Chapter contents

INTRODUCTION

The interrogation of children, especially young children, obviously needs to be carried out with the help of the child’s parents or other relatives. In older children (over the age of 5 years), although we still need the help of the parents in describing the child’s symptoms and signs, it is important to listen carefully to the child as well. When asking children about their symptoms, we should obviously avoid the use of difficult medical terms such as ‘abdomen’ and use colloquial terms such as ‘tummy’.

Most of the questions related to adults discussed in the previous chapters apply to children as well (e.g. digestive system and taste, thirst, defecation, urination, etc.). There are, however, several questions which pertain only to children and these are the mother’s pregnancy, childbirth, postpartum problems, immunizations and childhood diseases. In addition to the above areas of questioning, questions about the child’s digestive system, respiratory symptoms, earache, and sleep are also important and have a slightly different significance to that in adults.

MOTHER’S PREGNANCY

The period in the womb is extremely important in influencing the constitution of the baby. Many factors affect the baby and its constitution in the gestation period. Emotional shocks to the mother can affect the child’s nervous system and the Heart. The consumption of alcohol and recreational drugs and smoking obviously affect the child’s constitution adversely.

When a baby cries a lot at night and vomits frequently, this may be due to what the Chinese called ‘womb Heat’, which itself may be due either to the pregnant mother’s consumption of excessively hot foods or, more commonly, to her suffering from shock during pregnancy. Prenatal shock may also manifest with a bluish tinge on the baby’s forehead and chin.

The influence of pregnancy events on the baby’s health is discussed also in Chapter 48.

CHILDBIRTH

The conditions of childbirth also have an important influence on the baby’s constitution. Premature cutting of the umbilical cord, induction or a Caesarean birth can all affect the baby’s constitution adversely and in particular may cause a Lung deficiency. Therefore if a baby or very young child suffers from a Lung deficiency, this may be due to the above mentioned conditions in childbirth.

POSTPARTUM PROBLEMS

The main question to ask is about breast feeding: lack of breast feeding or too short breast feeding often adversely affects a baby’s digestive system causing either a Stomach deficiency or retention of food in the Stomach. Giving solid food to babies too early (before 6 months of age) is a very common cause of retention of food in babies and children.

CHILDHOOD DISEASES

We should always ask parents about their child’s childhood diseases. A history of several childhood diseases with rashes (e.g. measles, chickenpox, German measles) suggests the child’s tendency to Heat. Whooping cough has a weakening effect on the child’s lungs and this may cause a weak Lung constitution and the tendency to develop Lung patterns later in life.

DIGESTIVE SYMPTOMS

Symptoms and Signs, Chapter 90

Digestive symptoms are very common in children owing to the Stomach and Spleen being inherently weak at birth; the younger the child, the more common are digestive symptoms. The two most common causes of abdominal pain in children are retention of Cold in the Stomach and Intestines and stagnation of Qi in the Intestines. In babies, retention of food (called Accumulation Disorder in babies) is very common and it manifests with vomiting of milk and with colic.

IMMUNIZATIONS

A full discussion on immunizations is beyond the scope of this book. To understand the effect of immunizations from a Chinese perspective it is necessary to refer to the theory of the Four Levels (see Part 6). When a pathogenic factor invades the body, it enters the Defensive-Qi level first and, if not expelled, progresses through the Qi, Nutritive-Qi and Blood levels. The Four Levels represent four different energetic layers of penetration of Heat, the Defensive-Qi level being the most superficial and the Blood level the deepest.

From a Chinese perspective, therefore, immunizations basically consist in injecting a ‘pathogenic factor’ (i.e. the live or attenuated germ) directly at the Blood level. This may cause Latent Heat to develop at the Blood level, which may cause problems to the child both in the short term and in the long term.

In the short term, Latent Heat may cause a skin rash, insomnia and a temporary change in the child’s character. The long-term effects of immunizations are more difficult to establish and are the subject of great controversy. However, if immunizations lead to Latent Heat at the Blood level, it is quite possible that they may have serious long-term effects. These include brain damage, possibly autism, asthma, chronic cough, allergies and skin diseases later in life.

The effect of immunizations from the Chinese perspective is discussed also in Chapter 48.

RESPIRATORY SYMPTOMS AND EARACHE

Symptoms and Signs, Chapter 90

Questions concerning cough, wheezing, breathlessness or earache are always important in the child’s interrogation because children are very prone to invasions of Wind, which may cause the above symptoms.

SLEEP

We should always ask about sleep in babies and children because not only does it give us an indication of the state of the Mind but also a disturbance of sleep often reflects the presence of certain pathogenic factors.

Disturbed sleep with crying in babies is often due to retention of food and Stomach-Heat, in which case the baby will cry out loudly. If the baby cries relatively quietly during the night, it may be due to a prenatal shock.

Disturbed sleep in older children may be due to the same factors as in adults but the most common ones are Liver-Fire, Stomach-Heat and retention of food.

SLOW DEVELOPMENT

Slow development in children was summarized in ancient China as the ‘Five Retardations’. These consist in slow development in standing, walking, teeth growth, hair growth and speech.

Slow development is caused primarily by congenital weakness of the Liver and Kidneys with the Kidneys affecting standing, teeth growth and hair growth and the Liver affecting standing and walking. Among postnatal causes, the Stomach influences walking and the Heart speech. Figure 47.1 illustrates the influence of prenatal and postnatal deficiencies on the Five Retardations.