变蒸者，小儿生三十二日为一变，再变为一蒸，总五百七十六日。变蒸方足，凡变
蒸身热而脉乱，汗不出，不欲食，甚则烦啼躁渴，轻者五日解，重者八日解。其候与伤
寒相似，但变蒸则耳冷，上唇发 ，状如浊珠。若寒邪则腹中痛，啼叫不绝为异大都此
乃长养气血，滋荣五脏，不可妄加施治，唯宜秘方至宝丹（见胎热）常服。若不乳多啼，或寒
热间作，阴阳不升降，指迷汤（见胎寒）消息调之。
钱氏云∶一变肾，二变膀胱，三变心，四变小肠，五变肝，六变胆，七变肺，八变大
肠，九变脾，十变胃。《宝鉴》云∶初变肝，二变肺，三变心，四变脾，五变肾，二说不
同，其胶滞则一。夫人当长养气血之时，阴阳变换，五行颠倒，斯理至微，一用后天推
测分发，不足见造化之神妙矣。
咽喉与肺胃相接，为出入枢要，种种之症，与大人不同。大抵由热毒蕴积，致生风
痰，壅滞不散，为疮为肿，甚至吐咽不通，治宜桔梗汤。或牛蒡子汤，先去风痰，然后解
其热毒，次则以上清丸时时噙化服之亦佳。
肉鹅者，太阳少阴之火，为风寒壅遏，关隘不通，留连发肿，痰涎稠浊，疼痛难堪，用
大乌梅一个去核，纳入蜗牛一条，灰火煨透碾末，刺破鹅肿点之，或服清道汤、山豆根
汤。先天虚弱火泛者，巴戟汤俱效。
喉癣者，风火郁滞喉间，蒸湿生虫，或疼或痒，干燥枯涸，甚至面红耳热而不可忍，
百部汤治之，苡仁汤调之。
牛蒡子汤 治风热上壅，咽喉肿痛，或生乳鹅。
元参 升麻 黄芩 桔梗 木通 甘草 犀角（镑） 大力子
桔梗汤 咽喉微觉肿痛，声破难语神效。
桔梗 甘草 黄芩 当归 麻黄 桂枝 白僵蚕 马勃
上清丸 咽喉肿痛，痰涎壅塞妙方。
薄荷（一斤） 川芎 防风（各二两） 桔梗 砂仁（各五钱） 甘草（四两）
蜜丸弹子大，不拘时噙服，卧时更佳。
清道汤
花粉 元参 柴胡 芍药 甘草 麻黄 桔梗 山豆根
陈远公破隘汤即此。
山豆根汤
射干 麦冬 花粉 甘草 元参 山豆根
巴戟汤
熟地 茯苓 巴戟 麦冬 五味子
程汉章曰∶少阴之火，直如奔马，非借降泄，何以引而归元？此方加入牛膝、泽泻、山萸尤妙。
百部汤
白微 紫菀 百部 元参 麦冬 甘草 五味子 大力子 白芥子
苡仁汤
熟地 麦冬 苡仁 山萸 桑皮 贝母 生地 甘草
远公曰∶服百部汤虫死，服苡仁汤火息，更入肉桂数分，服二剂，不再发。
玉露汤 治初生喉肿。
陈茶叶 川黄连 荆芥穗 薄荷 甘草
吹药方
胆矾 牛黄 冰片 皂角灰（各一分） 麝（五厘）
玉锁匙 治风热喉闭，并缠喉风。
硼砂 僵蚕（各一钱） 焰硝（一钱五分） 冰片（三厘）
碾细盛固，临用取出，吹喉中甚效。
京师中一医，持秘方丸药治喉闭，获利其广。惟用拭面肥皂，金箔为衣，偶为翁曙
公识破，遇江湖无药处，以此灌之，稠痰尽吐，危症立苏。
咽喉以下十六门，名曰襟症，指孩抱中言也。然余治法，则自初生至少壮，广为设
立焉。若夫虚劳相火炽甚，致喉齿耳目等症者，载余医贯别裁中，始不及。
变蒸，是指婴儿出生后三十二天为一次“变”，再经过一段时间为一次“蒸”，总共经历五百七十六天。在变蒸即将结束时，凡是出现身体发热、脉搏紊乱、无汗、食欲不振，甚至烦躁啼哭、躁动口渴的症状，轻者五天自愈，重者八天自愈。其症状表现与伤寒相似，但变蒸时耳朵发凉，上唇出现类似浑浊珠子的白点。如果是寒邪致病，则会出现腹痛、持续啼叫等不同之处。大体而言，这是为了长养气血、滋润五脏，不可随意施加治疗，只宜常服秘方至宝丹（见胎热章节）。如果出现不吃奶、多啼哭，或寒热交替发作、阴阳之气升降失调的情况，可用指迷汤（见胎寒章节）斟酌调理。
钱乙说：一变对应肾，二变对应膀胱，三变对应心，四变对应小肠，五变对应肝，六变对应胆，七变对应肺，八变对应大肠，九变对应脾，十变对应胃。《小儿药证直诀》（简称《宝鉴》）说：初变对应肝，二变对应肺，三变对应心，四变对应脾，五变对应肾。两种说法不同，但其僵化固守的道理是一致的。人在长养气血之时，阴阳发生变换，五行次序颠倒，这道理极其精微，如果只用后天的理论去推测分析，不足以体现造化的神妙。
咽喉与肺、胃相连，是气机出入的关键枢纽，各种病症与成人不同。大体上是由热毒蕴结积聚，导致生风痰，壅滞不散，形成疮疡或肿胀，甚至吞咽不通，治疗适宜用桔梗汤。或者用牛蒡子汤，先祛除风痰，然后解除热毒，随后再用上清丸时时含服，效果也很好。
乳鹅（一种喉痹），是太阳经和少阴经的火邪，被风寒壅遏阻滞，关隘不通，停留并发肿，痰涎稠浊，疼痛难忍，可用一个大乌梅去核，纳入一条蜗牛，在灰火中煨透后碾成粉末，刺破乳鹅的肿胀处点涂，或者服用清道汤、山豆根汤。先天虚弱导致虚火上泛的，巴戟汤都有效。
喉癣，是风火郁滞于喉间，湿热熏蒸生虫，或痛或痒，干燥枯涸，甚至面部发红、耳朵发热而难以忍受，用百部汤治疗，苡仁汤调理。
牛蒡子汤：治疗风热上壅导致的咽喉肿痛，或生成乳鹅。
药材：玄参、升麻、黄芩、桔梗、木通、甘草、犀角（镑片）、大力子（牛蒡子）。
桔梗汤：治疗咽喉轻微肿痛，声音嘶哑难语，效果显著。
药材：桔梗、甘草、黄芩、当归、麻黄、桂枝、白僵蚕、马勃。
上清丸：治疗咽喉肿痛，痰涎壅塞的妙方。
药材：薄荷（一斤）、川芎、防风（各二两）、桔梗、砂仁（各五钱）、甘草（四两）。
制法：炼蜜制成如弹子大小的丸药，不拘时间含服，睡前服用更佳。
清道汤：
药材：花粉（天花粉）、玄参、柴胡、芍药、甘草、麻黄、桔梗、山豆根。
陈远公的破隘汤即为此方。
巴戟汤：
药材：熟地黄、茯苓、巴戟天、麦冬、五味子。
程汉章说：少阴之火，势如奔马，不借助降泄之法，怎么能引导回归本源？此方加入牛膝、泽泻、山茱萸尤其巧妙。
百部汤：
药材：白薇、紫菀、百部、玄参、麦冬、甘草、五味子、大力子、白芥子。
苡仁汤：
