【歌】婴儿脏腑未全成，长养之时必变蒸。变则气升蒸则热，八蒸十变始成人。
【论】夫小儿初生，形体虽具，其气、血、精、神、志、意、魂、魄，俱未能全，故三十二日一变，六十
四日一蒸。凡遇一变，即觉性情自有异于前，所以长养志意故也。初生至三十二日一变，生癸水，属足少阴肾，
主精志。六十四日一蒸二变，生壬水，属足太阳膀胱，其发耳与尻冷。至九十六日三变，生丁火，属手少阴心，
主藏神，其性为喜。至一百二十八日四变二蒸，生丙火，属手太阳小肠，其发汗出而微惊。至一百六十日五变，
生乙木，属足厥阴肝，主藏魂，喜哭。至一百九十二日六变三蒸，生甲木，属足少阳胆，其发目不闭而赤。至
二百二十四日七变，生辛金，属手太阴肺，主藏魄，生声。至二百五十六日八变四蒸，生庚金，属手阳明大肠，
其发肤热而汗，或不汗。至二百八十八日九变，生己土，属足太阴脾，主藏意与智。至三百二十日十变五蒸，
生戊土，属足阳明胃，其发不食，肠痛而吐乳。又，手厥阴心包络与手少阳三焦二经，俱无形状，故不变而不蒸。十变
五蒸者，天地之数以生成之，然后生志意，能言语，知喜忽，故云始全也。十变后，六十四日为一大蒸，计三
百八十四日也，长其经脉、手、足，故手受血而能持物，足受血而能行立。又六十四日为二大蒸，计四百四十
八日，则言语、意志大异于前。又六十四日为三大蒸，计五百一十二日，变蒸既足，儿乃成人。盖变者，变生
五脏志意，蒸者，蒸养六腑气血，故变则上气，蒸则体热。每一变蒸，轻则发热微汗如惊，五日乃解；重则壮
热脉乱而数，或吐或汗，或烦啼燥渴，七日始解。亦有变蒸之余，续感寒邪，随证调之可也。具有不热不惊而
暗变者，胎气实故耳。
柴胡汤
治变蒸骨热心烦，啼叫不已，或寒热往来。
人参 甘草 麦冬（去心） 防风 柴胡 龙胆草
惺惺散
治变蒸发热，咳嗽痰诞，鼻塞声重，或挟疮疹发热者。
川芎 桔梗 人参 白术 茯苓 甘草 细辛 花粉 生姜 薄荷
水煎温服。
紫阳黑散
治变蒸热不解及挟时瘟病。
麻黄（去根节，三分） 大黄（一分） 杏仁（一分，一半去皮，一半连皮）
上三味，烧存性，研末，每服半钱，水半盏，煎服，抱儿于暖处，取微汗，身凉即愈。
调气散
治变蒸吐泻，不乳多啼。
木香 香附 人参 浓朴 藿香 陈皮 甘草（等分）
姜、枣煎服。
消食丸
治变蒸时乳食过多，胃气不能消化。
砂仁 陈皮 三棱 蓬术 神曲 麦芽（等分） 香附（加倍）
末之，曲糊丸，白汤下，量儿加减。
【歌诀】婴儿的脏腑尚未完全发育成熟，在生长发育的关键时期必然经历“变”与“蒸”。所谓“变”，是指体内气机上升；所谓“蒸”，是指身体出现发热现象。经过十次“变”和五次“蒸”，婴儿的身体才算发育健全。
【论述】小儿刚出生时，虽然形体已经具备，但其气、血、精、神、志、意、魂、魄都未能完全充实，因此每三十二天发生一次“变”，每六十四天发生一次“蒸”。每当遇到一次“变”，就能察觉到孩子的性情自然与前不同，这是为了培养其志向和意识。从出生到三十二天为第一次“变”，生成癸水，归属于足少阴肾经，主管精与志。六十四天时发生第二次“变”和第一次“蒸”，生成壬水，归属于足太阳膀胱经，表现为耳朵和尾骶部发冷。九十六天时发生第三次“变”，生成丁火，归属于手少阴心经，主管藏神，其性情表现为喜悦。一百二十八天时发生第四次“变”和第二次“蒸”，生成丙火，归属于手太阳小肠经，表现为出汗且轻微惊悸。一百六十天时发生第五次“变”，生成乙木，归属于足厥阴肝经，主管藏魂，表现为喜欢哭泣。一百九十二天时发生第六次“变”和第三次“蒸”，生成甲木，归属于足少阳胆经，表现为眼睛不闭合且发红。二百二十四天时发生第七次“变”，生成辛金，归属于手太阴肺经，主管藏魄，表现为发出声音。二百五十六天时发生第八次“变”和第四次“蒸”，生成庚金，归属于手阳明大肠经，表现为皮肤发热且有汗，或者无汗。二百八十八天时发生第九次“变”，生成己土，归属于足太阴脾经，主管藏意与智。三百二十天时发生第十次“变”和第五次“蒸”，生成戊土，归属于足阳明胃经，表现为不吃奶、肠痛并吐乳。另外，手厥阴心包络与手少阳三焦经这两条经络，都没有具体的形态，所以不发生“变”也不发生“蒸”。所谓的十变五蒸，是依据天地生成的数理规律，之后才能产生志向意识，能够言语，知晓喜怒哀乐，所以说此时身体才算完整。在十变之后，再过六十四天为一次“大蒸”，累计三百八十四天，以此滋养经脉以及手足，因此手得到气血滋养就能拿取物品，脚得到气血滋养就能行走站立。又过六十四天为第二次“大蒸”，累计四百四十八天，此时言语和意志与前相比有显著差异。再过六十四天为第三次“大蒸”，累计五百一十二天，变蒸过程既已充足，孩子便成为真正的成人。大概来说，“变”是改变并生成五脏的志意，“蒸”是蒸腾养育六腑的气血，所以“变”则气机上行，“蒸”则身体发热。每一次变蒸，轻度的表现为发热、微汗、类似惊悸的样子，五天即可缓解；重度的表现为高热、脉象紊乱且快速，或者呕吐、出汗、烦躁啼哭、燥渴，七天才能缓解。也有在变蒸之余，继续感受寒邪的，应当根据证候进行调理即可。还有那些没有发热、没有惊悸而暗中变化的，是因为胎气充实的缘故。
柴胡汤
治疗变蒸期间骨骼发热、心烦、啼叫不止，或寒热往来。
人参、甘草、麦冬（去心）、防风、柴胡、龙胆草
惺惺散
治疗变蒸发热，咳嗽痰多，鼻塞声重，或夹杂疮疹发热的情况。
川芎、桔梗、人参、白术、茯苓、甘草、细辛、天花粉、生姜、薄荷
用水煎煮，温服。
紫阳黑散
治疗变蒸热势不退及夹杂时行瘟病的情况。
麻黄（去根节，三分）、大黄（一分）、杏仁（一分，一半去皮，一半连皮）
以上三味药，烧至存性，研成粉末，每次服用半钱，用水半盏，煎煮后服用，将婴儿抱在温暖处，使其微微出汗，身体凉爽即痊愈。
调气散
治疗变蒸期间呕吐腹泻，不吃奶且多啼哭。
木香、香附、人参、厚朴、藿香、陈皮、甘草（等分）
用生姜、大枣煎煮服用。
消食丸
治疗变蒸期间乳汁食物过多，胃气不能消化的情况。
砂仁、陈皮、三棱、蓬术、神曲、麦芽（等分）、香附（加倍）
研成粉末，用曲糊制作丸剂，用白开水送下，根据婴儿年龄酌情加减剂量。
[Verse] The viscera of an infant are not yet fully formed; during the period of growth and nourishment, "Bian" (Transformation) and "Zheng" (Steaming) must occur. "Bian" refers to the rising of Qi, while "Zheng" refers to the generation of heat. After ten Bians and five Zhengs, the human body is considered complete.
