凡小儿生三十二日为一变。六十四日再变。兼蒸。九十六日三变。一百二十八日四变。
又蒸
又
六十
血脉
其
是其候也。当变小剧。先期四五日便发。后剧三四日方歇。卒蒸五日。远至七日九日。当变
蒸之时。慎不可疗及灸刺。但和视之。若良久热不已。即微与紫双丸。热歇便止。若于变蒸
中。加以天行温疫病。或非变蒸而得天行者。其候皆似。唯耳及尻通热。口上无白泡尔。
当先服黑散子以发其汗。出温粉粉之。热当歇。便就瘥。若犹不都除。乃与紫双丸下之。
治小儿变蒸壮热。黑散子方。
麻黄（半两去根节） 川大黄（一分锉） 杏仁（半两汤浸去皮尖双仁）
上件药。并炒令黑。都研令细。每服。以温水调下半钱。服了。且令暖抱儿。令汗出。
良久
治小儿变蒸内。身体壮热。经时不解。心腹烦满。紫双丸方。
代赭（一两研如粉） 赤石脂（一两研如粉） 巴豆（三十枚去皮心出油） 杏仁（五
十枚汤
浸去
上巴豆等。别捣如膏。四味相和。捣二千杵。相得。入少蜜捣之。亦须密器
中收。三十日儿
热若未除。明
疹。二三十日
治小儿变蒸。经时不止。挟热。心烦。啼叫无歇。骨热面黄。柴胡散方。
柴胡（一两去苗） 龙胆（半两去芦头） 麦门冬（一两半去心焙） 玄参（一两） 甘
草（一
两炙
上件药。捣罗为散。每服一钱。以水一小盏。
煎至五分。去滓。不计时候温服。量儿大小。
加减服之。
凡是小儿出生三十二天称为“一变”。六十四天再次发生“变”，并伴随“蒸”。九十六天第三次“变”。一百二十八天第四次“变”，并伴随“蒸”。
六十天时，血脉充盈，这是其征候。当发生“变”时症状剧烈。提前四五天开始发作，延后三四天才停止。突然发生的“蒸”持续五天，远的可达七天或九天。在“变蒸”期间，千万不要进行治疗以及艾灸和针刺，只需温和地观察即可。如果长时间发热不退，就稍微给予紫双丸服用，热退就停药。如果在变蒸过程中，又加上流行性温疫疾病，或者并非变蒸而感染了流行病，其征候都相似，只有耳朵和臀部（尻）通体发热，口上无白泡而已。应当先服用黑散子以发汗，出汗后用温粉扑身，热势应当消退，病就好了。如果仍然不能完全消除，再给紫双丸攻下。
治疗小儿变蒸壮热，黑散子方：
麻黄（半两，去根节） 川大黄（一分，锉碎） 杏仁（半两，汤浸去皮尖及双仁者）
以上药物，一起炒至黑色，全部研成细末。每次服用，用温水调服半钱。服完后，暂且让婴儿保暖怀抱，使其出汗。
治疗小儿变蒸期间，身体壮热，长时间不缓解，心腹烦闷胀满，紫双丸方：
代赭石（一两，研如粉末） 赤石脂（一两，研如粉末） 巴豆（三十枚，去皮心并出油） 杏仁（五十枚，汤浸去皮……[原文此处有缺漏]）
将巴豆等药，另外捣成膏状，四味药混合，捣两千杵，使其均匀。加入少量蜂蜜再捣，也必须密封容器中收藏。三十日龄的婴儿……[原文此处有缺漏] 热若未除，明……[原文此处有缺漏] 疹。二三十日……[原文此处有缺漏]
治疗小儿变蒸，持续时间不止，挟带热邪，心烦，啼叫不停，骨蒸潮热面色黄，柴胡散方：
柴胡（一两，去苗） 龙胆（半两，去芦头） 麦门冬（一两半，去心焙干） 玄参（一两） 甘草（一两，炙）
以上药物，捣碎过筛为散剂。每次服用一钱，用水一小盏，煎至五分，去渣滓，不拘时候温服。根据婴儿大小，酌情加减服用。
When a child is thirty-two days old, it is called one "Bian" (transformation). At sixty-four days, there is another "Bian", accompanied by "Zheng" (steaming). At ninety-six days, there is the third "Bian". At one hundred and twenty-eight days, there is the fourth "Bian", accompanied by "Zheng".
At sixty days, the blood vessels are full; this is its sign. When "Bian" occurs, the symptoms are severe. It starts four or five days early and stops three or four days late. Sudden "Zheng" lasts for five days, extending to seven or nine days in some cases. During the period of Bian-Zheng, medical treatment, moxibustion, and acupuncture must strictly be avoided; one should only observe gently. If fever persists for a long time, administer Zi Shuang Wan (Purple Double Pill) slightly; stop when the fever subsides. If, during Bian-Zheng, an epidemic warm disease is contracted, or if an epidemic disease occurs not due to Bian-Zheng, the signs are similar, except that the ears and the buttocks (kao) are hot throughout, and there are no white blisters on the mouth. One should first administer Hei San Zi (Black Powder) to induce sweating, then apply Wen Fen (Warm Powder) to the body after sweating; the fever should subside, and the illness will heal. If the condition is not completely resolved, administer Zi Shuang Wan to purge.
Formula for treating severe fever in children due to Bian-Zheng: Hei San Zi Formula.
Mahuang (Ephedrae Herba, half liang, remove root and nodes) Dahuang (Rhei Radix et Rhizoma, one fen, cut into pieces) Xingren (Armeniacae Semen Amarum, half liang, soaked in hot water, remove skin and pointed end, discard double-kernel seeds)
The above ingredients are stir-fried until black, then all ground into fine powder. Each dose consists of half qian, mixed with warm water. After administration, keep the infant warm in the arms to induce sweating.
Formula for treating severe body heat persisting for a long time, with mental restlessness and abdominal fullness during Bian-Zheng: Zi Shuang Wan (Purple Double Pill).
Daizhe (Haematitum, one liang, ground into powder) Chishizhi (Halloysitum Rubrum, one liang, ground into powder) Badou (Crotonis Fructus, thirty seeds, remove skin and heart, express oil) Xingren (Armeniacae Semen Amarum, fifty seeds, soaked in hot water... [text missing])
Separately pound Badou and other ingredients into a paste. Mix the four ingredients and pound two thousand times until uniform. Add a small amount of honey and pound again; store in a sealed container. For infants aged thirty days... [text missing] If the heat is not removed, clearly... [text missing] rash. Twenty or thirty days... [text missing]
Formula for treating prolonged Bian-Zheng with lingering heat, mental restlessness, incessant crying, bone-steaming fever, and sallow complexion: Chaihu San (Bupleurum Powder).
Chaihu (Bupleuri Radix, one liang, remove sprouts) Longdan (Gentianae Radix, half liang, remove rhizome head) Maimendong (Ophiopogonis Radix, one and a half liang, remove heart and roast) Xuanshen (Scrophulariae Radix, one liang) Gancao (Glycyrrhizae Radix et Rhizoma, one liang, processed with honey)
The above ingredients are crushed, sifted, and made into a powder. Each dose is one qian, decocted with one small cup of water until reduced to half a cup. Strain the dregs and take warm at any time. Adjust the dosage according to the size of the infant.