〔脉诀〕欲产之妇脉离经，沉细而滑也同名。夜半觉痛应分诞，来日日午定知生。
（《脉经》曰∶离经其脉浮，腹痛引腰脊为欲生也，但离经者，不产也。又云∶其脉离经，
夜半觉，日中则生也。经者，常也，谓离其常处为离经。假如孕妇昨日见左沉实，为男之
脉，今日或脉浮，是离其寻常之脉，而异于昨日，又且腹痛，知是将诞也。通真子引
《难经》一呼三至曰离经为解。李 范又引《难经》一呼一至曰离经，以解沉细而滑，皆
非也。《难经》言损至二至虽同名离经，其脉与理则不同。且《脉经》明言离经其脉浮
也，不曾引援《难经》之文合《脉诀》。因其言脉浮，又添沉细而滑，同名离经，盖以
前所诊男女脉，或云浮大为女，若只脉浮为离经，若平常见浮大为女之脉，安辨离经，
故又增沉细而滑，以见离为浮大之常经，为常滑也。《圣惠方》云∶夜半子时觉腹痛，
来日午时必定生产。谓子午相冲，正半日时数也。通真子曰∶夜半痛，日午生，此言恐未
为的。又曰∶腹痛而腰不痛，未产也。若腹痛运腰痛甚者，即产。所以然者，肾系于腰，
胞系于肾，故也。诊其尺脉转急如切绳转珠者，即产也。生产有难易，痛来有紧慢，
安可定以半日，当以活法。）身重体热寒又频，舌下之脉黑复青，反舌上冷子当死，
腹中须遣母归冥。面赤舌青细寻看，母活子死定应难，唇口俱青沫又出，母子俱死总教
拼。面青舌赤沫出频，母死子活定知真，不信若能看应验，寻之贤哲不虚阵。（《脉指
南》作面青舌赤。盖面以候母，舌以候子，今云子活，合以舌赤为是，若云舌青，则
与前面赤舌青，母活子死之候相反。若胎先下，其子得活，如未下，子母俱亡。
自身重体热寒又频至此，并不用脉，只以外候参诀子
母生死，盖以临产脉不可定，但当以察色而知之。）
杨子建《十产论》
一曰正产者，妇人怀胎，十月满足，忽腰腹作阵疼痛，相次胎气顿陷，至于脐腹痛
极，乃至腰间重痛，谷道挺迸，继之浆破血出，儿子遂生，名曰正产。
二曰伤产者，盖一人之生，阴注阳定，各有时日，不可改移。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，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。若未有正产之候，而用力伤早，并妄服药饵，令
儿下生，譬如堰苗而助长，无益而有害矣。此名伤产。
〔娄〕上伤产一法，最为切要，慎勿轻忽也。凡十月未足，临产腹痛，或作或止，或
痛不甚者，名曰弄痛，非正产之候。或腹虽痛甚而腰不甚者，非正产之候。胎高未陷下
者，非正产之候。谷道未挺迸者，非正产之候。水浆未破，血未出者，非正产之候。浆
血虽出而腹不痛者，非正产之候。凡未有正产候，且令扶行熟忍，如行不得，或凭物坐
之，或安卧之，或服安胎药一二服，得安即止。慎勿妄服催生药饵，怆惶致令产母忧恐
而挫其志。务要产母宽心存养调停，亦令坐婆先说解论之。如觉心中烦闷，可取白蜜一
匙，新汲水调下，切勿亡乱用力，先困其母。直待子逼门户，腰重痛极，眼中如火，谷道
挺迸时，是正产候，方可用力，并服催生药也。予男妇于未产一月以前，腰腹俱痛，全
似将产，其痛至甚，但遇巳牌稍止。如此者将十余日，计无所出，因阅此条，遂与安胎
药加参、术数服，间与肉味养之，由是平复不痛，又二十余日始产一男。是时若妄动乱
用力，并服催生等药，立见危亡矣。
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，此名催产。
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，此名冻产。
〔薛〕荆妇孟冬分娩艰难，劳伤元气，产子已死，用油纸捻烧断脐带，藉其气以暖
之，俄顷忽作声，此儿后无伤食作泻之证，可见前法之功不诬。
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、头痛、面赤、昏昏如醉，乃至不知人事，此名热产。
（若夏月风凉阴雨，亦不可任意取凉，恐生大病。）
六日横产者，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，此名横产。
七曰倒产者，产母胎气不足，关键不牢，用力太早，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
儿自顺云。
蛇蜕散 治妊妇欲产时，不肯伸舒行动，多曲腰眠卧忍痛，儿在腹中，不能得转，故
脚先出，谓之逆生，须臾不救，母子俱亡。
用乌蛇蜕（一条） 蝉蜕（十四枚） 血余（一握，用胎发）
并烧灰存性，研分二服，温酒调，连进之，仰卧少顷。或用小绢针于儿脚心刺三五
刺，用盐少许涂刺处，实时顺生，母子俱活。又法，以盐涂儿足底，又可爪甲搔之，并以
盐摩母腹上。又以手中指取锅底墨。交画儿足下，即顺生。又方，取其父名，书儿足下
即顺生。若孕妇横生不可出者，以车前子为末，酒服二钱匕。又方，菟丝子为末，酒调
服一钱匕，米饮调亦得。又以百草霜、香白芷（不见火各等分。）用童便与好醋各一合，调成
膏，沸汤浸服。甚者二服即生。若妇人横逆难产，子死腹中，先用黑豆一大合，炒，熟
水与重便合煎服，神效。又方，用艾叶半斤，酒四升，煮取一升，服之。又以当归为末，酒
服方寸匕，紫苏汤调服亦可。
八曰偏产者，儿身未正，产母用力一逼，致令儿头偏拄左腿，或偏拄右腿，故头虽露，
偏拄一畔，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。若是小儿头后骨偏拄谷道，只露其额，当
