《孫真人備急千金要方》Vol. 9

Scroll Nine of the Essential Prescriptions Worth a Thousand in Gold by the Perfected Sun

(Edited by Lin Yi and others, who served as Court Gentleman for Service, Acting Vice Minister of the Court of Imperial Sacrifices, and Collator at the Secret Pavilion.)

On the Second Day After Birth

The text says: When a child has just been born, wrap a finger in cotton cloth and wipe the blue mucus and foul blood from the child’s mouth and tongue. This is called “Jade Balance” (also written “Jade Bit”). If it is not wiped away promptly, the child may cry and swallow the residue, which could lead to various illnesses.

If the child does not cry after birth, pour a vessel of warm water over the child; usually the child will cry after a short while. If the child still makes no sound, this is probably because the birth was difficult and the child lacks strength. Hold the end of the umbilical cord nearest the child’s body and stroke it toward the child, so that breath enters the abdomen. At the same time, blow gently toward the child, repeating this a hundred times; the child will then cry naturally. You can also gently tap the child with the white part of a scallion to prompt crying.

The child should be picked up immediately after birth. If this is delayed, the child may catch cold, and the abdomen may rumble like thunder. Bathe the child first, then cut the umbilical cord. Do not cut it directly with a knife. Instead, bite through it with a single layer of clothing or similar material between your teeth and the cord, then warm it with your breath seven times. Bind the remaining cord so that it reaches approximately to the child’s instep. If too little cord is left, the child may easily catch cold, develop abdominal distress, and often have diarrhea.

If the cord is cut before bathing, water may enter the navel and cause abdominal pain. After cutting the cord, if you see a worm inside it, remove it at once; otherwise it may enter the child’s abdomen and cause illness. When cutting the cord, leave six inches: if it is too long, it may injure the muscles; if too short, it may harm the internal organs. If the cord is not cut promptly and its fluid is not fully squeezed out, its warmth will gradually diminish. The child may then catch cold and develop umbilical wind.

After a boy is born, it is best to wrap him in old clothes worn by his father; after a girl is born, use old clothes worn by her mother. Old clothes are more suitable than new silk or fine fabric. Do not dress the child too warmly, as this may damage the skin, impede the circulation of the blood and vessels, and cause various sores and rashes or yellowing of the skin. In particular, avoid dressing the child in overly thick, warm cotton or silk garments, and take great care.

A newborn child’s skin has not yet fully developed, so the child should not be dressed too warmly. Excessive warmth can make the sinews and bones soft and weak. Let the child be exposed to wind and sunlight at appropriate times; if the child never encounters wind, the skin will become fragile and soft, and easily injured. Use old cotton batting for clothing, not new cotton batting. When the weather is warm and calm, have the mother take the child…

Children are often active during the day. Letting them feel the wind and bask in the sun in moderation strengthens their Qi and blood and firms their muscles, helping them withstand wind and cold and making them less likely to fall ill. If they are always kept hidden behind curtains and dressed too warmly, they are like plants growing in the shade: without wind or sunlight, they grow weak and cannot withstand the cold.

To wrap a child’s navel, soften a piece of fine white silk by beating it, then cut it into a square four cun on each side. Take new cotton about half a cun thick, layer it with the silk, and wrap the navel snugly but not too tightly. Wrapping too tightly may make the child vomit or spit up milk. Wait until twenty days after birth before unwrapping it to inspect the navel. If, around the child’s tenth day, the child becomes restless and cries as though pricked by something inside the clothes, the navel may have dried and tightened, causing pain that pulls at the abdomen. Unwrap it, change the child’s clothes, and wrap it again.

When wrapping the navel, close the doors, lower the curtains, and light a fire inside to keep the room warm. Do the same when changing the child’s clothes, and dust the navel with warm powder. Take particular care to protect the child from cold in winter. If the navel still does not heal well, burn red silk to ash and apply it. If it continues to ooze after a month, burn a frog to ash and apply it three or four times a day.

