TCM Pediatrics

TCM Pediatrics
General Introduction
Violet Song
Introduction
BianQue(4 century BC.)

The first TCM Pediatrician
in history
• Sui Dynasty
– Cao Yuanfang(6-7
century A.D)
Zhu Bing Yuan HouLun

(Treatise on the Origins &
Symptoms of Various
Diseases)
PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

ÿÿ
• North Song Dynasty
– QianYi (1032-1113 A.D)
Xiao ErYao ZhengZhiJue
(A Collection of Essential Pediatric
Patterns &Treatments)
Pediatric Sage
Physiology
• The internal organs are tender and fragile
and the Qiis not full
• Children have a pure yang constitution
Etiology
• Congenital factor
• External factor
• Diet
• Emotional factor
• Injury
• Medical factor

ÿÿ
Pathology
• Children are easily susceptible to disease
which then transmits and changes rapidly
• Children’s internal organ Qiis clear and
effective; therefore, they easily and quickly
return to health
• Insufficient • Excessive
– Lungs – Liver
– Spleen – Heart
– Kidneys – yang
– yin
Pediatric Diagnosis
• Observation
• Listening and smelling
• Requiring
• Palpation

ÿÿ
Observation
• Observe Shen and color
• Observe body form
• Observe sprouts and orifices
• Skineruption
• Urine & stools
• Index finger vessel
Observe Shenand color
• Yellow, relates to SP, indicates :

– Weak constitution
– Improper diet
– Dampness

ÿ駿ÿ
• Green, relates to Liver,
indicates:
–Wind
–Pain
–Blood stasis
–Convulsion
• Red, relates to H, indicates:

–Heat
–Convulsion
• White, relates to LU, indicates:

–Deficiency
–Cold

ÿÿ
• Black, relates to K, indicates
–Cold
–Pain
–Water retention
–Malignant situation
Observe body form

• head, neck, fontanel
• trunk
• limbs
• skin
• hair
• nails
Observe Sprouts&Orifices
• Eyes
• Nose
• Teeth
• Throat
• Cheeks
• Tongue
• Ears
• Twolowerorifices

ÿÿ
• Observe stools
• Observe urine
Veins in the Index Finger
– Check the location of veins in the index

finger
• Veins in Wind Bar (the area between the
metacarpal phalangealjoint and the
proximal inter-phalangealjoint): indicates
acute stage, superficial and beginning of
a disease and therefore it has a better
prognosis
• Veins in QiBar (between the proximal and
distal inter-phalangealjoints): indicates
the middle stage of a disease and the
prognosis is not as good;
• Veins in Life Bar (from the distal inter-
phalangealjoint to the tip of the index
finger): indicates the severe stage of a
disease and the prognosis is worse.

ÿÿ
• Superficial-Exterior
• Deep-Interior
• Red-Cold
• Purplish-Heat
• Fluency-Deficiency
• Sluggish-Excessive
– Check the color of the veins

• Fresh red: external excessive cold
• Purple red: external or internal excessive heat
syndrome
• Green color: pain and panic or fear
• Dark purple or black purple: food stagnation,
particularly for blood stagnation
• Light or pale red: deficient cold
• Light or pale yellow: Inner wind due to spleen
deficiency
• Light or pale purple: deficient heat
Listening & smelling

• Crying
• Breathing
• Coughing
• Language
• Smelling

ÿÿ
• Age Breathe(/min) Pulse(/min) B：P
• New born 40~45 120~140 1 ：3
• <ly 30～40 110~120 1 ：3~4
• 2～3y 25～30 100~120 1 ：3~4
• 4～7y 20～25 80~100 1 ：4
• 9～l4y 18～20 70~90 1 ：4
Requiring
Palpation
• Fontanel
• Skin
• Chest
• Abdomen

ÿÿ
Pulse
Age >3 y
Take 3 guans with one finger
Superficial Deep
Slow Rapid
With strength Without strength
Treatment
• Treatment principles
• Treatment methods
• Dosage
• Be careful with extremely bitter, cold, acrid,

heat herbs, toxic herbs, harsh hers
• Once the treatment works , do not continue.
• Choose the mild herbs from the same
category
• The prescription must be convenient for
taking
• Do not prescribe herbs without symptoms
10

ÿÿ
• Internal treatment
• External treatment
• Tuinaand acupuncture
Other Methods
• Inhalation therapy
• Drops
• Herb bags
• Bathing
• Warm ironing
Dosage
• New born baby 1/6 of adult dose
• < 1 year old, 1/3 of adult dose
• 1-6 years old, 1/2 of adult dose
• 7-12 years old, 2/3 of adult dose
• Over 12 years old, same dose as adult
11

ÿÿ
Administration
• <1y 100ml
• 1~3y 100~250ml
• >3y 250~500ml
TCM Pediatrics
Cough
Introduction
• 1.Concept
• 2. Onset
– Season
– Age: <3 years
– Characteristics
– Prognosis
12

ÿÿ
The Etiology and Pathogenesis
– Due to invasion of external pathogens
– Due to irregular diet
– Spleen and lung Qideficiency due to poor
body constitution
Wind Cold Dysfunction of

External dispersing and
Skin/Mouth/Nose LU descending; Obstruction
Attack
Wind Heat of qitract
Ph-H Adversely Cough

Source of upward qidue to
Dysfunction of Phlegm qiobstruction
phlegm Ph-Damp
SP
Internal
Invasion
Weak Susceptible to Injury of
Constitution ex-pathogenic LU & SP Dysfunction of descending
factors
The key points for diagnosis