令看生之人，以绵衣炙温裹手，于谷道外方，轻轻推儿头令正，便令产母用力送儿生也。此
名偏产。
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，此名碍生。
上横产，倒产、偏产、碍产四法，若看生之人，非精良妙手，不要根据用此法，恐恣
其愚，以伤人命也。按∶倒产者，今世往往随其倒足生下，并无后患，子母双全，不必
根据推足上之法亦可。又碍产者，往往肚带有缠在儿顶上，而儿头自出在产门外，看生之
人，以手拨其肚带，从儿头顶过而下之者，又有肚带缠在顶上一匝，而儿与胞衣自然同下
者，皆无妨，不必以此碍产法入产门拨下也。
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。此名坐产。
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 收尽，此良法也。
按∶前证古方以蓖麻子仁四十九粒，研涂产母头顶，肠收上，急洗去。其肠若干，以
磨刀水少许湿润之。内用磁石煎汤饮之即收上。磁石须阴阳家用有验者，若以水 母面，
恐惊则气散。
〔丹〕产后肠不收，香油五斤煎热，盛盆中，候温，坐油盆中约一食时，以皂角末
吹入鼻中，嚏作立上，妙。（《斗门》。）
〔大〕半夏为末，搐鼻中，则肠上矣。
又方以大纸捻蘸香油点灯吹灭，以烟熏产母鼻中，肠即上矣。
又方 肠出，盛以洁净漆器，浓煎黄 汤浸之，肠即上。
〔薛〕欲产之时，觉腹内转动，即当正身仰卧，待儿转身向下时作痛，试捏产母手
中指中节或本节跳动，方与临盆，即产矣。若初觉不仰卧，以待转胞，或未产而水频下，此
胞衣已破，血水先干，必有逆生难产之患。若胎衣破而不得分娩者，保生无忧散以固其血，
自然生息。如血已耗损，用八珍汤料一斤，益母草半斤，水数碗，煎熟不时饮之，亦有得
生者，凡孕妇只腹痛，未产也。若连腰痛甚者，将产也。盖肾候于腰，胞系于肾故也。凡
孕家宜预请有仁心知事稳婆，常以恩结其心，先与说知，倘有生息不顺，只说未产。或遇
双胎，只说胎衣未下，恐惊则气散，愈难生息。余家亲验之，大抵难产多患于郁闷安佚
富贵之家，治法虽云胎前清气，产后补血，不可专执。若脾胃不实，气血不充，宜预调补，
不然临产必有患难。如因难产，或大寒时，急以大油纸捻徐徐烧断其脐带，虽儿已死，令
暖气入腹，多得复生，切勿用刀断之。
【脉诀】即将临产的妇女，其脉象称为“离经”，表现为沉细而滑。若在半夜感到腹痛，应在清晨分娩；若来日午时（中午）感到腹痛，则定知在当日分娩。
（《脉经》说：离经之脉浮，腹痛牵引腰脊为将要生产，但仅凭脉离经并不能断定立即生产。又说：脉象离经，半夜感觉腹痛，到日中时分就会生产。“经”指常度，所谓离经，是指脉象离开了平常的位置。例如孕妇昨日诊得左脉沉实，这是男胎的脉象，今日脉象变浮，这是离开了她平常的脉象，且不同于昨日，再加上腹痛，就知道将要分娩了。通真子引用《难经》中“一呼三至”称为离经来解释。李范又引用《难经》中“一呼一至”称为离经，用来解释沉细而滑，这些都不对。《难经》说损脉和至脉虽同名离经，但其脉理不同。况且《脉经》明确说离经之脉是浮脉，并没有引用《难经》的文句来合释《脉诀》。因为提到脉浮，又增添了沉细而滑，都叫离经，大概是因为之前诊断男女胎的脉象，有时浮大为女胎脉，如果只以脉浮作为离经的标准，那么平时常见的浮大女胎脉，如何辨别是否为离经呢？所以又增加沉细而滑，以显示离开的是浮大的常脉，变为常滑之脉。《圣惠方》说：半夜子时感到腹痛，来日午时必定生产。这是因为子午相冲，正好是半日的时间。通真子说：半夜痛，日午生，这种说法恐怕不够确切。又说：只有腹痛而腰不痛的，还没有生产。如果腹痛且腰部疼痛严重的，就要生产了。之所以这样，是因为肾系于腰，胞宫系于肾的缘故。诊察尺脉转急如切绳或转珠状的，就是要生产了。生产有难易之分，疼痛有紧慢之别，怎么能固定说是半天呢？应当灵活掌握。）身体沉重、发热、恶寒频繁交替，舌下静脉发黑且青紫，舌头反卷且上冷，胎儿将死，腹中必须导致母亲死亡。面色赤红、舌色青紫，仔细查看，母亲存活而胎儿死亡的情况很难避免，嘴唇和口角都发青且流出泡沫，母子都将死亡。面色青紫、舌色赤红且频繁流沫，母亲死亡而胎儿存活是确定的真相，如果不信可以观察验证，寻找贤哲之言确实不虚。（《脉指南》作面青舌赤。盖面部候母，舌部候子，现在说子活，应以舌赤为准，如果说舌青，则与前面提到的面赤舌青、母活子死的征象相反。如果胎先露出，胎儿能活，如果未露出，母子俱亡。从自身重体热寒频至此段，并不使用脉诊，只通过外候来判断母子生死，大概是因为临产脉象不可固定，只能通过观察面色来知晓。）
杨子建《十产论》
第一是正产，妇人怀胎十月满足，忽然腰腹部阵痛，接着胎气顿陷，直到脐腹疼痛至极，甚至腰间重痛，肛门挺迸，随后破水出血，婴儿出生，这叫正产。
第二是伤产，人的出生，阴注阳定，各有定时，不可改变。现在有未足月一个月以前，忽然脐腹疼痛，好像要生产，却又没事，这叫试月，不是正产。但是所有产妇，在没有出现正产征兆之前，不可以让人抱腰，产妇也不可以胡乱用力，因为将要生产的妇女，脐腹疼痛，胎儿身体尚未顺位，接生的人却让产妇虚乱用力，胎儿身体刚转动，却被产妇用力一逼，使胎儿走错路，忽横忽倒，不能正常出生，这都是因为产妇用力不当造成的。凡是产妇用力，必须等到胎儿身体顺位，临近产门，才开始用力一送，让胎儿生下，这才是产妇用力的恰当时候。如果没有正产征兆就过早用力，并胡乱服药，让胎儿提前出生，就像拔苗助长，无益而有害。这叫伤产。
