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Chapter "Investigating the Origin of Diseases" in the "Ciyu" (Nurturing Children) section of *Shengji Jing* states: Infants have concentrated Qi and pure will, crying all day without hoarseness, which is the ultimate state of harmony. However, their five Zang organs are not yet settled; even slight injuries from emotions or desires, as well as wind, rain, cold, heat, improper diet, and living conditions, can easily cause illness. Therefore, when external pathogens invade deficiency, they enter and become various Wind diseases. Excessive consumption of rich and sweet foods leads to accumulation and causes Gan jaundice. Negligence during infancy allows pathogens to affect the skin and pores, causing chills and fever. Irregular daily activities cause the spirit to be unguarded, leading to Ke Wu (intruding evil); internal heat accumulation causes macules and toxins; internal cold accumulation causes night crying. These occur because Yin and Yang in infants are more vulnerable than in robust adults. Moreover, some causes are rooted internally and present from birth. For example, if the mother is startled during pregnancy, the child may be born with Dian Ji (epilepsy). If Kidney Qi is incomplete, the child may be born with Jie Lu (delayed closure of fontanelles). If wind-heat injures the fetus, the child may be born with Kou Jin (lockjaw). If wind-cold injures the fetus, the child may be born with body spasms and crying. Ingestion of filth leads to Xue Pi (blood stasis); fetal weakness leads to various Xian syndromes. These mostly stem from the beginning of conception, not a matter of one day or night. Thus, those who skillfully protect infants use detailed treatment methods including emesis, purgation, moxibustion, acupuncture, hot compress, bathing, powdering, and massage, adapting flexibly to situations. If the pathogen is in the chest and foul fluid has been swallowed, emesis is required for cure. If the pathogen is in the intestines and milk cannot be taken, purgation is required for cure. For Chong She (double tongue) and Chong Yin (swollen gums), treat with fine needles. For sudden epilepsy with straight body, treat with moxibustion. Apply hot compress to Fengchi (GB20) to dissipate minor pathogens; bathe the skin to disperse chills and fever. Massage the fontanelle to relieve nasal congestion; apply powder to stop sweating and secure the pores. For the membrane of double tongue, cut it with fingernails; for fierce evil qi, use Zhuyou (incantation therapy) to exorcise. Generally, because children are weak, diseases spread easily. Only with a compassionate heart, focusing on preventing problems before they arise, can one exhaust all measures. Those who adhere to "no treatment" or let nature take its course like country children miss the timing of disease. Those who over-treat, using strong medicines regardless of seasons, risk damaging the body with decoctions. Both are biased errors, not understanding the general principles of treatment.

*Culun Jing* states: Newborns suffering from E Kou (goose mouth/thrush), Cuo Jin (mouth grasping), and Kou Jin are caused by Ke Feng (intruding wind) affecting the head and umbilicus after birth. They can be cured by applying three small moxa cones and cauterization.
Newborns crying at night have abdominal pain due to blood stasis; crying increases at night due to Yin dominance.
Newborns within one month having milky diarrhea like glue are affected by maternal cold injuring the Stomach.
Newborns within one month having milky diarrhea like blood are affected by maternal chest stagnation-heat.
Newborns within one month with red eyes were exposed to maternal consumption of roasted/fried hot foods causing Qi stagnation, which steamed the fetal brain.

Pediatric warm diseases generally arise from excess Qi clashing with Stomach Qi. If purged, Qi levels and health returns; if Qi is deficient, it generates Jing (startle) and transforms into Xian (epilepsy). Pediatric Jing-Xian arises from the clash of deficient evil and intruding heat. Treatment should use nourishing and harmonizing methods; adding cold-natured drugs or overdosing leads to death. Pediatric hiccups and vomiting arise from Stomach deficiency and rebellious Qi invading Zang Qi; treat by harmonizing Stomach and nourishing Qi. Simply stopping diarrhea is extreme/dangerous. Pediatric Huoluan (cholera-like vomiting/diarrhea) arises from conflict between Stomach Qi and Yin-Yang Qi; treat with harmonizing and tonifying drugs. Other cases result in death. Pediatric Ke Wu and Wugu diseases arise from contact with intruding evils or exposure to stars/moonlight; children are tender and weak, so these present as malignant.

