龟背者。由儿生下。风客于脊。入于骨髓。小续命去附加防风。龟胸者。因肺受湿热。攻于
胸膈。龟胸丸。并用龟尿点其骨节。多有得愈者。盖小儿腠理不密。风邪乘之。或痰饮蕴热于肺。
风热交攻而致。或坐早风入骨髓。治用上法。若禀受肝肾虚热。六味丸。肾气不足。八味丸。背。
加鹿茸。胸。加龟甲。治之贵早。迟则不验。
小儿虚羸。因脾胃不和。不能乳食。使肌肤瘦弱。或大病后脾气尚弱。不能传化谷气所致。
若冷者。时时下利。唇口清白。热者。身温壮热。肌体微黄。更当审形色。察见证。如面赤多啼。
心之虚羸也。面青目札。肝之虚羸也。耳前后或耳下结核。肝经虚火也。颈间肉里结核。食积虚
热也。面黄痞满。脾之虚羸也。面白气喘。肺之虚羸也。目睛多白。肾之虚羸
也。仍参相胜治之。
五迟者。立迟行迟齿迟发迟语迟是也。盖肾主骨。齿者骨之余。发者肾之荣。若齿久不生。
生而不固。发久不生。生则不黑。皆胎弱也。良由父母精血不足。肾气虚弱。不能荣养而然。若
长不可立。立而骨软。大不能行。行则筋软。皆肝肾气血不充。筋骨痿弱之故。有肝血虚而筋不
荣膝。膝盖不成。手足拳挛者。有胃气虚而髓不温骨。骨不能用。而足胫无力者。并用地黄丸为
主。齿迟。加骨碎补、补骨脂。发迟。加龟版、鹿茸、何首乌。立迟。加鹿茸、桂、附。行迟。
加牛膝、鹿茸、五加皮。语迟之因不一。有因妊母卒然惊动。邪乘儿心不能言者。有禀父肾气不
足而言迟者。有乳母五火遗热。闭塞气道者。有病后津液内亡。会厌干涸者。亦有脾胃虚弱。清
气不升而言迟者。邪乘儿心。菖蒲丸。肾气不足。地黄丸加远志。闭塞气道。加味逍遥散。津液
内亡。七味白术散。脾胃虚弱。补中益气汤。若病久或五疳所致者。但调补脾胃为主。五硬者。
仰头哽气。手脚心坚。口紧肉硬。此阳气不荣于四末。独阳无阴之候。若腹筋青急者。木乘土位
也。六味丸加麦冬、五味。若系风邪。小续命去附子。五软者。头项手足口肉皆软。胎禀脾肾气
弱也。若口软不能啮物。肉软不能辅骨。必先用补中益气以补中州。若项软天柱不正。手软持物
无力。足软不能立地。皆当六味丸加鹿茸、五味。兼补中益气。二药久服。仍令壮年乳母乳哺。为第一义。
Gui Bei (Tortoise Back) is caused by wind pathogen lodging in the spine and penetrating into the bone marrow after birth. Treatment may employ Xiao Xuming Decoction (Minor Continuation of Life Decoction) with Fuzi (Aconite Root) removed and Fangfeng (Saposhnikovia Root) added.
Gui Xiong (Tortoise Chest) occurs due to damp-heat invading the Lung, attacking the chest and diaphragm. Guixiong Wan (Tortoise Chest Pill) can be used, applying Gui Niao (Turtle Urine) to the joints; many patients recover. This is primarily because infants have loose Cou Li (skin texture and pores), allowing wind pathogen to invade, or phlegm-fluid retention transforms into heat in the Lung, where wind and heat attack each other. Alternatively, sitting too early allows wind to enter the bone marrow. The aforementioned treatments apply. If it stems from congenital deficiency causing Liver-Kidney deficient heat, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is indicated. For Kidney Qi deficiency, Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) is used. For back lesions, Lurong (Deer Antler) is added; for chest lesions, Guijia (Turtle Shell) is added. Early treatment is crucial; delay renders it ineffective.