[娄]上面关于伤产的一种方法，最为关键，千万不要轻视。凡是十月未满，临产腹痛，或作或止，或疼痛不厉害的，名叫弄痛，不是正产征兆。或者腹部虽然痛得很厉害但腰部不痛的，不是正产征兆。胎位高未下降的，不是正产征兆。肛门未挺迸的，不是正产征兆。羊水未破，血未出的，不是正产征兆。羊水血液虽出但腹部不痛的，不是正产征兆。凡是没有正产征兆的，暂且让产妇扶行忍耐，如果走不了，或者靠着物体坐，或者安卧，或者服用一两服安胎药，得到安宁就停止。千万不要胡乱服用催生药物，惊慌失措导致产妇忧恐而挫伤意志。务必要让产妇宽心存养调理，也让接生婆先解说开导。如果觉得心中烦闷，可取白蜜一匙，新汲水调服，千万不要慌乱用力，先使母亲困乏。直等到胎儿逼近产门，腰部重痛至极，眼中如火，肛门挺迸时，才是正产征兆，才可以用力，并服用催生药。我有个亲戚在未足月一个月以前，腰腹俱痛，完全像要生产，疼痛非常剧烈，但遇到巳牌（上午9-11点）稍止。像这样的情况持续了十余天，想不出办法，于是查阅此条，就给服用加人参、白术的安胎药几服，间或给予肉类食物调养，因此平复不痛，又过了二十多天终于生下一个男孩。当时如果妄动乱用力，并服用催生等药，立刻就会危及生命。
第三是催产，说妇人想要生产，破水出血，脐腹阵痛极甚，腰重肛门挺迸已见，这是正产征兆。但胎儿却未生出，就可以服药来催产。或者已经过了几天，产妇困苦，已分明见得是正产征兆，但胎儿难生，也可以服药来助产妇正气，让胎儿速得生下，这叫催产。
第四是冻产，冬月天气寒冷，产妇经血遇冷则凝结，以致胎儿不能生下。这危害最深，如果冬月生产，下部不可脱去棉衣，也不可坐卧寒处，应当满房生火，常有暖气，让产妇背身向火，让脐下腿膝间常暖，血得热则流散，使胎儿易生，这叫冻产。
[薛]荆氏妇人在孟冬分娩艰难，劳伤元气，产下的孩子已死，用油纸捻烧断脐带，借其热气来温暖胎儿，片刻后忽然发出声音，这个孩子后来没有伤食作泻的症状，可见前法功效不虚。
第五是热产，盛夏之月，产妇要温凉适宜，不可恣意贪凉，损伤胎气，也不可人多热气逼迫产妇，使产妇血沸而有发热、头痛、面赤、昏昏如醉，乃至不知人事，这叫热产。（如果夏月风凉阴雨，也不可任意贪凉，恐怕生大病。）
第六是横产，胎儿先露出手，或先露出臂，这是由于产妇未当用力而过度用力所致。胎儿身体未顺，用力一逼，遂致身体横置不能生下，应当让产妇安然仰卧，然后让接生的人，先推其手使其入内直上，渐渐逼近身体，以中指摩擦其肩部推上并矫正它，或者用手指攀拉其耳朵来矫正它，必须是产妇仰卧，然后推儿直上，徐徐矫正，等到身体端正，煎好一盏催生药吃下，才可以用力，让胎儿生下，这叫横产。
第七是倒产，产妇胎气不足，关键不牢，用力太早，致使胎儿不能回转，便直下先露出其脚。应当让产妇仰卧，让接生的人，推其脚回去，不可让产妇用分毫力，也不得惊恐，使胎儿自然顺位。
蛇蜕散 治疗妊妇欲产时，不肯伸舒行动，多曲腰眠卧忍痛，胎儿在腹中，不能得转，所以脚先出，谓之逆生，片刻不救，母子俱亡。
用乌蛇蜕（一条） 蝉蜕（十四枚） 血余（一握，用胎发）
一起烧灰存性，研末分两次服用，温酒调服，连续进服，仰卧片刻。或者用小绢针在胎儿脚心刺三五下，用少许盐涂在刺处，实时顺生，母子俱活。又一种方法，用盐涂在胎儿足底，也可以用指甲搔之，并用盐摩擦母亲腹部。又以手中指取锅底墨，交叉画在胎儿脚下，即顺生。又一方，取其父亲的名字，写在胎儿脚下即顺生。如果孕妇横生不可出的，用车前子为末，酒服二钱匕。又一方，菟丝子为末，酒调服一钱匕，米饮调服也可以。又以百草霜、香白芷（不见火各等分），用童便与好醋各一合，调成膏，沸汤浸服。严重的两服即生。如果妇人横逆难产，子死腹中，先用黑豆一大合，炒熟，用水与重便合煎服，神效。又一方，用艾叶半斤，酒四升，煮取一升，服之。又以当归为末，酒服方寸匕，紫苏汤调服也可以。
第八是偏产，胎儿身体未正，产妇用力一逼，致使胎儿头偏拄左腿，或偏拄右腿，所以头虽露出，偏拄一边，不能生下。应当让产妇仰卧，其次让接生的人，轻轻推儿近上，用手正其头，让胎儿头顶端正，然后让产妇用力一送，即便生下。如果是小儿头后骨偏拄肛门，只露出其额头，应当让接生的人，用绵衣炙温裹手，在肛门外方，轻轻推儿头令正，便令产妇用力送儿生也。这叫偏产。
第九是碍产，胎儿身体已顺而露正顶，不能生下，盖因胎儿身体回转，肚带攀其肩，以此露正顶而不能生。应当让产妇仰卧，让接生的人，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，这叫碍生。
上面横产、倒产、偏产、碍产四种方法，如果接生的人，不是精良妙手，不要根据使用此法，恐怕放纵其愚昧，以伤人命。按：倒产者，今世往往随其倒足生下，并无后患，子母双全，不必根据推足上的方法也可以。又碍产者，往往肚带有缠在儿顶上，而儿头自出在产门外，接生的人，用手拨其肚带，从儿头顶过而下之的，又有肚带缠在顶上一匝，而儿与胞衣自然同下的，皆无妨，不必以此碍产法入产门拨下也。
第十是坐产，胎儿将要出生，其母亲疲倦久坐，椅褥抵住其生路，急于高处系一手巾，让产妇以手攀之，轻轻屈足坐身，让胎儿生下，并非坐在物体上。这叫坐产。
第十一是盘肠产，临产时母亲肠子先出来，然后胎儿出生。赵都运恭人，每次生产则大肠先出，然后产子，产后其肠不收，非常痛苦，医生不能治疗。偶然在建昌，得到一位接生婆的方法而收摄之，该方法是用醋半盏，新汲水七分调和，面向产妇，每收缩一次，三次收尽，这是良法。
按：前证古方用蓖麻子仁四十九粒，研涂产妇头顶，肠收上，急洗去。其肠若干，以磨刀水少许湿润之。内服磁石煎汤饮之即收上。磁石须阴阳家用有验者，如果用水洗面，恐怕惊则气散。
