（凡五类）
（论三首 方二首 择乳母法）
论曰∶夫生民之道，莫不以养小为大，若无于小，卒不成大。故《易》称积小以成大。
《诗》有厥初生民，《传》曰声子生隐公，此之一义，即是从微至着，自少及长，人情共见，
不待经史，故今斯方先妇人小儿，而后丈夫耆老者，则是崇本之义也。然小儿气势微弱，医
士欲留心救疗，立功瘥难，今之学人，多不存意，良由婴儿在于襁褓之内，乳气腥臊，医者
操行英雄，讵肯瞻视，静言思之，可为太息者矣。《短剧方》云∶凡人年六岁以上为小，十
六岁以上为少，（《巢源》、《外台》作十八以上为少），三十以上为壮（《巢源》、《外台》作
二十以上为壮），五十以上为老。其六岁以下，经所不载，所以乳下婴儿有病难治者皆为无
所承据也。中古有巫妨（《巢源》作巫方）者，立小儿《颅囟经》，以占夭寿，判疾病死生，
世相传授，始有小儿方。逮于晋宋，江左推诸苏家，传习有验，流于人间。齐有徐王者，也
有《小儿方》三卷，故今之学人，颇得传授。然徐氏位望隆重，何暇留心于少小，详其方意，
不甚深细，少有可采，未为至秘。今博采诸家及自经用有效者，以为此篇，凡百居家，皆宜
达兹
又曰∶小儿病与大人不殊，惟用药有多少为异。其惊痫客忤解颅不行等八九篇合为此卷
，下痢等余方并散在诸篇，可披而得之。
凡生后六十日瞳子成，能咳笑应和人。百日任脉成，能自反复，（一作百五十日。）百八
十日尻骨成，能独坐。二百一十日掌骨成，能匍匐。三百日膑骨成，能独立。三百六十日膝
骨成，能行。此其定法，若不能根据期，必有不平之处。
凡儿生三十二日一变。六十四日再变，变且蒸。九十六日三变。一百二十八日四变，变
且蒸。一百六十日五变。一百九十二日六变，变且蒸。二百二十四日七变。二百五十六日八
变，变且蒸。二百八十八日九变。三百二十日十变，变且蒸。积三百二十日小蒸毕后，六十
四日大蒸，蒸后六十四日复大蒸，蒸后一百二十八日复大蒸。凡小儿自生三十二日一变，再
变为一蒸，凡十变而五小蒸，又三大蒸，积五百七十六日，大小蒸都毕，乃成人。小儿所以
变蒸者，是荣其血脉，改其五脏，故一变，竟辄觉情态有异。其变蒸之候，变者上气，蒸者
体热，变蒸有轻重，其轻者体热而微惊，耳冷尻冷，上唇头白泡起如鱼目珠子，微汗出，其
重者体壮热而脉乱，或汗或不汗，不欲食，食辄吐 ，目白睛微赤，黑睛微白。又云∶目
者重，赤黑者微。变蒸毕，目睛明矣，此其证也。单变小微，兼蒸小剧，凡蒸平者五日而衰
，远者十日而衰，先期五日后之五日为十日之中，热乃除耳。儿生三十二日一变，二十九日
先期而热，便治之如法，至三十六七日蒸乃毕耳。恐不解了，故重说之。且变蒸之时，不欲
惊动，勿令旁多人，儿变蒸或早或晚不如法者多。又初变之时或热甚者，违日数不歇，审计
变蒸之日，当其时有热微惊，慎不可治及灸刺，但和视之。若良久热不可已，少与紫丸微下
，热歇便止。若于变蒸之中，加以时行温病，或非变蒸时而得时行者，其诊皆相似，惟耳及
尻通热，口上无白泡耳。当先服黑散以发其汗，汗出，温粉粉之，热当歇，便就瘥。若犹不
都除，乃与紫丸下之。儿变蒸时若有寒加之，即寒热交争，腰腹夭纠，啼不止者，熨之则愈
也。（熨法出下编炙粉絮熨者是。）变蒸与温壮伤寒相似，若非变蒸，身热耳热尻亦热，此乃
为他病，可作余治，审是，变蒸不得为余治也。
又一法，凡儿生三十二日始变，变者身热也。至六十四日再变，变且蒸，其状卧端正也
。至九十六日三变，定者候丹孔出而泄。至一百二十八日四变，变且蒸，以能咳笑也。至一
百六十日五变，以成机关也。至一百九十二日六变，变且蒸，五机成也。至二百二十四日七
变，以能匍匐也。至二百五十六日八变，变且蒸，以知欲学语也。至二百八十八日九变，以
亭亭然也。凡小儿生至二百八十八日九变四蒸也，当其变之日，慎不可妄治之，则加其疾。
变且蒸者是儿送迎月也，蒸者甚热而脉乱，汗出是也。近者五日歇，远者八九日歇也。当是
蒸上不可灸刺妄治之也。
（共五类）
（论述三篇 方剂两首 选择乳母的方法）
论述说：养育百姓的道理，没有不把抚养幼儿当作根本大事的，如果不重视幼儿阶段，最终也无法成就大人。所以《易经》说积累微小以成就宏大。《诗经》中有“厥初生民”的诗句，《左传》记载声子生下隐公，这一层含义，就是从微小到显著，从幼少到长大，这是人们共同看见的事实，不需要经过经史典籍的考证。因此，现在的这部医方先讲妇人和小儿，而后讲成年男子和老年人，这就是尊崇根本的意义。然而小儿的气血气势微弱，医生如果想要留心救治，建立功绩使疾病痊愈很难，现在的学医者，大多不在意，确实是因为婴儿还在襁褓之中，乳汁气息腥臊，医生操行高尚杰出，谁肯去瞻视照料呢？静下心来思考这件事，真是令人叹息啊。