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In cases of extreme deficiency, symptoms such as heart deficiency (deficiency of the Heart organ and its functions), shortness of breath, dizziness, and excessive sweating occur. One should add Glehniae Radix (Shashen), Ziziphi Spinosae Semen (Zaoren), Rehmanniae Radix Praeparata (Shudi), and Polygonati Odorati Rhizoma (Yuzhu) to the previous formula to nourish the body. Additionally, incorporating human urine (Tongbian) can guide blood stasis downward, which is also effective. Cases with alternating chills and fever are also caused by blood deficiency failing to nourish the entire body; it is appropriate to use a large dose of the previous formula to nourish blood, and one must not treat it as an exterior contraction. The *Jingui Yaolue* discusses three diseases in postpartum women: first, spasm (Jing); second, depression and vertigo (Yumao); third, difficulty in defecation. When blood fails to nourish the Liver, internal stirring of Wind occurs, leading to spasm; this is a disease of the sinews. When blood deficiency causes Liver Yang to ascend, depression, vertigo, blurred vision, vomiting with inability to eat, and sweating only on the head occur; this is a disease of the Spirit. When blood deficiency fails to moisten the intestines, difficulty in defecation occurs; this is a disease of fluids. In summary, these are all manifestations of Yin deficiency and blood dryness. Large doses of Yin-nourishing and blood-nourishing formulas, such as Fumai Tang (Decoction for Reviving the Pulse), should be used. It is strictly forbidden to use acrid-warm dispersing agents. Even if there is external Wind, wind-dispersing drugs that raise Yang should be avoided to prevent death from collapse due to excessive sweating and blood loss. Mr. Chunshan stated: "To treat Wind, first nourish the Blood; when Blood is sufficient, Wind extinguishes itself." Changing the character "chong" (fill) to "yang" (nourish) in ancient songs is superior. Another condition is postpartum blood stasis attacking upward due to weakness, causing fullness and oppression in the epigastrium or excessive phlegm-saliva, even leading to coma and lockjaw. More severely, blood stasis rushing to the Heart may cause laughter, cursing, climbing walls, and roofs, often resulting in untreatable conditions. Regardless of excess or deficiency, hot human urine should be administered immediately. Excess patterns will necessarily present with abdominal pain and tenderness upon pressure; mild cases should use Shenghua Tang (Decoction for Generating New Blood), while severe cases should use Huisheng Dan (Elixir for Reviving Life). If postpartum illness is caused by the Six Qi (Six Pathogenic Factors) exterior pathogens, treatment should follow sweating, clearing, or purging methods according to the syndrome, rapidly eliminating the pathogen while protecting the deficiency. An army without provisions relies on swift battle; one must not be bound by the saying that postpartum conditions require warmth rather than cooling. The *Neijing* states "if there is a cause, there is no injury," which does not refer exclusively to pregnancy. These are the main principles of gynecology; scholars should contemplate them and progress accordingly, avoiding deviation.

Children correspond to Spring, possess Wood Virtue, and are like flower buds and fruit calyces. They have immature Yang that is not yet full and immature Yin that is not yet grown. Because immature Yang is not full, their skin and muscles are thin and susceptible to external pathogens; because immature Yin is not grown, their Zang-Fu organs are tender, prone to rapid transmission of disease, and easily damaged in terms of Yin. Therefore, pediatric diseases are more serious than adult diseases, and preserving Yin must be the primary principle. Preserving Yin does not mean tonifying Yin. All acrid-dry ascending and dispersing, warm-dry bitter-astringent, and digestive-promoting drugs consume Yin fluids. Often, when Yin fluids are damaged, Liver Wind stirs internally, driving Phlegm upward, and Blood fails to nourish the sinews, causing spasms and convulsions. With immature Yang, bitter-cold drugs should be avoided because they damage the vital energy of life, and bitterness can transform into dryness, further injuring Yin. Mineral drugs stabilize the Spirit but cause dullness; Borneolum Syntheticum (Bingpian) and Moschus (Shexiang) are drying and penetrating, consuming Heart fluids most severely. The Classics state: "Mineral drugs cause mania, aromatic herbs cause madness." This must be known!
