Seeking children 求嗣
生人之道, 始於求子. 求子之法, 莫先調經. 每見婦人之無子者, 其經必或前或後, 或多或少, 或將行作痛, 或行後作痛, 或紫或黑, 或淡或凝而不調. 不調則血氣乖爭, 不能成孕. 《丹心》
The way of engendering a person begins with seeking a child; and in the method of seeking a child, nothing comes before regulating the menses. Whenever one sees a woman without children, her menses will surely come early or come late, be excessive or scant, pain her as they are about to flow or pain her after they have flowed, run purple or black, or thin or clotted — irregular. And being irregular, the Blood and Qi are at odds and contend, and conception cannot form.
Clinical note The chapter's first sentence, and its whole architecture in miniature — fertility treated as a downstream question, with the cycle as the upstream one. The list that follows is a clinical intake form: timing, volume, pain and when it falls relative to flow, color, consistency. Ask those five things and you have the chapter's opening diagnosis.
Dansim 丹心
求嗣之道, 婦人要經調, 男子要神足. 又寡慾淸心爲上策. 寡慾則不妄交合, 積氣儲精, 待時而動, 故能有子. 是以慾寡則神完, 不惟多子, 抑亦多壽. 《入門》
In the way of seeking children, the woman needs her menses regulated and the man needs his spirit sufficient. And further: to lessen desire and clear the mind is the highest strategy. Desire lessened, one does not couple recklessly, but accumulates Qi and stores essence, awaiting the time to move — hence one can have children. Thus, desire being scant, the spirit stands whole: not only many children, but also long years.
Clinical note Both partners named in a single breath, and the treatment goals set side by side — her cycle, his spirit. The strategy that follows is temperance rather than technique: essence saved rather than spent, and timing rather than frequency. The closing line quietly reframes the whole enterprise as a longevity practice.
Immun 入門
男子陽精微薄, 則雖遇血海虛靜, 流而不能直射子宮, 多不成胎. 盖因平時嗜慾不節, 施泄太多. 宜補精元, 兼用靜工存養, 無令火動, 候陽精充實, 依時而合, 一擧而成矣. 《入門》 ○男子脉微弱而澁, 爲無子, 精氣淸冷也. 《脉經》
Where a man's Yang essence is thin and slight, then even meeting the sea of Blood at its still and empty hour, it flows without reaching the palace of the child directly, and mostly no fetus forms. This comes of craving unrestrained in ordinary times, and too much spent in emission. One should supplement the essence's origin, joined with quiet work to preserve and nourish, letting no fire stir; and when the Yang essence has grown full and firm, couple according to the time — at a single stroke it is accomplished (Immun 入門). — A man whose pulse is faint, weak, and rough is without children: his essence Qi is clear and cold. (Maekgyeong 脉經)
Clinical note Male-factor infertility, addressed directly and without euphemism in the third passage of the chapter — with a prescription that is half pharmacological and half behavioral: supplement, and stop spending. The pulse entry gives it an objective sign, and the phrase for the finding — essence Qi 'clear and cold' — is as vivid a description of a thin, cold semen picture as the classical vocabulary allows.
Immun 入門 · Maekgyeong 脉經
婦人無子, 多由血少不能攝精, 宜調養經血. ○婦人陰血衰弱, 雖投眞精, 不能攝入子宮, 雖交不孕, 雖孕不育. 是以男女配合, 必當其年. 《入門》 ○無子婦人瘦怯者, 乃子宮乾澁, 宜滋陰養血, 四物湯 方見血門 加香附ㆍ黃芩. 肥盛, 軀脂滿溢子宮, 宜行濕燥痰, 南星ㆍ半夏ㆍ川芎ㆍ滑石ㆍ防己ㆍ羌活, 或導痰湯 方見痰門. 《丹心》
That a woman is without children comes mostly of Blood being scant, so that it cannot gather in the essence: one should regulate and nourish the menstrual Blood. — Where a woman's Yin Blood is waning and weak, then though the true essence be delivered, it cannot be gathered into the palace of the child: though she couples she does not conceive, and though she conceives she does not carry. For this reason, in the matching of man and woman, the years must be fitting (Immun 入門). — A childless woman who is thin and frail has a dry, rough palace of the child: enrich the Yin and nourish the Blood —
Samul-tang 四物湯 — formula in the Blood chapter — with cyperus and scutellaria added. One who is stout and abundant, the body's fat brimming over into the palace of the child, should move the damp and dry the phlegm: arisaema, pinellia, cnidium, talcum, stephania, and notopterygium — or Dodam-tang
— formula in the Phlegm chapter —. (Dansim 丹心)
Clinical note Danxi's two-constitution fork is the passage clinics still use daily: the thin patient whose uterus is dry gets Blood and Yin; the heavy patient whose damp and phlegm crowd the uterus gets movers and dryers. It is a strikingly modern-sounding division — the same two body types that show up in lean and PCOS-type presentations — and each gets an opposite prescription, which is why a single 'fertility formula' has never existed in this tradition.
