（蒸忤 啼哭） 凡九门
《圣济经》慈幼篇·形气变成章曰∶天有精，地有形，形精相感而化生万物。故曰∶天地者，万物之父母也。
天为阳，地为阴；水为阴，火为阳。阴阳者，血气之男女。水火者，阴阳之证兆。惟水火既济，血气变革，然
后刚柔有体而形质立焉。造化炉锤间，不能外，是以成物。兹婴孺始生，有变蒸之理也。原受气之初，由胚胎
而有血脉，由血脉而成形体，由形体而能动，由动而筋骨立，以至毛发生而脏腑具，谷气入胃而百神备，是乃
具体未形，有常不变之时也。若夫萌区有状，留动而生，血脉未荣，五脏未固，尚资阴阳之气，水火之齐甄
陶以成，非道之自然，以变为常者哉。儿生三十二日一变，六十四日再变。变且蒸，变者上气，蒸者体热。上
气则以五脏改易，气皆上朝，脏莫高于肺，而肺主气故尔。体热则以血脉敷荣，阳方外固。阳在外，为阴之
使，故尔积二百八十八日九变，三百二十日十变且蒸，是之谓小蒸。毕后六十四日一大蒸，积二百五十六日大
蒸毕。凡五百七十六日变蒸数足，形气成就。每经一变，则情态异常。盖天有五行，御五位，以生寒、暑、燥、
湿、风；人有五脏，化五气，以生喜、怒、悲、忧、恐。七情之生得非成于变蒸之候耶。其候有轻重，其时
有远近。轻者体热微汗，似有惊候，耳与后阴所会皆冷。重者壮热而脉乱，或汗或否，此其候也。平者五日而
衰。远者十日而衰。先期五日，后之五日，为十日之中热乃除，此其时也。当是时务致和平，不欲惊扰，灸刺、
汤剂皆非所宜。或先变而热作，或后蒸而未解，则治之当如成法。或变蒸之中加以时行温病，与夫非变而得天
行者，其诊大率相类，惟耳及后阴所会皆热为异尔。学人可不审焉！
《巢氏病源》∶变蒸者，以长血气也。变者上气，蒸者体热。变蒸有轻有重，其轻者体热而微惊，耳冷，髋
亦冷，上唇头白疣起如死鱼目珠子，微汗出，而近者五日而歇，远者八、九日乃歇。其重者体壮热而脉乱，或
汗或不汗，不欲食，食辄吐 ，无所苦也。变蒸之时，目白睛微赤，黑睛微白，（《千金》又曰∶目白者重，
赤黑者微。）亦无
所苦，蒸毕自明了矣。先变五日，后蒸五日，为十日之中热乃除。变蒸之时，不欲惊动，勿令旁边多人，变蒸
或早或晚，根据时如法者少也。初变之时，或热甚者，违日数不歇。审计日数，必是变蒸，服黑散发汗；热不止
者，服紫双丸。如小瘥便止，勿复服。（《千金翼》云∶自当有余热，变蒸尽，乃除耳。）其变蒸之时，遇寒加之，
则寒热交争，
腹痛夭矫，啼不止者熨之则愈。变蒸与温壮伤寒相似，若非变蒸，身热、耳热、髋亦热，此乃为他病，可为
余治；审是变蒸，不得为余治。其变日数，从初生至三十二日一变。六十四日再变，变且蒸。九十六日三变，
变者丹孔出而泄也。至一百二十八日四变，变且蒸。一百六十日五变，一百九十二日六变，变且蒸。二百二十
四日七变，二百五十六日八变，变且蒸。二百八十八日九变。三百二十日十变，变且蒸。积三百二十日小蒸毕，
后六十四日大蒸，蒸后六十四日复大蒸，蒸后一百二十八日复大蒸，积五百七十六日，大小蒸毕也。
《颅囟经》∶凡孩子自生，但任阴阳推移，即每六十日一度变蒸，此骨节长来，四肢发热，或不下食乳，遇
如此之时，上唇有珠子，如粟粒大，此呼为变蒸珠子，以后方退热饮子疗之，不宜别与方药。（《颅囟经》
以六十日为一变，《巢氏病源》以三十二日为一变，以有不同，故兼存之。）
《葛氏肘后》云∶凡小儿自生三十二日一变，再变为一蒸，凡十变五小蒸，又有三大蒸。凡五百七十六日
变蒸毕，乃成人。其变蒸之候，身热、脉乱、汗出，（崔氏云∶脉乱、汗出、目睛不明，微似欲惊及不乳哺。）
数惊不乳哺，上唇头
小白泡起如珠子，耳冷，尻冷，此其证也。单变小微，兼蒸小剧，平蒸五日，或七日、九日，慎不可疗。若或
大热不已，则与少紫丸微下。
《葛氏肘后》又云∶若于变蒸中，加以时行温病，其证相似，惟耳及尻通热，口上无白泡耳，当先服黑散发
汗，汗出以粉敷之瘥，若不尽除，即以紫丸下之。
《千金》论凡小儿自生三十二日一变，再变为一蒸，凡十变而五小蒸，又三大蒸。积五百七十六日大小蒸都
