何以知怀子之且生也?身有病而无邪脉也。(身有病,谓经断、恶阻之类也。身病者脉亦当病,或断续
不调,或弦涩细数,是皆邪脉,则真病也。若六脉和滑而身有不安者,其为胎气无疑矣。)人有重
身,九月而喑。(妇人怀孕,则身中有身,故曰“重身”。喑,声哑不能出也。)胞之络脉绝也。(胎怀九
月,儿体已长,故能阻绝胞中之络脉。)何以言之?胞络者,系于肾少阴之脉,贯肾系舌本,故不能
言。无治也,当十月复。(胞中之络,冲任之脉也,胞络者,系于肾而上会于咽喉,故胞中之络脉绝则不
能言,十月子生而胞络复通,则能言矣,故不必治。)无损不足、益有余以成其疹。(疹,疾也。不当治而
治之,反以成疾。)无损不足者,身羸瘦无用 石也;(妊娠九月,则身重疲劳,养胎力困,正虚羸不足
之时,必不可用针石以复伤其气。)无益其有余者,腹中有形而泄之,泄之则精出,而病独擅中,
故曰疹成也。(胎元在胞而刺之,则精气必泄。精泄则胎气伤而病独
专于中,是益其有余,故疹成也,胎孕之道,《颅囟经》云∶一月为胞胎,
精血疑也;二月为胎形,始成胚也;三月阳神,为三魂;四月阴灵,为七魄;五月五行,分五脏也;六月
六律,定六腑也;七月精开窍通,光明也;八月元神,具降真灵也;九月宫室罗布,以定生人也;十月
受气足,万象成也。生后六十日瞳子成,能咳笑应和人;百五十日任脉成,能自反复;百八十日髋骨成,能
独坐;二百一十日掌骨成,能扶伏;三百日髌骨成,能行也。若不能根据期者,必有不平之处,巢元方曰∶
妊娠一月名胎胚,足厥阴脉养之;二月名始膏,足少阳脉养之;三月名始胎,手心主脉
养之,当此之时,血不流行,形象始化,未有定仪,因感而变,欲于端正庄严,常口谈正言,身行正事,欲子
美好,宜佩白玉,欲子贤能,宜看诗书,是谓外象而内感者也;四月始成其血脉,手少阳脉养之;五月始成其
气,足太阴脉养之;六月始成其筋,足阳明脉养之;七月始成其骨,手太阴脉养之;八月始成肤革,手
阳明脉养之;九月始成毛发,足少阴脉养
之;十月五脏六腑、关节人神皆备,此其大略也。当推其理,若足厥阴者,肝脉也,足少阳者,胆脉也,
此一脏一腑之经也,余皆如此,凡四时之令必始春木,故十二经之养始于肝胆,所以养胎在一月、二月;手心
主包络也,手少阳三焦也,属火而王夏,所以养胎在三月、四月;足太阴脾也,足阳明胃也,属土而王长
夏,所以养胎在五月、六月,手太阴肺也,手阳明大肠也,属金而王秋,所以养胎在七月、八月;足少阴肾也,
属水而王冬,所以养胎在九月;至十月,儿于母腹之中受足诸脏之气,然后待时而生也,然十二经中,惟手
少阴心脉、手太阳小肠脉及足太阳膀胱脉,皆不言养胎者,盖九月之养在肾,则膀胱亦在其中矣,惟心与小肠
为表里,心为五脏六腑之主,虽其尊而无为,然脏气所及则神无不至,小肠切近胞胎,丙火所化,则气无
不至,所以皆不主月而实无月不在也,胎孕之道。无出此矣。第胎有男女,则成有迟速,体有阴阳,则怀分
向背。故男动在三月,阳性早也,女动在五月,阴性迟也。女胎背母而怀,故母之腹软,男胎面母而怀,故
母之腹硬。此又男胎、女胎之有不同者也,至若既生之
后,儿之寿夭,其因有二∶盖一则由于禀赋,一则由于抚养,夫禀赋为胎元之本,精气之受于父母者是也。
抚养为寿夭之本,居处寒温、饮食得失者是也。凡少年之子,多有羸弱,欲勤而精薄也。老年之子,反多强壮
者,欲少而精全也。多饮者子多不育,盖以酒乱精,则精半非真,而湿热胜也。多欲者子多不育,以孕后不
节,则盗泄母阴,夺养胎之气也。此外如饥饱劳逸,五情六气,无不各有所关,是皆所谓禀赋也。至于抚养之
法,俗传有云“若要小儿安,须带三分饥与寒。”此言殊为未当,恐饮食之过,伤脾而积聚生,故当防其放
肆无度。叠进而骤,脾不及化,必使饮食匀调,节其生冷,何病之有?若云带饥,则不可也。至若“寒”之
一字,关系非浅,圣人避风如避箭,则风寒之为害也不小。彼婴儿以未成之血气,嫩薄之肌肤,较之大人相
去百倍,顾可令其带寒耶?新产之儿,多生惊风抽搐等病,盖其素处腹中,裹护最密,及胞胎初脱,极易
感邪,而收生者迟慢不慎,则风寒袭之,多致不救,及其稍长,每多发热,轻则为鼻塞咳
嗽,重则为小儿伤寒,幼科不识,一概呼为变蒸,误药致毙者此也。或寒气伤脏,则为吐为泻,或因寒生热,
则为惊为疳。种种变生,多由外感,虽禀体强盛,不畏风寒者亦所常有,但强者三之一,弱者三之二,伤热
者十之三,伤寒者十之七,矧膏粱贫贱,气质本自不同,医家不能察本,但知见热攻热,婴儿不能言,病家不
能辨,徒付之命,诚可叹也。又有谓“小儿为纯阳之体,多宜清凉之治”者,此说尤为误人。女子二七,男子
二八,而后天癸至。夫天癸者,阴气也,小儿之阴气未至,故曰纯阳,原非阳气有余之谓,特稚阳耳。稚阳
之阳,其阳几何?使阳本非实,而误认为火,则必用寒凉妄攻其热,阴既不足,又伐其阳,多致阴阳俱败,脾
肾俱伤,又将何所藉赖而望其生乎?又曰“小儿无补肾法”,此何说耶?夫小儿之阴气未成,即肾虚也,或
父母多欲而所禀水亏,亦肾虚也。阴既不足。而不知补之,阴绝则孤阳亦灭矣,何谓无可补耶?此义惟薛立
斋独得之。)
