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Article 89, twenty prescriptions, two moxibustion methods, one discussion.

While in the womb, the fetus is a "pei" (embryo) in the first month, a "tai" (fetus) in the second month, blood vessels form in the third month, physical shape is completed in the fourth month, movement begins in the fifth month, bones are formed in the sixth month, hair grows in the seventh month, internal organs are complete in the eighth month, food enters the stomach in the ninth month, and all spirits (mental consciousness) are prepared in the tenth month, then it is born. Sixty days after birth, the pupils are formed, capable of coughing, smiling, and responding to people; one hundred and fifty days later, the Ren Mai (Conception Vessel) is formed, capable of rolling over independently; one hundred and eighty days later, the hip bones are formed, capable of sitting alone; two hundred and ten days later, the metacarpal bones are formed, capable of crawling on hands and knees; three hundred days later, the patella is formed, capable of standing; three hundred and sixty days later, the knee popliteal fossa is formed, capable of walking. If development does not follow this schedule, there must be some imbalance in the body.

When an infant first lands on the ground, if there is blood in the mouth, it must be removed immediately. If not removed, and the infant swallows it, it will form a "pi" (mass/blockage) disease leading to death.

Method for treating an infant who makes no sound upon landing: Take a basin of warm water and bathe the infant; within a short time, the infant will make sounds.

When a newborn is born, it should be lifted immediately. If lifted late, it will suffer from cold, causing borborygmus (rumbling in the abdomen). Bathe the infant first, then cut the umbilical cord. The umbilical cord should be left long, reaching the dorsum of the foot; if too short, it causes cold invasion, leading to abdominal dysfunction and diarrhea. If the cord is cut before bathing, water may enter the umbilicus, causing abdominal pain. If water or cold enters the umbilicus, it causes severe abdominal colic, constant crying day and night, and blue-black complexion. This is due to water entering the umbilicus. One should apply hot cotton wadding as a compress to the area. Care for the umbilicus promptly. If it swells, treat according to severity; for severe cases, moxibustion should be applied immediately, up to eighty or ninety moxa cones. For mild cases, where the umbilicus is not severely swollen but exudes fluid and cries frequently, grind Angelicae Sinensis Radix (Danggui) into powder and apply it to the umbilicus. Apply hot cotton wadding daily until one hundred days old, when healing is confirmed by the cessation of crying. Clear urine indicates cold, similar to water entering the umbilicus.

When cutting the umbilical cord of a newborn, leave it six cun long. If too long, it damages muscles; if too short, it damages internal organs. Failure to cut it in time, or incomplete drainage of umbilical fluid, leads to self-generated cold, resulting in "Wind Umbilicus" disease.

Method for wrapping the umbilicus:
Beat silk until soft, cut into four-cun squares. Place half-cun thick new cotton wool, matching the size of the silk. Adjust tightness; if too tight, it causes vomiting. After twenty days of birth, untie and inspect the umbilicus. If after ten-plus days the infant cries angrily as if pricked by something in the clothes, this may be dryness of the umbilicus irritating the abdomen. Untie and change clothes. When re-wrapping, close doors and windows, lower curtains, and place fires on both sides to keep the interior warm. Changing clothes should also be done this way, dusting with warm powder. This is for winter cold. If the umbilicus does not heal, burn red silk to ash, powder the umbilicus with it. If after one month there is still discharge, burn toad (Bufo bufo gargarizans) to ash, powder the umbilicus, three to four times daily. If the umbilicus has not healed, it may be due to overfeeding, causing Wind Umbilicus.

Newborns should not be dressed too warmly, as this damages skin and muscles, causing chaotic blood vessels, sores, and jaundice.

For newborns whose skin and flesh are not yet formed, do not use warm clothing. Warm clothing causes tendons and bones to become lax and weak. They should be exposed to wind and sunlight occasionally. Without exposure, skin becomes brittle and easily injured. Use old cotton wadding for clothes, not new cotton. On mild, windless days, let the mother play with the child in the sun, exposing them to wind and sunlight frequently. This consolidates Qi and blood, strengthens muscles, and builds resistance to wind and cold, preventing disease. Keeping them hidden in curtains with heavy warm clothing is like grass in the shade—soft, fragile, and unable to withstand wind and cold.

Infants should not be fed until ten days after birth. Start with an amount the size of a jujube pit, double it at twenty days, the size of a pellet at fifty days, and the size of a jujube at one hundred days. If milk is insufficient, do not follow this strictly; increase gradually with care. Feeding starting at thirty days prevents disease. Early and excessive feeding causes sores on the head, face, and body, which recur after healing, and leads to weakness and difficulty digesting.

