Library

In ancient times, the *Tianyuan Yuce* (Jade Register of the Heavenly Origin), *Bencao* (Compendium of Materia Medica), and the *Lingshu* (Spiritual Pivot) and *Suwen* (Basic Questions) — collectively known as the *Huangdi Neijing* (Yellow Emperor's Inner Canon) — authored by Fuxi, Shennong, the Yellow Emperor, and his minister Qibo in antiquity, served as the progenitors of medical literature. Subsequently, through the Han, Tang, Song, Yuan, Ming, and Qing dynasties, although books were transmitted from generation to generation, specialized collections for pediatrics remained as rare as morning stars. Moreover, those that existed were incomplete, mixed with impure content, rigidly adherent to ancient methods without understanding contemporary practices, and constructed on empty theories lacking empirical verification.

Even someone as humble and dull-witted as I, Chen Shouzhen, know that the difficulty of medicine lies in conforming to the timing of Heaven, measuring the bias of Qi (vital energy/climatic factors), adapting to human emotions, and comprehending the principles of things; it is difficult to encompass both nomenclature and numerical symbolism simultaneously. The difficulty of pediatrics lies particularly in the fact that one cannot practice it effectively without mastering pulse diagnosis and gynecology, nor without thoroughly understanding the source of biological transformation; this is the most difficult aspect among all medical difficulties. Infants have thin skin and sparse Ying (Nutritive Qi) and Wei (Defensive Qi); upon contact with pathogens, their conditions can transform in myriad ways. Their Zang-Fu organs are soft, and bones and sinews are brittle; upon injury, the entire body is shaken. As the sages said: "Children's illnesses stem externally no further than the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire), and internally no further than fetal toxins and dietary irregularities." Those who proposed this theory often claimed that treating children's diseases was not difficult. Who could know that children's joy, anger, sorrow, and happiness are more focused and profound than those of adults? Healthy children rely on their parents, while sick children rely on doctors. Parents fear only their children's hunger but do not consider overfeeding; they fear only their children's cold but do not consider overheating. They fail to realize that excessive fullness and warmth are indeed the mediators of disease. When a child falls ill and a doctor is summoned, the responsibility for treatment lies with the physician.

Ancient physicians stated that children possess a "Pure Yang" constitution. This was actually a statement from alchemists referring to the state before sexual maturity. Due to the misunderstanding of the term "Pure Yang," practitioners indiscriminately used bitter-cold herbs when children were ill. Bitterness can drain dampness, yet few realize that humans, like other creatures, belong to the element of Wet Earth. Children with heavy dampness tend to be obese, while those with light dampness tend to be thin. How can one completely drain their dampness and leave them emaciated and withered? Coldness can purge fire, but few understand that only "Zhuang Huo" (Blazing Fire/pathological hyperactivity) should be reduced, whereas "Shao Huo" (Mild Fire/physiological vital fire) is what sustains life. The more one purges, the thinner the child becomes; the more one transforms, the drier the condition becomes. Severely damaging the stomach fluids inevitably leads to Jing-Jue (spasms and convulsions). Even when contracting exterior syndromes, practitioners use herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix), Mahuang (Ephedrae Herba), and Xixin (Asari Radix et Rhizoma) to weaken the Cou-Li (skin pores and interstices). When pathogens are not interior excess, they use Scorpion (Quanxie), Centipede (Wugong), Bingpian (Borneolum Syntheticum), Shexiang (Moschus), Yuanhua (Genkwa Flos), and Daji (Euphorbiae Pekinensis Radix) to deplete the primordial essence. What guilt have children committed to deserve such great errors? Speaking of this pains my heart. Li Shicai said, "Using ancient formulas to treat modern diseases is like using old materials to rebuild a new house." These words are truly true. Medicines are used for treatment; if there is a disease, taking the corresponding medicine eliminates the disease. If there is no such disease, taking the medicine damages the Qi. Treating potential diseases requires precise targeting; treating iatrogenic diseases caused by erroneous medication results in lingering ailments. Being untalented, I have compiled my lifelong experimental experiences in pediatrics into a book titled *Cuijing* (Essence of Pediatrics), to express the meticulous effort concentrated over two winter-summer cycles.

I believe that children's "Zhuyang" (Immature Yang) is not yet full, and their "Zhuyin" (Immature Yin) is not yet grown. Diagnosis should carefully examine the Exterior/Interior, Yin/Yang, Deficiency/Excess, and Cold/Heat. Prescriptions should follow the Jun-Chen-Zuo-Shi (Monarch-Minister-Assistant-Courier) principles, considering properties, flavors, and functions. Slightly rigid application leads to stagnation; slightly heavy dosage causes damage; slightly mismatched prescriptions make the location of the pathology unknown. Based on these intentions, this volume was compiled. Who is not a parent? Who does not have a son? It is my hope that everyone will watch for opportunities in advance, like preparing for flood control, forever celebrating the solidity of the dyke. With calculations settled in the chest, one need not worry about the hardship of digging wells when thirsty. May all children in the world enjoy longevity. This is the single incense stick of my heart, which I devoutly offer day and night to bless the world and benefit the people.

On the 16th day of the 10th month of the 18th year of the Republic of China, Chen Shouzhen of Minhou wrote this preface at his medical clinic in Sandeli, Hankou French Concession.