郭稽中曰∶产难者，因儿转身，将儿枕血块破碎，与胞中败血壅滞儿身，不能便利，是
以难产，急服胜金散消其血，使儿自易生。陈无择云∶多因儿未转顺，坐草太早，或努力太
过，以致胞衣破而血水干，产路涩而儿难下，宜先服催生如神散，以固其血，设或逆生横
产，当用前法针刺之。
大全云∶治胞浆先破，恶水来多，胎干不得下，须先与四物汤，补养血气，次煎浓葱汤，
放冷，令稳婆洗产户，须是款曲洗，令气上下通畅，更用酥油滑石末涂产口里，次服神妙
乳朱丹，或葵子如圣散。
一曰正产者。妇人怀胎十月满足，忽腰腹作阵疼痛相似，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，儿自遂生。
二曰伤产者。盖因人之生，阴注阳定，各有时日，不可改易，今有未产一月以前，忽然
脐腹疼痛，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（紧抱则儿不能转身，故不可），产母亦不可妄乱用力，盖欲产之妇，脐腹疼痛，儿
身未顺，收生之妇，却教产母虚乱用力，儿身才方转动，却被产母用力一逼，使儿错路，忽
横忽倒，不能正生，皆缘产母用力未当之所致也。凡产母用力，须待儿子顺身，临逼门户，方
始用力一送，令儿下生，此方是产母之用力当也（此学养子法，可于平日令儿女子熟闻之）。
若未有正产之候，而用力伤早，并妄服药饵，令儿下生，譬如揠苗助长，无益而有害矣。
三曰催产者。言妇人欲产，浆破血下，脐腹作阵疼痛，极甚，腰重，谷道挺迸，已见是正
产之候，但儿却未生，即可服药以催之。或有，经及数日，产母困苦，已分明见得是正产之
候，但儿子难生，亦可服药以助产母之正气，令儿速得下生。（补正气确是良工，有用人参
五钱催生最妙）
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。
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、头疼、面赤，昏昏如醉，乃至不知人事。
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，然后推儿直上，徐
徐正之，候其身正，煎催生药一盏吃了，方可用力，令儿下生。
七曰倒产者。产母胎气不足，关键不牢，用力太早（母气弱而倒产者，当服补剂，若用
力早者，又当别论），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。
八曰偏产者。儿身未正，产母用力一逼，至令儿头偏在左腿，或偏在右腿，故头虽露，
偏在一畔，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。若是小儿头后骨偏在谷道，只露其额，当令看生
之人，以绵衣炙温裹手，于谷道外方，轻轻推儿头正，便令产母用力，送儿生也。（立顶三法）
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。
十曰坐产者。儿将欲生，其母疲倦，久坐椅褥，抵其生路，急于高处系一手巾，令产母
以手攀之，轻轻屈足坐身，令儿生下，非坐在物上也。
十一曰盘肠产者。临产母肠先出，然后儿生。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，医不能疗，偶在建昌，得坐婆一法而收之，其法以醋半盏，新汲
水七分调停， 产母面，每 一缩，三 尽收，此良法也。（收肠法妙绝）
郭稽中说：难产，是因为胎儿转身时，将儿枕（胎盘及附属物）的血块破碎，与胞宫中的败血壅滞于胎儿身体周围，导致产道不畅，因此难产。此时应紧急服用胜金散以消散瘀血，使胎儿自然容易出生。陈无择说：多因胎儿尚未转正，坐草（临盆）太早，或者用力太过，以致胞衣破裂而血水干涸，产路涩滞而胎儿难以产出。适宜先服用催生如神散，以固护阴血；倘若出现逆生或横产，应当使用前述方法针刺治疗。
《大全》说：治疗胞浆先破，恶露羊水流出过多，胎体干燥无法降下，须先给予四物汤，补养血气；其次煎煮浓葱汤，放冷后，让稳婆清洗产户，必须细致清洗，使气机上下通畅；更用酥油和滑石末涂抹产口内；随后服用神妙乳朱丹，或葵子如圣散。
第一种叫正产。妇人怀胎十月满足，忽然腰腹阵痛，胎气顿陷，直到脐腹痛极，乃至腰间重痛，肛门挺迸，接着羊水破裂出血，胎儿自然顺遂出生。
第二种叫伤产。大概因为人的出生，阴阳注定，各有其时，不可改变。现在有未临产前一个月以前，忽然脐腹疼痛，好像要生产，结果却无事发生，这名叫试月，不是正产。但一切产妇，在没有正产的征兆之前，就不可让人紧抱腰部（紧抱则胎儿不能转身，所以不可以），产妇也不可胡乱用力。凡是欲生产的妇女，脐腹疼痛，胎儿身体未顺，接生的人却让产妇虚乱用力，胎儿身体才刚转动，却被产妇用力一逼，使胎儿错路，忽横忽倒，不能正生，这都是因为产妇用力不当所致。凡产妇用力，须待胎儿身体顺直，临近门户，方才用力一送，令胎儿生下，这才是产妇用力的恰当时候（这是养育子女的方法，可让儿女平日熟闻）。若没有正产的征兆，而用力过早，并胡乱服药饵，令胎儿提前生下，譬如拔苗助长，无益而有害了。
第三种叫催产。指妇人欲生产，浆破血下，脐腹阵痛，极其严重，腰重，肛门挺迸，已经见到是正产的征兆，但胎儿却未生出，即可服药以催产。有的经过数日，产妇困苦，已分明见得是正产的征兆，但胎儿难生，亦可服药以助产妇的正气，令胎儿速得生下。（补正气确实是高明医生的做法，用人参五钱催生产最妙）
第四种叫冻产。冬月天冷，产妇经血得冷则凝，以致胎儿不能生下，这种危害最深。若冬月生产，下部不可脱去绵衣，也不可不坐卧寒处，应当满房着火，常有暖气，令产妇背身向火，令脐下腿膝间常暖，血得热则流散，使胎儿易生。
第五种叫热产。盛夏之月，产妇要温凉得所，不可恣意取凉，损伤胎气。也不可人多，热气逼袭产妇，使产妇血沸，而有发热、头疼、面赤，昏昏如醉，乃至不知人事。
