疗逆产方 盐涂儿足底。又可急搔抓之，并以盐摩产妇腹上，即产。
又方∶以盐和粉，涂儿两足，下即顺矣。
《集验方》疗逆产 烧钱令赤，纳酒中饮之。
又方∶取夫阴毛二、七茎烧，以猪膏和丸如豆大，水吞下，儿手即握出，神验。
疗产难方 取车 中膏画腋下及掌心。崔氏、文仲、《短剧》、《千金》、《集验》、《备急》
同。
疗逆产胞衣不出方 取灶屋黑尘，研为细末，酒调方寸匕。一方用梁上尘。
疗横生、逆产，服诸符药不捷者 灸右脚小指尖头三壮，艾炷如小麦大。
疗横生、倒产，手足先出方（并出《外台》）。用粗针刺儿手足，入二分许，儿得痛惊转
即缩，自当回顺。文仲、《备急》、《千金》、崔氏、《集验》同。
横产、逆产二条，其理虽别，疗法盖同。可以意量，逐善参用也。
论曰∶产难者何？胎侧有成形块为儿枕，子欲生时，枕破与败血裹其子，故难产。但服
胜金散，逐其败血即自生。若逆生、横生，并皆治之。
麝香（一钱，研） 盐豉（一两，以旧青布裹了，烧令赤，急以乳钵研细）
上为末，取秤锤烧红，以酒淬之，调下一大钱。
陈无择评曰∶产难不只胎侧有儿枕破，与败血裹凝伤其胎息，因缘自有难易。其如横逆
，多因坐草太早，努力过多，儿转未逮；或已破水，其血必干，致胎难转。若先露脚谓之逆
，先露手谓之横。法当以针刺之，使自缩入，即服神应黑散以固其血，必自转生。《养生方
》云∶仓皇之间，两命所系，不可不广传，盖赞黑散之功也。或以盐涂儿脚底搔抓之。
神应黑散方（见前，即催生如神散）
治疗逆产（胎儿足部或臀部先露出的难产）的方法：用盐涂抹婴儿脚底。也可以迅速搔抓婴儿脚底，并用盐按摩产妇腹部，即可分娩。
另一种方法：将盐和米粉混合，涂抹在婴儿双脚上，胎儿下来时就会顺产。
又一种方法：取丈夫的阴毛十四根烧成灰，用猪油调和制成如豆粒大小的药丸，用水送服，婴儿的手就会握拳伸出，疗效神奇。
治疗产程困难（产难）的方法：取车轴中的油脂，涂抹在腋下及手掌心。崔氏、文仲、《短剧》、《千金方》、《集验方》、《备急方》均记载此法相同。
治疗逆产且胎盘（胞衣）不出的方法：取灶屋墙壁上的黑色灰尘，研成细末，用酒调服一方寸匕。另一种方法使用房梁上的灰尘。
治疗横生（胎儿横向先露）、逆产，服用各种符咒药物无效者：灸右脚小脚趾尖三壮，艾炷大小如小麦。
治疗横生、倒产（头位异常或肢体先露），手足先露出的方法（均出自《外台秘要》）：用粗针刺入婴儿手足约二分深，婴儿因疼痛惊吓而转动身体，手脚自然缩回，胎儿便会自行回转顺产。文仲、《备急方》、《千金方》、崔氏、《集验方》记载相同。
横产和逆产两条，虽然原理不同，但治疗方法大致相同。可以凭心意斟酌，选择更好的方法参合使用。
论述说：什么是产难？胎儿侧面有成形块状物称为“儿枕”，胎儿将要出生时，儿枕破裂与败血包裹住胎儿，所以导致难产。只需服用胜金散，驱除败血即可自然分娩。无论是逆生、横生，都用此法治疗。
麝香（一钱，研磨） 盐豉（一两，用旧青布包裹，烧至通红，迅速用乳钵研细）
以上两味药研为细末，取秤锤烧红，用酒淬炼（将烧红的秤锤投入酒中），调服一大钱。
陈无择评论说：产难不仅仅是因为胎儿侧面有儿枕破裂，与败血凝结损伤胎息，因缘自有难易之分。至于横产、逆产，多因坐草（临产准备）太早，用力过多，胎儿转动不及；或者已经破水，血液必然干枯，导致胎儿难以转动。如果先露出脚称为逆产，先露出手称为横产。治疗方法应当用针刺使其缩回体内，然后服用神应黑散以固摄血液，胎儿必定会自行转位分娩。《养生方》说：仓皇之间，关系到两条性命，不可不广泛传播，这是称赞黑散的功劳。也有人用盐涂抹婴儿脚底并搔抓。
Formulas for Treating Breech Presentation (Nì Chǎn, a condition where the fetus presents feet or buttocks first): Apply salt to the soles of the infant's feet. Alternatively, rapidly scratch the soles of the infant's feet and massage the mother's abdomen with salt; delivery will ensue immediately.
