CHILDREN’S PROBLEMS

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Chapter 90

CHILDREN’S PROBLEMS

Chapter contents

For problems such as learning dificulty and hyperactivity, see Chapter 80.

FEVER

Low-grade fever

Retention of food

Recurrent low-grade fever, epigastric fullness, loose stools, sour regurgitation, foul breath, abdominal pain, thick sticky tongue coating, Slippery pulse.

Residual Heat in the Lungs

Low-grade fever, dry cough, a feeling of heat, irritability, tongue Red in the front, Fine-Rapid pulse.

Damp-Heat

Low-grade fever that is worse in the afternoon, sweating, a feeling of heaviness, thirst with no desire to drink, nausea, loose stools, sticky yellow tongue coating, Slippery-Rapid pulse.

Qi deficiency

Low-grade fever, sweating, listlessness, shortness of breath, pale complexion, poor appetite, Pale tongue, Empty pulse.

Yin deficiency

Low-grade fever in the afternoon, night sweating, dry throat, mental restlessness, malar flush, Red tongue without coating, Floating-Empty and Rapid pulse.

VOMITING

Accumulation of breast milk from overfeeding in infants

Vomiting of curdled milk with offensive odour, crying, better after vomiting, epigastric fullness and distension, stools with offensive odour.

Damp-Heat in the Stomach and Spleen

Vomiting, nausea, sticky taste, skin rashes, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without a desire to drink, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Stomach-Qi deficiency

Vomiting of fluids, cold limbs, pale complexion, listlessness, Pale tongue, Weak pulse.

Stomach-Yin deficiency

Vomiting of thin fluids, retching, dry lips, dry mouth with a desire to drink in small sips, irritability, crying, tongue without coating in the centre, Floating-Empty pulse.

Spleen- and Kidney-Yang deficiency

Vomiting of thin fluids, dull-pale complexion, cold limbs, listlessness, loose stools, Pale-Swollen tongue, Deep-Weak pulse.

Invasion of Cold in the Stomach

Sudden vomiting, epigastric pain, desire to drink warm liquids, thick white tongue coating, Tight pulse.

DIARRHOEA

Spleen-Qi deficiency

Chronic diarrhoea, poor appetite, tiredness, slight abdominal distension, pale complexion, Pale tongue, Empty pulse.

Retention of food

Loose stools, epigastric fullness and pain, foul breath, sour regurgitation, nausea, thick sticky tongue coating, Slippery pulse.

Invasion of Cold in the Spleen

Sudden diarrhoea, abdominal pain, a feeling of heat and cold, thick white tongue coating, Tight pulse.

Invasion of Damp-Heat

Sudden diarrhoea with offensive odour, abdominal pain and fullness, irritability, a feeling of heat, dark urine, sticky yellow tongue coating, Slippery-Rapid pulse.

RESPIRATORY PROBLEMS

Cough

Interrogation, Chapter 47

Invasion of Wind-Cold

Cough with expectoration of white sputum, aversion to cold, fever, occipital headache, stiff neck, sneezing, body aches, tongue with thin white coating, Floating- Tight pulse.

Invasion of Wind-Heat

Cough with expectoration of yellow sputum, aversion to cold, fever, sore throat, headache, body aches, slight sweating, tongue with Red sides/front, Floating-Rapid pulse.

Phlegm-Heat in the Lungs

Barking cough with expectoration of profuse sticky yellow or green sputum, shortness of breath, wheezing, a feeling of oppression of the chest, a feeling of heat, thirst, Red and Swollen tongue with a sticky yellow coating, Slippery-Rapid pulse.

Lung- and Spleen-Qi deficiency

Slight cough with low sound, expectoration of thin sputum, shortness of breath, pale complexion, poor appetite, loose stools, Pale tongue, Weak pulse.

Wheezing

Interrogation, Chapter 47

Cold-Phlegm in the Lungs

Acute wheezing, cough with expectoration of white sputum, pale face, shortness of breath, a feeling of tightness of the chest, sticky white coating, Slippery-Slow pulse.

