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The complexion and qi color are normal, but the earlobes are cold; there is frequent coughing and sneezing, with cold hands and feet.
When fever occurs, it resembles a fright state, with body tremors and shivering; there is increased ocular discharge (eye gunk), and the pulse is floating and long.

If the complexion is cyanotic, yellowish, or white, it is often due to food stagnation caused by fright; prolonged diarrhea results in greenish stool.
Dysregulation of the zang-fu organs leads to dysentery; heat-type dysentery presents with red stool, while cold-type presents with white stool, with distinct symptom differentiation.
This is the presentation of fright-diarrhea and dysentery. If accompanied by abdominal pain, passage of red and white mucus like jelly, thirst, irritability, fever, and an inability to eat, it is considered difficult to treat.

Teeth grinding, pale lips, and thin, withered limbs are often due to improper feeding damaging the Spleen and Stomach.
Scorched hair, white urine, abdominal distension with hollow sounds upon percussion, and a sallow body shape.
Thirst, blurred vision, body heat, rubbing of the eyebrows and nose, and shiny facial skin.
Diarrhea with green stool, vomiting, and regurgitation are all signs of infantile malnutrition (Gan syndrome); there are effective prescriptions to prolong life.

A thin neck, high abdomen, and slender limbs, lacking spirit and vitality, with frequent crying.
Chronic bone-steaming fever (yin deficiency heat) and Spleen-Stomach decline in infants and children is known as "Ding Xi" disease.
Separated cranial sutures, alternating chills and fever, vomiting of worms, and regurgitation indicate weak Stomach qi.
Emaciation and wasting, afternoon tidal fever (Bu Lu), irritability, thirst, lack of spirit, and inability to open the eyes.

Multiple tubercles behind the ears and on the sides of the neck are likely caused by friction from testicles or clothing against the infant's skin.
Emaciation, high fever, and pus-blood stools indicate parasites invading the skin, leading to premature death.
These three conditions are all complexions and presentations seen in mid-stage pediatric illnesses.

Blackness at the Shan Gen (root of the nose) signals impending death; purple qi is often due to fright from diet.
Cyanosis must be attributed to human fright; physicians must distinguish these carefully.

Darkness on the forehead and cheekbones, cyanotic lips, fixed gaze, head shaking, and non-rotating eyeballs.
Phlegm rattle in the throat sounding like a saw indicates a terminal sign; no further discussion is needed.
This represents the collapse of qi in the five zang and six fu organs, manifesting as dark qi; even potent medicines cannot cure this.

Umbilical wind disease in infants arises from careless umbilical cord cutting after birth, resulting in three syndromes: Jin Feng (lockjaw), Cuo Kou (mouth puckering), and Qi Feng (umbilical wind). Though named differently, they are essentially one disease.
Jin Feng symptoms include lockjaw, closed eyes, diminishing cry, millet-grain-like white spots on the tongue, inability to suckle, frothy saliva, and constipation of both bowels and bladder. This is caused by fetal heat-toxin entering the Spleen.
Cuo Kou symptoms include sallow face, asthma, and absent cry. This is caused by fetal heat injuring the Heart and Spleen, leading to a stiff tongue, cyanotic lips, mouth puckering, and inability to suckle.
Qi Feng symptoms arise when water-dampness, wind, and cold enter the umbilicus after cutting, flowing into the Heart and Spleen, causing abdominal distension, umbilical swelling, rigid limbs, constant day-and-night crying, inability to suckle, and wind spasms. These are ominous signs; if appearing within the first month, they are truly difficult to treat. To ignore them is pitiable.
One should check for millet-sized white blisters on the gums. If present, urgently wipe them broken with warm water-soaked cloth wrapped around the finger. The mouth will open, bowels will move, and the child will be calm; self-healing may occur without medicine. This is a good method.
If white sores cover the mouth preventing suckling, it is called "Suo Ge" (locked septum/throat), which is difficult to treat.

Bian Zheng (transformation and steaming) illness: "Bian" means change; "Zheng" means steaming within the five zang organs and blood-qii.
After birth, 32 days constitute one "Bian," and 64 days constitute one "Zheng." With each Bian and Zheng, the child's temperament changes.
Mild cases involve low-grade fever resembling fright; severe cases involve high fever, vomiting, sweating, and irritability.
Mild cases resolve in 3-5 days; severe cases in 7-8 days. Symptoms resemble wind-cold, but during Bian Zheng, the ears are cold, bubbles form on the upper lip, and crying is incessant.
Treatment requires mild, harmonizing formulas that slightly release the exterior and slightly drain the interior; avoid cold, cool, sour, or astringent drugs. Some cases heal spontaneously.
The Classics state: Ten Bians and five Zhengs take over a year to complete.