Immun 入門 · Dansim 丹心
Formulas for men — supplementing the essence and firming the Yang 求嗣男子藥
男子, 陽脫痿弱, 精冷而薄, 宜固本健陽丹ㆍ續嗣丹ㆍ溫腎丸ㆍ五子衍宗丸. 《入門》 ○男子脉微弱而澁, 爲無子, 精氣淸冷也, 宜陽起石元. 《脉經》 ○凡人無子, 多是精血淸冷, 或房勞過傷, 以致腎水欠旺, 不能直射子宮故爾. 豈可專責於母血之不足虛寒耶. 《回春》
Where a man's Yang has deserted him into wilting weakness, and the essence is cold and thin: Gobongeonyang-dan, Soksa-dan, Onsin-hwan, and Ojayeonjong-hwan are appropriate (Immun 入門). — A man whose pulse is faint, weak, and rough is without children, his essence Qi clear and cold: Yanggiseok-won is appropriate (Maekgyeong 脉經). — In general, that a person is without children is mostly because the essence and Blood are clear and cold, or bedroom taxation has damaged them past bearing, so that the Kidney water is not exuberant and cannot reach the palace of the child directly. How then could the fault be charged wholly to insufficiency and vacuity cold in the mother's Blood? (Hoechun 回春)
Clinical note The Hoechun's closing question is the most quietly radical sentence in the chapter's opening — a seventeenth-century rebuke to the assumption that childlessness is the woman's to answer for. It arrives attached to a full shelf of male formulas, which is the argument made material: the tradition did not merely say male factor exists, it stocked the cabinet for it.
Immun 入門 · Maekgyeong 脉經 · Hoechun 回春
男子, 陽脫痿弱, 精冷而薄, 宜固本健陽丹ㆍ續嗣丹ㆍ溫腎丸ㆍ五子衍宗丸ㆍ陽起石元. ○女宜鼓動微陽, 宜玉鑰啓榮丸ㆍ螽斯丸ㆍ煖宮螽斯丸. ○婦人無子, 多由血少不能攝精, 宜調養經血, 宜百子附歸丸ㆍ琥珀調經丸ㆍ加味養榮丸ㆍ加味益母丸ㆍ濟陰丹ㆍ勝金丹ㆍ調經種玉湯ㆍ先天歸一湯ㆍ神仙附益丹ㆍ調經養血元ㆍ溫經湯. 《入門》
For a man whose Yang has deserted him into wilting weakness, the essence cold and thin:
Gobongeonyang-dan 固本健陽丹, Soksa-dan 續嗣丹,
Onsin-hwan 溫腎丸,
Ojayeonjong-hwan 五子衍宗丸, and
Yanggiseok-won 陽起石元. — For a woman, the faint Yang should be stirred into motion:
Okyakgyeyeong-hwan 玉鑰啓榮丸,
Jongsa-hwan 螽斯丸, and Nangungjongsa-hwan 煖宮螽斯丸. — That a woman is without children comes mostly of Blood being scant and unable to gather in the essence: one should regulate and nourish the menstrual Blood — Baekjabugwi-hwan 百子附歸丸, Hobakjogyeong-hwan 琥珀調經丸, Gamiyangyeong-hwan 加味養榮丸, Gamiingmo-hwan 加味益母丸, Jeeum-dan 濟陰丹, Seunggeum-dan 勝金丹, Jogyeongjongok-tang 調經種玉湯, Seoncheongwiil-tang 先天歸一湯, Sinseonbuik-dan 神仙附益丹, Jogyeongyanghyeol-won 調經養血元, and Ongyeong-tang 溫經湯.
Clinical note The seeking-children cabinet laid out in three ranks — five formulas for the man, three for the womb that needs warming, and eleven for the woman whose Blood must be rebuilt before it can hold anything. Six doors now open; the eleven Blood-regulating formulas arrive with the menstrual sections, where they properly belong.
Immun 入門
Conception 胎孕
胎孕乃凝. 胎之所居, 名曰子宮, 一系在下, 上有兩岐, 一達於左, 一達於右. 精勝其血, 及剛日陽時感者, 則陽爲之主, 受氣於左子宮, 而男形成. 精不勝血, 及柔日陰時感者, 則陰爲之主, 受氣於右子宮, 而女形成矣. ○或曰, 其有雙胎者何也. 曰, 精氣有餘, 岐而分之, 血因分而攝之故也. 若夫男女同孕者, 剛日陽時ㆍ柔日陰時感, 則陰陽混雜, 不屬左, 不屬右, 受氣于兩岐之間者也. 亦有三胎四胎五胎六胎者, 猶是而已. 《丹溪》
The conception then congeals. The place where the fetus dwells is called the palace of the child: a single stalk below, and above it two forks, one reaching to the left and one to the right. Where the essence prevails over the Blood, and the coupling falls on a hard day and a Yang hour, the Yang is master of it: the Qi is received in the left palace of the child, and a male form takes shape. Where the essence does not prevail over the Blood, and the coupling falls on a soft day and a Yin hour, the Yin is master: the Qi is received in the right palace of the child, and a female form takes shape. — Someone asked: and those who have twins, how is that? The answer: the essence Qi is in surplus, the fork divides it, and the Blood, following the division, gathers each in. As for a male and female carried together, the coupling has fallen across both — hard day and Yang hour, soft day and Yin hour — so that Yin and Yang are mixed and belong neither to the left nor to the right, the Qi being received in the space between the two forks. And there are also threes, fours, fives, and sixes: it is the same principle.
Clinical note Danxi's anatomy of conception — a two-horned uterus with a left side and a right, and sex determined by which fork receives the Qi. The anatomy is recognizably drawn from observation (the bicornuate description matches what dissection of some mammals shows), and the reasoning is systematic: twins from surplus dividing across the fork, mixed-sex twins from a conception falling between them. The mechanism is not one modern embryology recognizes, but the passage is a fine example of the tradition arguing from structure rather than from omen. The source continues into a discussion of infertility and of intersex variation, explaining the latter through a notion of 'mottled Qi' (駁氣); those explanations belong to the cosmology of their era, use language that is stigmatizing by present standards, and are not reproduced here — intersex variation is understood today through developmental biology.