《短剧方》说：凡人年龄六岁以上称为小，十六岁以上称为少，《巢源》、《外台秘要》作十八岁以上为少，三十岁以上称为壮（《巢源》、《外台秘要》作二十岁以上为壮），五十岁以上称为老。其中六岁以下，医经中不记载，所以哺乳期以下的婴儿有病难以治疗的原因，都是因为没有依据可循。中古时期有巫妨（《巢源》作巫方）这个人，制定了小儿《颅囟经》，用来占卜夭折或长寿，判断疾病的生死，世间相互传授，才开始有了小儿方剂。到了晋宋时期，江东地区推崇苏家，传承学习有验证效果，流传于民间。齐国有徐王，也有《小儿方》三卷，所以现在的学医者，颇能得到传授。然而徐氏地位声望隆重，哪里有空闲留心于幼小之事，详细考察他的方剂意旨，并不十分深细，少有可取之处，不算是最为秘传的。现在广泛采集各家以及自己经验有效的方剂，作为本篇，凡是居家的人，都应该通晓这些道理。
又说：小儿的疾病与成人没有不同，只是用药剂量多少有差异。关于惊痫、客忤、解颅、不行等八九篇合并为此卷，下痢等其他方剂并分散在各篇，可以翻阅得到。
凡是出生后六十天瞳孔形成，能咳嗽、笑、应答和人互动。一百天任脉形成，能自己翻身翻转（另一种说法是一百五十天）。一百八十天骶骨形成，能独自坐立。二百一十天掌骨形成，能爬行。三百天髌骨形成，能独立站立。三百六十天膝骨形成，能行走。这是固定的规律，如果不能按照期限做到，必定有不平衡的地方。
凡是婴儿出生三十二天发生一次变化。六十四天第二次变化，变化伴随蒸热。九十六天第三次变化。一百二十八天第四次变化，变化伴随蒸热。一百六十天第五次变化。一百九十二天第六次变化，变化伴随蒸热。二百二十四天第七次变化。二百五十六天第八次变化，变化伴随蒸热。二百八十八天第九次变化。三百二十天第十次变化，变化伴随蒸热。累积三百二十天小蒸结束后，再过六十四天大蒸，大蒸后六十四天再次大蒸，大蒸后一百二十八天再次大蒸。凡是小儿从出生三十二天一次变化，两次变化为一次蒸，总共十次变化五次小蒸，加上三次大蒸，累积五百七十六天，大小蒸都结束，才成为成人。小儿之所以变蒸，是滋养其血脉，改变其五脏，所以每次变化结束，往往觉得情态有异样。变蒸的征候，变化表现为上气（呼吸急促或头部发热感），蒸表现为身体发热，变蒸有轻重之分，轻的表现为身体发热而轻微惊悸，耳朵冷、骶骨冷，上唇头出现白色水泡像鱼目珠子一样，微微出汗；重的表现为身体高热而脉搏紊乱，或者出汗或者不出汗，不想吃东西，吃了就吐，眼白微红，黑睛微白。又有人说：眼睛红的重，黑白分明的微。变蒸结束后，眼睛明亮了，这就是证候。单变轻微，兼蒸剧烈，凡是平稳的蒸热五天衰退，远的十天衰退，提前五天之后到第五天为十天之内，热才会消除。婴儿出生三十二天一次变化，第二十九天提前发热，就依法治疗，到三十六七天蒸热才结束。恐怕不理解透彻，所以重新说一遍。而且变蒸的时候，不希望惊动，不要让旁边人多，小儿变蒸有的早有的晚不符合法度的很多。另外初变的时候如果热很严重，超过日期不消退，仔细计算变蒸的日子，正当时候如果有轻微发热惊悸，千万不要治疗和灸刺，只要调和观察即可。如果很久热不能停止，稍微给予紫丸轻微泻下，热停就停止。如果在变蒸之中，加上时行温病，或者不是变蒸时候得了时行病，诊断都相似，只有耳朵和骶骨全部发热，口上没有白色水泡罢了。应当先服用黑散来发汗，汗出后，用温粉扑身，热应当停止，病就好了。如果还不能完全消除，再给紫丸泻下。小儿变蒸时如果有寒邪加上，即寒热交争，腰腹扭曲，啼哭不止的，熨烫就可以痊愈。（熨法出自下编炙粉絮熨法是。）变蒸与温壮伤寒相似，如果不是变蒸，身体热耳朵热骶骨也热，这才是其他疾病，可以做其他治疗，如果是变蒸，不得做其他治疗。
又一种方法，凡是婴儿出生三十二天开始变化，变化就是身体发热。到六十四天第二次变化，变化伴随蒸热，其状是躺卧端正。到九十六天第三次变化，定下来是候丹孔出而泄。到一百二十八天第四次变化，变化伴随蒸热，因为能咳嗽笑了。到一百六十天第五次变化，因为机关形成。到一百九十二天第六次变化，变化伴随蒸热，五机形成。到二百二十四天第七次变化，因为能爬行。到二百五十六天第八次变化，变化伴随蒸热，因为知道想学说话。到二百八十八天第九次变化，因为亭亭然（直立挺拔的样子）。凡是小儿出生到二百八十八天九次变化四次蒸，当变化的日子，千万不要胡乱治疗，否则会加重疾病。变化伴随蒸热是婴儿送迎月令的意思，蒸热是很热且脉搏紊乱，出汗就是表现。近的五天休息，远的八九天休息。当是蒸热之上不可灸刺胡乱治疗。
(There are five categories in total)
(Three treatises, two formulas, and a method for selecting wet nurses)
