千金儿初生,不可令衣过浓热,令儿伤皮肤,害血脉,发杂疮而黄,又小儿始生,肌
肤未成,不可暖衣,暖衣则令筋骨缓弱,宜时见风日,若都不见风日,则令肌肤脆软,便易
中伤。皆当以故絮衣之,勿用新绵也,天和暖无风之时,令母将于日中嬉戏。数见风日,则
血凝气刚,肌肉牢密,堪耐风寒,不致疾病,若常脏于帏帐之中,重衣温暖,譬犹阴地之草
木,不见风日,软脆不堪风寒也。(出第五卷中)
崔氏论曰,凡小儿初受气,在娠一月结胚,二月作胎,三月有血脉,四月形体成,五月
能动,六月筋骨立,七月毛发生,八月藏腑具,九月谷气入胃,十月百神能备而生矣,生后
六十日,目瞳子成,始笑应知人,百五十日百脉生,能反复,百八十日尻骨成,能独坐,二
百一十日掌骨成,能匍匐。三百日髌骨成,能独倚,三百六十日为一期,膝骨成,乃能行。
此其定法,若有不依期者,必有不平之处。
崔氏小儿生三十二日一变,六十四日再变兼蒸,九十六日三变,百二十八日四变,又蒸,
百六十日五变,百九十二日六变,又蒸,二百二十四日七变,二百五十六日八变,又蒸,二
百八十八日九变,三百二十日十变。又蒸,此小变蒸毕也,后六十四日又蒸,蒸后六十四日
又一大蒸,蒸后百二十八日又一大蒸。此大小蒸都毕也,凡五百七十六日乃成人,所以变蒸
者,皆是荣其血脉,改其五脏,故一变毕,辄觉情态忽有异也,其变蒸之候,令身热脉乱汗
出,目睛不明,微似欲惊,不乳哺,上唇头小白泡起如珠子,耳冷尻亦冷,此其诊也,单变
小微,兼蒸小剧,先期四五日便发,发后亦四五日歇,凡蒸平者,五日而衰,远至七日九日
而衰。当变蒸之时,慎不可疗及灸刺。但和视之,若良久热不已,可微与紫丸,热歇便止,
若于变蒸中,加以天行温病,或非变蒸而得天行者,其诊皆相似,唯耳及尻通热,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
又黑散方。
麻黄(一分去节) 大黄(一分) 杏仁(二分去皮尖熬令变色)
上三味先捣麻黄大黄为散,杏仁别捣如脂,乃细细内散,又捣令调和讫,内密器中,一
月儿服如小豆大一枚,以乳汁和服之,抱令得汗,汗出温粉粉之,勿使见风,百日儿服如枣
核,以儿大小量之为度。
又紫丸方。
代赭 赤石脂(各一两) 巴豆(三十枚去心皮熬) 杏仁(五十枚去尖皮熬)
上四味捣代赭等二味为末,巴豆杏仁别捣如膏,又内二味,合捣三千杵。自相和,若硬
,入少蜜更捣,密器中盛,封之三十日,儿服如麻子一丸,与少乳汁令下喉,食顷后与少乳
,勿令多,至日中当小下,热除,若未全除,明旦更与一丸,百日儿服如小豆一丸,以此
准量增减也,小儿夏月多热,喜令发疹,二三十日辄一服甚佳。此丸无所不治,代赭须真者
,若不真,以左顾牡蛎代之,忌猪肉芦笋。(并出第十上卷中)
【儿初生将息法二首】
新生儿出生时,不可让衣物过于厚重闷热,否则会导致小儿皮肤受损,血脉受害,引发各种疮疡并出现黄疸。另外,小儿刚出生时,肌肤尚未发育成熟,不能使用暖热的衣物;若使用暖衣,会使筋骨变得松弛软弱。适宜时常让小儿接触风和阳光,如果完全不见风日,就会使肌肤脆软,容易受到外邪伤害。这些都应当用旧的棉絮来给小儿穿衣,不要使用新的棉花。在天气温和无风的时候,让母亲抱着孩子在阳光下嬉戏。经常见到风日,则能使血液凝练、气机刚强,肌肉坚实紧密,能够耐受风寒,不会导致疾病。如果总是让孩子处在帷帐之中,穿着多层衣服保暖,这就好比阴地里的草木,不见风日,变得软弱脆弱,无法抵御风寒。(出自第五卷中)
【小儿初受气论一首】
崔氏论述说:凡是小儿最初受胎气,怀孕一个月结成胚胎,两个月形成胎体,三个月产生血脉,四个月形体长成,五个月胎儿能活动,六个月筋骨确立,七个月毛发生长,八个月脏腑具备,九个月谷气进入胃中,十个月百神(精神意识等生理功能)完备而出生。出生后六十天,瞳孔成形,开始笑并能识别亲人;一百五十天百脉生成,能翻身;一百八十天尻骨(尾椎骨)长成,能独自坐立;二百一十天掌骨长成,能匍匐前进;三百天髌骨(膝盖骨)长成,能独自依靠站立;三百六十天为一个周期,膝骨长成,才能行走。这是固定的规律,如果有不依循这个时间进程的,必定有身体不平顺的地方。
【小儿变蒸论二首】
崔氏认为:小儿出生后三十二天发生第一次“变”,六十四天第二次“变”兼有“蒸”,九十六天第三次“变”,一百二十八天第四次“变”兼有“蒸”,一百六十天第五次“变”,一百九十二天第六次“变”兼有“蒸”,二百二十四天第七次“变”,二百五十六天第八次“变”兼有“蒸”,二百八十八天第九次“变”,三百二十天第十次“变”兼有“蒸”。至此小范围的变蒸结束。之后再过六十四天再次“蒸”,这次“蒸”过后六十四天又有一次大的“蒸”,这次大“蒸”过后一百二十八天还有一次大的“蒸”。至此大小变蒸全部完成。总共五百七十六天成人。之所以称为变蒸,都是因为要荣养其血脉,改变其五脏的功能。所以每次变蒸结束,往往会发现孩子的情态忽然有所不同。其变蒸的征候,表现为身体发热、脉搏紊乱、出汗、眼睛目光不明亮、微微像要受惊的样子、不吃奶、上唇头出现小白泡像珠子一样、耳朵冷、屁股也冷,这就是诊断依据。单纯的“变”症状轻微,兼有“蒸”的症状稍重。通常在预期日期前四五天发作,发作后也经过四五天缓解。凡是平稳的变蒸,五天后衰退,远的到七天或九天才衰退。在变蒸期间,千万不可治疗以及进行艾灸和针刺。只需平和地观察即可。如果长时间发热不退,可以稍微给予紫丸,热退就停止。如果在变蒸期间,又加上流行性温热病,或者不是变蒸却得了流行性温病,其诊断表现都相似,只是耳朵和屁股都通体发热,口上没有白泡罢了。应当先服用黑散,以发汗,汗出后用温粉扑身,热势应当消退,病就好了。如果还不能完全消除,再给予紫丸攻下。
又有黑散方:
麻黄(一分,去节)、大黄(一分)、杏仁(二分,去皮尖,炒至变色)。
以上三味药,先将麻黄、大黄捣成散剂,杏仁单独捣如脂状,然后细细加入散剂中,再捣匀,放入密封容器中。一个月大的婴儿服用如小豆大一枚,用乳汁调和送服,抱持使其出汗,汗出后用温粉扑身,不要让见风。百日大的婴儿服用如枣核大,根据婴儿的大小酌情增减。
又有紫丸方:
代赭石、赤石脂(各一两)、巴豆(三十枚,去心皮,炒制)、杏仁(五十枚,去尖皮,炒制)。