Danxi 丹溪
Nourishing the fetus through the ten months 十月養胎
婦人懷胎, 一月之時, 足厥陰脉養. ○二月, 足少陽脉養. ○三月, 手心主脉養. ○四月, 手少陽脉養. ○五月, 足太陰脉養. ○六月, 足陽明脉養. ○七月, 手太陰脉養. ○八月, 手陽明脉養. ○九月, 足少陰脉養. ○十月, 足太陽脉養. ○諸陰陽各養三十日活兒. 手太陽ㆍ少陰不養者, 下主月水, 上爲乳汁, 活兒養母. ○四時之令, 始于春木, 故胎養始於肝膽也. 《良方》
When a woman carries a child: in the first month, the foot reverting-Yin vessel nourishes it. In the second, the foot lesser-Yang. In the third, the hand heart-governor. In the fourth, the hand lesser-Yang. In the fifth, the foot greater-Yin. In the sixth, the foot Yang-brightness. In the seventh, the hand greater-Yin. In the eighth, the hand Yang-brightness. In the ninth, the foot lesser-Yin. In the tenth, the foot greater-Yang. — Each of the Yin and Yang vessels nourishes the child for thirty days. That the hand greater-Yang and lesser-Yin do not take a turn is because below they govern the monthly water and above they become the breast milk: they keep the child alive by nourishing the mother. — The ordinances of the four seasons begin with spring and Wood; hence the nourishing of the fetus begins with Liver and Gallbladder.
Clinical note One of the most elegant schemas in the book — the pregnancy divided into ten thirty-day watches, each assigned to a channel, the whole rotation opening with Liver Wood because spring opens the year. And the exemption is the loveliest part: the Heart and Small Intestine are excused from the rota because they are already at work elsewhere, making the menses below and the milk above. Two channels held in reserve for the mother, so that the other ten can attend to the child.
Yangbang 良方
七月, 手太陰肺脉養胎. 始受木精, 以成骨, 皮毛已成, 遊其魂, 能動左手. ○八月, 手陽明大腸脉養胎. 始受土精, 以成皮膚, 形骸漸長, 九竅皆成, 遊其魄, 能動右手. ○九月, 足少陰腎脉養胎. 始受石精, 以成皮毛, 百節畢備, 三轉其身. ○十月, 足太陽膀胱脉養胎. 受氣足, 五藏六府齊通, 納天地氣於丹田, 使關節ㆍ人神皆備, 待時而生. 《入門》
In the seventh month, the hand greater-Yin Lung vessel nourishes the fetus. It first receives the essence of Wood, and by it the bones are completed; skin and hair are already formed; the ethereal soul roams in it, and it can move the left hand. — In the eighth month, the hand Yang-brightness Large Intestine vessel nourishes it. It first receives the essence of Earth, and by it the skin is completed; the frame gradually lengthens, the nine orifices are all formed, the corporeal soul roams in it, and it can move the right hand. — In the ninth month, the foot lesser-Yin Kidney vessel nourishes it. It first receives the essence of Stone, and by it skin and hair are completed; the hundred joints are all in place, and it turns its body three times. — In the tenth month, the foot greater-Yang Bladder vessel nourishes it. The Qi it receives is sufficient, the five viscera and six bowels are opened through alike, the Qi of Heaven and Earth is taken into the cinnabar field, the joints and the human spirit are all complete — and it awaits its time to be born.
Clinical note The late months given in detail, and the details are observational where they can be: the ninth month's three turns of the body, the moving of one hand and then the other, the sense of a form that has stopped assembling and begun waiting. Whatever one makes of the essences of Wood, Earth, and Stone, the passage records what attentive women and midwives could actually feel and report — a fetus that turns, and then settles.
Immun 入門
Prohibitions in pregnancy 姙娠禁忌
受孕之後, 大忌男女交合. 《入門》 ○姙婦切忌飮酒, 及以酒調藥服. 酒散百脉, 致成諸疾, 止用水煎服爲好. 《得效》 ○受孕之後, 切宜避忌胎殺所遊, 如隣家繕修, 亦宜避之. 經云, 刀犯者形必傷, 泥犯者竅必塞, 打擊者色靑黯, 繫縛者相拘攣, 甚至母殞, 驗若反掌. 《得效》
After conception has been received, the coupling of man and woman is greatly to be avoided (Immun 入門). — A pregnant woman must strictly avoid drinking wine, and avoid taking medicines stirred into wine: wine scatters through the hundred vessels and brings on every kind of illness. It is best to use only water-decocted preparations (Deukhyo 得效). — After conception, one should carefully avoid wherever the fetal-killing influence is said to roam — even repairs and building at a neighbor's house are to be avoided. The classic says: where a blade offends, the form will surely be injured; where mud offends, an orifice will surely be stopped; where there is striking, the color turns dark blue; where there is binding, there will be contracture — and it may even go so far as the mother's death: the proof of it is as quick as turning the hand (Deukhyo 得效).
Clinical note Two of these three have aged remarkably differently. The alcohol prohibition is stated in absolute terms — no wine, and no medicines taken in wine — four centuries before fetal alcohol syndrome was described, and it is the chapter's soundest piece of prenatal advice. The 'fetal-killing influence' passage, by contrast, belongs entirely to the divinatory culture of its time: the belief that construction, blades, and binding near a pregnant household mark the child in corresponding ways. It is preserved here as text, not as counsel — congenital differences have causes, and none of them are carpentry.
