夫小儿初生。血气未定。阴阳未和。脏腑未足。骨格未生。有变蒸之候。变者异常也。
蒸者
发热也。所以变生五脏。蒸养六腑。须要变蒸多遍。则骨节脏腑。由是而全。胎毒亦因变而
散。气血方荣。性情有异。后来出痘亦轻可也。自生之日始。每三十二日一变。凡人有三
百
六十五骨。除手足四十五碎骨外。止有三百二十骨。自生下骨而上。一日十骨。三十二HT 为一
变。骨气始全。一变生一脏。或一腑。十变则脏腑始足。每变轻则发热微汗其状似惊。重则
壮热。脉乱而数。或吐或汗。或烦啼燥渴。轻则五日解。重则八日解。凡小儿之病。无有不
由变蒸而得也。而不热不惊。无他病候。是暗变者多矣。此受胎气壮故也。凡变蒸。须看儿
唇口。如上唇微肿。有如卧蚕。或有珠泡子者。是真变蒸之候也。此则决不可妄投针灸药饵
若误之。则为药引入各经。症遂难识。而且缠绵不脱。反为药之所害也。如或因伤食。因
伤风。因惊吓等项。夹杂相值而发。令人疑惑。亦须守候两三日。俟其病势真的。是食则
消食。是风则行痰。是惊则安神。随症调治。或非变蒸。时而得伤寒时行瘟病。则口上无白
泡。其诊皆相似。惟耳及尻通热。此为他病。可作余治。业幼科者。奚不详究耶。
When infants are first born, their Qi and Blood are not yet stable, Yin and Yang are not yet harmonized, the Zang-Fu organs are not yet fully developed, and the skeletal structure is not yet formed. At this stage, there is a phenomenon known as Bianzheng (Variation and Steaming). "Bian" refers to abnormal changes in the body, while "Zheng" refers to fever. Through the process of Bianzheng, the Five Zang Organs (Heart, Liver, Spleen, Lung, Kidney) are generated, and the Six Fu Organs (Gallbladder, Stomach, Small Intestine, Large Intestine, Bladder, Sanjiao) are nourished. It is necessary to undergo multiple cycles of Bianzheng so that the bones, joints, and Zang-Fu organs can develop completely. The fetal toxins will also dissipate due to these variations, allowing Qi and Blood to flourish and temperament to change, which may result in milder symptoms when smallpox or chickenpox erupts later. Starting from the day of birth, a variation occurs every thirty-two days. Humans have three hundred and sixty-five bones in total; excluding the forty-five fragmented bones in the hands and feet, there remain three hundred and twenty bones. From the perspective of bone growth after birth, ten bones grow per day. Thirty-two days constitute one variation, at which point the Qi of the bones is initially complete. Each variation generates one Zang organ or one Fu organ. After ten variations, the Zang-Fu system becomes fully equipped. If a variation is mild, it presents with slight fever and micro-sweating, resembling signs of fright. If severe, it presents with high fever, chaotic and rapid pulse, vomiting, sweating, irritability, crying, dryness, and thirst. Mild cases resolve within five days, while severe cases resolve within eight days. All illnesses in infants originate from Bianzheng. However, if there is no fever or fright, and no other pathological signs, it is considered "hidden variation," which is common due to strong prenatal Qi. When observing for Bianzheng, one must examine the infant's lips and mouth. If the upper lip is slightly swollen, resembling a silkworm, or has pearl-like blisters, these are true signs of Bianzheng. In such cases, acupuncture or herbal medication must absolutely not be administered indiscriminately. Misapplication may guide pathogens into the meridians, making the condition difficult to diagnose and leading to lingering illness, thereby harming the child with medicine. If symptoms arise from mixed causes such as food stagnation, wind-cold invasion, or fright, confusion may ensue. One should wait two to three days until the pathology is clear: treat food stagnation by promoting digestion, wind by resolving phlegm, and fright by calming the spirit, adjusting treatment according to symptoms. If it is not Bianzheng but rather an attack of Cold Damage (Shanghan) or epidemic pestilence, there will be no white blisters on the lips. Although the diagnosis may seem similar, heat throughout the ears and the sacrum indicates a different disease, which should be treated accordingly. How can practitioners of pediatrics fail to investigate this in detail?