胎死。只宜佛手散。服之自下。或不下。再用平胃散一服。加朴硝二三钱。能令化下极
易耳。古人立法各有精义。且经屡验。不吾欺也。勿用奇方怪药。以伤母命。
或问何以知其胎死。曰面赤舌青。母活子死。面青舌赤。子活母亡。面舌俱青。子母俱
死。况死胎坠胀。疼痛亦与常产不同。
或问胞衣不下何故。曰总是临盆早之故。当产之时。骨节开张。壮者数日而合。怯者
弥月方合。今不待其开。而强出之。故胎出而骨眼随闭。以致胞出不及耳。
又曰。闻此乃极恶之症。可以损命。有诸。曰不妨。不必服药。亦不必惊惶。若胞衣不出。
急用粗麻线将脐带系住。又将脐带双折再系一道。以微物坠住。再将脐带剪断。
过三五日。自痿缩干小而下。累用有验。只要与产母说知。放心不必惊恐。不必听
稳婆。妄用手取。多有因此而伤生者。慎之慎之。
乳少者血虚之故。如产母去血过多。又或产前有病。以及贫俭之家。仆妇下人。产后
失于调养。血脉枯槁。或年至四十。血气渐衰。皆能无乳。但服通脉汤。自有乳。若乱
用穿山甲。王不留行。等药。往往不效。即或勉强打通。乳汁清薄。令儿不寿。且损伤
气血。产后多病。不久便干。反为不美。
大全方曰。妇人怀孕。或有七八个月生者。有一年二年。乃至四年。而后生者。不可不知。
杨子建十产论。可谓详悉之极。予之所论多本于此。但惜稍冗。匆猝视之。安能得其
要乎。谨录伤胎一篇。亦足以尽之矣。
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
未至正产之候。切不可令人抱腰。产母亦不可妄乱用力。盖儿身未顺。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。或横或倒。不
能正生。皆缘产母用力未当之所致。凡产母用力。须待儿已顺身。临逼门户。方始
用力一送。令儿下生。此方是产母之用力当也。若未至正产之候。而用力伤儿。并
妄服药饵。令儿下生。譬如揠苗助长。无益而有损矣。此名伤产。
薛院使云。欲产之时。觉腹内转动。即当正身仰睡。待儿转身向下。时时作痛。试捏产母手中指节。
或本节跳动。方与临盆。即产矣。
大旨云。大凡生产。自有时候。未见时候。切不可强用催生药。
又云。切不可坐草。及令稳婆乱动手 。
朱丹溪先生云。催生只用佛手散。最稳当。又效捷。
又云。产后以大补气血为主。虽有他症。亦末治之。
胎儿死亡。只适宜使用佛手散。服用后胎儿自然会娩出。如果仍未娩出，再服用一剂平胃散，并加入朴硝二三钱，能使死胎极其容易地化解排出。古人制定方法各有精妙义理，且经过多次验证，不会欺骗我们。不要使用奇奇怪怪的方药，以免伤害母亲的生命。
有人问如何知道胎儿已经死亡？回答说：孕妇面色红润而舌色发青，是母体存活而胎儿死亡；孕妇面色发青而舌色红润，是胎儿存活而母体将亡；面色和舌色都发青，则是母子双亡。况且死胎坠落时的胀痛感，疼痛也与正常分娩不同。
有人问胎盘（胞衣）不下的原因是什么？回答说：这总是因为临盆过早的缘故。在应当生产的时候，骨节张开，身体强壮的人几天就能闭合，身体虚弱的人要一个月才能闭合。现在不等待其自然张开，就强行让胎儿出来，所以胎儿出来后骨眼随即关闭，导致胎盘来不及排出。
又说：听说这是极恶毒的病症，会损害生命。是这样吗？回答说：不妨事。不必服药，也不必惊慌。如果胎盘不出，急忙用粗麻线将脐带系住，再将脐带对折系上一道，用轻微的重物坠住，然后将脐带剪断。过三五天，胎盘自然会萎缩、干枯、变小并排出。多次使用都有验证。只要告知产妇，让她放心，不必惊恐。不要听信稳婆（接生婆），胡乱用手去取，多有因此丧命的。千万谨慎，千万谨慎。
乳汁少是因为血虚的缘故。如产妇失血过多，或者产前有病，以及贫穷俭省之家，仆妇下人，产后缺乏调养，血脉枯槁，或者年龄到了四十岁，气血逐渐衰退，都能导致无乳。只需服用通脉汤，自然会有乳汁。如果乱用穿山甲、王不留行等药，往往无效。即使勉强打通，乳汁清稀淡薄，使婴儿不能长寿，而且损伤气血，产后多病，不久便干涸，反而不好。
《大全方》说：妇女怀孕，有的七八个月就生的，有一年两年，乃至四年后才生的，不可不知道。杨子建的《十产论》，可以说详细至极。我所论述的多以此为基础。只是可惜篇幅稍长，匆忙看时，怎么能得其要领呢？谨录《伤胎》一篇，也足以概括了。
现在有未足月（正产一月以前），忽然脐腹疼痛，好像要生产，结果却没事，这叫试月，不是真正的生产。但未到真正生产的时机，切不可让人抱腰扶持，产妇也不可胡乱用力。因为胎儿身体尚未顺位，接生妇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，使胎儿走错路，或横或倒，不能正常出生，都是因为产妇用力不当所致。凡是产妇用力，必须等到胎儿身体已顺，临近产门，才开始用力一送，让胎儿降生。这才是产妇用力的恰当时候。如果未到正产时机，而用力伤了胎儿，并胡乱服药饵，让胎儿提前出生，譬如拔苗助长，无益而有损。这叫伤产。
薛院使说：将要生产时，感觉腹内胎儿转动，就应当端正身体仰卧，等待胎儿转身向下，时时作痛，试着捏产妇的中指节，如果本节跳动，才是临盆，即要生产了。
大旨云：大凡生产，自有时候。未见时候，切不可强用催生药。
又说：切不可坐草（指上产床准备生产），及令稳婆乱动手。
又说：产后以大补气血为主，虽有他症，也不治它（先治本）。
Fetal death. Only Foshou San (Buddha's Hand Powder) is suitable. After taking it, the fetus will naturally be expelled. If it does not come out, take another dose of Pingwei San (Calm the Stomach Powder) with 2-3 qian of Poxiao (Mirabilite). This can make the dead fetus dissolve and pass out extremely easily. The ancient methods for formulating prescriptions each have profound significance, and they have been verified repeatedly; they do not deceive us. Do not use strange or bizarre remedies to harm the mother's life.