Phlegm-Heat in the Lungs

Acute wheezing, cough with expectoration of yellow sputum, a feeling of oppression of the chest, slightly red face, shortness of breath, sticky yellow coating, Slippery-Rapid pulse.

Residual Phlegm in the Lungs with Lung-Qi deficiency

Chronic wheezing, cough with occasional expectoration of scanty sputum, insomnia, a feeling of oppression of the chest, tiredness, pale face, shortness of breath, Pale tongue with swelling in the Lung area, Empty pulse.

Residual Phlegm in the Lungs with Spleen-Qi deficiency

Chronic wheezing, cough with occasional expectoration of scanty sputum, insomnia, a feeling of oppression of the chest, tiredness, pale face, shortness of breath, poor appetite, loose stools, a desire to lie down, Pale tongue with swelling in the Lung area, Empty pulse.

Deficiency of the Defensive-Qi system of the Lungs and Kidneys

Chronic wheezing, allergic asthma, history of eczema, hay fever, Pale tongue, Empty pulse.

EAR PROBLEMS

Earache

Interrogation, Chapter 47

Invasion of Wind-Heat in the Lesser-Yang channels

Acute earache, aversion to cold, fever, sore throat, headache, body aches, slight sweating, tongue with Red sides/front, Floating-Rapid pulse.

Invasion of Damp-Heat in the Lesser-Yang channels

Acute earache, discharge from the ear, swollen glands, fever, aversion to cold, headache, irritability, body aches, nausea, indigestion, tongue with unilateral sticky yellow coating, Slippery-Rapid pulse.

Residual Damp-Heat in the Lesser-Yang channels with Spleen-Qi deficiency

Chronic earache which comes and goes, a feeling of pressure in the ear, blocked ears, periodically slightly swollen glands, irritability, insomnia, poor appetite, listlessness, pale face, Pale tongue with unilateral sticky yellow coating, Soggy pulse.

Damp-Heat in the Gall-Bladder and Liver channels

Chronic earache, loss of hearing, feeling of pressure in the ear, blocked ears, slight bleeding of the ear drum on examination, swollen glands, insomnia, irritability, hyperactivity, red face, nervous child, Red tongue with redder sides and sticky yellow coating, Wiry-Rapid pulse.

Glue ear

‘Glue ear’ is a condition characterized by accumulation of fluid behind the ear drum, which causes a blockage of the Eustachian tube with the result that air cannot enter the middle ear. When this occurs, the cells lining the middle ear begin to produce fluid, which can be runny or thick, eventually filling the middle ear; this may cause a severe decrease in hearing. Glue ear is most common in children between 2 and 4 years old. Glue ear may be associated with ear infections but it may also occur without.

Damp-Phlegm

Glue ear, decreased hearing, dull headaches, sinus problems, poor concentration, listlessness, chronic catarrh, Swollen tongue with a sticky coating, Slippery pulse.

Dampness

Glue ear, decreased hearing, dull frontal headaches, sinus problems, listlessness, tongue with sticky coating, Slippery pulse.

Other symptoms and signs depend on whether Dampness is associated with Cold or Heat.

Clinical note

• Both earache and glue ear in children are nearly always due to residual Dampness in the ears.

• This usually occurs when a child suffers repeated invasions of Wind which are treated with antibiotics.

HOT PALMS AND SOLES

Accumulation Disorder with Spleen deficiency

Hot palms and soles, thin body, sallow complexion, withered hair, a desire to lie down, an increased desire to suckle, abdominal distension and fullness, red face, irritability, a feeling of heat in the afternoon, night sweating, restlessness at night, loose stools, turbid urine, sticky tongue coating, Weak-Soft pulse.

‘Accumulation Disorder’ is a paediatric condition characterized by accumulation of food in the stomach; it is equivalent to ‘retention of food’ in adults.