第六种叫横产。胎儿先露出手，或先露出臂，这是由于产妇未当用力而用过力，胎儿身体未顺，用力一逼，遂至身体横置，不能生下。当令产妇安然仰卧，然后让接生的人，先推其手使其入内，直上渐渐逼身，以中指摩其肩，推上而正之，或以手指攀其耳而正之，须是产妇仰卧，然后推儿直上，徐徐正之，候其身体端正，煎服一盏催生药吃了，方可用力，令胎儿生下。
第七种叫倒产。产妇胎气不足，关键不牢，用力太早（母气弱而倒产者，当服补剂，若因用力早者，又当别论），致使胎儿不能回转，便直下先露出其足，当令产妇仰卧，令接生的人，推其足入去，不可令产妇用分毫力，亦不得惊恐，使胎儿自然顺遂。
第八种叫偏产。胎儿身体未正，产妇用力一逼，致使胎儿头偏在左腿，或偏在右腿，故头虽露，偏在一侧，不能生下，当令产妇仰卧，次令接生的人，轻轻推儿近上，以手正其头，令胎儿头顶端正，然后令产妇用力一送，即便生下。若是小儿头后骨偏在肛门，只露其额，当令接生的人，以绵衣炙温裹手，于肛门外方，轻轻推儿头正，便令产妇用力，送儿生也。（立顶三法）
第九种叫碍产。胎儿身体已顺，而露正顶，不能生下，盖因胎儿身体回转，肚带（脐带）攀其肩，以此露正顶而不能生，当令产妇仰卧，令接生的人，轻推儿近上，徐徐引手以中指按儿肩下，拨其肚带，仍须候胎儿身体正顺，方令产妇用力一送，使胎儿生下。
第十种叫坐产。胎儿将要出生，其母疲倦，久坐椅褥，抵其生路，急于高处系一手巾，令产妇以手攀之，轻轻屈足坐身，令胎儿生下，并非坐在物体上也。
第十一种叫盘肠产。临产时产妇肠先出，然后胎儿生。赵都运恭人，每次生产则大肠先出，然后产子，产后其肠不收，甚以为苦，医生不能疗治，偶然在建昌，得到一位稳婆的方法而收摄之，其法以醋半盏，新汲水七分调停，产妇面部，每收缩一次，三次尽收，这是良法。（收肠法妙绝）
Guo Jizhong stated: Dystocia (difficult labor) occurs because, as the fetus turns, it breaks the blood clots of the "fetal pillow" (placenta and its appendages), which obstructs the fetal body with stagnant blood in the uterus, causing blockage in the birth canal. Therefore, difficult labor ensues. In such cases, one should urgently administer Shengjin San (Golden Victory Powder) to dissipate the blood stasis, allowing the fetus to be born naturally and easily. Chen Wuyue said: It is often due to the fetus not having turned into the correct position yet, sitting on the birthing mat too early, or exerting excessive effort, leading to the rupture of the amniotic sac and drying up of blood and fluids. This makes the birth passage slippery and difficult for the fetus to descend. It is appropriate to first administer Cui Sheng Rushen San (Divine Spirit Inducing Delivery Powder) to consolidate the yin blood. If breech presentation or transverse lie occurs, acupuncture methods described previously should be used.
The *Daquan* states: For treatment where the amniotic fluid ruptures prematurely, with excessive discharge of lochia and waters, resulting in a dry fetus unable to descend, one must first administer Siwu Tang (Four Substances Decoction) to tonify blood and qi. Next, decoct a strong scallion soup, let it cool, and have the midwife wash the vulva carefully, ensuring thorough cleaning to facilitate the free flow of qi up and down. Additionally, apply a mixture of butter and talcum powder to the vaginal opening. Subsequently, administer Shenmiao Ruzhu Dan (Miraculous Pearl Milk Pill) or Kuizi Rusheng San (Hibiscus Like-Saint Powder).