If water gets into the navel or it is exposed to cold, the child may suffer abdominal cramps, curl up and cry, and turn bluish or dark in the face. This is attributed to water entering the navel. Warm some cotton batting and place it over the child’s abdomen. If care is delayed and the navel swells, treat it according to the severity. For severe swelling, the text says moxibustion may be used, with at most eighty or ninety cones of moxa; a “cone” is a unit of measurement for moxibustion, usually the amount of moxa burned in one application. If the swelling is mild, but the navel occasionally oozes and the child cries, mix powdered Chinese angelica with lead powder and apply it. Then warm cotton batting and use it to press and warm the area each day, continuing until the child is a hundred days old. The child’s stopping its cries is taken as a sign of improvement. Green stools are also attributed to exposure to cold and are treated in the same way as water entering the navel.

After bathing the child, cutting the umbilical cord, and settling the child, do not give cinnabar and honey at once. Give licorice decoction first: take a piece of licorice about the length of a finger joint, pound it, and boil it in two ge of water. Take one ge of the liquid, soak cotton in it, and let the child suck on it until it has taken in about the amount held in a small clam shell. The text says this will help the child bring up the “bad fluids” lodged around the chest and heart. If the child has already vomited, there is no need to give more. If not, observe whether the child is hungry or thirsty, then offer some again after a while. If neither the first dose nor the later offering has caused vomiting, the full ge may be given in small amounts over several feedings. According to the text, if the child brings up the so-called “bad fluids,” its mind and spirit will be clear, and it will be clever and seldom ill. If it drinks the entire ge without vomiting at all, the text concludes that it did not contain these “bad fluids.”

If a child has bleeding from the ear, stop giving him licorice decoction. At this point, you may give him “Cinnabar Honey,” a mixture of cinnabar and honey, to calm the mind and settle the hun and po.

Cinnabar Honey should be given sparingly during the first three days after birth. Too much may chill the child’s spleen and stomach, cause abdominal distension, and bring on symptoms such as Yin convulsions, labored breathing, clenched jaws, and spasms. It may even cause death.

To give Cinnabar Honey to a newborn, take cinnabar that has been purified by firing, about the size of a soybean, and mix it with one shellful of red honey. Wrap cotton around the end of a chopstick, dip it into the mixture, and let the child suck on it. Dip it three times, then stop. Give the child this soybean-sized portion of cinnabar over the course of one day. Continue for three days, using three soybean-sized portions in total. Do not exceed this amount, or the child may be harmed.

After the course of Cinnabar Honey, you may give the child bovine bezoar in a similar dose. Bovine bezoar benefits the liver and gallbladder, clears heat, calms the spirit, stops convulsions, and dispels inauspicious influences. It treats various childhood illnesses.

Three days after birth, the child’s digestive tract begins to function freely and can help digest food. At this point, grind rice and cook it into a thick, cheese-like rice drink. Give the child a portion about the size of a bean each time. Feed three times in succession, for a total of three bean-sized portions; give it three times a day. Once the child is seven days old, feeding may begin.

When the child is ten days old, begin feeding about a date pit’s worth at each meal. At twenty days, double the amount; at fifty days, give about a pellet’s worth; and at one hundred days, about the size of a date. If the mother has little milk and cannot follow this method, increase the amount slightly as needed.

Beginning to feed the child at thirty days can help prevent illness. If fed too early, the child’s spleen and stomach may not be able to handle grain, making illness more likely. Sores may repeatedly appear on the head, face, and body, healing only to return, and the child may grow thin and difficult to nourish. Even after the child reaches thirty days and feeding begins, do not give too much. If the child does not want to eat, do not force him; food that cannot be digested may cause illness.

If a child refuses milk or food, this is usually because of phlegm accumulation in the abdomen, a type of stagnation recognized by the ancients. Use the Four-Ingredient Purple Pill to gently purge, and temporarily reduce milk and food. The child will usually recover on his own after a few days. The same approach may be used when a young child has even mild chills or fever: first purge the bowels, and then the child will recover.

Do not let the child drink so much milk that he becomes full, or he may vomit. Whenever a child spits up milk, it is because he has had too much; let him suck briefly at an empty breast, and he will digest it. Feed him four times a day.

