《颅囟经》∶孩子或夏中热时,因乳母沐浴多使冷水,奶得冷气,血脉皆伏,见孩子气未定便与奶,使孩子
多胃毒及赤白两般恶痢,此乃是奶母之过也。凡浴后可令定息良久,候气定熟揉与之,即令无患。
《千金》论∶凡乳儿不欲太饱,饱则呕吐,每候儿吐者,乳太饱也。以空乳乳之即消,日四乳儿。若脐未愈,
乳儿太饱,令风中脐也。夏不去热乳,令儿呕逆。冬不去寒乳,令儿咳痢。母新房以乳儿,令儿羸瘦,交胫不
能行。母有热以乳儿,(《千金翼》云∶母患热以乳儿。)令变黄不能食。母怒以乳儿,令喜惊发气疝,又令
上气癫狂。母新
吐下以乳儿,令虚羸。母醉以乳儿,令身热腹满。凡乳母乳儿,当先极 ,散其热气,勿令汁奔出令儿噎,辄
夺其乳,令得息息,已复乳之。如是十返五返,视儿饥饱节度,知一日中几乳而足以为常,又常捉去宿乳。儿
若卧,乳母当以臂枕之,令乳与儿头平乃乳之,令儿不噎。母欲寐则夺其乳,恐填口鼻,又不知饥饱也。
《圣惠》论∶凡为乳母,皆有节度。如不禁忌,即令孩子百病并生。如是自晓摄调,可致孩子无疾长寿。是
以春夏切不得冲热哺孩子,必发热疳并呕逆。秋冬勿以冷乳哺孩子,必令腹胀羸瘦。乳母嗔怒次不得哺孩子,
必患狂邪。乳母醉后,不得哺孩子,必患惊痫、天 、急风等病。如母有娠,不得哺孩子,必患胎黄及脊疳。
乳母有疾,不得哺孩子,必患癫痫风病。乳母吐后,不得哺孩子,必令呕逆羸瘦。乳母伤饱,不得哺孩子,必
致多热喘急。(诸书并取此三书以为说,别无异论。)
《婴孺》云∶凡儿生一日至七日,取乳一合,分作三服。二十日至三十日,以三合为三服。生八日至十五日,
取一合半为三服。生三十日至四十日,以至五合为三服。生十六日至二十日,取二合为三服。四十日以上,方
法准此为率,节级加减。
《婴童宝鉴》云∶凡乳母饮酒淫餐,勿饲儿乳,令发霍不治。
钱乙乌药散 治乳母冷热不和,及心腹时痛,或水泻、或乳不好。
天台乌药 香附子(破,用白者) 高良姜 赤芍药(各等分)
上为末。每服一大钱,水一盏,同煎六分温服。如心腹疼痛,入酒煎。水泻,米饮调下,无时。
《庄氏家传》治乳母体热,令小儿黄瘦。姜黄散方
姜黄 人参(去芦头) 陈橘皮
上件等分为粗末。每服一钱,水一盏,煎至六分,去滓温服,日只一服。
《颅囟经》说:孩子在夏季炎热时,如果因为乳母用大量冷水沐浴,导致乳汁沾染了冷气,血脉凝滞。此时若见孩子气息尚未平稳就立即喂奶,会使孩子产生胃中毒邪以及赤白两种恶痢,这都是乳母的过错。凡是沐浴后,应让乳母静息良久,待其气息平稳、身体暖和后再给孩子喂奶,这样就不会有祸患。
《千金方》论述:凡喂养婴儿不要使其过饱,过饱就会呕吐。每当看到孩子呕吐,是因为吃奶太饱所致。排空乳房后再喂,乳汁即可消化,每天喂奶四次。如果脐带伤口未愈合,喂奶过饱,会导致风邪侵入脐部。夏天不除去热毒的乳汁(指乳母体内有热或乳汁过热),会使孩子呕吐逆气;冬天不除去寒气的乳汁(指乳母体内有寒或乳汁过冷),会使孩子咳嗽腹泻。乳母刚行房事就喂奶,会使孩子消瘦,双腿交叉无法行走。乳母有热症时喂奶,(《千金翼方》说:母亲患热病时喂奶。)会使孩子变成黄病且不能进食。乳母发怒时喂奶,会使孩子容易受惊、发作气疝,又会上气癫狂。乳母刚吐泻完就喂奶,会使孩子虚弱消瘦。乳母醉酒时喂奶,会使孩子身体发热、腹部胀满。凡乳母喂奶,应当先极力按摩乳房,散除其中的热气,不要让乳汁喷射出来呛到孩子,要暂时停止喂奶,让孩子呼吸片刻,然后再喂。像这样反复十次或五次,观察孩子的饥饱程度,知道一天中喂几次奶足够并以此为常法,还要经常挤掉残留的陈旧乳汁。如果孩子躺着,乳母应用手臂垫着孩子,使乳房与孩子头部平齐再喂奶,以免孩子呛着。乳母想睡觉时就夺去乳头,恐怕堵塞口鼻,而且也不知道孩子的饥饱情况。
