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Qian Yi stated: The Kidney primarily manifests deficiency syndromes, which are diseases of insufficient congenital endowment.

According to the *Classic of Internal Medicine* (*Huangdi Neijing*): The Kidney governs the bones; the meeting point of the bones is at Dazhu (BL11). Above Dazhu lies the laryngeal bone. The neck is the stalk of the head; if the stalk is weak, the head tilts. Below Dazhu lies the spine. The spine is the pillar of the body; if the spine is weak, the body curves. Below the spine lies the sacrococcygeal bone. If the sacrococcygeal bone fails to develop properly, the infant sits late. Below the sacrococcygeal bone lie the hip bones (innominate bones); if they are weak, standing is impossible. Below the hips lie the knee bones; if they are weak, walking is impossible. Teeth are the surplus of bones; if bone Qi is insufficient, teeth erupt late. Hair is the surplus of blood; since the Kidney governs blood, if blood is insufficient, hair does not grow. All these are diseases caused by insufficient congenital endowment, termed "Five Softnesses" (Wu Ruan). Such infants are difficult to rear and should generally be treated with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Danggui (Angelicae Sinensis Radix), Duzhong (Eucommiae Cortex), Niuxi (Achyranthis Bidentatae Radix), and Chuanxuduan (Dipsaci Radix).

The Kidney and Liver reside in the lower jiao and share a mother-child relationship. The Kidney governs bones, and the Liver governs tendons. Bones attach to tendons, and tendons bind bones; the two rely on each other for support. When Liver deficiency leads to tendon weakness, it is also appropriate to treat with Dihuang Wan (Rehmannia Pill), following the principle of "tonifying the mother when there is deficiency."

The Kidney governs marrow and bone marrow; the spine is the pathway for marrow; the brain is the sea of marrow. The Liver meridian and the Kidney meridian run internally through the spinal column and converge upward at the brain. Therefore, conditions such as Jielu (splitting fontanelle) and Ji Gan (spinal malnutrition) arise from Wind-Heat in the Liver and Kidney, transmitted from the child organ to the mother organ.

Jielu presents in two forms. One type occurs after birth, where the cranial sutures split open in four directions, the scalp becomes shiny and tight, the head enlarges daily, and the eye fissures become narrow; this indicates Marrow Heat. Another type occurs when the fontanelle, having closed after five or six months of age, reopens. These children are generally difficult to rear and suffer from Liver-Kidney Wind-Heat; they should be treated with Jia Wei Xie Qing Wan (Modified Draining Blue Pill), illustrating the principle of "draining the child when there is excess." Lu Hui Xie Qing Wan (Aloe Draining Blue Pill) added with Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), and Huanglian (Coptidis Rhizoma) in equal parts, ground into powder and formed into honey pills, should be taken.

Gan Liver Malnutrition: After birth, the infant develops sores that form cake-like lesions resembling inverted plates; this is due to Wind-Heat. It should be treated with Jia Wei Xie Qing Wan added with Manjingzi (Viticis Semen) and Baijili (Tribuli Fructus) stir-fried together.

Spinal Malnutrition (Ji Gan): The infant suffers from malnutrition emaciation, the spine resembles a sawtooth, ribs protrude high, and percussion produces a sound. It should be treated with Jisheng Wan (Sage Collection Pill) added with Longdancao (Gentianae Radix), Zhizi Ren (Gardeniae Semen), and Huangbai (Phellodendri Cortex), processed into pills.

Blackening and rotting of the gum roots, accompanied by foul breath and bleeding, is named Zouma Gan (Running Horse Malnutrition/Gangrene). It is treated with Xiangdou San (Oak Cup Powder).

Take Oak cups (shell of acorn), any quantity, fill them with salt, join two shells together, roast them in fire, grind into powder, and apply to the teeth.

I had a clan grandson who was fatherless; at one year old, he developed Running Horse Gangrene. I scraped the white sediment from the bottom of a urine bucket, dried it over a tile until dry (5 fen), used 3 fen of Wubeizi (Galla Chinensis), 3 fen of Shufu (Ferulae Rhizoma or similar insect, here likely referring to *Pseudoscorpion* or similar traditional remedy context, often translated as Ferula root or similar, but strictly *Shufu* is *Pseudoscorpion* or *Oniscus*, here likely *Oniscus asellus* / Woodlouse dried), and 1 qian of Kubaijian (Alumen Exsiccatum). These were ground into powder together. First, soak with aged tea leaves, wash with rice water, then apply the medicine. It was highly effective and named Bu'er San (Unparalleled Powder).

When an infant suffers a severe illness and suddenly loses voice (aphonia), this is due to Kidney timidity/weakness. It should be treated with Dihuang Wan added with Shichangpu (Acori Tatarinowii Rhizoma).

Infants after smallpox who have chronic difficulty with bowel movements and tenesmus suffer from Kidney deficiency and Blood insufficiency. The *Classic of Difficult Issues* (*Nan Jing*) states: "Diarrhea/Dysentery with heaviness below is the sign." Do not listen to incompetent physicians who recklessly use purgatives. Instead, treat with Dihuang Wan added with Danggui (2 liang) and Huomaren (Cannabis Seed, 2 liang).