Blood and Yin deficiency

Hot palms and soles, listlessness, thin body, dry cough, dry mouth, a feeling of heat in the afternoon, malar flush, night sweating, mental restlessness, dry stools, tongue without coating, Floating-Empty pulse.

CONSTITUTIONAL WEAKNESS

Constitutional weakness in children may manifest with slow mental development, early-onset asthma, early-onset myopia, thin body, poor muscle development, early-onset whooping cough, fearfulness, or crying at night.

Heart deficiency

Quiet child, bluish tinge on the forehead, fearful, crying at night, pale-bluish cheeks, palpitations, cold limbs.

This condition may be due to the mother eating Wind-producing foods, which dry out the fetus’s Blood and weaken its Heart. Wind-producing foods include shrimps, prawns, crab, lobster and all shellfish, spinach and mushrooms. A constitutional Heart deficiency may also be due to the mother suffering a severe shock during pregnancy.

Liver deficiency

Tense child, early-onset myopia and headaches, sinewy body, greenish complexion, crying, a history of convulsions in infancy, twitching during sleep, crying at night, desire to suckle frequently, contraction of the tendons, ridged nails.

This condition may be due to the mother suffering an emotional upset and anger during pregnancy.

Spleen deficiency

Quiet child, poor muscle development, flaccid muscles, sallow complexion, pale lips, cold limbs, poor digestion, poor appetite, crying with a low sound, loose stools, vomiting, diarrhoea.

This condition may be due to the mother eating too many Phlegm-producing foods or to overworking during pregnancy.

Lung deficiency

Quiet child, fearful, pale complexion, shortness of breath, crying with weak sound, moaning, weeping, cold hands, lustreless flaccid skin, thin chest, early-onset asthma/eczema, Lung cracks on the tongue.

This condition may be due to the mother suffering from sadness or grief during pregnancy.

Kidney deficiency

Quiet child, lassitude, thin body, slow mental and physical development, early-onset myopia, weak limbs, early-onset asthma/eczema, frequent urination, feeling cold, nocturnal enuresis after the age of 3 years. This condition is usually due to a Kidney-Essence deficiency of both parents.

CONSTIPATION IN INFANCY

Fetus Heat

Constipation in infancy, no desire to suckle, crying, crying at night, irritability, red face, dry lips, abdominal pain, dark urine.

Constitutional weakness

Constipation in infancy, listlessness, poor appetite, tendency to be easily startled, crying at night with weak sound, pale complexion.

URINATION PROBLEMS

Retention of urine in infancy

Heat in the Bladder

Retention of urine, dark urine, irritability, crying, dry lips.

Deficiency of Original Qi

Retention of urine, quiet child, pale face, listlessness, crying with a low sound, pale complexion, pale lips, slow development.

Nocturnal enuresis

Urination in bed at night in children constitutes ‘nocturnal enuresis’ only in children over the age of 3 years.

Kidney-Yang deficiency

Nocturnal enuresis, quiet child, a feeling of cold, bright-white complexion, tiredness, abundant clear urination, Pale and wet tongue, Deep-Weak pulse.

In children, this is usually a constitutional Kidney-Yang deficiency and, due to their age, there will not be many Kidney-deficiency symptoms. Indeed, if a child suffers from nocturnal enuresis and the tongue is Pale and the Kidney pulse is Weak, these signs are enough to diagnose a constitutional Kidney-Yang deficiency. This child will usually be a quiet, shy child without much energy.

Liver-Fire

Nocturnal enuresis, tense and highly-strung child, headaches, dizziness, tinnitus, irritability, propensity to outbursts of anger, red face, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Spleen- and Lung-Qi deficiency

Nocturnal enuresis, tiredness, poor appetite, loose stools, poor digestion, chronic weak cough, weak voice, sweating, Pale tongue, Weak pulse.