If the child’s navel has not yet healed, overfeeding may allow pathogenic wind to enter through it. In summer, if the milk is not allowed to cool before feeding, it may cause retching; in winter, if it is not warmed, it may cause coughing and diarrhea. If the mother nurses immediately after intercourse, the child may become thin, cross his legs, and be unable to walk. If the mother nurses while feverish, the child may turn yellow and be unable to eat. If the mother nurses while angry, the child will…

Strong emotions such as anger, joy, alarm, and fear can disrupt the movement of Qi, leading to illnesses such as Qi obstruction, counterflow of Qi, and mania. If a mother has just vomited or had diarrhea, she should not nurse her child, as this can leave the child weak and thin. If she nurses after drinking alcohol, the child may develop a fever and abdominal distension.

During a newborn’s first month, it is often beneficial to feed the child some pig’s milk. Before nursing, the wet nurse should massage her breasts thoroughly to soften them, so the milk does not gush out all at once and cause the child to choke. If the child chokes, remove the nipple and let the child catch their breath before nursing again. Repeat this process five to ten times. Pay attention to whether the child is hungry or full, establish how many feedings a day are sufficient, and follow that routine. Any milk that has accumulated in the breasts should also be expressed regularly.

If the wet nurse is lying down while the child feeds, she should place her arm beneath the child’s head so that the breast and the child’s head are level. This makes the child less likely to choke. When the wet nurse wants to sleep, she should remove the nipple from the child’s mouth, so milk does not block the child’s mouth or nose and the child is not left unable to regulate how much they take.

When bathing a child, make sure the water is neither too hot nor too cold. Water at an unsuitable temperature may frighten the child and can also lead to diseases of the Five Viscera. In winter, do not bathe the child for too long, or they may become chilled. In summer, do not bathe them for too long either, or they may become overheated. Bathing too often until the child’s back grows cold may bring on epilepsy; never bathing the child may cause their hair to fall out.

When bathing a newborn, one may take a pig’s gallbladder, add its bile to the bathwater, and bathe the child in it. It is said that this prevents the child from ever developing sores or scabies. Do not bathe a child in unclean water.

On the third day after birth, the child may be bathed in a decoction of peach, plum, and apricot roots: use two liang of each; branches of the trees may be used instead. Chop the ingredients, add three dou of water, and boil for twenty rolling boils. Strain out the herbs and bathe the child in the decoction. This is said to be beneficial, to ward off ill fortune, and to prevent the child from ever developing sores or scabies.

To treat childhood fright wind and drive away harmful influences, one may bathe the child in Golden Tiger Decoction: take one jin of gold and a tiger’s skull, and boil them in three dou of water to make a decoction. Prepare it fresh whenever a bath is needed.

Some children are born with thrush: white flakes like grains of rice appear on the tongue, and in severe cases inside the nose as well. This is said to result from the child receiving too much grain Qi in the womb; others believe it is caused by the pregnant woman’s fondness for glutinous rice. To treat it, wrap hair around the end of a chopstick, dip it in well-flower water—the first water drawn from a well at dawn—and wipe the affected area. After three days, the white flakes should come away. If they do not, boil the thin inner skin of chestnuts into a concentrated liquid, wrap cotton around the end of a chopstick, and wipe with it. In spring and summer, when chestnuts are unavailable, boil chestnut bark and wipe in the same way, using well-flower water.

If a newborn has a “joined tongue”—a membrane beneath the tongue that binds it down—…

If there is a band of tissue beneath the tongue, attached to its underside and resembling the membrane between the seeds of a pomegranate, it may later cause a child to speak unclearly and move the tongue with difficulty. It may be pinched through with a fingernail; a little bleeding is harmless. If the bleeding does not stop, burn some hair to ash and apply the ash to the wound to staunch it.

Six or seven days after birth, the child’s blood and Qi settle, and the body’s tissues gradually develop. The mouth, tongue, throat, and insides of the cheeks then become clear. If something like a water-filled reed sheath appears on the throat or tongue, or if the uvula (commonly called the “little tongue”) is swollen and raised, wrap cotton around a long needle, leaving only a needle point about the size of a millet grain exposed. Pierce the swelling and let the Qi and the bluish, yellow, or red bloody fluid inside drain out. After one puncture, observe the child for a day. If the swelling has not subsided, pierce it again the next day, up to three times at most; it will usually go down. Any small swelling that remains will subside on its own, even without further puncturing.

