变蒸之时。有外感风寒者。宜发散。惺惺散主之。按摩法亦可用也。有内伤乳食者。宜
导。胃苓丸生之。轻则节之可也。有被惊吓及客忤者。安神丸至圣保命丹。如变蒸而后发病
。以治病为主。慎勿犯其胃气。咳嗽。甘草桔梗汤加阿胶。吐泻。理中汤加藿香叶。惊风。
琥珀抱龙丸。泻青丸。导赤散。如受病后而变蒸。以养正补脾为主。钱氏异功散加对病之药
。惺惺散。四君子汤加苏叶。加防风。
湖广按察司宪长。有子九月发热。恐是痘疹。差人来取予。往视之。非痘。是变蒸也。
。何以辨之。予曰。以日计之。有当变蒸之期。以证察之。亦无痘疹之症。公问。痘何证也
。予曰。痘者五脏之液毒也。故五脏各见一证。呵欠惊悸心也。项急顿闷肝也。咳嗽喷嚏肺
也。吐泻昏睡脾也。身体皆凉肾也。今公子无之。知非痘。乃变蒸将退也。次日果安。公喜
曰。汝术甚精。赠以白金五两。应付而归。
本县胡正瞿。有子二月。发热不乳。予见之。虽似变蒸非变蒸。时乳母皆肥健。必因伤
乳发热也。令损之。次日热退而安矣。
（儿生一岁后。至七岁后。变蒸已足。脉虽难诊。口则能言。病多伤食之证。八岁以后
。有脉可诊。证与大人同。但用剂小耳。）
有因气动而病生于内者。如盘肠内吊蛔虫癖块之类。有因气动而病生于外者。重舌木舌
口口疮。痈疽疮癣之类。有不因气动而病生内者。如伤饮食生冷之类。有不因气动而病生于
外者。如四时感冒。金刃汤火伤之类。
上四因之病。治见各证之下。
一小儿周岁。因初食鸡肉太早。自此成积。日渐羸瘦。不思乳食。其父以详告予。予取
之。养脾消积丸先服。三日后服丁香脾积丸。鸡肉汤下。取下鸡肉一片。犹未化也。再进养
脾丸而愈。
家传养脾消积丸 消宿食。去陈积。神效。
白术（一两） 陈皮（七钱五分） 苍术（五钱） 浓朴（姜汁炒五钱） 枳壳（面炒五钱） 半
（五钱） 青皮（五钱） 神曲（五钱） 麦芽（五钱） 山楂（五钱） 炙甘草（三钱） 上为细末。
蒸饼为丸黍米大。每服二三十丸。米饮送下。
育婴延龄解毒丸 能解胎毒。初生小儿宜服。
儿断脐带连胞。不拘长短。剪取新瓦上焙干。每一钱加生甘草末二钱。黄连末一钱。朱
半钱。共和匀。生白砂糖调和。瓷罐收贮。每服一豆许。纳儿口中。以乳送下。一日一次。
药尽而止。
在变蒸期间，如果患儿感受了外感风寒，适宜采用发散法治疗，以惺惺散为主方。按摩疗法也可以使用。如果是因为内伤乳食所致，适宜采用消导法治疗，以胃苓丸来生发胃气。病情轻的，只需节制饮食即可。如果是受到惊吓或客忤（外来邪气侵扰），可用安神丸、至圣保命丹。如果是变蒸之后才发病的，应以治疗疾病为主，务必小心不要损伤患儿的胃气。如果出现咳嗽症状，用甘草桔梗汤加阿胶；出现吐泻症状，用理中汤加藿香叶；出现惊风症状，用琥珀抱龙丸、泻青丸、导赤散。如果是先受病而后出现变蒸现象的，应以扶正补脾为主，使用钱氏异功散加入针对病症的药物，或者使用惺惺散、四君子汤加苏叶、防风。
湖广按察司宪长有一位儿子，九个月大时发热，家人担心是痘疹，派人来请我。我去诊视后，判断不是痘疹，而是变蒸。如何辨别呢？我说：根据日期推算，正值变蒸的时期；观察证候，也没有痘疹的症状。他问：痘疹有什么证候呢？我说：痘疹是五脏的液毒，所以五脏各自显现一种证候：呵欠、惊悸属于心；项强、顿闷属于肝；咳嗽、喷嚏属于肺；吐泻、昏睡属于脾；身体皆凉属于肾。现在您的公子没有这些症状，可知不是痘疹，而是变蒸即将消退。第二天果然安然无恙。他高兴地说：“你的医术非常精湛。”赠送给我白金五两，我应付后便回去了。
本县胡正瞿有一个两个月大的儿子，发热且不吃奶。我见到他，虽然看似变蒸，但并非变蒸。当时乳母都体态肥健，必定是因为乳汁过盛导致伤乳发热。嘱咐减少哺乳量，第二天热退而安。
（小儿出生后一岁到七岁之间，变蒸已经充足。此时脉象虽难诊断，但口已能言语，生病多为伤食的证候。八岁以后，有脉可诊，证候与成人相同，只是用药剂量较小罢了。）
有的因为气动而在体内生病，如盘肠内吊、蛔虫、癖块之类；有的因为气动而在体外生病，如重舌、木舌、口疮、痈疽、疮癣之类；有的不因气动而在体内生病，如伤于饮食生冷之类；有的不因气动而在体外生病，如四时感冒、金刃汤火伤之类。上述四种病因引起的疾病，治疗方法见各证候之下。
