bubble_chart Concept

Fetal feebleness generally refers to symptoms of developmental disorders in children, such as low intelligence and weak limbs, due to insufficient innate endowment during their gestation in the mother's body.

Some medical practitioners also refer to the condition where a child in the mother's womb does not grow properly as "fetal feebleness," but this is different from the aforementioned condition and is not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Heart Qi Deficiency and Weakness︰When a newborn baby has a dull and dark complexion, pale and bloodless skin, lies lethargically with restless palpitations, or exhibits a bluish-purple complexion and cold limbs, it is because the heart governs mental activity and blood vessels, and its vitality manifests in the face. Therefore, insufficiency of heart qi causes the baby to lie lethargically with restless palpitations and a dull, lifeless complexion. If heart qi is deficient and weak, leading to blocked vessels, a bluish-purple complexion and cold limbs may be observed.
2. Liver Qi Deficiency︰At birth, the infant's face is pale and dull, the eyes are open but do not close, the crying is slow, the hands and feet convulse, the muscles are weak and feeble, the nails are thin and soft, or brittle, cracked, and deformed, dry and lacking luster. The liver governs the tendons, its orifice opens into the eyes, and its vitality manifests in the nails. Therefore, when liver qi is insufficient, infants commonly exhibit a pale and dull complexion, eyes that remain open and unclosed, convulsions in the hands and feet, weak and feeble muscles, thin and soft nails, or brittle, cracked, and deformed nails that are dry and lack luster.
3. Spleen Qi Deficiency︰At birth, the infant's complexion is sallow, the lips are pale and withered, the skin and muscles are thin and weak, the hands and feet appear emaciated, the baby refuses to suckle, cries weakly, has loose stools, and fails to digest milk. The spleen governs transportation and transformation, distributing essential nutrients, is associated with muscles in the body, and opens into the mouth. Therefore, the key diagnostic points of spleen qi deficiency are: a sallow complexion, pale and withered lips, thin and weak muscles, and emaciated hands and feet. If transportation and transformation are impaired, symptoms such as refusal to suckle, weak crying, loose stools, and undigested milk will appear.
4. Lung Qi Deficiency︰At birth, the infant's complexion is pale, with short and intermittent shallow breathing, weak crying resembling moaning, low body temperature, aversion to cold, thin and flaccid skin, grayish skin tone, and absence of hair growth. The lung, being a delicate zang-organ, dominates qi and governs respiration. Therefore, the key diagnostic points for lung qi deficiency are: short, shallow, and intermittent breathing, weak crying resembling moaning. The lung governs the skin and body hair, nourishing and moistening the skin. With lung qi deficiency, manifestations include thin and flaccid skin, as well as absence of hair growth.
5. Kidney Qi Deficiency︰At birth, the infant's face is dark and lacks luster, with excessive white of the eye, weak joints, open cranial sutures, pigeon breast and tortoise back (hunchback), weak limbs, and dull hair. The kidney, being the innate foundation, governs the bone marrow, and its vitality manifests in the hair. Therefore, the key diagnostic points for kidney qi deficiency are: weak joints, open cranial sutures, pigeon breast and tortoise back (hunchback), weak limbs, and dull hair.

Fetal feebleness syndromes all belong to deficiency pattern. There are three causes of the disease: first, the parents have children in their later years, and the essential qi has already declined; second, the mother has multiple pregnancies and births, and the constitution has already weakened; third, the mother has been ill for a long time and is physically weak. At the time of conception, the primordial essence is already deficient, and after conception, the supply of qi and blood is also poor, resulting in insufficient innate endowment of the fetus and weakness after birth. Due to the varying strengths and weaknesses of the functions of the zang-fu organs in the body, the symptoms manifested also differ. Generally, there are the following distinctions:

The growth and development of children rely entirely on the innate kidney qi, and the innate essence relies on the nourishment of the essence of water and grain. Therefore, the treatment of fetal feebleness should preserve the innate kidney qi and supplement the acquired spleen qi. Clinical manifestations, such as those dominated by liver, kidney, and insufficiency of heart qi, should be treated by enriching yin and tonifying the kidney, with the representative formula being Six-Ingredient Rehmannia Pill; if dominated by insufficiency of spleen qi and lung qi, the method should be tonifying qi and invigorating the spleen, with the representative formula being Ginseng, Poria and White Atractylodes Powder.

In summary, for children with fetal feebleness, clinical diagnosis should identify which organ is deficient, so that appropriate adjustments can be made to aid their development. Due to the weak constitution of children with this condition, although they can maintain a minimal standard of living, their lack of adaptability to the external environment results in a lower survival rate.

bubble_chart Documentation

1. 《Infantile Hundred Questions: Fetal Diseases》: "Fetal feebleness results in a dull complexion, thin muscles, white watery stools, a pale body, frequent hiccups, and lackluster eyes. It should be treated with the bathing therapy."
2. Youke Fahui ．Fetal Diseases: "Fetal feebleness is caused by insufficient endowment of qi. The child, being a part of the parents, inherits qi from them. If the lung qi is insufficient, the skin becomes fragile and thin, unable to withstand cold, and hair does not grow; if the heart qi is insufficient, the blood lacks luster and the complexion is dull; if the spleen qi is insufficient, muscles do not develop, and the hands and feet appear emaciated; if the liver qi is insufficient, the tendons do not bind the bones properly, leading to joint stiffness; if the kidney qi is insufficient, the bones become soft. These are diseases of fetal endowment and should be treated according to the deficient organ qi. For insufficiency of liver and kidney qi, the Six-Ingredient Rehmannia Pill should be used; for insufficiency of spleen and lung qi, Ginseng, Poria, and White Atractylodes Powder should be used. The weakness of the child is due to the weakness of the parents' essence and blood. It is said that if the father is strong and the mother is weak, the daughter will be weak; if the father is weak and the mother is strong, the son will be weak. Therefore, symptoms such as a broken head, slow spirit, weak neck, drooping head, weak hands and feet, irregular teeth, non-black hair, and inability to walk, sit, or stand without support are all signs of insufficient fetal endowment. These should all be treated with the Six-Ingredient Rehmannia Pill."