小儿自初生至周岁有疾者。皆为胎疾。
气。阳也。血。阴也。人之有生。受气于父。阳之变也。成形于母。阴之合也。阴阳变
成其身。身之中形藏四。头面一也。耳目口鼻二也。手足三也。皮肉筋骨四也。神藏五。心
藏神。肝藏魂。脾藏意。肺藏魄。肾藏志是也。凡九藏者。皆父母一体而分者也。形拘于一
偏。而不能相通者。阴之静也。神随感而动者。阳之动也。儿之初生。只是一块血肉耳。虽
有形而无所用。虽有五脏。而无其神。犹空藏也。至于变蒸之后。皮肉筋骨。以渐而坚。声
色臭味。以渐而加。志意智能。以渐而发。知觉运动。而始成童。此天地生物之心。至诚不
息也。有因父母禀受所生者。胎弱胎毒是也。胎弱者。禀受于气之不足也。子于父母。一体
而分。如受肺之气为毛皮。肺气不足。则皮脆薄怯寒。毛发不生。受心之气为血脉。心气不
足。则血不华色，面无光彩。受脾之气为肉。脾气不足。则肌肉不生。手足如削。受肝之气
为筋。肝气不足。则筋不束骨。机关不利。受肾之气为骨。肾气不足。则骨软。此胎禀之病
。当随其藏气求之。肝肾心气不足。宜六味地黄丸主之。脾肺不足者。宜参苓白术丸主之。
子之羸弱。皆父母精血之弱也。所谓父强母弱。生女必羸。父弱母强。生男必弱者是也。故
儿有头破。颅解。神慢。气少。项软。头倾。手足痿弱。齿生不齐。发生不黑。行走坐立。
要人扶掖。皆胎禀不足也。并宜六味地黄丸主之。
胎毒者。精血中之火毒。即命门相火之毒。命门者。男子以藏精。女子以系胞也。观东
瘤之论。丹溪胎毒之论。治法可见矣。古方有解毒之方。如黄连甘草法。又有育婴解毒延龄
丹。皆良方也。予新立一方。用丹溪三补丸方。苓连 半生用半酒炒。甘草半生半炙各等分
为末。雪水丸麻子大。朱砂雄黄为衣。名曰生熟解毒丸。小儿日与食之佳。
有胎毒所生者。如虫疥流丹。浸淫湿疮。痈疖结核。重舌木舌。鹅口口疮。与夫胎热胎
黄胎惊之类。儿之初生。有病多属胎毒。如一腊之脐风。百 之痰嗽。难治。恰半岁而真搐
者凶。未一岁而流丹者死。是也。况初生之儿。肠胃薄小。血气未充。药石则难进也。荣卫
微弱。筋脉未实。针灸则难用也。业幼科者。慎毋忽诸。
一小儿丹发于脸。眼中红肿。手不可近。三日死。
一小儿生下一月后。遍身虫疥浸淫湿烂。其皮如脱。日夜啼。忽一日。其疮尽隐。发搐
或问。胎禀不足之证。得于父母有生之初。如何医得。予曰。诸器破损者。尚可补之。
胎弱者。不可补之乎。贵得其要也。夫男女之生。受气于父。成形于母。故父母强者。生子
亦强。父母弱者。生子亦弱。所以肥瘦长短。大小妍媸。皆肖父母也。儿受父母之精血以生
。凡五脏不足者。古人用地黄丸主之。或曰。五脏不足。而专补肾何也。曰。太极初分。天
一生水。精血妙合。先生两肾。肾者五脏之根本。经曰。植木者必培其根。此之谓也。
或问胎毒之说。予曰。先贤论之详矣。盖人生而静。天之性也。感物而动。胎之欲也。
火也。故思虑之妄。火生于心。恚怒之发。火生于肝。悲哀之过。火生于肺。酒肉之餍。火
生于脾。淫佚之纵。火起于肾。五欲之火。隐于母血之中。即是毒也。男女交媾。精气凝结
。毒亦附焉。此胎毒之原也。如谓儿在母腹。饥则食母之血。渴则饮母之血。及其破胎而出
。口有余血。拭之不净。咽下腹中。是谓胎毒。斯言也。一人倡之。百人和之。未有辩之者
。此书之不可尽信也。胚胎资始。父精所生。身体资生。母血所养。是水珠露花。男女渐分
，毫发筋骨。形象斯具。诞弥厥月。气足形全。乃破胎而生矣。初在母腹之时。如鸟之雏。
伏于卵壳之中。何所饮食也。口内之血。乃母临产。恶露渍入口中。未必是母腹中所衔之血
也。既云咽下腹中。则入于大肠界。从大便出矣。安得留
一儿颈细。其父尝问于予。可养何如。予曰。颈者头之茎也。颈细则不能任元。在父母
调养之。八岁后再议。至五岁死。
一儿解颅。未一岁认字念书。父母甚爱之。予曰。此儿胎禀不足。肾虚颅解。真阳弱矣
。聪慧早发。真阳泄矣。恐遗父母忧。未一岁而发搐死。