药材：熟地黄、麦冬、薏苡仁、山茱萸、桑白皮、贝母、生地黄、甘草。
陈远公说：服用百部汤后虫子死亡，服用苡仁汤后火势平息，再加入肉桂数分，服用两剂，不再复发。
玉露汤：治疗初生儿的喉肿。
药材：陈茶叶、川黄连、荆芥穗、薄荷、甘草。
吹药方：
药材：胆矾、牛黄、冰片、皂角灰（各一分）、麝香（五厘）。
玉锁匙：治疗风热喉闭，以及缠喉风。
药材：硼砂、僵蚕（各一钱）、焰硝（一钱五分）、冰片（三厘）。
制法：碾细保存好，临用时取出，吹入喉中非常有效。
京城有一位医生，拿着秘方的丸药治疗喉闭，获利丰厚。只使用擦拭面部的肥皂，外面包裹金箔作为外衣，偶然被翁曙公识破，遇到江湖上没有药的地方，就用这个灌服，稠痰全部吐出，危重的病症立刻苏醒。
咽喉以下的十六个门类，称为“襟症”，指的是婴幼儿时期所说的。然而我的治疗方法，则是从初生到壮年，广泛设立的。至于那些因虚劳相火炽盛，导致喉、齿、耳、目等病症的，记载在我其他的医书《医贯别裁》中，这里就不涉及了。
Bianzheng (Variable Evaporation) refers to a developmental process in infants where thirty-two days constitute one "Bian" (Change), followed by a period constituting one "Zheng" (Evaporation), totaling five hundred and seventy-six days. As Bianzheng nears completion, symptoms such as fever, chaotic pulse, absence of sweating, anorexia, and in severe cases, irritability, crying, restlessness, and thirst may appear. Mild cases resolve in five days, while severe cases resolve in eight days. These manifestations resemble Shanghan (Cold Damage); however, during Bianzheng, the ears are cold, and the upper lip exhibits white spots resembling turbid pearls. In contrast, pathogenic cold causes abdominal pain and incessant crying. Generally, this process is for nourishing Qi and Blood and enriching the Five Zang Organs; thus, arbitrary treatment should be avoided. It is advisable to regularly administer Zhibao Dan (Precious Pill, see Fetal Heat). If the infant refuses milk, cries excessively, or experiences alternating chills and fever with impaired ascending and descending of Yin and Yang, Zhimi Tang (Finger-Pointing Decoction, see Fetal Cold) should be used for adjustment.
Qian Yi stated: The first Bian corresponds to the Kidney, the second to the Bladder, the third to the Heart, the fourth to the Small Intestine, the fifth to the Liver, the sixth to the Gallbladder, the seventh to the Lung, the eighth to the Large Intestine, the ninth to the Spleen, and the tenth to the Stomach. *Xiao'er Yaozheng Zhijue* (Treasures of Pediatric Medicine) states: The first Bian corresponds to the Liver, the second to the Lung, the third to the Heart, the fourth to the Spleen, and the fifth to the Kidney. Although these two theories differ, their rigid adherence remains the same. During the phase of nourishing Qi and Blood, Yin and Yang transform, and the Five Elements invert. This principle is extremely subtle; relying solely on postnatal theoretical deduction fails to capture the miraculous nature of creation.