How can one know that a pregnant woman is about to give birth? The body exhibits symptoms of illness, but the pulse is not pathological. ("Body with illness" refers to conditions such as amenorrhea and morning sickness. Typically, when the body is ill, the pulse should also be abnormal, such as being intermittent or irregular, or presenting as wiry (Xian), choppy (Se), fine (Xi), or rapid (Shu). These are all pathological pulses indicating true disease. If the six pulses are harmonious and slippery, yet the body feels uncomfortable, this is undoubtedly due to fetal qi.)
A pregnant woman is referred to as having "double bodies" (Chongshen). By the ninth month, she may become aphonic (Yin). (Pregnancy means there is a body within a body, hence "double bodies." Aphonia refers to hoarseness or inability to speak.) This is because the collaterals of the uterus are obstructed. (By the ninth month of pregnancy, the fetus has grown sufficiently to block the flow of collaterals within the uterus.) Why is this so? The uterine collaterals connect to the Foot-Shaoyin Kidney meridian, penetrate the kidney, and link to the root of the tongue; therefore, speech becomes impaired. No treatment is required; speech will return after the tenth month. (The collaterals within the uterus refer to the Chong and Ren meridians. The uterine collaterals connect to the kidney and ascend to meet at the throat. When these collaterals are blocked, speech is lost. After the tenth month, when the fetus is born, the uterine collaterals reopen, and speech returns. Thus, no treatment is necessary.)
Do not damage those with deficiency of healthy qi, nor tonify those with excess of pathogenic factors, lest you exacerbate the condition. ("Zhen" here refers to disease. Treating when treatment is not indicated will only cause further illness.) "Do not damage the deficient" means that emaciated individuals should not undergo harsh treatments like bian stone therapy. (In the ninth month of pregnancy, the body is heavy and fatigued, and energy is depleted nourishing the fetus. This is a time of righteous qi deficiency and insufficiency; it is absolutely forbidden to use needles or stones to further injure the qi.) "Do not tonify the excessive" means that if there is a formed fetus in the abdomen, using purgative methods will cause essence to leak out, leaving the pathogen dominant in the interior. Hence, the disease forms. (If the fetus in the uterus is pierced, essence must leak. Leakage of essence injures fetal qi, allowing the pathogen to dominate the center. This increases the excess, leading to disease formation.)