[丹]产后肠不收，香油五斤煎热，盛盆中，候温，坐油盆中约一顿饭时间，以皂角末吹入鼻中，打喷嚏立上，妙。（《斗门》。）
[大]半夏为末，搐鼻中，则肠上矣。
又一方以大纸捻蘸香油点灯吹灭，以烟熏产妇鼻中，肠即上矣。
又一方 肠出，盛以洁净漆器，浓煎黄芩汤浸之，肠即上。
[薛]欲产之时，觉腹内转动，即当正身仰卧，待胎儿转身向下时作痛，试捏产妇手的中指中节或本节跳动，才与临盆，即产矣。如果初觉不仰卧，以待转胞，或未产而水频下，这是胞衣已破，血水先干，必有逆生难产之患。如果胎衣破而不得分娩者，保生无忧散以固其血，自然生息。如血已耗损，用八珍汤料一斤，益母草半斤，水数碗，煎熟不时饮之，亦有得生者，凡孕妇只腹痛，未产也。若连腰痛甚者，将产也。盖肾候于腰，胞系于肾故也。凡孕家宜预请有仁心知事稳婆，常以恩结其心，先与说知，倘有生息不顺，只说未产。或遇双胎，只说胎衣未下，恐惊则气散，愈难生息。我家亲验之，大抵难产多患于郁闷安佚富贵之家，治法虽云胎前清气，产后补血，不可专执。若脾胃不实，气血不充，宜预调补，不然临产必有患难。如因难产，或大寒时，急以大油纸捻徐徐烧断其脐带，虽儿已死，令暖气入腹，多得复生，切勿用刀断之。
[Mai Jue (Pulse Aphorisms)] For a woman about to give birth, the pulse is termed "Li Jing" (Departing from the Regular Pulse), presenting as deep, fine, and slippery. If labor pain begins at midnight, delivery should occur at dawn; if pain begins at noon the next day, delivery will surely happen that day.
(The *Mai Jing* [Pulse Classic] states: The Li Jing pulse is floating; abdominal pain radiating to the lower back and spine indicates impending birth, but merely having a Li Jing pulse does not guarantee immediate delivery. It also says: With a Li Jing pulse, if pain is felt at midnight, birth occurs at midday. "Jing" refers to the constant or regular state. "Li Jing" means departing from one's usual pulse pattern. For example, if a pregnant woman had a deep and solid pulse on the left side yesterday—indicative of a male fetus—and today her pulse has become floating, this represents a departure from her usual pulse and differs from yesterday's. Coupled with abdominal pain, it indicates imminent delivery. Tongzhenzi interpreted this using the *Nan Jing* [Classic of Difficult Issues], defining Li Jing as three pulses per breath. Li Fan further cited the *Nan Jing*, defining Li Jing as one pulse per breath, to explain the deep, fine, and slippery pulse; both interpretations are incorrect. The *Nan Jing* mentions that both deficient and excessive pulses can be named Li Jing, but their pulse characteristics and principles differ. Moreover, the *Mai Jing* explicitly states that the Li Jing pulse is floating, without citing the *Nan Jing* to harmonize it with the *Mai Jue*. Because the text mentions a floating pulse, it adds "deep, fine, and slippery," all termed Li Jing. This is likely because previous diagnoses for fetal sex showed that a large floating pulse might indicate a