Sun Simiao's *Yuguan Jue* says: First distinguish the form and syndrome of pediatric diseases. The song says:
Shaking head and rubbing eyes indicates Liver Heat generating Wind.
Eye discharge, tearing, and photophobia indicate Sanjiao heat accumulation.
Clear nasal discharge indicates Lung Cold.
Red cheeks and yellow face indicate Wind injuring Fu organs with Heat.
Huoluan vomiting indicates Stomach Qi injury from accumulation.
Irregular diarrhea indicates Qi attacking slippery intestines.
Blue face and yawning indicate Startle Qi transmitting to Liver.
Frequent night sweats indicate hidden Zang deficiency-heat.
Shanghan with startle convulsions indicates excessive Wind causing madness.
Stomach Heat generating macules indicates Qi injury with cold厥 (reversal).
Sighing and grinding teeth indicate excessive Wind generating Qi.
Looking up, shaking head, and high saliva indicate Stomach knotting.
Lung obstruction and Qi injury cause coughing and hemoptysis.
Excess saliva and fever indicate accumulation injuring Wind-Heat.
Scanty red urination indicates Heat gathering in Bladder.
Hernia from crying indicates fetal accumulation.
Milk spleen and masses are caused by injury from substances.
Throat closure and sores indicate Lung receiving Heat.
Eating dirt indicates Spleen generating Gan.
Vomiting phlegm-saliva indicates Ascaris rising.
Rectal prolapse and bloody stool indicate mixed cold-heat accumulation.
Xiaoke (wasting-thirst) and mouth sores indicate Heart receiving Heat.
Yellow face and edema indicate Qi attack from accumulation.
Crane knee and jie lu indicate Wind-Fu Heat.
Delayed walking and slurred speech indicate fetal Qi injury.
Neck stiffness and Liver Wind indicate Qi injury with Mu She (wooden tongue).
Medical classics require distinguishing disease sources. Careful application brings benefit.