– The sound of cough
– The amount of phlegm
– The color of phlegm
13

ÿÿ
Commonly used herbs for cough
• Herbs to remove external pathogens
– Ma Huang, ZiSu Ye, Jing Jie, Fang Feng, QiangHuo, Xi Xin,
ShengJiang; Bo He, Sang Ye, ChaiHu
• Herbs to descend lung Qi
– Chen Pi, ZhiKe, Lai Fu Zi, HouPo
• Herbs to remove phlegm
– QianHu, BeiMu, GuaLou, Dan Nan Xing (heat-phlegm);
– Ban Xia, TianNan Xing, XuanFu Hua, JieGeng(cold-
phlegm);
– Xing Ren, ZiWan, KuanDong Hua, Su Zi, Pi Pa Ye, Sang Bai
Pi (relieve coughing and wheezing);
– Fu Ling, Du Huo(dampness)
• Herbs to remove heat

– ZhiZi, Shi Gao, Lu Gen, Huang Qin, Lian
Qiao, Yu Xing Cao
• Herbs to moisten lungs
– ShaShen, Mai Men Dong, Yu Zhu
• Herbs to tonifylungs
– Huang Qi, RenShen, Dang Shen, GanCao,
BaiZhu
Differential Diagnosis and Treatment
• 1.External cough
• 2.Internal cough
14

ÿÿ
• 1-1 Wind-Cold Cough
– Symptoms-Frequent cough with heavy sound, itchy
throat, thin white phlegm, stuffy nose and runny nose,
aversion to cold and without perspiration, or fever with
body pain
• T-light red tongue body with thin white coating
• P-floating tight pulse; floating red finger vessel
– Therapy- Expel wind – cold, disperse lungs to stop
cough.
• Formula: JīngF ángB àiD ú Sǎn

– JīngJi è
– FángF ēng
– QiāngHu ó
– Dú Huó
– ChuānXi ōng
– CháiH ú
– QiánH ú
– Jié Gěng
– Zhǐ Ké
– Fú Líng
– GānC ǎo
– ShēngJi āng
JīngF áng ÈrHu óÈ rH ú Xiōng
Zhǐ Ké Fú LíngJi é GānY ōng
• Modification:
– Cough with large amount of phlegm, greasy
coating : HòuPo, C āngZh ú
– Severe cold: Má Huáng
15

ÿÿ
• 1-2. Wind-Heat Cough
– Symptoms- cough with sticky yellow phlegm
or with difficulty to cough phlegm out. Thirst
and sore throat, turbid snot, or accompany
with fever and headache, aversion to wind,
sweating
• T-red tongue body with thin yellow coating
• P-floating rapid pulse; floating purple finger
vessel.
– Therapy-Expel wind and clear heat, disperse
lung and resolve phlegm.
– Formula-SāngJ ú Yǐn
• SāngY è
• Jú Huā
• XìngR én
• LiánQi ào
• Bó He
• Jié Gěng
• GānC ǎo
• Lú Gēn
Sā ngJ ú Yǐ nY òngJi é XìngQi ào
Lú Gē nG ā nC ǎ oB ó Hè Ráo
• Modifications
– Severe LU heat with yellow sticky phlegm, yellow
coating: HuángQín, ZhīMǔ, YúXīngCǎo
– Severe ST heat with heavy breathe, severe thirst:
ShíGāo, TiānHuāFěn
– Red and swollen tonsil: NiúBàngZǐ, ShèGān,
XuánShen, BǎnLánGēn
– Sever cough & a lot of phlegm: ZhèBèiMǔ,
TíngLìZǐ
16

ÿÿ
• 2-1. Damp-Heat Cough
– Symptoms-Cough with large amount of
phlegm, or cough with retching. Epigastria
distension and poor appetite; turbid thick snot;
afternoon fever, the disease is lingering.
• T-red tongue body with thick greasy or greasy
yellow coating
• P-slippery & rapid; purplish sluggish finger
vessel
– Therapy-clear and disperse lung, resolve
phlegm and eliminate dampness
– Formula –ShàngJi āoXu ānB ì Tāng

• Pí Pā Yè
• Shè Gān
• DànD òuCh ǐ
• Yù Jīn
• TōngC ǎo
• Modifications:
– Severe dampness: BànXi à
– Severe heat: HuángQ ín
17

ÿÿ
• 2-2 Phlegm-Heat Cough
– Symptoms-cough with thick sticky yellow
phlegm and with difficulty to cough the
phlegm out. Red face and lips, bitter taste in
mouth and thirst; fever, dry stools,
concentrated urine
• T-red tongue body with greasy yellow coating
• P-slippery & rapid; purple finger vessel，
– Therapy-clear heat from lungs and resolve
phlegm
– Formula-QīngQ ì Huà TánW án

• Guā LóuR én
• DǎnN ánX īng
• HuángQ ín
• BànXi à
• ChénP í
• Zhǐ Shí
• XìngR én
• Fú Líng
• JiāngZh ī
• Modification:
– A lot of phlegm and fast breathing: Yú
XīngC ǎo, SāngB áiP í
– Sticky plegmwhich is difficult being
coughed out : reduce BànXi à, add Qīng
Dài, HǎiG é Fěn, Shā Shēn
18

ÿÿ
• 2-3 Phlegm Dampness Cough
– Symptom-cough with large amount of white
watery phlegm. Chest oppressed and poor
appetite, fatigue and lassitude
• T-light red tongue body with white greasy
coating
• P-slippery
– Therapy-dry dampness and resolve phlegm
– Formula 1- Liù ĀnJi ān

• BànXi à
• ChénP í
• Fú Líng
• GānC ǎo
• XìngR én
• BáiJi è Zǐ
• Shē ngJi ā ng
– Formula 2 –ÈrCh énT āng

• BànXi à
• ChénP í
• Fú Líng
• Zhì GānC ǎo
19

ÿÿ
• Modification
– With oppressed chest : Sū Gěng、Zhǐ Ké
– With food stagnation: ShénQ ǚ, MàiY á, Shān
Zhā, LáiF ú Zǐ
• 2-4 Dry Cough due Yin-Deficiency