Acute fright wind (Ji Jing Feng) attacks fiercely and suddenly: lockjaw, high fever, salivation, upward staring, opisthotonos, convulsions, head shaking, hot breath, red cheeks and lips, cyanotic fingernails, rapid pulse, and scanty yellow urine.
This is due to internal accumulated heat and external wind pathogen; heart heat accumulates fright, liver wind generates spasms, leading to phlegm obstruction, lockjaw, and unconsciousness.
Treatment must be swift; delay allows the disease to deepen and become hard to retreat.

Chronic fright wind (Man Jing Feng) often results from prolonged vomiting and diarrhea damaging the Spleen and Stomach, or from excessive use of cold/cool drugs in acute cases.
Symptoms include limb spasms, lethargy, exposed eyes during sleep, phlegm rattling, slight asthma, open eyes with sluggish spirit, tongue protrusion, head shaking, intermittent onset, warm limbs, cold breath from mouth/nose, and pale cyanotic complexion. This is the chronic fright wind pattern.
Treatment should regulate the Stomach and Spleen, adding wind-extinguishing and spasm-stopping agents to restore yin-yang harmony.

Slow Spleen Wind (Man Pi Feng) originates from the progression of chronic fright wind or long-term vomiting/diarrhea causing Stomach qi deficiency, allowing wind pathogen to invade the Spleen.
Symptoms include cyanotic face, sweaty forehead, short tongue, drooping head, closed eyes, lethargy, head shaking, tongue protrusion, foul-smelling vomit, lockjaw, teeth grinding, limb spasms, cold extremities, and faint pulse.
In treatment, there is no wind to dispel and no fright to calm; only phlegm in the throat, alternating deficiency heat, and coma are seen. This is what is meant by the incurability of slow fright wind—specifically Slow Spleen Wind.
Ten out of one hundred recover. Early signs include head shaking, oblique gaze, reaching out to touch people, lethargy, and profuse sweating. Immediate use of Spleen-nourishing and wind-dispelling herbs can save life. Once full symptoms appear, rescue is difficult.

Fright wind pathology: green diarrhea, timidity, fluctuating phlegm, red face, and fever indicate wind arising but not yet arrived.
Night crying with fear, cyanotic face, teeth grinding, panting, and upward staring indicate fright approaching but not yet fully developed.
Treat based on the affected zang organ. Listen to the cry during sleep: floating/bright sound is easy to treat; deep/muffled is difficult.

Tian Diao (Heavenly Hook) belongs to Yang: high fever, fright, rolling eyes, limb jerking, crying, and cyanotic nails. Caused by heat in Heart and Lung. Treatment requires clearing and relieving.
Nei Diao (Internal Hook) belongs to Yin: abdominal pain, frequent crying, scrotal swelling, black lips, red veins in eyes, chest elevation, and leg retraction. Caused by fetal fright/wind causing internal spasms. Treatment requires warming Kidney and Liver.

Zhong Feng (Wind Stroke) is a sudden illness causing instant unconsciousness. It arises because pediatric blood-qii is unstable, temperature regulation is poor, and pathogens enter through deficiency.
Symptoms include high fever, red face, spasms, and coarse breathing.

Ye Ti (Night Crying) and Ke Wu (Guest Intoxication): Night crying is due to cold viscera; yin dominates at night, causing abdominal pain and restless crying.
Ke Wu is caused by sudden contact with alien qi or objects. Symptoms resemble fright: blue froth from mouth, panting, spasms, but without upward eye deviation or ear abnormalities.

Xian Ji (Epilepsy) is a severe pediatric disease. Symptoms include sudden collapse, lockjaw, salivation, neck stiffness, opisthotonos, wide staring eyes, and limb convulsions. Periodic consciousness return defines epilepsy.
Body rigidity with crying and trance indicates Fright Epilepsy.
Sweating, undressing, wind invasion, accumulated heat generating phlegm, and counting fingers with flexion indicate Wind Epilepsy.
Fright during feeding causing milk/food stagnation forms Fright Stagnation (Shi Xian).
Ancient texts link epilepsy to six animals due to the similarity of cries; hence the name.

Pediatric Gan (Malnutrition) disease arises from irregular feeding and excessive rich/sweet foods.
Delicate organs are injured by overeating (Stomach) or hunger (Spleen), leading to Spleen-Stomach damage and Gan syndrome.
Symptoms include tidal fever, abdominal distension, borborygmus, white milky urine, tight shiny scalp, scorched sparse hair, nose/eyebrow rubbing, sallow body, white lips, thirst, spontaneous sweating, blurred vision, and diarrhea.
Pathology involves the five zang organs, classified into five types of Gan. Though starting from diet, chronic deficiency transforms into parasites. Treatment focuses on eliminating parasites and nourishing the Stomach. I prescribe according to symptoms.