一儿周岁后多笑。予曰。此儿难养。父问其故。予曰。肾为水。心为火。水阴火阳。阴
常不
。待人引之而笑者。此有情也。见人自笑者。此无情也。后以痘疮而死。
一儿头缝四破。皮光而急。两眼甚小。予曰。脑者髓之海也。肾主骨髓。中有伏火。故
髓热而头破。额颅大而眼楞小也。宜服地黄丸。父母不信。至十四岁而死。
一儿发搐。五日不醒。药石难入。予针其三里合谷人中而醒。父母喜曰。吾儿未出痘疹
。愿
。可保无事。若在近年不敢许。次年果以痘疹死。
一儿四岁。出痘时颈软头倾。不能自举。予谓其父曰。此儿胎禀不足。疮毒正发。壮火
食气。亟补元气。使痘易发易压。幸而保全。再补其阴。不然恐难出二八数也。乃大作调元汤。
连服之获安。
有三因所生者。衣太浓则热。太薄则冷。冷热之伤。此外因也。乳多则饱。乳少则饥。
之伤。此内因也。客忤中恶。坠仆折伤。此不内不外因也。若顺乎天时。适其寒温。则不伤
冷伤热矣。慎择乳母。节其饮食。则不伤饥饱。调护之久。爱惜之深，必无纵弛之失也。慎
勿使庸医。妄投汤药。误儿性命。
小儿从初生到一周岁期间患的疾病，都称为胎疾。
气，属于阳；血，属于阴。人生命的产生，禀受于父亲的是气，这是阳的变化；形成形体的是母亲的血，这是阴的合和。阴阳结合形成了人的身体。身体之中，形藏有四个：头面是一个；耳目口鼻是第二个；手足是第三个；皮肉筋骨是第四个。神藏有五个：心藏神，肝藏魂，脾藏意，肺藏魄，肾藏志，这就是所谓的九脏。这九个脏腑，都是父母一体分化而来的。形体拘束于某一偏侧，不能相互贯通，这是阴的静性；精神随着外物感应而活动，这是阳的动性。婴儿刚出生时，只是一块血肉罢了，虽然有形体但没有功能，虽然有五脏但还没有神志，就像空的脏腑一样。等到变蒸（婴幼儿生长发育过程中的生理现象）之后，皮肉筋骨逐渐坚固，声音、颜色、气味、味道感知逐渐增强，志向、意识、智能逐渐开发，知觉运动能力具备，才开始成为儿童。这是天地化生万物的本心，至诚不息的表现。
有的疾病是因为父母禀赋遗传而生的，如胎弱、胎毒。所谓胎弱，是指禀受的气不足。子女与父母是一体分开的，比如受肺气而生皮毛，如果肺气不足，则皮肤脆薄、怕冷、毛发不生；受心气而生血脉，如果心气不足，则血液不能荣华面色，面无光彩；受脾气而生肌肉，如果脾气不足，则肌肉不丰，手足消瘦；受肝气而生筋脉，如果肝气不足，则筋不能约束骨骼，关节活动不利；受肾气而生骨骼，如果肾气不足，则骨骼软弱。这些都属于胎禀的病证，应当根据各脏腑气的虚实来治疗。肝肾心气不足的，宜用六味地黄丸主治；脾肺不足的，宜用参苓白术丸主治。子女的羸弱，都是因为父母精血的虚弱所致。所谓“父强母弱，生女必弱；父弱母强，生男必弱”就是这个道理。所以，如果孩子出现头颅破裂、囟门不合、神情倦怠、气息微弱、颈部软弱、头部倾斜、手足痿弱无力、牙齿生长不齐、头发不长黑、行走坐立需要人扶持等情况，都属于胎禀不足，都适宜用六味地黄丸主治。
所谓胎毒，是精血中的火毒，也就是命门相火的毒邪。命门，在男子用来藏精，在女子用来系胞（联系子宫）。参考戴元礼（东瘤应为戴元礼之误或别称，此处依原文保留语境，实指朱丹溪学派观点）和朱丹溪关于胎毒的论述，治疗方法就可以知道了。古代方剂中有解毒的方子，如黄连甘草法，又有育婴解毒延龄丹，都是良方。我新创立一方，采用朱丹溪三补丸的方义，黄芩、黄连各半生用、半酒炒，甘草半生半炙，各等分为末，用雪水制成梧桐子大小的丸药，以朱砂、雄黄为衣，名叫生熟解毒丸。让小儿每天服用效果很好。
有的病是由胎毒引起的，如虫疥、流丹（丹毒）、浸淫湿疮、痈疖结核、重舌、木舌、鹅口疮、口疮，以及胎热、胎黄、胎惊之类。婴儿刚出生时的疾病多属于胎毒，如满月内的脐风、百日内痰嗽，难以治疗；刚半岁发生真搐（惊风）预后凶险；未满一岁发生流丹会死亡，说的就是这种情况。况且初生的婴儿，肠胃薄弱细小，血气未充盈，药物难以进服；营卫之气微弱，筋脉未坚实，针灸也难以施用。从事儿科的医生，千万不要忽视这些情况。