毕，乃成人。小儿所以变蒸者，是荣其血脉，改其五脏，故一变竟，辄觉情态有异。单变小微，兼蒸小剧。凡
蒸平者五日而衰，远者十日而衰。先期五日，后之五日，为十日之中热乃除耳。儿生三十二日一变，二十九日
先期而热，便治之如法，至三十六、七日蒸乃毕耳。恐不解了，故重说之。（变蒸之日，《千金要》、《翼》皆与
《葛氏肘后》诸家并并
同，此其中语有小异者，故又载之。）且儿变蒸或早或晚，不如法者多。又初变之时，或热甚者，违日数不歇，
审计变蒸之
日。当其时有热微惊，慎不可治及灸刺，但和解之。若良久热不可已，少与紫丸微下，热歇便止。若于变蒸之
中，加以时行温病，或非变蒸时而得时行者，其诊皆相似。惟耳及尻通热，口上无白泡耳，当先服黑散以发其
汗。汗出，温粉粉之，热当歇，便就瘥。若犹不都除，乃与紫丸下之。
《千金》又法∶凡儿生三十二日始变，变者身热也。至六十四日再变，变且蒸，其状卧端正也。至九十六日
三变，定者候丹孔出而泄。至一百二十八日四变，变且蒸，以能咳笑也。至一百六十日五变，以成机关也。至
一百九十二日六变，变且蒸，五机成也。至二百二十四日七变，以能匍匐语也。至二百五十六日八变，变且蒸，
以知欲学语也。至二百八十八日九变，已亭亭然也。凡小儿生至二百八十八日九变、四蒸也。当其变之日，慎
不可妄治之，则加其疾。变且蒸者，是儿送迎月也。蒸者，甚热而脉乱，汗出是也。近者五日歇，远者八九日
歇。当是蒸上不可灸刺妄治之也。
《千金翼》∶儿身壮热而耳冷、髋亦冷者，即是蒸候，慎勿治之。儿身热，髋、耳亦热者病也，乃须治之。
（《千余》叙变蒸议论皆同，独用紫丸、黑散，叙得甚明。又云∶变蒸中病乃须治。）
《圣惠》∶小儿变蒸都毕，凡五百七十六日乃成人，血脉骨木皆坚牢也。
《茅先生方》小儿有变蒸伤寒候∶身壮热，唇尖上起白珠，或热泻，或呻吟，或虚惊，此候小儿生下便有变
蒸而长意志，乃四十九日一变而长骨肉。此候有之，所治者只用镇心丸（方见一切惊门中）夹匀气散（方见
胃气不和门中）与服，自平和也，不服药也安乐。（此又云∶四十九日一变，与前亦异。）
汉东王先生《家宝》变蒸候∶宜用神仙黑散子三二服，并调胃气，观音散三二服。（方见胃气不和门中。）
钱乙论变蒸云∶小儿在母腹中乃生骨气，五脏六腑成而未全。自生之后，即长骨脉、五脏六腑之神智也。
变者，易也。（《巢源》云∶上多变气。）又生变蒸者，自内而长，自下而上，又身热，故以生之日后三十二
日一变。变每
毕，即情性有异于前。何者长生腑脏、智意故也？何谓三十二日长骨添精神？人有三百六十五骨，除手足中
四十五碎骨外，有三百二十数。自生下，骨一日十段而上之，十日百段，而三十二日计三百二十段，为一变，
亦曰一蒸。骨之余气，自脑分入龈中，作三十二齿，而齿牙有不及三十二数者，由变不足，其常也。或二十八
日即至长二十八齿，以下仿此，但不过三十二之数也。凡一周遍乃发虚热诸病，如是十周则小蒸毕也。计三百
二十日生骨气，乃全而未壮也。故初三十二日一变，生肾志，六十四日再变，生膀胱。其发耳与 冷，肾与膀
胱俱主于水，水数一，故先变生之。九十六日三变，生心喜；一百二十八日四变，生小肠，其发汗出而微惊。
心为火，数二。一百六十日五变，生肝及哭。一百九十二日六变，生胆，其发目不开而赤。肝主木，木数三。
二百二十四日七变，生肺声。二百五十六日八变，生大肠，其发肤热而汗，或不汗。肺属金，数四。二百八十
八日九变，生脾智。三百二十日十变，生胃，其发不食，肠痛而吐乳。此后乃齿生能言，知喜怒，故云始全也。
《太仓》云∶气入四肢，长碎骨于十变，后六十四日长其经脉。手足受血，故能持物，足立能行也。经云∶变且
蒸，谓蒸毕而足一岁之日也。师曰∶不汗而热者发其汗，大吐者微泻，不可余治，是以小儿须变蒸脱齿者如花
之易苗。所谓不及三十二齿，由变之不及，齿当与变日相合也，年壮而视齿方明。
《秘要指迷》论凡小儿才生变蒸后，多有身热、微泻青黄者，不可用药止住，须温暖药匀气。如药力重，