[Dissertation] When a child is first born, although the physical form is complete, its Qi, Blood, Essence, Spirit, Zhi (Will), Yi (Intent), Hun (Ethereal Soul), and Po (Corporeal Soul) are not yet fully developed. Therefore, a Bian occurs every 32 days, and a Zheng occurs every 64 days. Whenever a Bian occurs, one can perceive that the child's temperament naturally differs from before; this is to cultivate their Zhi and Yi. From birth to 32 days constitutes the first Bian, generating Gui Water, which belongs to the Foot Shaoyin Kidney Meridian, governing Essence and Zhi. At 64 days, the second Bian and the first Zheng occur, generating Ren Water, which belongs to the Foot Taiyang Bladder Meridian, manifesting as coldness in the ears and the sacrum. At 96 days, the third Bian occurs, generating Ding Fire, which belongs to the Hand Shaoyin Heart Meridian, governing the storage of Shen (Spirit), with a temperament characterized by joy. At 128 days, the fourth Bian and the second Zheng occur, generating Bing Fire, which belongs to the Hand Taiyang Small Intestine Meridian, manifesting as sweating and slight palpitations. At 160 days, the fifth Bian occurs, generating Yi Wood, which belongs to the Foot Jueyin Liver Meridian, governing the storage of Hun, manifesting as a tendency to cry. At 192 days, the sixth Bian and the third Zheng occur, generating Jia Wood, which belongs to the Foot Shaoyang Gallbladder Meridian, manifesting as eyes that do not close and appear red. At 224 days, the seventh Bian occurs, generating Xin Metal, which belongs to the Hand Taiyin Lung Meridian, governing the storage of Po, manifesting as the production of vocal sounds. At 256 days, the eighth Bian and the fourth Zheng occur, generating Geng Metal, which belongs to the Hand Yangming Large Intestine Meridian, manifesting as skin heat and sweating, or absence of sweating. At 288 days, the ninth Bian occurs, generating Ji Earth, which belongs to the Foot Taiyin Spleen Meridian, governing the storage of Yi (Intent) and Zhi (Wisdom). At 320 days, the tenth Bian and the fifth Zheng occur, generating Wu Earth, which belongs to the Foot Yangming Stomach Meridian, manifesting as refusal to eat, abdominal pain, and regurgitation of milk. Furthermore, the Hand Jueyin Pericardium Meridian and the Hand Shaoyang Sanjiao (Triple Burner) Meridian have no distinct shape; therefore, they do not undergo Bian or Zheng. The ten Bians and five Zhengs follow the numerical laws of Heaven and Earth for generation and completion; only then are Zhi and Yi produced, speech is acquired, and emotions like joy and surprise are understood, hence it is said that the body is now complete. After the ten Bians, another 64 days constitute a Great Zheng, totaling 384 days, which nourishes the meridians, hands, and feet; thus, when the hands receive Blood, they can grasp objects, and when the feet receive Blood, they can walk and stand. Another 64 days constitute the second Great Zheng, totaling 448 days, at which point speech and will differ significantly from before. Another 64 days constitute the third Great Zheng, totaling 512 days; once the Bian and Zheng processes are sufficient, the child becomes an adult. Generally speaking, "Bian" transforms and generates the Zhi and Yi of the Five Zang Organs, while "Zheng" steams and nourishes the