Clinical note

• Remember: nocturnal enuresis is not always due to a constitutional Kidney deficiency. In a tense, nervous child with a Red tongue, think of Liver-Fire as a possible cause. If so, use HE-7 Shenmen and LIV-2 Xingjian.

CRYING

Spleen deficient and cold

Crying with a weak sound, arching of the back, crying without tears, a desire to lie down, pale bluish complexion, abdominal pain, poor appetite, pale lips, Pale tongue, Deep- Weak-Slow pulse.

Heart-Heat

Crying with a loud sound, irritability, insomnia, crying at night, crying as soon as the light is switched on, dark urine, red face, red lips, Red tongue with yellow coating.

Heart deficiency

Crying with a low sound, crying at night, tendency to be easily startled, pale-bluish complexion, quietness, thin body, pale lips, Pale tongue.

Shock

Crying, crying at night, grimacing, tendency to be easily startled, bluish tinge on the forehead, crying when left alone, white foam emerging from the corners of the mouth, bluish lips, clinging to the mother.

Retention of food

Crying with a loud sound, crying after eating, crying at night, abdominal fullness and hardness, vomiting, absence of desire to suckle, loose stools with foul smell.

Crying at night in babies

Spleen deficient and cold

Crying at night with low sound, a preference for lying on the stomach, falling asleep easily but waking up, arching the back whilst crying, cold limbs, poor appetite, loose stools, bright-white complexion.

Heart-Heat

Crying at night with loud sound, a preference for sleeping on the back, difficulty in falling asleep, crying and then stopping when lights are turned on, irritability, dark urine, red face, red lips.

Shock

Crying at night, tendency to be easily frightened, fear of going to sleep, waking up frightened during the night, bluish tinge on forehead, pale-bluish face and lips, clinging to the mother.

DISTURBED SLEEP

Liver-Fire

Disturbed sleep, waking up during the night, excessive dreaming, nightmares, night sweating, headaches, irritability, propensity to outbursts of anger, red face, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Heart-Fire

Disturbed sleep, waking up during the night, excessive dreaming, nightmares, palpitations, thirst, agitation, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Wiry-Rapid pulse.

Residual pathogenic factor (Heat)

Disturbed sleep after a febrile episode, a feeling of tightness of the chest, irritability, hypochondrial pain, tongue Red in the front, Wiry-Rapid pulse.

Retention of food

Disturbed sleep, excessive dreaming, night sweating, epigastric fullness, undigested food in the stools, sour regurgitation, vomiting, thick sticky tongue coating, Slippery pulse.

Stomach-Heat

Disturbed sleep, excessive dreaming, night sweating, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Shock

Disturbed sleep, tendency to be easily frightened, fear of going to sleep, waking up frightened during the night, bluish tinge on forehead, pale-bluish face and lips, clinging to the mother.

ACCUMULATION DISORDER

‘Accumulation Disorder’ is a typical children’s problem characterized by retention of food and slow digestion. It is very common early in life because the Spleen and Stomach energy are always weak in small children and they get stronger as they grow up. Accumulation Disorder is equivalent to ‘retention of food’ in adults and is characterized by poor digestion, abdominal full- ness and pain, poor appetite, vomiting and diarrhoea. Accumulation Disorder in babies is usually due to not breast-feeding, breast-feeding for too short a time or weaning too early.

Stagnation of food

Babies: vomiting of curdled milk, no appetite, milky film on palate, foul-smelling stools, restlessness, whining, red cheeks.

Children: vomiting of undigested food, abdominal pain relieved by bowel movement, irritability, crying, low-grade fever, sweating at night, sallow complexion, a burning sensation in the palms, thick sticky tongue coating, Slippery pulse.

Spleen-Qi deficiency with retention of food

Sallow complexion, poor digestion, poor appetite, listlessness, slight abdominal pain and fullness, loose stools, vomiting, restless sleep, sleepiness during the daytime, Pale tongue with sticky coating, Weak-Slippery pulse.