The treatise states: The way of nurturing the people is such that no one fails to regard raising children as the great foundation; without attending to the young, one cannot ultimately become an adult. Thus, the *I Ching* (Book of Changes) says, "Accumulate the small to achieve the great." The *Shi Jing* (Classic of Poetry) contains the verse "At the beginning of the birth of the people," and the *Zuo Zhuan* records that Shengzi gave birth to Duke Yin. This meaning—that which is minute becomes prominent, and that which is young grows long—is evident to all human nature, not requiring verification through classics or histories. Therefore, this medical text discusses women and children first, and then adult men and the elderly, which embodies the principle of honoring the root. However, infants have weak qi and vital energy. If physicians wish to pay attention to their treatment and achieve cures, it is difficult. Many contemporary learners do not pay heed, largely because infants are within swaddling clothes, carrying the fishy and pungent odor of breast milk, and physicians of noble conduct are unwilling to gaze upon them. Reflecting quietly on this matter, one can only sigh deeply. The *Duanju Fang* states: Anyone aged six years and above is considered "small" (child); sixteen years and above is considered "young" (adolescent). (*Chao Yuanfang's Zhubing Yuanhou Lun* and *Waitai Miyao* state eighteen years and above is "young"); thirty years and above is considered "strong" (prime adult) (*Chao Yuanfang* and *Waitai Miyao* state twenty years and above is "strong"); fifty years and above is considered "old." Those under six years old are not recorded in medical classics; therefore, illnesses in nursing infants are difficult to treat due to lack of authoritative basis. In the middle ancient period, a person named Wu Fang (*Zhubing Yuanhou Lun* writes Wu Fang) established the *Luxin Jing* (Classic of the Cranial Fontanelle) for children, used to divinate premature death