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Section 3
Etiological Characteristics

Children have the different physiological characteristics with adults,so their susceptibility level to diseases is distinctly different from that of adults.With delicate and immature lung,children are easy to be affected by six external pathogens and virulent epidemic diseases.The younger they are,the more susceptible they will be.The spleen of children is often insufficient,so they are easy to be affected by milk and food damage,and the younger,the easier.Exogenous factors and milk and food are the main causes for children’s diseases; congenital causes are peculiar etiology to children,diseases by emotional disorders are increasing year by year,and much attention should be paid to accidental injury and iatrogenic injury.

Exogenous factors

Children have immature yin and immature yang in the body. Zang-fu organs are delicate and weak,especially the lung qi is often insufficient and they cannot adapt to cold and heat changes by themselves.Compared to adults,children are much easier affected by six pathogens.Exogenous factors are the most pathogenic factors in children,including six climatic pathogens (wind,cold,summer-heat,dampness,dryness and fire) and virulent epidemic diseases.Wind has the nature of shifting and changing.Lung is often insufficient in children so that it is more likely to be attacked by pathogenic wind.The most commonly seen diseases are common cold,cough and pneumonia.Wind is the primary pathogen,and always accompanied by other pathogens to attack the human body.Windcold and wind-heat often present with the external-contraction exterior pattern,and aggravate from superficies to the interior for insufficiency of healthy qi.Summer-heat is a yang pathogen with the character of sweltering heat,and easy to damage qi yin; summer-heat is often combined with dampness to block spleen qi which is often prolonged and difficult to cure.Both wind-cold—dampness and wind-dampness-heat are combination of three qi,forming the impediment pattern.Dryness is characterized by being dry and withered.It can transform into fire most quickly and damage lung,stomach,yin and fluid.Fire is the extreme of heat,and six exogenous pathogenic factors transfer from the fire.Young children are susceptible to exogenous pathogens,so children mostly suffer from the febrile diseases.

Virulent epidemic diseases are a group of highly contagious pathogens characterized by a sudden onset,severe condition,similar symptoms and tendency to popularize.Young children have the body of immature yin and yang,undeveloped physique and qi.They are less able to resist pathogens and susceptible to infectious pestilence,such as measles,rubella,chickenpox,mumps and hand-foot-mouth disease which are easy to popularize in children.of effectively controlling their food intake and some may be fed inappropriately,which may cause spleen and stomach disorders.If the mother has a shortage of milk after birth,or there a delay in adding complementary,resulting in less food intake,insufficiency of generating and transforming of qi and blood will be impaired and infantile malnutrition will occur.Excessive food intake leading to indigestion will impair spleen and stomach.Pampering a child’s food preference and unbalanced diet will result in insufficient spleen qi,and failure of transportation and transformation,causing anorexia and malnutrition.Young children’s lack of self-control and self-regulation of food intake can easily develop into picky or fussy eating.Cold food damages yang,excessive hot food damages yin,excessive fatty,sweet and greasy food damages spleen,inadequate vegetable causes constipation,and some food provokes allergic reactions.It was said in Elaboration on Pediatrics —Guide for Pediatric Formulas ( Yòu Kē Fā Huī —Xiăo Ér Zhèng Jué Zhǐ Nán Fù, 幼科发挥·小儿正诀指南赋) that “Intestine and stomach of young children are so delicate and weak that they are easily damaged by drink and food”.

Unhygienic diet is also a common cause of illness in children.Children have limited health knowledge,taking food without washing hands,or eating contaminated food that will cause gastrointestinal diseases such as vomiting,diarrhea,abdominal pain,parasitic disorders,even some contagious diseases like bacillary dysentery,typhoid fever,and viral hepatitis,and so on.Besides,food contamination,pesticides residue,and excessive hormone content have become a common concern of the pathogenic factors.