有一个周岁的小儿，因为刚开始吃鸡肉太早，从此形成积滞，日渐消瘦，不想吃奶和食物。他的父亲详细告诉了我。我取来养脾消积丸让他先服用，三天后服用丁香脾积丸，用鸡肉汤送服，排出了一片鸡肉，还没有消化。再服用养脾丸而痊愈。
家传养脾消积丸：消除宿食，去除陈积，效果神奇。
白术（一两） 陈皮（七钱五分） 苍术（五钱） 浓朴（姜汁炒五钱） 枳壳（面炒五钱） 半夏（五钱） 青皮（五钱） 神曲（五钱） 麦芽（五钱） 山楂（五钱） 炙甘草（三钱）。以上药物研为细末，用蒸饼做丸，大小如黍米。每次服用二三十丸，用米饮送下。
育婴延龄解毒丸：能解除胎毒，初生婴儿适宜服用。
剪取新生儿断脐带连带的胞衣，不拘长短，在新瓦上焙干。每一钱药中加入生甘草末二钱、黄连末一钱、朱砂半钱，混合均匀。用生白砂糖调和，装入瓷罐收贮。每次服用如豆粒大小，放入婴儿口中，用乳汁送下。一日一次，药尽为止。
During the period of Bianzheng (periodic physiological growth and development in infants), if the child is affected by external Wind-Cold, it is appropriate to use dispersing methods, with Xingxing San (Stupefying Powder) as the primary formula. Massage therapy can also be used. If caused by internal injury from milk and food, guiding and resolving methods are appropriate, using Weiling Wan (Weiling Pill) to nourish stomach qi. For mild cases, dietary restriction suffices. If frightened or affected by Ke Wu (external malevolent influences), Anshen Wan (Spirit-Calming Pill) or Zhisheng Baoming Dan (Supreme Life-Preserving Pellet) may be used. If illness occurs after Bianzheng, treat the disease primarily, being careful not to damage the stomach qi. For cough, use Gancao Jiegeng Tang (Licorice and Platycodon Decoction) plus Ejiao (Donkey-Hide Gelatin); for vomiting and diarrhea, use Lizhong Tang (Regulate the Middle Decoction) plus Huoxiang Ye (Patchouli Leaf); for convulsions, use Hupo Baolong Wan (Amber Embracing Dragon Pill), Xieqing Wan (Drain Liver Pill), or Daochi San (Direct Red Powder). If Bianzheng occurs after contracting illness, focus on supporting righteousness and tonifying the spleen, using Qian Shi Yigong San (Master Qian’s Extraordinary Power Powder) added with herbs targeting the specific disease, or Xingxing San, Sijunzi Tang (Four Gentlemen Decoction) plus Ziyeh (Perilla Leaf) and Fangfeng (Saposhnikovia Root).
