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General Summary: Cold stomach (Stomach Cold) is all due to congenital deficiency, or caused by severe and prolonged illness; urgent warming and tonification are needed to support the Yuan Qi (Original Qi), lest the body become emaciated.

The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Stomach is the sea of water and grain, and the great source of the six fu organs. The qi, blood, zang-fu organs, and vessels of the human body are all generated by Stomach Qi. Therefore, Li Dongyuan's medical method focuses primarily on the Spleen and Stomach, which is what is meant by "tonifying the Spleen is better than tonifying the Kidney." For infants, although they consume milk and food, the essence of water and grain is not yet complete, so they still rely on Stomach Qi. If Stomach Qi becomes deficient, the other four zang organs will lose their nourishment. Thus, Zhu Danxi said that infants often suffer from Spleen and Stomach diseases. If the complexion is pale, the eyes lack luster, the breath from the mouth is cold and there is no desire to eat, vomiting of clear fluid occurs, muscles are emaciated with abdominal pain, these are symptoms of Deficiency-Cold of Stomach Qi, treated mainly with Wuwei Yigong San (Five-Ingredient Powder for Extraordinary Efficacy). If the stool is unformed, indicating concurrent Spleen deficiency, add Ganjiang (Dried Ginger) to warm it. If there is abdominal fullness and discomfort, it indicates impaired Spleen transportation; add Muxiang (Aucklandia Root) to promote qi movement and relieve obstruction. If the Fire of the Gate of Vitality (Mingmen) is deficient and cannot warm the Earth (Spleen), use Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) to tonify; this pill is also used for congenital insufficiency of Stomach Qi. This is because when the True Yang of the lower jiao is abundant, it ascends, and the Spleen Yuan naturally steams and digests water and grain. As stated in the *Neijing*: "Benefit the source of fire to eliminate yin shadows," which precisely refers to this medication principle.

[Attached Formulas]
Wuwei Yigong San: See under Convulsion Syndrome (remove Muxiang).
Bawei Dihuang Wan: Is Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) plus Rougui (Cinnamon Bark) and Fuzi (Prepared Aconite Root), each one liang.

(Attachment: Infant Five Softnesses)
General Summary:
Fetal Heat: In infants aged three days to beyond ten days or a month, closed eyelids with swollen lids can be inferred as a symptom; constant moaning and irritability confirm Fetal Heat without doubt.
Fetal Cold: Around one hundred days of age, signs of Fetal Cold appear: legs bent and difficult to extend, hands clenched into fists; cold mouth, distended abdomen, trembling body, crying incessantly during the day and suffering more at night.
Fetal Jaundice: After birth, the infant presents with Fetal Jaundice, transmitted from the mother who contracted heat-toxin; urgently administer Dihuang Xijiao San (Rehmannia and Rhinoceros Horn Powder); if the jaundice subsides and the body cools, life can be saved.
Fetal Startle: Fetal Startle is also acquired in the womb due to improper care by the mother; if the facial luster and eye gaze are good, survival is possible; if the area between the eyebrows is dark black, the condition is truly critical.
Umbilical Wind: Umbilical Wind receives pathogenic factors early into the umbilicus; within seven days, auspicious or ominous outcomes can be verified; if abdominal pain and umbilical protrusion are seen, accompanied by harsh sounds and puckered lips, this is Wind disease.
Umbilical Protrusion: In infants after ten days post-birth, umbilical protrusion with shiny swelling is not a major disease; the cause is foul water stagnating inside; slowly apply medication to resolve it.
Visceral Cold: Hands and feet are cold, complexion slightly green, abdominal pain with borborygmus and frequent diarrhea; this is due to contracting cold-dampness at birth; crying is intense at night but lighter during the day.

The Yellow Emperor said: If one cannot accurately observe the condition of the young, even a sage with innate knowledge would find it difficult. Why? Because newborns have fragile bones and flesh, and their five zang organs are not yet filled, just like bubbles on water or dew on grass. Within the first seven days after birth, can the pathogens of the eight winds of heaven and earth harm them quickly? It is actually because during gestation, the mother failed to protect herself, perhaps overexerting qi and blood, irregular eating habits, conflicting hot and cold influences, or sorrow and fright, thereby damaging fetal qi. Consequently, after birth, conditions such as Fetal Heat, Fetal Cold, and Fetal Startle arise. External causes include improper bathing, wiping the mouth, cutting the umbilical cord, or cauterizing the fontanelle, or frightening the infant while holding, or inappropriate temperature management during feeding, leading to symptoms like locked mouth, Umbilical Wind, locked belly, and failure to suckle. Such patients are difficult to treat, hence the Yellow Emperor said it was difficult, implying a special regimen is required! We must understand signs of life and death, discern the cold and hot nature of medicines, probe the depth of the patient's condition, and treat with caution. Do not lightly abandon an infant simply because the illness appeared within seven days.