The throat connects with the Lungs and Stomach, serving as a crucial pivot for the entry and exit of Qi. Various disorders here differ from those in adults. Generally, they arise from the accumulation of heat toxins leading to the generation of Wind-Phlegm, which stagnates and does not disperse, causing sores or swelling, and even obstructing swallowing. Treatment should prioritize Jiegeng Tang (Platycodon Decoction). Alternatively, Niubangzi Tang (Arctium Decoction) can be used to first expel Wind-Phlegm, then clear heat toxins, followed by the frequent lozenges of Shangqing Wan (Upper-Clearing Pill).
Ru'e (Milk Goose, a type of throat obstruction) involves Fire from the Taiyang and Shaoyin channels being constrained by Wind-Cold, blocking the passageways, resulting in swelling, thick turbid phlegm, and unbearable pain. Apply a paste made from one large Wumei (Chinese Plum) pitted and stuffed with one snail, roasted in ash until thoroughly cooked, and ground into powder, applied to the punctured swelling. Alternatively, Qingdao Tang (Clearing the Path Decoction) or Shandougen Tang (Sophora Root Decoction) may be administered. For cases caused by congenital deficiency with floating deficient fire, Bajitang (Morinda Decoction) is effective.
Houxuan (Throat Tinea) results from Wind-Fire stagnating in the throat, where dampness steams and generates parasites, causing pain or itching, dryness, and withering. In severe cases, the face becomes red and ears hot, intolerable. Treat with Baibu Tang (Stemona Decoction) and regulate with Yiren Tang (Coix Seed Decoction).
Niubangzi Tang: Treats wind-heat congestion causing sore and swollen throat, or formation of Ru'e.
Ingredients: Xuanshen (Scrophulariae Radix), Shengma (Cimicifugae Rhizoma), Huangqin (Scutellariae Radix), Jiegeng (Platycodonis Radix), Mutong (Akebiae Caulis), Gancao (Glycyrrhizae Radix et Rhizoma), Xijiao (Rhinocerotis Cornu - note: substitute with Buffalo Horn in modern practice), Niu Bang Zi (Arctii Fructus).
Jiegeng Tang: Highly effective for mild sore and swollen throat with hoarseness and difficulty speaking.
Ingredients: Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Bai Jiangcan (Bombyx Batryticatus), Ma Bo (Pulvis Malvae).