– Symptoms-non-productive cough, or with
little sticky phlegm and with difficulty to cough
it out. Thirst and dry throat, hoarse voice,
feverish palms, or phlegm with blood,
afternoon fever, night sweating
• T-red tongue body lack of coating
• P-thin rapid。
– Therapy-moisten lung yin
• Formula-Sh ā ShēnM àiD ōngT āng

– Shā Shēn
– Yù Zhú
– MàiD ōng
– TiānHu ā Fěn
– BiǎnD òu
– ShēngG ānC ǎo
– SāngY è
20

ÿÿ
• Modification
– Yin deficiency: XuánSh ēn, ShēngD ì Huáng
– Severe cough: ChuānB èiM ǔ, Zhì Pí Pá Yè, Zhì Bǎi
Bù
– Blood in phlegm: BáiM áoG ēn, ǑuJi ē, Cè BǎiY è,
Ē Jiāo
– Tidal fever and nigh sweating: YínCh áiH ú, Biē Jiǎ,
QīngH āo, Dì Gǔ Pí
• 2-5 Chronic Cough due to Lung qideficiency

• Symptoms-repetitive cough, cough without
strength, watery white phlegm, pale white face,
short of breath with disinclination to talk. Low &
weak voice, prefer warmth but aversion to cold.
Spontaneous sweating and aversion to wind
– T-pale tongue body with teeth marks on edge
– P-thin & lack of strength
• Therapy-invigorate spleen to tonifyqiand to
stop cough.
• Formula-Liù JūnZ ǐ Tāng

– RénSh ēn
– BáiZh ù
– Fú Líng
– Zhì GānC ǎo
– ChénP í
– BànXi à
21

ÿÿ
• Modification
– Qiand yin deficiency : ShēngM àiS ǎn
– Long duration of cough: Wū Méi、Hē Zǐ、
Wǔ WèiZ ǐ
Pediatric Asthma
Introduction
• 1.Concept
• 2. Onset
– Season
– Body constitution
– Stimulators
22

ÿÿ
Etiology
– Internal factors
• poor body constitution with lung, spleen and
kidney Qideficiency, as well as retention of
phlegm and dampness
– External factors
• Invasion of external pathogens, such as wind,
cold, dampness and dryness, etc, attacking the
lungs
• Cold food or spicy food;
Pathogenesis
• Rebelling lung Qiwith retention of phlegm
• Wheezing is called Xiàowhile dyspneais
called Chuǎn. Dyspneamay be seen in
other diseases but the wheezing must
have dyspnea.
Cold-ph block
Endogenous
Lu/Sp/K
deficiency Ph-heat bind
Phlegm & water

Ex-cold & In-heat
Acute
retention
LU lost
descending
Weak constitution
Asthma
with lingering
pathogen
Exogenous
Temperature Phlegm
change obstruct in air
tract
Deficient ex
Remission
Attach to
stimulators Deficient mid-qi
Deficient Original qi
23

Diagnosis
• Main symptoms
• Repetitiveonset
• Disease history
• Compare with pneumonia
Treatment strategies
• In acute stage, one should treat the
excess in the lungs while in the remission
stage, one should tonifylung, spleen and
kidneys. It’s therefore called treat the
upper in acute stage and treat the lower in
chronic stage.
• Prevent the dampness and phlegm is
another important issue. Take no cold food
or heavy greasy products.
During acute attack

1. Hot asthma
– Symptoms-Cough, panting, and wheezing,
thick, yellow-colored phlegm, fever, a red face,
a stuffy, oppressed feeling in the chest, thirst
with a desire to drink, reddish yellow urine,
dry stools or constipation,
• T-red tongue body with yellow coating
• P-slippery rapid pulse
– Therapy-Clear the lungs, transform phlegm,
and stabilize the asthma
24

ÿÿ
1. Hot asthma
• Formula1- DìngChu ǎnT āng
– Má Huáng
– BáiGu ǒ
– HuángQ ín
– SāngB ǎiP í
– BànXi à
– KuǎnD ōngHu ā
– XìngR én
– Sū Zǐ
– GānC ǎo
1. Hot asthma
• Formula 2-Má XìngSh í GānT āng
– Má Huáng
– Shí Gāo
– XìngR én
– GānC ǎo
• Modifications
– Severe heat: Yú XīngC ǎo；
– A lot of phlegm: Zhú Lì
– Constipation: QuánGu ā Lóu, Dà Huáng
25

ÿÿ
During acute attack
• 2. Cold asthma
– Symptoms-Cough with rapid breathing, the sound
of phlegm rattling in the throat, cough with clear,
watery, white-colored phlegm, a cold body and no
perspiration, a dull, lusterless, stagnant facial
complexion which may even be a bit bluish green,
lack of warmth in the four limbs, no thirst or thirst
with a desire for hot drinks only,
• T-white greasy coating
• P-floating slippery pulse
– Therapy- Warm the lungs, transform phlegm, and
stabilize asthma
2. Cold asthma
• Formula 1- XiǎoQ īngL óngT āng
– Má Huáng
– Guì Zhī
– SháoY ào
– GānJi āng
– BànXi à
– Xì Xīn
– Wǔ WèiZ ǐ
– GānC ǎo
• XiǎoQ īngL óngY òngGu ì Zhī Tāng
• Má Xì BànXi à Wǔ WèiCh áng
• Formula 2- Shè GānM á HuángT āng

– Shè Gān
– Má Huáng
– Xì Xīn
– Zǐ Wǎn
– BànXi à
– ShēngJi āng
– Wǔ WèiZ ǐ
– Dà Zǎo
26

