保婴一术。号曰哑科。口不能言。脉无可视。惟形色以为凭。竭心思而施治。故业擅于专门。以补化工不及。欲知
其病。必观乎色。左颊青龙属肝。右颊白虎属肺。天庭高而离阳心火。地阁低而坎阴肾水。鼻在面中。脾应唇际。
观乎色之所见。知其病之所起。舌乃心之苗。目为肝之液。胃流注于两颐。肾通窍于两耳。爪则筋余。而脾为之
运。发乃血余。而肾为之主。脾司手足。肾运牙齿。苟本脏之或衰。即所属之失惫。能观乎外。可知其内。红光见而
热痰壅盛。青色露而惊痫怔悸。如煤之黑兮。中恶传逆。似橘之黄兮。脾伤吐痢。白乃疳劳。紫为热炽。青遮口角
难医。黑掩太阳莫治。年寿赤光。多生脓血。山根青黑。频见灾危。朱雀贯于双瞳。火入水乡。青龙绕于四白。肝乘
脾部。泻痢而面赤者须防。咳嗽而色青者可畏。面青而唇口撮。疼痛方殷。面赤而目窜视。惊搐将至。火光焰焰
外感风寒。金气浮上。中藏积滞。乍白乍黄。疳热连绵。又赤又青。风邪紧急。气乏兮囟陷成坑。血衰兮头毛作穗。
脾冷则口角流涎。肝热则目生眵泪。面目虚浮。定腹胀而气喘。眉毛频蹙。必腹痛而多啼。风气二池如黄土。则
为不宜。左右两颊似青黛。即成客忤。风门黑主疝而青主惊。方广昏暗凶而光滑吉。手如数物兮肝风将发。面
若涂朱兮心火实炎。伸缩就冷。阳热无疑。坐卧爱暖。阴寒可必。肚大脚细。脾欲困而成疳。目瞪口张。势已危而
必毙。察之若精。治必得理。鸦声鱼口。枉费神思。肉脱皮干。神劳气乏。蛔出兮脾胃将败。唇冷兮脏肺先亏。然五
体以头为尊。一面惟神可恃。况乎声有轻重之不同。啼有干湿之顿异。病之初作。必先呵欠。火之将发。忽作惊
啼。重舌木舌。热积心脾。哽气喘气。火伤肝肺。齿龈宣露牙疳。丁奚哺露食积。心热欲睡而不能。脾热好睡而不
歇。咳嗽失音者肺痿。病后失音者肾怯。腹痛而口流清水者虫多。泻痢而大便酸臭者食积。口频撮而脾虚。舌
长伸而心热。烦热在心。恶见灯光。疳热在脾。爱吃泥土。鸡胸兮肺火胀于胸膈。龟背兮肾风入于骨髓。鼻干黑
燥。金受水刑。肚大青筋。土遭木克。丹瘤疮疥。皆胎毒之留连。五疳泻痢。总食积之停滞。腹痛寒侵。口疮热炽。脐
风忌于一腊。变蒸防于周年。惊自热来。痫由痰至。惊本心生。风从肝使。急惊属热。宜乎清凉。慢惊属虚。宜于补
治。痘曰天疮。疹曰麻子。痘属五脏。疹属六腑。疹宜清凉。痘宜温补。先明阴阳。次识脏腑。补泻得宜。治有何误。
贵临机之通变。毋执一之成模。
保婴(保护婴儿健康)这一医术,被称为“哑科”(因婴幼儿无法言语而得名)。患儿口不能言,脉象难以切诊,只能以面色和形体作为诊断依据,耗尽心思来实施治疗。因此,从事此业者需具备专门技艺,以弥补自然造化之不足。想要了解病情,必须观察面色:左颊属青龙,对应肝脏;右颊属白虎,对应肺脏;天庭高耸对应离阳之心火;地阁低陷对应坎阴之肾水;鼻位于面部中央,脾脏对应唇际。通过观察面色的表现,可知疾病的起因。舌是心的苗窍,目是肝的液窍。胃经流注于两腮,肾经通窍于双耳。爪甲为筋之余,由脾脏运化滋养;头发为血之余,由肾脏主宰。脾主管手足,肾负责牙齿的生长。如果本脏功能衰弱,其所对应的体表组织就会显得疲惫无力。能观察外在表现,即可推知内在脏腑状况。面色发红光亮,提示热痰壅盛;面色发青,提示惊痫怔悸;面色黑如煤炭,提示中恶邪气传逆;面色黄似橘子,提示脾伤导致的呕吐泄痢;面色白主疳劳病;面色紫主热势炽盛;青色遮盖口角者难治;黑色掩盖太阳穴者不可治。年寿部位(鼻准下方至人中上方)出现赤光,多生脓血之症;山根(两眼之间鼻梁根部)青黑,频繁预示灾危。朱雀色贯入双瞳,为火入水乡(心火亢盛);青龙色环绕四白(眼下),为肝木乘脾土。泻痢而面赤者须防病情加重;咳嗽而面色青者可畏。面青且嘴唇口角收缩,疼痛剧烈;面赤且眼球窜视,惊厥抽搐将至。火光焰焰般红赤,多为外感风寒;金气(白色)浮上,体内藏有积滞;乍白乍黄,为疳热连绵;又赤又青,为风邪紧急。气虚则囟门凹陷成坑;血衰则头毛结成穗状。脾冷则口角流涎;肝热则眼生眵泪。面目虚浮,定是腹胀气喘;眉毛频频皱蹙,必是腹痛多啼。风气二池(颞部两侧)颜色如黄土,则为不宜;左右两颊似青黛色,即成客忤(小儿受惊吓或异气所致的病症)。风门黑主疝气,青主惊风;方广(额头)昏暗凶险,光滑吉利。手如数物动作,肝风将发;面若涂朱,心火实炎。身体伸缩喜冷,阳热无疑;坐卧爱暖,阴寒可必。肚大脚细,脾欲困顿而成疳证;目瞪口张,势已危重必死。察之精细,治必得理。鸦声鱼口(指临终前的特殊声音和形态),枉费神思;肉脱皮干,神劳气乏。蛔虫出,脾胃将败;唇冷,脏肺先亏。然而五体以头为尊,一面之中惟神色可恃。况且声音有轻重不同,啼哭有干湿顿异。疾病初起,必先呵欠;火邪将发,忽作惊啼。重舌、木舌,为热积心脾;哽气、喘气,为火伤肝肺。齿龈宣露、牙疳,为丁奚、哺露(两种严重的疳积病名)食积所致。心热欲睡而不能睡;脾热好睡而不歇息。咳嗽失音者为肺痿;病后失音者为肾怯。腹痛而口流清水者,虫多;泻痢而大便酸臭者,食积。口频撮而脾虚;舌长伸而心热。烦热在心,厌恶灯光;疳热在脾,爱吃泥土。鸡胸,为肺火胀于胸膈;龟背,为肾风入于骨髓。鼻干黑燥,为金受水刑(肾水侮肺金);肚大青筋,为土遭木克(肝木乘脾土)。丹瘤、疮疥,皆胎毒之留连;五疳、泻痢,总食积之停滞。腹痛因寒侵,口疮因热炽。脐风忌于出生一月内,变蒸(婴幼儿生长发育过程中的生理现象)防于周岁。惊自热来,痫由痰至。惊本心生,风从肝使。急惊属热,宜乎清凉;慢惊属虚,宜于补治。痘曰天疮,疹曰麻子。痘属五脏,疹属六腑。疹宜清凉,痘宜温补。先明阴阳,次识脏腑。补泻得宜,治有何误?贵在临机通变,毋执一成模。
The art of infant care is known as the "Mute Department" (a term for pediatrics, as infants cannot speak). Infants cannot speak, and their pulses are difficult to palpate; thus, diagnosis relies solely on complexion and physical form, requiring great mental effort to administer treatment. Therefore, practitioners must specialize in this field to supplement the limitations of natural processes. To understand the disease, one must observe the complexion: the left cheek corresponds to the Azure Dragon (Qinglong) and