典藏书目

The ancients called the most difficult diseases to treat those of pediatrics, naming it the "Mute Department" (Ya Ke). This is because infants and children suffer from pain and distress but cannot express it themselves; moreover, their Zang-Fu organs are delicate, their defensive barriers are sparse, making them prone to rapid disease transmission; their skin and muscles are tender, their Shen-Qi (Spirit and Vital Energy) is timid, making them susceptible to external pathogens. When prescribing medication, if the herbs are slightly too cloying, Qi stagnation occurs; if the dosage is slightly too heavy, healthy Qi is damaged; if the prescription slightly mismatches the syndrome, the disease progression becomes obscure, like trying to catch wind or shadows—the more one treats, the worse the condition becomes, and the further one gets from recovery. However, compared to adults, they lack injuries from the Seven Emotions and Six Desires; externally, they are only affected by the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire); internally, only by diet, fetal toxins, etc. Nevertheless, one who does not master formula pulse diagnosis and gynecology, and does not thoroughly understand the source of life generation and transformation, absolutely cannot practice pediatrics.

The ancients referred to children as "Pure Yang" (Chun Yang), which was a statement from alchemists, meaning they had not yet undergone sexual maturity (broken body), not that they possessed excessive Yang. Children are in a stage where their "Tender Yin" (Zhi Yin) is not full and their "Tender Yang" (Zhi Yang) is not grown. Males follow an eight-year cycle: at eight months, deciduous teeth emerge, and slight awareness develops; at eight years, deciduous teeth are replaced by permanent ones, and intelligence gradually opens; at sixteen, Jing-Qi (Essence and Qi) becomes accessible, and procreation is possible; at three times eight (24 years), true molars erupt, Jing is sufficient, bones and sinews are strong, and one can undertake tasks, indicating that as Yin grows, Yang also fills. Females follow a seven-year cycle: at seven months, deciduous teeth emerge, and they know how to be supported; at seven years, deciduous teeth are replaced, knowledge opens, and they no longer sit with males; at two times seven (14 years), Tian Gui (Menstruation) arrives; at three times seven (21 years), true molars erupt, Yin begins to be sufficient, and when Yin is sufficient, Yang fills, at which point marriage is arranged.
Are children really those with excessive Yang! The common belief that females' awareness usually precedes males' is due to the advancement of Yang and retreat of Yin.

People consider children to be of Pure Yang constitution, thus heavily employing Bitter-Cold (Ku Han) herbs. Bitter-Cold herbs are a major taboo in pediatrics. Zhu Danxi stated that using Bai Shao (Radix Paeoniae Alba) for postpartum women destroys the vital energy of life, but he did not realize that using Bitter-Cold herbs in pediatrics most severely destroys the vital energy of life. Children correspond to Spring, the East, and the Virtue of Wood. Their taste profile is Sour and Sweet. People may know the Sour taste, but many do not recognize the Sweet taste. The Xian (Wiry) pulse is the Pulse of Wood; the Classics state that if the Wiry pulse lacks Stomach Qi, death ensues. Stomach Qi is the Sweet taste; if Wood separates from Earth, death occurs. Further verifying this with wooden fruits reveals the reason: among wooden fruits, only early spring plums have much Sour and little Sweet, while others have little of both. Therefore, regulating the dietary flavor for children should favor Sweet over Sour, such as Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) by Qian Zhongyang. Why should Bitter-Cold not be used lightly? Heat rises and manifests as Bitter; all things transform upon seeing fire; Bitter can drain Dampness. Humans are also worms, with constitutions belonging to Damp-Earth. Excessive Dampness is indeed harmful to humans, but without Dampness, humans would die. Thus, those with heavy Dampness are fat, those with little Dampness are thin; can the Dampness in children be completely drained? Prescribers think they are clearing Fire, but unknowingly, the more they clear, the thinner the child becomes, and the more they transform, the drier the body gets. Bitter first enters the Heart, and its transformation leads to Dryness. Moreover, it heavily damages Stomach fluids, leading to cases of convulsions, coma, and death. For children's Fire, only Zhuang Huo (Hyperactive/Pathological Fire) can be reduced; if it is Shao Huo (Mild/Physiological Fire), which is the basis of life, how can one recklessly use Bitter-Cold to clear it? Therefore, preserving Yin and reducing fever is the best method; preserving Yin and reducing fever, nothing surpasses the Acid-Sweet transforming into Yin mechanism of Liu Wei Di Huang Wan. Only in the category of Damp-Warmth diseases can it be combined with Acrid-Light herbs; for Dry-Fire, it is inadvisable. In my previous preface on Warm-Thermal diseases, I mentioned that even for adults, whenever Bitter-Cold herbs are used, they must be monitored with plenty of Sweet-Cold herbs, except for wine drinkers who cannot tolerate Sweet-Cold.