ÿÿ
During acute attack
• 1-3 Exterior Cold & Interior heat
– Symptoms-fast wheezing, cough with phlegm
sound in throat, stuffy nose and sneezing,
runny nose with watery snot. Or aversion to
cold, hot sensation, yellow sticky phlegm,
thirst, dry stools, yellow urine
• T-red tongue body with white coating
• P-slippery rapid pulse, or with floating tight pulse.
– Therapy-relive exterior and clearing interior to
arrest asthma
• Formula-Dà QīngL óngT āng

– Má Huáng
– Guì Zhī
– XìngR én
– Zhì GānC ǎo
– ShēngSh í Gāo
– ShēngJi āng
– Dà Zǎo
• Modifications
– Severe heat:HuángQín
– A lot of phlegm :BànXi à、ChénP í、Sū Zǐ，
or BáiJi è Zǐ、TíngL ì Zǐ；
– Severe dyspnea: Dì Lóng；
– Heat phlegm: DàiG é Sǎn, Zhú Lì
27

ÿÿ
During acute attack
• 1-4 LU Excess & K Deficiency
– Symptoms-long duration of asthma, wheezing with
fullness in chest, getting worse after activities.
Lusterless complexion, aversion to cold and cold
limbs, fatigue, poor appetite, watery urine with large
amount. Often accompany with cough and phlegm in
throat
• T-pale tongue body with thin white coating;
• P-thin weak pulse
– Therapy-purge lung and tonifykidneys, consider
both Biao& Ben.
• Formula 1- Sū Zǐ JiàngQ ì Tāng

– Zǐ Sū Zǐ
– BànXi à
– QiánH ú
– HòuPo
– ChénP í
– DāngGu ī
– RòuGu ì
– GānC ǎo
– ShēngJi āng
– Dà Zǎo
• Formula 2- Shè GānM á HuángT āng

– Shè Gān
– Má Huáng
– ShēngJi āng
– Xì Xīn
– BànXi à
– Zǐ Wǎn
– Wǔ WèiZ ǐ
– Dà Zǎo
28

ÿÿ
• Formula 3- Dū Qì Wán
– Shú Dì
– ShānY ào
– ShānY ú Ròu
– DānP í
– Zé Xiè
– Fú Líng
– Wǔ WèiZ ǐ
• Modifications:
– Dyspneawith heavy sweating: W ǔ WèiZ ǐ，
HuángQ í， Fú XiǎoM ài；
During the remission stage

• 2-1. Lung Qideficiency
– Symptoms- A dull white or somber white facial
complexion, shortness of breath and disinclination
to speak, a soft, low voice, fatigue, lack of strength,
spontaneous perspiration or sweating on slight
movement, fear of chill, lack of warmth in the four
limbs,
• T-a pale tongue with thin white coating
• P-thin lack of strength pulse
– Therapy- Tonifylungs and secure the defensive
29

ÿÿ
2-1. Lung Qideficiency
• Formula-Yù PíngF ēngS ǎn
– HuángQ í
– FángF ēng
– BáiZh ú
• Modifications
– Heavy sweating: LóngG ǔ、Mǔ Lì、Fú Xiǎo
Mài；
– thirst, fever in palms and feet, red tongue
body with peeling coating: Shā Shēn、Mài
Dōng、Wǔ WèiZ ǐ

• 2-2. Spleen Qideficiency
– Symptoms-Cough with profuse phlegm,
diminished appetite, a full feeling in the
upper abdomen, a yellow, lusterless facial
complexion, loose stools, emaciation,
fatigue, lack of strength,
• T-a pale tongue with scanty fur,
• P-a slow forceless pulse.
– Therapy-Tonifyspleen Qiand transform
phlegm
30

ÿÿ
2-2. Spleen Qideficiency
• Formula-Liù JūnZ ǐ Tāng
– RénShen
– BáiZh ù
– Fú Líng
– GānC ǎo
– ChénP í
– BànXi à
• Modifications
– Loose stools: Mù Xiāng、Shā Rén；
– Poor appetite: JiāoSh ānZh ā、ShénQ ū、
ChǎoG ǔ Yá、ChǎoM àiY á

• 2-3 Kidney Qideficiency
– Symptoms-A somber or dull white facial
complexion, a cold body and fear of chill, lack of
warmth particularly in the feet and lower legs, lack
of strength in the lower legs, exertion causing heart
palpitations and rapid breathing, watery, loose
stools, possible bed-wetting at night,
• T-a pale tongue with white coating,
• P-deep, forceless pulse.
– Therapy-Tonifykidneys and secure the root
31

ÿÿ
2-3 Kidney Qideficiency
• Formula-J īnGu ì ShènQ ì Wán
– Dì Huáng
– ShānY ú Ròu
– ShānY ào
– Fú Líng
– Zé Xiè
– DānP í
– Guì Zhī
• Modifications
– Yin & yang deficiency :RénSh ēn、Gé Jiè、
XiānL íngP í、Wǔ WèiZ ǐ；
– Red tongue body with peeling coating: take
out Fù Zǐ、RòuGu ì，add Wǔ WèiZ ǐ；
– Night urine: Yì Zhì Rén、Tù Sī Zǐ
Other treatments
• Empirical Recipes
• Acupuncture and moxibustion
32

ÿÿ
• Dry Dì Lóngpowder in capsules
– 3g × 2 per day for heat type.
• Má Huáng、Wǔ WèiZ ǐ、GānC ǎoea. 30g
– Grind into powder and divide into 15 bags
– 1 bag × 2 per day for cold type.
• ShēngSh àiSh ēn60g （DǎngShēn120g），Gé Jiè 2
Pc，Má Huáng30g，XìngR én100g，Zhì GānC ǎo50g，
ShēngJi āng60g，HóngZ ǎo120g，BáiGu ǒ100g
– Decoct 3 times and concentrate the decoction with
rock candy 500g.
– 2 Scoops per day for remission stage with short of
breath problem.
• DōngCh óngXi à Cǎo10g ，stew pork 150g，LU & K
deficiency type。
• BáiJi è Zǐ、YánH ú Suǒ ea 21g，