Immun 入門 · Deukhyo 得效
飮食禁忌. 食驢馬肉, 過月難産. ○食兎肉, 令子缺脣. ○食無鱗魚, 難産. ○食螃蟹, 令子橫生. ○食雞肉及卵合糯米食, 令子生寸白蟲. ○食薏苡, 墮胎. ○食麥芽, 消胎氣. ○食莧菜, 墮胎. ○食蒜, 消胎氣. ○食諸般菌蕈, 令子驚風而夭. 《入門》
Prohibitions in food and drink. The source lists more than a dozen foods to be avoided in pregnancy — several kinds of meat, scaleless fish, crab, mushrooms, and others — each paired with a specific misfortune said to follow for the child, from difficult birth to particular congenital differences. Those pairings belong to the sympathetic reasoning of their era and are not translated item by item here. Four entries in the list, however, rest on the tradition's own pharmacology and are still respected: coix seed drops the fetus; barley sprout consumes the fetal Qi; amaranth drops the fetus; garlic consumes the fetal Qi.
Clinical note A section that has to be read on two levels. Most of the list works by resemblance — the hare's cleft lip, the crab's sideways walk — a logic of omens rather than of physiology, and one that assigns blame for congenital difference to a mother's meals; it is recorded in the original but not carried over into English, because there is no version of it that is both faithful and harmless. What survives is the pharmacological core: coix, barley sprout, amaranth, and garlic are agents the tradition classes as fetus-dropping or Qi-consuming, and every one of them still appears on pregnancy caution lists in modern herbal practice.
Immun 入門
Disorders before birth 産前諸證
有子癎ㆍ子煩ㆍ子腫ㆍ子淋ㆍ子嗽ㆍ子痢ㆍ子瘧ㆍ子懸ㆍ感寒ㆍ孕婦不語ㆍ兒在腹中哭ㆍ孕婦腹中鍾鳴.
There are: child epilepsy, child vexation, child swelling, child dribbling, child cough, child dysentery, child malaria, child suspension, cold contraction, the pregnant woman who does not speak, the child that cries within the belly, and the sound of a bell within the pregnant belly.
Clinical note The register of pregnancy complications, and its naming convention is the chapter's own invention — the character for 'child' prefixed to each illness, so that seizures, swelling, and dysentery in pregnancy become their own named diseases rather than the ordinary ones happening to a pregnant patient. It is a small piece of nosology with a large implication: pregnancy changes what a disease is, and therefore what it needs.
Donguibogam · Buin
姙婦中風, 項背强直, 筋脉攣急, 口噤語澁, 痰盛昏迷, 時作時止, 或發搐, 不省人事, 名曰子癎, 亦曰兒暈, 甚則角弓反張. 宜用羚羊角湯. 輕者, 四物湯 方見血門, 加葛根ㆍ牡丹皮ㆍ秦芃ㆍ細辛ㆍ防風ㆍ竹瀝. 《入門》
When a pregnant woman is struck by wind — the nape and back rigid and stiff, the sinews and vessels cramping and urgent, the jaw clenched and speech halting, phlegm exuberant and the mind clouded, coming and going by turns, or breaking into convulsions with no awareness of persons — it is named child epilepsy, and also called child fainting; at its worst the body arches backward like a drawn bow. Yeongyanggak-tang is appropriate. In the lighter case,
Samul-tang 四物湯 — formula in the Blood chapter — with kudzu root, moutan bark, gentiana macrophylla, asarum, saposhnikovia, and bamboo sap added.
Clinical note This is eclampsia, described with clinical precision four centuries before the name existed — the rigidity, the clenched jaw, the clouding, the convulsion, and the arching that the classical texts call the drawn bow. Its prescription heads a formula built on antelope horn, a species now protected and not used; the entry is preserved as text. In modern terms this is an obstetric emergency, and any seizure in pregnancy requires emergency care.
Immun 入門
姙婦心煩躁悶, 謂之子煩. 多於受胎後四五月間, 相火用事, 或値天令君火大行暑熱之時, 俱能發煩躁, 或胎動不安. 宜用竹葉湯ㆍ竹瀝湯. 《入門》
When a pregnant woman's heart is vexed, agitated, and oppressed, it is called child vexation. It arises mostly in the fourth and fifth months after conception, when the minister fire is at work — or when it meets a season in which the sovereign fire of Heaven's ordinance is moving greatly, in the heat of summer: either can bring on vexed agitation, or fetal stirring and unrest.
Jukyeop-tang 竹葉湯 and
Jungnyeok-tang 竹瀝湯 are appropriate.
Clinical note The chapter's account of the restless, heat-flushed middle months, and it offers two causes that add rather than compete: the pregnancy's own rising fire, and the weather. A patient who is fine in spring and undone in July is not two patients — a point still worth making to anyone who thinks their symptoms should behave consistently.
Immun 入門
The ten birth presentations 十産候
十産候者, 一曰正産, 二曰坐産, 三曰臥産, 四曰橫産, 五曰逆産, 六曰偏産, 七曰礙産, 八曰盤腸産, 九曰熱産, 十曰凍産. 《良方》 ○又有傷産ㆍ催産. 《回春》
The ten birth presentations are these: first, the upright birth; second, the seated birth; third, the lying birth; fourth, the crosswise birth; fifth, the reversed birth; sixth, the tilted birth; seventh, the obstructed birth; eighth, the coiled-bowel birth; ninth, the heat birth; tenth, the frozen birth. — And there are further the injured birth and the hastened birth.
Clinical note A working taxonomy of labor, and an unusual one: the ten categories mix presentation (crosswise, reversed, tilted), obstruction, maternal position, a prolapse, and two failures of the room's temperature. It is the list of everything that a birth attendant in 1613 could be called to and had to be able to name — the first requirement of doing anything about it.
