横生 儿先露臂也。令产母正卧。以手徐推儿臂。下体令其正直。复以中指摸
其肩。勿令脐带绊系。即生。
逆生 儿先露足也。令母正卧。以手徐推其足。仍推儿转正。即生。
偏生 儿头偏在一边也。亦照前法正其头。即生。或儿头后骨。偏在谷道旁。徐
推近上。即生。
碍产 儿头虽正。但不能下。盖因胎转时。脐带绊肩所致。用中指按儿两肩。理脱胎带。即生。
产坐 儿将欲出。其母疲倦。久坐椅褥。抵其生路。急用巾带高悬。令母以手攀
之。轻轻屈足。良久儿顺。即生。
沥浆生（又名沥胞生） 浆流一二日不产。或至数日外。亦无妨。惟安睡。候浆流渐少。或
流尽。当自生耳。不必惊恐。切勿动手。又有浆水沥尽。气机仍未。致胎干难产者。
此不得听其自然。急用大料四物汤。约二三斤。以大锅在房内煎熬。使药气满
房。口鼻吸受。以滋益之。内服加味芎归汤。一服未效。少停片时。再进一剂。连次
服之。以生为度。此言胎干而儿未脱胞者也。若儿未脱胞。可令明干稳婆。动手
取下为安。
或问盘肠生。是何缘故。曰亦是用力之过。盖因产母。平日气虚。及到临时。用力努挣。
浑身气血下注。以致肠随儿下。一次如此。下次路熟。又复如此。若能等待瓜熟蒂
落之时。何得有此怪异之症乎。
或问有一痛便生。令人措手不及者。此又何也。曰此乃正理。何足为异。盖胎气已足。
母子两分。儿自要出。虽欲留之而不可得。人人皆是如此。皆各有此一时。只要忍
耐得住。等待此一时耳。
或曰。稳婆不必用乎。曰既有此辈。亦不能不用。但要我用他。不可他用我。全凭自家作主
。不可听命于彼耳。大约此等人多愚蠢。不明道理。一进门来。不问迟早。不问
生熟。便令坐草用力。一定说孩儿头已在此。或令揉腰擦肚。或手入产门探摸。多
致损伤。总要见他功劳。不肯安静。更有一等狡恶之妇。借此居奇射利。祸不忍言
矣。按吴越之间。谓之稳婆。江淮间。谓之收生婆。徽宁间。谓之接生婆。按收接二字
之义。因其年老惯熟。令其接儿落地。收儿上床耳。原非要他动手动脚也。每见富
贵之家。预将稳婆留在家中。及到临时。稍不快利。前门后户。接到无数。纷纷攘攘
吵成一片。所谓天下本无事。庸人自扰之。
或问临时。有经验之药。亦可用否。曰不用。从前奇方。莫过鼠肾兔脑丸。今时盛行。莫
过回生丹。非谓其不效而不用也。总用不着耳。既不用力。又不动手。又有睡法佐
之。他自会生。何消用药。纵有不顺。睡为上策。
或问服药。有益无损否。曰安得无损。鼠兔二丸。大耗气而兼损血。回生丹。大破血而
兼损气。盖鼠兔例用香窜之药。产时百脉解散。气血亏虚。服此散气药。儿已出而
香未消。其损多矣。且令毛窍开张。招风入内。祸不可言。回生丹以大黄红花为君。
其余亦多消导之品。血已耗而又大破之。多致产后发热等病。遗患无穷。都只谓
产后失调。谁复归咎于药。按此数方。古今称为神灵奇宝者。尚然如此。其他可知。
送药者。本是善念。但知其利。不知其害耳。
或问总无可用之药乎。曰有。只须加味芎归汤。佛手散。二方。用之不尽矣。盖胎时全
要血足。血一足。如舟之得水。何患不行。惟恐产母血少。又或胞浆早破。以致干涩
耳。今二方皆大用芎归。使宿血顿去。新血骤生。药味易得。随地皆有。且使身体壮
健。产后无病。真正有益无损。此皆先贤洞明阴阳之理。制此神丹。以利济天下后
世。奈世人贵耳贱目。以为平常而不用。必求奇怪之药。而后用之。只要奇怪。不论
损益。岂不可叹。
或问根据此言。世间总无难产者耶。曰偶亦有之。或因产母太虚。胎气不足。血气未完。