即变成慢脾风也。
《五关贯真珠囊》小儿生下八蒸之候∶夫八蒸者，每四十五日一蒸变，变各有所属，重者五日而息也。（变蒸日
数稍异，故并载之。）
一蒸，肝生魂，肝为尚书。未蒸时魂未定，故儿目瞳子昏。蒸后肝生魂定，令目童子光明。二蒸，肺生魄、
肺为丞相。未蒸时魄未定，故儿未能嚏嗽。肺上通于鼻，蒸后能令嚏嗽。三蒸，心生神，心为帝王。未蒸前神
未定，故儿未言语。心通于舌，蒸后令儿能语笑也。四蒸，脾生智，脾为大夫，藏智，故未蒸前儿未能举
动，蒸后令儿举动任意也。五蒸，肾生精志，肾为列女。外应于耳，故蒸后能令儿骨髓气通流也。六蒸，筋
脉伸，故蒸后筋脉通行，九窍津液转流，令儿能立也。七蒸者，骨神定，气力渐加，故蒸后能令儿举脚行也。
八蒸者，呼吸无有停息，以正一万三千五百息也。凡呼出心与肺，吸入肾与肝，故令儿呼吸有数，血脉通流五
十周也。
汉东王先生《家宝》小儿变蒸候歌∶
变蒸之候若为程，（为程者，是有数也。三十二日为一度变矣。）一一从头别有名。第一看儿发毛立，口唇
尖上白珠生。（头发
立而不伏，又唇上有白泡子起也。）三两日间起寒热，（忽然发，却自住是也。）忽然睡里足虚惊。（睡中哭而不
觉也。）或则遍身流盗汗，（此是气
血长不逮，流于毛孔中出。）或然微痢腹中鸣。（腹中似泻水之声，此是变实，其肠胃而作声。）或则因闷皮肤
急，（忽闷，皮肤急及气急，少时却醒。）
（忽然吐逆气交横。忽然要吐 气急，盖因长其气血，不觉被气节之，即吐 ，不久自住也。）七日之中惊梦里，
（生不七日，忽睡中惊叫，人多疑床，
非也。此是长其神气，故童子能喜笑矣。）但看蒸变辨其名。（变蒸者，则是长其血气。长不逮后相滞，故发热
也，或者生筋骨，或者正其五脏也。）智者将心
信医药，下愚不晓逐邪行。虽然变蒸得其候，还须用药保长生。（亦须服和气丸散及不可当风洗浴也。）
长沙医者毛彬传疗小儿初生变蒸候歌∶
变蒸方长是婴儿，一出胎来数可推。未到期年蒸八变，四十九日一回期。第一肝蒸生于魂，双眼虽开瞳子
昏。三两日间微壮热，定目看人似欲言。第二变蒸生于魄，喷嚏咳嗽开胸膈。见人共语笑喃喃，暗里时时长筋
脉。第三变蒸生于神，渐能识母畏傍人。血脉初生学及覆，肌肉皮肤渐渐匀。第四脾蒸生于智，尻骨初成独坐
戏。三焦胃管渐开张，乳哺甘甜不肯离。第五肾蒸生精志，气候相通转流利。掌骨初成学匍匐，反复捉搦能随
意。第六筋骨蒸初成，九窍津液皆相应。时时放手亭亭立，气力加添日渐胜。第七膝踝骨初成，颜色红光遍体
荣。举脚抬肩便移步，嘻嘻学语百般声。第八呼吸定精神，风血气脉自回轮。八蒸之候细分别，一一从头为列
名。七日之中有乖治，但看外证辩其名。第一看儿毛发立，口唇尖起白珠生。三两日中寒热起，忽然睡里作虚
惊。或即遍身流盗汗，或乃微利腹中鸣。或即脊膂皮肤急，忽乃呕逆气交横，或则困闷通身
软，忽然啼哭没心情。重者不过一七日，轻者三朝便得平。上古圣贤制方论，还须服药觅延生。
《葛氏肘后》黑散方
麻黄（二两） 大黄（一两） 杏仁（二分）
上件并捣为散，将杏仁熬，别研如脂，乃内散同捣令调和，（《圣惠》并炒令黑，都研细。汉东
王先生并烧灰存性。）密盛器中，
勿令见风。一月儿服如小豆一枚，乳汁和咽之。拘令得汗，勿使见风。百日儿服如枣核，量大小与之佳。《千
金要》、《翼》分两同。《元和纪用经》大黄只半两。《千金要》三味先捣，麻黄、大黄为散，别研杏仁如
脂，乃细细内散。又捣令调和，内密器中。又《千金要》、《翼》黑散治小儿蒸变挟时行温病，或非变蒸时而
得时行。《元和纪用经》自四味饮以下，黑散、紫丸、至圣散、五加皮治不能行。蜀脂饮、麝香丸七分，谓
之育婴七宝。紫阳道士一名《保子七圣至宝方》，专为一书者，此方是也。
《葛氏肘后》紫丸方
代赭 赤石脂（各一两） 巴豆（四十枚） 杏仁（五十枚）
(Steam Disturbance and Crying) There are nine categories in total.