When this growth appears beneath the tongue, it is called “double tongue”; when it appears inside the cheeks or on the palate, it is called “double palate”; and when it appears on the gums, it is called “double gum.” In each case, it should be pierced to release the bloody fluid.

Treatment for a child who dies soon after birth

Examine the palate in front of the child’s uvula. If there is a blister there, use a finger to break its tip open and let it rupture and drain the bloody fluid. Do not let the blood flow into the throat, as this may endanger the child’s life. Take great care.

At birth, a child’s bones and flesh are not yet fully formed, and the muscles are still made up only of gathered blood and Qi. Once the blood congeals, it gradually becomes firm and forms muscle. If the blood and Qi are impaired and cannot gather to form muscle, the child may develop yellowing around the nose and mouth and on both sides of the face; cry with closed eyes, pursed lips, and a furrowed face; have a dry mouth; and be unable to extend or bend the limbs. These signs indicate that the blood vessels have not yet settled, and the child will often be difficult to raise. In such cases, the child should take Longdan Decoction (here referring to the formula prescribed in the book for treating convulsions).

How to judge a child’s lifespan

A newborn whose cry is continuous, with each sound joined to the next, is considered long-lived. A cry that breaks off and then rises sharply and urgently is considered a sign of a short life.

A cry that is scattered, with no complete sound discernible, is considered a sign that the child will not grow to maturity. A low, weak cry is likewise considered a sign that the child will not grow to maturity.

A navel without blood is considered a good sign; a small navel is considered a sign of a short life.

A body so limp that it seems to have no bones is considered a sign of a short life.

Clear white skin and a large build are considered signs of long life; eyes that open on their own soon after birth are considered a sign that the child will not grow to maturity.

An unfocused gaze and frequent eye movements are considered bad signs.

Sweat mixed with blood is considered a sign of many hardships and a short life; a child who does not sweat is considered unlikely to grow to maturity.

Urine that resembles coagulated oil is a sign that the child will not reach adulthood.

If the head has four unfused sutures or areas where the bones have not developed fully, the child will not reach adulthood. The same is true of a child who constantly moves their hands and feet.

Children who can sit, walk, grow teeth, or speak very early often have a poor disposition and are not people destined for good fortune and virtue.

A child whose hair does not cover the whole head will not reach adulthood. One whose hair is sparse and stubborn will not heed advice (another reading says “unintelligent”).

A whorl of hair on the forehead means the child will rise to prominence while young, but will bring trouble to their parents.

If a child is born with an incompletely formed occipital bone, the bone at the lower back of the head, they may speak but will die young. If the tailbone is incompletely formed, they may sit but will die young; if the bones of the palm are incomplete, they may crawl but will die young; if the heel bone is incomplete, they may walk but will die young; and if the kneecap is incomplete, they may stand but will die young.

One who cannot control their body will die; so will one whose mouth hangs open like a fish’s. One who has no flesh grown between the legs will die; so will one with a damaged chin, or one whose penis cannot become erect. If the skin beneath the scrotum is pale or red, the person will die. If the line between the testicles runs straight and is dark in color, the person will live long.

The text argues that, from the age of three to under ten, a child’s temperament and disposition can be observed to make a general judgment about how long they will live. Children who are exceptionally quick-witted and perceptive at a young age are often prone to an early death. Xiang Tuo and Yan Hui are examples from later life. By contrast, children whose bones and bodies develop fully, and whose movements and turns seem slow and composed—as though they need others to take care in raising them and patiently shaping them—often live longer. Children who can read others’ intentions at an early age and move with quick, nimble gestures are also prone to die young. Yang Xiu and Kong Rong are examples of this kind.

From these signs, one can roughly infer whether a person will live a long life or die young. It is like plum blossoms, which bloom early and often cannot withstand the cold of winter, while chrysanthemums bloom late and endure through the end of the year. Thus, late maturity is regarded as a sign of longevity.