The first type is called Zhengchan (Normal Labor). When a woman has completed ten months of pregnancy, she suddenly experiences intermittent pain in the waist and abdomen, the fetal qi sinks abruptly, leading to extreme pain at the navel and abdomen, heavy pain in the lower back, and protrusion of the anus. Following this, the amniotic fluid ruptures and bleeding occurs, and the fetus is born naturally and smoothly.
The second type is called Shangchan (Injured Labor). Generally, human birth is determined by yin and yang, each having its specific time, which cannot be altered. However, sometimes before one month prior to delivery, there is sudden pain in the navel and abdomen, resembling labor, but nothing happens. This is called "Shiyue" (Testing Month) and is not normal labor. All parturient women, before the signs of normal labor appear, should not have their waists tightly held (tight holding prevents the fetus from turning, thus it is inadvisable), nor should they exert force recklessly. For women in labor, when abdominal pain occurs, if the fetus is not in the correct position, and the midwife instructs the mother to exert force blindly, the fetus may begin to turn but is then forced off course by the mother's exertion, resulting in transverse or inverted positions. This is all due to improper timing of the mother's effort. Parturient women should only exert force when the fetus is aligned and approaching the cervix, pushing once to deliver the baby. This is the proper way to exert effort (This is a method of child-rearing; daughters-in-law should hear this regularly). If effort is made too early without the signs of normal labor, and medicines are taken recklessly to induce birth, it is like pulling shoots to help them grow—harmful rather than beneficial.
The third type is called Cuichan (Induced Labor). This refers to situations where a woman desires to give birth, with ruptured membranes and bleeding, severe intermittent abdominal pain, heavy waist, and anal protrusion, showing clear signs of normal labor, but the fetus has not yet been born. Medicines can be administered to induce labor. If several days have passed, the mother is exhausted, and the signs of normal labor are evident, but the fetus remains stuck, medicines can also be given to boost the mother's healthy qi, facilitating a quick delivery. (Tonifying healthy qi is indeed the practice of skilled physicians; using five qian of Ginseng Radix et Rhizoma Rubra for induction is excellent.)