The *Shengji Jing* (Classic of Holy Relief), in the "Caring for Children" chapter, section on "Transformation of Form and Qi," states: Heaven has essence, Earth has form; form and essence interact to transform into all things. Therefore it is said: Heaven and Earth are the parents of all things.
Heaven belongs to Yang, Earth belongs to Yin; Water belongs to Yin, Fire belongs to Yang. Yin and Yang are like the male and female aspects of Blood and Qi. Water and Fire are the manifestations of Yin and Yang. Only when Water and Fire achieve mutual interaction (Xin-Shen intersection, harmony of Yin and Yang), and Blood and Qi undergo transformation, can rigidity and softness take physical form, and material structure be established. Within the furnace and hammer of creation, nothing can escape this law, thus all things are accomplished. This applies to infants at birth, who possess the principle of Bian Zheng (developmental fever). Tracing back to the initial reception of Qi, from the embryo comes Blood vessels, from Blood vessels comes the body form, from body form comes movement, from movement come tendons and bones, until hair grows and Zang-Fu organs are complete, grain Qi enters the Stomach and hundred spirits are prepared. This is a time when the form is specific but not fully shaped, maintaining a constant state without change. However, in the sprouting stage where there is already shape, remaining in motion to generate life, Blood vessels are not yet flourishing, and Zang organs are not yet solid, they still rely on the Qi of Yin and Yang, using agents of Water and Fire to temper and refine to form the body. This is not the natural way of the Dao, but rather taking change as the norm. An infant experiences one "Bian" (transformation) at thirty-two days after birth, and a second "Bian" at sixty-four days. Bian and Zheng occur together; "Bian" refers to the transformation of Upper Jiao Qi, and "Zheng" refers to body heat. The transformation of Upper Qi causes changes in the five Zang organs, with Qi ascending and gathering; among the Zang organs, none is higher than the Lung, which governs Qi, hence this occurs. Body heat causes Blood vessels to distribute nourishment, with Yang energy securing the exterior. Yang outside acts as the servant of Yin, hence after accumulating two hundred and eighty-eight days of nine transformations, and three hundred and twenty days of the tenth transformation accompanied by Zheng, this is called Xiao Zheng (Minor Steam). After completing Xiao Zheng, sixty-four days later occurs one Da Zheng (Major Steam), accumulating two hundred and fifty-six days for Da Zheng to finish. In total, five hundred and seventy-six days constitute sufficient Bian Zheng cycles, achieving physical form and Qi maturity. Each time a Bian cycle passes, the child's temperament and behavior become abnormal. This is because Heaven has Five Elements controlling five positions, generating Cold, Heat, Dryness, Dampness, and Wind; Humans have five Zang organs transforming five Qi, generating Joy, Anger, Sorrow, Worry, and Fear. Did the generation of Seven Emotions not occur during the Bian Zheng period? The symptoms vary in severity, and the duration varies in length. Mild cases present with slight body heat and sweating, appearing somewhat startled, with cold ears and the junction of the posterior yin. Severe cases present with high fever and chaotic pulse, with or without sweating; these are the symptomatic presentations. In balanced cases, the heat subsides in five days. In prolonged cases, it takes ten days for the heat to subside. Starting five days early and ending five days late, within ten days the heat is cleared; this is the timeline. During this time, one must strive for peace and avoid startling or disturbing; moxibustion, acupuncture, and decoctions are all inappropriate. If heat arises before the expected Bian or persists after Zheng, treatment should follow established methods. If seasonal warm diseases (epidemic febrile diseases) are added during Bian Zheng, or if epidemic pathogens are contracted outside of Bian Zheng times, the diagnosis is generally similar, except that the ears and the junction of the posterior yin are hot, which is the difference. Scholars must examine this carefully!