Another formula: Mix salt with rice flour and apply it to both feet of the infant; upon descent, the birth will be smooth.
*Ji Yan Fang* (Collected Proven Prescriptions) for treating breech presentation: Burn a copper coin until red-hot, place it in wine, and have the patient drink it.
Another formula: Take fourteen strands of the husband's pubic hair, burn them to ash, mix with lard (Zhū Gāo, Pig Fat) to form pills the size of beans, and swallow with water. The infant's hands will grasp and emerge; this is highly effective.
Formula for Treating Dystocia (Chǎn Nán, difficult labor): Extract grease from an axle (Chē Zhóu), and apply it to the axilla and palms. This method is consistent across texts by Cui Shi, Wen Zhong, *Duan Ju*, *Qian Jin*, *Ji Yan*, and *Bei Ji*.
Formula for Treating Breech Presentation with Retained Placenta (Bāo Yī, fetal membranes): Collect black dust from the walls of a kitchen stove, grind into fine powder, and take one *cun bi* (a square-inch measure) mixed with wine. Another variant uses dust from roof beams.
For transverse presentation (Héng Shēng) and breech presentation where various talismanic medicines have failed: Moxibustion (Jiǔ) three applications on the tip of the little toe of the right foot. The moxa cone should be the size of a wheat grain.
Formula for Treating Transverse Presentation and Inverted Presentation (Dǎo Chǎn) where limbs present first (Excerpted from *Wai Tai Mi Yao*): Puncture the infant's hands and feet with a coarse needle to a depth of approximately two *fen*. The pain and fright will cause the infant to turn, allowing the limbs to retract naturally, facilitating a normal position. This is consistent with records by Wen Zhong, *Bei Ji*, *Qian Jin*, Cui Shi, and *Ji Yan*.
Although the pathophysiology of transverse and breech presentations differs, their therapeutic approaches are largely similar. One may exercise discretion to select the most appropriate method.
Discussion: What constitutes dystocia? A formed mass on the side of the fetus is called "Er Zhen" (Child's Pillow). When birth is imminent, this mass ruptures, and stagnant blood (Bài Xuè) wraps around the fetus, causing difficulty in delivery. Administering *Sheng Jin San* (Winning Gold Powder) to expel the stagnant blood allows for spontaneous delivery. This applies to both inverted and transverse presentations.
Ingredients:
She Xiang (Moschus, Musk) - 1 qian, ground.
Yan Chi (Fermented Soybeans) - 1 liang, wrapped in old blue cloth, burned until red-hot, then quickly ground finely in a mortar.
Process: Grind the above ingredients into powder. Heat a weight (scale hammer) until red-hot, quench it in wine, and use this liquid to administer one large qian of the powder orally.
Commentary by Chen Wuyue: Dystocia is not solely caused by the rupture of the "Child's Pillow" on the side of the fetus and the condensation of stagnant blood damaging fetal vitality; difficulties arise from various causes. Regarding transverse and breech presentations, these often result from starting labor preparations too early or excessive pushing before the fetus has rotated sufficiently. Or, if the waters have broken, the fluids dry up, making fetal rotation difficult. If the feet present first, it is called breech presentation; if the hands present first, it is called transverse presentation. The treatment should involve puncturing with a needle to induce retraction, followed by administering *Shen Ying Hei San* (Divine Response Black Powder) to consolidate the blood, ensuring the fetus turns spontaneously for delivery. *Yang Sheng Fang* states: "In moments of panic, two lives are at stake; this must be widely disseminated," praising the efficacy of the Black Powder. Some also recommend applying salt to the infant's soles and scratching them.
*Shen Ying Hei San* Formula (See previous section, also known as *Cu Sheng Ru Shen San*).