议曰儿在胎中母伤和气饥饱劳役神疲力倦多矣其有不劳役者即有忧愁思虑役乎其中动之
真气
攻之虚邪于乱神魄流入胎脏儿乃受之既生之后儿常昏困腹急气粗重则喘急睡思不稳狂啼烦哭
肌肉不滋亦生疮痍热发早晚精神少具良工正医平调脏腑脏腑既正热目散止
议曰儿在胎时将顺其月母喜食诸生冷物过度冷盛既寒肠鸣泄利时时有作降人之后其儿肚
上青脉
膨胀虚紧之者乃是虚气入腹呃呃作声日夜不禁虽则渐长终是脏腑阴阳二气受不匀调若不温
平分气长成痞结阳结易治冷结难医仍宜抑母服药庶得乳温令子调和不至延病成害为之叹也
议曰儿在胎中母曾发作子疟或者因患瘴气母或饮酒无厌或者冒风伤暑热入经络有伤荣卫
母虽
分免以脱其难儿袭其气阴阳不解初生嫩弱血气不和作热潮来先寒关紧身体作颤庸工未谙其理
即以艾炷灸之经络未全用之枉究医士但与调中均其阴阳二气若是肚紧宜以全条蛇蜕末醋炒令
热手帕盛系肚脐上即渐安乐
切闻天地之大惟人之性盖矣物象之众惟人之志鉴矣是故人为一物而灵于物气受一元而妙
于元
惟智者为能明之然其天地不陷乎人物之根于是人物不 乎天地之数无情者悉由造化而生有情
者皆自交接而养倘谙先王之道君君臣臣父父子子成人人为后达乎上古参同天性顺合圣意小人
不知其所以愚情反是曷足与语哉嗟乎既为医工调理幼幼诚为不易须当裁度幼幼禀赋形骸有壮
羸怯弱于脉较之涵蓄情性有宽缓暴急于神察之轻清重浊以气定之冷热虚实以色推之若也形
体不壮神全则未为咎色脉不充气固则无作恙气与神而有亏藉乎丸散脉共色以无补宜乎疗医
气壮即脉顺脉顺即神全神全即色正色正即五脏安和百脉调适矣色脉若不正定即与固其真气真
气若不和则神不悦神不悦则形体何安观其脉则知其气气若不顺则形萎羸察其气则知其神神若
不清则气浊乱神者五脏之主也气者一身之权也色者虚实之表也脉者溥变之令也脉之流行不可
不察色之变易不可不究神之散漫不可不疗气之盛衰不可不理婴孩五脏受虚其面白其气怯其神
溃其脉乱其体 羸五脏受热其唇红其气促其神昏其脉数其体枯槁五脏受实其脸赤其气壅其神
劣其脉浮其体烦躁五脏受冷其准黄其气泄其神困其脉沉其体嗜卧所由冷热虚实传受惊疳积痢
凡病按其标则知其本省其绝则起其危后进攻医但按图说执滞汤剂不务实效今着是书乃述源流
不特赘赘褊求一隅以别之尽性考究以羡补不足益有余故也即非调弦胶柱缘木求鱼之谓欤熟研
其议至理自明辄搜难解之意载留斯 好术之士足知可法以备阔略后世有HT 简要得无隐藏当与
智者鉴议庶彰不朽云耳
议曰:胎儿在母体中时,母亲若因情绪失调、饮食饥饱不均或过度劳累,导致精神疲惫、身体倦怠的情况非常多。即使没有体力劳动的劳累,也常有忧愁思虑等情志因素在体内扰动。这些情志波动会损伤真气,虚邪之气乘虚而入,扰乱神魄,流入胎脏,胎儿因此受到侵害。出生后,婴儿常表现为昏沉困倦、腹部拘急、呼吸气粗,重则喘息急促、睡眠不安、无故狂哭烦躁、肌肉消瘦不丰,也容易发生疮疡痈肿。若发热早晚不定,精神萎靡,只有高明的医生才能平和地调理脏腑,使脏腑功能恢复正常,热邪消散停止。
议曰:胎儿在母体中时,若顺应月份而让母亲喜好食用各种生冷食物,且过量摄入,导致寒气过盛。寒气侵入肠道,引起肠鸣和泄泻,时常发作。这类情况多见于降人(指地位低下或特定族群)的后代。其婴儿肚脐周围青色脉络显露,腹部膨胀且触之虚紧,这是虚气进入腹部的表现,伴有呃逆声日夜不停。虽然孩子逐渐长大,但终究是脏腑阴阳二气受纳不均。若不采用温补和平调的方法,长大后容易形成痞块结聚。阳结证容易治疗,冷结证难以医治。仍应约束母亲服药调理,以使乳汁温和,令子调和,不至于延误病情造成危害,对此令人叹息。
议曰:胎儿在母体中时,母亲曾患疟疾,或者因感染瘴气,母亲饮酒无度,或者感受风邪、伤于暑热,导致热邪进入经络,损伤营卫之气。母亲虽然分忧解脱,脱离了危难,但胎儿继承了这种病气,导致阴阳失调。初生时嫩弱,血气不和,出现寒热往来,先恶寒战栗,身体颤抖。庸医不了解其中道理,立即用艾炷灸治。此时经络尚未完全健全,使用灸法反而造成枉害。医者只应当调理中焦,平衡阴阳二气。如果腹部拘紧,宜用整条蛇蜕研末,醋炒后令其温热,用热手帕包裹系在肚脐上,即可逐渐安乐。
我听说天地广大,人的本性最为显著;万物众多,人的意志最能鉴察。所以人是一种比万物更灵秀的存在,禀受一元之气而比元气更精妙。只有智慧的人才能明白这一点。然而,天地并未陷入人物之根,于是人物未脱离天地之数。无情之物全由造化而生,有情之物皆自交接而养。倘若通晓先王之道,做到君君臣臣、父父子子,成人人为后辈表率,通达上古之道,参同天性,顺合圣意,小人不知道其中的原因,愚昧之情相反,哪里值得与他们交谈呢?唉!既然身为医生,调理婴幼儿确实不容易。必须裁度婴幼儿的禀赋形骸,有强壮、羸弱、怯弱之分,通过脉象比较;涵养性情,有宽缓、暴急之别,通过神态察知;以气的轻清重浊来定体质,以冷热虚实来推面色。如果形体不壮但神气充足,则不算过错;如果色脉不充但气机固密,则不会生病。如果气和神有所亏损,借助丸散药物;如果脉与色均无补益之象,适宜医疗调理。气壮则脉顺,脉顺则神全,神全则色正,色正则五脏安和,百脉调适。如果色脉不正,即需固护真气。真气如果不和,则神不悦;神不悦,则形体如何安宁?观察脉象可知气机,气若不顺,则形体萎弱羸瘦;察知气机可知神志,神若不清,则气机浊乱。神是五脏之主,气是一身之权柄,色是虚实之表象,脉是普遍变化的指令。脉的流行不可不察,色的变易不可不究,神的散漫不可不疗,气的盛衰不可不理。婴孩五脏受虚,则面白、气怯、神溃、脉乱、体羸;五脏受热,则唇红、气促、神昏、脉数、体枯槁;五脏受实,则脸赤、气壅、神劣、脉浮、体烦躁;五脏受冷,则鼻准黄、气泄、神困、脉沉、体嗜卧。由此,冷热虚实传变,以及惊、疳、积、痢等各种疾病,按其标症即可知其本源。绝处可起死回生,危重者可后进攻医。但有些医生只按图索骥,固执于汤剂,不务实效。如今编写此书,乃是阐述源流,并非赘述偏颇以求一隅,而是分别详尽,尽性考究,以弥补不足,增益有余。这难道不是调弦胶柱、缘木求鱼的说法吗?熟研其议论,至理自然明了。特意搜集难解之意,留给后世好术之士,足以知道可效法之法,以备粗略了解。后世若有隐藏不宣之处,当与智者鉴察讨论,庶几彰显不朽云耳。
