《千金》论曰∶小儿二百四十日,掌骨成,母当教以匍匐。一周满,母当扶以行步。此
皆则法。若或暖衣重围,不见风日,不着地气,致令筋骨软弱,数岁不能行者有之。今观田舍
小儿则反是,所以见风日得土气,筋力常健,岂贵贱之理有异哉?明乎此,则保婴之道得矣。
乳哺之法不可不慎。小儿脾胃怯弱,乳食易伤,初得作呕泻,久则成积癖。乳母饮食,
乳汁便通,儿食其乳,所感立应。母食热则乳热,母食寒则乳寒。夏食热乳则致吐逆,冬食寒
乳则致嗽利。母不欲怒,怒则气上为狂。母不欲醉,醉则身热腹痛。怀孕乳儿致令黄瘦腹大
脚软,名曰 病。大都乳哺不可大过,谚云∶小儿常病伤于饱也。又曰∶忍三分饥,吃七分饱,
亦至论也。
方书皆云∶小儿一出腹啼声未发之时,急用绵裹指拭去口内恶汁,固是良法。而仓猝之际
或有不及者,故有黄连、甘草、朱、蜜等法,用之殊佳。东垣云∶只须淡豆豉一味煎汤,与三
五口,其毒自下,又能助胃气也,尤妙。
凡乳母禀赋之浓薄,性情之缓急,德行之善恶,儿食其乳,能速肖之,此其关系非
为小故。殊不知渐染既
久,识性皆同,犹接木之造化也,故不可不择。
《颅囟经》曰∶囟门未合,筋骨柔弱。囟门青筋,肺虚不荣。囟门常坑,滑泻便便。囟门
突起,风疾不止。囟门久冷,吐利清清。囟门虚软,颠痫不免。囟门扁阙,暴泄易脱。囟门 长,
风作必亡。囟门连额,惊痫易得。囟门未完,怕热怯寒。囟门缓收,胎气不周。囟门动数,
神昏气弱。囟门宽大,多疾受害。颅囟者,精神之门户也,开窍之橐 也。上下相贯,百会
相通,七窍应透,五脏所藉,泥丸之官,魂魄之穴。气实则阖,气虚则开,良由长大不可不合。
医师见之,当知可否,用药消息之。囟门宽大,受病深重,恐药难疗,不可不慎也。
《千金方》论述说:小儿出生二百四十天后,掌骨发育成形,母亲应当教导孩子匍匐爬行。满一周岁后,母亲应当扶持孩子学习行走。这些都是遵循自然规律的方法。如果让孩子穿着过于暖和、包裹严密,不见阳光和空气,不接触地面之气,就会导致筋骨软弱,有的甚至到了几岁还不会走路。如今观察乡间农家的小孩则恰恰相反,因为他们见风日、得土气,所以筋骨力量通常很健壮,这难道是因为富贵与贫贱的道理有什么不同吗?明白了这一点,那么养育婴儿的方法就掌握了。
哺乳喂养的方法不可不谨慎。小儿脾胃功能怯弱,乳食容易受伤,初起表现为呕吐腹泻,日久则形成积滞癖块。乳母的饮食通过乳汁传导,孩子吃了母乳,身体的反应会立刻体现出来。母亲吃热性食物,乳汁就变热;母亲吃寒性食物,乳汁就变寒。夏天喝热乳会导致呕吐逆乱,冬天喝冷乳会导致咳嗽腹泻。母亲不要发怒,发怒则气机上逆导致狂躁。母亲不要醉酒,醉酒则身体发热腹痛。怀孕或哺乳期饮酒会导致孩子面色萎黄消瘦、腹部胀大、脚部软弱,这种病称为“酒疸”(此处原文似有缺字,结合语境及常见儿科论述,多指因母饮酒致儿的病症,如“酒病”或“胎惊”等,但依原文仅提取实体,故暂按原文逻辑翻译为类似病症描述,注:原文“名曰 病”中间有空格,可能漏字,译为“名为某种病”)。大体上哺乳喂养不可过度,谚语说:“小儿常因过饱而生病。”又说:“忍受三分饥饿,吃到七分饱”,这也是极至的真理。
医书都说:小儿刚出生啼哭未发之时,急忙用绵裹住手指擦去口内的恶浊汁液,固然是好方法。但在仓促之际有时来不及这样做,所以有用黄连、甘草、朱砂、蜂蜜等方法,使用效果很好。李东垣说:只需单味淡豆豉煎汤,喂服三五口,其毒自下,又能帮助胃气,尤其巧妙。
凡是乳母的禀赋浓薄、性情缓急、德行善恶,孩子吃了她的奶,能迅速模仿她,这其中的关系并非小事。殊不知沾染久了,见识性格都会相同,就像嫁接树木一样受母体影响,所以不可不选择乳母。
《颅囟经》说:囟门未闭合,筋骨柔弱。囟门青筋显露,是肺虚不能荣养。囟门常凹陷,是滑泻便溏。囟门突起,是风疾不止。囟门久冷,是吐利清稀。囟门虚软,难免癫痫。囟门扁平缺损,是暴泄易脱证。囟门狭长,风邪发作必死。囟门连额,易患惊痫。囟门未完全闭合,怕热畏寒。囟门缓收,是胎气不周。囟门跳动频繁,是神昏气弱。囟门宽大,多病受害。颅囟,是精神的门户,开窍的囊橐。上下贯通,百会穴相通,七窍应透达,五脏所依赖,泥丸宫所在,魂魄之穴。气实则闭合,气虚则开放,确实因为长大后必须闭合。医师见到这种情况,应当知道是否可行,用药斟酌处理。囟门宽大,受病深重,恐怕药物难治,不可不谨慎。
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: When an infant reaches two hundred and forty days of age, the metacarpal bones are formed, and the mother should teach the child to crawl. Upon completing one full year, the mother should support the child in learning to walk. These are methods following natural laws. If the child is clothed too warmly and wrapped tightly, deprived of exposure to wind and sunlight, and prevented from contacting the earth's qi, it may result in weak sinews and bones, with some children unable to walk even after several years. Observing rural children today reveals the opposite; because they are exposed to wind and sunlight and receive the qi of the soil, their sinews and strength are usually robust. Is this not due to differences in the principles of nobility and commonality? Understanding this, the way to protect infants is mastered.
The method of breastfeeding must be handled with caution. An infant's spleen and stomach are delicate, and milk/food is easily injured; initially manifesting as vomiting and diarrhea, prolonged injury leads to accumulation and masses. The diet of the wet nurse is transmitted through the breast milk; when the infant consumes it, the body's response is immediate. If the mother eats hot-natured food, the milk becomes hot; if she eats cold-natured food, the milk becomes cold. Drinking hot milk in summer causes vomiting and reflux; drinking cold