欲产之脉缓滑吉。实大弦急死来侵。
池氏曰。新产气血虚损。如见缓损脉。乃脾胃气和。则为吉。实大弦急之
脉。乃肝木胜脾土。木旺土衰。胃气损而死。其说亦是。愚谓凡病脉贵乎
相当。血虚脉虚理也。今新产则血已虚矣。其脉如缓而且滑则吉。何也。
缓则胃气存。滑则血不甚衰。故曰吉。若脉见实大弦急。则胃气衰而风
火乘之。是证脉不相当矣。故曰死来侵也。
若得重沉小者吉。忽若牢强命不停。
成自明曰。若产妇诊得沉重微小者。是形虚相应。故云吉兆之脉。忽然
诊得坚硬牢实之脉。是脉盛形衰相反。性命不可停流而死也。
寸口涩疾不调死。沉细附骨不绝生。审看此候分明记。常须念此向心经。
寸口者。十二经脉之所会也。新产而见涩疾不调。涩疾则血已衰。不调
者。无复伦次。是以知其当死。若诊得其脉沉细附骨。而往来反绝。是血
脉虽去。而元气尚存。正与新产之证相合。故曰生也。
伤寒头痛连百节。气急冲心溺如血。上生斑点赤黑时。壮热不止致胎灭。
夫妊娠。大事也。伤寒。大病也。妊娠而兼伤寒。其险可知矣。巢元方曰。人
体虚而为寒所伤。即成病为伤寒也。轻者啬啬恶寒。吸吸发热。微咳鼻
塞。数日乃止。重者头痛体疼。憎寒壮热。久不歇。亦伤胎也。巢氏之言如
此。然胎之所以伤者何也。凡胎喜凉而恶热。故安胎之药。多用寒凉。黄
芩薄荷之类是也。夫伤寒为热病。今壮热不止。则胎不安。胎不安则上
冲心而气急。下溺赤而如血。热毒攻于阳明。则生赤黑斑点。内外俱为
热毒所伤。而胎未有不殒者矣。在知机之士。预为防护。随其证而调治
之。如发斑黑色。小便如血。气喘急。胎欲落者。栀子仁汤。壮热头痛者。栀
子五物汤。斑黑溺血者。升麻六物汤。发斑黑小便如血胎欲落者。栀子
升麻汤。外用伏龙肝。井底泥土方涂脐下。庶可免其殒灭之患也。
呕逆不止心烦热。腰背俱强胎痛裂。六七日来热腹中。小便不通大便结。
巢氏病源曰。妊娠大小便不通。若热结膀胱。大便不通。热结小肠。小便
不通。若大小肠俱为热所结。故烦满大小便不通也。凡大小便不通。则
内热肠胃气逆。今变干呕也。又曰。妇人肾以系胞。妊娠而腰痛甚者。多
堕胎也。洁古曰。怀妊妇人伤寒病者。须问大小便。大小便如利。知不殒
胎。黄龙汤主之。薛立斋治妊娠热病头痛。呕吐烦闷。人参竹茹汤。或补
遗芦根汤。六七日来。大小便秘涩。大黄饮。又时气六七日。大小便不利。消热饮。
欲分娩时的脉象若呈现缓滑之象，则为吉兆；若呈现实大弦急之象，则预示死亡临近。
池氏说：新产后气血虚弱亏损，如果见到缓而微损的脉象，这是脾胃之气调和的表现，所以是吉兆。如果见到实大弦急的脉象，这是肝木克制脾土，木气过旺而脾气衰败，胃气受损，所以会导致死亡。这种说法也是有道理的。我认为凡是疾病，脉象与病情应当相称。血虚导致脉虚，这是常理。现在新产之后，血液已经亏虚，如果脉象缓而且滑，就是吉兆。为什么呢？缓脉说明胃气尚存，滑脉说明血液没有严重衰败。所以说这是吉兆。如果脉象出现实大弦急，那么胃气衰败，风邪和火邪乘虚而入。这就是证候与脉象不相称。所以说“死亡临近”。
如果诊得脉象重按之下细小者，为吉兆；忽然诊得脉象坚硬牢强者，生命难以维持。
成自明说：如果产妇诊得脉象沉重微小，这是脉象与形体虚弱的状态相应，所以说是吉兆的脉象。忽然诊得脉象坚硬牢实，这是脉象盛大而形体衰弱，两者相反，性命无法长久维持而致死。
寸口脉涩疾且不调者死，沉细而按至骨仍有根者生。仔细审察这些征候并明确记住，经常要念诵这些内容以铭记于心。
寸口，是十二经脉汇聚的地方。新产后如果出现涩、疾且不调的脉象，涩和疾说明血液已经衰败，不调说明脉律失去次序，因此知道患者将会死亡。如果诊得脉象沉细，按至骨部仍有搏动，虽然血脉看似断绝，但元气尚存，这正与新产后的证候相符，所以说能生存。
伤寒引起的头痛牵连头部百节，气急上冲心胸，小便出血如血状，身上出现赤黑色斑点，持续高热不止导致胎儿死亡。
妊娠是一件大事，伤寒是一种大病。妊娠期间兼患伤寒，其危险性可想而知。巢元方说：人体虚弱时被寒邪所伤，就会形成伤寒病。轻症表现为怕冷、发热、轻微咳嗽、鼻塞，几天后停止。重症表现为头痛、身体疼痛、憎恶寒冷、高热，长时间不缓解，也会损伤胎儿。巢氏的话就是这样。然而，胎儿之所以被损伤的原因是什么呢？凡胎儿喜欢凉爽而厌恶炎热，所以安胎的药物，多使用寒凉性质的，如黄芩、薄荷等。伤寒属于热病，现在高热持续不止，那么胎儿就不安宁。胎儿不安宁就会上冲心胸导致气急，下注膀胱导致小便色红如血。热毒攻入阳明经，就会产生赤黑色的斑点。内外都受到热毒的伤害，胎儿没有不堕落的。在懂得机变的人士那里，会预先进行防护，根据证候进行调理治疗。如出现发黑斑、小便如血、气喘急促、胎儿欲坠落者，用栀子仁汤；高热头痛者，用栀子五物汤；斑黑尿血者，用升麻六物汤；发黑斑、小便如血、胎儿欲坠落者，用栀子升麻汤。外用伏龙肝（灶心土）、井底泥土敷涂于脐下，或许可以避免胎儿死亡的祸患。