The *Zhu Bing Yuan Hou Lun* (Source Book of All Causes of Diseases) states: Bian Zheng serves to increase Blood and Qi. "Bian" is upper Qi transformation, "Zheng" is body heat. Bian Zheng has mild and severe forms. Mild cases present with slight body heat and minor fright, cold ears, and cold hips; white wart-like protrusions appear on the tip of the upper lip resembling dead fish eyes; slight sweating occurs, subsiding in five days for mild cases, or eight to nine days for severe ones. Severe cases present with high fever and chaotic pulse, with or without sweating, loss of appetite, vomiting upon eating, but no other distress. During Bian Zheng, the whites of the eyes may be slightly red, and the pupils slightly white; the *Qianjin Fang* adds that white eyes indicate severe cases, while red/black indicates mild ones. There is no other distress, and clarity returns naturally after Zheng completes. Five days before Bian and five days after Zheng, within ten days the heat clears. During Bian Zheng, do not startle or disturb; keep few people nearby. Bian Zheng occurring earlier or later rarely follows the standard timing. At the initial Bian, if heat is severe and does not subside according to the day count, carefully calculate the days; if it is definitely Bian Zheng, administer Hei San (Black Powder) to induce sweating; if heat persists, administer Zi Shuang Wan (Purple Double Pill). Stop medication if there is slight improvement; do not continue. (*Qianjin Yi Fang* states: residual heat will naturally remain; only after Bian Zheng completes will it clear.) If cold pathogen invades during Bian Zheng, cold and heat struggle, causing severe abdominal pain and incessant crying; applying heat compresses (moxibustion/ironing therapy) cures it. Bian Zheng resembles Wen Zhuang Shang Han (warm-fever typhoid); if not Bian Zheng, body heat, ear heat, and hip heat indicate another disease, treatable by other methods; if confirmed as Bian Zheng, do not treat as other diseases. The days of Bian start from birth: thirty-two days for the first Bian, sixty-four days for the second, ninety-six days for the third (where Dan Kong appears and excretion occurs), one hundred and twenty-eight days for the fourth, one hundred and sixty days for the fifth, one hundred and ninety-two days for the sixth, two hundred and twenty-four days for the seventh, two hundred and fifty-six days for the eighth, two hundred and eighty-eight days for the ninth, and three hundred and twenty days for the tenth. Accumulating three hundred and twenty days completes Xiao Zheng; then sixty-four days later is Da Zheng, followed by another sixty-four days for the second Da Zheng, and one hundred and twenty-eight days later for the third Da Zheng, totaling five hundred and seventy-six days for all major and minor steams to complete.
The *Lun Xin Jing* (Classic of Cranium and Fontanelle) states: For children from birth, following the推移 (movement) of Yin and Yang, there is one Bian Zheng every sixty days. This is bone joint growth, limb heating, or refusal to nurse. At such times, beads appear on the upper lip, sized like millet grains, called Bian Zheng Beads. Treat with the subsequent Fang Tui Re Yin Zi (Decoction to Clear Heat); do not use other formulas. (*Lun Xin Jing* uses sixty days per Bian, whereas *Zhu Bing Yuan Hou Lun* uses thirty-two days; due to differences, both are preserved.)
The *Ge Shi Zhou Hou Hou* (Emergency Prescriptions Kept in the Sleeve of Ge Hong) states: Infants experience one Bian every thirty-two days, with repeated Bian forming Zheng. Ten Bians make five Xiao Zhengs, plus three Da Zhengs. Total five hundred and seventy-six days for completion, then adulthood. Symptoms include body heat, chaotic pulse, sweating (Cui Shi adds: chaotic pulse, sweating, unclear vision, slight fright, refusal to nurse), frequent fright, refusal to nurse, white blisters on the upper lip like beads, cold ears, and cold coccyx. Single Bian is mild; combined Zheng is slightly more intense. Normal Zheng subsides in five, seven, or nine days; strictly avoid treatment. If high fever persists, give a small amount of Zi Wan (Purple Pill) for mild purgation.
*Ge Shi Zhou Hou Hou* further states: If seasonal warm diseases are added during Bian Zheng, symptoms are similar, except ears and coccyx are hot, and there are no white blisters on the mouth. Administer Hei San first to induce sweating; apply powder after sweating for recovery. If not fully resolved, use Zi Wan for purgation.