Qi and Blood of the Six Fu Organs; thus, Bian causes Qi to rise upward, and Zheng causes body heat. In each Bian-Zheng cycle, mild cases manifest as low-grade fever, slight sweating, and symptoms resembling palpitations, resolving within five days; severe cases manifest as high fever, chaotic and rapid pulse, vomiting, sweating, irritability, crying, dryness, and thirst, resolving within seven days. There are also instances where, after the Bian-Zheng process, external Cold pathogenic factors are contracted due to residual weakness; these should be treated according to the specific syndrome. Additionally, those who undergo hidden changes without fever or palpitations do so because their Fetal Qi is substantial.
Chaihu Tang (Bupleurum Decoction)
Treats bone heat, mental restlessness, incessant crying, or alternating chills and fever during the Bian-Zheng period.
Renshen (Ginseng Radix), Gancao (Licorice Radix et Rhizoma), Maidong (Ophiopogonis Tuber), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Longdancao (Gentianae Radix).
Xingxing San (Awakening Powder)
Treats fever due to Bian-Zheng, cough with profuse phlegm, nasal congestion with heavy voice, or fever complicated by sores and rashes.
Chuanxiong (Ligusticum Chuanxiong Rhizome), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Licorice Radix et Rhizoma), Xixin (Asari Radix et Rhizoma), Huafen (Trichosanthis Radix), Shengjiang (Zingiberis Rhizoma Recens), Bohe (Menthae Haplocalycis Herba).
Decoct in water and take warm.
Ziyang Heisan (Purple Yang Black Powder)
Treats persistent heat during Bian-Zheng and complications with seasonal epidemic diseases.
Mahuang (Ephedrae Herba, remove root nodes, 3 fen), Dahuang (Rhei Radix et Rhizoma, 1 fen), Xingren (Armeniacae Semen Amarum, 1 fen, half peeled, half unpeeled).
The above three ingredients are burned until carbonized but retaining their properties, then ground into powder. Take half a qian per dose, decoct with half a zhan of water, and administer. Hold the infant in a warm place to induce slight sweating; recovery occurs when the body cools down.
Tiaoqi San (Regulating Qi Powder)
Treats vomiting and diarrhea, refusal to nurse, and excessive crying during Bian-Zheng.
Muxiang (Aucklandiae Radix), Xiangfu (Cyperi Rhizoma), Renshen (Ginseng Radix), Houpo (Magnoliae Officinalis Cortex), Huoxiang (Agastaches Herba), Chenpi (Citri Reticulatae Pericarpium), Gancao (Licorice Radix et Rhizoma, equal parts).
Decoct with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) and take.
Xiaoshi Wan (Digestive Food Pills)
Treats indigestion due to excessive milk and food intake during the Bian-Zheng period, where Stomach Qi fails to digest.
Sharen (Amomi Fructus Rotundus), Chenpi (Citri Reticulatae Pericarpium), Sanleng (Sparganii Rhizoma), Pengzhu (Curcumae Rhizoma), Shenqu (Massa Medicata Fermentata), Maiya (Hordei Fructus Germinatus, equal parts), Xiangfu (Cyperi Rhizoma, doubled amount).
Grind into powder, make pills using Qu paste (fermented dough), and swallow with plain warm water. Adjust dosage according to the infant's condition.