milk in winter causes cough and diarrhea. The mother should not be angry, for anger causes qi to rise upward leading to mania. The mother should not be drunk, for drunkenness causes body heat and abdominal pain. Alcohol consumption during pregnancy or lactation can cause the child to become sallow and emaciated with a distended abdomen and weak legs, a condition named [missing character] disease. Generally, breastfeeding should not be excessive. As the proverb says: "Infants often suffer illness from overeating." It is also said: "Endure three parts hunger, eat until seven parts full," which is a supreme truth.
Medical texts state that when a newborn cries but has not yet fully vocalized, it is urgent to use cotton-wrapped fingers to wipe away the foul fluids in the mouth. This is indeed a good method. However, in hurried situations, one might not have time, so methods using Huanglian (Coptidis Rhizoma), Gancao (Licorice Root), Zhusha (Cinnabar), and honey are employed, yielding excellent results. Li Dongyuan stated: One only needs Dan Dou Chi (Fermented Soybean Decoction) as a single herb, boiled into soup, and given three to five mouthfuls; the toxicity will naturally descend, and it also assists stomach qi, which is particularly ingenious.
Whatever the wet nurse's constitution (rich or thin), temperament (slow or quick), and morality (good or evil), the infant who drinks her milk will quickly imitate these traits. The relationship here is significant. Unknowingly, after long-term contamination, the child's awareness and nature become identical to the mother's, similar to the transformation of grafting trees; therefore, selection is indispensable.
The *Lunxin Jing* (Classic of Cranial Fontanelles) states: If the fontanelle is not closed, the sinews and bones are soft. Blue veins visible at the fontanelle indicate Lung deficiency failing to nourish. A sunken fontanelle indicates slippery diarrhea and loose stools. A protruding fontanelle indicates unceasing wind disorders. A chronically cold fontanelle indicates clear vomiting and diarrhea. A flaccid fontanelle implies inevitable epilepsy. A flat or defective fontanelle indicates sudden diarrhea prone to collapse. A narrow and elongated fontanelle suggests death upon wind attack. A fontanelle extending to the forehead makes the child susceptible to fright and epilepsy. An incompletely closed fontanelle indicates fear of heat and aversion to cold. A slowly closing fontanelle indicates incomplete prenatal qi. Frequent pulsation of the fontanelle indicates mental confusion and weak qi. A wide fontanelle indicates susceptibility to severe illness. The cranial fontanelle is the gateway of spirit and the sac of apertures. It connects up and down, communicates with Baihui (GV20), allows the seven orifices to penetrate, relies on the five zang organs, houses the Niwang Palace, and serves as the cavity for hun and po souls. When qi is excess, it closes; when qi is deficient, it opens. Indeed, it must close as the child grows. Physicians observing this should discern feasibility and adjust medication accordingly. A wide fontanelle indicates deep-seated disease, where drugs may be difficult to cure; thus, caution is essential.