呕吐逆止不住，心烦发热，腰背僵硬，胎儿疼痛剧烈如撕裂，六七日来腹部发热，小便不通畅，大便干结。
巢氏《病源》说：妊娠期间大小便不通，如果是热邪结聚在膀胱，则大便不通；热邪结聚在小肠，则小便不通。如果大小肠都被热邪结聚，所以烦躁胀满，大小便都不通。凡是大便和小便不通，就会导致内热、肠胃之气上逆，现在变为干呕。又说：妇女的肾脏系连胞宫，妊娠期间腰痛严重的，大多会发生堕胎。洁古说：怀孕妇人患伤寒病的，必须询问大小便情况。如果大小便通畅，就知道不会堕胎，用黄龙汤主治。薛立斋治疗妊娠热病头痛、呕吐烦闷，用人参竹茹汤，或者补遗芦根汤。六七日来，大小便秘涩，用大黄饮。又有时行疫病六七日，大小便不利，用消热饮。
The pulse in the period of impending delivery is auspicious if it is slow and slippery (Huan Hua Mai, slow and slippery pulse); however, a solid, large, wiry, and rapid pulse (Shi Da Xian Ji Mai, solid, large, wiry, and rapid pulse) indicates imminent death.
Master Chi stated: After recent childbirth, qi and blood are deficient and depleted. If a slow and slightly weakened pulse is observed, it indicates harmonious spleen and stomach qi, which is auspicious. A solid, large, wiry, and rapid pulse indicates liver wood overcoming spleen earth, where wood is excessive and earth is weak, leading to damage of stomach qi and death. This explanation is also reasonable. I believe that for all diseases, the pulse should correspond to the condition. Blood deficiency leading to a deficient pulse is logical. Now, after recent childbirth, blood has already become deficient. If the pulse is slow and slippery, it is auspicious. Why? A slow pulse indicates that stomach qi remains; a slippery pulse indicates that blood is not severely depleted. Therefore, it is said to be auspicious. If the pulse appears solid, large, wiry, and rapid, then stomach qi is declining, and wind and fire pathogens take advantage of this weakness. This represents a mismatch between syndrome and pulse. Therefore, it is said that "death approaches."
If the pulse is heavy, deep, and small upon palpation, it is auspicious; if suddenly it becomes firm and strong, life cannot be sustained.