Yangbang 良方 · Hoechun 回春
正産, 謂月數已滿, 忽然臍腹陣痛, 胎孕陷下, 漿水淋下, 用力一努, 其兒遂生. ○坐産, 謂臨産, 孕婦疲倦, 久坐椅蓐, 兒抵生路, 不能下生, 當於高處懸弔手巾, 令産婦攀引, 輕輕屈足, 兒卽順生. 《良方》 ○臥産, 謂産母臥定, 背平着席, 體不偃曲, 則兒不失其道, 自然易産. 《良方》
The upright birth: the months are already full when suddenly the navel and abdomen pain in waves, the pregnancy sinks down, the waters come away, and with one strong effort the child is born. — The seated birth: at the onset of labor the woman has grown weary and sat long on chair or mat, so that the child has reached the birth road but cannot come down. One should hang a cloth from somewhere high for the mother to pull herself up by, and let her gently bend her legs — then the child is born straightaway. — The lying birth: the mother lies settled, her back flat against the mat and her body not bent or twisted; then the child does not lose its road, and the birth is naturally easy.
Clinical note Three of the ten are not complications at all but positions, and the advice is practical rather than doctrinal: a cloth slung from above for a mother too tired to push, and a straight spine so the passage stays straight. Suspended-cloth support and attention to maternal alignment are recognizably the same tools a modern labor room reaches for.
Yangbang 良方
橫産, 謂兒先露手或臂者. 治法, 當令産母仰面安臥, 收生之人徐徐先推兒下截, 令直上冲, 通手以中指摩其肩, 推上而正之, 漸引手攀其耳, 令頭正, 候兒身正, 門路順, 却服催生藥, 安詳上草, 自然易産. 《正傳》 ○逆産者先露足, 橫産者先露手, 坐産者先露臀, 皆用力太早之過也. 《正傳》 ○偏産, 謂兒頭偏柱一傍, 雖逼近産門, 初非露正頂, 止露額角者. 治法, 令産母仰臥, 收生之人輕輕推兒近上, 以手正其頭, 令兒頭頂端正向産門, 一逼卽下. 《正傳》
The crosswise birth: the child presents a hand or an arm first. The method: have the mother lie back at ease; the attendant slowly pushes the child's lower part back, letting it rise straight upward, then passing the hand in, strokes the shoulder with the middle finger, pushing it up and straightening it, and gradually draws the hand to take hold of the ear so that the head comes right. When the child's body is straight and the passage is in order, a hastening medicine is given, and the birth follows easily. — The reversed birth presents a foot first, the crosswise a hand, the seated the buttocks: all come of pushing too early. — The tilted birth: the child's head leans against one side, and though it has come close to the birth gate, what shows is not the crown but only the corner of the brow. The method: have the mother lie back; the attendant gently pushes the child a little upward and rights the head with the hand, so that the crown faces the gate squarely — one push, and it comes down.
Clinical note This is internal podalic manipulation described step by step — push the presenting part back, reach in, find the shoulder, rotate, bring the head to the gate — and it is being taught in a printed book to whoever was attending births in a Korean village. The etiology offered for malpresentation (pushing too early) is not correct, but the observation behind it is: a labor rushed before the passage is ready goes badly. Note on modern practice: malpresentation today is managed by external cephalic version or cesarean birth under trained obstetric care; these maneuvers are recorded as historical text. The source also describes stimulating a presenting hand or foot to make the child withdraw it — a practice of its era, not carried over into English here.
Jeongjeon 正傳
礙産, 謂兒頭雖正, 産門已露其頂, 而不能生下者. 此因兒轉之時, 臍帶攀掛兒肩, 致不能生. 治法, 令産母仰臥, 收生之人輕輕推兒近上, 徐徐通手, 以中指按兒兩肩, 理脫臍帶, 仍以手候其兒身正順, 産母努力, 卽生. 《正傳》 ○盤腸産, 謂孕婦臨産時, 子腸先出, 兒卽隨産. 治法, 頂上貼如聖膏 方見下, 自然收縮, 卽以水洗去. 如腸頭爲風吹乾, 不能收入, 以磨刀水微溫潤腸, 煎好磁石湯一盃, 産母飮之, 則其腸自收. 《正傳》
The obstructed birth: the child's head is straight and its crown already showing at the gate, yet it cannot be born. This is because, as the child turned, the umbilical cord caught over its shoulder, so that birth cannot proceed. The method: have the mother lie back; the attendant gently pushes the child a little upward, slowly passes the hand in, presses the child's two shoulders with the middle finger and works the cord free, then waits with the hand until the child's body lies straight and in order — the mother bears down, and it is born. — The coiled-bowel birth: at the onset of labor the bowel comes out first, and the child follows it in birth. The method: apply Yeoseong-go — formula below — to the crown, and it draws back of itself; then wash it away with water. If the protruding end has been dried by the wind and will not go back in, moisten it with slightly warmed whetstone water, decoct a good cup of magnetite broth for the mother to drink, and the bowel draws itself back.
Clinical note A nuchal cord, identified by its mechanism and released by feel — the attendant is told to find both shoulders, work the loop free, and then wait, hand in place, until the body lies straight. It is the most technically assured passage in the chapter. The coiled-bowel entry is prolapse, and its treatment is of its time; what carries over is the instinct to keep the exposed tissue moist and to get it back inside promptly.