有一个小孩，丹毒发于面部，眼中红肿，手不能靠近，三天后死亡。
另一个小孩出生后一个月，全身长满虫疥，浸淫湿烂，皮肤像脱落一样，日夜啼哭。忽然有一天，疮疹全部隐没，却发生了抽搐。
有人问：胎禀不足的证候，得之于父母受孕之初，怎么能医治呢？我说：各种器具破损了，还可以修补，胎弱的孩子难道不可以补益吗？关键在于掌握要领。男女出生，禀受气于父亲，成形于母亲。所以父母强健的，生子也强健；父母虚弱的，生子也虚弱。因此肥瘦、长短、大小、美丑，都相似于父母。孩子禀受父母的精血而生，凡是五脏不足的，古人用地黄丸主治。有人问：五脏不足，为什么专门补肾呢？我说：太极初分时，天一生水，精血妙合，先生出两肾。肾是五脏的根本，《内经》说：“种植树木的人一定要培育树根”，说的就是这个道理。
又有人问胎毒的说法，我说：先贤已经论述得很详细了。大概人生下来本性是静的，这是天的本性；感于外物而动，是胎中的欲望。这是火。所以思虑妄动，火生于心；愤怒发作，火生于肝；悲哀过度，火生于肺；酒肉饱食，火生于脾；淫佚放纵，火起于肾。五欲之火，隐藏在母血之中，就是毒。男女交媾，精气凝结，毒也随之附着，这就是胎毒的来源。如果说孩子在母腹中，饿了吃母亲的血，渴了喝母亲的血，等到破胎而出，口中有残留的血，擦拭不干净，咽下腹中，这就叫胎毒。这种说法，一个人倡导，百人附和，没有人辩驳过它。这本书里的话不能完全相信。胚胎开始形成，由父精所生；身体滋养成长，由母血所养。就像水珠、露水、花一样，男女逐渐区分，毫发筋骨，形象才具备。经过十月怀胎，气足形全，然后破胎而生。起初在母腹中时，就像鸟雏伏在蛋壳中，有什么饮食呢？口中的血，乃是母亲临产时，恶露渍入口中，未必是母腹中所含的血。既然说咽下腹中，那就进入大肠界，会从大便排出，怎么能留存下来呢？
有一个小孩脖子细，他的父亲曾经问我，这孩子能养活吗？我说：脖子是头的茎干，脖子细就不能支撑头部，在于父母的调养，八岁后再议。结果五岁时死亡。
有一个小孩囟门不合（解颅），不到一岁就能认字念书，父母非常喜爱。我说：这个孩子胎禀不足，肾虚导致囟门不合，真阳虚弱了。聪慧过早发育，是真阳泄露了，恐怕会给父母留下忧愁。果然不到一岁就发生抽搐死亡。
有一个小孩周岁后经常笑，我说：这个孩子难养。父亲问原因，我说：肾属水，心属火，水是阴，火是阳，阴常不足，需要阳来引导才能笑。见人自己笑的，这是无情（心神失守）。后来因为痘疮死亡。
有一个小孩头顶骨缝四散开裂，头皮光亮紧绷，两眼很小。我说：脑是髓的海，肾主骨髓，其中有伏火，所以髓热而头骨开裂，额头大而眼眶小。适宜服用地黄丸，父母不信，到十四岁时死亡。
有一个小孩发生抽搐，五天不醒，药物难以进入。我针刺足三里、合谷、人中穴使他苏醒。父母高兴地说：我的孩子还没出痘疹，希望保住无事。如果在近年我不敢保证。次年果然因痘疹死亡。
有一个小孩四岁，出痘疹时颈部软弱、头部倾斜，不能自己举起。我对他父亲说：这个孩子胎禀不足，疮毒正在发作，壮火消耗元气，急需补益元气，使痘疹容易发出且顺利收靥。幸而保全性命，再补其阴，不然恐怕活不过十六岁（二八之数）。于是大量使用调元汤，连续服用得以平安。
有三种病因产生的疾病：衣服太厚则热，太薄则冷，冷热伤害，这是外因；乳汁过多则饱，过少则饥，饥饱伤害，这是内因；客忤、中恶、坠仆折伤，这是不内不外因。如果顺应天时，适应寒温，就不会受冷热伤害；谨慎选择乳母，节制饮食，就不会受饥饱伤害。长期调护，爱惜深厚，必然没有纵容懈怠的失误。千万不要让庸医妄投汤药，误儿性命。
Diseases occurring in infants from birth to one year of age are all referred to as fetal diseases (Tai Ji).