Du Guangting's *Zhimi Fu* states:
Yin rises, Yang adds, seasons differ not. All things receive Heaven-Earth Qi; males and females originate from essence and blood. At thirty days, Yin is pure and thick, called Qiangbao; at two months, Yang begins to grow, called Ying'er. Within one hundred days, called Naixing; at half a year, called Ru. Children reach one year, Yin and Yang are half; at one thousand days, True Qi is abundant. Five-six years old reputation is set; ten years old name is glorious. Regarding Bianzheng (transformation/evaporation) signs, laws follow numerical schools. Hun becomes clear-eyed through transformation; Po gains Qi through transformation. At one hundred days, spirit transforms and smiles; fetal stagnation shows evil. Transformation makes Qi-Blood inferior; non-transformation leaves true root unobstructed. Milk diarrhea appears after five days; cuokou appears after ten days. Fetal startle occurs before transformation; internal heat at one hundred days resembles holding. Fetal jaundice comes from maternal heat transmission; Huang disease comes from Spleen-Stomach heat masses. Extreme heat bites people and grinds teeth; excessive Wind makes face like flowers. Internal heat makes body like fire; abdominal pain causes crying. Thus observe color and shape, distinguish evil and righteousness. Yellow-red face fearing coolness, vomiting and diarrhea dislike excessive heat. Jing-Xian body should be warm; Shanghan pulse is surging with evil breakthrough. Abdominal distension fears cold feet and sinking knees; cough prefers floating-slippery pulse. Xiaoke requires body heat and surging pulse; night crying is rebellious. Huoluan with large pulse and warm body, heart pain threatens life. Compatible signs allow medication; incompatible signs warn of critical illness. Yellow-red face, blue lips, vomiting indicate discussion needed; red eyes, red lips, internal heat, tidal fever require pulse diagnosis. Slightly red lip corners and black face prevent startle; yellow fingers and cold feet indicate startle-heat signs. Shaking head and rubbing eyes indicate Liver Heat with eye discharge; looking up and rough breathing indicate extreme Wind with salivary struggle. Cough connects with nasal congestion; macules are similar to Shanghan. Understanding turns fools to sages; realizing transcends ordinary to sagehood. Thus pediatric signs are hard to detail. More cold means dry skin; excessive heat means red face and yellow cheeks. Excessive heat causes Jing-Xian hair growth; cold feet cause Qi reversal prevention. Night heat reduces Yin; day cold damages Yang. Accumulated heat causes persistent fever; hidden cold causes fluctuating temperature. Shanghan heat means cold nose, hot ears, rough breathing; measles/smallpox heat means cold ear angles. Yellow lips, slightly blue, sleepy; milk appetite vomits, Spleen suffers. Urgent eyes, blue color, dark complexion; startle signs, saliva generation, Stomach fails. Following this ensures success. Knowing Ji Jing (acute startle) stems from internal heat accumulation; Man Pi (slow spleen) stems from middle Qi deficiency. Hidden Liver heat causes Que Mu (night blindness); filth plus Wind causes facial sores. Qing Mang (blindness) is Liver cold; Yi Mo (membrane) is Gallbladder strength. Night sweats arise from internal deficiency and consumptive bone injury; startle hidden in internal masses and cold-heat details. Continuous epistaxis indicates Heart excess and nasal sores. Spasms mean cold tendons; lockjaw means Wind striking strong Stomach. Ke Wu is same as object collision; stroke is same as evil poisoning. To recognize Ding Xi (abdominal distension), Qi gathers into accumulation. Disease in Fu treats differently; accumulation in Yin is hard to detail. Initially due to undigested milk, Sanjiao difficult to organize; gradually knots form, body wastes. Stomach cold refuses delicacies; Spleen heat eats coarse food. Gan thinness comes from internal heat injuring Stomach; abdominal distension is Spleen failure blocking Qi. Vomiting is Stomach deficiency; diarrhea is cold mass. Loving sweets/fat generates Gan worms; sores rise from Spleen origin where poison goes. Heart-Spleen heat causes mouth sores; two Zang extremes cause double tongue hitting. Understanding ensures success; using ensures merit. Thus evil generates disease; accumulation generates Gan. Dry skin and tufted hair; red face and unquenchable thirst. Lung Heat causes continuous nasal sores; Large Intestine cold causes watery stool. Heart Gan causes five-palm heat; Kidney Gan causes swollen face and sparse bones. Zang Qi losing control prevents Qi distribution. Sanjiao imbalance causes swelling; Ying-Wei disorder causes frequent abscesses. Skin-muscle stagnation and blood-Qi deficiency. Accumulation from early feeding; Gan thinness from sweets. Zang Qi not spreading causes illnesses. Eight types of diarrhea; startle generates acute/slow. Rebellious Stomach and cold intestines cause vomiting/diarrhea; deficient Spleen-Lung cause uninterrupted diarrhea. Exterior-interior cold causes water foam; Spleen-Stomach cold causes瓣 (petal-like) stool. Spleen heat/Stomach cold causes yellow water; Spleen deficiency/Heart heat causes soup-like stool. Small Intestine heat transmits causing bloody stool; Large Intestine extreme cold causes pus. Resembling diarrhea but not is Spleen cold/Heart heat steaming; drinking endlessly is Qi excess Metal-Fire struggling. Frequent signs clarify reverse/forward; frequent diseases familiarize wisdom. Bladder heat causes hematuria and five lin; Bladder-Small Intestine cold causes hernia and deep Qi reversal. Wind injury from exposure; nasal congestion from maternal Qi/fontanelle invasion. Malaria is summer heat not exiting; rectal prolapse is frequent cold intestinal diarrhea. Sleeping under moon invites Wugu disaster; immature pupils seeing rare objects trigger Ke Wu. Wind clashing Blood-Qi attacks upward forming scrofula; Heat obstructing Zang extremes causes uncontrollable erysipelas. Overeating causes soft bones/weak legs; loss of milk causes thin neck/less sound. Jie Lu is insufficient bone Qi; Crane Knee is muscle inability. Knowing disease source requires knowing floating/sinking. Startle-heat purges to cure; diarrhea/purges regulate Stomach deeply. Excessive Wind resolves to retreat; cold injury harmonizes Stomach/warms Yin. Pulse sizes undecided; differentiate disease by Tiger Mouth lines. Secondary finger divides into three grades; green/red in two searches. Exhausting distinguishes all diseases; using deepens all methods. Girls check right hand; boys check left finger. Qi in lower line; Wind in middle interior. Passing Wind gate is Life gate (order: Qi, Wind, Life). Determine green/purple colors. Discuss initial branch node first; faint red-purple indicates Spleen Qi stagnation. External green branch indicates Wind entering Spleen; purple branch indicates difficult-to-stop evil. Branch tips separating with black connection indicates Qi deficiency and Wind onset. Observing initial node determines auspicious/inauspicious and disease. Middle governs Wind, must observe carefully. Green line/purple branch indicates slow startle; purple line/green branch indicates worm not emerging. Empty startle disperses Qi; excess saliva is hard to treat. Green branch rushing Life indicates excessive Wind convulsions; red branch/red line indicates Wind invading Qi. Purple line/green branch warns of slow startle. Suddenly green line/purple branch passing Life gate indicates startle coming. Branch splitting two ends, thread-thin with saliva tide indicates death; faintly scattered red line is treatable; sudden grey-black indicates destruction. Red like rice indicates Lung Heat; wheezing/diarrhea Stomach not ending. Two rices green-purple entering Life gate, disease present but leaving like flowing water. Red-purple bursting nail indicates death; internal wrapping finger surface indicates no death. If attentive and proficient, pearls are incomparable.