Regarding the principles of conception, the *Cranium and Fontanelle Classic* (*Lunxin Jing*) states: In the first month, it is called "Tai Bao" (fetal sac), formed by the condensation of essence and blood; in the second month, it is called "Tai Xing" (fetal form), where the embryo begins to take shape; in the third month, the Yang Spirit manifests, forming the Three Hun souls; in the fourth month, the Yin Spirit manifests, forming the Seven Po souls; in the fifth month, the Five Elements distribute, differentiating the Five Zang organs; in the sixth month, the Six Laws stabilize, differentiating the Six Fu organs; in the seventh month, essence opens the orifices, granting vision; in the eighth month, the Yuan Spirit is complete, descending with true spiritual power; in the ninth month, the palace structure is fully arranged, determining the human form; in the tenth month, qi reception is sufficient, and all phenomena are completed.
After birth, at sixty days, the pupils form, and the infant can cough, laugh, and respond to others; at 150 days, the Ren Meridian forms, allowing self-turning; at 180 days, the hip bones form, enabling sitting alone; at 210 days, the palm bones form, enabling crawling on hands and knees; at 300 days, the patellae form, enabling walking. Failure to develop according to schedule indicates imbalance. Chao Yuanfang stated: The first month of pregnancy is named "Tai Pei," nourished by the Foot-Jueyin Liver Meridian; the second month is named "Shi Gao," nourished by the Foot-Shaoyang Gallbladder Meridian; the third month is named "Shi Tai," nourished by the Hand-Jueyin Pericardium Meridian. At this time, blood circulation is sluggish, forms are just beginning to transform, and there is no fixed pattern, making them susceptible to change through external influence. To desire a dignified and upright child, one should speak rightly and act rightly; to desire beauty, wear white jade; to desire virtue and ability, read poetry and books. This is the principle of "external images affecting internal sensations."
In the fourth month, blood vessels begin to form, nourished by the Hand-Shaoyang Sanjiao Meridian; in the fifth month, Qi begins to form, nourished by the Foot-Taiyin Spleen Meridian; in the sixth month, sinews begin to form, nourished by the Foot-Yangming Stomach Meridian; in the seventh month, bones begin to form, nourished by the Hand-Taiyin Lung Meridian; in the eighth month, skin and flesh begin to form, nourished by the Hand-Yangming Large Intestine Meridian; in the ninth month, hair begins to form, nourished by the Foot-Shaoyin Kidney Meridian; in the tenth month, the Five Zang and Six Fu organs, joints, and human spirit are all complete. This is the general outline. One should deduce the underlying logic. For instance, the Foot-Jueyin is the Liver Meridian, and the Foot-Shaoyang is the Gallbladder Meridian; this is a Zang-Fu pair. Similarly for the rest. Generally, the seasonal commands begin with Spring Wood; thus, the nourishment of the twelve meridians starts with the Liver and Gallbladder. Therefore, nourishment of the fetus occurs in the first and second months. The Hand-Jueyin Pericardium and Hand-Shaoyang Sanjiao belong to Fire and flourish in Summer; thus, nourishment occurs in the third and fourth months. The Foot-Taiyin Spleen and Foot-Yangming Stomach belong to Earth and flourish in Late Summer; thus, nourishment occurs in the fifth and sixth months. The Hand-Taiyin Lung and Hand-Yangming Large Intestine belong to Metal and flourish in Autumn; thus, nourishment occurs in the seventh and eighth months. The Foot-Shaoyin Kidney belongs to Water and flourishes in Winter; thus, nourishment occurs in the ninth month. By the tenth month, the fetus in the womb has received sufficient qi from all zang organs and waits for the proper time to be born.