Qi is Yang; Blood is Yin. The generation of human life involves receiving Qi from the father, which represents the transformation of Yang, and forming the physical body from the mother's blood, which represents the union of Yin. The interaction of Yin and Yang forms the body. Within the body, there are four Form Stores (Xing Zang): the head and face constitute one; the eyes, ears, mouth, and nose constitute two; the hands and feet constitute three; the skin, flesh, sinews, and bones constitute four. There are five Spirit Stores (Shen Zang): the Heart stores Shen (Spirit), the Liver stores Hun (Ethereal Soul), the Spleen stores Yi (Intellect), the Lung stores Po (Corporeal Soul), and the Kidney stores Zhi (Willpower). These nine stores are all differentiated from the unity of the parents. The form is confined to specific parts and cannot intercommunicate freely, reflecting the stillness of Yin; the spirit moves in response to stimuli, reflecting the activity of Yang. An infant at birth is merely a mass of flesh and blood; although it has form, it lacks function; although it has the five Zang organs, it lacks Shen, resembling empty stores. After the period of Bian Zheng (physiological developmental stages in infancy), the skin, flesh, sinews, and bones gradually become firm; sensory perceptions of sound, color, smell, and taste gradually develop; will, consciousness, and intelligence gradually emerge; perception and movement abilities mature, marking the transition to childhood. This reflects the creative heart of Heaven and Earth, sincere and unceasing.