GānSuì、Xì Xīn12g ，powder，divide
into 3 bags, every 10 days per bag.
• Ginger juice mix the powder as large as 5
cents coin.
• paste on BL13, BL15, BL17, REN17 for
2～4h
• the three ten-day periods of the hot
season
Lack of Appetite
33

ÿÿ
Introduction
• 1.Concept
• 2. Onset
– Season
– Age: 1~6 years
– Prognosis
Etiology
• Irregular diet
• Post-disease
• Constitutional weakness
Pathogenesis
• Dysfunction of SP and ST
34

ÿÿ
Regulation of SP
Lack of appetite
& ST
SP & ST injury
ImproperDiet
Unwilling to eat
SP /ST qi Poor
Deficiency transformation
Impropernursing & transportation
SP / ST yin
Deficiency
Diagnosis
• Long duration
• Pale face, thin body form, but normal
activities
• Diseasehistory
• 1. Irregularity of Sp & ST
– Symptoms-poor appetite, no thought for
food or drink, no taste in eating or drinking,
refusal to et or drink. Eat a bit more can
cause epigastricand abdominal distension.
A lusterless facial complexion and thin body
• T-thin white or greasy thin white coating
• P-slippery pulse; purplish engorged vein at
wind bar.
– Therapy-Invigorate SP and regulate ST
35

ÿÿ
– Formula1 –TiáoP í Sǎn
• CāngZh ù
• ChénP í
• ShénQ ū
• Jī NèiJ īn
• PèiL án
• Modifications：
– Severe abdominal distension: Mù Xiāng、Lái
Fú Zǐ；
– Yellow greasy coating: Huò Xiāng、Yì Yǐ Rén
– Formula 2-Bù HuànJ īnZh èngQ ì Sǎn

• HòuPo
• Huò Xiāng
• GānC ǎo
• BànXi à
• CāngZh ù
• ChénP í
• ShēngJi āng
• Dà Zǎo
• Huò XiāngP íngW èiS ǎn
36

ÿÿ
• 2. SP / ST qideficiency
– Symptoms- Unwilling to eat, eat without
delicious feeling, eat little, thin body form,
pale complexion, lassitude. Or loose stools
with undigested food.
• T-pale with thin white coating
• P- forceless pulse, a visible blue vein at the root
of the nose.
– Therapy-Invigorate SP and tonifyqi
• Formula 1- ShēnL íngB áiZh ù Sǎn

– RénSh ēn
– Fú Líng
– BáiZh ù
– ShānY ào
– LiánZ ǐ
– BiǎnD òu
– Yì Yǐ Rén
– Shā Rén
– Jié Gěng
– ChǎoG ānC ǎo
– Dà Zǎosoup
• Modifications
– Abdominal distension: take out GānC ǎo，add
Mù Xiāng、XiāngF ù；
– Spontaneous sweating :HuángQ í、Fáng
Fēng、Mǔ Lì
37

ÿÿ
• Formula 2-Yì GōngS ǎn
– RénSh ēn
– Fú Líng
– BáiSh ù
– ChénP í
– GānC ǎo
• 3. SP/ST yin insufficiency

– Symptoms-A dry mouth and a tendency to
drink a lot yet no desire to eat food, dry skin,
dry stools,
• T-a mirror-like or shiny tongue with peeled fur
and red tongue with a scanty coating and scanty
fluids
• P-thin rapid pulse.
– Therapy-Nourish SP & ST
– Formula- YǎngW èiZ ēngY è Tāng

• XuánSh ēn
• MàiD ōng
• ShēngD ì
• Shí Hú
• BáiSh áo
• Yù Zhú
• GānC ǎo
38

ÿÿ
• Modifications
– SP qideficiency :Sh ānY ào、BiǎnD òu；
– Thirst: Lú Gēn、TiānHu ā Fěn ；
– Constipation: Huǒ Má Rén、Guā LóuR én
• Other treatments
– Tuina
– chiropractictherapy
kneadandmassagethemusclesalongtheS
pine
Prevention
• Right nursing, correct bad habits.
• Find out the causes
39

ÿÿ
Pediatric Diarrhea
Introduction
• 1.Concept
• 2. Onset
– Season
– Age: <2 years
– Prognosis
Etiology
• Irregular diet
• Invasion of external pathogens
• Constitutional deficiency
40

ÿÿ
Pathogenesis
• Middle Jiao disorder
• According to Neijing, the diarrhea happens
when the spleen Qidoes not ascend but
descend. The turbid Qidoes not descend,
it may causes fullness, abdominal
distention, gas and bloating, etc.
Exogenous
factors
SP fails to
transformeand
transporrte Fluid into
Improper Diet damp
Downward
Injury of together Diarrhea
SP & ST with turbid
SP &ST in LI
deficiency Food into
obstruction
ST fails to digest
SP & K yang
deficiency
Diagnosis
• Frequency of bowel movement
• Stools Color
• Stools Quality
• Stools Smell
• Disease history
• Compare with Dysentery
41

ÿÿ
Herbs commonly used for digestive disorders
• Herbs for removing food stagnation

