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Xia Yuzhu stated: If the disease occurs within three days after birth, it is Umbilical Tetanus (Qifeng); if it occurs after seven days, it is certainly not Umbilical Tetanus. Predecessors only stated that wind pathogen enters the abdomen through the umbilicus, causing mouth contraction and lockjaw, but they did not explain the underlying medical principle. I pondered that after a newborn's birth, when the umbilical cord is cut, there is fluid at the stump. Wind pathogen indeed may invade the abdomen through the umbilicus taking advantage of this moisture. However, the abdomen is far from the lips and tongue; why do mouth contraction and tongue stiffness occur? Once I comprehended the principle of malicious pathogens counter-attacking organs, I realized that after wind enters the abdomen, it first attaches to the Liver. The Liver belongs to Wood, and wind attaches to wood to manifest. The eyes are the orifices of the Liver, hence yellow color appears at the two corners of the eyes. When wind invades the Liver, it must counter-attack the Spleen. The nasal tip belongs to the Spleen, so yellow color also appears on the nasal tip. When wind invades the Spleen, it must counter-attack the Kidney. The lips belong to the Kidney, so the lips turn yellow and contract. When wind invades the Kidney, it must counter-attack the Heart. The tongue is the sprout of the Heart, so the tongue becomes stiff. Until this point, wind and fire blaze together, and death is inevitable. I have comprehended the beginning and end of Umbilical Tetanus up to this stage, and even I find it hard to believe. As the saying goes, "Think repeatedly, and suddenly clarity will come," this probably refers to such a situation.

When Umbilical Tetanus first manifests, the infant's suckling will be slightly looser than before, and yellow color suddenly appears near the glabella at the corners of the eyes. Urgent treatment is required; treatment at this stage is easiest. If the yellow color spreads to the nose, treatment remains easy. If the yellow color reaches the Renzhong (GV26) and Chengjiang (CV24) points, treatment becomes somewhat difficult. If the mouth does not contract but shows slight puffing sounds, it is still treatable. However, if the lips and mouth tighten and lock, and the tongue is stiff and rigid, treatment should be abandoned. Upon seeing yellow color at the eye corners, nose, and Renzhong, provided the lips are not tightly contracted, one can bend the child's little finger, massage the Wailaogong (EX-UE10) acupoint, and immediately apply moxibustion with lamp-fire at the Fontanelle (Baihui area), Glabella (Yintang), Renzhong, Chengjiang, and Shaoshang (LU11) on both thumbs, one moxa cone each. For the unsevered cord, burn at the tying site; for the severed stump, burn at the separation site. A total of thirteen moxa cones are applied. The wind will cease, and the yellow color will recede. This method of fire attack is no different from the medicine in Lü Dongbin's pot or the life-saving prescription of Lu Gong. I wish all parents under heaven would follow my diagnosis and treatment methods. Even among hundreds, thousands, or tens of millions of children, absolutely none would die of Umbilical Tetanus.

I often see effective cases recorded in internal medicine books without surnames, which seems fictitious. Zhuoxi Sou, who appended these cases, always records surnames and dares not make mistakes. If names were borrowed falsely, upon the publication of this book, how could one face the gentlemen mentioned in the effective cases? Effective cases accumulated over two generations fill the bookshelves and cannot all be recorded. I have briefly selected difficult and complicated cases and appended them to the end of respective diseases, not to boast, but to provide material for those engaged in this profession to compare and verify.

Chu Eryou, a friend from Changshan, once sat down patting his hands, casually mentioning that scholars' children in the past did not die of Umbilical Tetanus. I made an agreement with him that if he had a child later, he would invite me to visit within three days, and this illness could be prevented. Later, as agreed, the child was brought out. Yellow color was just rising at the eye corners. Thirteen lamp-fire moxibustions were applied, and the yellow color receded immediately. This is one verification of accurately predicting Umbilical Tetanus.

Mr. Liu Bozong, a scholar residing in Yitong in my county, had a son named Ji. His third wife had just given birth to a daughter who suffered from Umbilical Tetanus. By the seventh day, the mouth was not puffing nor contracting, but the yellow color at the eye corners was deep and flowing, while the yellow color at the nasal tip and nasal alae grooves was faint. The body had a slight fever, which caused great surprise. It was unprecedented for Umbilical Tetanus to persist for seven days. Inferring from the intensity of the yellow color at the eyes and nose, I knew that the child's Spleen Earth constitution was very robust, making it difficult for wind to penetrate quickly, hence the prolonged course. I vigorously massaged Wailaogong (EX-UE10), applied thirteen lamp-fire moxibustions to extract Liver wind from above the nose, and added three moxa cones in the left and right nasal grooves to block the path. Fangfeng Decoction (Saposhnikoviae Radix) prepared with 3 grams was administered orally, resulting in immediate recovery. This is one verification of an atypical case of Umbilical Tetanus.