Someone asked how to know if the fetus has died. The answer is: if the mother's face is red and her tongue is blue, the mother lives while the fetus dies; if the mother's face is blue and her tongue is red, the fetus lives while the mother perishes; if both the face and tongue are blue, both mother and fetus die. Furthermore, the distension and pain caused by the expulsion of a dead fetus differ from normal childbirth.
Someone asked why the placenta (bao yi) fails to descend. The answer is: this is always due to premature labor. At the time of delivery, the joints open; robust individuals close them within a few days, while frail individuals may take a month to close them. Now, forcing the fetus out before the natural opening occurs causes the bony aperture to close immediately after the fetus exits, preventing the placenta from being expelled in time.
It is also said: It is heard that this is an extremely malignant condition that can endanger life. Is this true? The answer is: No need to worry. There is no need for medication, nor should one panic. If the placenta does not come out, urgently tie the umbilical cord with coarse hemp thread, fold the cord double and tie it again, hang a light weight on it to keep it taut, and then cut the umbilical cord. After three to five days, the placenta will naturally atrophy, dry up, shrink, and be expelled. This method has been verified many times. Simply inform the parturient woman to reassure her and eliminate fear. Do not listen to midwives who recklessly attempt manual extraction; many have died because of this. Be extremely cautious.
Scanty lactation is due to blood deficiency. For instance, if the parturient woman loses excessive blood during delivery, or was ill before delivery, or belongs to a poor family where servants lack proper postpartum care leading to withered blood vessels, or is around forty years old with declining qi and blood, all these can result in a lack of milk. Simply taking Tongmai Tang (Unblocking Vessels Decoction) will naturally produce milk. If one recklessly uses herbs such as Chuan Shan Jia (Pangolin Scales) and Wang Bu Liu Xing (Vaccariae Semen), it is often ineffective. Even if flow is forcibly established, the milk will be thin and watery, failing to sustain the infant's longevity, and damaging qi and blood, leading to various postpartum illnesses and rapid cessation of lactation, which is undesirable.
The *Da Quan Fang* states: Women may give birth at seven or eight months of pregnancy, or even after one, two, or four years of gestation; this must be known. Yang Zijian's *Shi Chan Lun* (Treatise on Ten Types of Childbirth) is extremely detailed. My discussions are largely based on this work. However, it is regrettable that it is somewhat lengthy; how can one grasp its essentials when reading it hastily? I have carefully recorded the chapter on "Injuring the Fetus," which is sufficient to cover the matter.
There are cases where, one month before full term, there is sudden pain in the navel and abdomen resembling labor pains, yet nothing happens. This is called "Shi Yue" (Trial Month) and is not true labor. Before the proper time for delivery arrives, one must absolutely avoid having someone support the waist, and the parturient woman must not exert herself recklessly. Because the fetus's body is not yet in position, if the midwife encourages the mother to exert force blindly, the fetus may shift slightly but then be forced off course by the mother's effort, resulting in transverse or breech presentation, unable to be born normally. This is all due to improper timing of the mother's exertion. Whenever the mother exerts force, she must wait until the fetus is aligned and approaching the cervix, then push once to deliver the baby. This is the correct timing for exertion. If one exerts force before the proper time, injuring the fetus, and takes medications to induce early birth, it is like pulling shoots to help them grow—harmful rather than beneficial. This is called "Shang Chan" (Injuring Labor).
Academician Xue stated: When labor is imminent, feeling fetal movement inside the abdomen, one should lie supine with the body straightened, waiting for the fetus to turn downward. When intermittent pains occur, try pinching the middle joint of the mother's middle finger; if the proximal joint throbs, labor has begun, and delivery will follow soon.
The general principle states: Childbirth has its own timing. Before the time arrives, one must absolutely not forcefully use催产药 (labor-inducing drugs).
It also states: One must absolutely not get onto the birthing bed ("sitting on grass") and must not allow midwives to handle the patient recklessly.
Mr. Zhu Danxi stated: For inducing labor, only use Foshou San (Buddha's Hand Powder); it is the safest and most effective.
He also stated: Postpartum treatment should primarily focus on greatly tonifying qi and blood. Even if other symptoms exist, they should not be treated first (prioritize treating the root).