巢氏曰∶小儿初生,肌肤未实,宜用旧絮护其背,不可太暖,更宜数见风日,则血气刚强,肌
肉致密,若藏于重帏密室,或浓衣过暖,则筋骨软脆,不任风寒,多易致病。衣服当随寒热加减,
但令背暖为佳,亦勿令出汗,恐表虚风邪易伤。乳哺亦不宜过饱,陈氏所谓忍三分寒,吃七分饱,
频揉肚,少洗澡,要肚暖头凉心胸凉,皆至论也。又须令乳母预慎六淫七情,浓味炙爆,则乳汁清
宁,儿不致疾。否则阴阳偏胜,血气沸腾,乳汁败坏,必生诸病。若屡用药饵,则脏腑阴损,多
变败证,可不慎欤。大抵保婴之法,未病则调和乳母,既病则审治婴儿,亦必兼治其母为善。
小儿饮食有任意偏好者,无不致病,所谓爽口味多终作疾也,极宜慎之。尝见王隐君曰∶余幼
时酷嗜甘饴,忽一日见饴中有蚯蚓伸头而出,自此不敢食饴,至长始知长上为之。此可为节戒之妙
法。
初生儿以手捻其头,摸其颐颔,不作声者为无病。总有病,以手指探其口,虽发声而从容咂指
者其病轻,若即发声不咂指而色或青红兼紫者,此落地受寒之甚也,其病重,须急辨其形色虚实而
治之。苦牙关紧闭不纳乳,或硬而不软,其病极重也,此惊邪入足太阳经及足阳明经而然,须急治
之,庶可平复。
一、初生儿肥胖色嫩日觉好看者,此其根本不坚,甚非佳兆,且亦最易感邪。凡邪入腑者,近
在第二三日见之,其证吐乳、夜啼发哭、腹鸣,皆胎惊之证,然犹浅而易治。若邪之入脏者,远在
六七日见之,此脐风、噤风、撮口风之候,其病深而难医。若大声口噤,舌大痰壅者不治,盖五六日间病传心肺脾
三经也。此风气甚
盛而无所泄,故形见于喉口于关声音也。其面额青紫黑色者不治,爪甲青黑者不治,脐青黑者亦不
治。凡父母肥者不可生肥儿,父母瘦者亦不可生肥儿。生而肥胖,必当以药敛之,使其肥肉坚实,
面转微黄之色则吉,不然则凶。生儿怯弱,必须以药扶助之。若七日之内,肌肉顿肥,则必病矣。
过此以往渐肥者,不足虑也。治肥之法,宜清痰湿,解胎毒,预防其风气,亦不可过用峻厉以伤脾
气。又当看小儿元气浓薄,浓者十无一失,薄者十无一生。然其中有死者,有不死者,则以病之所
生,有真伪也。凡怯弱者,宜专培脾肾为主。
巢元方说:新生儿初生时,肌肤尚未结实,应当用旧棉絮保护其背部,不可过于保暖,同时应经常让其接触风和阳光,这样气血才能刚强,肌肉才能致密。如果将其藏在厚重的帷帐和密闭的房间里,或者穿着过厚、保暖过度,就会导致筋骨软弱脆弱,不能抵御风寒,容易生病。衣服应当根据寒热情况增减,只要让背部温暖即可,也不要让孩子出汗,恐怕表虚会导致风邪容易侵袭。哺乳也不宜过饱,陈氏所说的“忍受三分寒冷,吃七分饱,频繁揉肚子,少洗澡,要肚子暖、头凉、心胸凉”,都是至理名言。还必须让乳母预先谨慎对待六淫(风、寒、暑、湿、燥、火)和七情(喜、怒、忧、思、悲、恐、惊),以及浓味、炙烤爆裂的食物,这样乳汁才会清静安宁,孩子才不会致病。否则阴阳偏胜,血气沸腾,乳汁败坏,必然产生各种疾病。如果屡次用药饵,则会损伤脏腑阴气,多变为败证,能不谨慎吗?大体上保婴的方法,未病时则调和乳母,既病时则审慎治疗婴儿,也必须兼治其母亲才是好的做法。小儿饮食如果有任意偏好者,无不致病,所谓爽口美味的食物吃多了终究会生病,极需谨慎。曾见王隐君说:“我小时候酷嗜甜食,忽然有一天看见糖中有蚯蚓伸头出来,从此不敢吃糖,长大后才知道是长辈故意做的。”这可以作为节制戒除嗜好的巧妙方法。
初生儿用手捏其头部,触摸其下巴颏,如果不哭叫的是无病。即使有病,用手指探其口腔,虽然发声但从容吸吮手指的,其病轻;如果立即发声但不吸吮手指,且面色或青红兼紫的,这是落地时受寒很严重,其病重,必须紧急辨别其形色虚实而治疗。如果牙关紧闭不纳乳,或者下颌硬而不软,其病极重,这是惊邪侵入足太阳膀胱经及足阳明胃经所致,必须紧急治疗,才可以平复。
一、初生儿肥胖、肤色嫩白、每天看着都好看的人,这是因为其根本不坚固,非常不是好兆头,而且最容易感受邪气。凡是邪气入腑的,多在第二三天出现症状,表现为吐乳、夜啼发哭、腹鸣,这都是胎惊的症状,然而病情尚浅且容易治疗。如果邪气入脏的,多在六七天出现症状,这是脐风、噤风、撮口风的征候,其病深而难医。如果大声喊叫、牙关紧闭、舌大痰壅的,属于不治之症,因为病在五六日间已传变至心、肺、脾三经。这是因为风气甚盛而无从宣泄,所以形体表现在喉口,影响声音。如果面额呈青紫黑色的不治,爪甲青黑的不治,肚脐青黑的也不治。凡是父母肥胖的,不可生出肥胖的儿子;父母瘦弱的,也不可生出肥胖的儿子。出生即肥胖,必须用药收敛,使其肥肉坚实,面色转为微黄色则为吉兆,否则为凶兆。出生怯弱的,必须用药扶助。如果在七日之内,肌肉突然变得肥壮,则必定生病。过了这个时间逐渐变肥的,不值得忧虑。治疗肥胖的方法,宜清除痰湿,解除胎毒,预防风气,也不可用过于峻猛的药物以损伤脾气。又应当观察小儿元气浓厚还是薄弱,元气浓厚的十人中无一失误,元气薄弱的十人中无一能活。然而其中有死的,有不死的,是因为所生的病有真伪之分。凡是怯弱的,宜专门以培补脾肾为主。
Chao Yuanfang stated: When a newborn is first born, the skin and muscles are not yet solid. It is appropriate to protect their back with old cotton wadding, avoiding excessive warmth. They should also be frequently exposed to wind and sunlight so that their blood and qi become strong and their muscles dense. If kept in heavy curtains and sealed rooms, or dressed too warmly, their bones and sinews will become soft and brittle, unable to withstand wind and cold, making them prone to illness. Clothing should be added or removed according to the temperature; keeping the back warm is ideal. One should also avoid causing the infant to sweat, as this may lead to exterior deficiency and make them susceptible to wind pathogens. Breastfeeding should not be excessive. As Chen Shi said, "Endure a third of coldness, eat until seventy percent full, frequently rub the abdomen, bathe less, keep the abdomen warm while the head and chest remain cool." These are profound truths. Furthermore, the nursing mother must carefully avoid the Six Evils (wind, cold, summer-heat, dampness, dryness, fire) and Seven Emotions (joy, anger, worry, thought, grief, fear, fright), as well as rich flavors and roasted or fried foods. This ensures the milk remains clear and tranquil, preventing disease in the child. Otherwise, yin and yang may become unbalanced, blood and qi may boil, and the milk may spoil, inevitably causing various diseases. Frequent use of medicinal tonics