– Shan Zha, ShenQu, GuYa, Mai Ya, JiNeiJin, Lai Fu Zi
• Herbs for moving Qiand improving transportation
– Chen Pi, (HouPo), ZhiShi/Ke, DaFu Pi, Xiang Fu, ChaiHu, Mu
Xiang
• Herbs for remove dampness and phlegm from middle Jiao
– HuoXiang, HouPo, CangZhu, Cao Dou Kou, Ban Xia, Fu Ling,
ZeXie, Yi YiRen, ShaRen
• Herbs for removing heat and dampness from middle Jiao
– LianQiao, Huang Lian, ZhiZi, Huang Bai, Qin Pi,
• Herbs for stabilize and bind
– Wu Wei Zi, Wu Mei
• Herbs for tonifyQiand nourish Yin
– Dang Shen, BaiShu, GanCao, Huang Qi, ShaShen, Mai Dong,
Yu Zhu, BaiBianDou
• 1. Food stagnation
– Symptoms-Abdominal pain and distention,
pain relieved by diarrhea, sour, foul-smelling
stools, bad breath, acid eructation, possible
desire to vomit, no thought for food or milk,
restless sleep, possible night-crying,
• T-thick, slimy or slight yellow tongue fur,
• P-a slippery pulse or a purplish, sluggish purplish
vein at the wind bar.
– Therapy-Eliminate food stagnation, lift clear
qito stop diarrhea
– Formula-BǎoH é Wán
• JiāoSh ānZh ā
• ShénQ ū
• BànXi à
• Fú Líng
• ChénP í
• LiánQi ào
• ChǎoL áiF ú Zǐ
• ChǎoM àiY á
42

ÿÿ
• Obvious abdominal pain & distention: Mù
Xiāng、HòuPo
• Vomiting: ShēngJi āng
• 2. Wind cold invasion

– Symptoms-A somber white facial
complexion, lassitude of the spirit, chilled
limbs, abdominal pain, intestinal noises,
clear, watery stools with no foul odor,
possible aversion to cold with fever,
• T-thin, white or white, slimy tongue fur,
• P-floating tight pulse.
– Therapy-Expel wind cold, warm middle jiao
to stop diarrhea
– Formula-Huò XiāngZh èngQ ì Sǎn

• Huò Xiāng
• Zǐ Sū Yè
• BáiZh ǐ
• ChénP í
• BànXi à Qū
• Fú Líng
• BáiZh ù
• Dà Fù Pí
• HòuPo
• Jié Gěng
• Zhì GānC ǎo
43

ÿÿ
• Severe interior cold: GānJi āng
• Food stagnation: ShānZh ā
• 3.Damp heat
– Symptoms-Watery, thin stools colored deep
yellow with a foul odor, possible explosive
discharge, redness and burning around the
anus, occasional abdominal pain, devitalized
desire for food, possible nausea, fever or no
fever, oral thirst, short, yellow urine, bodily
fatigue,
• T-red tongue body with yellow coating
• P-slippery rappid
– Therapy-Clear heat, eliminate dampness to
stop diarrhea
– Formula-Gé GēnQ ínLi ánT āng

• Gé Gēn
• HuángLi án
• HuángQ ín
• Zhì GānC ǎo
44

ÿÿ
• Modification
– Heat > damp: Huá Shí、JīnY ínHu ā、Lián
Qiào
– Damp>heat: Yì Yǐ Rén、Fú Líng、Chē Qián
Zǐ
– Abdominal distention: HòuPo 、Mù Xiāng
• 4. Spleen Deficiency
– Symptoms-Enduring diarrhea which does
not heal, loose stools, undigested water and
grains, diarrhea after eating, light colored
stools with no foul odor, a wallow yellow
facial complexion, emaciated, thin muscles
and flesh, lassitude of the spirit, listlessness,
• T-a pale tongue thin with white fur
• P-slow slippery pulse; blue vein at the root of the
nose
– Therapy-Tonifyspleen qi, and lift qito stop
diarrhea
– Formula-ShēnL íngB áiZh ū Sǎn

• Fú Líng
• RénSh ēn
• Zhì GānC ǎo
• BáiZh ù
• ShānY ào
• LiánZ ǐ
• BáiBi ǎnD òu
• Yì Yǐ Rén
• Shā Rén
• Jié Gěng
• ShēnL íngB áiZh ū LiánZ ǐ Gě ng

• ShānY àoBi ǎnD òuand ÈrR én
45

ÿÿ
• Modification
– Severe SP damp, with greasy coating: Huò
Xiāng、PèiL án
– Poor appetite: ShénQ ū、MàiY á
– Abdominal distension: HòuPo 、Mù Xiāng
• 5. Spleen Kidney yang deficiency

– Symptoms-Enduring diarrhea which will not
stop, if severe, possible anal prolapse,
diarrhea after eating, clear, watery stools,
undigested food in the stools, a cold body
and chilled limbs, a somber white facial
complexion, lassitude of the essence spirit,
• T-pale tongue body with white coating
• P-deep thin pulse; or a blue vein at the root of
the nose.
– Therapy-Tonifyspleen and wamkidneys,
consolidate to stop diarrhea
– Formula 1- Fù Zǐ Lǐ ZhōngT āng( Prepared

Aconite Pills to Regulate the Middle)
• GānJi āng
• Fù Zǐ
• RénSh ēn
• BáiZh ù
• Zhì GānC ǎo
46

ÿÿ
– Formula 2-Sì ShénW án
• RòuD òuK òu
• ChǎoB ǔ Gǔ Zhī
• Wǔ WèiZ ǐ
• Wú Zhū Yú
– Formula 1+ Formula 2
• Modification
– Prolapsed of rectum: HuángQ í、ShēngMá；
– Long term unstoppable diarrhea: Hē Zǐ、Chì
Shí Zhī、Yǔ Yú Liáng
• 7. Damaged yin fluid