Cheng Ziming stated: If a postpartum woman presents with a heavy, deep, minute, and small pulse, this corresponds to the physical deficiency, thus indicating an auspicious pulse. Suddenly presenting with a hard, firm, and solid pulse indicates that the pulse is vigorous while the body is weak, a contradiction where life cannot endure long, leading to death.
A cun-kou (radial artery at the wrist) pulse that is choppy, rapid, and irregular indicates death; a deep, fine pulse that persists when pressed to the bone indicates survival. Carefully examine these signs and remember them clearly; always keep them in mind.
The cun-kou area is the convergence point of the twelve meridians. After recent childbirth, if a choppy, rapid, and irregular pulse is seen, choppy and rapid indicate that blood has declined, and irregularity indicates a loss of rhythm. Thus, death is anticipated. If the pulse is found to be deep and fine, yet still palpable when pressed to the bone, although the blood vessels may seem severed, the primordial qi (Yuan Qi) remains. This aligns with the postpartum condition, hence survival is indicated.
Typhoid fever causing headache extending to all joints, urgent breathing rushing to the heart, urine resembling blood, appearance of red-black macules on the body, and continuous high fever leading to fetal demise.
Pregnancy is a major event, and typhoid fever is a serious disease. Pregnancy complicated by typhoid fever is undoubtedly dangerous. Chao Yuanfang stated: When the human body is deficient and injured by cold pathogens, typhoid fever results. Mild cases present with aversion to cold, low-grade fever, slight cough, and nasal congestion, resolving after several days. Severe cases present with headache, body pain, severe aversion to cold, and persistent high fever, which also damages the fetus. Such is Chao's statement. However, why is the fetus damaged? Fetuses prefer coolness and dislike heat. Therefore, herbs for calming the fetus often use cold and cooling properties, such as Huangqin (Scutellariae Radix, 黄芩) and Bohe (Menthae Haplocalycis Herba, 薄荷). Typhoid fever is a heat disease. Continuous high fever causes fetal unrest. Fetal unrest leads to upward rushing to the heart causing urgent breathing, and downward flow to the bladder causing urine to appear bloody. Heat toxins attack the Yangming channel, producing red-black macules. Both internal and external systems are damaged by heat toxins, and the fetus will inevitably abort. Those who understand these mechanisms should provide preventive care and treat according to the syndrome. For black macules, bloody urine, panting, and threatened abortion, use Zhizi Ren Tang (Gardeniae Semen Decoction, 栀子仁汤). For high fever and headache, use Zhizi Wuwu Tang (Gardeniae Five-Substance Decoction, 栀子五物汤). For black macules and hematuria, use Shengma Liuwu Tang (Cimicifugae Rhizoma Six-Substance Decoction, 升麻六物汤). For black macules, bloody urine, and threatened abortion, use Zhizi Shengma Tang (Gardeniae Cimicifugae Decoction, 栀子升麻汤). Externally, apply Fulonggan (Dragon's Liver Earth, 伏龙肝 - caulis longanae or furnace hearth soil) and mud from the bottom of a well to the lower umbilicus to perhaps avoid fetal loss.
Unstoppable vomiting and regurgitation, vexation and heat, stiffness of waist and back, severe fetal pain like tearing, abdominal heat for six or seven days, urinary retention, and constipation.
Chao's *Bing Yuan* states: In pregnancy, obstruction of urination and defecation occurs if heat binds in the bladder (causing constipation) or in the small intestine (causing urinary retention). If both intestines are bound by heat, there is vexation, fullness, and obstruction of both urination and defecation. Obstruction of urination and defecation leads to internal heat and rebellious qi in the stomach and intestines, manifesting now as dry retching. It is also stated: The kidneys bind the uterus in women. Severe lower back pain during pregnancy often leads to miscarriage. Jiegu stated: For pregnant women suffering from typhoid fever, one must inquire about urination and defecation. If they are unobstructed, it is known that the fetus will not be lost; treat with Huanglong Tang (Yellow Dragon Decoction, 黄龙汤). Xue Lizhai treated pregnancy complicated by heat disease with headache, vomiting, and vexation using Renshen Zhuru Tang (Ginseng and Bamboo Shavings Decoction, 人参竹茹汤) or Buyi Lugeng Tang (Reed Rhizome Decoction from Supplements, 补遗芦根汤). For six or seven days of constipation and difficult urination/defecation, use Dahuang Yin (Rhubarb Drink, 大黄饮). Also, for epidemic febrile diseases lasting six or seven days with difficulty in urination and defecation, use Xiaore Yin (Heat-Dispersing Drink, 消热饮).