小儿初生百日内脐风,方书率用南星、僵蚕等风药,多不效,当作胎毒,泻阳明火邪。马牙亦是胎毒,用
针挑破桑树白汁涂之。桑汁主小儿鹅口及口疮、舌上疮,神效。初生小儿,时时与看,频敷桑汁,不然,
舌硬紧,渐至撮口,难治。
愚按曾世显云∶婴儿一七之内,腹肚胀硬,脐畔浮肿,口撮不开,攒眉而叫,名脐风。或因剪脐带少
短,或因束缚不紧牵动,风入脐中,或因铁器断脐,冷气入内,传于脾络,致舌强唇青,手足微搐,不能
吮乳,啼声似鸦,喉痰潮响,急掐破口泡,去其毒水,以艾灸脐中,亦有复生者。治法多端,无如灸法,或
以天南星一钱,生姜自然汁调灌,为妙。
小儿不时变蒸,变者异常也,蒸者发热也,所以
变换五脏,蒸养六腑。须待变蒸多遍,气血方荣,骨脉始长。
愚按钱仲阳先生云∶小儿在母腹中,乃生骨气,五脏六腑成而未全;自生之后,即长骨脉,五脏六腑
之神智,自内而长,自下而上,故生后三十二日一变蒸,始即智意异前。盖人有三百六十五骨,除手足中
四十五碎骨外,有三百二十数。自生下,骨一日十段而上之,十日百段,三十二日,计三百二十段为一变,
亦曰一蒸。骨之余气,一自脑分入龈中,作三十二齿,则齿数当与变日相合。然而齿有不及三十二数者,由
变不足其常也;有或二十八日即止长二十八齿,以下仿此,但不过三十二之数。凡一周遍,乃生虚热诸病,
如是十周则小蒸毕也。计三百二十日生骨气,乃全而未壮也。故初三十二日一变生肾生志,六十四日再变
生膀胱,其发耳与 冷,肾与膀胱俱生于水,水数一,故先变主之。九十六日三变生心喜,一百二十八日四
变生小肠,其发汗出而微惊,心为火,火数二。一百六十日五变生肝哭,一百九十二日六变生胆,其发目
不开而赤,肝主木,木数三。二百二十四日七变生肺声,二百五十六日八变生大肠,其发肤热而汗,或不
汗,肺者金,金数四。二百八十八日九变生脾智,三百二十日十变生胃,其发不食,腹痛而吐乳。此后乃
齿生,能言,知喜怒,故云始全也。太仓云,气入四
肢长碎骨,于十变后六十四日长其经脉,手足受血,故能持物,能立,能行也。经云变且蒸,谓蒸毕而足
一岁之日也。师曰∶不汗而热者发其汗,大吐者微止,不可余治。全婴方云∶变蒸者,长气血。变者上气,
蒸者发热也。轻则体热,虚惊,耳冷,微汗,唇生白泡,三日可愈;重者寒热,脉乱,腹疼,啼叫,不能
乳食,食而即吐 ,五日方愈。其候与伤寒相似,但以唇上白泡验之。亦有受胎气壮实,不热不惊,或无
证候而暗变者。窃谓此症小儿所不能免,不必服药。古方以黑散子、紫丸子主之,非惟脏腑不能胜受,抑
且反伤气血,慎之慎之!尝见一小儿,至二变发热有痰,或治以抱龙丸一粒,卒至不救,可以验矣。然父
母爱子之心胜,稍有疾病,急于求医,而医者不究病情,率尔投剂,殊不知病因多端,见症相类,难以卒
辨,况古人禀浓,方多峻厉之剂,缓服可也。
小儿出生后一百天内患脐风,医书通常使用天南星、僵蚕等祛风药物,大多无效,应当将其视为胎毒,采用清泻阳明经火邪的方法治疗。马牙(婴儿牙龈上的白色小颗粒)也是胎毒所致,可用针挑破,涂抹桑树白汁。桑树汁主治小儿鹅口疮及口疮、舌上疮,疗效神奇。初生婴儿应经常检查口腔,频繁涂抹桑树汁,否则会导致舌头僵硬紧缩,逐渐发展为撮口(口唇收缩如鱼口),难以治愈。
我按语:曾世显曾说:婴儿出生七天内,腹部胀硬,肚脐周围浮肿,口唇收缩无法张开,皱眉啼哭,称为脐风。可能是因为剪断脐带时留得太短,或者包裹束缚不紧牵动伤口,导致风邪侵入脐中;也可能是因为用铁器切断脐带,寒气进入体内,传入脾络,导致舌头僵硬、嘴唇发青,手足轻微抽搐,不能吸吮乳汁,啼哭声像乌鸦叫,喉咙里有痰鸣声如潮水般响。此时应立即掐破口内水泡,排出毒水,并用艾灸灸肚脐中央,也有救活的情况。治疗方法多种多样,没有比艾灸更好的了。也可以用天南星一钱,用生姜自然汁调匀灌服,效果奇妙。
小儿不时出现变蒸现象,“变”是指生理功能的异常变化,“蒸”是指发热,这是为了变换五脏功能,蒸养六腑。必须经过多次变蒸,气血才能充盈,骨骼脉络才开始生长。
