While studying Traditional Chinese Medicine (TCM) Pediatrics, I first encountered the theory of “Bianzheng” (变蒸, transformation and steaming), but at that time, it seemed quite mysterious. After a brief discussion with my teacher, I set it aside. Recently, I revisited the “Maijing” (Pulse Classic) and found this theory again. Coincidentally, the Shen Yannian edition of “Maijing Jiaozhu” (Annotated Pulse Classic) also points out the theoretical evolution of the Bianzheng doctrine. The relevant original texts are excerpted below, with various scholars having explained it very clearly.
First, the original proposal of the “Bianzheng” theory in the “Maijing”:
Maijing · Volume 9 · On Children’s Miscellaneous Diseases, Chapter 9
- Children at their appropriate days will undergo Bianzheng, manifesting as body heat with chaotic pulse, no sweating, lack of appetite, and vomiting after eating. The pulse is chaotic but not painful.
- — The theory of Bianzheng in children originated with Wang Shuhe. Since the Sui and Tang dynasties, many medical texts such as “Bingyuan”, “Qianjin Fang”, “Waitai”, and “Xiao’er Yao Zheng Zhi Jue” have inherited this idea and elaborated it extensively. It is considered a normal physiological development process that children must experience before two years of age. The so-called “Bian” (transformation) means the transformation of emotion and intelligence, enhancing wisdom; the so-called “Zheng” (steaming) means steaming the blood and vessels to grow all the bones, not considered pathological. However, many physicians like Zhang Jingyue and Chen Fuzheng regard Bianzheng as pathological. With proper care, children may not necessarily exhibit the Bianzheng symptoms described in the theory during their physical and intellectual development. Later physicians tend to favor Zhang Jingyue’s view, so the Bianzheng theory still requires further study.
Maijing Jiaozhu, Shen Yannian
People’s Medical Publishing House
ISBN: 9787117171465
Below is Zhang Jingyue’s opposing view. Lacking clinical experience, I will not discuss who is correct for now. But based on the experience that “the simpler something is, the closer it is to the truth,” I currently tend to agree with Zhang Jingyue’s perspective. The “Maijing” and “Bingyuan” school is really too complicated.
Jingyue Quanshu · Volume 41, Miscellaneous Collections · Pediatrics, Part 3 · Bianzheng 36
- Mr. Chao said: Children’s Bianzheng arises from the growth of blood and qi. “Bian” refers to ascending qi, “Zheng” to body heat. Qian Zhongyang said: “Bian” means change. In the mother’s womb, the child’s bone qi is born, and the five viscera and six bowels are formed but not yet complete. After birth, bones and vessels grow, and the spirits in the viscera and bowels grow from inside out, from bottom to top. Thus, at 32 days after birth, one Bianzheng occurs, when feelings and thoughts become different from before. Why? Because the spirit of the viscera grows. What is the meaning of 32 days growing bones and adding spirit? Humans have 365 bone joints corresponding to celestial numbers. Excluding 45 small bones in the hands and feet, there are about 320 bones that grow from bottom up, ten sections a day, a hundred sections in ten days, and 320 sections in 32 days, called one cycle or one Zheng (steaming). Each cycle can produce various ailments of empty heat. After ten cycles (ten times 32 days), the small Zheng completes. Thus at the first 32 days is one Bian, generating kidney spirit; 64 days, second Bian and first Zheng, producing bladder; 96 days, third Bian, heart joy; 128 days, fourth Bian and second Zheng, producing small intestine; 165 days fifth Bian liver crying; 192 days sixth Bian and third Zheng producing gall bladder; 224 days seventh Bian lung sound; 256 days eighth Bian and fourth Zheng producing large intestine; 288 days ninth Bian producing spleen; 320 days tenth Bian and fifth Zheng producing stomach, called the end of small Zheng. Also, the hand Jueyin channel corresponds to viscera and the hand Shaoyang channel to Sanjiao, which are without manifestations and therefore do not undergo Bianzheng. Taicang said: qi enters limbs to grow fragmented bones. After ten Bian, 64 days form one large Zheng at 384 days; after another 64 days, second large Zheng at 448 days; another 64 days third large Zheng at 512 days; at 576 days Bianzheng finishes and the child becomes an adult. “Bian” means generating five viscera; “Zheng” means nourishing six bowels. Each Bian and Zheng changes the mood and condition, mild cases cause mild fever and sweating, resembling fright; severe cases cause strong fever, disordered and rapid pulse, sweating or vomiting, irritability, crying and thirst. Mild cases resolve in five days, severe cases in seven or eight days with symptoms similar to typhoid. Treatment: mild cases use mild exterior-relieving methods; strong heat with slight diarrhea use Zishuang Wan and Heisanzi, Chaihu San. If cold without heat, vomiting, diarrhea, poor breastfeeding and crying, Danggui San and Tiaoqi San are recommended.
- Xue Lizhai said: “Quanyi Fanglun” says: Bianzheng signifies growth of qi and blood. Bian, ascending qi; Zheng, releasing heat. Mild cases have body heat, virtual fright, cold ears, slight sweating, white foam on lips and recover in three days. Severe cases have fever and cold, chaotic pulse, abdominal pain and crying, refusal to feed and vomiting with recovery in five days. Traditional formulae include Heisanzi and Zishuang Wan. I believe these symptoms are unavoidable in children and can resolve without medicine. The previous medicines are rather strong, harmful and may harm qi and blood. Be cautious! I have seen a child with fever at second Bianzheng and phlegm, taken Baolong Wan (embracing dragon pill) in one dose but died, confirming this. If no heat or fright, slight or no symptoms but hidden change, this is due to a strong fetal qi.
- Jingyue said: The theory of children’s Bianzheng was not ancient, first mentioned by Wang Shuhe in Western Jin, and then increasingly passed down and elaborated upon since Sui and Tang by Mr. Chao. However, in my view, there is likely much that is unfounded. Why? Because children have completed gestation and although not fully mature in constitution, their viscera are complete. After birth, growth is like the waxing of the moon or a growing seedling, continuous without interruption. The bones reach completeness; changes occur every day. Why have one Bian generate kidney, two Bian bladder, with strict 32-day cycles for each Bian? Also, children’s illnesses are often due to disharmony, externally caused or internal injuries, but rarely without cause. Can this be true Bianzheng? Also, I have seen many children well cared for who grow without any illness or pain. So can the hidden Bianzheng be trusted? I fear clinical practitioners may be misled. Therefore, I express my ignorance and warn as Xue-san did; the wise will consider this carefully.
Jingyue Quanshu, Zhang Jiebin, Li Jiming
People’s Medical Publishing House
ISBN: 9787117251358