小儿变蒸。变者变其情智。蒸者蒸其血脉。大抵三十二日为一变。每经变毕。则情智异常。
全婴方论云。变蒸者。以长气血也。变者上气。蒸者发热。轻则体热虚惊。耳冷KT 冷。微汗。
唇生白泡。三日可愈。重者寒热。脉乱。腹疼啼叫。不能乳食。食即吐。五七日方愈。变蒸之时。
不欲惊动。当其时有热微惊。慎不可治及灸刺。但熟视之。若良久不已。少与紫丸微下。热歇便
止。若于变蒸之中。加以时行温病。或非变蒸而得时行病者。其证皆相似。惟耳及尻通热。口上
无白泡。当先服黑散以发其汗。汗出温粉粉之。热歇便瘥。若犹不除。乃与紫丸微下之。小儿禀
虚。在所不免。勿药可也。尝见小儿变蒸发热有痰。投以抱龙丸。卒至不救。若不热不蒸。略无
证候而暗变者。禀气壮实故也。
小儿胎证。谓胎热。胎寒。胎黄。胎肥。胎弱。是也。胎热者。生下有血色。旬日之间。目
闭面赤。眼胞肿。啼叫惊烦。壮热溺黄。
大便色黄。急欲食乳。此在胎中受热。及膏粱内蕴。宜用清胃散之类。胎寒者。初生面色 白。
啼声低小。或手足挛屈。或口噤不开。此母气虚寒。或在胎时。母过食生冷。或感寒气。宜用五
味异功散之类。胎黄者体目俱黄。小便秘涩。不乳啼叫。或腹膨泄泻。此在胎时。母过食炙爆辛
辣。致生湿热。宜用泻黄散之类。胎肥者。肌肉禀浓。目睛粉红。弥月后渐瘦。五心烦热。大便
不利。口吻流涎。此受母之胃热所致也。乳母服大连翘汤。儿亦饮少许以疏利之。胎弱者面无精
光。肌体瘦薄。身无血色。大便白水。时时哽气及哕。因父气不足者。六味地黄丸。因母气不足
者。八珍汤。母子并服。近世初生小儿。概与化毒丹。及黄连、犀角、贝母、甘草、朱砂之属。
殊不知此惟身面皆赤。胎禀多热毒者为宜。若身面皆白。胎禀虚寒。本来少毒者服之。反伐其始
生之气。多致夭枉。当用连皮胡桃肉三枚研极烂。橄榄核三枚烧存性。明雄黄研细水飞净三分。
甘草煎浓汁。和生白蜜数匙。研匀搅去滓。时时温服引出肾脏之毒。尝见服此者。多不出痘。即
出亦稀。而无苦寒伤胃之患。可不辨虚实寒热。而漫投化毒之剂乎。
小儿变蒸。变者变其情智。蒸者蒸其血脉。大抵三十二日为一变。每经变毕。则情智异常。
小婴儿的“变蒸”现象。“变”是指改变其情感和智力，“蒸”是指温煦其血脉。大致每三十二天完成一次“变”。每次“变”结束后，孩子的情感和智力会有所不同（有所进步）。
全婴方论云。变蒸者。以长气血也。变者上气。蒸者发热。轻则体热虚惊。耳冷KT 冷。微汗。
唇生白泡。三日可愈。重者寒热。脉乱。腹疼啼叫。不能乳食。食即吐。五七日方愈。变蒸之时。
不欲惊动。当其时有热微惊。慎不可治及灸刺。但熟视之。若良久不已。少与紫丸微下。热歇便
止。若于变蒸之中。加以时行温病。或非变蒸而得时行病者。其证皆相似。惟耳及尻通热。口上
无白泡。当先服黑散以发其汗。汗出温粉粉之。热歇便瘥。若犹不除。乃与紫丸微下之。小儿禀
虚。在所不免。勿药可也。尝见小儿变蒸发热有痰。投以抱龙丸。卒至不救。若不热不蒸。略无
证候而暗变者。禀气壮实故也。
《全婴方论》说：变蒸是为了生长气血。“变”表现为气息上升，“蒸”表现为发热。症状轻微的，身体发热、易受惊吓、耳朵和尾骨（尻）发凉、微微出汗、嘴唇上长出白色小泡，三天即可痊愈。症状严重的，出现忽冷忽热、脉搏紊乱、腹痛啼哭、无法吃奶进食，吃了就吐，需要五到七天才能痊愈。在变蒸期间，不希望受到惊吓干扰。如果当时有轻微发热和惊悸，千万不要进行治疗以及艾灸或针刺，只需仔细观察。如果长时间不停止，少量给予紫丸使其轻微通便，热退后便停止用药。如果在变蒸过程中，又感染了流行的温热病，或者并非变蒸而是感染了流行病，它们的症状都很相似，只是耳朵和尾骨都发热，嘴巴上没有白色小泡。这时应当先服用黑散来发汗，出汗后用温粉扑身，热退就好了。如果仍然不好转，再给紫丸轻微通便。小儿先天体质虚弱，这种情况在所难免，不用药也可以。我曾见过小儿变蒸发热且有痰，误用抱龙丸，最终导致无法挽救。如果不发热也不变蒸，几乎没有症状而暗中发育变化的，是因为禀赋之气壮实的原因。