以上四味药,将代赭石等两味药捣成粉末,巴豆、杏仁单独捣如膏状,再加入这两味药,合在一起捣三千杵。自然混合,如果太硬,加入少许蜂蜜再捣,盛放在密封容器中,封存三十天。婴儿服用如芝麻大一丸,加少许乳汁令其咽下,吃奶片刻后再喂少许乳汁,不要太多,到中午时会轻微腹泻,热除病愈。如果未完全清除,第二天早晨再给一丸。百日大的婴儿服用如小豆大一丸,以此为准量增减。小儿夏季多热,喜欢出疹子,二三十天服用一次很好。此丸无所不治,代赭石必须是真品,如果不真,可以用左顾牡蛎代替。忌食猪肉、芦笋。(均出自第十上卷中)
[Methods for Nursing a Newborn]
When a newborn is delivered, the infant should not be wrapped in overly thick or hot clothing, as this may damage the skin and harm the blood vessels, leading to various sores and jaundice. Furthermore, since the infant's skin and flesh are not yet fully developed at birth, warm clothing should not be used; doing so may cause the sinews and bones to become lax and weak. It is appropriate to frequently expose the infant to wind and sunlight. If completely deprived of wind and sunlight, the skin and flesh will become brittle and soft, making the infant susceptible to external pathogens. Old cotton wadding should be used for clothing, not new cotton batting. On mild, windless days, the mother should take the child out to play in the sunlight. Frequent exposure to wind and sunlight will consolidate the blood and strengthen the qi, resulting in firm and dense muscles capable of withstanding wind and cold, thereby preventing disease. If the child is kept within curtains, heavily clothed and kept warm, it is akin to grass and trees growing in the shade: deprived of wind and sunlight, they become soft, fragile, and unable to withstand wind and cold. (From Volume 5)
[Discussion on the Initial Reception of Qi in Infants]
Cui Shi stated: Regarding the initial reception of fetal qi, at one month of gestation, the embryo forms; at two months, the fetus takes shape; at three months, blood vessels appear; at four months, the physical form is complete; at five months, the fetus can move; at six months, sinews and bones are established; at seven months, hair grows; at eight months, the zang-fu organs are functional; at nine months, grain qi enters the stomach; and at ten months, all spiritual faculties are prepared, and the infant is born. Sixty days after birth, the pupils are formed, and the infant begins to smile and recognize people. At one hundred and fifty days, the meridians are generated, and the infant can roll over. At one hundred and eighty days, the coccyx bone develops, allowing the infant to sit alone. At two hundred and ten days, the metacarpal bones develop, enabling crawling. At three hundred days, the patella develops, allowing the infant to stand leaning. At three hundred and sixty days, completing one cycle, the knee bones develop, enabling walking. This is the fixed pattern. Any deviation from this timeline indicates an imbalance in the body.