– Symptoms-Enduring diarrhea which has
damaged yin fluids, lassitude of the essence
spirit, vexation and agitation, dry, parched
skin, sunken eyes and fontanel, diarrhea of
yellow water, short, scanty urination, dry
mouth, red lips,
• T-crimson tongue body lack of fluid
• P-thin and hollow pulse
– Therapy-astringent yin by applying sour
and sweet flavor herbs
47

ÿÿ
– Formula-RénSh ēnW ū MéiT āng
• RénSh ēn
• LiánZ ǐ
• Zhì GānC ǎo
• Wū Méi
• Mù Guā
• ShānY ào
• Modification
– Long term unstoppable diarrhea: ShānZh ā
Tàn、Chì Shí Zhī、Yǔ Yú Liáng
– Thirsty desire for water: Shí Hú、Yù Zhú
• 8. Damage of yang
– Symptoms-Enduring severe diarrhea which
has damaged yang qi. Watery stools, high
frequent bowel movements, lassitude of the
essence spirit, pale or greenish gray
complexion, weak breathe, cold
spontaneous sweating
• T-pale tongue body with white coating
• P-deep minute pulse
– Therapy-warm yang to rescue from yang
collapse
48

ÿÿ
– Formula-Sh ēnF ù LóngM ǔ Jiù Nì Tāng
• RénSh ēn
• Fù Zǐ
• LóngG ǔ
• Mǔ Lì
• BáiSh áo
• Zhì GānC ǎo
• Other therapy
– External treatment with herbs
– Acupuncture & Moxibustionand Tuina
• DīngXiāng２g，Wú Zhū Yú30g，

blackpepper 30pc ，
• Grind into powder １～３g per day, mix
with vinegar, put on umbilicus
• Wind-cold attack type, SP deficiency type
49

ÿÿ
Enuresis
Introduction
• 1.Concept
• 2. Onset
– Age: >3 years
– Boys > Girls
Etiology
• Congenital factors
• Emotion disorders
• Diet
50

ÿÿ
Pathogenesis
• The kidneys failed to hold urine
Differentiation and treatment

• 1. Kidney qideconsolidation
– Symptoms-Night time enuresis 1-2 or more
times each night, frequent, clear urination, a
pale, facial complexion, a tendency to low
back or knee soreness or weakness,
possible chilled limbs and a fear of cold,
• T-pale tongue body with thin white coating
• P-deep thin forceless pulse
– Therapy-Warm and supplement kidney
yang, secure and astringe the urination
• Formula 1- JīnSu ǒ Gù JīngW án

– Shā YuànJ í Lí
– QiànSh í
– LiánX ū
– LóngG ǔ
– Mǔ Lì
51

ÿÿ
• Formula 2- SāngPi āoXi āoS ǎn
– SāngPi āoXi āo
– LóngG ǔ
– Cù Guī Bǎn
– YuǎnZh ì
– Shí ChāngP ú
– RénShen
– Fú Shén
– DāngGu ī
• Formula 3- Suō QuánW án

– Yì Zhì Rén
– Wū Yào
– ShānY ào
• Modification
– Fatigue, poor appetite, loose stools: Dǎng
Shēn，Fú Líng，BáiShù，ShānZh ā
– Poor IQ: RénSh ēn，Shí ChāngP ú，Yuǎn
Zhì
52

ÿÿ
• 2. Spleen / Lung QiDeficiency

– Symptoms-Night time enuresis, shortness
of breath, disinclination to speak, lassitude
of the spirit, lack of strength, a somber white
facial complexion, devitalized appetite, loose
stools, spontaneous perspiration,
• T-pale tongue with white fur,
• P-Thin and forceless
– Therapy-Bank origin and boost the Qi,
secure and astringe the urination
• Formula – Bǔ ZhōngY ì Qì Tāng

– HuángQ í
– RénSh ēn
– BáiZh ú
– Zhì GānC ǎo
– DāngGu ī
– ChénP í
– ShēngM á
– CháiH ú
• Modification
– Spontaneous sweating: DuànM ǔ Lì，Wǔ Wèi
Zǐ
– Obese due to phlegm accumulation: Cāng
Shù，ShānZh ā，BànXi à
53

ÿÿ
• 3. Liver Channel Damp-heat

– Symptoms-Slippage of a small amount of
urine, which smells foul and is colored
relatively yellow, emotional tension and
agitation, talking in their sleep, bruxism
during sleep, red lips,
• T-red tongue body with yellow or yellow greasy
coating
• P-wiry rapid pulse.
– Therapy-Drain the liver and clear heat
• Formula- LóngD ǎnXi è GānT āng

– LóngD ǎnC ǎo
– HuángQ ín
– Zhī Zǐ
– Mù Tōng
– Chē QiánZ ǐ
– Zé Xiè
– ShēngDiHu áng
– DāngGu ī
– GānC ǎo
• LóngD ǎnXi è GānZh ī QínCh ái
• ShēngDiCh ē QiánZ é Xiè Kāi
• Mù TōngG ānC ǎoD āngGu ī Xià
• Modifications
– Bad sleep: HuángLi án，Zhú Yè，LiánQi ào
– Severe smelling urine, yellow greasy coating:
HuángB ǎi， Huá Shí
54

ÿÿ
Other treatments
• Patent formula
• Empirical Recipes
• Acupuncture and moxibustion
• YìZhì Rén12g，Má HuángSh í ChāngP ú

ea.10g，SāngPi āoXi āo15g ，Pig Bladder
1
• Cook pig bladder 30min first, then decoct
together with rest herbs 30 min
• 2 times per day, 4~8 bags
• K deficiency & phlegm covering type.
• Wǔ BèiZ ǐ, Hé ShǒuW ū ea. 3g

• Grind into powder, mix with vinegar, put on
umbilicus
• 1 time per night, 3~5 nights
• K deficiency type
55

