Library

(There are five categories in total)

(Three treatises, two formulas, and a method for selecting wet nurses)

The treatise states: The way of nurturing the people is such that no one fails to regard raising children as the great foundation; without attending to the young, one cannot ultimately become an adult. Thus, the *I Ching* (Book of Changes) says, "Accumulate the small to achieve the great." The *Shi Jing* (Classic of Poetry) contains the verse "At the beginning of the birth of the people," and the *Zuo Zhuan* records that Shengzi gave birth to Duke Yin. This meaning—that which is minute becomes prominent, and that which is young grows long—is evident to all human nature, not requiring verification through classics or histories. Therefore, this medical text discusses women and children first, and then adult men and the elderly, which embodies the principle of honoring the root. However, infants have weak qi and vital energy. If physicians wish to pay attention to their treatment and achieve cures, it is difficult. Many contemporary learners do not pay heed, largely because infants are within swaddling clothes, carrying the fishy and pungent odor of breast milk, and physicians of noble conduct are unwilling to gaze upon them. Reflecting quietly on this matter, one can only sigh deeply. The *Duanju Fang* states: Anyone aged six years and above is considered "small" (child); sixteen years and above is considered "young" (adolescent). (*Chao Yuanfang's Zhubing Yuanhou Lun* and *Waitai Miyao* state eighteen years and above is "young"); thirty years and above is considered "strong" (prime adult) (*Chao Yuanfang* and *Waitai Miyao* state twenty years and above is "strong"); fifty years and above is considered "old." Those under six years old are not recorded in medical classics; therefore, illnesses in nursing infants are difficult to treat due to lack of authoritative basis. In the middle ancient period, a person named Wu Fang (*Zhubing Yuanhou Lun* writes Wu Fang) established the *Luxin Jing* (Classic of the Cranial Fontanelle) for children, used to divinate premature death or longevity, and judge life and death from diseases. It was passed down through generations, marking the beginning of pediatric formulas. During the Jin and Song dynasties, the Jiangzuo region promoted the Su family lineage; their transmission and practice proved effective and spread among the populace. In Qi, Prince Xu also authored three volumes of *Xiao'er Fang* (Pediatric Formulas), so contemporary learners could obtain some transmission. However, given Prince Xu's high status and prestige, he had little leisure to focus on the young. Examining his formulas closely, they were not particularly profound or detailed, with little to recommend them, and were not considered highly secret. Now, having extensively collected various schools' methods and those effective through personal experience, I compile this chapter. Every household should understand these principles.

It is also said: Children's diseases are not different from adults', differing only in the dosage of medication. Chapters on jingxian (startled epilepsy), kewu (alien fright), jielu (splitting fontanelle), and buxing (inability to walk)—totaling nine chapters—are combined into this volume. Other formulas, such as those for xili (dysentery), are scattered across other chapters and can be found by browsing.

Sixty days after birth, the pupils form, and the infant can cough, laugh, and respond to others. At one hundred days, the Ren Mai (Conception Vessel) forms, and the infant can roll over independently (another version says one hundred and fifty days). At one hundred and eighty days, the sacral bone forms, and the infant can sit alone. At two hundred and ten days, the carpal bones form, and the infant can crawl. At three hundred days, the patella forms, and the infant can stand independently. At three hundred and sixty days, the knee bones form, and the infant can walk. These are fixed rules; if milestones are not met according to schedule, there must be imbalance.