Translation:
It is discussed that when a fetus is in the womb, if the mother suffers from emotional disharmony, irregular diet (hunger or overeating), or excessive labor, leading to mental fatigue and physical exhaustion, such cases are numerous. Even without physical labor, there may be emotional disturbances such as worry and contemplation acting within. These movements damage the Zhen Qi (True Vital Energy) and attack with deficiency pathogens; they confuse the Shen Po (Spiritual Soul) and flow into the fetal viscera, causing the fetus to receive them. After birth, the infant often appears drowsy and lethargic, with abdominal urgency, coarse breathing, and in severe cases, panting and rapid breathing, unstable sleep, wild crying, and irritability. The muscles lack nourishment, and sores and ulcers may develop. With fever occurring at morning or evening and lacking spiritual vitality, only skilled physicians can peacefully regulate the Zang-Fu organs. Once the Zang-Fu organs are regulated, the heat dissipates and stops.
It is discussed that during pregnancy, if one follows the months but allows the mother to excessively consume raw and cold foods, leading to an excess of coldness, this cold invades the intestines, causing borborygmus and diarrhea, which occur frequently. This is often seen in the descendants of "Jiang Ren" (a term referring to specific groups or lower status individuals). The infant presents with blue veins on the abdomen, abdominal distension, and a hollow, tight sensation upon palpation, indicating deficiency Qi entering the abdomen, accompanied by hiccups day and night without cessation. Although the child grows gradually, ultimately it is due to uneven regulation of Yin and Yang Qi in the Zang-Fu organs. If not treated with warming and balancing methods,痞 (痞块/abdominal masses) and Jie (结/nodules) will form upon growth. Yang Jie (Yang nodules) is easy to treat, while Cold Jie (Cold nodules) is difficult to cure. It is advisable to restrain the mother's medication intake so that the breast milk becomes warm and harmonious for the child, preventing the disease from worsening and causing harm, which is a cause for sighing.