Mr. Mao on Pediatric Disease Origins:
Five Zangs suffer diseases, listen to origins carefully. Red eyes indicate Liver toxin-heat; fear of light indicates Liver-Heart startle. Liver-Spleen accumulation causes night blindness; throat Qi indicates Spleen deficiency bloating. Heat in Spleen causes sleepiness; tooth gan comes from milk-food toxicity. Vomiting worms indicates Large Intestine excess heat; Spleen gan eating dirt generates Wind. Toxic food Spleen heat causes malaria accumulation. Major food injury Spleen heat diarrhea; deafness is Kidney heat-toxin accumulation. Double tongue/mouth sores indicate Heart extreme heat; milk eczema is Spleen heat moving. Spleen accumulation causes high abdomen; Heart deficiency sees water and startles. Lung heat causes nasal blockage; wooden tongue is Heart-Intestine accumulation. Fontanelle swelling indicates Kidney death; Large Intestine heat causes sores. Internal heat closes mouth; accumulation causes heart distension/eye spots. Five-palm tidal fever indicates severe Gan consumption; residual Gan heat causes tinnitus. Spleen toxin prevents milk digestion; biting milk wind enters bone startle. Turtle back is Lung heat; turtle chest is intruding Wind injuring back. Ear issues originate in Kidney; toxin injuring Lung shows clearly. General edema from endless accumulation; running horse gan named after Kidney. Tian Feng (umbilical wind) obtained thus; throat phlegm fears Wind startle. Urinary difficulty is Qi accumulation not dispersing. Recognize startle/epilepsy/idiocy as Liver signs and Spleen startle. Joy/sorrow unpredictable; evil entering Spleen needs quick treatment. Abdominal distension/mouth sores/Gan Qi, rebellious chest/phlegm heat cross. Night sweats like boiling water; Heart heat disharmony confuses mind. Much laughing is residual startle or Heart heat disturbing mind. Long-term diarrhea involves startle/food; cold-heat combined generates specially. Briefly stating causes is easy to see, avoiding life entering springs.

*Wuguan Guanzhen Zhu Nang* Pediatric Signs:
Much vexation means blue face. Excess saliva means eye turning. Extreme excess means vomiting saliva. Extreme deficiency means Huoluan. Milk injury means yellow face. Heart heat means tongue growing sores. Cuokou belongs to Qi, grinding teeth plus Wind. Hoarse cry injures Lung. Empty startle blue face lying on ground injures Spleen. Touching hands means all Zang-Fu deficient.

*Wuguan Guanzhen Zhu Nang* Three Knots:
Upper knot mostly from Heat and Shanghan, forms after measles/rashes settle, often cheek swelling, throat blockage, inability to swallow. Middle knot mostly from continuous vomiting/diarrhea, cold air knots in Spleen, unable to eat downwards, gradually suffocates, becomes slow startle wind. Lower knot mostly from doctors misidentifying source, random purging, later failing to regulate Qi, Large Intestine receives Wind deficiency, blocks, abdominal rumbling, purging stops, then constipation.

*Wuguan Guanzhen Zhu Nang* Discussion: After one lunar month, before one hundred days, fear two diseases.
One is Tian Feng (Heaven Wind). Heaven covers, Earth carries. Heaven is father, Earth is mother. Tian Feng startle wind comes from Heaven. Two is Nei Feng (Internal Wind). Caused by swallowing wet nurse's bad blood, milk enters abdomen, triggered by cold, attacks heart-chest. Initial sign: refuses milk, mouth opens poorly, limbs contract, endures pain, called Nei Feng.

