万物春生夏热长，儿生同此变形神，三十二日为一变，六十四日曰一蒸。变长百骸生脏腑，蒸增智
慧发聪明，十八五百七十六，变蒸既毕形神成，变蒸之状身微热，耳尻骨冷无病情。
【注】天地生化万物，必以春温、夏热。儿之初生，变生形神亦同此理。自生之日至
三十二日，曰一变；至六十四日，曰一蒸。变则长其百骸，生其脏腑；蒸则增其智能，发
其聪明也。曰十八五百七十六者，谓十变五蒸之外，又有三大蒸，合计五百七十六日也。
变蒸既毕，形神俱足，此后则不复变蒸矣。然每变蒸之时，其状惟身微热、耳冷、尻骨冷，
而无他病情状。盖以阴阳和变，生化形神，故无他病情状也。身微热者，以阴阳氤氲变蒸
之气而然也；耳尻冷者，耳尻属阴，以阳不伤阴，而与阴和之象，故不热也。
【按】变蒸既曰生五脏六腑次序，又曰包络、三焦二经俱无形状，故不变不蒸。夫包
络乃周身脂膜联系百骸脏腑者，三焦乃躯壳内气充满百骸脏腑者，变蒸时岂独不及之耶？
其说不经，细阅《灵》《素》自知，附辨以俟识者。
心主惊兮肝主风，心热肝风作急惊，素虚药峻因成慢，吐泻后起慢脾风。急惊阳证有实象，慢脾阴证有虚形，慢惊
半阴半阳证，虚实寒热要详明。
【注】心藏神，心病故主惊也；肝属木，肝病故主风也。凡小儿心热肝盛，一触惊受
风，则风火相搏，必作急惊之证也，若素禀不足，或因急惊用药过峻，暴伤元气，每致
变成慢惊之证。更有因吐泻既久，中气大虚，脾土衰弱，肝木乘虚而内生惊风者，名曰慢
脾风也。三者致病之因既不同，故所现之证
亦各异。急惊属阳，必有阳热有余等实象也；慢脾属阴，必有阴冷不足等虚象也。至于慢
惊初得之时，阴阳尚未过损，或因急惊传变而成，其中常有夹痰、夹热等证，故属半阴
半阳，不比慢脾纯阴之病也。治者须详分虚、实、寒、热以治之，庶不致误矣！
万物在春季生发、夏季生长，婴儿的出生与成长也遵循同样的规律，表现为形体和神智的变化。每三十二天为一次“变”，每六十四天为一次“蒸”。“变”使骨骼肢体增长，脏腑生成；“蒸”则增加智慧，开发聪明。经过十八次“变”和五次“蒸”（共计五百七十六日），“变蒸”过程结束后，形体与神智便发育成熟。在“变蒸”期间，婴儿身体会有轻微发热，耳部和尻骨（尾椎部位）发冷，但这并非病态。
【注】天地化生万物，必然经历春温夏热的过程。婴儿初生，其形体与神智的变化也符合这一道理。从出生之日起到第三十二天，称为一次“变”；到第六十四天，称为一次“蒸”。“变”的功能是使骨骼肢体增长，脏腑生成；“蒸”的功能是增进智能，开发聪明。所谓“十八变五蒸共五百七十六日”，是指在十次“变”和五次“蒸”之外，还有三次大的“蒸”，合计五百七十六天。“变蒸”过程完成后，形体与神智都具备完备，此后就不再发生“变蒸”了。然而每次“变蒸”之时，其表现仅仅是身体轻微发热、耳朵和尻骨发冷，而没有其他病症表现。这是因为阴阳调和变化，化生形体与神智，所以没有其他病症表现。身体轻微发热，是因为阴阳之气氤氲交融进行“变蒸”所致；耳朵和尻骨发冷，是因为耳和尻骨属阴，阳气不损伤阴气，而是与阴气和谐相合的表现，所以不发烫。
【按语】既然说“变蒸”是按照顺序生成五脏六腑，又说心包络和三焦这两条经络都没有具体的形态，所以不参与“变”和“蒸”。其实，心包络是连接全身脂膜、联系骨骼脏腑的组织，三焦是充满躯壳内部、充盈骨骼脏腑的气机通道，在“变蒸”时难道唯独不包括它们吗？这种说法缺乏经典依据，仔细研读《灵枢》和《素问》自然明白，在此附上辨析以等待有识之士指正。
心脏主管惊悸，肝脏主管风邪。心热与肝风相互作用会导致急惊风；素体虚弱或用药过于猛烈会形成慢惊风；吐泻之后引发的则是慢脾风。急惊风属于阳证，具有实证的表现；慢脾风属于阴证，具有虚证的表现；慢惊风属于半阴半阳证，虚实寒热需要详细辨明。
【注】心藏神，心病故主惊悸；肝属木，肝病故主风邪。凡是小儿心火偏盛、肝气旺盛，一旦受到惊吓或风邪侵袭，风火相互搏结，必定引发急惊风证候。如果小儿先天禀赋不足，或者因为治疗急惊风时用药过于峻猛，突然损伤元气，往往导致转变为慢惊风证候。更有因长期吐泻，中气大虚，脾土衰弱，肝木乘虚而入内生惊风的，称为慢脾风。这三种病因既然不同，所以表现出的证候也各异。急惊风属于阳证，必然有阳热有余等实证表现；慢脾风属于阴证，必然有阴冷不足等虚证表现。至于慢惊风，在初起之时，阴阳尚未严重受损，或因急惊风传变而成，其中常夹杂痰湿、热邪等证候，所以属于半阴半阳，不同于慢脾风纯阴的病证。治疗者必须详细分辨虚、实、寒、热来施治，才不会导致误诊！
All things sprout in spring and grow in summer; a child's birth and development follow the same pattern, manifesting as changes in form and spirit. Every thirty-two days constitutes one "Bian" (Transformation), and every sixty-four days constitutes one "Zheng" (Steaming). "Bian" promotes the growth of bones and limbs and the formation of Zang-Fu organs; "Zheng" enhances intelligence and awakens acuity. After eighteen "Bian" and five "Zheng" (totaling 576 days), the process of "Bian-Zheng" is completed, and both form and spirit are fully developed. During the "Bian-Zheng" periods, the infant may exhibit slight body heat and coldness in the ears and sacrum (coccyx area), but this is not pathological.
