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A Handbook of TCM Pediatrics

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A Handbook of TCM Pediatrics A Handbook of TCM Pediatrics A Handbook of TCM Pediatrics Bob Flaws Blue Poppy Press Published by: BLUE POPPY PRESS A Division of Blue Poppy Enterprises, Inc. 5441 Western Ave. #2 BOULDER, CO 80301 FIRST EDITION, JANUARY 1997 SECOND PRINTING, JUNE 2002 SECOND EDITION, MARCH 2006 ISBN 0-936185-72-4 LC 96-86028 COPYRIGHT 2006 © BLUE POPPY PRESS All rights reserved. No part of this book may be reproduced, stored in a retrieval system, transcribed in any form or by any means, electronic, mechanical, photocopy, recording, or any other means, or translated into any language without the prior written permission of the publisher. Disclaimer: The information in this book is given in good faith. However, the translators and the publishers cannot be held responsible for any error or omission. Nor can they be held in any way responsible for treatment given on the basis of information contained in this book. The publishers make this information available to English language readers for scholarly and research purposes only. The publishers do not advocate nor endorse self-medication by laypersons. Chinese medicine is a professional medicine. Laypersons interested in availing themselves of the treatments described in this book should seek out a qualified professional practitioner of Chinese medicine. COMP Designation: Original work using a standard translational terminology Text & Cover design by Eric Brearton Printed at National Hirschfeld, Denver, CO 10 9 8 7 6 5 4 3 2 1 Contents P reface vii Book One 1 Introduction 3 2 The Unique Characteristics of Children 7 3 The Main Cause of Most Children’s Diseases 13 4 Key Points in Diagnosing Children 17 5 Key Points in Treating Children 29 6 Chinese Dietary Therapy & Pediatrics 33 7 Chinese Herbal Medicine 43 8 Acupuncture & Moxibustion 49 9 Antibiotics & Immunizations 51 Book Two 1 The Diagnosis & Treatment of Commonly Encountered Pediatric Diseases 63 2 Emergency Formulas 305 3 Case Histories 315 Appendix 1: Developmental Mileposts 321 Appendix 2: Resources for Going Further 325 Bibliography 331 General Index 331 Formula Index 343 V Preface In 1985 I published a book on Oriental pediatrics titled Turtle Tail and Tender Mercies. It was based on my research of the English language literature available at that time and my study of and clinical experience in pediatric tui na in China. That book sold well and undoubtedly helped many practitioners and patients alike. Blue Poppy Press still gets orders for that book even though it has been out of print for some years. However, although Turtle Tail filled a need in its time, after several years it became apparent to me that, as a clinical manual of TCM pediatrics, it was seriously flawed. As publisher of Blue Poppy Press, I have tried several times to commission a really good TCM pediatric text to meet the needs of Western practitioners and their patients. Unfortunately, no one has submitted a completed manuscript though more than one Chinese practitioner has promised. In the intervening years, I have taught myself to read medical Chinese. Thus I have taken it upon myself to create a new English language clinical manual on the TCM treatment of pediatric diseases. As my practice has developed over the years, I have more and more concentrated on the prescription of internally administered Chinese herbal medicines. Turtle Tail gave herbal, acupuncture, and tui na treatments for most of the diseases it covered. In this book and consistent with the majority of Chinese TCM pediatric books, except for a short chapter on pediatric acupuncture in general and a short section on acupuncture under most of the diseases discussed, I have primarily focused on the herbal treatment of pediatric diseases. Acupuncture can be an effective modality for the treatment of certain pediatric diseases. However, I find the prescription of Chinese herbal medicines mostly sufficient, quite convenient to administer, and I prefer, if possible, not to make my little friends cry. For more detailed information on pediatric acupuncture, the reader is referred to Julian Scott’s Acupuncture in the Treatment of Children published by Eastland Press of Seattle, WA. As for pediatric tui na, Blue Poppy Press has published a treatment manual on pediatric tui na written by Dr. Fan Ya-li formerly of the Shandong VIII A HANDBOOK OF TCM PEDIATRICS College of TCM. Therefore, I have left it to that book to discuss that treatment modality. In reviewing the Chinese literature on pediatrics, it is clear that most Chinese pediatric manuals discuss a number of diseases that Western children do not com- monly suffer from, such as malnutrition, epidemic dysentery, and epidemic encephalitis B. Other conditions discussed in Chinese manuals, such as polio, tetanus, and leukemia, are better and more appropriately treated by modern Western