*Qianjin Fang* discusses: Infants experience one Bian every thirty-two days, repeated Bian forming Zheng. Ten Bians make five Xiao Zhengs, plus three Da Zhengs. Total five hundred and seventy-six days for completion, then adulthood. Bian Zheng nourishes blood vessels and transforms five Zang organs; thus, after each Bian, temperament changes. Single Bian is mild; combined Zheng is slightly more intense. Balanced Zheng subsides in five days, prolonged in ten. Early by five days, late by five days, heat clears within ten days. Infant has one Bian at thirty-two days; if heat starts on the twenty-ninth day, treat according to method; Zheng completes by thirty-sixth or thirty-seventh day. To avoid confusion, this is repeated. (*Qianjin Yao* and *Yi* agree with *Ge Shi Zhou Hou Hou*; minor textual differences are recorded here.) Many infants' Bian Zheng occur early or late, deviating from standards. At initial Bian, if heat is severe and exceeds day counts, carefully audit the days. When heat and slight fright occur, absolutely avoid treatment, moxibustion, or acupuncture; only harmonize. If heat persists for a long time, give a little Zi Wan for mild purgation; stop when heat subsides. If seasonal warm diseases are added during Bian Zheng, or contracted outside Bian Zheng times, diagnosis is similar. Only ears and coccyx are hot, and no white blisters on the mouth; administer Hei San first to induce sweating. Apply warm powder after sweating; heat subsides, recovery ensues. If not fully resolved, use Zi Wan for purgation.
*Qianjin Fang* additional method: Infants begin Bian at thirty-two days; Bian is body heat. Second Bian at sixty-four days, accompanied by Zheng, lying straight. Third Bian at ninety-six days, stable case shows Dan Kong excretion. Fourth Bian at one hundred and twenty-eight days, accompanied by Zheng, able to cough and laugh. Fifth Bian at one hundred and sixty days, joints formed. Sixth Bian at one hundred and ninety-two days, accompanied by Zheng, five mechanisms complete. Seventh Bian at two hundred and twenty-four days, able to crawl and speak. Eighth Bian at two hundred and fifty-six days, accompanied by Zheng, knowing desire to learn speech. Ninth Bian at two hundred and eighty-eight days, standing upright. Infants reach nine Bians and four Zhengs by two hundred and eighty-eight days. On Bian days, absolutely avoid reckless treatment, which worsens illness. Bian and Zheng represent the months of sending off and welcoming. Zheng is high fever, chaotic pulse, and sweating. Subsides in five days for mild cases, eight or nine for severe. Do not use moxibustion or reckless treatment during Zheng.
*Qianjin Yi Fang*: If infant has high fever with cold ears and hips, it is Zheng symptom; absolutely do not treat. If infant has body heat with hot hips and ears, it is disease; must treat. (*Qianjin* discusses Bian Zheng similarly, uniquely using Zi Wan and Hei San, clearly stated. Also says: illness during Bian Zheng must be treated.)
*Tai Ping Hui Min He Ji Ju Fang*: When infant Bian Zheng completes, five hundred and seventy-six days pass, then adulthood; blood vessels and bones become firm.
*Mao Xiansheng Fang*: Infant Bian Zheng Shang Han syndrome presents with high fever, white beads on lip tip, or heat diarrhea, groaning, or false fright. This syndrome involves Bian Zheng growing willpower from birth, changing every forty-nine days to grow flesh and bone. If this syndrome exists, treat only with Zhen Xin Wan (see All Fright Category) and Yun Qi San (see Stomach Qi Disharmony Category); self-balances, no need for medicine brings peace. (Also says: changes every forty-nine days, differing from previous texts.)
Han Dong Wang Xiansheng *Jia Bao* Bian Zheng syndrome: Suitable to use Shen Xian Hei San Zi two or three doses, regulating Stomach Qi, and Guanyin San two or three doses. (See Stomach Qi Disharmony Category.)
Qian Yi discusses Bian Zheng: Infants develop bone Qi in the womb, Zang-Fu organs form but are incomplete. After birth, bone vessels and Zang-Fu spirit/intellect grow.