WORMS

Pinworms

Abdominal pain that comes and goes, gurgling in the intestines, vomiting, profuse urination, itching of the anus at night, sweaty perineum, vaginal itching in girls, sallow complexion, thin body, poor appetite, a desire to eat strange objects such as soil, raw rice, tea leaves or paper, white spots on the face, small grey spots in the eyes, small spots under the lips, red points on the tongue.

Roundworms

Abdominal pain, vomiting, listlessness, thin body, sallow complexion, white spots on the face, small grey spots in the eyes, darkness under the eyes, itchy nose, small spots below the lips, red points on the tongue, a desire to eat strange objects, constipation or loose stools, abdominal distension.

FIVE FLACCIDITIES

‘Five Flaccidities’ is called wu ruan in Chinese, which literally means ‘five softnesses’: these are flaccidity of the head and neck (cannot keep the head up), flaccidity of the mouth (dribbling and difficulty in chewing), flaccidity of the arms (cannot hold objects), flaccidity of the legs (cannot stand up), and flaccidity of the muscles.

Constitutional Kidney deficiency

Five Flaccidities, cannot hold the head up or straight, head leaning to one side, dificulty in walking, mental retardation, inability to stand up, frequent urination, inability to grasp objects, pale lips, Pale tongue, Deep-Weak pulse.

Constitutional Spleen deficiency

Five Flaccidities, especially flaccid muscles, poor digestion, poor appetite, listlessness, sleepiness, inability to grasp objects, dificulty in speaking, open mouth, slow development, dificulty in walking, mental retardation, sallow complexion, Pale tongue, Weak pulse.

FIVE RETARDATIONS

The ‘Five Retardations’ indicate late development in children, in standing, walking, teeth development, growth of hair and speech. The slow development is due to a combination of prenatal and postnatal deficiency. The Five Retardations are called wu chi in Chinese. The organs involved in the pathology of the Five Retardations are the Kidneys (lateness in being able to stand, slow teeth and hair development), Liver (lateness in being able to stand and walk), Heart (slowness in speech development) and Stomach (lateness in being able to walk).

Cold fetus

Five Retardations, a feeling of cold, cold body, cold limbs, lying stiff, pale-bluish complexion, shortness of breath, crying with low sound, dificulty in suckling, pale lips, Pale and wet tongue, Deep-Slow pulse.

Liver and Spleen deficiency

Five Retardations, poor appetite, abdominal distension, blue veins in the abdomen, flaccid muscles, pale-greenish complexion, Pale tongue, Weak pulse.

INFLAMMATIONS

Acute skin rash

Wind-Heat at Defensive-Qi level

Acute skin rash that starts on the head and then spreads rapidly to the trunk and finally to the limbs, red papules, low fever, itching, swelling behind the ears, swollen tonsils, cough, sneezing, yellow nasal discharge, sore throat, red eyes, tongue Red in the front/sides with red points, Floating-Rapid pulse.

Heat at the Qi level

Acute rash, high fever, red papules with dense distribution, intense thirst, sweating, mental restlessness, dry stools, dark urine, Red tongue with yellow coating, Overflowing pulse.

Erysipelas

Toxic Heat on the Exterior

Erysipelas, fever, sticky discharge in the corner of the eyes, convulsions, crying, bright-red macular rash, hardened skin that is hot and painful to touch, restlessness, Red tongue with red points and with yellow coating.

Toxic Heat in the Interior

Erysipelas, high fever at night, mental restlessness, crying, dry mouth, a feeling of fullness of the chest, delirium, fainting, coarse breathing, blurred vision, dull dark-red or purple macular rash, skin hot and painful to touch, Red tongue with red points and without coating.

JAUNDICE

Damp-Heat

Jaundice, bright-yellow skin, bright-yellow eyes like tangerine peel, sweating, dark urine, fever, thirst, abdominal fullness and distension, pale stools, listlessness, poor appetite, sticky yellow tongue coating.