Formerly, Qian Zhongyang formulated Liuwei Wan (Six-Ingredient Pill with Rehmannia) for children, based on the principle of sour and sweet transforming into Yin. Sour is the flavor of Water; Sweet is the flavor of Earth. Wood cannot grow without Water, nor be supported without Earth. Young fruits are often sour, inheriting the original flavor of Wood; mature fruits are purely sweet, where Jia and Yi combine to transform into Earth, obtaining the true flavor of Earth. Among the five flavors, only Sweet is non-toxic. Sweet and moistening, benefiting from sufficient Water and Earth Qi, can nourish fluids. Zhongyang truly deserves to be called the guardian of children's lives! However, common people fail to deduce the principles of Six Qi causing disease, the principle that Six Qi easily transforms into dryness, and the principle that children with immature Yang and Yin are especially prone to dryness. Seeing fever in children, they do not identify the pathogen, generally calling it Wind-Cold, and immediately administer acrid-dry ascending drugs mixed with bitter-warm and bitter-dry digestive agents. In my hometown, there is a misconception that Bohe (Menthae Haplocalycis Herba) and Jingjie (Schizonepetae Herba) are acrid-cool, so they are used indiscriminately. Jingjie is drying and aromatic, ascending to the vertex; Bohe is drying and extremely pungent. Using 3-5 fen in an acrid-moist formula to harmonize rejection is acceptable, but using it alone, in large doses, or frequently will consume fluids and cause spasms. Once spasms occur, it is labeled as "Jing Feng" (Wind-Stirring), and Borneolum, Moschus, and mineral bitter-cold toxic drugs are recklessly thrown in under the guise of opening orifices, calming fright, clearing heat, and dispelling wind. Family secret recipes and pills often contain such ingredients, causing much misdiagnosis and harm, which is pitiable. Some mistake "Jing" (Fright) for "Jin" (Sinew), performing tendon-piercing and bloodletting, or forceful manipulation. In wealthy families, this causes rapid disaster. I have seen doctors and prescriptions arriving in succession; one doctor uses hot drugs, another cold, trying dozens of prescriptions and needles/minerals in a day, or summoning spirits, disturbing the child's peace, wrapping them in thick cotton near fires, subjecting them to intense heat. Can flower buds and fruit calyces endure such mutilation? Alas! Who errs? The parents err. If a knowledgeable doctor were consulted to treat according to the syndrome, how could it reach such extremes?
Mr. Ju Tong of my hometown, pitying the suffering of children, wrote *Jie Er Nan* (Resolving Pediatric Difficulties). It categorizes Cold Spasm, Wind-Warm Spasm, Warm-Thermal Spasm, Summer-Heat Spasm, Dampness Spasm, and Dryness Spasm as Six Qi causing spasm; Internal Injury from Diet Spasm and Primary Organ Self-Disease Spasm as Internal Injury spasms; and Ke Wu Spasm as Fright Spasm. It states that spasm following initial infection is the popular "Jing Feng"; spasm after prolonged illness is "Man Jing" (Slow Convulsion). Citing the *Suwen*, Taiyang causes spasm (rigidity/opisthotonos); Shaoyang causes chi-zong (twitching/clonic movements). Studying these categories reveals they revolve around Dryness and Dampness, ultimately归结ing to Dryness. Thus, the theory that Six Qi easily transforms into dryness, and children are especially prone to dryness, is not merely my private view.
Let us analyze this. Cold and Dryness share a source. Wind-Cold is the dry-condensing Qi of Heaven and Earth; dryness transforms quickly, hence the Classic says Cold Damage is a type of Heat Disease. Wind and Heat are Yang pathogens; Wind-Warm and Warm-Thermal are Warm-Dry Qi. Summer-Heat has both Heat and Dampness, being Dryness intermixed with Dampness. Dampness opposes Dryness and cannot cause spasm; thus, Dampness Spasm involves Wind. Combined with Wind-Cold, treat Cold-Dry binding Dampness; combined with Wind-Heat, treat Wind-Dry binding Dampness. Dryness occurs in mid-Autumn with Metal Wind, yellowing leaves, representing Cool-Dry binding, milder than Cold Damage. Summer-Dampness lurking internally with external Cool-Damp creates Dryness binding Dampness. Thus, among Six Qi pathogens, Dryness and Dampness are key, with Dryness being heavier. Internal Injury Spasm from diet arises from parents overprotecting and failing to regulate diet; irregular eating causes Spleen stagnation; Spleen dysfunction fails to transport fluids, leading to Dampness retention. Prolonged diarrhea damages the Spleen, depleting the source of Blood generation. Blood deficiency fails to nourish the Liver, causing Liver Yang to stir and Internal Wind to arise, with Wood overacting on Earth, causing twitching. This is Wet transforming into Dry, known as Slow Convulsion or Slow Spleen Wind. Slow Spleen Wind is Liver Wind generated by Spleen sluggishness. Primary Organ Self-Disease Spasm stems from congenital weakness and parental overprotection (overclothing/heating), causing sweating, blood loss, blood dryness, and Internal Wind. Or, frequent crying depletes tears (Liver fluid), injuring Yin, stirring Liver Yang and Internal Wind. This primary organ disease is the root of Six Qi-induced spasm; once external pathogens enter, Internal Wind moves, causing spasm. These two internal injuries involve Dryness and Dampness, ultimately transforming into Dryness. The proverb "Keep a child safe with slight hunger and cold" means moderate diet and avoiding overheating. Ke Wu Spasm, per Mr. Se'an, is the only true "Fright" syndrome. It arises from Heart/Gallbladder Blood deficiency and Spirit timidity; sudden fright triggers spasm. The "Wind" here is not external but Internal Liver Wind. Symptoms include sweating or none, fluctuating complexion, fear of strange sights/sounds, sleep-talking, and limb twitching, differing from Six Qi spasm with clouded Spirit. This confirms Blood Dryness generating Wind.