Jeongjeon 正傳
熱産, 謂盛暑之時, 産母當要産室凉爽, 不可太熱, 熱則血溢, 令人昏暈. ○凍産, 謂隆冬之時, 産室宜溫暖, 不可太冷, 冷則血凝, 令人難産. 《良方》 ○傷産, 謂胎未離經, 而用力太早, 兒未轉身, 强逼之故也. 《回春》
The heat birth: in the height of summer, the birth room should be kept cool and airy and must not be too hot — for with heat the Blood overflows, and the mother faints. — The frozen birth: in deep winter, the birth room should be warm and must not be too cold — for with cold the Blood congeals, and the birth comes hard. — The injured birth: the pregnancy has not yet left its channel, yet effort is used too early; the child has not turned its body, and it is forced.
Clinical note Two of the ten presentations are simply the temperature of the room, which tells you what the tradition thought the attendant controlled. And the last entry names the era's own commonest iatrogenic injury: labor forced before it was ready. The chapter has now said three times, in three different sections, that pushing too early is the cause of most of what goes wrong.
Yangbang 良方 · Hoechun 回春
Hastening the birth 催生
孕婦臨月, 宜服佛手散, 則縮胎易産, 自無難産之患. 《回春》 ○難産及橫逆産, 或子死腹中, 宜三退散ㆍ三退六一散ㆍ催生丹ㆍ如聖膏. ○催生, 宜用佛手散ㆍ香桂散ㆍ桂香丸ㆍ奪命丸ㆍ烏金散ㆍ催生散. 《諸方》
In the final month, a pregnant woman should take
Bulsu-san 佛手散: the pregnancy is drawn in, the birth comes easily, and she is naturally free of the trouble of a hard birth (Hoechun 回春). — For a hard birth, a crosswise or reversed birth, or a child dead within the belly: Samtoe-san 三退散, Samtoeyugil-san 三退六一散, Choesaeng-dan 催生丹, and Yeoseong-go 如聖膏. — For hastening the birth:
Bulsu-san 佛手散, Hyanggye-san 香桂散, Gyehyang-hwan 桂香丸, Talmyeong-hwan 奪命丸, Ogeum-san 烏金散, and Choesaeng-san 催生散.
Clinical note The hastening shelf, headed by the one formula on it that is still in daily use. Several of the others are built from materials the tradition reached for only in extremity — sloughed snake skin, cicada shells, musk, a paste of croton applied to the navel — and are recorded here as text rather than as prescriptions; musk in particular comes from a species now protected. What survives clinically is the first line: two herbs, taken through the last month, to give a labor enough Blood and enough movement.
Hoechun 回春 · Various formularies 諸方
霹靂丹, 治臨産驀然氣痿, 目翻口噤, 面黑脣靑, 口中沫出, 子母俱殞. 兩臉微紅, 子死母活, 急用此救之. 蛇退 一條, 蚕退紙(幷燒存性) 各二錢, 男子頭髮(燒灰)ㆍ路上左脚草鞋(燒存性) 各一錢, 乳香 五分, 黑鉛 二錢半, 水銀 七分半(二物入銚中, 火上熔化, 結砂子, 硏細). 右爲末, 以猪心血和丸梧子大, 金箔爲衣, 每取二三丸, 倒流水送下. 《入門》
Byeongnyeok-dan, the Thunderbolt Elixir, treats the moment in labor when the Qi suddenly fails — the eyes rolling back, the jaw clenched, the face black and the lips blue-green, froth issuing from the mouth, and both child and mother perishing. If the two cheeks are faintly red, the child has died and the mother lives; use this urgently to rescue her. Snake slough, one length, and silkworm-moult paper, both burnt with their nature retained, 2 don each; a man's hair burnt to ash, and the left-foot straw sandal from the road, burnt with its nature retained, 1 don each; frankincense 5 fun; black lead 2.5 don and quicksilver 7.5 fun, the two put in a pan and melted over fire until they set into granules, then ground fine. Powder all and bind with pig's heart blood into pills the size of parasol-tree seeds, coated with gold leaf; take 2–3 pills sent down with backward-flowing water.
Clinical note Recorded here as text rather than as a formula page, because black lead and quicksilver are what they are. What the entry documents is an obstetric catastrophe — eclamptic seizure or amniotic fluid embolism, by any modern reading — and a practitioner's attempt to act at the moment when both lives were being lost. The prognostic sign is the part worth keeping: faint color returning to the cheeks meant the mother was still with them. Everything else in the recipe belongs to a pharmacy no one should reopen.
Immun 入門
Disorders after birth 産後諸證
有兒枕腹痛ㆍ血暈ㆍ血崩ㆍ衄血ㆍ喘嗽ㆍ咳逆ㆍ産後不語ㆍ産後見鬼譫妄ㆍ産後發熱ㆍ産後乳懸證ㆍ下乳汁ㆍ産後陰脫ㆍ産後鬱冒ㆍ産後風痓ㆍ産後頭痛ㆍ産後心腹腰脇痛ㆍ産後嘔逆ㆍ産後淋瀝遺尿ㆍ産後泄痢ㆍ産後秘結ㆍ産後浮腫.
There are: afterpains of the child's pillow, blood dizziness, blood flooding, nosebleed, panting cough, cough with counterflow, the postpartum woman who does not speak, postpartum seeing of ghosts with delirious speech, postpartum heat effusion, the postpartum hanging-breast pattern, bringing down the milk, postpartum prolapse, postpartum clouding and oppression, postpartum wind tetany, postpartum headache, postpartum pain of heart abdomen lumbus and flanks, postpartum retching counterflow, postpartum dribbling urine and incontinence, postpartum diarrhea and dysentery, postpartum constipation, and postpartum swelling.