Cold-Dampness

Jaundice, dull-yellow skin, dull-yellow eyes, listlessness, a desire to lie down, poor appetite, abdominal fullness and distension, pale stools, loose stools, pale urine, sticky white tongue coating.

INFECTIONS

Chickenpox

Wind-Heat at the Defensive-Qi level

Chickenpox, vesicles like dew filled with clear fluid, headache, fever, runny nose with white discharge, cough, sneezing, tongue Red on the sides/front with white coating, Floating-Rapid pulse.

Toxic Heat

Chickenpox, dull-coloured vesicles which are red around the edge, filled with a turbid fluid and with a dense distribution, fever, mental restlessness, thirst, red face, red lips, tongue ulcers, dark urine, Red tongue with thick, dry yellow coating and red points, Deep-Rapid pulse.

Mumps

Invasion of Wind-Heat

Mumps, fever, shivers, headache, cough, sore throat, pain, redness and swelling behind the ears, tongue Red on the sides/front with red points, Floating-Rapid pulse.

Toxic Heat at the Qi level

Mumps, high fever, a feeling of heat, irritability, headache, thirst, red lips, vomiting, swelling, redness, pain and hardness behind the ears, sore throat, swollen tonsils, constipation, dark urine, Red tongue with thick yellow coating and red points, Deep-Full-Slippery pulse.

FLAPPING OF NOSTRILS

Wind-Heat in the Lung Defensive-Qi portion

Flapping of nostrils, sore throat, cough, fever, shivers, slight thirst, slight sweating, tongue Red on the sides or front with white coating, Floating-Rapid pulse.

Phlegm-Heat in the Lungs

Flapping of nostrils, barking cough with profuse, sticky yellow or green sputum, shortness of breath, wheezing, a feeling of oppression of the chest, a feeling of heat, thirst, Red and Swollen tongue with a sticky yellow coating, Slippery-Rapid pulse.

Lung and Kidney deficiency

Flapping of nostrils, shortness of breath, shallow breathing, dull-pale complexion, listlessness, sweating, cold limbs, Pale tongue, Deep-Weak pulse.

CONVULSIONS

Acute

An old paediatric book mentions eight characteristics of ‘acute convulsions’: twitching of the limbs, open hands, pulling of the head towards the shoulder, tremor of the limbs, arching of the body, stretching of the hands, the eyes turning up, and blurred vision.

Invasion of Wind with penetration of Heat at the Qi level

Acute convulsions, tremor of the limbs, high fever, sweating, headache, cough, red face, irritability, mental confusion, delirium, dark urine, constipation, abdominal fullness and pain, Red tongue with yellow coating and red spots, Deep-Full pulse.

Phlegm-Heat

Acute convulsions, fever, hot body, red face, irritability, thirst, cough with expectoration of yellow sputum, shortness of breath, wheezing, clenching of teeth, dark urine, dry stools, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Retention of food

Acute convulsions, sallow complexion, vomiting, abdominal fullness and pain, constipation, foul breath, rattling sound in the throat, thick, sticky yellow tongue coating, Slippery-Rapid pulse.

Shock

Acute convulsions, no fever, bluish complexion, cold hands, tendency to be easily startled, insomnia or sleepiness with dificulty in being aroused and crying after waking up, crying at night, Moving pulse.

Chronic

Liver- and Kidney-Yin deficiency with Empty-Heat

Chronic convulsions, slight tremor of limbs which comes and goes, thin body, malar flush, mental restlessness, insomnia, five-palm heat, night sweating, Red tongue without coating, Floating-Empty and Rapid pulse.

Stomach- and Spleen-Yang deficiency

Chronic convulsions, eyes turning up, sleepiness, wet glazed eyes, mental confusion, listlessness, sallow complexion, cold limbs, loose stools, Pale tongue, Deep-Weak pulse.

Spleen- and Kidney-Yang deficiency

Chronic convulsions, slight tremor of the limbs which comes and goes, listlessness, sleepiness, sallow complexion, sunken fontanelle, sweating, cold limbs, loose stools, weak breathing, Pale tongue, Deep-Weak pulse.