Feeding should begin only after thirty days. Early feeding overwhelms the infant's ability to process grain Qi, causing illness and emaciation despite fat accumulation. After thirty days, feed moderately. Do not force-feed if the infant refuses. Forced feeding that is not digested causes disease. Infants refusing milk likely have phlegm-fluid retention in the abdomen. Treat mildly with Siwu Ziwan (Four-Ingredient Purple Pill). Reduce feeding frequency for a few days, and it will heal itself.

Infant cold-heat disorders should also be treated with purgation to achieve recovery.

Nurses should massage their breasts to disperse heat before nursing, preventing forceful ejection of milk. Withdraw the breast periodically during feeding to allow the infant to rest, repeating this several times. Observe the infant's hunger and satiety to determine the appropriate frequency per day as a routine. Regularly express residual milk.
If the infant lies down, the nurse should support the infant's arm, keeping the nipple level with the infant's head to prevent choking. If the nurse feels sleepy, withdraw the breast to avoid blocking the nose and mouth and to monitor hunger.

Infants with congenital cold experience abdominal pain. They cry while lying on their backs, vomit frequently, or have hard masses in the abdomen resembling egg yolks that move like water when pressed and return. This is harmless. Administer Danggui Wan (Angelica Pill) and Huangqi San (Astragalus Powder) early for cure. (See Qianjin Fang for formulas).

Do not overfeed infants; overfeeding causes vomiting. Vomiting indicates overfeeding; switch to emptying the breast to resolve it. In summer, failing to remove hot milk causes vomiting and reflux; in winter, failing to remove cold milk causes coughing and dysentery. Nursing immediately after intercourse causes emaciation and inability to walk due to crossed legs. Nursing during maternal fever causes jaundice and anorexia. Nursing during maternal anger causes fright, Qi hernia, upward Qi rebellion, and mania. Nursing after maternal vomiting or purging causes deficiency and emaciation. Nursing after maternal drunkenness causes body heat and abdominal fullness.

Infants unable to nurse should be given Ziwann (Purple Pill) to purge.

Bath water for infants must be perfectly temperature-balanced. Improper temperature causes fright and five-Zang diseases.
In winter, do not bathe infants for long periods to avoid cold injury; in summer, avoid long baths to avoid heat injury.
Do not bathe infants too frequently; a cold back can induce epilepsy. However, lack of bathing can cause hair loss.

For infants dying at birth: Inspect the anterior upper part of the uvula in the mouth. If red vesicles are present, puncture them with a fingernail to drain, wipe clean with small cotton, ensuring blood does not enter the throat, as blood in the throat is fatal. Be extremely cautious.

Infants undergo changes every thirty-two days: the second change at sixty-four days (with steaming/fever), third at ninety-six days, fourth at one hundred and twenty-eight days (with steaming), fifth at one hundred and sixty days, sixth at one hundred and ninety-two days (with steaming), seventh at two hundred and twenty-four days, eighth at two hundred and fifty-six days (with steaming), ninth at two hundred and eighty-eight days, tenth at three hundred and twenty days (with steaming). After three hundred and twenty days, the minor steaming cycle ends. Sixty-four days later, major steaming occurs. Another major steaming occurs sixty-four days after that, and another one hundred and twenty-eight days after that. The entire cycle of major and minor steaming completes at five hundred and seventy-six days.

"Change" manifests as upward Qi disturbance; "Steaming" manifests as body heat. Mild steaming subsides in five days; distant ones in ten days. The fever resolves after five days of change and five days of steaming (ten days total).

The first change occurs at thirty-two days. Fever may start on the twenty-ninth day; treat accordingly. Steaming completes around thirty-six to thirty-seven days. To clarify: During the calculated days of change and steaming, if there is slight fever or fright, do not use moxibustion or acupuncture. During medication or active steaming, avoid disturbance. Keep bystanders away. If timing is off, infants may have high fever, anorexia, and vomiting. If cold invades, cold and heat struggle, causing severe abdominal and lumbar pain and incessant crying; moxibustion/compresses will heal this.

Body heat, chaotic pulse, and sweating are signs of steaming.
During steaming, cloudy whites of the eyes indicate severity; slight redness/blackness indicates mildness. After steaming ends, vision clarifies.
Small white bumps on the upper lip tip, resembling dead fish eyes, are signs of steaming. If fever occurs during initial steaming, administer Heifa (Black Powder) to sweat; if fever persists, use Ziwann. Stop Ziwann once fever subsides; residual heat will clear naturally after steaming ends.
High body heat with cold ears and hips indicates steaming; do not treat. High body heat with hot ears and hips indicates disease; treatment is required.