can damage the yin of the zang-fu organs, often leading to critical conditions; how can one not be cautious? Generally, the method for protecting infants involves regulating the mother before illness occurs and treating the infant prudently after illness begins, but it is best to treat the mother concurrently. Infants who have arbitrary dietary preferences will inevitably fall ill, as sweet and palatable foods consumed in excess ultimately cause disease; this requires extreme caution. Wang Yinjun once said, "In my childhood, I was extremely fond of sweets. One day, I saw an earthworm sticking its head out of the candy, and since then I dared not eat sweets. Only later did I learn that elders had placed them there intentionally." This serves as a clever method for curbing such cravings.
For a newborn, gently pinch the head and touch the chin. If the infant does not cry, they are free of disease. Even if sick, probing the mouth with a finger: if the infant cries but calmly sucks their finger, the illness is mild. If the infant cries immediately without sucking the finger, and the complexion is mixed blue-red and purple, this indicates severe cold contracted at birth, signifying a serious condition requiring urgent differentiation of form, color, and excess/deficiency for treatment. If the jaw is tightly closed and refuses milk, or is hard rather than soft, the condition is extremely severe. This is caused by shock-pathogens invading the Foot-Taiyang Bladder Meridian and Foot-Yangming Stomach Meridian, requiring urgent treatment to ensure recovery.
1. Newborns who are obese, have tender pale skin, and appear increasingly attractive daily, possess weak constitutional roots, which is a bad omen and makes them highly susceptible to pathogens. Pathogens entering the fu-organs typically manifest on the second or third day, presenting as spitting up milk, night crying, and abdominal borborygmi, all signs of fetal shock (Tai Jing). However, these are superficial and easy to treat. Pathogens entering the zang-organs typically manifest on the sixth or seventh day, presenting as neonatal tetanus (Qi Feng), lockjaw (Jin Feng), or puckered mouth (Cuo Kou Feng). These are deep-seated and difficult to cure. Cases with loud screaming, locked jaws, enlarged tongue, and phlegm obstruction are incurable, as the pathogen has transmitted to the Heart, Lung, and Spleen meridians within five to six days. This results from overwhelming wind-pathogen accumulation without outlet, manifesting in the throat and affecting speech. Incurable signs include cyanotic-black forehead, cyanotic-black fingernails/toenails, and cyanotic-black umbilicus. Parents who are obese should not give birth to obese infants, nor should thin parents. Neonatal obesity requires medication to consolidate the flesh and turn the complexion slightly yellow for a favorable outcome; otherwise, it is ominous. Frail newborns require medicinal support. If an infant becomes suddenly fleshy within seven days, illness is certain. Gradual weight gain thereafter is not concerning. Treatment for obesity should focus on resolving phlegm-dampness, clearing fetal toxins, and preventing wind-pathogens, avoiding overly harsh drugs that damage spleen qi. One must assess the infant's yuan qi (original qi): those with abundant qi rarely fail, while those with deficient qi rarely survive. Mortality varies because some diseases are true and others false. For frail infants, the primary treatment should be tonifying the Spleen and Kidney.