(月内不测诸病)
《千金》论曰∶芽儿出腹,骨肉未敛,肌肉未成,犹尚是血,血凝,则坚而成肌
肉也。又云∶如水上之泡,草头之露。夫初生一腊之内,天地八风之邪岂能速害,
良由在胎之时,母失爱护,或劳动气血相干,或坐卧饥饱相役,饮酒食肉,冷热相
制,恐怖惊扑,血脉相乱,蕴毒于内,损伤胎气,故降生之后,有胎热胎寒,胎肥
胎怯,胎惊胎黄,诸证生焉,外因浴洗拭口,断脐灸囟之不得法,或绷HT 惊恐,乳
哺寒温之乖其宜,致令噤口脐风,锁肚不乳等证,病患致此,亦难救疗,坐视其毙,
良可哀悯,故黄帝云∶吾不能察其幼小,谓别是一家调理耳。用药者必明消息形候,
审定生死,察病患之浅深,知药性之寒温,而后庶乎少失也。
《千金》儿初生辄死,视儿口中悬痈前上 有胞者(《翼》云赤胞,以指甲摘取头,决
令溃去血,勿令血入咽,入咽杀儿,慎之。)
《三因》云∶小儿初生气绝不能啼者,必是难产或冒寒所致,急以绵絮包裹抱怀
中,未可断脐带,且将胞衣置炉炭中烧之,仍捻大纸条蘸油点火,于脐带下熏之,
盖脐带连儿,火熏时有火气由脐入腹,更以热醋汤荡洗脐带,须臾气回,啼哭如常,
方可洗浴,了,即断脐带。婴儿哭迟者,以葱白细鞭背上,即啼。《水鉴方》云∶
胎风生下不能啼,须使园中小叶葵,捣取汁调熊胆末,才交入口免倾危。看舌下法
见前。儿生下地,即不啼哭,不能吞乳,奄奄如死者,急看喉间悬痈前 上有一
泡,用指摘破,以帛拭去恶血,勿令咽下,即能通声吞乳。
(出生一个月内不诊察其他疾病)
《千金方》论述说:婴儿刚离开母腹,骨肉尚未收敛,肌肉尚未形成,身体还主要由血液构成,血液凝聚,才能坚固地形成肌肉。又说:婴儿的身体就像水面上的水泡、草叶上的露珠一样脆弱。在出生后的第一个星期内,天地间的八风邪气难道能迅速造成伤害吗?这主要是因为胎儿在母体期间,母亲未能妥善爱护,或者因劳累导致气血相互干扰,或者因坐卧姿势不当、饥饱不均而役使身体,饮酒吃肉,冷热饮食相互制约,遭受恐怖惊吓或跌扑撞击,导致血脉紊乱,毒素蕴结于体内,损伤了胎气。因此,出生后会出现胎热、胎寒、胎肥、胎怯、胎惊、胎黄等各种证候。此外,外因如洗浴、擦拭口腔、断脐、灸囟门等方法不得当,或者用布带捆绑时受到惊恐,哺乳喂养时寒温调节失宜,导致出现噤口(牙关紧闭)、脐风、锁肚(大便不通)、拒乳等证候。患儿患此病,也难以救治,只能坐视其死亡,实在令人哀悯。所以黄帝说:“我不能详细考察幼小的情况,认为这是需要另行调理的一家之学。”用药的人必须明白观察病情变化的道理,审定生死预后,察看病患病的深浅程度,了解药性的寒温属性,然后才可能少出差错。
《千金方》记载:婴儿刚出生就死亡,查看婴儿口中悬雍垂前上方是否有胞衣组织(《千金翼方》说是赤色胞衣,用指甲掐取头部,刺破使其溃破流出血液,不要让血液流入咽喉,流入咽喉会杀死婴儿,务必谨慎。)
《三因极一病证方论》说:小儿刚出生气息微弱不能啼哭的,一定是难产或受寒所致。应立即用棉絮包裹抱在怀中,暂时不要剪断脐带,先将胎盘放在炉炭中烧掉,再捻大纸条蘸油点火,在脐带下方熏烤。因为脐带连着婴儿,火熏时有火气通过脐部进入腹部,再用热醋汤荡洗脐带,片刻后气息恢复,啼哭如常,才可以洗浴。洗完之后,再剪断脐带。婴儿哭声延迟的,用葱白轻轻鞭打背部,就会啼哭。《水鉴方》说:胎风导致生下不能啼哭,必须找园中的小叶葵,捣取汁液调和熊胆末,刚入口就能避免危险。看舌下的方法见前文。婴儿落地后,就不啼哭,不能吞咽乳汁,奄奄一息像死了一样,急忙查看喉间悬雍垂前上方有一个泡,用手指甲挑破,用布擦去恶血,不要让血液咽下,就能发声并吞咽乳汁。
(Not diagnosing other diseases within the first month)
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: When an infant leaves the womb, the flesh and bones have not yet consolidated, and the muscles are not yet formed; the body is still largely composed of blood. When the blood coagulates, it solidifies to form muscle tissue. It also says: [An infant's body] is like a bubble on water or dew on grass—fragile. Within the first week after birth, can the evil qi of the eight winds from heaven and earth cause harm so quickly? This is primarily because during gestation, the mother failed to provide proper care, or fatigue caused interference between qi and blood, or improper sitting and lying postures, irregular hunger and fullness, served as burdens on the body. Consuming alcohol and meat, or conflicting cold and hot dietary elements, along with fear, fright, or falls, caused chaos in the blood vessels. Toxins accumulated internally, damaging the fetal qi. Consequently, after birth, conditions such as fetal heat, fetal cold, fetal obesity, fetal weakness, fetal fright, and fetal jaundice arise. Additionally, external factors such as improper methods for bathing, wiping the mouth, cutting the umbilical cord, or moxibustion on the fontanelle, or