the Liver; the right cheek corresponds to the White Tiger (Baihu) and the Lungs; a high forehead corresponds to the Li Yang Heart Fire; a low chin corresponds to the Kan Yin Kidney Water; the nose is in the center of the face, corresponding to the Spleen at the lips. By observing the manifestations of the complexion, one can know the origin of the disease. The tongue is the sprout of the Heart; the eyes are the fluid of the Liver. The Stomach meridian flows into the cheeks; the Kidney orifices connect to the ears. Nails are the surplus of sinews, governed by the Spleen's transportation; hair is the surplus of blood, governed by the Kidneys. The Spleen controls the hands and feet; the Kidneys govern the teeth. If the Zang organ declines, its associated external manifestation becomes weak. Observing the exterior allows one to know the interior. A red and bright complexion indicates abundant phlegm-heat; a bluish complexion indicates fright, epilepsy, and palpitations; black like coal indicates poisoning and reversal; yellow like an orange indicates spleen injury with vomiting and dysentery; white indicates malnutrition consumption (Gan syndrome); purple indicates intense heat; blue covering the corners of the mouth is difficult to treat; black covering the Taiyang area is untreatable. Red light on the Nianshou area (area below the nose tip) often leads to pus and blood disorders; green-black on the Shangen (root of the nose between eyes) frequently portends disaster. Vermilion penetrating both pupils indicates fire entering the water region (Heart fire hyperactivity); Azure Dragon winding around Sibai (under eyes) indicates Liver overacting on the Spleen. Diarrhea with red face requires caution; coughing with blue face is alarming. Blue face with puckered lips indicates severe pain; red face with wandering eyes indicates impending convulsions. Flaming redness indicates exogenous wind-cold; floating metallic qi (white) indicates internal stagnation; alternating white and yellow indicates continuous Gan-heat; mixed red and blue indicates urgent wind pathogen. Qi deficiency causes fontanelle depression; blood deficiency causes hair tufts. Cold Spleen causes drooling; hot Liver causes eye discharge. Puffy face and eyes indicate abdominal distension and asthma; frequent frowning indicates abdominal pain and crying. Yellowish earth color in the Fengqi areas is unfavorable; cyan dye-like color on both cheeks indicates Ke Wu (fright from alien qi). Black Fengmen indicates hernia; blue indicates fright. Dark Fangguang (forehead) is ominous; smooth is auspicious. Hand movements resembling counting indicate impending Liver wind; face painted with vermilion indicates excess Heart fire. Stretching towards cold confirms Yang heat; sitting/lying preferring warmth confirms Yin