medicine. Therefore, I have kept the topics discussed in this book solely to the diseases and conditions which typically present in a TCM outpatient clinic in the West. These diseases, other than seasonal epidemics such as measles and mumps, have been presented in a roughly longitudinal manner, meaning that they have been introduced more or less chronologically in terms of their likelihood of appearance. For additional information on the treatment of common skin diseases in children, the reader is referred to Liang Jian-hui’s Handbook of Traditional Chinese Dermatology, also published by Blue Poppy Press, and to Manual of Dermatology in Chinese Medicine by Shen De-hui, Wu Xiu-fen, and Nissi Wang published by Eastland Press. The material in this book is taken from a number of Chinese sources. These are listed in the bibliography. I have used Nigel Wiseman’s terminology as it appears in A Practical Dictionary of Chinese Medicine, Paradigm Publications, 1998, as consistently as possible. Medicinals are identified in Pinyin followed by Latin pharmacological nomenclature in parentheses. These identifications are primarily based on Bensky et al. Chinese Herbal Medicine: Materia Medica. In a very few cases, they are based on Hong-yen Hsu’s Oriental Materia Medica: A Concise Guide, or the Shanghai Science & Technology Press’s Zhong Yao Da Ci Dian (Dictionary of Chinese Medicinals). This book is meant for students and professional practitioners of Traditional Chinese Medicine. It is not intended as a parent’s guide. For parents and lay read- ers, I have specifically written Keeping Your Child Healthy with Chinese Medicine: A Parent’s Guide to the Care and Prevention of Common Childhood Diseases. That book is meant as a companion volume to this one, explaining tra- ditional Chinese theories on diet and child care. Although that book does give a number of simple home remedies for common pediatric complaints, parents of children who are ill are advised to seek out professional TCM care for their charges. The full benefit of TCM pediatrics is only made manifest when treatment is based on a professional pattern discrimination which is beyond the means of most Western parents. Many readers know that my first specialty is TCM gynecology. However, because PREFACE IX I treat so many women, when they see how much good Chinese medicine has done for them, they frequently ask me to also treat their children. Therefore, it is not uncommon for me to see in my clinic as many or even more infants and tod- dlers in a day than adult women. As a father myself, I love babies and children of all ages, and it is one of my joys in life to be able to relieve the suffering of what in Chinese are called ‘our little friends.’ Some Western TCM practitioners are hes- itant to or simply do not treat babies and children in their practices. However, it is my experience that Chinese medicine offers quick and effective treatment for the majority of common childhood complaints. Once one knows the key essentials of TCM pediatric diagnosis and treatment, TCM pediatrics is a relatively simple spe- cialty and one which deserves much more attention in the Western world. Hopefully this book will help to show how easy it is to diagnosis and treat our lit- tle friends with Chinese medicine. Bob Flaws Boulder, CO BOOK ONE 1 Introduction Pediatrics is one of the oldest specialties within Chinese medicine. Zhang Zhong-jing’s Jin Gui Yao Lue (Essentials of the Golden Cabinet) and Wang Shu-he’s Mai Jing (Pulse Classic) both date from the late Han dynasty (i.e., the late 200s CE) and both contain chapters specifically on pediatrics. Wang Dao’s Wai Tai Mi Yao (Secret Essentials of an Outer [i.e., Frontier] Official), Sun Si-maio’s Bei Ji Qian Jin Yao Fang (Emergency Formulas [Worth] a Thousand [Pieces of] Gold), and Chao Yuan-fang’s Zhu Bing Yuan Hou Lun (Treatise on the Origins & Symptoms of Various Diseases) all contain chapters specifically about pediatrics. Qian Yi, also known as Qian Zhong-yang, was one of the earliest and most famous Chinese pediatric specialists. Living in the Song dynasty from 1032-1113 CE, he was the author of the first book devoted solely to pediatrics in Chinese medical literature, the Xiao Er Yao Zheng Zhi Jue (A Collection of Essential Pediatric Patterns & Treatments). He was also the first Chinese pediatrician to detail the different patterns in measles, scarlet fever, chicken pox, and smallpox. Qian pointed out the unique characteristics of infants and young children and he introduced new methods of diagnosis and treatment based on those unique characteristics. Also in the Song dynasty, Liu Fang wrote a book on pediatrics titled You You Xin Shu (The Heart Book of Pediatrics) which sits on the shelf in front of me as I write this introduction. In the Ming dynasty (1368-1644 CE), a number of influential pediatricians summarized their experiences and theories in various books on TCM pediatrics.
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