The Commissioner of Surveillance of Huguang Province had a son who developed fever at nine months old. Fearing it was smallpox, he sent for me. Upon examination, I determined it was not smallpox but Bianzheng. How to distinguish them? I said: By calculating the days, it falls within the expected period of Bianzheng; observing the symptoms, there are no signs of smallpox. He asked: What are the symptoms of smallpox? I said: Smallpox is the toxic fluid of the five zang organs, so each organ manifests one symptom: yawning and palpitations belong to the Heart; neck stiffness and chest oppression belong to the Liver; cough and sneezing belong to the Lungs; vomiting, diarrhea, and lethargy belong to the Spleen; coldness throughout the body belongs to the Kidneys. Since your son lacks these, it is not smallpox, but the subsiding phase of Bianzheng. The next day, he recovered naturally. Delighted, he said, "Your medical skill is exquisite," and gifted me five taels of silver, which I accepted before departing.
Mr. Hu Zhengqu of this county had a two-month-old son who had a fever and refused to nurse. Upon seeing him, although it resembled Bianzheng, it was not. The wetnurses were all robust and well-fed, so the fever was certainly due to overfeeding causing milk stagnation. I advised reducing the feeding frequency. The next day, the fever subsided, and he became calm.
(After birth until age seven, Bianzheng is complete. Although pulse diagnosis is difficult, the child can speak, and illnesses are mostly due to food stagnation. After age eight, the pulse can be diagnosed, and symptoms resemble those of adults, though medication dosages are smaller.)
Some diseases arise internally due to Qi movement, such as intestinal colic, roundworms, and phlegm masses. Some arise externally due to Qi movement, such as double tongue, wooden tongue, mouth ulcers, carbuncles, sores, and tinea. Some arise internally without Qi movement, such as injuries from improper diet or raw/cold foods. Some arise externally without Qi movement, such as seasonal colds, knife wounds, or burns/scalds. The treatments for diseases caused by these four factors are detailed under their respective syndromes.
A one-year-old child developed accumulation because chicken meat was introduced too early. Gradually, he became emaciated and lost appetite for milk and food. His father explained the situation in detail. I prescribed Yangpi Xiaoji Wan (Spleen-Nourishing and Accumulation-Resolving Pill) first. After three days, Dingxiang Pi Ji Wan (Clove Spleen-Accumulation Pill) was administered with chicken broth, resulting in the expulsion of an undigested piece of chicken. Subsequent administration of Yangpi Wan led to recovery.
Family-Inherited Yangpi Xiaoji Wan: Eliminates retained food and removes chronic accumulation; highly effective.
Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang) Chenpi (Citri Reticulatae Pericarpium, 7 qian 5 fen) Cangzhu (Atractylodis Rhizoma, 5 qian) Houpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice, 5 qian) Zhike (Aurantii Fructus, stir-fried with flour, 5 qian) Banxia (Pinelliae Tuber, 5 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 5 qian) Shenqu (Massa Medicata Fermentata, 5 qian) Maiya (Hordei Fructus Germinatus, 5 qian) Shanzha (Crataegi Fructus, 5 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 3 qian). Grind into fine powder. Form pills with steamed bread dough, size of millet seeds. Take 20-30 pills per dose, washed down with rice water.
Yuying Yanling Jiedu Wan: Resolves fetal toxins; suitable for newborns.
Take the umbilical cord and placenta immediately after cutting the cord, regardless of length. Dry-roast on a new tile. For every 1 qian of dried material, add 2 qian of raw Gancao powder (Glycyrrhizae Radix et Rhizoma), 1 qian of Huanglian powder (Coptidis Rhizoma), and 0.5 qian of Zhusha powder (Cinnabaris). Mix uniformly. Blend with raw white sugar and store in a porcelain jar. Administer a bean-sized amount into the infant's mouth, washed down with breast milk. Once daily, stop when the medicine is exhausted.