or longevity, and judge life and death from diseases. It was passed down through generations, marking the beginning of pediatric formulas. During the Jin and Song dynasties, the Jiangzuo region promoted the Su family lineage; their transmission and practice proved effective and spread among the populace. In Qi, Prince Xu also authored three volumes of *Xiao'er Fang* (Pediatric Formulas), so contemporary learners could obtain some transmission. However, given Prince Xu's high status and prestige, he had little leisure to focus on the young. Examining his formulas closely, they were not particularly profound or detailed, with little to recommend them, and were not considered highly secret. Now, having extensively collected various schools' methods and those effective through personal experience, I compile this chapter. Every household should understand these principles.
It is also said: Children's diseases are not different from adults', differing only in the dosage of medication. Chapters on jingxian (startled epilepsy), kewu (alien fright), jielu (splitting fontanelle), and buxing (inability to walk)—totaling nine chapters—are combined into this volume. Other formulas, such as those for xili (dysentery), are scattered across other chapters and can be found by browsing.
Sixty days after birth, the pupils form, and the infant can cough, laugh, and respond to others. At one hundred days, the Ren Mai (Conception Vessel) forms, and the infant can roll over independently (another version says one hundred and fifty days). At one hundred and eighty days, the sacral bone forms, and the infant can sit alone. At two hundred and ten days, the carpal bones form, and the infant can crawl. At three hundred days, the patella forms, and the infant can stand independently. At three hundred and sixty days, the knee bones form, and the infant can walk. These are fixed rules; if milestones are not met according to schedule, there must be imbalance.
