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Chao Yuanfang stated: The "bianzheng" (periodic growth and fever) in infants is for the generation of Qi and Blood. "Bian" refers to the transformation of upper Qi, while "Zheng" refers to body heat. Qian Yi (courtesy name Zhongyang) said: "Bian" means change. He further stated that bianzheng grows from within outward, from below upward, accompanied by body heat. Therefore, after each bianzheng cycle concludes, one perceives a difference in the child's temperament compared to before. Why is this? It is because the Zang-Fu organs, intentions, and intelligence are growing.

What is meant by "thirty-two days to grow bones and add spirit"? The human body has three hundred and sixty-five bones to symbolize the celestial cycle, corresponding to the annual period, and distributed among the twelve meridians. From birth to the thirty-second day constitutes the first Bian, generating Gui Water, belonging to the Foot Shaoyin Kidney Meridian; the Kidney stores Essence and Will. On the sixty-fourth day, the second Bian and first Zheng occur, generating Ren Water, belonging to the Foot Taiyang Bladder Organ; its manifestation is coldness in the ears and sacrum. The Kidney and Bladder are interior-exterior pairs, both governing Water; Heaven generates Water with One, Earth completes it with Six. On the ninety-sixth day, the third Bian occurs, generating Ding Fire, belonging to the Hand Shaoyin Heart Meridian; the Heart stores Spirit, and its emotion is Joy. On the hundred-and-twenty-eighth day, the fourth Bian and second Zheng occur, generating Bing Fire, belonging to the Hand Taiyang Small Intestine Organ; its manifestation is sweating and slight fright. The Heart and Small Intestine are interior-exterior pairs governing Fire; Earth generates Fire with Two, Heaven completes it with Seven. On the hundred-and-sixtieth day, the fifth Bian occurs, generating Yi Wood, belonging to the Foot Jueyin Liver Meridian; the Liver stores Hun (Ethereal Soul) and tends toward weeping. On the hundred-and-ninetieth day, the sixth Bian and third Zheng occur, generating Jia Wood, belonging to the Foot Shaoyang Gallbladder Organ; its manifestation is eyes remaining open (or closed, depending on the text version) and redness. The Liver and Gallbladder are interior-exterior pairs governing Wood; Heaven generates Wood with Three, Earth completes it with Eight. On the two-hundred-and-twenty-fourth day, the seventh Bian occurs, generating Xin Metal, belonging to the Hand Taiyin Lung Meridian; the Lung stores Po (Corporeal Soul) and governs voice. On the two-hundred-and-fifty-sixth day, the eighth Bian and fourth Zheng occur, generating Geng Metal, belonging to the Hand Yangming Large Intestine Organ; its manifestation is skin heat with or without sweating. The Lung and Large Intestine are interior-exterior pairs governing Metal; Earth generates Metal with Four, Heaven completes it with Nine. On the two-hundred-and-eighty-eighth day, the ninth Bian occurs, generating Ji Earth, belonging to the Foot Taiyin Spleen Meridian; the Spleen stores Yi (Intellect) and Zhi (Memory). On the three-hundred-and-twentieth day, the tenth Bian and fifth Zheng occur, generating Wu Earth, belonging to the Foot Yangming Stomach Organ; its manifestation is anorexia, abdominal pain, and regurgitation of milk. The Spleen and Stomach are interior-exterior pairs governing Earth; Heaven generates Earth with Five, Earth completes it with Ten. Additionally, the Hand Jueyin Pericardium is a Zang organ, and the Hand Shaoyang Sanjiao (Triple Burner) is a Fu organ. These two have no distinct physical manifestations, thus they do not undergo bian or zheng. The previous ten Bians and five Zhengs follow the numbers of Heaven and Earth for generation and completion. Thereafter, such as the eruption of teeth, ability to speak, and understanding of joy and anger, indicate that development is complete. Chunyu Yi (courtesy name Taicang) stated: Qi enters the four limbs; sixty-four days after the ten Bians constitutes a major Zheng, totaling three hundred and eighty-four days, to grow the meridians. When the hands receive blood, they can grasp objects; when the feet receive blood, they can walk and stand. The classics state: "Bian and Zheng" implies that after the Zheng cycles conclude, more than one year has passed. The masters say: If there is fever without sweating, induce sweating; if there is severe vomiting, mildly stop vomiting and do not apply other treatments. Another sixty-four days later constitutes the second major Zheng, totaling four hundred and forty-eight days. Another sixty-four days later constitutes the third major Zheng, totaling five hundred and twelve days. By five hundred and seventy-six days, the bianzheng process is complete, and the child becomes an adult. Bian generates the five Zang organs, and Zheng nourishes the six Fu organs; Bian involves the ascent of Qi, and Zheng involves fever. With each Bian and Zheng, the demeanor changes. Mild cases present with low-grade fever and slight sweating, resembling wind-stroke; severe cases present with high fever, chaotic and rapid pulse, sweating or vomiting, irritability, crying, restlessness, and thirst. Mild cases resolve in five days, severe cases in seven to eight days. The symptoms resemble Cold Damage (Shanghan). Some infants, while residual qi from bianzheng remains, contract cold pathogenic factors. In bianzheng, the ears and sacrum are cold, and blisters like turbid pearls appear on the upper lip. If cold pathogenic factors contend, there is alternating chills and fever, abdominal pain, and ceaseless crying day and night. Bian means change; Zheng in the Liver causes dizziness and slight redness of the eyes; Zheng in the Lung causes sneezing, coughing, and erecting of hair. All five Zang and six Fu organs, tendons, vessels, and bones have cyclic corresponding syndromes. For treatment: mild cases require releasing the exterior; excess-heat cases require mild purgation. Zi Shuang Wan (Purple Frost Pill), Hei San Zi (Black Powder), and Chaihu Tang (Bupleurum Decoction) may be administered. For cases with cold but no heat, accompanied by vomiting, diarrhea, refusal to nurse, and excessive crying, Danggui San (Angelica Sinensis Powder) and Tiaoqi San (Regulating Qi Powder) are indicated. Apart from bianzheng, the infant's appearance and demeanor should naturally be peaceful. Generally, humans obtain the Way of Mean Harmony to become pure, with Yin and Yang in their proper places, rigid and soft assisting each other, Qi and Blood harmonious, and all meridians smooth. Thus, mental acuity increases, spirit is complete, Zang-Fu organs are full, the physique is solid and strong, teeth are fine, hair is black, voice is resonant, and sleep is steady. This indicates sufficient reception of Qi, balanced constitution, and absence of disease. The aforementioned symptoms are unavoidable for infants; even without medication, they will resolve. The aforementioned medicines are harsh; not only may the Zang-Fu organs fail to withstand them, but they may also damage Qi and Blood. I often saw an infant who, during the first Bian, had fever and phlegm. After administering one pill of Baolong Wan (Pill for Embracing the Dragon), the child died suddenly. This case serves as verification; one must be extremely cautious! Those who do not have fever or fright, show no symptoms, but undergo hidden bianzheng, do so because their prenatal Qi is robust.