或因产母伤寒之后。热毒伤胎。又或因夫妇同房太多。以致欲火伤胎。平日过食
椒姜。煎炒热物。火毒伤胎。以及跌扑损伤。皆致难产。多令胎死腹中。除此之外。无
难产者矣。又有严寒天气。滴水成冰之时。贫家房中火气微薄。以致血寒而凝。亦
令不出。然此亦因临盆太早。去衣久坐之故耳。若令拥被安卧。待时而产。岂有此
患。
凡生产艰难。或天寒。孩儿生下不哭。或已死者。急用衣物包裹。再用香油纸捻。将脐
带慢慢烧断。暖气入腹。渐渐作声而活。倘或先剪断脐带则死矣。
或问临产时。饮食如何。曰此时心内忧疑。腹中疼痛。甚至精神疲倦。口中失味。全要
好饮食调理。但不宜过于肥腻耳。倘不能食。只将鸡鸭汤。肉汤之类。吹去油澄清。
频频饮之。亦能壮助精神。人以食为命。岂可一日阙乎。
横生：胎儿先露出的是手臂。让产妇平躺，用手轻轻将胎儿的手臂推回，使下身保持正直，再用中指触摸到胎儿的肩膀，注意不要让脐带缠绕束缚，胎儿即可娩出。
逆生：胎儿先露出的是脚。让产妇平躺，用手轻轻将胎儿的脚推回，并将胎儿身体转正，即可娩出。
偏生：胎儿头部偏向一侧。也按照前面的方法矫正胎头位置，即可娩出。或者如果胎儿后脑勺偏向肛门旁边，轻轻将其向上推近，即可娩出。
碍产：胎儿头部虽然端正，但不能下降。这是因为胎位转动时，脐带绊住了肩膀所致。用中指按压胎儿的两肩，理顺并解脱被胎带缠绕的情况，即可娩出。
产坐：胎儿即将产出时，产妇疲倦，长时间坐在椅子或褥垫上，阻塞了产道。急忙用巾带高高悬挂，让产妇用手攀扶，轻轻弯曲双腿，过一会儿胎儿顺位，即可娩出。
沥浆生（又名沥胞生）：羊水流出了一两天仍不生产，或者到了几天以后，也没有妨碍。只需安心睡眠，等待羊水逐渐减少，或者流尽，胎儿自然会出生。不必惊恐，千万不要动手干预。又有羊水沥尽，但气机仍未恢复，导致胎干难产的情况。这种情况不能听任其自然发展，急忙使用大剂量的四物汤，约二三斤，在大锅中于房内煎熬，使药气充满房间，通过口鼻吸入以滋养身体。内服加味芎归汤，一剂无效，稍停片刻，再服用一剂，连续服用，直到胎儿娩出为止。这是指胎干而胎儿尚未脱离胞衣的情况。如果胎儿未脱胞，可以让经验丰富、手脚稳当的接生婆动手取下为安。
有人问：盘肠生是什么原因造成的？回答说：这也是用力过度的缘故。因为产妇平日气虚，等到临产时，用力努挣，浑身气血下注，导致肠道随胎儿一起脱出。一次如此，下次路径熟悉，又会再次发生。如果能等待瓜熟蒂落的时候，怎么会有这种怪异的病症呢？
有人问：有一种疼痛一下就生出来，让人措手不及的情况，这又是怎么回事？回答说：这是正常的道理，有什么可奇怪的。因为胎气已足，母子分离，胎儿自然要出来，即使想留住也不可能。人人都是这样，都各有这一时刻，只要忍耐得住，等待这一刻到来即可。
有人说：接生婆不需要用了吗？回答说：既然有这类人，也不能不用。但要由我来使用她们，而不是被她们控制。全凭自己作主，不可听从她们的摆布。大概这类人多愚蠢，不明道理，一进门来，不问早晚，不问是否准备好，就让人坐草用力。一定说孩子的头已经到了这里，或者让人揉腰擦肚子，或者手入产门探摸，多造成损伤。总要显示她们的功劳，不肯安静。更有一类狡诈凶恶的妇女，借此抬高身价谋取利益，祸患不堪设想。按吴越地区称为稳婆，江淮地区称为收生婆，徽宁地区称为接生婆。按“收”、“接”二字的含义，是因为她们年老且习惯熟练，让她们接婴儿落地，收抱婴儿上床罢了。原本并不是要她们动手动脚。常见富贵人家，预先将接生婆留在家中，等到临产时，稍微不顺利，前后门户，接到无数人，纷纷攘攘吵成一片。所谓天下本无事，庸人自扰之。
