夫小儿初生。血气未定。阴阳未和。脏腑未足。骨格未生。有变蒸之候。变者异常也。
蒸者
发热也。所以变生五脏。蒸养六腑。须要变蒸多遍。则骨节脏腑。由是而全。胎毒亦因变而
散。气血方荣。性情有异。后来出痘亦轻可也。自生之日始。每三十二日一变。凡人有三
百
六十五骨。除手足四十五碎骨外。止有三百二十骨。自生下骨而上。一日十骨。三十二HT 为一
变。骨气始全。一变生一脏。或一腑。十变则脏腑始足。每变轻则发热微汗其状似惊。重则
壮热。脉乱而数。或吐或汗。或烦啼燥渴。轻则五日解。重则八日解。凡小儿之病。无有不
由变蒸而得也。而不热不惊。无他病候。是暗变者多矣。此受胎气壮故也。凡变蒸。须看儿
唇口。如上唇微肿。有如卧蚕。或有珠泡子者。是真变蒸之候也。此则决不可妄投针灸药饵
若误之。则为药引入各经。症遂难识。而且缠绵不脱。反为药之所害也。如或因伤食。因
伤风。因惊吓等项。夹杂相值而发。令人疑惑。亦须守候两三日。俟其病势真的。是食则
消食。是风则行痰。是惊则安神。随症调治。或非变蒸。时而得伤寒时行瘟病。则口上无白
泡。其诊皆相似。惟耳及尻通热。此为他病。可作余治。业幼科者。奚不详究耶。
小儿初生之时，气血尚未稳定，阴阳尚未调和，脏腑功能尚未充实，骨骼尚未完全生成，此时会出现“变蒸”的现象。“变”是指身体的异常变化，“蒸”是指发热。通过变蒸过程，五脏得以生成，六腑得以滋养。必须经历多次变蒸，骨骼关节和脏腑才能由此发育健全，胎毒也会随着变蒸而消散，气血才会旺盛，性情也会有所不同，将来出痘疹时症状也会较轻。从出生之日算起，每三十二天发生一次变蒸。人共有三百六十五块骨头，除去手足四十五块碎骨外，只剩三百二十块骨头。自出生后骨骼生长而言，每天长十块骨头，三十二天为一变，至此骨气始全。每一次变蒸产生一个脏或一个腑，经过十次变蒸，脏腑才完全具备。每次变蒸若轻微，则表现为低热、微汗，症状类似受惊；若严重，则表现为高热、脉搏紊乱且快速，或呕吐、出汗、烦躁啼哭、口干渴。轻微的变蒸五天可缓解，严重的八天可缓解。凡是小儿的疾病，没有不是由变蒸引起的。如果不发热、不惊恐，也没有其他病症表现，这属于“暗变”，这种情况很多，是因为胎儿时期禀受的元气壮实所致。凡遇到变蒸，必须观察孩子的嘴唇和口腔，如果上唇微微肿胀，像卧蚕一样，或者有珍珠状的小水泡，这才是真正的变蒸征候。这种情况下，绝对不可以随意使用针灸或药物。如果误治，药物会引邪进入各条经络，导致病情难以辨识，而且缠绵难愈，反而被药物所害。如果是由于伤食、伤风、惊吓等原因夹杂在一起引发，容易让人疑惑。也需要等待两三天，待病情真正明确后，是食积就消食，是风邪就化痰，是惊吓就安神，根据症状进行调理。如果不是变蒸，而是得了伤寒或时行瘟病，则口上没有白泡，诊断方法都相似，只有耳朵和尾椎部位通体发热，这是其他疾病，可以按照其余病症治疗。从事儿科的医生，怎么能不详细研究呢？
When infants are first born, their Qi and Blood are not yet stable, Yin and Yang are not yet harmonized, the Zang-Fu organs are not yet fully developed, and the skeletal structure is not yet formed. At this stage, there is a phenomenon known as Bianzheng (Variation and Steaming). "Bian" refers to abnormal changes in the body, while "Zheng" refers to fever. Through the process of Bianzheng, the Five Zang Organs (Heart, Liver, Spleen, Lung, Kidney) are generated, and the Six Fu Organs (Gallbladder, Stomach, Small Intestine, Large Intestine, Bladder, Sanjiao) are nourished. It is necessary to undergo multiple cycles of Bianzheng so that the bones, joints, and Zang-Fu organs can develop completely. The fetal toxins will also dissipate due to these variations, allowing Qi and Blood to flourish and temperament to change, which may result in milder symptoms when smallpox or chickenpox erupts later. Starting from the day of birth, a variation occurs every thirty-two days. Humans have three hundred and sixty-five bones in total; excluding the forty-five fragmented bones in the hands and feet, there remain three hundred and twenty bones. From the perspective of bone growth after birth, ten bones grow per day. Thirty-two days constitute one variation, at which point the Qi of the bones is initially complete. Each variation generates one Zang organ or one Fu organ. After ten variations, the Zang-Fu system becomes fully equipped. If a variation is mild, it presents with slight fever and micro-sweating, resembling signs of fright. If severe, it presents with high fever, chaotic and rapid pulse, vomiting, sweating, irritability, crying, dryness, and thirst. Mild cases resolve within five days, while severe cases resolve within eight days. All illnesses in infants originate from Bianzheng. However, if there is no fever or fright, and no other pathological signs, it is considered "hidden variation," which is common due to strong prenatal Qi. When observing for Bianzheng, one must examine the infant's lips and mouth. If the upper lip is slightly swollen, resembling a silkworm, or has pearl-like blisters, these are true signs of Bianzheng. In such cases, acupuncture or herbal medication must absolutely not be administered indiscriminately. Misapplication may guide pathogens into the meridians, making the condition difficult to diagnose and leading to lingering illness, thereby harming the child with medicine. If symptoms arise from mixed causes such as food stagnation, wind-cold invasion, or fright, confusion may ensue. One should wait two to three days until the pathology is clear: treat food stagnation by promoting digestion, wind by resolving phlegm, and fright by calming the spirit, adjusting treatment according to symptoms. If it is not Bianzheng but rather an attack of Cold Damage (Shanghan) or epidemic pestilence, there will be no white blisters on the lips. Although the diagnosis may seem similar, heat throughout the ears and the sacrum indicates a different disease, which should be treated accordingly. How can practitioners of pediatrics fail to investigate this in detail?