凡婴儿初生,当随手包裹,切不可为风寒所侵。盖儿在腹中,遮护最密,及其初脱胞胎,肌肤脆嫩,极易
感邪。若在夏令,自所无虑,但觉稍寒,即须慎之。尝见儿生未久,多有惊风、发热、抽搐等病,率由乎此。
小儿初生,天气微凉,即大忌洗沐,恐腠理不密,元气发泄,而外邪乘之也。
凡产母分娩艰难,劳伤胎气,多有儿虽脱胞而乏力垂危,或已死者,切不可便断脐带,当急用大纸捻蘸香
油,于脐带上往来烧断之,取其阳气以续胎元,俄顷儿
得啼声,即已活矣。且可免胃寒泄泻之病。凡见此者,若以刀断脐带,则子母皆多难保。此出立斋医案。
凡烧带之法,惟素多阳虚及产时气脱者最宜用之,以助阳气。若母气阳强,或儿声洪亮者,皆不宜用,恐
火从脐入,日后致生热毒,则反为害不小。
凡子死腹中者,多以触伤,或犯禁忌,或以胎气薄弱,不成而殒;或以胞破血干,持久困败。但察产母,
腹胀舌黑者,其子已死。若非产期,而觉腹中阴冷重坠,或为呕恶,或秽气上冲,而舌见青黑者,皆子死之
证。宜速用下死胎方下之。下后察其虚实,随加调补自愈。若唇舌面色俱青,则母子皆危之兆也。
补遗方∶治胎死腹中。用红花以酒煮汁,饮二三碗,即下。
新法下胎方∶用当归一两,浓朴三钱,陈皮二钱,入酒水各一碗,煎至一碗,加朴硝三五钱,再煎十余
沸,去渣,热服,死胎自下。或只用脱花煎,更妙。
凡是婴儿刚出生时,应当立即用衣物包裹好,千万不要让风寒邪气侵袭。因为胎儿在母腹中,受到最严密的保护,等到刚刚脱离胞胎,肌肤娇嫩脆弱,极易感受外邪。如果在夏季,自然无需担忧,但如果觉得稍微有些寒冷,就必须谨慎防护。我曾见到许多婴儿出生后不久,出现惊风、发热、抽搐等疾病,大多都是因为这个原因造成的。
小儿刚出生时,如果天气微凉,就绝对禁止给婴儿洗澡沐浴,恐怕是因为此时腠理(皮肤毛孔及纹理)不够致密,元气容易外泄,从而导致外邪乘虚而入。
凡是产妇分娩困难,劳损伤及胎气,多有婴儿虽然脱离了胞胎但体力衰竭濒临死亡,或者已经死亡的,千万不要立刻剪断脐带,应当紧急使用大纸捻蘸取香油,在脐带上反复烧灼将其烧断,借此利用火的阳气来接续胎元,片刻之后婴儿若能发出啼哭,就已经存活了。而且这样可以避免婴儿日后患胃寒泄泻的疾病。凡是遇到这种情况,如果用刀切断脐带,则母子都难以保全。这一方法出自薛立斋的医案。
凡是采用烧断脐带的方法,只有那些素来阳气虚弱以及分娩时气脱的产妇最为适宜使用,以此来辅助阳气。如果母亲体质阳气偏盛,或者婴儿哭声洪亮有力的,都不宜使用此法,恐怕火气从脐部进入体内,日后导致热毒内生,反而造成不小的危害。
凡是胎儿死于腹中的情况,大多是因为受到外伤,或者违反了禁忌,或者是胎气薄弱,未能成形而流产;或者是胞衣破裂血液枯竭,拖延时间过久导致困顿败坏。只要观察产妇,出现腹部胀满、舌苔发黑的症状,说明胎儿已经死亡。如果不是预产期,却感觉腹中阴冷沉重下坠,或者出现呕吐恶心,或者有秽浊之气上冲,并且舌色呈现青黑色的,都是胎儿死亡的证候。应当迅速使用下死胎方剂将其排出。排出后观察产妇体质的虚实,随即加以调补即可自愈。如果嘴唇、舌头和面色全部发青,则是母子都有危险的征兆。
补遗方:治疗胎死腹中。用红花以酒煮取汁液,饮用二三碗,胎儿即可排出。
新法下胎方:用当归一两,厚朴三钱,陈皮二钱,加入酒和水各一碗,煎煮至剩下一碗药液,加入朴硝三五钱,再煎煮十余次沸腾,滤去药渣,趁热服用,死胎自然排出。或者只使用脱花煎,效果更佳。
Whenever an infant is born, it should be wrapped immediately with clothing; one must strictly avoid invasion by wind-cold pathogens. This is because the fetus within the womb is most tightly protected, but upon emerging from the amniotic sac, its skin and muscles are tender and fragile, making it extremely susceptible to pathogenic factors. In summer, there is naturally no need for worry, but if a slight chill is felt, caution is required. I have often seen infants, shortly after birth, suffering from convulsive disorders (Jing Feng), fever, and spasms, mostly due to this reason.
When newborns are exposed to slightly cool weather, bathing is strictly contraindicated. It is feared that the couli (skin pores and interstices) are not yet dense, leading to the leakage of Yuan Qi (Primordial Qi), allowing external pathogens to take advantage.
In cases where childbirth is difficult, damaging the fetal qi, the infant may emerge from the sac but be too weak to survive or already dead. One must not cut the umbilical cord immediately. Instead, urgently use a large paper twist dipped in sesame oil to burn through the umbilical cord repeatedly. This utilizes the Yang Qi of fire to sustain the Tai Yuan (Fetal Origin). After a moment, if the infant cries, it has revived. This also prevents subsequent diseases such as cold-stomach diarrhea. If the umbilical cord is cut with a knife in such cases, both mother and child are at great risk. This method comes from the medical cases of Xue Lizhai.
The method of burning the cord is most suitable only for those who are constitutionally deficient in Yang Qi or experienced Qi collapse during delivery, to assist Yang Qi. If the mother’s constitution is strong in Yang, or if the infant’s cry is loud and robust, this method should not be used, as fear exists that fire might enter through the navel, causing heat-toxin later, which would do significant harm.
Regarding fetuses dying in the uterus, causes often include trauma, violation of taboos, weak fetal qi leading to miscarriage before formation, or rupture of the amniotic sac with dried blood, prolonged retention leading to exhaustion and decay. If the mother presents with abdominal distension and a black tongue, the fetus is dead. If outside the expected delivery date, the mother feels coldness and heavy bearing down in the abdomen, or experiences vomiting/nausea, foul odor rushing upward, and the tongue appears green-black, these are signs of fetal death. One should promptly administer a formula to expel the dead fetus. After expulsion, assess the deficiency or excess pattern and apply appropriate tonification or purgation accordingly for recovery. If the lips, tongue, and complexion are all blue-green, it indicates danger for both mother and child.
Supplementary Prescription: For treating fetal death in utero. Use Hong Hua (Carthami Flos) boiled in wine to extract the juice; drink two to three bowls, and the fetus will be expelled.
New Method Formula for Expelling Fetus: Use Dang Gui (Angelicae Sinensis Radix) 1 liang, Hou Po (Magnoliae Officinalis Cortex) 3 qian, Chen Pi (Citri Reticulatae Pericarpium) 2 qian. Add one bowl of wine and one bowl of water, decoct until one bowl remains. Add Piao Xiao (Natrii Sulfas) 3-5 qian, boil for about ten more boils, strain, and take hot. The dead fetus will naturally be expelled. Alternatively, using Tuo Hua Jian (Decoction for Expelling Flowers/Fetus) alone is even better.