Cough has various causes: wind-cold invasion or accumulated fright generating heat.
Wind-cold affecting Lung qi causes nasal congestion, heavy voice, clear rhinorrhea, chills, and fever (Wind-Cold Cough).
Accumulated fright heat generating phlegm causes throat rattling, hoarse voice, copious phlegm, and incessant cough (Accumulated Heat Cough).
Persistent cough spreads to the five zang organs; treat according to specific organ patterns.

Wheezing and急促 breathing (Chuan Ji) share origins but differ in name. Chuan involves open-mouth difficulty breathing; Qi Ji involves shortness of breath progressing to Chuan.
Severity varies. Wind-cold lingering in Lung generates heat, leading to coarse breathing and wheezing.
Acidic/sour food irritating the Lung/Stomach causes asthma. Differentiate clearly for treatment.

Spleen-Stomach diseases are crucial in pediatrics. Improper feeding damages Spleen-Stomach. Stomach injury causes vomiting and anorexia; Spleen injury causes distension, sallow face, abdominal pain, diarrhea, and undigested milk/grains.
Excess milk harms the Stomach; forced feeding harms the Spleen.

Diarrhea has deficiency and excess types. Dietary irregularity damages Spleen-Stomach, causing food stagnation, undigested stool, or unseparated fluids.
Dampness flowing into Spleen causes irritability, thirst, and watery diarrhea (Spleen Excess/Damp Diarrhea).
Spleen deficiency failing to transform food causes postprandial distension and diarrhea (Spleen Deficiency Diarrhea).
Initially, avoid tonifying/astringent herbs like Ginseng, Atractylodes, and Chebula; use digestion-promoting and diuretic methods first. Long-standing cases require tonification.

Vomiting stems from tender Spleen-Stomach, irregular feeding, fright, or wind-cold preventing food intake. Stomach heat generating phlegm also causes vomiting. Initial treatment... [Text incomplete].

Huo Luan (Cholera-like disorder) often results from summer dietary irregularity or consuming raw/cold/oily foods, causing latent heat and turbid-clear conflict, leading to vomiting and diarrhea.
Thirst with drinking desire or cold limbs/coma require distinguishing cold/heat patterns for treatment.

Dysentery arises from weak Spleen-Stomach qi, external summer-dampness, or internal injury from raw/cold/oily foods causing intestinal stagnation and tenesmus.
Red vs. white stool distinguishes Blood vs. Qi involvement; treat accordingly.
Vomiting with lockjaw, cold limbs, empty anus with yellow fluid discharge is untreatable.
Fever, irritability, and asthma are also untreatable.

Malaria results from summer heat pathogens lodging in collaterals, combined with autumn sun exposure, creating conflicting heat.
Or, dietary injury to Spleen-Stomach, or improper holding/exposure to wind-cold, disrupts blood-qii harmony and yin-yang struggle, causing alternating chills and fever.

Food Stagnation disease presents with sallow complexion, abdominal distension/edema, lethargy, poor appetite, constipation, oily urine, or sour-smelling vomiting/diarrhea.
Types include Milk Stagnation, Fright-Qi Stagnation, and Food Stagnation. Differentiate and resolve.

Swelling/Distension results from dietary irregularity, indigestion, and excessive cold/raw foods damaging Spleen-Stomach transport, causing qi stagnation.
Wind-cold injuring Lung can cause qi reversal leading to wheezing/swelling. Trace the origin and differentiate for resolution.

Shang Han (Cold Damage) is similar to adults in pathology and treatment, except for concurrent fright and food stagnation.
Initial stage: aversion to wind-cold, seeking warmth/hiding (Exterior Syndrome).
Red face, uncovered head, restlessness, thirst, dry stool, kicking blankets, coarse breathing (Interior Syndrome).
Warm head/cold feet, abdominal pain, green stool (Yin-Cold Disease). Differentiate exterior release, interior purgation, or warming dispersion.

Shang Feng (Wind Injury) is Lung infection by wind pathogen: heavy cough, nasal congestion, rhinorrhea, chills/fever, copious phlegm, coarse breathing, potentially progressing to asthma.
Method: Release exterior first, then clear internally.

Constipation is due to Large Intestine accumulated heat causing blockage, abdominal distension, sudden umbilical pain.
Urinary difficulty is due to heat entering Small Intestine, impairing Bladder qi transformation.
Treatment requires promoting urination and bowel movement.

Rectal prolapse is often due to prolonged diarrhea/dysentery causing Large Intestine qi deficiency, or heat accumulation forcing prolapse.

Wu Ruan (Five Softnesses) refers to softness of the head, neck, hands, feet, and muscles.