Clinical note Twenty-one named conditions of the postpartum period — the longest single register in the chapter, and a fair measure of how the tradition regarded the weeks after birth: not as a return to normal but as its own season of illness, with its own diseases. Several entries name what modern obstetrics tracks under other headings: postpartum hemorrhage, puerperal fever, eclamptic seizure, prolapse, incontinence, and the confusion and low mood that appear here as 'not speaking' and 'seeing ghosts.'
Donguibogam · Buin
産後血虛, 熱入血室, 以致發熱煩躁, 晝輕夜重, 或譫語如見鬼, 或往來寒熱, 宜用柴胡四物湯ㆍ凉血地黃湯ㆍ牛黃膏. 《保命》
Postpartum Blood vacuity, with heat entering the chamber of Blood, brings on heat effusion and vexed agitation — lighter by day and heavier by night, or delirious speech as if seeing ghosts, or chills and fever coming and going.
Sihosamul-tang 柴胡四物湯, Yanghyeoljihwang-tang 凉血地黃湯, and Uhwang-go 牛黃膏 are appropriate.
Clinical note 'Heat entering the chamber of Blood' is the classical name for the fever that follows childbirth into the emptied uterus, and the description is exact: worse at night, with the mind slipping at the peak. Read against a modern chart, this is where puerperal infection lived before it had a germ theory — and the night-heavy pattern, the delirium, the alternating chills are all findings a clinician would still record.
Bomyeong 保命
Acupuncture and moxibustion 鍼灸法
無子, 取陰交ㆍ石門ㆍ關元ㆍ中極ㆍ湧泉ㆍ築賓ㆍ商丘ㆍ陰廉. 《甲乙》 ○催生難産, 及下死胎, 取大衝補ㆍ合谷補ㆍ三陰交瀉, 立時分解. ○胞衣不下, 取三陰交ㆍ中極ㆍ照海ㆍ內關ㆍ崑崙. 《綱目》 ○産後血暈, 取三里ㆍ三陰交ㆍ陰交ㆍ神門ㆍ關元. 《綱目》 ○産後陰下脫, 灸臍下橫紋二七壯, 又取照海. 《良方》 ○橫生逆産, 諸藥不效, 急於産母右脚小指尖頭上灸三壯, 卽産. 亦治胞衣不下. 醫鑑云, 卽至陰穴. 《得效》
For childlessness: CV7 Eumgyo, CV5 Seongmun, CV4 Gwanwon, CV3 Jungguk, KI1 Yongcheon, KI9 Chukbin, SP5 Sanggu, and LR11 Eumnyeom (Gabeul 甲乙). — To hasten a hard birth, and to bring down a dead fetus: supplement LR3 Daechung, supplement LI4 Hapgok, drain SP6 Sameumgyo — and it resolves at once. — For the afterbirth not descending: SP6 Sameumgyo, CV3 Jungguk, KI6 Johae, PC6 Naegwan, and BL60 Gonryun (Gangmok 綱目). — For postpartum blood dizziness: ST36 Samni, SP6 Sameumgyo, CV7 Eumgyo, HT7 Sinmun, and CV4 Gwanwon (Gangmok 綱目). — For postpartum prolapse below: moxa fourteen cones at the transverse crease below the navel, and take KI6 Johae (Yangbang 良方). — For a crosswise or reversed birth where no medicine has worked: urgently moxa three cones at the tip of the mother's right little toe, and the birth follows. It also treats the afterbirth not descending. The Uigam says this is the Jieum point, BL67 (Deukhyo 得效).
Clinical note The needle's version of the whole chapter, from conception to the hour after birth — and the last entry is the one still in use worldwide: moxa at the little-toe point for malpresentation, which has been the subject of modern clinical trials and remains a standard offering for breech presentation in many hospitals. Note the pattern in the birth prescriptions: supplement above, drain at the ankle. The chapter thinks of labor as something to be let down rather than pushed out.
Gabeul 甲乙 · Gangmok 綱目 · Yangbang 良方 · Deukhyo 得效
一婦人, 産後暴卒, 其母爲灸會陰ㆍ三陰交, 各數壯而甦. 其母盖名醫女也. 《資生》 ○婦人無子, 或産後久不再孕, 取稈心一條, 長同身寸之四寸, 令婦人仰臥舒手足, 以所量稈心自臍心直垂下, 盡頭處以墨點記. 後以此稈心平摺, 橫安前點處, 兩頭盡處是穴. 按之自有動脉應手, 各灸三七壯, 神驗. 卽上所云胞門ㆍ子戶穴也. 《醫鑑》
A woman collapsed suddenly after giving birth. Her mother moxaed CV1 Hoeeum and SP6 Sameumgyo, several cones at each, and she revived. Her mother, it turns out, was a renowned woman physician (Jasaeng 資生). — For a woman without children, or one who after a birth has long not conceived again: take a length of straw pith four body-inches long; have the woman lie face up with limbs extended; hang the measured straw straight down from the center of the navel and mark the far end with ink. Then fold the straw in half, lay it crosswise on that mark, and where its two ends fall are the points. Press them and a pulse answers the hand of itself. Moxa twenty-one cones at each: a spirit-level effect. These are the Womb Gate and Child Door points named above.
Clinical note Two entries that between them say a great deal about who practiced this medicine. The first is a case report of a postpartum collapse reversed with moxa — and its last clause, added almost in passing, records that the woman who did it was a renowned female physician: one of the few places in the book where such a practitioner is named as such. The second is a measuring technique using a straw, so that a point could be found on any body without a chart, and confirmed by feeling for the pulse beneath the finger. Portable, verifiable, and requiring nothing but a length of straw.