Food and milk

The spleen in young children is often insufficient,and the focus of their diet is on order,time and temperance.Children are incapable

Congenital Factors

Congenital factors refer to natural prenatal factors,that is,etiological factors in fetal period or at birth.Genetic causes are major contributing factors in the etiology of congenital factors.The parental genetic flaw may produce children’s congenital malformation,physiological defect,or metabolic disorders.If a woman in pregnancy neglects nourishing and protecting the fetus,or if she has intemperance of taking food,unpleasant moods,maladjustment between work and rest,invasion of exogenous pathogens,or intemperance in sexual life,the infant will be also affected to have congenital diseases.In addition,industrial and agricultural and environmental pollutions also increase the chances of new distortion,canceration and mutation.Moreover,dystocia,asphyxia,infection,birth injury and so on are also common causes of many diseases after birth.

Emotional Factors

Young children’s thought is relatively simple,they have less social contact than adults,and their perspectives on surrounding environment are different from that of adults,therefore,they are subjected to injuries by seven emotions and six desires less than adults.Thus the emotional factors that cause emotional disorders in children have certain differences from those of adults.The children heart is timid and spirit is weak,so fear and sudden fright is the most common emotions to cause damage.When children suddenly glance at strange thing or hear strange sounds,they tend to be frightened,which can easily damage the heart-spirit,manifesting as night crying,palpitation,panic,or convulsions.Besides,long time of failure to satisfy the desires,learning burden,high expectations and lack of concerns will induce anxiety,damage heart and spleen,so leading to headache,fatigue,insomnia,anorexia,or behavior disorder.Too inordinate love from parents will lessen the psychological bearing capability of children.Parents divorce,remarriage,death in the family,punishment from teachers,and insult from friends may affect the children with mental shock followed by mental behavior disorders such as ADHD,tic disorder,depression,etc.

Accidental Factors

Children are young and ignorant.They have no or lack of life experience and are less able to judge the state of their surroundings,so accidental injuries can occur to them.Common accidents include drowning,electric shock,burns,bruises,poisoning,choking by accidental inhalation of foreign bodies.

Iatrogenic Factors

The hospital is the place where the patients are concentrated,and the iatrogenic harm to children is increasing day by day in the modern society.Children’s lung is often insufficient,lacking immunity to all kinds of infections,so hospital infections are prone to occur.Qi and blood in children is not sufficient,and zang-fu organs are delicate and immature,easily get hurt by drugs.All the medicine of great bitter,cold,pungent and heat,along with reinforcing,drastic and poisonous drugs,can impair healthy qi and worsen the condition.Many toxic effects of some western medicine,such as corticosteroids of Cushing syndrome that is syndrome of yin deficiency and exuberant fire; toxic and side-effect on hematopoietic function,hepatic and renal function,nervous system by gastrointestinal reactions to antibiotics; dual infection caused by long-term use of broad-spectrum antibiotics; immunodepressant-induced viscera damage,myelosuppression and reproductive toxicity,which are all commonly seen in clinic.In addition,radiation injuries,including injuries to fetuses and children,are also common iatrogenic factors.

Others

With the improvement of industrialization,the impact of the environment on children’s health is becoming more and more prominent.All kinds of inhalation of dust in the air,such as dust mites,pollen and fungi are the main cause of allergic diseases such as asthma,and mucous snivel.A variety of chemicals,such as sulfur dioxide and formaldehyde,can increase the incidence of cancer.Cosmetics,leaded toys and lead dust in the environment can cause lead poisoning in children.In addition,social,economic and cultural factors,such as eating habits in starch-and-high-fat-food-based countries where the incidence of obesity in children is higher; pets will increase the incidence of allergic diseases.

QUESTIONS

1.Please interpret the following terms: immature yin and yang,body of pure yang,spleen being often in insufficiency,liver being often in superabundance.

2.What are the main causes of children’s diseases?

3.Try to describe the pathological characteristics of children.

4.What is the “easy to become deficient or excess,cold or heat”? Try to give some examples. ro0MgEr77vm/PCweMSGtYaRCeC/jomQNw6tWTw30S15Ovcy6RCH/mmpLU313gtvs

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