[Note] Heaven and Earth generate all things through the warmth of spring and the heat of summer. A newborn's transformation of form and spirit follows this same principle. From the day of birth to the thirty-second day is called one "Bian"; to the sixty-fourth day is called one "Zheng". "Bian" causes the growth of bones and limbs and the generation of Zang-Fu organs; "Zheng" increases intelligence and develops acuity. The phrase "eighteen Bian and five Zheng totaling 576 days" refers to ten "Bian" and five "Zheng", plus three major "Zheng" phases, summing up to 576 days. Once the "Bian-Zheng" process is complete, form and spirit are fully endowed, and no further "Bian-Zheng" occurs thereafter. However, during each "Bian-Zheng" period, the manifestations are limited to slight body heat and coldness in the ears and sacrum, without other signs of illness. This is because Yin and Yang harmonize and transform to generate form and spirit, thus presenting no other pathological signs. Slight body heat results from the mingling Qi of Yin and Yang during the "Bian-Zheng" process; coldness in the ears and sacrum occurs because these areas belong to Yin, and Yang does not damage Yin but harmonizes with it, hence they remain cool.
[Commentary] It is stated that "Bian-Zheng" generates the Zang-Fu organs in a specific order, yet it is also said that the Pericardium (Baoluo) and Sanjiao (Triple Burner) meridians lack distinct forms and thus do not undergo "Bian" or "Zheng". In fact, the Pericardium connects the body's fatty membranes and links bones and organs, while the Sanjiao fills the body cavity and permeates bones and organs with Qi. Would the "Bian-Zheng" process exclude them? This theory lacks canonical basis; careful study of the *Ling Shu* and *Su Wen* will clarify this. I offer this辨析 for scholars' consideration.
The Heart governs fright (Jing); the Liver governs wind (Feng). Heat in the Heart combined with Wind in the Liver leads to Acute Convulsion (Ji Jing Feng); constitutional deficiency or overly harsh medication results in Chronic Convulsion (Man Jing Feng); convulsions arising after prolonged vomiting and diarrhea are termed Slow Spleen Wind (Man Pi Feng). Acute Convulsion belongs to Yang syndromes and presents with excess signs; Slow Spleen Wind belongs to Yin syndromes and presents with deficiency signs; Chronic Convulsion belongs to half-Yin half-Yang syndromes, requiring detailed differentiation of deficiency/excess and cold/heat.
[Note] The Heart stores the Spirit (Shen); Heart pathology therefore governs fright. The Liver corresponds to Wood; Liver pathology therefore governs wind. When a child has excessive Heart Fire and vigorous Liver Qi, any exposure to fright or wind pathogens causes Wind and Fire to clash, inevitably triggering Acute Convulsion. If the child has innate insufficiency, or if treatment for Acute Convulsion uses overly harsh drugs that suddenly damage Yuan Qi (Original Qi), it often transforms into Chronic Convulsion. Furthermore, prolonged vomiting and diarrhea can severely deplete Middle Qi, weaken Spleen Earth, and allow Liver Wood to invade due to emptiness, generating internal wind known as Slow Spleen Wind. Since the etiologies of these three conditions differ, their clinical presentations vary. Acute Convulsion is Yang-type, necessarily exhibiting excess signs such as hyperactive Yang-Heat. Slow Spleen Wind is Yin-type, necessarily exhibiting deficiency signs such as Yin-cold insufficiency. Regarding Chronic Convulsion, at its onset, Yin and Yang are not yet severely damaged, or it may result from the transmission of Acute Convulsion; it often involves concurrent Phlegm or Heat, placing it in the half-Yin half-Yang category, distinct from the pure Yin nature of Slow Spleen Wind. Practitioners must carefully differentiate deficiency, excess, cold, and heat to treat appropriately, thereby avoiding errors.