Fetal Heat: After birth, the infant has excessive phlegm-saliva, rapid breathing, red eyes with swollen lids, lethargy with yawning, hiccups, generalized fever, red urine, constipation, and occasional startle/irritability. This is due to heat accumulated in the womb, mistakenly treated with warm agents, causing heat to accumulate internally and steam the fetal qi. First, administer Mutong San (Akebia Decoction) to the mother, and Dihuang Gao (Rehmannia Paste) to the infant. Do not use cold/clearing drugs to attack, lest other diseases arise. The nursing mother must avoid spicy, pungent, alcoholic, and wheat products.

Fetal Cold: Within the first hundred days, the infant feels cold mouth and abdominal pain, experiences chills and tremors, bends legs and clenches fists, cries day and night, or has a locked jaw, named Fetal Cold. This may result from the mother consuming raw/cold foods or fruits, or contracting wind-cold-summerheat-dampness before delivery, or overdosing on cold medicines, injuring fetal qi internally. After birth, the infant sleeps drowsily, occasionally sucks milk then passes white stool. Use Danggui San (Angelica Decoction) to settle pain, Baizhu San (Atractylodes Macrocephala Decoction) to nourish the Stomach, Shaoyao Tang (Peony Decoction) to dispel cold-dampness, and the nursing mother should observe dietary restrictions.

Fetal Jaundice: Upon birth, the entire body and face are yellow, resembling gold color, with constipation and bloody urine; this is Fetal Jaundice. It is also caused by maternal heat transmitting to the fetus. Once this symptom appears, both mother and infant should take Dihuang Tang (Rehmannia Decoction). Some infants born at one hundred days or half a year old develop yellow skin without illness; this is Stomach Heat. Those yellow from birth have Fetal Dan-Jaundice. The Classics state: All jaundices are heat syndromes, characterized by deep yellow color, treated with Xijiao San (Rhinoceros Horn Decoction). If the yellow is pale and mixed with white, this is Stomach Weakness, treated with Baizhu San.

Fetal Startle: Caused by the pregnant woman's irregular lifestyle; whatever the mother encounters, the fetus is affected. Symptoms include internal warmth, abdominal tossing, rolling eyes, clenched fists, locked jaw, grinding teeth, stiff back and waist, salivation, vomiting, convulsions, startle crying, or red cheeks, blue face, closed eyes. Whenever Fetal Wind causes closed eyes, do not mistake it for Slow Spleen Wind and recklessly use warm medicines. Dark/black discoloration between the eyebrows indicates untreatable conditions. Grind pig's milk finely, mix with small amounts of Niuhuang (Calculus Bovis) and Shexiang (Musk), and smear into the mouth for immediate recovery.

Locked Anus: Caused by heat in the womb, where heat-toxins are abundant and knot at the anus, blocking passage without lubrication. If not open by the third day, urgently have a woman rinse her mouth and suckle the infant's anterior/posterior chest, below the umbilicus, and palms/soles of hands (seven points total), four or five times. Then, take Qingfen (Calomel) 5 fen, dissolve with a little honey in warm water, and give small doses frequently until通畅 (unblocked). If still blocked, it implies internal fusion of the anus; insert a gold or jade hairpin about two cun into the anus, insert a small amount of Suheli Wan (Suhexiang Pill) into the hole, aiming for fecal discharge. If the abdomen is distended, unable to feed, making moaning sounds for up to seven days, life can be preserved.

Umbilical Wind: After cutting the umbilical cord, wind-cold-dampness enters the umbilicus, flows to the Spleen meridian, causing abdominal distension, swollen umbilicus, heavy body, rigid limbs, constant crying day and night, inability to suckle, and potentially developing into wind convulsions. Blue-black umbilical border, puckered mouth, internal convulsions, and black nails indicate death; treat with Qianjin Longdan Tang (Thousand Gold Gentian Decoction).

Umbilical Protrusion is not Umbilical Wind; it is caused by loose tying during bathing allowing foul water to enter. After ten days, the umbilicus suddenly shines like blown glass, makes slight noise when pressed, or cries at night. Urgently use Dahuang (Rhubarb) and Moli (Oyster Shell), half liang each, roasted and powdered, mixed evenly with Xiaoyan (Mirabilite), applied with water infused from field snails, 1 qian or 2 qian, smeared on the swelling to resolve it. (Note: Newborns have no skin, only red flesh; use rice-coarse powder dry-powdered until skin forms. Or if body resembles fish blisters/crystal, breaking leaks fluid; use Mituoeng (Lead Monoxide) finely ground, sifted, dry-powdered.)

Visceral Cold closely resembles Fetal Cold, but only hands/feet are slightly cold, lips/face slightly green, forehead sweating, refusal to suckle, night crying, diarrhea of green watery stool, lacking the cold/chills difference. Medication is the same as for Fetal Cold.