我按语:钱仲阳先生说:小儿在母腹中时,才生成骨气,五脏六腑形成但未完全成熟;出生后,就开始增长骨脉,五脏六腑的神智功能,从内部向外部生长,从下方向上方发展,所以出生后三十二天进行一次变蒸,开始表现出与之前不同的智慧意态。大概人有三百六十五块骨头,除去手脚中的四十五块碎骨外,还有三百二十块。自出生起,骨头每天长十段向上发育,十天长一百段,三十二天,共计三百二十段为一次变,也称为一次蒸。骨的余气,一部分从脑部进入牙龈,长出三十二颗牙齿,那么牙齿的数量应当与变蒸的天数相符合。然而牙齿数量不足三十二颗的,是因为变蒸未能达到常规标准;有的二十八天就停止生长,长出二十八颗牙齿,其余依此类推,但不会超过三十二颗的数量。凡经历一个周期(十次变蒸),会出现虚热等各种病症,像这样经历十个周期,小蒸就结束了。共计三百二十天完成骨气的生长,此时身体完备但还不够强壮。所以前三十二天第一次变蒸产生肾,主志;六十四天第二次变蒸产生膀胱;其表现为耳朵冷,因为肾与膀胱都属水,水数为1,所以最先由肾主导。九十六天第三次变蒸产生心,主喜;一百二十八天第四次变蒸产生小肠;其表现为出汗且轻微惊悸,因为心属火,火数为2。一百六十天第五次变蒸产生肝,主哭;一百九十二天第六次变蒸产生胆;其表现为眼睛睁开后发红,因为肝主木,木数为3。二百二十四天第七次变蒸产生肺,主声;二百五十六天第八次变蒸产生大肠;其表现为皮肤发热且有汗,或者无汗,因为肺属金,金数为4。二百八十八天第九次变蒸产生脾,主智;三百二十天第十次变蒸产生胃;其表现为不吃东西,腹痛并吐乳。此后才长出牙齿,能说话,知道喜怒,所以说身体才算真正完备。太仓公说,气进入四肢并长出碎骨,在十次变蒸后的六十四天长出经脉,手足得到血液滋养,所以能拿取物品,能站立,能行走。经文说“变且蒸”,是指蒸腾完毕满一岁之日。老师说:不出汗而发热的,用发汗法治疗;呕吐严重的,稍微止住即可,不可再用其他方法治疗。《全婴方》说:变蒸是为了增长气血。“变”是上焦之气变化,“蒸”是发热。轻症表现为身体发热,虚惊,耳朵冷,微汗,嘴唇生白泡,三天可痊愈;重症表现为寒热交替,脉搏紊乱,腹痛,啼哭叫喊,不能进食,吃了就吐,五天才能痊愈。其症状与伤寒相似,但以嘴唇上的白泡作为验证依据。也有受胎气壮实,不发热不惊悸,或者没有症状而暗中变蒸的。我认为这种病症是小儿不可避免的,不必服药。古方用黑散子、紫丸子来主治,不仅脏腑承受不了药力,反而损伤气血,务必谨慎!曾经见到一个小儿,到第二次变蒸时发热有痰,有人用一粒抱龙丸治疗,最终导致死亡,足以作为验证。然而父母爱子之心强烈,稍有疾病,就急于求医,而医生不探究病情,贸然投药,殊不知病因多种多样,表现症状相似,难以立即辨别,况且古人禀赋浓厚,方剂多峻烈猛烈,缓慢服用还可以。
For neonatal tetanus (Umbilical Wind) occurring within the first hundred days after birth, medical texts generally use wind-dispelling herbs such as Rhizoma Arisaematis Cum Bile (Nanxing) and Bombyx Batryticatus (Jiangcan), but these are often ineffective. It should be treated as fetal toxin, employing methods to drain fire pathogens from the Yangming channel. "Ma Ya" (Horse Teeth, white granules on infant gums) is also caused by fetal toxin; it can be pricked with a needle and coated with the white sap of a mulberry tree. Mulberry sap is effective for treating infant thrush (Goose Mouth), oral ulcers, and tongue sores. For newborns, the mouth should be checked frequently, and mulberry sap applied often; otherwise, the tongue may become stiff and tight, progressing to "Cuo Kou" (mouth contraction resembling a fish's mouth), which is difficult to treat.
