小儿生下,三十二日一变,六十四日一蒸。变者,变生五脏;蒸者,蒸养六腑;长血气
而生精神、益智能也,积五百七十六日乃除。蒸变必烧热,其状似惊,耳尻俱冷,口内上唇
有白泡,如鱼目粟米大者是也。蒸变之候,口唇舌色俱照寻常无异,烧热虽有重轻,精神却
不丧失,口气必不暴戾,轻则三四日解,重则六七日除,不可妄投药饵,听其自愈。
脾实热,鼻必红燥,唇必红燥而裂,牙之里旁必掀肿而红紫,大便色必深黄,或身热不
食,或精神疲倦,或热吐、热泻,治用伏龙肝五钱,熟石膏一钱,服之自愈。脾虚本无热,
所以热者虚使然耳,初由脾虚而复伤饮食,其候身微热,鼻微红而微汗,口虽渴而唇必惨白
,口气必微弱。以手按之而不蒸手,或食而不化,或见食而不喜食,或泻,或吐,此皆虚热
之症也。治宜补脾为主,用六君子汤加藿香。有脾虚腹肿,或因伤食而起,以指弹之如鼓声
,以手捺之如绵软,切不可用通药,宜用六君子汤加浓朴,或脚肿加大腹皮。如腹肿弹之不
响,捺之铁硬,上有青筋,作肚大青筋论。四肢俱肿,作肿胀论。如脾虚腹肿,一用通药,十有
十死,连用六君子汤十剂自消。
脾湿,由脾弱不能制水,水反侮土。其候面暗而不泽,唇晦而不红,或痰易动而不化;
或食稍伤而即泻,泻下澄清如水,或身上发热,此脾湿症也。治用苍术、白术、陈皮、白茯
苓、半夏,甘草。如脾土伤食而生痰者,治用消导二陈汤加炮姜。
小儿出生后,每过三十二天发生一次“变”,每过六十四天发生一次“蒸”。“变”,是指五脏形态与功能的转变;“蒸”,是指六腑得到滋养;这是为了生长血气,从而产生精神、增进智力,经过五百七十六天后这一过程才结束。
发生“蒸变”时必然会出现发热,其症状表现类似惊风,耳朵和尾骶部(尻)都发凉,口腔内上唇有白色小泡,大小像鱼眼或粟米一样。在“蒸变”期间,口唇和舌头的颜色与平时无异,虽然发热有轻重之分,但精神并未丧失,口气也不暴戾刺鼻。轻症三四天即可缓解,重症六七天即可消除,不可胡乱投药,听任其自愈。
脾实热证,鼻子必然红且干燥,嘴唇必然红且干燥甚至开裂,牙齿内侧边缘必然红肿且呈红紫色,大便颜色必然深黄,或者身体发热而不进食,或者精神疲倦,或者热性呕吐、热性腹泻。治疗使用伏龙肝五钱,熟石膏一钱,服用后自愈。
脾虚证本来没有实热,之所以出现热象,是因为虚损所致。起初由脾虚又加上饮食损伤,其表现为身体微热,鼻子微红且微汗,口中虽觉口渴但嘴唇必然惨白,口气必然微弱。用手触摸腹部感觉不到热气蒸腾,或者吃了东西不消化,或者看见食物却不喜吃,或者腹泻,或者呕吐,这些都是虚热的症状。治疗应以补脾为主,使用六君子汤加藿香。
如果有脾虚导致腹部肿胀,或因伤食引起,用手指弹击腹部声音如鼓声,用手按压则像棉絮般柔软,切不可使用通利攻下的药物,宜用六君子汤加厚朴;如果伴有脚肿,可加大腹皮。如果腹部肿胀,弹击不响,按压坚硬如铁,上面有青色筋脉显露,按“肚大青筋”论治。如果四肢全部肿胀,按“肿胀”论治。如果是脾虚导致的腹部肿胀,一旦使用通利攻下的药物,十例必死十例;连续服用六君子汤十剂,肿胀自然消退。
脾湿证,是由于脾弱不能制约水液,水反侮土(脾)。其表现为面色晦暗无光泽,嘴唇晦暗不红润,或者痰液易动但不能化解;或者稍微饮食不慎即发生腹泻,泻下物清澈如水,或者身上发热,这就是脾湿的症状。治疗使用苍术、白术、陈皮、茯苓、半夏、甘草。如果是脾土受伤、饮食停滞而生痰者,治疗使用消导二陈汤加炮姜。
After birth, the infant undergoes a transformation every 32 days and a "steaming" process every 64 days. The "transformation" refers to the changes in the Five Zang Organs (Zang organs); the "steaming" refers to the nourishment of the Six Fu Organs (Fu organs). This process generates blood and Qi, thereby producing Spirit (Shen) and enhancing intelligence. It concludes after 576 days.