Regarding diagnosis, color observation is primary. Abundant Spirit and good luster indicate strong constitution and health; timid Spirit, dull eyes, pale/withered complexion, and red lips without luster indicate weak constitution and susceptibility to disease. Assess congenital and acquired constitution. Congenital deficiency presents as delayed fontanelle closure, late teething/speaking/walking, weak neck, sparse hair, or visible blue veins. Acquired deficiency presents as poor appetite, slow digestion, distended abdomen, diarrhea, and pale face/lips/tongue. Observing the Tiger’s Mouth (thenar eminence) lines originates from Master Hua. The rhyme states: For children under three, check three gates on the Tiger’s Mouth; Purple indicates Heat, Red indicates Wind-Cold, Green indicates Fright, White indicates Malnutrition; Pale Red/Yellow indicates health. Lower gate (Wind) is mild, middle gate (Qi) is heavy, upper gate (Life) is critical; penetrating all three is very critical. Tuina follows this, but origins are unclear. The *Lingshu* states meridians are invisible; their deficiency/excess is known via the radial pulse. Visible vessels are collateral vessels. Blue collaterals indicate Cold/Pain; Red indicates Heat; Blue at Yuji indicates Stomach Cold; Red at Yuji indicates Stomach Heat; Black indicates chronic Bi; Mixed colors indicate Cold/Heat; Short Blue indicates Qi deficiency. Tiger’s Mouth diagnosis derives from this. However, *Neijing* applies to all diseases, not just pediatrics. Hua’s left-male/right-female rule is rigid; Red indicating Wind-Cold contradicts the Classic. Using collateral length to judge depth is valid, but naming gates Wind/Qi/Life is fabricated. Xia Yuzhu emphasizes Four Diagnostic Methods, prioritizing Color and Miao Qiao (Orifices). This is logical. Disease transmission varies; even *Neijing*’s color diagnosis shouldn't be rigid. Hand collaterals should not be exposed, as exposure indicates Blood Dryness generating Wind.
Tuina is the massage method of *Neijing*. Only for internal dietary injury, gentle abdominal massage aids transformation. For other diseases, it is harmful. Acupuncture is valued in *Lingshu*, but pricking hand collaterals is not standard. Except for Cholera (Huo Luan) where Qi blockage causes Blood blockage with blue-black collaterals (chronic Bi), puncturing Chize (Cubital fossa) and Quchi (Elbow crease) opens Qi/Blood effectively. Others should not needle blindly to avoid damaging collaterals.
Syndrome differentiation focuses on Dryness/Dampness as the outline, Wind/Cold/Summer-Heat as mechanisms, Fire transformation as progression, and Yin damage severity as medication depth. Mr. Chunshan states Varicella is extreme Dryness-Fire, followed by Spasm. Spasm is mostly Dryness-Heat transforming into Wind, actually a Liver Yang disorder. Sinews lose nourishment, causing rigidity and Dryness signs.