Puckered Mouth: Caused by fetal qi carrying heat, wind pathogen entering the umbilicus, flowing toxins to Heart and Spleen meridians, causing weak tongue, blue lips, puckered mouth/face, and inability to eat. If white foam exits the mouth and limbs are cold, it is incurable. Abdominal distension with visible veins, hernia, internal pain are due to intestinal/stomach qi stagnation; treatment prioritizes draining and regulating. Puckered Mouth is most urgent, especially severe within seven days; use Chen Sha Gao (Cinnabar Paste) to drain or Cuofeng San.

Cuofeng (Wind-Puckering): Eyelids tight, mouth open, decreasing cry, flesh accumulation on tongue like millet grains, inability to suckle, foaming at mouth, normal bowel/bladder movements. Seen from one month to 120 days, named Fanfeng Jin (Contracting Wind Lockjaw). Care according to principles to prevent beforehand. If this symptom appears, urgently check for spots on the infant's palate, scratch them with fingernails first, then apply Chen Sha Quanxie San (Cinnabar and Scorpion Powder). If mouth is locked and medicines fail, use Sheng Nanxing (Raw Arisaema) peeled and powdered finely, mixed with a little Longnao (Borneol), dip finger in ginger juice, rub on upper gums to open immediately. Umbilical Wind, Puckered Mouth, and Lockjaw differ in presentation but share the same root cause: interior qi stagnation and blockage. Generally, administer Danshi Zhi (Light Fermented Soybean Juice) to drink to expel fetal toxins. *Qianjin Fang* says: Infants' illnesses are vigorous; even minor ailments require purgation. Without purgation, they become major diseases hard to treat; use Zishuang Wan酌情 (according to circumstances).

[Attached Formulas]
Mutong San: See under Cyst Syndrome (remove ingredients related to accumulation).
Dihuang Gao: Zhiren (Gardenia Seed) 1.5 liang, Lvdou Fen (Mung Bean Powder) 1.5 liang, Fugcao (Licorice) 6 qian, Shengdi (Rehmannia Root) 1.5 liang; add Honey 1.5 liang. Simmer the first four in a porcelain vessel into a paste, mix with previous herbs to make pills, taken with Maidong Tang (Ophiopogon Decoction).
Danggui San: Danggui (Angelica Sinensis), Bo Gui (Thin Cinnamon Twig), Chuanxiong (Ligusticum), Jiang (Ginger), Gancao (Licorice), Mutong (Akebia), Xiangfu (Cyperus); taken with milk.
Baizhu San: See under Heat Syndrome (add Shanyao/Yam).
Baishao Tang: See under Abdominal Pain Syndrome (add Gouteng/Hookvine).
Dihuang Tang: Tianhuafen (Trichosanthes Root), Shengdi, Yinchen (Artemisia Capillaris), Chishao (Red Peony Root), Chifuling (Red Poria), Gancao, Zhuling (Polyporus), Zexie (Alisma), Danggui.
Xijiao San: Xijiao (Rhinoceros Horn - note: substitute with Buffalo Horn in modern practice), Yinchen, Shengma (Cimicifuga), Shengdi, Dancao (Gentiana), Hanshuishi (Calcitum), Tianhuafen, Gancao.
Qianjin Longdan Tang: Dancao (Gentiana), Gouteng, Chaihu (Bupleurum), Huangqin (Scutellaria), Pianlang (Beetle, remove wings/legs), Gancao, Shaoyao, Fuling, Jiegeng (Platycodon), Huanglian (Coptis).
Chensha Gao: Mayaxiao (Saltpeter), Chensha (Cinnabar), Pengsha (Borax), Quanxie (Scorpion), Xuanmingfen (Thenardite), Shexiang, Zhenzhu (Pearl). Powder together, form paste with black date flesh. Take size of a bean. For startle, use Jinyin (Honeysuckle) and Bohe (Mint); for tidal fever, use Gancao Tang. For infants within one month, mix with breast milk, apply to nipple for infant to suckle.
Cuofeng San: Chi Jiao Wugong (Red-legged Centipede) one strip (remove head, roast yellow), Zhusha (Cinnabar), Jiangcan (Silkworm), Xiwei (Scorpion Tail) (each 1 qian), Shexiang (Musk)少许 (small amount). Powder, take one spoonful mixed with Zhuli (Bamboo Sap). Treats Umbilical Wind, Puckered Mouth, Lockjaw.
Zishuang Wan: Daizheshi (Hematite), Chishizhi (Red Halloysite), Bashuang (Croton Seed Resin), Xingren (Apricot Seed).
Xiaoru Wan: Sharen (Amomum), Chenpi (Tangerine Peel), Sanleng (Sparganium), Ezhu (Curcuma), Shenqu (Medicated Leaven), Maiya (Barley Sprout), Xiangfu.