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Dai discussed the syndrome of "Five Softnesses" (Wu Ruan), naming it "Fetal Frailty" (Tai Qie). This is indeed due to insufficiency of the father's essence and chronic deficiency of the mother's blood, a statement that is truly accurate. From my deduction, some cases arise because the mother's Sea of Blood (Xue Hai) has been cold for a long time, and pregnancy was achieved by forcibly using tonifying medicines; some occur when the mother was frequently ill at conception; or the father indulged in lust and alcohol, resulting in weak constitution, or the father was advanced in age when the child was conceived; some are born prematurely; some result from failed attempts to induce abortion with abortifacient drugs, yet pregnancy persists. These situations vainly consume the True Qi (Zhen Qi). If survival occurs by chance, it is like grass growing in shallow soil on shady ground: although it sprouts, few grow lush. It is also like cultivating trees but disturbing their roots, making successful growth rare. Therefore, infants are frail and cannot withstand cold or heat; even if they reach adulthood, they often suffer from diseases. After birth, the marrow and essence are not filled, the sinews and bones are flaccid and weak, muscles are emaciated, and the spirit and complexion are dull and slow. Once invaded by the Six Excesses (Liu Yin, i.e., Wind, Cold, Summer-heat, Dampness, Dryness, Fire), it leads to softness of the head, neck, hands, feet, and body, known as the "Five Softnesses." The treatment method involves using Tiaoyuan San to tonify the Kidney, and Dihuang Wan for gradual conditioning, bringing peace only after a long period. If medication proves ineffective, the child may become disabled.

Some children appear robust and plump, not emaciated, yet suddenly exhibit floppiness of the neck, termed "Descending Prostration" (Xia Cuan). This is all due to deficiency of Liver and Kidney Qi, where pathogenic factors invade the Fengfu acupoint and transmit to the sinews and bones, causing this disease. The Liver governs the sinews, and the Kidney governs the bones. When both sinews and bones are weak, the neck becomes floppy and hangs down without strength, also called "Tian Zhu Dao" (Collapse of the Heavenly Pillar). This is similar to the Five Softnesses, and the treatment is the same as mentioned above.

There is a condition called "Jie Lu" (Splitting Skull), characterized by the failure of the fontanelle sutures to close, caused by insufficient Kidney Qi. The Kidney governs bones, and the brain is the Sea of Marrow. Insufficient Kidney Qi results in an incomplete filling of the brain marrow, hence the unclosed sutures. For those suffering from this condition, death usually occurs within a thousand days, though occasionally some survive for several years. Occasionally, due to attack by other diseases, they become disabled. If the complexion is bright and clear, and the child can eat and drink, frequent administration of Tiaoyuan San and Bushen Dihuang Wan may show considerable effect within ten days to a month; with sequential conditioning, there might be a chance of cure. However, if the condition remains unchanged after medication, it is difficult to treat.

The world generally believes that swelling of the fontanelle indicates Heat, not realizing there are two syndromes: Yin and Yang. Careful differentiation is essential. Hardness indicates Yin, while redness and softness indicate Yang. Thus, the *Ying'er Bao Shu* states: "When Cold Qi rushes upward, it becomes firm and hard; when Hot Qi rushes upward, it becomes soft." This refers precisely to this situation. For Yin syndromes, Yunqi San and Lizhong Tang are used as primary treatments. For Yang syndromes, Yulu Yin, Danggui San, and Fangfeng Tang are employed.

Cases of sunken fontanelles indicate extreme deficiency. Deficiency and Cold of Stomach Qi cause the fontanelle to sink, which can be seen in Slow Convulsion (Man Jing). Vomiting and diarrhea caused by Stomach Cold and Spleen stagnation represent extreme deficiency; urgent treatment with Jinye Dan, Guzhen Tang, and various Yuan-rescuing medicines is required, applied externally with Wufu Gao. A depression at the back of the occiput indicates an even more severe condition. The treatment method is the same as for sunken fontanelles; if ineffective, it is also difficult to treat, representing extreme deficiency with almost no hope of survival.