"Bian" means change. (*Zhu Bing Yuan Hou Lun* says: Upper Qi changes frequently.) Generating Bian Zheng grows from inside out, bottom up, with body heat, hence one Bian thirty-two days after birth. After each Bian, temperament differs from before. Why? Because Zang-Fu and intellect grow. What does thirty-two days of bone growth adding spirit mean? Humans have three hundred and sixty-five bones; excluding forty-five fragmented bones in hands and feet, there are three hundred and twenty. From birth, bones grow ten segments daily; ten days make one hundred segments; thirty-two days make three hundred and twenty segments, constituting one Bian, also called one Zheng. Residual Qi of bones enters gums from brain, forming thirty-two teeth. Teeth fewer than thirty-two are due to insufficient Bian, which is normal. Twenty-eight days may grow twenty-eight teeth, following this pattern, not exceeding thirty-two. One full cycle develops deficiency heat diseases; ten cycles complete Xiao Zheng. Three hundred and twenty days generate bone Qi, complete but not strong. Thus, first thirty-two days one Bian generates Kidney Will; sixty-four days second Bian generates Bladder. Ears and coccyx cold, Kidney and Bladder govern Water, Water number is one, hence generated first. Ninety-six days third Bian generates Heart Joy; one hundred and twenty-eight days fourth Bian generates Small Intestine, sweating and slight fright. Heart is Fire, number two. One hundred and sixty days fifth Bian generates Liver and Crying. One hundred and ninety-two days sixth Bian generates Gallbladder, eyes closed and red. Liver governs Wood, Wood number three. Two hundred and twenty-four days seventh Bian generates Lung Sound. Two hundred and fifty-six days eighth Bian generates Large Intestine, skin heat and sweating or no sweat. Lung belongs to Metal, number four. Two hundred and eighty-eight days ninth Bian generates Spleen Intellect. Three hundred and twenty days tenth Bian generates Stomach, refusal to eat, intestinal pain, and vomiting milk. After this, teeth grow, speech begins, joy and anger known, hence called "complete."
*Tai Cang* states: Qi enters four limbs, growing fragmented bones in ten Bians, then meridians grow in sixty-four days. Hands and feet receive blood, hence holding objects and walking. Classic says: Bian and Zheng means Zheng completes fulfilling one year of days. Master says: No sweat but heat induces sweating; excessive vomiting requires mild purgation; do not treat otherwise. Hence infants must shed teeth through Bian Zheng like flowers shedding seedlings. Teeth fewer than thirty-two are due to insufficient Bian; teeth should match Bian days; age strengthens, viewing teeth clarifies.
*Mi Yao Zhi Mi* discusses: After infant Bian Zheng, often body heat and slight green-yellow diarrhea; do not use medication to stop; must use warming herbs to harmonize Qi. If herb potency is heavy, it becomes Man Pi Feng (Slow Spleen Wind).
*Wu Guan Guan Zhen Zhu Nang* Eight Zheng syndromes after infant birth: Eight Zhengs, one Zheng every forty-five days, each belonging to specific organs, severe cases rest in five days. (Bian Zheng day counts vary slightly, so recorded together.)
First Zheng: Liver generates Hun (Ethereal Soul), Liver is Minister. Before Zheng, Hun unstable, infant pupils dim. After Zheng, Hun stabilizes, pupils bright.
Second Zheng: Lung generates Po (Corporeal Soul), Lung is Chancellor. Before Zheng, Po unstable, infant cannot sneeze/cough. Lung connects to nose, after Zheng enables sneezing/coughing.
Third Zheng: Heart generates Shen (Spirit), Heart is Emperor. Before Zheng, Shen unstable, infant cannot speak. Heart connects to tongue, after Zheng enables speech/laughter.
Fourth Zheng: Spleen generates Zhi (Intellect), Spleen is Doctor, stores intellect. Before Zheng, infant cannot move voluntarily. After Zheng, movements arbitrary.
Fifth Zheng: Kidney generates Jing-Zhi (Essence-Will), Kidney is Consort. External correspondence to ears, after Zheng marrow Qi flows.
Sixth Zheng: Tendons/Meridians extend, after Zheng meridians conduct, nine orifices fluids circulate, enabling standing.
Seventh Zheng: Bone Spirit stabilizes, strength increases, after Zheng enables walking.
Eighth Zheng: Breathing uninterrupted, correcting thirteen thousand five hundred breaths. Exhalation Heart/Lung, inhalation Kidney/Liver, giving infant rhythmic breathing, blood vessels circulating fifty cycles.
Han Dong Wang Xiansheng *Jia Bao* Song on Infant Bian Zheng Syndrome:
Bian Zheng symptoms have a schedule, (Schedule means fixed numbers. Thirty-two days is one Bian.) each named distinctly from the start. First check infant hair standing, white beads on lip tip. (Hair stands erect, white blisters rise on lips.) Cold and heat arise in three days, (Sudden onset, self-resolving.) sudden false fright in sleep. (Crying in sleep unaware.) Or whole body night sweats, (Qi/Blood growth lagging, flowing out pores.) Or slight diarrhea with abdominal rumbling. (Sound like water in abdomen, Bian solidifying intestines making sound.) Or stifled tight skin, (Sudden stuffiness, tight skin/breath, waking soon.)
