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Thrush in infants is a common oral condition in pediatrics, often occurring in newborns, especially in premature babies and those with weak constitutions or prolonged illnesses. It is characterized by white patches covering the mouth and tongue of the affected child, resembling thrush, hence the name. It is commonly referred to as "thrush."

bubble_chart Pattern Analysis

1. Excessive Heat in the Spleen︰The infant's mouth and tongue are covered with white patches resembling snow, with a flushed face and red lips, fetid mouth odor, drooling, dysphoria, restlessness, crying, severe constipation, scanty dark urine, a red tongue texture, and a white greasy coating, with purple and stagnant finger veins. This condition is due to heart and spleen heat accumulation causing thrush, often resulting from the fetus inheriting maternal heat toxin or external contraction of warm-heat pathogens. The heat accumulates in the heart and spleen, and since the tongue is the sprout of the heart and the mouth is the orifice of the spleen, excessive heart and spleen fire rises along the Taiyin and Shaoyin meridians, scorching the mouth and tongue, leading to thrush, which is categorized as excess heat. Clinically, the white patches in the mouth are slightly thick, overlapping, and resemble coagulated milk curds, sticking together and difficult to remove, reappearing after wiping, surrounded by a deep red halo. If they spread throughout the mouth, extend to the nasal passages, reach the throat, and obstruct the airway, breathing difficulties and nursing problems may occur, often accompanied by fetid mouth odor and drooling. Due to heat toxin stagnation, symptoms like a flushed face, red lips, crying, dysphoria, restlessness, and severe constipation may also appear. Treatment should focus on clearing heat and purging fire, with the representative formula being Qingre Xiesan San. If severe constipation persists, Hangxie Dan may be added to promote bowel movements and expel heat.
2. Spleen-kidney Yin Deficiency︰The mouth, cheeks, and tongue are covered in snow-white patches, accompanied by physical weakness, pale complexion with flushed cheeks, dry mouth without desire to drink, or loose stools. The tongue texture is pale with thin white coating, and the finger veins appear faint and indistinct. Thrush due to spleen-kidney yin deficiency arises from congenital insufficiency or prolonged illness with improper care, leading to dual depletion of kidney yin and spleen fluids. Insufficient water fails to restrain fire, resulting in yin deficiency with effulgent fire and deficiency fire flaming upward, manifesting as thrush. Clinically, the white patches in the mouth are relatively thin and pale, resembling frost, with less pronounced surrounding redness and mild pain. Fetid mouth odor and drooling are minimal. This is rootless fire, with deficiency fire floating upward, hence the flushed cheeks, pale complexion, physical weakness, and loose stools. Treatment should focus on nourishing water to restrain fire and returning fire to its origin. The representative formula is Six-Ingredient Rehmannia Pill with the addition of Cassia Bark.

The clinical manifestations of this condition vary in severity. For mild cases, external treatment can be used: clean gauze or cotton is dipped in cold boiled water to first wipe away the white spots inside the mouth, and then Borneol and Borax Powder is applied, 3 to 5 times a day. For severe cases, both internal and external treatments are combined.

bubble_chart Documentation

1. Beiji Qianjin Yaofang．The second chapter on newborns: "When a newborn baby has thrush, there will be white debris like rice on the tongue; in severe cases, it can also be found in the nose. This is due to the strong grain energy the baby received in the womb. Or it may be caused by the mother's craving for sticky rice during pregnancy. The treatment method is to wrap hair around the end of a chopstick, dip it in well water, and gently wipe the affected area. Repeat this for three days, and it will fall off; if it does not, boil chestnut juice until concentrated, wrap cotton around the chopstick, and wipe with it. If chestnuts are not available in spring or summer, boil chestnut bark and use it in the same way as well water."
2. 《Ying Tong Bai Wen．aphtha．thrush．Chong E》: "Chao Shi said: The condition of thrush is when a newborn baby has white debris all over the mouth and tongue, resembling the mouth of a goose, hence the name thrush. This is due to fetal heat with the heart and spleen being most vigorous, causing the heat to rise to the mouth. Ge Shi used hair wrapped around a finger, dipped in well water to wipe it, and at bedtime, used red lead that has been heated to remove the fire energy, sprinkled on the tongue."
3. Waike Zhengzong．thrush》: "Thrush is caused by fetal heat from the heart and spleen meridians rising upwards, leading to white patches like snowflakes all over the mouth; in severe cases, the throat may swell repeatedly, making breastfeeding difficult and causing frequent crying. Wrap a piece of blue gauze around the end of a chopstick, dip it in freshly drawn water, and wipe off the white coating until clean, even if it causes bleeding. Then apply Borneol and Borax Powder, and take cooling and soothing medicine internally."