An infant undergoes a change every thirty-two days. At sixty-four days, the second change occurs, accompanied by zheng (steaming heat). At ninety-six days, the third change. At one hundred and twenty-eight days, the fourth change, accompanied by steaming heat. At one hundred and sixty days, the fifth change. At one hundred and ninety-two days, the sixth change, accompanied by steaming heat. At two hundred and twenty-four days, the seventh change. At two hundred and fifty-six days, the eighth change, accompanied by steaming heat. At two hundred and eighty-eight days, the ninth change. At three hundred and twenty days, the tenth change, accompanied by steaming heat. After accumulating three hundred and twenty days, the minor zheng concludes. Sixty-four days later, major zheng begins. Sixty-four days after that, another major zheng occurs. One hundred and twenty-eight days after that, yet another major zheng. Generally, from birth, an infant changes every thirty-two days; two changes constitute one zheng. There are ten changes and five minor zheng, plus three major zheng. Accumulating five hundred and seventy-six days, both minor and major zheng are completed, and the child becomes an adult. The reason for bianzheng (changes and steaming) in children is to nourish their blood vessels and transform their five zang organs. Thus, after each change, one notices alterations in temperament. Signs of bianzheng: "Bian" manifests as upper qi symptoms (such as head heat or respiratory changes), while "Zheng" manifests as body heat. Bianzheng varies in severity. Mild cases present with slight body heat and mild startle, cold ears and sacrum, white blisters appearing on the upper lip like fish eyes, and slight sweating. Severe cases present with high fever, chaotic pulse, either sweating or not, anorexia, vomiting after eating, slightly red whites of the eyes, and slightly white irises. Another source says: Red eyes indicate severity; clear distinction between black and white indicates mildness. Upon completion of bianzheng, the eyes become bright. These are the signs. Single bian is mild; combined zheng is severe. For stable zheng, heat subsides in five days; for distant/longer courses, in ten days. Specifically, counting five days prior to the expected date and five days after constitutes a ten-day window during which the heat resolves. An infant changes at thirty-two days post-birth; if heat appears early on day twenty-nine, treat according to method, and the zheng completes by day thirty-six or thirty-seven. To avoid misunderstanding, I reiterate: During bianzheng, avoid disturbance; do not allow many people nearby. Many infants exhibit bianzheng earlier or later than prescribed. If initial heat is severe and persists beyond the scheduled days, carefully calculate the bianzheng dates. If mild heat and startle occur at the appropriate time, absolutely avoid treatment, moxibustion, or acupuncture; simply observe harmoniously. If heat persists for a long time, administer Zi Wan (Purple Pill) mildly to induce purgation; stop once heat subsides. If, during bianzheng, the infant contracts shixing wenbing (seasonal warm disease), or contracts seasonal illness outside of bianzheng, the diagnosis resembles bianzheng, except the ears and sacrum are uniformly hot, and there are no white blisters on the mouth. Administer Hei San (Black Powder) first to induce sweating; after sweating, apply Wen Fen (Warm Powder) to the body; the heat should subside, and recovery follows. If symptoms persist, administer Zi Wan to purge. If cold pathogen combines with bianzheng, cold and heat struggle, causing abdominal twisting and incessant crying; moxibustion/warming therapy will cure it. (Warming methods are described in the lower section using heated cotton wool.) Bianzheng resembles Wenzhuang Shanghan (warm-fever typhoid); however, if it is not bianzheng, but the body, ears, and sacrum are all hot, it is another disease, and other treatments apply. If confirmed as bianzheng, do not use other treatments.

Another method: Infants begin changing at thirty-two days post-birth; "bian" refers to body heat. At sixty-four days, the second change occurs, accompanied by steaming heat, characterized by lying straight and upright. At ninety-six days, the third change, marked by the emergence and discharge of Dan Kong (red pores/spots). At one hundred and twenty-eight days, the fourth change, accompanied by steaming heat, evidenced by the ability to cough and laugh. At one hundred and sixty days, the fifth change, marking the formation of joints/mechanisms. At one hundred and ninety-two days, the sixth change, accompanied by steaming heat, with five mechanisms formed. At two hundred and twenty-four days, the seventh change, evidenced by crawling. At two hundred and fifty-six days, the eighth change, accompanied by steaming heat, evidenced by the desire to learn speech. At two hundred and eighty-eight days, the ninth change, evidenced by standing upright ("Tingting"). By two hundred and eighty-eight days, an infant has undergone nine changes and four zheng. On the days of change, absolutely avoid arbitrary treatment, or it will exacerbate illness. "Bian qie zheng" refers to the infant's monthly transitions; zheng involves intense heat, chaotic pulse, and sweating. Heat subsides in five days for early courses, or eight to nine days for late ones. Do not perform moxibustion or acupuncture or treat arbitrarily during zheng.