My commentary: Zeng Shixian stated that within the first seven days after birth, if an infant has a distended and hard abdomen, swelling around the umbilicus, inability to open the mouth due to lip contraction, frowning while crying, this is called Umbilical Wind. This may occur because the umbilical cord was cut too short, or because loose binding caused traction, allowing wind pathogens to enter the umbilicus; or because iron tools were used to cut the cord, allowing cold qi to enter internally and transmit to the spleen collaterals, resulting in a stiff tongue, cyanotic lips, slight twitching of hands and feet, inability to suckle milk, a cry resembling a crow's croak, and tidal phlegm sounds in the throat. In such cases, one should immediately pinch open the oral blisters to drain toxic fluids, and apply moxibustion to the center of the umbilicus; recovery is possible. Although there are many treatment methods, none surpass moxibustion. Alternatively, one qian of Rhizoma Arisaematis Cum Bile (Nanxing) mixed with fresh ginger juice and administered orally can be effective.
Infants undergo periodic "Bian Zheng" (Transformation and Steaming). "Bian" refers to abnormal physiological changes, and "Zheng" refers to fever; this process transforms the functions of the five zang organs and nourishes the six fu organs. Only after multiple cycles of Bian Zheng will the qi and blood flourish, and bones and vessels begin to grow.
My commentary: Mr. Qian Zhongyang stated that while in the womb, an infant develops bone qi, and the five zang and six fu organs form but are not fully mature. After birth, bones and vessels grow, and the spiritual intelligence of the zang and fu organs develops from the inside out and from bottom to top. Thus, thirty-two days after birth, the first cycle of Bian Zheng occurs, marking the emergence of distinct intellectual awareness. Humans have 365 bones; excluding 45 small bones in the hands and feet, there are 320 main bones. From birth, bones grow ten segments per day upwards; in ten days, they grow 100 segments. In thirty-two days, totaling 320 segments constitutes one "Bian," also called one "Zheng." The residual qi of the bones enters the brain and gums to form 32 teeth, so the number of teeth should correspond to the days of Bian Zheng. However, some infants have fewer than 32 teeth because their Bian Zheng did not reach the standard; some stop growing at 28 days with 28 teeth, and so on, but never exceeding 32. Upon completing one full cycle (ten cycles), various deficiency-heat conditions arise. After ten such cycles, the minor steaming concludes. This takes 320 days for bone qi to complete formation, resulting in a body that is complete but not yet robust. Therefore, the first cycle at 32 days generates the Kidney, governing Will (Zhi); the second cycle at 64 days generates the Bladder; manifestations include cold ears, as Kidney and Bladder belong to Water, and the number of Water is 1, so the Kidney leads initially. The third cycle at 96 days generates the Heart, governing Joy (Xi); the fourth cycle at 128 days generates the Small Intestine; manifestations include sweating and slight palpitations, as the Heart belongs to Fire, and the number of Fire is 2. The fifth cycle at 160 days generates the Liver, governing Crying (Ku); the sixth cycle at 192 days generates the Gallbladder; manifestations include red eyes upon opening, as the Liver governs Wood, and the number of Wood is 3. The seventh cycle at 224 days generates the Lungs, governing Voice (Sheng); the eighth cycle at 256 days generates the Large Intestine; manifestations include skin heat and sweating, or lack thereof, as the Lungs belong to Metal, and the number of Metal is 4. The ninth cycle at 288 days generates the Spleen, governing Intelligence (Zhi); the tenth cycle at 320 days generates the Stomach; manifestations include refusal to eat, abdominal pain, and vomiting milk. Thereafter, teeth emerge, speech develops, and emotions like joy and anger are understood, hence it is said the body is truly complete. Tai Cang Gong stated that qi enters the limbs and grows small bones; sixty-four days after the ten cycles, meridians grow, and hands and feet receive blood, enabling grasping, standing, and walking. The classic states "Bian and Zheng," referring to the completion of steaming at one year of age. The Master said: For fever without sweating, induce sweating; for severe vomiting, stop it mildly; do not use other treatments. *Quan Ying Fang* states that Bian Zheng increases qi and blood. "Bian" is the transformation of upper qi, and "Zheng" is fever. Mild cases present with body heat, false fright, cold ears, slight sweating, and white blisters on lips, resolving in three days; severe cases present with alternating chills and fever, chaotic pulse, abdominal pain, crying, inability to feed, and immediate vomiting after eating, resolving in five days. Symptoms resemble Cold Damage (Shanghan), but verification is made via white blisters on the lips. Some infants with strong prenatal qi show no fever or fright, or undergo silent Bian Zheng without symptoms. I believe this condition is unavoidable for infants and does not require medication. Ancient formulas using Hei San Zi (Black Powder Pill) or Zi Wan Zi (Purple Pill) are unsuitable, as the viscera cannot withstand them, and they反而 damage qi and blood; caution is advised! I once saw an infant who, during the second cycle of Bian Zheng, had fever and phlegm. Treatment with one pill of Bao Long Wan resulted in death, serving as a warning. Parents' love for their children is intense; upon any illness, they rush to seek doctors. However, physicians who do not investigate the condition may rashly administer drugs. One must realize that etiology is diverse, symptoms are similar, and differentiation is difficult. Moreover, ancients had robust constitutions, and ancient formulas were often harsh; slow administration might be tolerable.