ÿÿ
Attention Deficit Disorder
Etiology
• Congenital factors
• Poor body constitution
• Poor diet
Pathogenesis
• Deficient Yin failed to hold yang and yang
is floating
56

ÿÿ
• 1. Spleen Deficiency, liver hyperactivity
– Symptoms-Uncontrollable fidgeting, emotional
tension, easy anger, poor sleep, fatigue, diminished
appetite, easily developing diarrhea in response to
emotional stress,
• T-thin white tongue coating
• P-wiry pulse.
– Therapy-Fortify the spleen and harmonize the liver
• Fomrula-Yì GānS ǎn
– ChǎoB áiZh ú
– Fú Líng
– DāngGu ī
– ChuānXi ōng
– GōuT éng
– CháiH ú
– GānC ǎo

• 2. Heart/Spleen insufficiency
– Symptoms-A sallow or somber white facial
complexion, pale nails and pale lips, fatigue,
insomnia, heart palpitations, shortness of breath, a
poor appetite, a tendency to loose stools, poor
memory,
• T-fat, pale tongue with thin, white fur
• P-thin , weak pulse
– Therapy-tonifythe spleen and supplement the heart,
supplement the Qiand nourish the blood
57

ÿÿ
• Fomrula-Guī Pí Tāng
– HuángQ í
– LóngY ǎnR òu
– RénSh ēn
– BáiZh ú
– DāngGu ī
– Fú Shen
– Zhì YuǎnZh ì
– SuānZ ǎoR én
– Mù Xiāng
– Zhì GānC ǎo

• 3. Yin deficiency, yang hyperactivity
– Symptoms-Besides tending to be thin, children with
this pattern also have a red tongue with diminished
fur or a pale tongue with a red tip. Their pulses are
fine and rapid and they tend to suffer from insomnia,
heart palpitations, agitation, dizziness, ringing in the
ears, possible low back pain, possible bed-wetting
at night, flushed cheeks, and possible night sweats.
– Therapy-Supplement the kidneys and enrich Yin,
subdue yang and quiet the spirit
• Formula 1-Zuǒ Guī Wán

– Shú DiHu áng
– ShānY ào
– ShānZh ū Yú
– GōuQ ǐ Zǐ
– ChuānNi ú Xī
– Tù Sī Zǐ
– Lù JiǎoJi āo
– Guī Jiāo
• Zuǒ Guī WánZh ōngY òngGu ī Lù
• Niú Tù Zhū GǒuSh ānY àoSu ǐ
58

ÿÿ
• Formula 2-Shēng MàiS ǎn
– RénSh ēn
– MàiM énD ōng
– Wǔ WèiZ ǐ

• 4. Phlegm confounding the portals of the
heart and heat harassing the heart spirit
– Symptoms-Easy anger or pronounced irritability,
vexation and restlessness, possible nausea,
possible profuse phlegm, chest fullness and
oppression, a bitter taste in the mouth when waking
up in the morning,
• T-tongue with red edges and slimy, yellow fur
• P-wiry, slippery, rapid pulse.
– Therapy-Remove heat-phlegm and calm Shen
• Formula-HuángLi ánW ēnD ǎnT āng

– BànXi à
– ChénP í
– Zhú Rú
– Zhǐ Shí
– Fú Líng
– Zhì GānC ǎo
– Dà Zǎo
– HuángLi án
– WēnD ǎnT āngZh ōnguse ÈrChén
– Zhǐ Shí Zhú Rú and ShēngJiāng
59

ÿÿ
• 5. Blood stasis obstructing the channels
and malnourishment of the portals
– Symptoms-Hyperactivity plus a history of
birth trauma with intracranial hemorrheage,
a dull, dark facial complexion, easy anger
over nothing
• T-dark red tongue
• P-choppy pulse
– Therapy-Quicken the blood and dispel
stasis
• Formula-TōngQiàoHu ó XuèTāng
– Chì Sháo
– ChuānXi ōng
– TáoR én
– HóngHu ā
– Dà Zǎo
– CōngB ái
– ShēngJi āng
– Shè Xiāng
• TōngQi àoHu ó Xuè TáoH óngShè
• Chì SháoChu ānXi ōngC ōngJi āngZ ǎo
60

ÿÿ

TCM Pediatrics

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

TCM Pediatrics

Uploaded by

Copyright:

Available Formats

TCM Pediatrics

BianQue(4 century BC.)

Zhu Bing Yuan HouLun

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

Observe Shenand color

• Yellow, relates to SP, indicates :

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• Red, relates to H, indicates:

• White, relates to LU, indicates:

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

Observe body form

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

Veins in the Index Finger

– Check the location of veins in the index

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

– Check the color of the veins

Listening & smelling

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• Be careful with extremely bitter, cold, acrid,

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

Wind Cold Dysfunction of

Ph-H Adversely Cough

The key points for diagnosis

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• Herbs to remove heat

Differential Diagnosis and Treatment

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• Formula: JīngF ángB àiD ú Sǎn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

– Formula –ShàngJi āoXu ānB ì Tāng

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

– Formula-QīngQ ì Huà TánW án

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

– Formula 1- Liù ĀnJi ān

– Formula 2 –ÈrCh énT āng

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• 2-4 Dry Cough due Yin-Deficiency

• Formula-Sh ā ShēnM àiD ōngT āng

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• 2-5 Chronic Cough due to Lung qideficiency

• Formula-Liù JūnZ ǐ Tāng

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

Phlegm & water

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

During acute attack

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• Formula 2- Shè GānM á HuángT āng

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• Formula-Dà QīngL óngT āng

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

• Formula 1- Sū Zǐ JiàngQ ì Tāng

• Formula 2- Shè GānM á HuángT āng

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn

During the remission stage

PDF 文件使用 "pdfFactory" 试用版本创建 www.fineprint.cn