The fourth type is called Dongchan (Cold Labor). In winter, due to cold weather, the menstrual blood coagulates upon exposure to cold, preventing the fetus from being born. This harm is profound. For winter deliveries, the lower body must not be stripped of woolen garments, nor should one sit or lie in cold places. The room should be heated with fire to maintain warmth. The mother should face her back toward the fire, keeping the area below the navel and knees warm. Blood flows freely when warmed, making birth easier.
The fifth type is called Rechchan (Hot Labor). In midsummer, the parturient woman must maintain appropriate temperature balance, avoiding excessive cooling which damages fetal qi. There should not be too many people present, as heat oppression can cause the mother's blood to boil, leading to fever, headache, flushed face, dizziness as if drunk, and even loss of consciousness.
The sixth type is called Hengchan (Transverse Lie). The fetus presents a hand or arm first. This is caused by the mother exerting force improperly or excessively before the fetus is aligned. The force pushes the fetus sideways, preventing delivery. The mother should lie supine comfortably. Then, the attendant should gently push the presenting limb back inside, guiding it upward along the body. Use the middle finger to massage the shoulder and push it up to correct the position, or use fingers to adjust the ear. The mother must remain supine while the fetus is pushed upward and gradually corrected. Once the body is aligned, administer a cup of Cui Sheng Yao (Delivery-Inducing Medicine), drink it, and then the mother may exert force to deliver the fetus.
The seventh type is called Daochan (Breech Presentation). Due to insufficient fetal qi and weak pelvic floor muscles, combined with premature exertion (if caused by weak maternal qi, tonics should be used; if due to premature exertion, different measures apply), the fetus fails to turn and descends feet-first. The mother should lie supine. The attendant should gently push the feet back inside. The mother must not exert any force, nor should she be frightened, allowing the fetus to naturally align.
The eighth type is called Pianchan (Oblique Lie). The fetus is not upright, and the mother's forceful pushing causes the head to shift to the left or right thigh. Although the head is visible, it is deviated to one side, preventing birth. The mother should lie supine. The attendant should gently push the fetus upward, manually correcting the head so that the vertex is centered. Then, the mother exerts force to deliver the baby. If the occiput is deviated toward the anus, exposing only the forehead, the attendant, with hands wrapped in warm cotton cloth, should gently push the head from outside the anus to correct it, after which the mother exerts force to deliver. (Three methods for vertex correction)
The ninth type is called Aichan (Obstructed Labor). The fetus is aligned and the vertex is presenting, but cannot be born. This is because, during fetal rotation, the umbilical cord wraps around the shoulder, obstructing the vertex. The mother should lie supine. The attendant should gently push the fetus upward, slowly inserting a finger to press under the shoulder and dislodge the cord. Wait until the fetus is fully aligned, then instruct the mother to exert force to deliver.
The tenth type is called Zuochan (Sitting Labor). As birth approaches, the mother becomes fatigued and sits on cushions, obstructing the birth canal. Tie a handkerchief high up. Let the mother hold it, gently bend her legs, and assume a sitting posture to facilitate delivery. This does not mean sitting on an object during birth.
The eleventh type is called Panchangchan (Prolapsed Intestine Labor). The intestines prolapse before the fetus is born. Lady Gong, wife of Zhao Duyun, experienced prolapse of the large intestine before every delivery, which could not be retracted postpartum, causing great distress. Physicians could not treat it. While in Jianchang, she learned a method from a midwife to retract it: mix half a cup of vinegar with seven parts fresh well water. Apply this mixture to the mother's face. Each time the intestine retracts slightly, repeat three times until fully retracted. This is an excellent method. (Method for retracting prolapsed intestine is superb)