Jasaeng 資生 · Uigam 醫鑑
Emergency care of the newborn 小兒初生救急
初生, 氣欲絶不能啼, 必是難産, 或冒寒所致. 急以綿絮包, 置懷中, 勿斷臍帶. 且將胞衣置爐火中燒之, 仍作大紙撚, 蘸油點火, 於臍帶下熏之, 令火氣入腹. 更以熱醋湯盪洗臍帶, 須令氣回, 啼哭如常, 方可斷臍帶. 《三因》
A newborn whose Qi is on the point of departing and who cannot cry has surely come of a hard birth, or of being struck by cold. Urgently wrap the child in cotton wadding and hold it against the breast, and do not cut the umbilical cord. Set the afterbirth in the brazier's fire; make a large paper taper, dip it in oil and light it, and warm the cord beneath, letting the warmth of the fire enter the belly. Wash the cord with hot vinegar broth. Only when the Qi has returned and the child cries as it should may the cord be cut.
Clinical note The most remarkable passage in the chapter, and the one that has aged best. Four measures are given for a newborn who will not breathe — wrap it, hold it skin to skin at the mother's chest, keep the cord warm, and above all do not cut the cord until the child is breathing. Every one of those is standard neonatal practice today, and delayed cord clamping in particular was reintroduced to modern obstetrics only in recent decades after a long period of the opposite. Whatever the reasoning behind it in 1613, the instruction was right: while the cord pulses, the child is still being helped.
Samin 三因
初生, 面靑身冷口噤, 乃胎寒也. 用白殭蚕散急救之. 白殭蚕ㆍ木香ㆍ肉桂ㆍ陳皮ㆍ檳榔ㆍ甘草(灸) 各五分. 右剉, 水煎取汁, 以綿蘸, 入兒口中. 《入門》 ○初生, 忽患撮口, 不飮乳, 名曰馬牙. 不治則百無一生. 《俗方》
A newborn whose face is blue-green, whose body is cold and whose jaw is clenched has fetal cold. Use Baekgangjam-san to rescue it urgently: white silkworm, aucklandia, cinnamon bark, tangerine peel, areca, and roasted licorice, 5 fun each — cut, decocted in water, the liquid taken up on a wad of cotton and put into the child's mouth. — A newborn suddenly afflicted with pursed mouth, unable to take the breast, is said to have 'horse teeth'; untreated, not one in a hundred lives.
Clinical note The clenched jaw, the inability to feed, the near-total mortality: this is neonatal tetanus, described with painful accuracy centuries before its cause was known, and the passage records exactly what such a birth attendant would have seen. It was among the leading causes of newborn death worldwide until maternal immunisation and clean cord care all but eliminated it in most countries — which is to say the problem this section could not solve has been solved, by other means.
Immun 入門 · Sokbang 俗方
初生, 有卽死者, 急看兒口中懸雍前㬽上, 有泡如石榴子, 以指摘破出血, 以帛拭去. 若惡血入口中, 卽死. ○初生, 穀道無孔, 不得大便, 急用金玉簪尖, 看其的處, 刺穿作孔. ○初生, 大小便不通, 腹脹氣欲絶, 急令婦人以溫水漱口了, 吸咂兒前後心, 幷臍下手足心, 共七處, 每一處凡咂三五次, 漱口更咂, 取紅赤色爲度. 《入門》 《俗方》 《回春》
The section continues with emergency measures for the newborn who dies at once, for one born without an opening at the anus, and for one whose stool and urine will not pass with the belly distended and the Qi failing — the last treated by an attendant sucking at seven points on the child's chest, back, navel, and palms and soles. These are procedures of their time, several of them invasive, and they are not rendered here as instructions; the original is preserved above for scholarly reference.
Clinical note Read as a record rather than a manual, these entries are moving. An attendant in 1613 met a newborn with an imperforate anus — a condition that is today diagnosed within hours and corrected surgically — and had a hairpin and their own judgment. What the passage documents is not a technique worth reviving but a duty: someone was expected to try, and to have thought beforehand about what trying would look like. The chapter that opened with the seeking of children closes with the last thing that can be done for one.
Immun 入門 · Sokbang 俗方 · Hoechun 回春
婦人無子, 或産後久不再孕, 取稈心一條, 長同身寸之四寸, 令婦人仰臥舒手足, 以所量稈心自臍心直垂下, 盡頭處以墨點記. 後以此稈心平摺, 橫安前點處, 兩頭盡處是穴. 按之自有動脉應手, 各灸三七壯, 神驗. 卽胞門ㆍ子戶穴也. 《醫鑑》
For a woman without children, or one who after a birth has long not conceived again: take a length of straw pith four body-inches long; have the woman lie face up with limbs extended; hang the measured straw straight down from the center of the navel and mark the far end with ink. Then fold the straw in half, lay it crosswise on that mark, and where its two ends fall are the points. Press them and a pulse answers the hand of itself. Moxa twenty-one cones at each: a spirit-level effect. These are the Womb Gate and Child Door points.
Clinical note The chapter ends where it began — with a woman who wants a child — and its last instrument is a length of straw. Measured against her own body, folded once, laid across a mark of ink: two points found without a chart and confirmed by the pulse rising under the finger. After the seed pills and the birth maneuvers and the emergencies, the closing image of the Women's chapter is of a practitioner kneeling with a straw and a hand, taking a measurement that belongs to no one but the patient in front of them.
Uigam 醫鑑