FETUS TOXIN

According to Chinese medicine, most fetuses absorb toxin in the uterus and develop Toxic Heat: this is all the more likely to happen when the mother eats too many hot and spicy foods, suffers an invasion of Toxic Heat or has a shock during pregnancy.

Fetus Toxin Heat

Fever, hot body, red face and eyes, mouth closed, noisy breathing, swollen eyes, shortness of breath, crying, tendency to be easily startled, dark urine, dry stools.

Fetus Toxin Cold

Pale face, mental confusion, sleepiness, shortness of breath, cold body, cold limbs, abdominal pain, crying, mouth open.

Fetus Toxin convulsions

Convulsions, body hot, face bluish, clenched teeth, shortness of breath, wheezing, stiffness of body, eyes turning up, grimacing.

Fetus Toxin jaundice

Jaundice, golden-yellow skin and eyes, hot body, dark urine, crying.

FONTANELLES

Sunken fontanelles

Spleen- and Kidney-Yang deficiency

Sunken fontanelle, late closure of fontanelle, quiet child, cold limbs, listlessness, poor appetite.

Exhaustion of Qi and Fluids

Sunken fontanelle, dry skin, listlessness, crying at night.

Raised fontanelles

Toxic Heat

Raised and swollen fontanelle like a heap, soft to touch, red skin over the fontanelle, headache, thirst, crying, sweating, red face and lips, shortness of breath, dark urine, Red tongue with red points and dry, thick yellow coating, Rapid-Overflowing pulse.

Cold in the Interior

Raised fontanelle, which is hard to touch, white skin over the fontanelle, dull-pale complexion, cold limbs, possibly twitching of the limbs, Pale tongue, Deep-Tight pulse.

Late closure of fontanelles

Observation, Chapter 5

The posterior fontanelle usually closes about 2 months after birth; the sphenoid fontanelle closes at about 3 months, the mastoid one closes near the end of the first year, and the anterior fontanelle may not close completely until the middle or end of the second year.

Kidney-Essence deficiency

Late closure of fontanelle, listlessness, weak and quiet child, slow mental and physical development.

Spleen deficiency

Late closure of fontanelle, listlessness, poor digestion, poor appetite, quiet child, loose stools.

WHITE SPOTS ON THE PALATE AND TONGUE

Heat in Spleen and Heart

White spots on the palate and tongue like snow, red face, red lips, thirst, irritability, insomnia, crying, palpitations, dark urine, Red tongue with yellow coating, Overflowing-Rapid pulse.

Spleen- and Kidney-Yin deficiency

White spots on palate and tongue like snow, listlessness, poor development, malar flush, dry mouth, tongue without coating, Floating-Empty pulse.

LONG PENIS

Observation, Chapter 17

Congenital Kidney-Yin deficiency

Long penis, slow development, lateness in walking and standing, slow growth of the teeth, normal coloured tongue without coating, Floating-Empty pulse.

Spleen-Qi sinking

Long penis, a feeling of bearing down in the abdomen, tiredness, lassitude, poor appetite, loose stools, failure to thrive, Pale tongue, Empty pulse.

Phlegm and Blood stasis in the Lower Burner

Long penis, sputum in the throat, slow mental and speech development, a feeling of oppression of the throat, abdominal pain, Purple and Swollen tongue, Wiry-Slippery pulse.

Damp-Heat in the Liver channel

Long penis, fullness of the hypochondrium, abdomen or hypogastrium, bitter taste, poor appetite, nausea, a feeling of heaviness of the body, pain, redness and swelling of the scrotum, genital, papular or vesicular skin rashes and itching, urinary dificulty, burning on urination, dark urine, Red tongue with redder sides and a sticky yellow coating, Slippery-Wiry-Rapid pulse.

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CHILDREN’S PROBLEMS

CHILDREN’S PROBLEMS