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Since children have different physiological characteristics from adults,there are differences with adults in the incidence,the type of disease,changes and outcome of diseases,which are manifested in the following two aspects.
Young children’s zang-fu organs are immature and delicate,their physique and qi are not well developed,yin and yang are immature and insufficient.Therefore,they are lack of strong pathogen preventive ability and disease resistance.In addition,the young children are unable to adapt themselves to hot and cold weathers,and lack of self-control of food intake.If children are inappropriately nursed and cared for,it is easier for them to be attacked externally by the six pathogens or damaged internally by food intake.The younger the children are,the higher the incidence will be.Lung delicacy,spleen insufficiency,heart and liver superabundance,and kidney deficiency are the pathological basis for children’s diseases.
a.Easily diseased due to delicate lung
The lung is a delicate viscus,and governs diffusion and dispersion,linking with the skin and body hair,and governing the outer surface of the body.Young children are easily attacked by pathogenic factors since their lung functions are not well developed,interspaces of skin and muscles are loose,and the ability to consolidate the exterior to defend against pathogens is weak.The lung controls breathing and governs the qi of the whole body.The lung function of purification and descent are imperfect,and functions of management and regulation of qi are also immature.Therefore,six excesses as pathogenic factors,either from mouth and nose or from skin and hair,will invade the lung first.That’s why in childhood,young children are easy to suffer from lung diseases such as cold,cough,pneumonia,wheezing and asthma,and the disease of lung is the most common diseases in pediatrics.
b.Easily injured due to weak spleen
The spleen is the foundation of the aquired constitution,the source of qi and blood production.The body’s nutrients depend on it.Young children grow and develop rapidly,and the functional state of the spleen and stomach is usually not suitable enough for the child’s body requirements for rapid growth and development.If a child is inappropriately fed or is eating without temperance,it will be easy for them to develop digestive problems with the processes of nutritional transportation and transformation,including vomiting,enterorrhagia,stomachache,indigestion,and anorexia.The incidence of spleen system diseases in pediatrics ranks second only to lung system diseases.
c.Easily frightened due to heat of heart,easily convulsed due to excess of liver
Another aspect of children’s physiological characteristics is that both the heart qi and liver qi are often superabundant.This refers to the frequent occurrences of heart-fright patterns and liver wind easily arising in the pediatric clinic.The heart qi is often superabundant,which means excessive fire in a heart as well as excessive heat qi and prosperous vitality.Young children consequently tend to have heart syndromes like dysphoria,terror,coma,fickle crying,etc.Superabundance in liver summarizes the pediatric feature of the frequent occurrence of liver wind in children.Pathogenic qi easily runs rampant because the zang-fu organs are delicate and immature.This will be translated into a high fever.Tic may occur because of liver wind triggered by high fever,or high-fever-induced terrified convulsion and opisthotonos because fire-heat flourishing cause genuine-yin damaged and tendons dystrophy.Superabundance in the liver in young children is the common reason for neurobehavioral disorders such as ADHD and tic disorder in children.
d.Easily damaged due to kidney deficiency
Kidney deficiency in young children deals with children’s “blood and qi being not sufficient and kidney qi not solid”.The kidney stores essence,governs the bones and is the foundation of the congenital constitution.The function of kidney is especially important for young children who are not well developed in physique and immature in multiple physiologic function,which is directly related to the growth and functions of the bone,brain,hair,ears and teeth,and also to growth,development and sexual maturity.Therefore,kidney disorders associated with insufficient kidney essence and bone changes,such as the five retardations,five weaknesses,infantile metopism,enuresis,edema and puberty praecox.
e.Easily infected due to pestilence
Young children have immature yin and yang and their resistance against pathogens and the power to fight diseases is weak,it is much easier for them to contract seasonal diseases.Pathogens,entering the body through the nose or mouth,invade the lung- wei ,causing measles,mumps,chickenpox and other contagious diseases; or invade the spleen and stomach,causing dysentery,cholera and hepatitis.Contagious diseases can spread among young children and become epidemic.