Xiao'er Xu Lei (Pediatric Emaciation) results from Spleen-Stomach disharmony, preventing proper feeding, leading to emaciated muscles and skin, or from weak Spleen Qi following a severe illness, failing to transform grain Qi. Cold patterns present with frequent diarrhea and pale lips/mouth; heat patterns present with warm or high fever and slightly yellowish skin. One must examine facial features and symptoms. For instance: red face with excessive crying indicates Heart Xu Lei; blue face with eye twitching indicates Liver Xu Lei; tubercles behind or below the ears indicate Liver Meridian deficient fire; deep neck tubercles indicate food stagnation causing deficient heat; yellow face with distension indicates Spleen Xu Lei; white face with asthma indicates Lung Xu Lei; eyes with excessive sclera indicate Kidney Xu Lei. Treatment should still refer to the theory of mutual overcoming (Wu Xing).
Wu Chi (Five Delays) refers to delays in standing, walking, teething, hair growth, and speech. The Kidney governs bones; teeth are the surplus of bones; hair is the flourishing aspect of the Kidney. Delayed or insecure tooth eruption, and delayed or non-black hair growth, all stem from fetal weakness, largely due to insufficient essence and blood of parents and weak Kidney Qi failing to nourish. Inability to stand or soft bones upon standing, and inability to walk or soft sinews upon walking, result from insufficient Liver-Kidney Qi and Blood, leading to flaccid tendons and bones. Cases of Liver Blood deficiency causing tendon malnourishment and undeveloped knees, or Stomach Qi deficiency failing to warm bones with marrow, resulting in weak calves, are primarily treated with Dihuang Wan (Rehmannia Pill). For teething delay, Gusuibu (Drynaria Rhizome) and Buguzhi (Psoralea Fruit) are added. For hair delay, Guiban (Turtle Plastron), Lurong (Deer Antler), and Heshouwu (Polygonum Multiflorum Root) are added. For standing delay, Lurong (Deer Antler), Guizhi (Cinnamon Twig), and Fuzi (Aconite Root) are added. For walking delay, Niuxi (Achyranthes Root), Lurong (Deer Antler), and Wujia Pi (Acanthopanax Bark) are added.
Speech delay has various causes: sudden fright during pregnancy affecting the fetal Heart; insufficient Kidney Qi inherited from the father; residual heat from the wet nurse's "five fires" blocking airways; depletion of body fluids post-illness drying the epiglottis; or Spleen-Stomach weakness failing to ascend clear Qi. For heart invasion, Changpu Wan (Acorus Pill); for Kidney Qi deficiency, Dihuang Wan with Yuanzhi (Polygala Root); for blocked airways, Jia Wei Xiaoyao San (Modified Free Wanderer Powder); for fluid depletion, Qiwei Baizhu San (Six-Ingredient Atractylodes Powder); for Spleen-Stomach weakness, Buzhong Yiqi Tang (Middle-Warming Qi-Supplementing Decoction). If chronic or caused by five types of Gan syndrome, focus on tonifying Spleen-Stomach.
Wu Ying (Five Hardnesses) manifest as head retraction with gasping, hard palms/soles, tight mouth, and stiff muscles. This signifies Yang Qi failing to nourish the four extremities, a state of solitary Yang without Yin. If abdominal veins are blue and tense, Wood overacting on Earth (Liver overacting on Spleen). Treat with Liuwei Dihuang Wan plus Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Berry). If due to wind pathogen, use Xiao Xuming Decoction without Fuzi.
Wu Ruan (Five Flaccidities) involve softness of the head/neck, limbs, and mouth muscles, due to congenital weak Spleen-Kidney Qi. If the mouth is too soft to chew or muscles too soft to support bones, first use Buzhong Yiqi Tang to tonify the Middle Jiao. If the neck is too soft for upright posture, hands too weak to hold objects, or feet too weak to stand, use Liuwei Dihuang Wan with Lurong (Deer Antler) and Wuweizi (Schisandra Berry), combined with Buzhong Yiqi Tang. Long-term use of these two medicines, along with breastfeeding by a healthy young woman, is the primary principle.