It is discussed that while in the womb, if the mother suffered from malaria, or contracted miasma, drank alcohol without restraint, or was exposed to wind and summer-heat, causing heat to enter the meridians and injure Ying Wei (Nutritive and Defensive Qi). Although the mother eventually escapes the difficulty, the fetus inherits this pathogenic Qi, resulting in unresolved Yin-Yang imbalance. At birth, the infant is tender and weak, with disordered Blood and Qi, presenting with alternating chills and fever, starting with chills, tight joints, and body tremors. Unskilled doctors, unfamiliar with the principle, immediately apply moxibustion with moxa cones. Since the meridians are not yet fully developed, using moxibustion causes wrongful harm. Physicians should only regulate the Middle Jiao and balance the Yin and Yang Qi. If the abdomen is tight, use whole snake skin powder, stir-fried with vinegar until hot, wrapped in a hot handkerchief, and tied to the umbilicus, which will gradually bring comfort and peace.
I have heard that among the vastness of Heaven and Earth, human nature is most prominent; among the multitude of phenomena, human will is the best mirror. Thus, humans are a unique entity, more spiritual than other things, receiving the One Qi and being more subtle than the primal origin. Only the wise can understand this. However, Heaven and Earth do not fall into the root of creatures, so creatures do not deviate from the numbers of Heaven and Earth. Inanimate beings are born entirely through creation, while animate beings are nurtured through interaction. If one understands the Way of the Former Kings, fulfilling the roles of ruler, minister, father, and son, setting an example for adults, and reaching back to ancient times to align with natural nature and sage intent, then those who are petty do not know why they are foolish, and their emotions are contrary. How can one speak with them? Alas! As a physician, regulating infants is indeed not easy. One must assess the infant's constitution and physique, distinguishing between robust, emaciated, and timid types via pulse comparison; observe the nurturing of temperament, distinguishing between relaxed and irritable types via spirit observation; determine constitution by the lightness/clarity or heaviness/turbidity of Qi; and deduce cold/heat and deficiency/excess via complexion. If the physique is not robust but the Spirit is full, it is not a fault; if the color and pulse are not充盈 (full) but the Qi is solid, illness will not arise. If Qi and Spirit are deficient, rely on pills and powders; if Pulse and Color offer no benefit, medical treatment is appropriate. Robust Qi leads to smooth Pulse; smooth Pulse leads to full Spirit; full Spirit leads to correct Complexion; correct Complexion leads to harmonious Zang-Fu organs and adjusted hundred vessels. If Color and Pulse are incorrect, one must consolidate True Qi. If True Qi is not harmonious, the Spirit is not joyful; if the Spirit is not joyful, how can the physique be at peace? Observing the Pulse reveals the Qi; if Qi is not smooth, the physique becomes withered and emaciated. Observing the Qi reveals the Spirit; if Spirit is unclear, Qi becomes turbid and chaotic. Spirit is the master of the five Zang organs; Qi is the authority of the whole body; Complexion is the manifestation of deficiency and excess; Pulse is the decree of universal change. The flow of Pulse must not be ignored; the changes of Complexion must not be investigated; the dissipation of Spirit must not be neglected; the rise and fall of Qi must not be unmanaged. When the five Zang organs of an infant suffer deficiency, the face is pale, Qi is timid, Spirit is collapsed, Pulse is chaotic, and the body is emaciated. When suffering heat, lips are red, Qi is rapid, Spirit is confused, Pulse is frequent, and the body is withered. When suffering excess, the face is red, Qi is obstructed, Spirit is inferior, Pulse is floating, and the body is restless. When suffering cold, the nose tip is yellow, Qi leaks, Spirit is trapped, Pulse is deep, and the body desires sleep. From this, the transmission of cold, heat, deficiency, and excess, as well as disorders like Jing (Fright), Gan (Malnutrition), Ji (Accumulation), and Li (Dysentery), can be understood by examining the symptoms to know the source. From despair, life can be revived; in critical stages, advanced treatment can be applied. However, some physicians merely follow diagrams, stick rigidly to decoctions, and neglect practical effects. This book is written to describe the origins, not to add redundant details seeking partial truths, but to distinguish thoroughly, investigate exhaustively, supplement deficiencies, and increase surplus. Is this not the method of tuning strings with fixed pegs or climbing a tree to catch fish? By carefully studying these discussions, the profound principles will become clear. I have collected difficult-to-understand meanings and left them for scholars interested in medicine, sufficient to provide models for practice and prepare for broad understanding. If there are hidden aspects for future generations, let them be reviewed by the wise, so that immortality may be manifested.