小儿胎证。谓胎热。胎寒。胎黄。胎肥。胎弱。是也。胎热者。生下有血色。旬日之间。目
闭面赤。眼胞肿。啼叫惊烦。壮热溺黄。
大便色黄。急欲食乳。此在胎中受热。及膏粱内蕴。宜用清胃散之类。胎寒者。初生面色 白。
啼声低小。或手足挛屈。或口噤不开。此母气虚寒。或在胎时。母过食生冷。或感寒气。宜用五
味异功散之类。胎黄者体目俱黄。小便秘涩。不乳啼叫。或腹膨泄泻。此在胎时。母过食炙爆辛
辣。致生湿热。宜用泻黄散之类。胎肥者。肌肉禀浓。目睛粉红。弥月后渐瘦。五心烦热。大便
不利。口吻流涎。此受母之胃热所致也。乳母服大连翘汤。儿亦饮少许以疏利之。胎弱者面无精
光。肌体瘦薄。身无血色。大便白水。时时哽气及哕。因父气不足者。六味地黄丸。因母气不足
者。八珍汤。母子并服。近世初生小儿。概与化毒丹。及黄连、犀角、贝母、甘草、朱砂之属。
殊不知此惟身面皆赤。胎禀多热毒者为宜。若身面皆白。胎禀虚寒。本来少毒者服之。反伐其始
生之气。多致夭枉。当用连皮胡桃肉三枚研极烂。橄榄核三枚烧存性。明雄黄研细水飞净三分。
甘草煎浓汁。和生白蜜数匙。研匀搅去滓。时时温服引出肾脏之毒。尝见服此者。多不出痘。即
出亦稀。而无苦寒伤胃之患。可不辨虚实寒热。而漫投化毒之剂乎。
小儿的胎证，指的是胎热、胎寒、胎黄、胎肥、胎弱这几种情况。胎热，指婴儿出生时身上带有血色，十几天内眼睛紧闭、面色发红、眼睑肿胀、啼哭叫喊、惊恐烦躁、高热、小便黄、大便颜色黄、急切想吃奶。这是因为在母胎中受热，以及母亲体内膏粱厚味蕴结所致，适宜使用清胃散之类的方剂。胎寒，指刚出生时面色苍白、啼哭声低微细小，或者手足蜷缩拘挛，或者牙关紧闭不能张开。这是因为母亲体质虚寒，或者在怀孕时，母亲过多食用生冷食物，或者感受了寒气，适宜使用五味异功散之类的方剂。胎黄，指身体和眼睛都发黄，小便不通畅涩滞，不吃奶且啼哭叫喊，或者腹部胀大腹泻。这是因为在母胎时，母亲过多食用烧烤辛辣食物，导致产生湿热，适宜使用泻黄散之类的方剂。胎肥，指肌肉禀赋浓厚，眼珠呈粉红色，满月之后逐渐消瘦，手心脚心及心胸烦热，大便不通畅，嘴角流口水。这是受到母亲胃热的影响所致。乳母服用大连翘汤，婴儿也喝少许以疏通利导。胎弱，指面部没有光泽神采，肌体瘦弱单薄，身上没有血色，大便像白水一样，时常哽咽气和干呕。如果是父亲精气不足导致的，用六味地黄丸；如果是母亲精气不足导致的，用八珍汤。母子同时服用。近代以来，对刚出生的婴儿，一概给予化毒丹，以及黄连、犀角、贝母、甘草、朱砂这类药物。却不知道这些只适合全身和面部都发红、胎禀多有热毒的婴儿。如果全身和面部都发白，胎禀虚寒，本来就没有多少毒邪的婴儿服用，反而会损伤其初生的元气，大多导致早夭。应当用带皮的核桃仁三枚研磨至极烂，橄榄核三枚烧至存性，明雄黄研磨细并用水飞法净化至三分，甘草煎煮成浓汁，调和生白蜜几匙，搅拌均匀后滤去渣滓，不时温服以引出肾脏的毒邪。曾见到服用这个方子的婴儿，大多不出天花，即使出了也很稀疏，而且没有苦寒药物伤害胃气的弊端。怎么能不辨别虚实寒热，就随意投用化毒的药物呢？
Pediatric "Bian Zheng" (Developmental Changes and Steam-like Phenomena). "Bian" refers to the transformation of emotions and intelligence, while "Zheng" refers to the steaming/warming of blood vessels. Generally, every thirty-two days constitutes one cycle of "Bian". Upon completion of each "Bian", the child's emotional and intellectual state exhibits changes (advances).