female fetus. If only a floating pulse were defined as Li Jing, how would one distinguish a Li Jing pulse from the common large floating pulse seen in female pregnancies? Thus, "deep, fine, and slippery" was added to show that departing from the usual large floating pulse results in a slippery pulse. The *Shenghui Fang* [Prescriptions of Holy Grace] states: If abdominal pain is felt at midnight (Zi hour), delivery will definitely occur at noon (Wu hour). This is because Zi and Wu hours oppose each other, spanning half a day. Tongzhenzi stated that "pain at midnight, birth at noon" is perhaps not entirely accurate. He also said: Abdominal pain without lower back pain indicates no delivery yet. Severe abdominal pain accompanied by severe lower back pain indicates imminent delivery. This is because the Kidneys govern the lower back, and the uterus is connected to the Kidneys. Palpating the Chi position [pulse at the wrist] showing urgency like cutting a rope or rolling beads indicates imminent delivery. Delivery varies in difficulty, and pain intervals vary in tightness or slowness; how can one fixate on half a day? One must apply flexible methods.) Body heaviness, fever, and frequent alternating chills; blackish-blue sublingual veins; tongue turning backward and cold on top indicate fetal death, leading to maternal death. Red face and blue tongue require careful examination; if the mother survives, fetal survival is difficult. Blue lips and mouth with frothing indicate death for both mother and child. Blue face and red tongue with frequent frothing indicate maternal death but fetal survival. If you do not believe this, observe the verification; the words of sages are not false. (*Maizhi Nan* [Guide to Pulse Indications] reads "blue face and red tongue." The face reflects the mother, the tongue reflects the fetus. Since it states the fetus lives, red tongue is correct. If the tongue were blue, it would contradict the earlier sign of red face/blue tongue indicating maternal survival/fetal death. If the fetus presents first, it may survive; if not, both perish. From "body heaviness..." onwards, pulse diagnosis is not used; instead, external signs are consulted to determine the life or death of mother and child, because the labor pulse is not fixed, and color observation is relied upon.)