[Discussion on Bianzheng in Infants]
Cui Shi posited: Thirty-two days after birth, the infant undergoes the first "Bian" (transformation); at sixty-four days, the second "Bian" occurs accompanied by "Zheng" (steaming); at ninety-six days, the third "Bian"; at one hundred and twenty-eight days, the fourth "Bian" accompanied by "Zheng"; at one hundred and sixty days, the fifth "Bian"; at one hundred and ninety-two days, the sixth "Bian" accompanied by "Zheng"; at two hundred and twenty-four days, the seventh "Bian"; at two hundred and fifty-six days, the eighth "Bian" accompanied by "Zheng"; at two hundred and eighty-eight days, the ninth "Bian"; and at three hundred and twenty days, the tenth "Bian" accompanied by "Zheng". With this, the minor Bianzheng cycles conclude. Another "Zheng" occurs sixty-four days later; another major "Zheng" occurs sixty-four days after that; and another major "Zheng" occurs one hundred and twenty-eight days after the previous one. Thus, both minor and major Bianzheng are completed. The infant reaches adulthood after five hundred and seventy-six days. The term Bianzheng refers to the process of nourishing the blood vessels and transforming the five zang organs. Consequently, upon the completion of each transformation, one often notices sudden changes in the infant's demeanor. Signs of Bianzheng include fever, irregular pulse, sweating, unclear gaze, slight signs of fright, refusal to nurse, small white blisters appearing on the upper lip like beads, cold ears, and a cold buttocks. These constitute the diagnostic criteria. Pure "Bian" presents with mild symptoms, while "Bian" accompanied by "Zheng" presents with slightly more severe symptoms. Symptoms typically begin four to five days before the expected date and subside four to five days after onset. For stable Bianzheng, symptoms decline within five days, or up to seven or nine days in some cases. During the period of Bianzheng, treatment, moxibustion, and acupuncture must strictly be avoided. One should only observe calmly. If fever persists for a long time, Zi Wan (Purple Pill) may be administered mildly, stopping once the fever subsides. If epidemic warm pathogenic factors are superimposed during Bianzheng, or if the infant contracts an epidemic warm disease unrelated to Bianzheng, the diagnosis appears similar, except that the ears and buttocks are uniformly hot, and there are no white blisters on the mouth. In such cases, Hei San (Black Powder) should be administered first to induce sweating. After sweating, Wen Fen (Warm Powder) should be applied to the body. The fever should then subside, and recovery follows. If symptoms do not fully resolve, Zi Wan may be given to purge.
Formula for Hei San (Black Powder):
Mahuang (Ephedrae Herba, 1 fen, nodes removed), Dahuang (Rhei Radix et Rhizoma, 1 fen), Xingren (Armeniacae Semen Amarum, 2 fen, skin and tips removed, stir-baked until color changes).
Pulverize Mahuang and Dahuang together. Separate Xingren and grind into a paste. Mix the paste finely into the powder, blend thoroughly, and store in a sealed container. For a one-month-old infant, administer one pill the size of a soybean, mixed with breast milk. Hold the infant to induce sweating. Apply Warm Powder after sweating. Avoid exposure to wind. For a hundred-day-old infant, administer the size of a jujube pit, adjusting according to the infant's size.
Formula for Zi Wan (Purple Pill):
Daizhe (Hematitum, 1 liang), Shizhi (Halloysitum Rubrum, 1 liang), Badou (Crotonis Fructus, 30 seeds, heart and skin removed, stir-baked), Xingren (Armeniacae Semen Amarum, 50 seeds, tips and skin removed, stir-baked).
Pulverize Daizhe and Shizhi. Grind Badou and Xingren separately into a paste. Combine the pastes with the powders and pound three thousand times until well mixed. If too hard, add a little honey and pound again. Store in a sealed container for thirty days. Administer one pill the size of a sesame seed to an infant, mixed with a little breast milk to help swallow. Feed a little breast milk after a short while, but do not overfeed. Mild diarrhea is expected around noon, indicating the removal of heat and cure. If not fully resolved, administer another pill the next morning. For a hundred-day-old infant, administer one pill the size of a soybean, adjusting dosage accordingly. In summer, infants are prone to heat and rashes; administering this pill every twenty to thirty days is beneficial. This pill treats all ailments. Daizhe must be genuine; if not, Zuogu Muli (Ostreae Concha facing left) may be substituted. Avoid pork and Asparagus cochinchinensis. (From Volume 10, Upper Part)