有人问：临产时，有经验的老方药，也可以使用吗？回答说：不用。从前的奇方，莫过于鼠肾兔脑丸，现在盛行，莫过于回生丹。不是说它们没有效果而不使用，而是总用不着。既然不用力，也不动手，又有睡眠法辅助，胎儿自然会生，何必用药。即使有不顺，睡觉也是上策。
有人问：服药，只有益处没有损害吗？回答说：怎么可能没有损害。鼠肾兔脑二丸，大大耗气并且兼损血；回生丹，大大破血并且兼损气。因为鼠兔丸通常使用香窜的药物，生产时百脉解散，气血亏虚，服用这种散气的药物，胎儿已经出来而香气未消，损害很大。而且令毛孔开张，招致风邪入内，祸患不可言说。回生丹以大黄、红花为主药，其余也多属消导之品。血已消耗而又大大破血，多导致产后发热等疾病，遗患无穷。人们只说是产后调理不当，谁又会归咎于药物呢？按这几方，古今被称为神灵奇宝的，尚且如此，其他的可想而知。送药的人，本是善意，但只知道其利，不知道其害罢了。
有人问：真的完全没有可以用的药吗？回答说：有。只需要加味芎归汤、佛手散这两个方子，用之不尽了。因为怀孕期间全要靠血充足，血一旦充足，就像船有了水，还担心什么不行？只怕产妇血少，或者胞浆早破，导致干涩而已。现在这两个方子都大量使用川芎、当归，使宿血顿去，新血骤生。药味容易获得，随地皆有，且能使身体健壮，产后无病，真正有益无损。这都是先贤洞明阴阳之理，制作此神丹，以利济天下后世。无奈世人贵耳贱目，认为平常而不使用，必求奇怪的药物，然后才使用。只要奇怪，不论损益，岂不可叹。
有人问：根据这番话，世间就没有难产的人了吗？回答说：偶尔也有。或者因为产妇太虚弱，胎气不足，血气未完；或者因为产妇伤寒之后，热毒伤胎；又或者因为夫妇同房太多，以致欲火伤胎；平日过食椒姜、煎炒热物，火毒伤胎；以及跌扑损伤，都导致难产，多令胎死腹中。除此之外，就没有难产的了。又有严寒天气，滴水成冰之时，贫寒人家房中火气微薄，以致血寒而凝，也导致胎儿不出。然而这也是因为临盆太早，脱衣久坐的缘故。如果让产妇拥被安卧，等待时机分娩，怎么会有这种祸患呢？
凡是生产艰难，或者天寒，孩子生下不哭，或者已经死亡的，急忙用衣物包裹，再用香油纸捻，慢慢烧断脐带，暖气进入腹部，渐渐发出声音而复活。倘若先剪断脐带则死了。
有人问：临产时，饮食如何？回答说：此时内心忧虑疑惑，腹中疼痛，甚至精神疲倦，口中无味，全靠好的饮食调理。但不宜过于肥腻。如果不能进食，只将鸡鸭汤、肉汤之类，吹去油澄清，频频饮用，也能壮助精神。人以食为命，怎么能一天缺食呢？
Transverse presentation: The fetus presents with an arm first. Let the parturient lie supine. Gently push the fetal arm back with your hand, ensuring the lower body remains straight. Then use the middle finger to palpate the shoulder, taking care not to let the umbilical cord entangle or bind it. Delivery will occur immediately.