Treatment mirrors adults. For initial Wind/Cold/Dryness with fever/no sweat, use Acrid-Moist (Almond, Bullace Seed, Platycodon). For severe Cold, add Warm-Moist (Scallion, Fermented Soybean, Fresh Ginger). For Wind-Warm/Warm-Thermal, use Acrid-Cool (Mulberry Leaf, Trichosanthes Peel, Gardenia Peel, Forsythia, Sugarcane Peel, Pear Peel, Glehnia). For severe Heat, add Cool-Moist (Chrysanthemum, Honeysuckle, Anemarrhena, Antelope Horn, Bamboo Leaf, Reed Rhizome, Pear Juice, Sugarcane Juice). If pathogenic factors stir Internal Wind and Phlegm obscures clear orifices, causing coma or spasm, add Acrid-Moist to open internal closure (Mustard Seed, Fresh Acorus, Ginger Juice). For Phlegm blocking orifices: Hot Phlegm adds Fritillaria, Talcum, Glehnia, Trichosanthes Seed, Areca Seed, Bamboo Sap, Ginger Juice; Damp Phlegm adds Pinellia, Honey-fried Tangerine Peel. For severe Dryness-Fire, Qingzao Jiufei Tang is essential. For Summer-Heat/Dampness, add Acrid-Light (Cardamom Peel/Seed, Akebia, Polyporus, Smilax, Lotus Leaf, Bean Flower); for Damp-Heat, add Ginger-fried Akebia and Coptis for Bitter-Acid opening. For extreme Yin fluid depletion (withered complexion, dry orifices, no tears/saliva, locked jaw), urgently rescue fluids with Rehmannia, Ophiopogon, Scrophularia, Polygonatum, Donkey-hide Gelatin, Egg Yolk, Dendrobium, Polygonatum, Ligustrum, Turtle Shell, Oyster Shell, Cassia Seed, Swallow Nest. For severe fluid deficiency/dryness, continue the same formula; do not change midway. If fluid deficiency/dryness coexists with Phlegm-Heat blocking orifices and Summer-Dampness, add Acrid-Moist to open orifices and resolve Phlegm within fluid-nourishing formulas; Acrid-Moist also moves water and removes dampness. Doctors should not stick rigidly to formulas; match pure diseases with pure medicines. Han dynasty methods are flexible and profound. These are general principles for Six Qi diseases.
For Primary Organ Spasm, the method is rescuing fluids and moistening dryness. For Internal Dietary Spasm, before Dampness transforms to Dryness, regulate diet and strengthen Spleen Yang (Shenling Baizhu San, Eight Immortals Cake, Single Herb Chicken Gizzard Membrane Powder). If already transformed to Dryness, add Sweet-P neutral-Moist (Prepared Fleeceflower, Yam, Dolichos, Astragalus complanatus, Goji, Dodder, Jujube Seed, Donkey-hide Gelatin, Turtle Shell, Mussel, Swallow Nest). This condition involves both Yin/Yang injury and Dryness/Dampness, often untreatable. Ke Wu Spasm arises from Blood/Spirit deficiency; if confirmed without other causes, use Fumai Tang minus Ginseng, Cinnamon, Jujube, Ginger, adding Jujube Seed and Oyster Shell. For sweating/restlessness/fear, add Dragon Bone, Amber, Cinnabar (using their Qi, not substance).
Malnutrition (Gan Ji) is "Dryness born from Dampness," same cause as Internal Dietary Spasm. Dryness born from Dampness is the origin; Dampness becoming Dryness is the extremity. Before Dampness becomes Dryness, use Zisheng or Zhizhu Pills to soothe/tonify Middle Jiao, mimicking ancient music-to-aid-eating rituals to stimulate Spleen Yang. For Greasy/Sweet excess causing Damp-Heat Parasites, add Bitter-Cold/Acrid-Sour (Coptis, Plum, Sichuan Pepper, Croton). If Dampness has become Gan, Bitter-Cold parasites killers hurt Spleen/Stomach; Zisheng pills are too drying. Use a Beijing formula: Scorpion (Quelled toxicity, dried powder) with Beef. Scorpion (Green/Wood) penetrates and soothes Earth; Beef (Sweet/Warm) tonifies Earth. Scorpion + Beef balances movement and tonification, treating Gan Ji excellently. Single Herb Chicken Gizzard Membrane Powder is also excellent. Li Xiaolian’s Huayin formula: Dates stuffed with Rheum, baked, pill-sized, highly effective. Both formulas are Tonifying/Moving, Moistening/Non-drying. Western medicine attributes Gan Ji to lacteal vessel obstruction. Lacteals absorb nutrients, branching in intestinal mesentery, merging into the thoracic duct near the spine, entering the heart. Gan Ji is blockage of these vessels, causing emaciation despite eating. This aligns with Ju Tong’s theory: Application depends on flexibility; enlightenment depends on the practitioner.