议曰古今天下同议者贫富贵贱是也所产男女自幼及长总曰小儿然幼幼有牙儿婴儿孩儿长
曰髫
童兆童稚童殊不究竟富贵之同贫贱之辱二者人情间于中道混而言之盖胞胎气血之不同故以辨
之贵者富者风化同途贫者贱者门列一等所以礼识相远日用致差虽有少殊宜审其偏正（外家之子
有任爱之者）度其亲疏（抱继之子因人亲生视之乃为一等矣）中等常情之家礼识未亏日用得过
者又有大过不及之议夫人之运神发性惟心不可役心役则气耗气耗则血衰血衰则虚自此始肾堂
不寒
而且惫心室不足而旦虚原夫精元假之为胚为胞为形为骸胎质藉之乃气乃血乃乳乃脉贵富生子
顺养抚育之有余贫贱生子调摄固爱之不足有余者大过之谓不足者不及之谓也大过则伤之不节
不及则复之共时不节共时皆生病疾寒暑冒之或表或里冷热攻之或脾或胃所谓审度测源医者必
须知之贵富之子食之有伤于不精寒之有伤于大燠暑气有伤于凡凉泉流有伤于水冷肠胃气血柔
而不刚使之然也贫贱生子食之有伤于不时寒之有伤于冻馁暑之有伤于烦躁脾胃有伤于湿腻水
谷不分肠胃气血壮而不坚使之然也父母不自贵受治禀气虚谬况贵子懦弱者耶是故胎气不足血
脉荫籍之有亏良由男方刚情兴造次共即儿生之后牙婴儿固同将护有平饥饱寒暑劳逸之不同又
于变蒸之时有伤于气血及至立行之时有伤于筋骨由是抚养之共情鞠育之不意调度之不宜将
理之
鱼法故易得其病病易得虚虚易得坏坏易得失贵富之子疾之反是也未寒先衣未热先凉未食先饱
（未至食时余食过膈）未眠先睡睡之恣晏食之过满寒之重衾热之就湿故易得 之未虚强食令
之虚脉气未坏强药为之坏学不究则不精甲不专则不妙矣若执之得法妄之为要 乎丸散不良智
者吁哉
议曰：古往今来，世人共同议论的话题，无非是贫富贵贱罢了。所生育的男女，从幼年到成年，统称为小儿。然而幼儿阶段又有牙儿、婴儿、孩儿、长髫童、兆童、稚童等不同称谓，并不详尽。富贵与贫贱这两种人情之间的差异，往往混杂在一起谈论，这是因为胎儿在母体中气血禀受不同，所以需要加以辨析。
贵者富者，家风教化相同；贫者贱者，门第地位相当。因此礼仪见识相差甚远，日常生活的细节也产生差别。虽然有些细微的不同，但应当仔细审察其偏颇与端正之处（如外家之子若有被宠爱者），衡量其亲疏关系（如抱继之子若视同亲生，则视为一等）。中等常情之家，礼仪见识未受损失，日常生活能够维持，但又存在过大或不及的议论。
人的精神活动与性情发作，皆由心主宰。若心被外物役使，则气会耗散；气耗散则血衰败；血衰败则虚损由此开始。肾堂不寒且疲惫，心室不足而早晨即感虚弱。原本精元假借形成胚胎、胞衣、形体和骨骼。胎质依赖于此，进而化为气、血、乳、脉。
富贵人生子，顺遂养育，抚育有余；贫贱人生子，调摄固护，关爱不足。“有余”称为“大过”，“不足”称为“不及”。大过则因不节制而受伤，不及则因恢复不及时而生病。无论是大过还是不及，若不节制，都会导致疾病。寒暑侵袭，病邪或在表或在里；冷热攻伐，损伤或在脾或在胃。所谓审度测源，医者必须知晓这些道理。
富贵之子，饮食因不精细而受伤；寒冷因过度温暖而受伤；暑气因饮用普通凉泉而受伤；水流因水冷而伤及肠胃。因其肠胃气血柔弱而不刚强，所以如此。贫贱之子，饮食因不按时而受伤；寒冷因冻饿而受伤；暑热因烦躁而受伤；脾胃因湿腻食物而受伤，导致水谷不分。因其肠胃气血壮实但不坚固，所以如此。
父母自身不尊贵，所受治养禀气虚谬，何况贵子懦弱呢？因此胎气不足，血脉荫籍有所亏缺，大多是因为男方情欲冲动仓促所致。孩子出生之后，牙儿、婴儿虽然同样需要保护，但在调节饥饱、寒暑、劳逸方面存在不同。又在变蒸之时，气血受到伤害；到学步行走之时，筋骨受到伤害。
由于抚养的情意、鞠育的不周、调度的不宜、调理的方法不当，所以容易患病，病易致虚，虚易致坏，坏易致死。贫富贵贱之子的疾病情况则相反。未冷先穿衣，未热先纳凉，未进食先吃饱（未到食时余食已过膈），未困倦先睡觉，睡觉恣意晚起，饮食过满，寒冷时盖厚被，炎热时睡湿处。所以容易得病，未虚强食令其虚，脉气未坏强药为之坏。学习不探究则不精通，用药不专一则不巧妙。如果执持得当法，妄为则是关键所在。丸散不良，智者叹息啊。
Discussion: Throughout history, the topic commonly discussed by people is poverty and wealth. Both male and female offspring are collectively referred to as "children" from infancy to adulthood. However, within the early childhood stage, there are distinct terms such as *yaya* (toothed child), *ying'er* (infant), *haier* (child), *changtiao tong* (long-haired child), *zhao tong* (young child), and *zhi tong* (toddler), though these classifications are not exhaustive. The differences in human sentiment between the rich/noble and the poor/base are often conflated in discussion; however, they must be distinguished because the qi and blood endowment of the fetus differs.