During the "steaming" and "transformation" periods, fever is inevitable. The presentation resembles Wind-Stroke or Convulsions (Jing Feng), with cold ears and sacrum, and white blisters on the upper lip inside the mouth, sized like fish eyes or millet grains. During this period, the color of the lips and tongue remains normal. Although the fever may vary in severity, the Spirit is not lost, and the breath is not foul or aggressive. Mild cases resolve in 3–4 days, and severe cases in 6–7 days. One should not administer medicine recklessly but allow it to heal spontaneously.
In Spleen Excess Heat patterns, the nose is necessarily red and dry, the lips are red, dry, and cracked, the gums behind the teeth are swollen, red, and purplish, and the stool is necessarily dark yellow. Alternatively, there may be body heat with anorexia, mental fatigue, heat-type vomiting, or heat-type diarrhea. Treatment uses Wulonggan (Furnace Earth, 5 qian) and Shushi Gao (Calcined Gypsum, 1 qian), which leads to spontaneous recovery.
Spleen Deficiency patterns inherently lack excess heat; any heat present is due to deficiency. Initially caused by Spleen Deficiency compounded by dietary injury, the manifestations include slight body heat, slightly red nose with slight sweating, thirst with pale lips, and weak breath. Palpation of the abdomen reveals no heat radiating from the hands. Symptoms may include indigestion after eating, aversion to food despite seeing it, diarrhea, or vomiting. These are all symptoms of Deficiency Heat. Treatment should focus on tonifying the Spleen, using Liujunzi Tang (Six Gentlemen Decoction) with Huoxiang (Patchouli).
If abdominal swelling arises from Spleen Deficiency or dietary injury, tapping the abdomen produces a drum-like sound, and palpation feels soft like cotton. Do not use purgatives or draining agents. Instead, use Liujunzi Tang with Houpo (Magnolia Bark); if accompanied by leg edema, add Dafupi (Areca Peel). If the abdominal swelling does not resonate when tapped and feels hard as iron upon palpation, with visible blue veins on the surface, it is classified under "Abdominal Distension with Blue Veins." If all four limbs are swollen, it is classified under "Swelling" (Zhong Zhang). If Spleen Deficiency causes abdominal swelling, the use of purgatives results in mortality in ten out of ten cases. Continuous administration of Liujunzi Tang for ten doses will cause the swelling to subside naturally.
Spleen Dampness arises because the weak Spleen cannot control Water, leading to Water insulting Earth. Manifestations include a dull, lusterless complexion, dark and non-red lips, phlegm that moves easily but fails to transform, diarrhea immediately following minor dietary indiscretion with clear watery stools, or low-grade body heat. This constitutes the Spleen Dampness pattern. Treatment uses Cangzhu (Atractylodes Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Chenpi (Tangerine Peel), Fuling (Poria), Banxia (Pinellia Tuber), and Gancao (Licorice Root). If Spleen Earth is injured by food stagnation generating phlegm, treatment uses Xiaodao Erchen Tang (Digestive Two-Aged Phlegm Decoction) with Paojiang (Prepared Ginger).