Breech presentation (Reverse birth): The fetus presents with feet first. Let the mother lie supine. Gently push the feet back and rotate the fetus into a correct position. Delivery will occur immediately.
Asynclitism (Oblique birth): The fetal head is tilted to one side. Correct the head position using the method described above. Delivery will occur immediately. Alternatively, if the occiput of the fetal head is shifted towards the anus, gently push it upward and closer to the center. Delivery will occur immediately.
Obstructed labor: The fetal head is correctly positioned but cannot descend. This is caused by the umbilical cord becoming entangled around the shoulders during fetal rotation. Press on both shoulders of the fetus with the middle finger to untangle and release the cord. Delivery will occur immediately.
Sitting in labor: As the fetus is about to be born, the mother is exhausted and sits for a long time on a chair or cushion, obstructing the birth canal. Quickly hang a cloth belt high up, have the mother hold onto it, and gently bend her legs. After a while, the fetus will align properly, and delivery will occur.
Amniotic fluid leakage without labor (also known as bladder leakage): Amniotic fluid flows for one or two days without labor, or even for several days; this is not harmful. Simply sleep peacefully, waiting for the fluid flow to gradually decrease or stop completely. The baby will deliver spontaneously. Do not panic, and absolutely do not intervene manually. In cases where amniotic fluid is completely drained, yet Qi mechanism fails to recover, leading to dryness and difficult labor due to a dried-out fetus, one must not leave it to nature. Immediately prepare a large dose of Siwu Tang (Four Substances Decoction), approximately 2-3 jin (1-1.5 kg), decocted in a large pot within the room, so that the medicinal vapor fills the room. Inhale the vapor through the mouth and nose to nourish the body. Internally administer Jiawei Xionggui Tang (Modified Chuanxiong and Angelica Decoction). If one dose is ineffective, wait a short while and administer another dose. Continue administering until delivery occurs. This refers to the condition where the fetus is dry but has not yet expelled from the uterus. If the fetus has not expelled from the membranes, allow an experienced and steady midwife to manually remove it for safety.
Question: What is the cause of prolapsed intestine during childbirth? Answer: It is also due to excessive straining. Because the mother has deficient Qi normally, and upon labor, she strains excessively, causing all Qi and Blood to sink downward, resulting in the intestine descending with the fetus. If this happens once, the path becomes familiar, and it may happen again next time. If one could simply wait for the melon to ripen and the stem to fall naturally, how could such a bizarre symptom occur?
Question: There are cases where labor is so sudden that one is caught off guard. What causes this? Answer: This is normal physiology, nothing strange about it. When fetal Qi is sufficient, the mother and child separate, and the fetus naturally seeks to exit. Even if one wishes to retain it, it is impossible. Everyone experiences this; everyone has this moment. One only needs to endure and wait for this moment.
Statement: Midwives are unnecessary. Response: Since such people exist, they cannot be entirely unused. However, you must employ them, not be employed by them. Maintain full control over yourself; do not submit to their commands. Generally, such people are often foolish and lack understanding. Upon entering, regardless of timing or readiness, they instruct the mother to sit on the birthing stool and strain. They invariably claim the head is already present, or instruct others to rub the waist and abdomen, or insert hands into the vaginal opening to probe. This often causes injury. They insist on demonstrating their "merits" and refuse to remain quiet. Worse still, there are cunning and malicious women who exploit this situation to inflate prices and seek profit, leading to unbearable disasters. Note: In the Wu-Yue region, they are called Wenpo (steady woman); in Jianghuai, Shoushengpo (collecting birth woman); in Huining, Jieshengpo (receiving birth woman). The meanings of "collect" and "receive" imply that because they are old and experienced, they are used to receive the baby upon landing and carry the baby to bed. Originally, it was not intended for them to touch or manipulate excessively. It is common to see wealthy families keeping midwives at home in advance. When labor begins, if progress is slightly slow, they summon countless midwives through front and back doors, creating chaos and noise. As the saying goes, "The world originally has no troubles; fools create them for themselves."