Yang Zijian's *Ten Types of Labor*
First is Zheng Chan [Normal Labor]: When a woman carries a fetus for ten months, she suddenly experiences阵痛 (paroxysmal pain) in the waist and abdomen. Subsequently, the Qi of the fetus descends abruptly. Pain reaches its peak in the umbilical and abdominal region, extending to severe heaviness and pain in the lower back. The anus protrudes (tenesmus-like sensation). Then, the amniotic sac ruptures, blood flows, and the infant is born. This is called Normal Labor.
Second is Shang Chan [Injured/Preterm Labor]: A person's birth is determined by Yin and Yang at specific times, which cannot be altered. If a woman experiences sudden umbilical and abdominal pain resembling labor more than a month before term, but nothing happens, this is called "Shi Yue" [Testing Month], not Normal Labor. However, for all parturient women, before the signs of Normal Labor appear, one must not hold the woman by the waist, nor should she exert force recklessly. In women about to deliver, when the abdomen hurts, the fetus is not yet in position. If the midwife encourages the mother to exert force prematurely, causing the fetus to shift, and the mother pushes hard, the fetus may turn sideways or upside down, unable to be born normally. This is caused by improper timing of maternal effort. Maternal effort should only begin when the fetus is in position and approaching the cervix ("gate"), pushing once to deliver the baby. This is the proper use of force. Exerting force early without Normal Labor signs, or taking drugs indiscriminately to induce early birth, is like pulling shoots to help them grow—it is harmful and useless. This is called Injured Labor.
[Lou] The method regarding Injured Labor above is crucial; do not neglect it. If it is less than ten months, and there is labor pain that comes and goes, or is mild, it is called "Nong Tong" [Playing Pain], not a sign of Normal Labor. If abdominal pain is severe but lower back pain is mild, it is not Normal Labor. If the fetus is high and has not descended, it is not Normal Labor. If the anus does not protrude, it is not Normal Labor. If water and blood have not issued, it is not Normal Labor. If water and blood issue but there is no abdominal pain, it is not Normal Labor. In the absence of Normal Labor signs, let the woman walk and endure patiently. If she cannot walk, let her sit leaning on something, lie down, or take one or two doses of Fetus-Anchoring Medicine. Stop once she is calm. Do not recklessly take Parturition-Inducing Drugs, causing panic and fear, which damages her spirit. Ensure the mother remains relaxed and nurtured; the midwife should explain and comfort her. If she feels stifled, take one spoonful of white honey mixed with fresh water. Do not exert force wildly, exhausting the mother first. Only when the fetus presses against the cervix, causing extreme lower back heaviness/pain, eyes feeling fiery, and anus protruding, is it the sign of Normal Labor. Then, exert force and take Parturition-Inducing Drugs. I had a relative who, more than a month before term, experienced severe waist and abdominal pain resembling labor, peaking until the Si hour (9-11 AM) when it subsided. This lasted over ten days. Having exhausted ideas, I consulted this text and prescribed Fetus-Anchoring Medicine with Ginseng and Atractylodes for several doses, along with meat broth for nourishment. She recovered and felt no pain, delivering a boy twenty days later. Had she exerted force wildly or taken inducing drugs then, she would have faced immediate danger.
Third is Cui Chan [Induced Labor]: When a woman is ready to deliver, with ruptured membranes, bleeding, severe paroxysmal abdominal pain, heavy lower back, and protruding anus, these are signs of Normal Labor. But if the fetus has not yet been born, one may administer medicine to induce delivery. Or, if several days have passed, the mother is suffering, and the signs of Normal Labor are clear, but the fetus is difficult to deliver, one may administer medicine to boost the mother's healthy Qi, facilitating rapid delivery. This is called Induced Labor.
