bubble_chart Concept

Infantile malnutrition with accumulation refers to the symptoms of emaciated body, dry hair, large head and thin neck, abdominal distension and fullness, and irregular bowel movements in children.

"Gujin Yijian" states: "The various types of malnutrition are caused by excessive consumption of rich and sweet foods...

This condition has numerous names in classical medical texts, Yizong Jinjian includes names such as infantile malnutrition involving the spleen, infantile malnutrition involving the heart, infantile malnutrition involving the lung, stomach malnutrition, and infantile malnutrition involving the liver. Nowadays, it is commonly referred to as "infantile malnutrition with accumulation."

bubble_chart Pattern Analysis

1. Spleen and Stomach Damage︰The complexion is sallow and lusterless, the body is emaciated, the hair is dry, and the spirit is listless. There is a reluctance to eat, abdominal distension and fullness, a distended belly, or vomiting after eating, a feverish feeling in the palms and soles, irritability and easy crying, restlessness and thirst, restless sleep at night, loose stools or constipation, yellow and turbid urine, or urine resembling rice water, a greasy tongue coating, and a pulse that is soft, thin, and slippery or rapid. The fingerprints are pale and sluggish. Due to irregular eating habits or overeating, the spleen and stomach's functions of transportation and transformation are impaired. The spleen and stomach are the "granary officials," responsible for receiving, transporting, and transforming water and grain. The essence they produce nourishes the zang-fu organs, enriches the body, and moistens the hair. If one indulges excessively in rich, sweet, or raw and cold foods, the spleen and stomach are injured, disrupting their transportation and transformation functions. As a result, the source of the essence from water and grain becomes insufficient, leading to deficiencies in qi and blood. The zang-fu organs and skin lose their nourishment, manifesting as a sallow complexion, emaciation, and dry hair. This condition is characterized by deficiency with underlying excess, as prolonged food retention transforms into heat, which damages fluids. The spleen governs dampness, and when the spleen is injured, dampness fails to be transported. Thus, signs of dampness-heat damaging yin appear. Key diagnostic points include the feverish feeling in the palms and soles, restlessness and thirst, abdominal distension and fullness with hardness and tenderness upon pressure, a yellow and greasy tongue coating, and yellow, turbid urine or urine resembling rice water.
2. Post-illness Disharmony︰Complexion shallow yellow, appearing haggard, dry and brittle hair, listlessness, no desire to eat or poor digestion, epigastric abdominal distension and fullness, cold limbs, restless sleep, eyes not fully closed when sleeping, occasional crying with weak cries, pale tongue color, thin and weak pulse, and faint finger vein color. This is often due to inadequate recuperation after illness, prolonged vomiting and diarrhea, or excessive use of purgative medications, leading to severe depletion of qi and yin, body fluids drying up, spleen-stomach weakness, and loss of nourishment, resulting in symptoms such as complexion shallow yellow, haggard appearance, and emaciation. Both are deficiency patterns, but they are purely deficiency patterns. Due to spleen-stomach weakness, food cannot nourish the skin and muscles, and qi and fluids are gradually depleted, leading to dual damage to qi and yin and loss of nourishment. Hence, there is listlessness, cold limbs, eyes not fully closed when sleeping, and dry and brittle hair. Although there is epigastric abdominal distension and fullness, it is mostly soft rather than hard and is characterized by a preference for rubbing or pressing. The treatment principle should be based on constitution and specific conditions, adopting methods such as first dispersing and then tonifying, first tonifying and then dispersing, or combining both dispersing and tonifying. For example, in the initial stage [first stage] where excess symptoms are prominent, Xiaogan Li Pi Tang (Digestion-Promoting and Spleen-Regulating Decoction) with modifications can be used; for retention of food transforming into heat, Xiang Lian Dao Zhi Tang (Costus and Coptis Stagnation-Resolving Decoction) can be used; for cases with both deficiency and excess, Chubby Child Pill with modifications can be employed. For cases of post-illness imbalance and spleen-stomach weakness, the treatment should focus on supporting the spleen and nourishing the stomach, using Ginseng, Poria and White Atractylodes Powder with modifications, or Ginseng Qi Pi Wan (Ginseng Spleen-Activating Pill) to strengthen the spleen, regulate qi, and resolve malnutrition.

Although the manifestations of this condition are numerous, its primary mechanism of disease is injury to the spleen and stomach, leading to sluggish transportation and transformation functions, resulting in the inability of water and grain essence to nourish the body, leading to deficiency of qi and fluids, and lack of nourishment of qi and blood. The spleen and stomach are the foundation of postnatal life, and damage to them can lead to dysfunction of other zang-fu organs, resulting in symptoms of infantile malnutrition: such as a bluish complexion and nails, difficulty opening the eyes due to eye discharge and tears, which is infantile malnutrition involving the liver; a red face and red eye vessels, frequent irritability, and sores in the mouth and tongue, which is infantile malnutrition involving the heart; a pale complexion, counterflow cough, and sores on the nose and cheeks, which is infantile malnutrition involving the lung; a dark and sallow complexion, emaciation, cold feet, abdominal pain, and diarrhea, which is infantile malnutrition involving the kidney. There are also conditions such as gan diarrhea, infantile nutritional edema, gan fever, gan dysentery, infantile malnutrition due to ascariasis, as well as nasal vestibulitis and ulcerative gingivitis. Although there are many different syndromes, the root lies in the spleen. When treating various types of infantile malnutrition, it is crucial to first consider the healthy functioning of the spleen and stomach, as this is the key to treating gan.

bubble_chart Documentation

1. Youyou Jicheng．"Treatment of Infantile Malnutrition": "In all cases of malnutrition where the body is not robust, it is due to the decline of qi. If the complexion is not radiant, it is due to the weakness of blood. When qi declines and blood is weak, it is known that the spleen and stomach must be damaged. Some cases are caused by insufficient breastfeeding in infancy, when the intestines and stomach are not yet strong, and early introduction of solid food depletes vital qi, leading to malnutrition. Others are caused by excessive consumption of rich and sweet foods, overeating, and prolonged retention of food, resulting in a sallow complexion and emaciation. Some cases are due to the mother's irregular diet or emotional disturbances, or breastfeeding after excessive sexual activity, leading to malnutrition. In children aged two or three, indulgence in grains, meat, fruits, and vegetables can cause stagnation in the middle energizer, leading to food accumulation and eventually malnutrition. Additionally, excessive purging to remove accumulation can deplete stomach qi, or severe illnesses such as vomiting, diarrhea, malaria, or dysentery, followed by reduced breastfeeding, can lead to poor nourishment of the spleen and stomach. Although the causes differ, they all ultimately result in deficiency."