Question: Can experienced herbal formulas be used during labor? Response: No. Formerly, the most famous miraculous formula was Shushen Tubrao Wan (Mouse Kidney and Rabbit Brain Pill). Currently, the most prevalent is Huisheng Dan (Life-Returning Pill). It is not that they are ineffective and thus unused; rather, they are simply unnecessary. Since no force is exerted, no manual intervention is made, and sleep methods assist, the baby will deliver naturally. Why use medicine? Even if complications arise, sleeping is the best strategy.
Question: Does taking medicine do good without harm? Response: How can there be no harm? The Mouse Kidney and Rabbit Brain pills greatly consume Qi and damage Blood. Huisheng Dan greatly breaks Blood and damages Qi. These pills typically contain aromatic and penetrating herbs. During labor, the meridians are dispersed, and Qi and Blood are deficient. Taking Qi-scattering drugs means that after the baby is born, the aromatic properties linger, causing significant harm. Furthermore, it opens the pores, inviting Wind pathogens inward, leading to unspeakable disasters. Huisheng Dan uses Dahuang (Rhubarb) and Honghua (Safflower) as chief ingredients, with other ingredients being mostly digestive and draining agents. Since Blood is already depleted, further breaking Blood leads to postpartum fever and other diseases, leaving endless troubles. People attribute these issues to improper postpartum regulation, rarely blaming the medicine. Considering these formulas, which are regarded as divine treasures in ancient and modern times, cause such harm, one can imagine the effects of others. Those providing the medicine act out of goodwill but know only the perceived benefits, not the harms.
Question: Is there truly no usable medicine? Response: Yes. Only Jiawei Xionggui Tang (Modified Chuanxiong and Angelica Decoction) and Foshou San (Buddha's Hand Powder) are needed, and they are inexhaustible. During pregnancy, sufficiency of Blood is paramount. Once Blood is sufficient, like a boat having water, why worry about movement? The fear lies only in the mother's Blood deficiency or premature rupture of membranes leading to dryness. Both formulas heavily use Xiong (Chuanxiong) and Gui (Danggui/Angelica Sinensis), instantly removing stale Blood and rapidly generating new Blood. The ingredients are easily obtained everywhere. They strengthen the body and prevent postpartum illness, truly doing good without harm. These were created by sages who thoroughly understood Yin and Yang principles, formulating these divine elixirs to benefit future generations. Alas, people value hearsay over direct observation, considering them ordinary and unused, seeking only strange medicines. They prioritize strangeness over benefit or harm. Is this not lamentable?
Question: Based on this, does no difficult labor exist in the world? Response: Occasionally, yes. It may be due to the mother being extremely deficient, insufficient fetal Qi, or incomplete Qi and Blood. Or it may result from Heat-Toxin damaging the fetus after the mother suffered from Shanghan (Cold Damage). Or it may be due to excessive sexual intercourse, causing Desire-Fire to damage the fetus. Or habitual consumption of pepper, ginger, fried, and hot foods, causing Fire-Toxin to damage the fetus. Also, falls and injuries can lead to difficult labor, often resulting in intrauterine fetal death. Apart from these, there is no difficult labor. Additionally, in severe cold weather when water freezes, poor households may have insufficient warmth, causing Cold-Blood coagulation and preventing delivery. However, this is also due to going into labor too early and sitting bare/cold for too long. If the mother had stayed warm under blankets and waited for the proper time, this trouble would not have occurred.
In cases of difficult labor, or cold weather where the newborn does not cry or appears dead, quickly wrap the infant in clothing. Use a paper wick soaked in sesame oil to slowly burn the umbilical cord. Warm Qi enters the abdomen, and the infant gradually makes sounds and revives. If the cord is cut first, the infant will die.
Question: What should the diet be like during labor? Response: At this time, the mind is anxious and doubtful, abdominal pain is present, and mental fatigue sets in, with loss of taste. Good dietary nourishment is essential, but avoid overly rich and greasy foods. If unable to eat, drink clarified chicken broth, duck broth, or meat broth frequently. This can also boost spirit and strength. Food is life for humans; how can one go without food for a day?