Diseases conditions change quickly in afflicted children.The main manifestations are easy to become deficient or excess,cold or heat,that is,both patterns of cold and heat,deficient and excess change more quickly than that of adults.
a.Easily deficient and easily in excess
The terms deficiency and excess refer to whether the healthy qi in the children is weak or strong,and secondly how strong the pathogenic qi is in relation to it.“Easy to become deficient and easy to become excess” refers to the pathogenic qi easily rising to excess and the healthy qi falling easily into deficiency.An excess pattern can rapidly turn into a deficiency pattern,and a deficiency pattern can also turn into excess; or both deficiency and excess patterns can also appear at the same time.For example,if a child is ill with pneumonia due to lung qi blocking,excess symptoms of fever,cough,phlegm obstruction,breath shortness and nasal flaring will appear.But delayed or improper treatment may give rise to deficiency symptoms with healthy qi deficiency,pathogenic qi sinking and trapped in,and heart yang deficiency and collapse.These signs and symptoms will quickly appear like whitish complexion,purple lips,cold limps,great dripping sweat and palpitation.For another example,if a child is ill with diarrhea mostly due to internal damage caused by infantile dyspepsia,or attack of the dampness-heat pathogen,deficiency symptoms of abdominal distention,acid diarrhea,oliguria,red tongue,greasy fur and slippery and strong pulse.But if treatment is delayed or improper,and enterorrhea can’t stop,deteriorated syndrome of impairment of both qi and yin,or depletion of both yin and yang will appear very soon.Such a feature of rapid changes in the condition of a disease is unique to children.
b.Easy to become cold and easy to become heat
Cold and heat are two different physiological attributes in diseases.Easily developing into cold or heat means that in the course of a disease,a child may have heat syndrome of yin deficiency and yang hyperactivity because of children’s immature yin; and that a child may have cold syndrome of yang deficiency because of children’s immature yang undeveloped.Easily becoming cold or heat syndromes often presents alternatively with frequent transformation into deficiency or excess patterns.For example,pediatric windcold pattern of exterior-excess type is easy to develop into pattern of external cold and internal heat,even excess heat pattern with inward penetration of pathogenic heat.Delayed or improper treatment will result into deficiency cold pattern with deficient and weak yang qi,or deficiency heat pattern with yin damaging internal heat.
In summary,diseases in children are easy to develop,and in the course of disease,changes between deficiency and excess,or cold and heat are much quicker and also complicated.Just like what Wu Ju-tong said in Resolving children’s Diseases “young children with thin skin and weak spirit,channels and zang-fu organs delicate and immature,cannot endure diffusion and discharge of triple initial qi.Pathogens come like the potential of horses,and the changes are rapid like lightning”.Therefore,the diagnosis and treatment of pediatric diseases must depend on observation on children’s physiological characteristics and the development regularity.Timely diagnosis to predict possible changes in pathogenesis can improve the treatment effect.
Young children have a pure yang body and life activity is vigorous.They have pure and clear zang qi full of vitality.Their tissue regeneration and repairment are quicker and they usually respond well to all kinds of treatment; children also have less chronic conditions and the causes are relatively simple,and they are less affected by emotional factors when afflicted by diseases.Although children have the unfavorable factors of easily becoming sick and experiencing rapidly changing disease conditions,they will recover faster with a higher curative effect than adults if diagnosis is correct,syndrome differentiation clear,treatment in time,medication reasonable and nursing care appropriate.For example,most children with common cold,cough and diarrhea will show a fast onset and rapid recovery.Children with asthma,epilepsy and yin edema will have a relatively better prognosis than adults,although the diseases may linger.Zhang Jing-yue stated in The Complete Works of [Zhang] Jing-yue —Pediatrics that “Children with diseases respond well to treatment due to their zang qi being pure and clear.As long as the root of the disease is found,it can be cured by a single course of medication.This is incomparable with adult injuries and diseases that are often chronic and difficult to cure”.