The *Quan Ying Fang Lun* (Treatise on Infant Formulas) states: Bian Zheng serves to nourish Qi and Blood. "Bian" manifests as the rising of Qi, and "Zheng" manifests as fever. In mild cases, there is body heat, spontaneous fright, cold ears and buttocks (Kao), slight sweating, and white blisters forming on the lips; this resolves in three days. In severe cases, there are alternating chills and fever, chaotic pulse, abdominal pain with crying, inability to nurse or eat, and vomiting immediately after eating; this resolves in five to seven days. During the period of Bian Zheng, one should avoid startling or disturbing the child. If there is slight fever and fright during this time, treatment, moxibustion, or acupuncture must be strictly avoided; one should only observe carefully. If the symptoms persist for a long time, administer a small amount of Zi Wan (Purple Pill) to induce mild purgation; stop when the fever subsides. If, during Bian Zheng, an epidemic warm disease (Shi Xing Wen Bing) is superimposed, or if the illness is not due to Bian Zheng but rather an epidemic disease, the symptoms are similar. However, in these cases, both the ears and the buttocks are hot throughout, and there are no white blisters on the lips. One should first administer Hei San (Black Powder) to induce sweating, and apply warm powder to the skin after sweating; the condition improves when the fever subsides. If it still does not resolve, then administer Zi Wan (Purple Pill) for mild purgation. Since infants have congenital deficiency, this situation is inevitable, and medication may be omitted. I have seen cases where infants with fever and phlegm during Bian Zheng were given Bao Long Wan (Dragon Embracing Pill), leading to fatal outcomes. If there is no fever or steaming, and no obvious symptoms, yet development proceeds secretly, it is because the infant's constitutional Qi is robust.
Pediatric Fetal Syndromes refer to Fetal Heat, Fetal Cold, Fetal Jaundice, Fetal Obesity, and Fetal Weakness.
Fetal Heat: The newborn has a reddish hue to the skin. Within ten days, the eyes remain closed, the face is red, the eyelids are swollen, and the infant cries, calls out, shows signs of fright and irritability, has high fever, yellow urine, yellow stool, and urgently desires milk. This results from heat acquired in the womb and the accumulation of rich/greasy foods in the mother. It is suitable to use formulas like Qing Wei San (Stomach-Clearing Powder).
Fetal Cold: The newborn has a pale complexion, a low and quiet cry, or curled/flexed hands and feet, or clenched jaws that cannot open. This is due to the mother's deficient and cold constitution, or the mother consuming excessive raw/cold foods, or contracting cold pathogens during pregnancy. It is suitable to use formulas like Wu Wei Yi Gong San (Five-Ingredient Extraordinary Efficacy Powder).
Fetal Jaundice: Both the body and eyes are yellow, urination is difficult and scanty, the infant refuses milk and cries, or has abdominal distension and diarrhea. This results from the mother consuming excessive roasted, fried, and spicy foods during pregnancy, leading to damp-heat generation. It is suitable to use formulas like Xie Huang San (Draining-Yellow Powder).
Fetal Obesity: The muscles are thick and robust, the eyeballs appear pinkish-red. After one month, the infant gradually becomes thin, experiences heat in the palms, soles, and chest (Wu Xin Fan Re), has difficulty with bowel movements, and drools from the mouth corners. This is caused by receiving stomach heat from the mother. The nursing mother should take Da Lian Qiao Tang (Large Forsythia Decoction), and the infant should drink a small amount to promote unblocking and draining.
Fetal Weakness: The face lacks luster and vitality, the body is emaciated and thin, the skin lacks color, the stool resembles clear water, and the infant frequently gasps and hiccups. If caused by the father's insufficient Qi, use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill). If caused by the mother's insufficient Qi, use Ba Zhen Tang (Eight-Treasure Decoction). Both mother and infant should take them together.
In recent times, newborns are generally given Hua Du Dan (Toxin-Dissolving Pill), along with herbs such as Huang Lian (Coptis Rhizome), Xi Jiao (Rhinoceros Horn - note: banned/substituted in modern practice), Bei Mu (Fritillaria Bulb), Gan Cao (Licorice Root), and Zhu Sha (Cinnabar). Little do they know that these are only suitable for infants whose bodies and faces are entirely red and who have a fetal constitution prone to heat-toxins. If the body and face are white, indicating a deficient-cold fetal constitution with little inherent toxin, administering these drugs will instead damage the newly generated Qi, often leading to premature death. Instead, one should use three walnuts (with skin) ground into a fine paste, three olive pits charred until carbonized but retaining their nature, three fen of Ming Xiong Huang (Realgar) finely ground and purified by water flotation, mixed with concentrated decoction of Gan Cao (Licorice Root) and several spoons of raw white honey. Grind uniformly, strain off dregs, and administer warm doses occasionally to draw out toxins from the Kidney system. I have observed that infants taking this remedy rarely develop smallpox, or if they do, the eruption is sparse, without the harm of bitter-cold herbs damaging the Stomach. How can one indiscriminately administer toxin-dissolving agents without distinguishing between deficiency/excess and cold/heat?