cold. Large belly and thin legs indicate Spleen exhaustion leading to Gan syndrome; staring eyes and open mouth indicate critical condition leading to death. Precise observation ensures correct treatment. Crow voice and fish mouth (signs of terminal illness) waste effort; emaciated flesh and dry skin indicate spirit fatigue and Qi depletion. Roundworms exiting indicate failing Spleen and Stomach; cold lips indicate prior deficiency of Zang and Fu organs. Among the five body parts, the head is supreme; among the face, only the spirit is reliable. Voices differ in weight; cries differ in wetness and dryness. At the onset of disease, yawning occurs first; when fire is about to erupt, sudden frightened crying occurs. Double tongue and wooden tongue indicate heat accumulation in Heart and Spleen; choking breath and panting indicate fire injuring Liver and Lungs. Exposed gums and periodontal disease relate to Dingxi and Bulu (severe Gan syndromes) caused by food stagnation. Heart heat causes desire to sleep but inability; Spleen heat causes propensity to sleep without rest. Coughing with loss of voice indicates Lung flaccidity; post-illness loss of voice indicates Kidney weakness. Abdominal pain with clear saliva indicates many parasites; diarrhea/dysentery with sour-smelling stool indicates food stagnation. Frequent lip puckering indicates Spleen deficiency; long extended tongue indicates Heart heat. Heat vexing the Heart makes one dislike light; Gan-heat in the Spleen makes one crave eating dirt. Chicken chest indicates Lung fire swelling the chest/diaphragm; turtle back indicates Kidney wind entering the bone marrow. Dry, black, and cracked nose indicates Metal suffering from Water punishment (Kidney insulting Lung); large belly with visible veins indicates Earth being overcome by Wood (Liver attacking Spleen). Dan tumors, sores, and scabies are all lingering fetal toxins; Five Gans and dysentery are all due to food stagnation. Abdominal pain from cold invasion; mouth ulcers from intense heat. Umbilical tetanus is contraindicated within the first month; Bianzheng (physiological growth phenomena) should be guarded against during the first year. Fright comes from heat; epilepsy arises from phlegm. Fright originates from the Heart; wind follows the Liver. Acute fright belongs to heat, suitable for cooling; chronic fright belongs to deficiency, suitable for tonification. Smallpox is called Heavenly Blister; measles are called Maizi. Smallpox relates to the Five Zang organs; measles relate to the Six Fu organs. Measles require cooling; smallpox requires warming and tonifying. First clarify Yin and Yang, then identify Zang and Fu organs. With appropriate tonification and purgation, how can treatment err? Value adaptability in practice; do not adhere rigidly to fixed patterns.