Those who are noble and wealthy share similar family traditions and education, while those who are poor and base share similar social status. Consequently, their etiquette and knowledge differ significantly, leading to disparities in daily life. Although there are minor differences, one must carefully examine their biases and correctness (e.g., children from the maternal side may be favored). One must also assess kinship closeness (e.g., adopted children treated as biological ones are considered equal). In average families where etiquette is maintained and daily needs are met, there are still discussions regarding excess and deficiency.
Human spirit and temperament are governed by the Heart. If the Heart is enslaved by external desires, qi dissipates; if qi dissipates, blood declines; if blood declines, deficiency begins. The Kidney palace becomes cold yet exhausted, and the Heart chamber is insufficient, feeling weak even in the morning. Originally, the essence and yuan (primordial energy) form the embryo, placenta, body, and skeleton. The fetal constitution relies on this to transform into qi, blood, milk, and vessels.
For the noble and wealthy, childbirth is smooth, and nurturing is abundant ("excess"). For the poor and base, care and protection are insufficient ("deficiency"). "Excess" refers to over-indulgence, which causes injury due to lack of restraint. "Deficiency" refers to inadequacy, which leads to illness due to lack of timely recovery. Whether excess or deficiency, failure to maintain moderation results in disease. Cold and heat invade, affecting either the exterior or interior; cold and hot pathogens attack, damaging either the Spleen or Stomach. Physicians must understand these principles of investigation and source analysis.
Children of the wealthy suffer dietary injuries from imprecise food, thermal injuries from excessive warmth, summer-heat injuries from drinking ordinary cool spring water, and gastrointestinal injuries from cold water. Their gastrointestinal qi and blood are soft and not robust, leading to this state. Children of the poor suffer dietary injuries from irregular meals, thermal injuries from freezing and hunger, summer-heat injuries from irritability, and Spleen-Stomach injuries from damp and greasy foods, causing indistinct separation of water and grain. Their gastrointestinal qi and blood are strong but not solid, leading to this state.
Parents themselves may lack nobility and possess deficient/misguided constitutions due to hasty sexual activity before conception. How much more so for their children? Thus, fetal qi is insufficient, and the nourishment of blood vessels is lacking. After birth, although infants require similar care, differences exist in regulating hunger/fullness, cold/heat, and labor/rest. During the period of "bianzheng" (physiological fever in infants), qi and blood may be injured; when learning to walk, bones and sinews may be injured.
Due to improper nurturing, inadequate upbringing, unsuitable management, and incorrect care methods, illness arises easily, leading to deficiency, then deterioration, and finally death. The situation for wealthy/noble children is reversed. They dress before feeling cold, cool down before feeling hot, eat before being hungry (food remains above the diaphragm before mealtime), sleep before being tired, wake up late, overeat, bundle up heavily in cold, and lie on damp surfaces in heat. Thus, they easily fall ill. Forced feeding turns non-deficiency into deficiency; forced medication ruins healthy pulse qi. Lack of study leads to lack of precision; lack of focus in treatment leads to ineffectiveness. Adherence to proper methods is essential; arbitrary action is detrimental. Poor quality pills and powders cause sighs from wise physicians.