*Huiyan Guanzheng* Discussion on Miscellaneous Disease Sources: After startle wind, epilepsy and idiocy occur because startle Qi entered Heart and did not retreat. Turtle back mainly from Shanghan, intruding Wind injuring back. Closed mouth indicates Large Intestine excess heat. Startle/joy/sorrow indicates Startle Qi entering Spleen. Fear light love dark indicates Heart-Liver heat. Dysentery with burning thirst indicates Large Intestine dryness. Dysentery with pure blood indicates Large Intestine Qi deficiency. Hematemesis/epistaxis indicates post-Shanghan Qi-Blood stagnation not following normal path. Heavy scrotum indicates Kidney cold injury flowing inward, lower hernia. Head/face sores indicate Yang Qi gathering on head/face, generating with heat. General high fever, dry mouth/nose, tufted hair indicates Heat Qi rushing four limbs. Red rot/sores under nose with occasional cough indicates Lung Gan rushing to brain. General sores, red eyes, scanty urine indicates Heart-Lung extreme heat. Born with many ear issues indicates brain internal Wind-Heat plus toxic gas entering Kidney. Dry belly/Qi pain indicates cold/raw attacking Stomach or hard objects injuring Spleen. Small Intestine urgent pain, yellow/scanty urine. Sweating every 1-2 days or irregular high fever every 1-2 days generates Bone Steaming.

*Zhuang Family Transmission* Pediatric Sources: Humans receive Heaven-Essence transforming into form. Father's essence is Hun, Mother's blood is Po, accumulating parents' essence-blood to form fetus. Month 1 like white dew, Month 2 like peach blossom, Month 3 male/female distinct, Month 4 form complete, Month 5 moves limbs, Month 9 turns three times, Month 10 form full, mother-child separate inside. Extending months means less disease; lacking months means more disease. 60 days pupils connect recognizing mother; 210 days bones/tendons form sitting; 300 days palm bones form crawling. Bones open, Zang-Fu wide, hair grows, teeth generate. Vomiting, diarrhea, heat, startle appear intermittently. Distinguishing Bianzheng shapes, calling ghosts, or burning/moxa causes Heart agitation, transforming into Startle Wind. Or becoming Startle Epilepsy convulsions, commonly called Wind. Or becoming Milk Epilepsy, clear diarrhea, undigested milk, upper heat/lower cold, irregular breathing, cold limbs, general deficiency sweat. Without observing signs, diseases vary; without good doctors, many die in vain. Children under seven have fifteen Wugu diseases, followed by five Gans, eight dysenteries, twenty-four signs, must know forms. Not distinguishing sources, medicine ineffective. Wugu includes: Umbilical Wind, Cuokou, Kou Jin, Chong She, Mu She, Que She, Ru Jia, Nai Xian, Nai Huo, Gui Xiong, Jue Xie, Hou Sun Jin, Jing Feng, Tian Feng, Chi Liu, total fifteen. Five Gans include: Heart Startle Gan, Liver Wind Gan, Lung Qi Gan, Spleen Food Gan, Kidney Urgent Gan.

Heart Song:
Whole body strong heat, limbs cannot bear. Fear cold add heavy cover, red cheeks face like gold. Dry mouth often nose dry, gradually disease root deep. Only from startle fall, this disease originates from Heart.

Liver Song:
Shake head rub mouth/nose, white film covers eyes blind. Back pain often涩 (stiff), both eyes closed not see. Blue-yellow face ugly, sores/eczema body lose spots. Hair stand fur burnt, originally obtained from Liver.

Lung Song:
Cough much crying, sores grow mouth/nose sides. Loud voice only grinding teeth, slippery diarrhea thin. Limbs no tendon strength, appearance not usual. Vomiting pus and blood, this is Lung family injury.

Spleen Song:
Milk/food hard digest, only stool in mud. Abdomen high blue veins show, hair thin top hair sparse. Panting much cough, no joy only love cry. Diarrhea much sour smell, this disease originates from Spleen.

Kidney Song:
Diarrhea much frequent, usually just startle. Stool rice grains out, skin millet wrinkles grow. Body bake like fire, just cool then like water. Urgent Gan how to treat, originally from Kidney family.