An infant undergoes a change every thirty-two days. At sixty-four days, the second change occurs, accompanied by zheng (steaming heat). At ninety-six days, the third change. At one hundred and twenty-eight days, the fourth change, accompanied by steaming heat. At one hundred and sixty days, the fifth change. At one hundred and ninety-two days, the sixth change, accompanied by steaming heat. At two hundred and twenty-four days, the seventh change. At two hundred and fifty-six days, the eighth change, accompanied by steaming heat. At two hundred and eighty-eight days, the ninth change. At three hundred and twenty days, the tenth change, accompanied by steaming heat. After accumulating three hundred and twenty days, the minor zheng concludes. Sixty-four days later, major zheng begins. Sixty-four days after that, another major zheng occurs. One hundred and twenty-eight days after that, yet another major zheng. Generally, from birth, an infant changes every thirty-two days; two changes constitute one zheng. There are ten changes and five minor zheng, plus three major zheng. Accumulating five hundred and seventy-six days, both minor and major zheng are completed, and the child becomes an adult. The reason for bianzheng (changes and steaming) in children is to nourish their blood vessels and transform their five zang organs. Thus, after each change, one notices alterations in temperament. Signs of bianzheng: "Bian" manifests as upper qi symptoms (such as head heat or respiratory changes), while "Zheng" manifests as body heat. Bianzheng varies in severity. Mild cases present with slight body heat and mild startle, cold ears and sacrum, white blisters appearing on the upper lip like fish eyes, and slight sweating. Severe cases present with high fever, chaotic pulse, either sweating or not, anorexia, vomiting after eating, slightly red whites of the eyes, and slightly white irises. Another source says: Red eyes indicate severity; clear distinction between black and white indicates mildness. Upon completion of bianzheng, the eyes become bright. These are the signs. Single bian is mild; combined zheng is severe. For stable zheng, heat subsides in five days; for distant/longer courses, in ten days. Specifically, counting five days prior to the expected date and five days after constitutes a ten-day window during which the heat resolves. An infant changes at thirty-two days post-birth; if heat appears early on day twenty-nine, treat according to method, and the zheng completes by day thirty-six or thirty-seven. To avoid misunderstanding, I reiterate: During bianzheng, avoid disturbance; do not allow many people nearby. Many infants exhibit bianzheng earlier or later than prescribed. If initial heat is severe and persists beyond the scheduled days, carefully calculate the bianzheng dates. If mild heat and startle occur at the appropriate time, absolutely avoid treatment, moxibustion, or acupuncture; simply observe harmoniously. If heat persists for a long time, administer Zi Wan (Purple Pill) mildly to induce purgation; stop once heat subsides. If, during bianzheng, the infant contracts shixing wenbing (seasonal warm disease), or contracts seasonal illness outside of bianzheng, the diagnosis resembles bianzheng, except the ears and sacrum are uniformly hot, and there are no white blisters on the mouth. Administer Hei San (Black Powder) first to induce sweating; after sweating, apply Wen Fen (Warm Powder) to the body; the heat should subside, and recovery follows. If symptoms persist, administer Zi Wan to purge. If cold pathogen combines with bianzheng, cold and heat struggle, causing abdominal twisting and incessant crying; moxibustion/warming therapy will cure it. (Warming methods are described in the lower section using heated cotton wool.) Bianzheng resembles Wenzhuang Shanghan (warm-fever typhoid); however, if it is not bianzheng, but the body, ears, and sacrum are all hot, it is another disease, and other treatments apply. If confirmed as bianzheng, do not use other treatments.
Another method: Infants begin changing at thirty-two days post-birth; "bian" refers to body heat. At sixty-four days, the second change occurs, accompanied by steaming heat, characterized by lying straight and upright. At ninety-six days, the third change, marked by the emergence and discharge of Dan Kong (red pores/spots). At one hundred and twenty-eight days, the fourth change, accompanied by steaming heat, evidenced by the ability to cough and laugh. At one hundred and sixty days, the fifth change, marking the formation of joints/mechanisms. At one hundred and ninety-two days, the sixth change, accompanied by steaming heat, with five mechanisms formed. At two hundred and twenty-four days, the seventh change, evidenced by crawling. At two hundred and fifty-six days, the eighth change, accompanied by steaming heat, evidenced by the desire to learn speech. At two hundred and eighty-eight days, the ninth change, evidenced by standing upright ("Tingting"). By two hundred and eighty-eight days, an infant has undergone nine changes and four zheng. On the days of change, absolutely avoid arbitrary treatment, or it will exacerbate illness. "Bian qie zheng" refers to the infant's monthly transitions; zheng involves intense heat, chaotic pulse, and sweating. Heat subsides in five days for early courses, or eight to nine days for late ones. Do not perform moxibustion or acupuncture or treat arbitrarily during zheng.