Some conditions arise from parental endowment, such as Fetal Weakness (Tai Ruo) and Fetal Toxin (Tai Du). Fetal Weakness refers to insufficient inherited Qi. Since children are a differentiation of their parents' unity, for instance, receiving Lung Qi to generate hair and skin: if Lung Qi is insufficient, the skin becomes fragile and thin, cold intolerance occurs, and hair fails to grow. Receiving Heart Qi to generate blood vessels: if Heart Qi is insufficient, blood fails to nourish the complexion, resulting in a lackluster face. Receiving Spleen Qi to generate muscle: if Spleen Qi is insufficient, muscles fail to develop, leading to emaciated limbs. Receiving Liver Qi to generate sinews: if Liver Qi is insufficient, sinews fail to bind the bones, causing joint dysfunction. Receiving Kidney Qi to generate bones: if Kidney Qi is insufficient, bones become soft. These are diseases of fetal endowment and should be treated by addressing the deficiency of the respective Zang Qi. For deficiencies in Liver, Kidney, and Heart Qi, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) is indicated. For Spleen and Lung deficiencies, Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) is indicated. The child's emaciation stems from the weakness of the parents' Essence and Blood. As stated, "If the father is strong and the mother weak, the daughter will likely be frail; if the father is weak and the mother strong, the son will likely be frail." Therefore, symptoms such as cranial suture separation, fontanelle non-closure, lethargy, weak respiration, neck flaccidity, head drooping, limb flaccidity, irregular tooth eruption, dark hair failure, and the need for support when walking or sitting indicate fetal endowment insufficiency and are all treated with Liu Wei Di Huang Wan.
Fetal Toxin refers to the Fire Toxin within Essence and Blood, specifically the toxin of the Ministerial Fire (Ming Men Huo) residing in the Ming Men (Gate of Life). In men, the Ming Men stores Essence; in women, it connects to the uterus (Bao Luo). Referring to the theories of Dai Yuanli and Zhu Danxi regarding Fetal Toxin, treatment methods can be understood. Ancient formulas include detoxifying prescriptions such as the Huang Lian Gan Cao Method and Yu Ying Jie Du Yan Ling Dan, both of which are effective. I have newly formulated a prescription based on Zhu Danxi's San Bu Wan: Huang Qin (Scutellariae Radix) and Huang Lian (Coptidis Rhizoma) are half raw and half wine-fried; Gan Cao (Glycyrrhizae Radix et Rhizoma) is half raw and half honey-roasted. All ingredients are equal in proportion, ground into powder, and formed into pills the size of hemp seeds using snow water, coated with Zhu Sha (Cinnabar) and Xiong Huang (Realgar). This is named Sheng Shu Jie Du Wan (Raw-Cooked Detoxifying Pill). It is beneficial for infants to consume this daily.
Conditions caused by Fetal Toxin include insect scabies, erysipelas (Liu Dan), oozing eczema, carbuncles, boils, lymphatic nodules, double tongue, wooden tongue, thrush, oral ulcers, as well as Fetal Heat, Fetal Jaundice, and Fetal Convulsion. Diseases appearing shortly after birth often belong to Fetal Toxin. For example, neonatal tetanus (Umbilical Wind) within one month and phlegm-cough within 100 days are difficult to treat; true convulsions at six months are ominous; erysipelas before one year leads to death. Moreover, newborns have thin and small intestines and stomachs, and unfulfilled Qi and Blood, making herbal administration difficult; their Ying and Wei (Nutritive and Defensive) Qi are weak, and sinews and vessels are not solid, making acupuncture difficult. Pediatricians must not neglect these factors.
Case 1: An infant developed erysipelas on the face with severe redness and swelling of the eyes, unable to tolerate touch, and died after three days.
Case 2: An infant, one month old, suffered from widespread insect scabies and oozing eczema, with skin peeling off, crying day and night. Suddenly, the sores disappeared, but convulsions ensued.
Q: How can Fetal Endowment Insufficiency, originating from conception, be treated?
A: Broken vessels can be repaired; why not Fetal Weakness? The key lies in grasping the essentials. Humans receive Qi from the father and form from the mother. Strong parents produce strong offspring; weak parents produce weak offspring. Thus, physique and appearance resemble the parents. Children are born from parental Essence and Blood. For deficiencies in the five Zang organs, ancients used Di Huang Wan (Rehmannia Pill).
Q: Why specifically tonify the Kidneys for five Zang deficiencies?