《太平圣惠方》论述:凡是做乳母,都有节度规范。如果不加禁忌,就会让孩子百病丛生。如果能自己懂得调理摄养,就可以使孩子无病长寿。因此春夏季节切忌顶着热气给孩子喂奶,必然会导致发热、疳积和呕吐逆气。秋冬季节不要用冷乳汁给孩子喂奶,必然会导致腹胀、消瘦。乳母生气发怒之后不得给孩子喂奶,必然会导致狂躁邪病。乳母醉酒后,不得给孩子喂奶,必然会导致惊痫、天钓、急风等疾病。如果母亲怀孕,不得给孩子喂奶,必然会导致胎黄及脊疳。乳母有病时,不得给孩子喂奶,必然会导致癫痫风病。乳母呕吐之后,不得给孩子喂奶,必然会导致呕吐逆气、消瘦。乳母吃得太饱受伤后,不得给孩子喂奶,必然会导致多热、气喘急促。(各种书籍都引用这三本书作为依据,没有其他不同的论点。)
《婴孺书》说:凡是婴儿出生第一日至第七日,取乳汁一合,分作三次服用。第二十日第三十日,以三合分为三次服用。出生第八日至十五日,取一合半分为三次服用。出生三十日至四十日,以五合分为三次服用。出生十六日至二十日,取二合分为三次服用。四十日以上,方法以此为准,按等级加减。
《婴童宝鉴》说:凡是乳母饮酒或饮食放纵,不要给婴儿喂奶,否则会导致霍乱等不治之症。
钱乙乌药散:治疗乳母冷热不调,以及心腹时常疼痛,或者水样腹泻、或者乳汁不好。
天台乌药、香附子(破开,用白色的)、高良姜、赤芍药(各等分)。
以上药物研为细末。每次服用一大钱,用水一盏,同煎至六分,温服。如果心腹疼痛,加入酒同煎。如果是水泻,用米汤调下,不限时间。
《庄氏家传》治疗乳母体质热,导致小儿发黄消瘦。姜黄散方:
姜黄、人参(去掉芦头)、陈橘皮。
以上药物等分为粗末。每次服用一钱,用水一盏,煎至六分,去渣温服,每天只服一次。
*The Lu Xin Jing* (Classic of the Cranium and Fontanelle) states: When a child is in the heat of summer, if the wet nurse bathes extensively with cold water, the milk may acquire cold qi, causing the blood vessels to stagnate. If the child is fed before their qi has stabilized, it will cause gastric toxicity and both red and white dysentery. This is the fault of the wet nurse. After bathing, one should allow the wet nurse to rest quietly for a long time until her breath and body temperature stabilize before feeding the infant, thus avoiding harm.
*Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) discusses: Feeding infants should not be done to excess; overfeeding leads to vomiting. Whenever an infant vomits, it is due to excessive feeding. Emptying the breast before feeding ensures digestion. Feed the infant four times a day. If the umbilical cord has not yet healed, overfeeding allows wind pathogens to invade the umbilicus. In summer, failing to eliminate "hot milk" causes infant regurgitation and counterflow qi; in winter, failing to eliminate "cold milk" causes coughing and dysentery. If the wet nurse engages in sexual intercourse and then nurses, the infant may become emaciated and unable to walk with crossed legs. If the wet nurse has internal heat and nurses, (as *Qian Jin Yi Fang* notes: when the mother suffers from heat disease and nurses,) the infant may develop jaundice and lose appetite. If the wet nurse is angry and nurses, the infant may suffer from fright, Qi hernia, and upward rushing qi leading to mania. If the wet nurse has just vomited or had diarrhea and nurses, the infant becomes weak and emaciated. If the wet nurse is drunk and nurses, the infant develops fever and abdominal fullness. When nursing, the wet nurse should first vigorously massage the breasts to dissipate heat, preventing milk from spurting out and choking the infant. Temporarily withdraw the breast to let the infant breathe, then resume. Repeat this ten or five times, observing the infant's hunger and satiety to determine the appropriate frequency per day as a routine. Frequently express and discard residual old milk. If the infant lies down, the wet nurse should support the infant's head with her arm so that the breast is level with the infant's head to prevent choking. If the wet nurse feels drowsy, she must remove the nipple to avoid blocking the infant's mouth and nose, as she would no longer perceive the infant's hunger or satiety.
*Tai Ping Sheng Hui Fang* (Great Imperial Healer's Essential Prescriptions) discusses: There are strict regulations for wet nurses. Without adhering to taboos, the infant will suffer from myriad diseases. By understanding self-care and regulation, one can ensure the infant remains healthy and lives long. Therefore, in spring and summer, one must strictly avoid nursing while hot, which inevitably causes fever, malnutrition syndromes (Gan), and vomiting. In autumn and winter, do not use cold milk to feed the infant, which inevitably causes abdominal distension and emaciation. Do not nurse immediately after anger, which leads to manic disorders. Do not nurse after intoxication, which leads to convulsions, Tian Diao (infantile tetanus), and acute wind diseases. If the mother is pregnant, she should not nurse, as this causes fetal jaundice and spinal Gan. If the mother is ill, she should not nurse, leading to epilepsy and wind diseases. After vomiting, do not nurse, causing regurgitation and emaciation. After overeating, do not nurse, leading to excessive heat and rapid breathing. (All books cite these three texts as authority, with no differing opinions.)
*Ying Ru Shu* (Book on Infants) states: From the first to the seventh day after birth, take one he of milk, divided into three doses. From the twentieth to the thirtieth day, take three he divided into three doses. From the eighth to the fifteenth day, take one and a half he divided into three doses. From the thirtieth to the fortieth day, take five he divided into three doses. From the sixteenth to the twentieth day, take two he divided into three doses. For those over forty days, follow this standard, adjusting incrementally.
*Ying Tong Bao Jian* (Precious Mirror for Infants and Children) states: If the wet nurse drinks alcohol or eats excessively/improperly, do not feed the infant, lest it trigger untreatable Huo Luan (cholera-like syndrome).
Qian Yi's Wu Yao San (Lindera Powder): Treats wet nurses with imbalance of cold and heat, frequent heart and abdominal pain, watery diarrhea, or poor quality milk.
Tiantai Wu Yao (Linderae Radix), Xiang Fu Zi (Cyperi Rhizoma, broken, using the white part), Gao Liang Jiang (Galangali Rhizoma), Chi Shao Yao (Paeoniae Radix Rubra) (equal parts).
Grind into powder. Take one large qian per dose, decoct with one cup of water until reduced to 0.6 cup, and take warm. If there is heart/abdominal pain, decoct with wine. For watery diarrhea, administer with rice water, at any time.
*Zhuang Shi Jia Chuan* (Zhuang Family Transmission) treats wet nurses with constitutive heat causing yellowing and emaciation in infants. Jiang Huang San (Curcuma Powder):
Jiang Huang (Curcumae Longae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma, remove the rhizome/chin), Chen Ju Pi (Citri Reticulatae Pericarpium).
Grind equal parts into coarse powder. Take one qian per dose, decoct with one cup of water until reduced to 0.6 cup, strain, and take warm. Administer once daily.