However, among the twelve meridians, the Hand-Shaoyin Heart Meridian, Hand-Taiyang Small Intestine Meridian, and Foot-Taiyang Bladder Meridian are not explicitly mentioned as nourishing the fetus. This is likely because the ninth-month nourishment lies in the Kidney, which includes the Bladder. Only the Heart and Small Intestine are exterior-interior pairs. The Heart is the master of the five zang and six fu organs. Although noble and non-action-oriented, wherever its zang qi reaches, its spirit arrives. The Small Intestine is close to the fetal sac, transformed by Bing Fire, so its qi reaches everywhere. Thus, they do not govern specific months but are present in every month. The principles of conception do not go beyond this.
Nevertheless, male and female fetuses differ in the speed of development due to their nature, and in position due to yin-yang distinctions. Male fetuses move at three months because yang energy acts early; female fetuses move at five months because yin energy acts late. Female fetuses face away from the mother, so the mother's abdomen feels soft; male fetuses face the mother, so the mother's abdomen feels firm. These are differences between male and female fetuses.
Regarding lifespan after birth, there are two causes: constitution (Binfu) and upbringing (Fuyang). Constitution is the root of the fetal origin, receiving essence and qi from parents. Upbringing is the root of longevity or premature death, involving the warmth/cold of the dwelling and the gains/losses in diet. Children of young parents are often frail because desires are frequent and essence is thin. Children of older parents are often robust because desires are few and essence is complete. Those who drink excessively have children who often fail to survive, as alcohol disturbs essence, making it impure and increasing damp-heat. Those with excessive sexual desire have children who often fail to survive, as lack of restraint during pregnancy drains the mother's yin and steals the qi used to nourish the fetus. Additionally, hunger/fullness, work/rest, the five emotions, and the six climatic factors are all relevant; these constitute "constitution."
Regarding upbringing methods, folk wisdom says, "To keep a child safe, keep them slightly hungry and cold." This statement is highly inappropriate. Overeating damages the Spleen and generates accumulations; thus, one must prevent uncontrolled indulgence. Eating too much too quickly overwhelms the Spleen's transformation capacity. Diet must be balanced and regular, avoiding raw and cold foods, to prevent disease. Advocating "hunger" is inadvisable. Regarding "cold," the implication is profound. Sages avoid wind as if avoiding arrows; thus, the harm of wind-cold is significant. Infants, with undeveloped blood/qi and tender skin, differ from adults by hundreds of times. How can they be allowed to endure cold? Newborns often suffer from convulsions and spasms because they were tightly protected in the womb and are easily invaded by pathogens upon birth. If midwives are slow or careless, wind-cold attacks, often leading to fatal outcomes. As they grow slightly older, fever is common. Mild cases present as nasal congestion and cough; severe cases present as pediatric exogenous febrile diseases. Pediatricians unfamiliar with these may misdiagnose them as "bianzheng" (transformational fever), leading to death from incorrect medication. Cold damaging the zang organs causes vomiting and diarrhea; cold generating heat causes convulsions and malnutrition syndromes. Various complications arise mostly from external invasions. Even strong infants who resist wind-cold exist, but they are one-third; weak ones are two-thirds. Heat injuries account for 30%, while cold injuries account for 70%. Moreover, nobles and commoners have different constitutions. Physicians who fail to identify the root cause and merely attack heat with cold herbs, combined with infants' inability to speak and families' inability to distinguish symptoms, lead to resignation to fate, which is lamentable.
Another saying claims, "Infants are pure yang bodies and should be treated with cooling agents." This is particularly misleading. Women reach menarche at fourteen, men at sixteen, marking the arrival of Tian Gui (innate essence). Tian Gui is yin qi. Since infants have not yet attained yin qi, they are called "pure yang," meaning they possess only immature yang, not an excess of yang. Immature yang is minimal. If one mistakes this non-excess for fire and wrongly uses cold-cooling herbs to attack heat, both yin and yang will be damaged, leading to failure of both yin and yang, and injury to the Spleen and Kidney. What then remains to sustain life? Another claim states, "There is no method to tonify the Kidney in infants." What kind of reasoning is this? If an infant's yin qi is undeveloped, it constitutes Kidney deficiency. If parents had excessive desires, the inherited water essence is deficient, also constituting Kidney deficiency. If yin is insufficient and not tonified, yin exhaustion leads to the extinction of lone yang. How can one say there is nothing to tonify? This insight was uniquely grasped by Xue Lizhai.)