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Gui Xiong (Turtle Chest) is characterized by a high and distended chest, shaped like an inverted palm. This is often caused by the wet nurse consuming excessive amounts of "Wu Xin" (Five Pungent Spices: garlic, chives, leeks, shallots, and asafetida), alcohol, wheat-based foods, or roasted/grilled items, or by feeding the infant hot milk or leftover cold milk during summer. Since infants' Lung Qi is the purest, and the Lung serves as the Hu Gai (Canopy covering all viscera) for the five zang organs, prolonged stagnation of phlegm generates wind-heat. When the Lung is affected by fire pathogenic factors, the sternum becomes distended and raised. After recovery from measles and smallpox, this condition frequently occurs; it is appropriate to clear the Lung and descend fire using Xingren Jian (Almond Decoction).

Gui Bei (Turtle Back) refers to the inability to protect oneself after birth, allowing exogenous wind pathogens to penetrate into the bone marrow; or premature sitting by the child, which damages qi and blood; or chronic coughing leading to Lung deficiency, thereby failing to nourish the Kidney. The Kidney governs the bones; when wind-cold enters the bone marrow due to deficiency, causing jing and blood to fail to circulate freely, Gui Bei results. Treatment should involve Songrui Dan (Pine Pollen Pill), with an external application method using turtle urine. This represents the previous scholars' syndrome differentiation and treatment protocols.

In my commentary: Gui Xiong is treatable, whereas Gui Bei is considered incurable. The previous scholars' syndrome differentiation and treatments were still imperfect. Although they attributed it to exogenous wind penetrating the bones, premature sitting causing damage, and chronic cough leading to Lung deficiency, they failed to discern the root cause of the disease, merely describing present symptoms. I have observed children with sufficient innate true yuan (primordial essence) who sat naked in the wind and dew for half a week, then sat in support frames, without ever hearing of cases where exogenous wind entered the bones, premature sitting caused damage, or chronic cough led to Gui Bei. This condition likely arises from insufficient essence inherited from parents and depletion of primordial yang. Observe that in Gui Bei, the deformity centers around the Mingmen (Gate of Life), with gradual protrusion of bone joints and a waist curved like a bow; this is truly due to Gu Wei (bone atrophy/weakness) unable to provide support, not due to wind pathogens. This condition is rarely curable (one in a hundred survives); originally, there was no effective treatment. Yet previous scholars arbitrarily established Songrui Dan, utilizing attacking and dispersing herbs such as Ephedrae Herba (Mahuang, 麻黄), Rheum Radix et Rhizoma (Dahuang, 大黄), Angelicae Pubescentis Radix (Duohuo, 独活), and Saposhnikoviae Radix (Fangfeng, 防风), which only serves to hasten death. In my opinion, one should use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) supplemented with Cinnamon Twig (Guizhi, 桂枝) and Deer Antler (Lurong, 鹿茸) to rescue the congenital foundation, followed by Sijunzi Tang (Four Gentlemen Decoction) or Liujunzi Tang (Six-Gentlemen Decoction) to support stomach qi. Perhaps one in ten could be saved. Aside from this, there are no other treatments. If anyone claims Songrui Dan can cure Gui Bei, I do not believe it.