(Sudden vomiting/regurgitation with chaotic Qi. Sudden urge to vomit/breath difficulty, due to Qi/Blood growth, Qi constrained, vomiting resolves soon.) Seven days of fright in dreams, (Not seven days old, sudden sleep screaming, people suspect bed, incorrect. Growing Spirit/Qi, pupil smiles.) Just watch Zheng Bian to distinguish names. (Bian Zheng grows Blood/Qi. Lagging growth stagnates, causing fever, or growing bones/tendons, or rectifying five Zang.) Wise trust medicine, fools chase evil. Although knowing Bian Zheng symptoms, must use medicine to preserve life. (Also take He Qi Pills/Powders, avoid wind bathing.)
Changsha Physician Mao Bin's Song on Infant Initial Bian Zheng:
Bian Zheng growing is infant, counting possible from birth. Before one year, eight Zhengs/Bians, forty-nine days per cycle. First Liver Zheng generates Hun, eyes open but pupils dim. Slight high fever in three days, staring at people as if speaking. Second Bian Zheng generates Po, sneezing/coughing opens chest/diaphragm. Seeing people chatting/laughing murmuring, secretly growing tendons/meridians. Third Bian Zheng generates Shen, gradually recognizing mother fearing bystanders. Blood vessels newly born learning turning over, muscles/skin gradually even. Fourth Spleen Zheng generates Zhi, coccyx formed sitting alone playing. San Jiao/Stomach tubes opening, sweet milk refusing to leave. Fifth Kidney Zheng generates Jing-Zhi, climate connecting turning smooth. Palm bones formed learning crawling, grasping freely. Sixth Tendons/Bones Zheng initially formed, nine orifices fluids responding. Letting go standing upright, strength increasing daily. Seventh Knee/Ankle bones formed, red color glowing body. Lifting legs/shoulders moving steps, laughing learning speech various sounds. Eighth Breath stabilizing Spirit, wind/blood/Qi/Meridians cycling. Eight Zheng symptoms carefully distinguished, listed from start. Seven days deviation in treatment, just look at external signs to distinguish name. First check infant hair standing, white beads on lip tip. Cold/heat in three days, sudden false fright in sleep. Or whole body night sweats, or slight diarrhea abdominal rumbling. Or spine/skin tight, suddenly vomiting chaotic Qi, or exhausted body soft, suddenly crying no mood. Severe not exceeding seven days, mild three mornings calm. Ancient sages made formulas/discussions, must take medicine seeking longevity.
*Ge Shi Zhou Hou Hou* Hei San Formula
Mahuang (Cinnamon Twig Decoction source/Ephedrae Herba) (2 liang) Dahuang (Rhubarb Radix et Rhizoma) (1 liang) Xingren (Apricot Seed) (2 fen)
All ingredients pounded into powder. Roast Xingren, grind separately to paste consistency, then mix with powder, pound to blend. (*Tai Ping Hui Min He Ji Ju Fang* stir-fry until black, grind fine. Han Dong Wang Xiansheng burn to ash retaining nature.) Store in sealed vessel, avoid wind. One-month infant dose size of mung bean, mixed with breast milk to swallow. Ensure sweating, avoid wind. Hundred-day infant dose size of jujube pit, adjust to size best. *Qianjin Yao* and *Yi* dosages same. *Yuanhe Ji Yong Jing* Dahuang only half liang. *Qianjin Yao* three ingredients first pounded, Mahuang/Dahuang as powder, separate Xingren ground to paste, then finely mixed into powder. Pounded to blend, stored in sealed vessel. Also *Qianjin Yao/Yi* Hei San treats infant Zheng Bian complicated by seasonal warm disease, or seasonal disease outside Bian Zheng. *Yuanhe Ji Yong Jing* from Si Wei Yin downwards, Hei San, Zi Wan, Zhi Sheng San, Wu Jia Pi treating inability to walk. Shu Zhi Yin, She Xiang Wan 7 fen, called Yu Ying Qi Bao (Infant Nurturing Seven Treasures). Zi Yang Dao Shi named *Bao Zi Qi Sheng Zhi Bao Fang*, dedicated book, this formula is it.
*Ge Shi Zhou Hou Hou* Zi Wan Formula
Dai Zhe (Hematite) Chi Shi Zhi (Red Halloysite) (each 1 liang) Ba Dou (Croton Seed) (40 seeds) Xingren (Apricot Seed) (50 seeds)