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From birth to adulthood,children go through a dynamic continuous process of growth and development.They are therefore different in physiological characteristics from adults.The younger they are,the more significant the difference will be.
Zàng fǔ refers to the five zang organs and the six fu organs; jiāo nèn means delicate and resistant to attacks; xíng refers to the body constitution of the limbs,bones,tendons,muscles,and essence,blood,fluids and so on; qì refers to all the physiological activities; chōng means sufficient and prosperous.“ zàng fǔ jiāo nèn,xíng qì wèi chōng ” recapitulates the children’s immature organs and morphology,and imperfect physiological functions during their growth and development period.In The Spiritual Pivot ( Líng Shū ),it was stated that“In infants,the muscles are fragile,the blood is deficient,and qi is insufficient”,which is manifested as: the newborns cannot stand with kidney qi insufficient,bones fragile,and fontanels unclosed; they have no primary teeth at birth but the surplus of the bone,with uneven mastication; the brain is not well developed,with timid and weak mind,and they cry unstably and irregularly; defensive function of muscles and skin is insufficient and solid,easy to be invaded by pathogen; zang-fu organs are delicate and weak,susceptible to attacks; slight medication tends to be effectless while more medication tends to do damage; physique and qi are insufficient,and the development of language,intelligence,motion and psychology are not perfect.
The infants’ physique and qi are insufficient,especially qi of lung,spleen and kidney.The lung and the spleen often present with insufficiency and the kidney often presents with weakness.The lung is often insufficient in young children and the defensive function of the body surface is weak,which allows external pathogens to enter the body and cause lung conditions such as common cold,cough,pneumonia and asthma; the spleen is often insufficient in young children and manifests with weak transportation and transformation functions.On account of the fast growth of children,there is a greater demand for essence,blood,fluid and nutritional substances than adults,so the young children may easily develop digestive disorders such as indigestion,vomiting and diarrhea; the kidney is often deficient,manifesting with insufficient kidney essence,weak kidney qi,no menstruation for adolescent girls and no spermatic ejaculation for adolescent boys,and inability to control their urine and stool or weak self-control.Young children’s heart and liver functions are also immature.The heart governs blood vessels and spirit.The heart qi is imperfect in young children with weak and timid spirit,manifesting with rapid pulse,susceptible to scare,poor ability to think and act; the liver governs the free flow of qi and is the viscus of wind.In infants,the liver qi is less substantial and the activities of contraction and relaxation of the channel sinew are not properly harmonized with a balance between strength and gentleness.This presents in children being very active,restless,irritable and prone to spasms and convulsions.Wan Quan,a physician of Ming Dynasty put forward an idea of “three insufficiencies and two superabundances” specifically on basis of five zang features.“Three insufficiencies” mearns that the spleen of infants is often insufficient,“infants with spleen qi insufficient are short of natural essence of grain”; the lung is often insufficient because “lung qi is weak,difficult to regulate and easy to be injured”; the kidney is often insufficient because “the kidney qi in infants is congenitally deficient”.“Two superabundances” means that the liver qi and the heart qi are often superabundant.“This superabundance refers to qi of growth congenitally sufficient”,which are also the physiological characteristics of young children.Besides,that the liver is often superabundant means “the liver qi is qi of shaoyang ;the birth of man is like the sprout of wood,so qi of shaoyang is qi of growth and development; it is sufficient for getting stronger with the growth”.
Wu Ju-tong of the Qing Dynasty pointed out that “yang children have immature yang that is not sufficient and have immature yin that is not well developed”.Here yīn refers to the tangible body substances such as essence,blood,fluid,zang-fu organs,tendons,bones,brain,marrow,vessels,muscles and skin; yáng refers to the human body’s various physiological functions and activities; zhì means young and immature. Zhì yīn zhì yáng (tender yin and immature yang) involves characteristics like soft and weak body,insufficient qi and blood,frail spleen and stomach,insufficient kidney qi,loose striae of skin and muscles,timid and weak mind,and unsolid bones.Wu Ju-tong’s theory of zhì yīn zhì yáng ,from the aspects of the yin-yang theory,further clarified that young children are relatively insufficient in both physique and physiological functions,but will gradually improve and get mature with age.
In the process of growth and development,children are developing rapidly and steadily,involving physical changes in body and form,physiological functions.The younger,the more vigorous.There are obvious changes every month in a child within one year of age in weight,length,head circumference,chest circumference and teeth.For example,the length of a one-year-old child is 1.5 times as long as it was born,and the weight is 3 times.The young children’s abilities of thinking,language,and motor are also developing rapidly as they grow.
Ancient physicians used chún yáng (pure yang) in The Book of Changes ( Yì Jīng, 易经) to describe the children’s physiological characteristics of vigorous life activities,rapid growth and development. Fontanelle and Skull Classic : Pulse Diagnosis ( Lú Xìn Jīng — Mài Fă, 颅囟经·脉法) first claimed that “children under 3 years old are called chún yáng since their original qi has not been exhausted”.Here chún refers to the original yin and yang without any dissipation, yáng refers to the vitality that is getting more and more prosperous like the rising sun and sprouting of new plants.Ancient physicians held different opinions over the chún yáng in children,and they would mostly elaborate it from pathology angle.Ye Tian-shi in Essentials of Pediatrics:General Introducition ( Yòu Kē Yào Lüè — zǒng lùn, 幼科要略·总论) said the newborns have the pure yang body,so mostly they have febrile diseases. Clear Synopsis on Recipes: Pediatrics ( Xuān Míng Lùn Fāng — Xiăo Ér Mén, 宣明论方·小儿门) pointed out that most of the diseases in children are caused by heat and there are more febrile diseases in clinic.Contemporary physicians always interpret the phenomenon of vigorous life activities,rapid growth and development of young children from physiological aspects,integrating the process of growth and development and the text of Fontanelle and Skull Classic .It is not appropriate to interpret children with pure yang body as either exuberance of yang with the decline of yin or pure yang without yin. Chún yáng theory clarifies that due to the rapid growth and development of children,the demand for the essence from food is also pressing.
The theories of zhì yīn zhì yáng (childhood immature yin and yang) and chún yáng (pure yang) sum up two aspects of young children’s physiological features.The former reflects the young child’s immature body where both yin and yang qi are insufficient,while the latter points out the young children’s vitality in life and rapid growth and development.Both theories provide an important theoretical basis for elucidating the etiological and pathological features of children and guiding the clinical diagnosis and treatment.The theory of “three insufficiencies and two superabundances” is a specific description of the physiological characteristics of children,and helps to better understand the physiological characteristics of children.