Fourth is Dong Chan [Cold Labor]: In winter, due to cold weather, the mother's menstrual blood coagulates upon exposure to cold, preventing the fetus from being born. This harm is profound. In winter deliveries, the lower body must not be stripped of cotton clothes, nor should the mother sit or lie in cold places. The room should be heated with fire to maintain warmth. The mother should face the fire with her back, keeping the area below the navel and knees warm. Warmth causes blood to flow freely, making delivery easier. This is called Cold Labor.
[Xue] Lady Jing suffered difficult labor in early winter, damaging her Yuan Qi. The child was born dead. We burned an oil-paper wick to sever the umbilical cord, using its heat to warm the infant. Shortly after, the infant made a sound. Later, this child never suffered from food stagnation or diarrhea, proving the efficacy of this method.
Fifth is Re Chan [Hot Labor]: In midsummer, the parturient woman must maintain appropriate warmth and coolness. She must not indulge in cooling herself excessively, damaging fetal Qi. Nor should many people crowd around, generating heat that oppresses the mother, causing her blood to boil, resulting in fever, headache, red face, dizziness like drunkenness, or loss of consciousness. This is called Hot Labor. (If summer brings cool winds or rain, one must not seek coolness arbitrarily, lest serious illness arise.)
Sixth is Heng Chan [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 in position, forceful pushing causes the body to lie transversely, preventing birth. The mother should lie supine. The attendant should first push the limb back inside, guiding it up towards the body. Using the middle finger, rub the shoulder and push upwards to correct it, or pull the ear to straighten it. The mother must be supine while the attendant pushes the fetus up gently. Once the body is aligned, administer a cup of Parturition-Inducing Medicine. After ingestion, the mother may exert force to deliver the fetus. This is called Transverse Lie.
Seventh is Dao Chan [Breech Presentation]: Due to insufficient fetal Qi and lax pelvic ligaments, premature exertion prevents the fetus from turning, causing the feet to present first. The mother should lie supine. The attendant should push the feet back up. The mother must not exert any force, nor should she be frightened, allowing the fetus to naturally assume the correct position.
She Tuo San [Snake Molt Powder]: Treats pregnant women about to deliver who refuse to stretch and move, preferring to curl up and endure pain. The fetus cannot turn in the womb, so the feet present first, called "Ni Sheng" [Reverse Birth]. Without prompt rescue, both mother and child die.
Use Black Snake Molt (one piece), Cicada Slough (fourteen pieces), Xue Yu [Scorched Hair] (a handful, using fetal hair).
Burn all to ash while retaining their nature, grind into powder, divide into two doses. Mix with warm wine and take consecutively. Lie supine for a short while. Alternatively, prick the sole of the fetal foot three to five times with a small silk needle. Apply a little salt to the puncture sites. Delivery will proceed smoothly, saving both mother and child. Another method: Apply salt to the sole of the fetal foot, scratch with fingernails, and rub the mother's abdomen with salt. Use the middle finger to collect soot from the bottom of a pot. Draw crosswise marks on the sole of the fetal foot; delivery will proceed smoothly. Another prescription: Write the father's name on the sole of the fetal foot; delivery will proceed smoothly. For transverse presentation where the fetus cannot emerge, take Plantago Seed powder, mix with wine, and take two qianbi. Another prescription: Take Dodder Seed powder, mix with wine, and take one qianbi. Rice water decoction is also acceptable. Combine Bai Cao Shuang [Allay Dust] and Xiang Bai Zhi [Angelica Dahurica] (equal parts, not roasted). Mix with child's urine and good vinegar (one he per each) to form a paste. Soak in boiling water and ingest. Severe cases resolve in two doses. For difficult transverse/breech labor with fetal death in utero, first stir-fry one dahe of black beans. Cook with water and "heavy urine" (late-stage pregnancy urine) and ingest. Miraculous effect. Another prescription: Boil half a jin of Mugwort Leaf in four sheng of wine until one sheng remains. Ingest. Alternatively, take Angelica Root powder, mix with wine, and take a fangcunbi. Perilla Decoction is also acceptable.
Eighth is Pian Chan [Oblique Lie]: The fetus is not upright. Forceful maternal pushing causes the head to rest obliquely against the left or right leg. Although the head emerges, it is stuck on one side and cannot be born. The mother should lie supine. The attendant should gently push the fetus upward, manually correcting the head so the vertex is centered. Then, the mother exerts force to deliver. If the occiput rests against the anus, exposing only the forehead, the attendant should wrap hands in warmed cotton cloth and gently push the head from outside the anus to correct it, then instruct the mother to push. This is called Oblique Lie.