A: At the beginning of Taiji, Heaven generates Water. When Essence and Blood unite, the two Kidneys are formed first. The Kidneys are the root of the five Zang organs. The Classic states, "Those who plant trees must cultivate the roots," which applies here.
Regarding the theory of Fetal Toxin: Ancients discussed this in detail. Human nature is originally quiet, which is the Nature of Heaven; moving upon contact with things is the desire of the fetus. This is Fire. Thus, excessive thinking generates Fire in the Heart; anger generates Fire in the Liver; excessive grief generates Fire in the Lung; overindulgence in food and drink generates Fire in the Spleen; sexual excess generates Fire in the Kidney. The Fire of the five desires hides in the maternal blood, becoming toxin. During intercourse, when Essence and Qi condense, the toxin attaches to it. This is the origin of Fetal Toxin. Some claim that while in the womb, the fetus eats/drinks maternal blood, and upon birth, residual blood in the mouth is swallowed, causing Fetal Toxin. This view was initiated by one person and echoed by many without refutation. However, this book's assertions cannot be fully trusted. Embryonic formation begins with paternal Essence; bodily nourishment comes from maternal Blood. Like dewdrops or flowers, male and female distinctions gradually appear, and hair, sinews, bones, and features take shape. After ten months, Qi is full and form is complete, then birth occurs. Initially in the womb, like a chick in an egg, where does it eat or drink? The blood in the mouth is likely lochia entering during delivery, not necessarily blood swallowed in the womb. If swallowed into the abdomen, it would enter the large intestine and exit via stool; how could it remain?
Case 3: An infant had a thin neck. The father asked if he could survive. I replied, "The neck is the stem of the head; a thin neck cannot support the head. It depends on parental care; we will reassess at age eight." He died at age five.
Case 4: An infant had cranial suture separation (Jie Lu) but could recognize characters and read before one year. The parents loved him greatly. I said, "This child has fetal endowment insufficiency, Kidney deficiency causing fontanelle separation, and weak True Yang. Early brilliance indicates leakage of True Yang. It may cause sorrow for the parents." He indeed died of convulsions before one year.
Case 5: An infant smiled excessively after one year. I said, "This child is hard to raise." The father asked why. I said, "Kidney is Water, Heart is Fire. Water is Yin, Fire is Yang. Yin is often deficient and needs Yang guidance to smile. Smiling spontaneously upon seeing people indicates loss of emotion (Shen instability)." He later died of smallpox.
Case 6: An infant had open cranial sutures, tight shiny scalp, and small eyes. I said, "The brain is the sea of Marrow. The Kidneys govern Marrow. Hidden Fire causes Marrow heat, leading to cranial splitting, large forehead, and small eye sockets. Use Di Huang Wan." The parents refused. He died at age fourteen.
Case 7: An infant had convulsions and remained unconscious for five days, unable to take medicine. I acupunctured Zusanli (ST36), Hegu (LI4), and Renzhong (GV26), and he woke up. The parents rejoiced, saying, "My child has not yet had smallpox; please ensure safety." I said, "I dare not guarantee this in recent years." Indeed, he died of smallpox the following year.
Case 8: A four-year-old had neck flaccidity and head drooping during smallpox eruption, unable to lift his head. I told the father, "This child has fetal endowment insufficiency. The pathogenic toxin is erupting. Excessive Fire consumes Qi. Urgently tonify Original Qi to facilitate eruption and resolution. Fortunately, he survived. Now tonify Yin, otherwise he may not reach sixteen years (2x8)." I prescribed Diao Yuan Tang (Regulate Origin Decoction) heavily. Continuous administration led to recovery.
There are three categories of causes: Clothing too thick causes heat; too thin causes cold. Cold/Heat injury is an External Cause. Breast milk too much causes fullness; too little causes hunger. Hunger/Fullness injury is an Internal Cause. Shock from strangers, evil invasion, falls, and fractures are Neither-Internal-Nor-External Causes. By following seasonal changes and adapting to temperature, one avoids Cold/Heat injury. Carefully selecting wet nurses and regulating diet avoids Hunger/Fullness injury. Long-term care and deep affection prevent negligence. Do not allow quacks to prescribe arbitrary decoctions, endangering the child's life.