水煮约半天,待枳实煮透变软后,去掉桑白皮不用。取枳实去除瓤,切成薄片,焙干。再加入以下药物:
木香(半两)、甘草(炙制半两)。
以上四味药混合研为细末,用炼蜜制成梧桐子大小的丸剂,晒干。每日空腹、中午及睡前,各用温米饮送下三十丸,剂量可增加至五七十丸,每日服用三次。怀孕七个月后开始服用。
Answer: Regarding sitting and lying postures before delivery, one must conform to the directions of the four seasons and avoid taboos related to the Five Elements. Violations of these taboos often lead to difficult labor. It may also be due to leakage of the fetus causing blood loss and dryness of the uterus, or because the uterus harbors chronic conditions such as rashes, compounded by violating taboos. If abdominal pain is felt before the time of delivery, panic and agitation may cause premature rupture of membranes (leakage of amniotic fluid), leading to a dry and slippery birth canal. Combined with maternal exhaustion and malpositions such as transverse or breech presentations, these constitute dystocia. Cases where the fetus presses upward against the heart are generally caused by improper care during pregnancy.
Generally speaking, during the onset of labor, if there is abdominal pain but no lower back pain, delivery has not yet begun. If severe abdominal pain radiates to the lower back, delivery is imminent. This is because the Kidney manifests in the lower back, and the uterus is connected to the Kidney. Palpation of the Chi pulse becoming large and slippery, resembling rolling ropes or pearls, is termed "Li Jing" (Departing from the Canon) pulse. If this pulse is perceived during the day, delivery occurs at midnight; if severe lower back pain is present, delivery happens immediately.
I believe that transverse presentation (Heng Sheng) and breech presentation (Ni Chan) occur primarily because first-time mothers, unable to endure pain during labor, attempt to force the fetus downward prematurely. They fail to realize that the timing is not yet ripe and fetal Qi has not descended, preventing the fetus from turning. Unable to withstand the pressure, the fetus exits directly without turning, resulting in a breech birth. In cases of transverse presentation, after the fetus detaches, it attempts to turn downward but is squeezed tightly by the mother's efforts midway, preventing it from completing the turn, thus resulting in a transverse exit. As the ancients said, "When the melon is ripe, it falls from the vine; when millet is ripe, it drops out naturally." This is the principle of nature. All instances of transverse or breech presentation stem from the mother's inability to endure pain.
Wujin San (Black Dust Powder): Treats transverse dystocia and promotes labor. (This formula can save both mother and child in an instant.)
Baicaoshuang (Soot from Hundred Herbs), Xiang Baizhi (Angelicae Dahuricae Radix).
Grind the above two herbs into fine powder in equal proportions. Take 2 qian per dose, mixed with a small amount of fresh urine (Tongbian) and vinegar, then swallowed with hot water. Repeat if necessary.
Ruxiang Wan (Frankincense Pill): Treats dystocia.
Ruxiang (Frankincense Resin, 1 liang, ground into fine powder).
Mix with pig heart blood to form ten pills. Take one pill per dose, dissolved in a decoction of Ruxiang.
Chuyi Fa (Method for Expelling the Placenta): Treats retained placenta due to intrauterine fetal death during pregnancy, or sudden illness requiring urgent travel postpartum.
If the placenta has not been expelled and the abdomen is distended, boil 1 liang of pork lard in 1.5 cups of water until it boils five to seven times. Consume the liquid along with the lard.
Wusheng Wan (Awakening Birth Pill): Treats dystocia.
Zhishi (Immature Bitter Orange Fruit, 6 liang; some versions use Zhike/Ripe Bitter Orange Fruit), Sangbaipi (Morus Alba Root Bark, dried, 6 liang).
Place the above two herbs in a large pot and boil in river water for approximately half a day until Zhishi becomes soft. Remove and discard Sangbaipi. Take the Zhishi, remove the pith, slice thinly, and bake until dry. Add the following herbs:
Muxiang (Aucklandiae Radix, 0.5 liang), Gancao (Licorice Root, honey-fried, 0.5 liang).
Grind all four herbs into a fine powder. Mix with refined honey to make pills the size of paulownia seeds. Dry them. Take 30 pills per dose with warm rice broth on an empty stomach in the morning, at noon, and before bed. The dosage can be increased to 50–70 pills. Take three times daily. Begin taking this prescription after the seventh month of pregnancy.