Shangqing Wan: An excellent formula for sore and swollen throat with phlegm obstruction.
Ingredients: Bohe (Menthae Haplocalycis Herba, 1 jin), Chuanxiong (Ligustici Chuanxiong Rhizoma), Fangfeng (Saposhnikoviae Radix, each 2 liang), Jiegeng (Platycodonis Radix), Sharen (Amomi Fructus Rotundus, each 5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 4 liang).
Preparation: Honey-pilled to the size of a bullet. Lozenge at any time, preferably before sleep.
Qingdao Tang:
Ingredients: Huafen (Trichosanthis Radix), Xuanshen (Scrophulariae Radix), Chaihu (Bupleuri Radix), Shaoyao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Mahuang (Ephedrae Herba), Jiegeng (Platycodonis Radix), Shandougen (Sophorae Tonkinensis Radix).
Chen Yuangong's Po'ai Tang is identical to this formula.
Shandougen Tang:
Ingredients: Shegan (Belamcandae Rhizoma), Maidong (Ophiopogonis Radix), Huafen (Trichosanthis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Xuanshen (Scrophulariae Radix), Shandougen (Sophorae Tonkinensis Radix).
Bajitang:
Ingredients: Shudi (Rehmanniae Radix Praeparata), Fuling (Poria), Bajitian (Morindae Officinalis Radix), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Chinensis Fructus).
Cheng Hanzhang noted: The Fire of Shaoyin moves like a galloping horse; without descending and purging methods, how can it be guided back to its origin? Adding Niuxi (Achyranthis Bidentatae Radix), Zexie (Alismatis Rhizoma), and Shanyuzhu (Corni Fructus) to this formula is particularly ingenious.
Baibu Tang:
Ingredients: Baiwei (Cynanchi Atrati Radix), Ziwan (Asternis Radix), Baibu (Stemonae Radix), Xuanshen (Scrophulariae Radix), Maidong (Ophiopogonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Wuweizi (Schisandrae Chinensis Fructus), Niu Bang Zi (Arctii Fructus), Baijiezi (Sinapis Semen).
Yiren Tang:
Ingredients: Shudi (Rehmanniae Radix Praeparata), Maidong (Ophiopogonis Radix), Yiren (Coicis Semen), Shanyuzhu (Corni Fructus), Sangbai pi (Mori Cortex), Beimu (Fritillariae Thunbergii Bulbus), Shengdi (Rehmanniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
Chen Yuangong stated: After taking Baibu Tang, the parasites die; after taking Yiren Tang, the fire subsides. Adding a few fen of Rougui (Cinnamomi Cortex) and taking two doses prevents recurrence.
Yulu Tang: Treats initial throat swelling in newborns.
Ingredients: Chen Chaye (Old Tea Leaves), Chuan Huanglian (Coptidis Rhizoma), Jingjiesui (Schizonepetae Spica), Bohe (Menthae Haplocalycis Herba), Gancao (Glycyrrhizae Radix et Rhizoma).
Chu Yao Fang (Blowing Powder):
Ingredients: Danfan (Alumen), Niuhuang (Calculus Bovis), Bingpian (Borneolum Syntheticum), Zaojiaohui (Fructus Gleditsiae Sinensis Cinis, each 1 fen), Shexiang (Moschus, 5 li).
Yusuoshi (Jade Lock Key): Treats Wind-Heat Hou Bi (Throat Closure) and Chan Hou Feng (Entangling Throat Wind).
Ingredients: Pengsha (Borax), Jiangcan (Bombyx Batryticatus, each 1 qian), Yanxiao (Natrii Nitras, 1.5 qian), Bingpian (Borneolum Syntheticum, 3 li).
Preparation: Grind finely and store securely. Use when needed by blowing into the throat; highly effective.
In the capital, a physician treated Hou Bi using secret pill medicines, gaining substantial profit. He used facial cleansing soap coated with gold foil. This was accidentally exposed by Weng Shugong. In areas lacking medical supplies, administering this substance induced vomiting of thick phlegm, instantly reviving patients in critical condition.
The sixteen categories below the throat are called "Jin Zheng" (Collar Symptoms), referring specifically to infants. However, my therapeutic methods are broadly established from infancy to adulthood. Conditions involving deficiency consumption with excessive Ministerial Fire affecting the throat, teeth, ears, and eyes are recorded in my other work, *Yiguan Biecai*, and are not covered here.