Ninth is Ai Chan [Impeded Labor]: The fetus is in position and the vertex presents, but cannot be born. This is because the fetus turned, and the amnion/chord wrapped around the shoulder, preventing the vertex from descending. The mother should lie supine. The attendant should gently push the fetus upward, slowly reaching in. Using the middle finger, press under the shoulder to dislodge the membrane. Wait until the fetus is properly aligned, then instruct the mother to push. This is called Impeded Birth.
Regarding the four methods above (Transverse, Breech, Oblique, Impeded): If the attendant is not highly skilled, do not attempt these methods, lest ignorance cause harm. Note: In modern times, breech births often occur naturally with feet presenting first, with no sequelae, and both mother and child survive. It is not necessary to forcibly push the feet up. Regarding Impeded Labor: Often, the amnion wraps around the vertex, but the head emerges naturally. The attendant may simply dislodge the membrane from the vertex. Sometimes the membrane wraps once around the vertex, and the fetus and placenta descend together naturally. These are harmless; there is no need to insert fingers into the vagina to dislodge the membrane as described in the Impeded Labor method.
Tenth is Zuo Chan [Sitting Labor]: As the fetus is about to be born, the mother sits for a long time out of fatigue. The chair/cushion obstructs the birth canal. Tie a handkerchief high up. Let the mother grasp it, bend her legs slightly, and sit in a semi-squatting position to facilitate delivery. This does not mean sitting on an object. This is called Sitting Labor.
Eleventh is Pan Chang Chan [Prolapsed Intestine Labor]: During labor, the mother's intestine prolapses before the fetus is born. Lady Gongren, wife of Zhao Duyun, always experienced rectal prolapse before delivery. Postpartum, the intestine did not retract, causing great distress. Doctors could not treat it. While in Jianchang, she learned a method from a midwife to reduce it: Mix half a zhan of vinegar with seven parts fresh water. Apply to the mother's face. Each time the intestine retracts slightly, repeat three times until fully reduced. This is an excellent method.
Note: Ancient prescriptions for this condition used forty-nine kernels of Castor Bean, ground and applied to the mother's vertex to reduce the intestine. Wash off immediately. Moisten the prolapsed intestine slightly with water used for sharpening knives. Internally, drink a decoction of Magnetite. Use Magnetite verified by Feng Shui masters for efficacy. Washing the face with water may cause fright and scatter Qi.
[Dan] For postpartum intestinal prolapse, heat five jin of Sesame Oil. Pour into a basin. When warm, sit in the oil basin for about the duration of a meal. Blow Rhinolithis Powder [Gleditsia Sinensis Powder] into the nose to induce sneezing, which reduces the intestine instantly. Excellent. (*Doumen*)
[Da] Grind Pinellia Tuber into powder. Snuff into the nose; the intestine rises.
Another prescription: Dip a paper twist in Sesame Oil, light it, blow it out, and smoke the mother's nose with the smoke; the intestine rises.
Another prescription: Place the prolapsed intestine in a clean lacquerware vessel. Immerse in a strong decoction of Scutellaria Baicalensis [Chinese Skullcap] soup; the intestine rises.
[Xue] At the onset of labor, when internal movement is felt, the mother should lie supine upright. Wait for the fetus to turn downward and pain to begin. Test the mother's middle finger; if the middle or proximal phalanx pulses, she is ready for delivery, and birth will follow. If she does not lie supine initially to wait for fetal rotation, or if water leaks frequently before labor, the membranes have ruptured, and blood/fluids are depleted. This risks reverse or difficult birth. If membranes rupture but delivery fails, use Bao Sheng Wu You San [Treasure Life Fearless Powder] to consolidate blood, ensuring natural birth. If blood is already depleted, use one jin of Ba Zhen Tang [Eight Treasures Decoction] ingredients plus half a jin of Motherwort Herb. Decoct in several bowls of water. Drink frequently. Some survive. Generally, if a pregnant woman has only abdominal pain, she has not delivered. If severe lower back pain accompanies it, delivery is imminent. This is because the Kidneys manifest in the lower back, and the uterus connects to the Kidneys. Pregnant women should hire a compassionate and experienced midwife in advance, building rapport through kindness. Inform her beforehand. If birth is difficult, tell her to say "not yet in labor." If twins, say "placenta not yet delivered." Fright scatters Qi, making birth harder. My family has verified this. Generally, difficult labor is common among wealthy families who are sedentary and depressed. Treatment theory states clearing Qi during pregnancy and tonifying blood postpartum, but one must not adhere rigidly. If Spleen/Stomach are weak and Qi/Blood insufficient, pre-conditioning tonification is necessary. Otherwise, labor difficulties are inevitable. In case of difficult labor or extreme cold, urgently burn the umbilical cord slowly with a thick oil-paper wick. Even if the infant is dead, warmth entering the abdomen may revive the child. Never cut with a knife.