Zi Shuang Wan (Formula see Cukou section)

Ziyang Heisan treats residual heat after the resolution of bianzheng.
Mahuang (Ephedrae Herba, two liang, nodes not removed) Dahuang (Rhei Radix et Rhizoma, half liang) Xingren (Prunus Armeniacae Semen, peeled, two fen and half, pounded)
Mix the above three ingredients, pound into powder, slightly roast until the original nature is preserved. Then mix with Xingren paste (Apricot Kernel Paste), store in honey. Take an amount the size of a bean per dose, mixed with breast milk and swallowed.

Chaihu Tang treats bone heat and vexation during bianzheng, with incessant crying.
Renshen (Ginseng Radix, two qian) Gancao (Licorice Root, lightly roasted, two qian) Maimendong (Ophiopogonis Radix, heart removed, two qian) Longdancao (Gentianae Radix, wine-fried until black) Fangfeng (Saposhnikoviae Radix, one qian each) Chaihu (Bupleuri Radix, five fen)
Take one qian per dose, decoct in water.

Danggui San treats bianzheng with cold but no heat.
Danggui (Angelicae Sinensis Radix, two qian) Muxiang (Aucklandiae Radix) Guigui (Cinnamomi Cortex, pungent variety) Gancao (Licorice Root, roasted) Renshen (Ginseng Radix, one qian each)
Take one qian per dose, decoct in water with ginger and jujube.

Tiaoqi San treats bianzheng with vomiting and diarrhea, refusal to nurse, excessive crying, and impending slow convulsion.
Muxiang (Aucklandiae Radix) Xiangfuzi (Cyperi Rhizoma) Renshen (Ginseng Radix) Jupi (Citri Reticulatae Pericarpium) Huoxiang (Agastaches Herba) Gancao (Licorice Root, roasted. One qian each)
Grind into powder. Take one qian per dose, decoct in water with ginger and jujube.