fright caused by tight swaddling, or inappropriate temperature regulation during breastfeeding, lead to conditions such as trismus (lockjaw), neonatal tetanus (umbilical wind), abdominal locking (constipation), and refusal to suckle. Patients suffering from these conditions are difficult to treat; one can only watch them die, which is truly pitiable. Therefore, Huangdi said, "I cannot fully examine the young, considering them a category requiring separate management." Physicians using herbs must understand how to observe changes in symptoms, determine prognosis regarding life and death, assess the depth of the patient's condition, and know the cold and warm properties of medicines, so that errors may be minimized.
The *Qianjin Fang* records: If an infant dies immediately upon birth, inspect the area above the anterior aspect of the uvula in the infant's mouth for the presence of a vesicle (The *Qianjin Yifang* [Supplement to Essential Prescriptions Worth a Thousand Gold] describes this as a red vesicle; use fingernails to pinch the head of the vesicle, puncture it to drain the blood, ensuring the blood does not enter the throat, as entering the throat will kill the infant. Be extremely cautious.)
The *San Yin Ji Bing Zheng Fang Lun* (Treatise on Causes and Manifestations of All Diseases) states: If a newborn has weak breath and cannot cry, it is certainly due to dystocia (difficult labor) or exposure to cold. Immediately wrap the infant in cotton wadding and hold them against your chest. Do not cut the umbilical cord yet. Instead, burn the placenta in a charcoal brazier. Then, twist a large paper strip, dip it in oil, light it, and smoke the area below the umbilical cord. Since the cord connects to the infant, the fire's qi enters the abdomen through the umbilicus. Subsequently, wash the umbilical cord with hot vinegar water. After a moment, when the breath returns and crying resumes normally, bathing may proceed. Afterward, cut the umbilical cord. For infants with delayed crying, gently whip the back with white parts of green onions, and they will cry. The *Shuijian Fang* (Water Mirror Formulas) states: For inability to cry at birth due to fetal wind, gather small-leaf hibiscus from the garden, crush it to extract juice, mix with bear gallbladder powder, and administer orally; this prevents imminent danger. See the method for inspecting under the tongue mentioned earlier. If an infant does not cry upon touching the ground, cannot swallow milk, and appears nearly dead, urgently inspect the area above the uvula in the throat for a blister. Puncture it with a fingernail, wipe away the bad blood with cloth, ensuring it is not swallowed, and the infant will be able to vocalize and swallow milk.