Five kinds of retardation and five kinds of flaccidity are disorders of abnormal development in children. The former refers to the delay of hair growth, teeth eruption, and the ability to of stand, walk and speak, and the latter to the weakness and softness of the neck, mouth, upper and lower extremities and muscles. Clinically both of them usually appear at the same time. Various neuromuscular diseases in modern medicine, such as atelencephalia, cerebral paralysis, etc., may be differentiated and treated with the principles mentioned in this section.

Etiology and Pathogenesis

Congenital deficiency of liver and kidneys or postnatal impairment of the spleen and stomach leading to qi and blood deficiency is responsible for the pathogenesis of these disorders. The five kinds retardation are mainly due to the deficiency of liver and kidneys and the insufficiency of heart-blood, while the five kinds of flaccidity are mainly caused by the deficiency of spleen and kidneys as well as the insufficiency of qi and blood.

FIVE KINDS OF RETARDATION

Syndrome Differentiation and Therapeutic Principles

A. Syndrome Differentiation A mild case manifests itself as unsteadiness of walking, delay of closure of fontanels, tardiness of teeth eruption, restlessness, sleeplessness and polyhidrosis but no disturbance of motor function. In serious cases, there appears muscular flaccidity, inability to stand and speak, sparse, yellow and thin hair, emaciation and listlessness.

B. Therapeutic principles The therapy of tonifying liver and kidneys or that of nourishing heart-blood is recommended. In addition, acupuncture and moxibustion therapy may be used to supplement.

Classification and Treatment

A. Deficiency of the liver and kidneys

Manifestation: Marked delay in the ability to sit and walk, delay in teeth eruption, lusterless complexion, mental fatigue, debility, pale tongue with tin, white tongue coating and thready and weak pulse.

Therapeutic principles: Tonify the liver and kidneys.

Prescription: The Modification of Bolus of Six Drugs Containing Rehmanniae Praeparata

Radix Rehmanniae Praeparata 10 g
Fructus Corni 10 g
Rhizoma Dioscoreae 10 g
Cortex Moutan Radicis 10 g
Poria 10 g
Rhizoma Alismatis 6 g
Semen Cuscutae 10 g
Radix Morindae Officinalis 10 g
Colla Cornus Cervi 10 g
Radix Achyranthis Bidentatae 10 g

B. Insufficiency of heart-blood

Manifestations: Disturbance of mental development, apathy, tardiness of speaking and hair growth, pale skin, poor appetite, pale tongue with little coating and thready and weak pulse.

Therapeutic principles: Tonify the heart, and nourish blood.

Prescription: Pill of Acori Graminei Radix of Ginseng 10 g
Radix Ophiopogonis 10 g
Radix Angelicae Sinensis 6 g
Rhizoma Chuanxiong 3 g
Rhizoma Acori Graminei 10 g
Radix Polygalae 6 g
Cinnabaris (mixed with decoction) 1.5 g
Olibanum 5 g

FIVE KINDS OF FLACCIDITY

Syndrome Differentiation and Therapeutic Principles

A. Syndrome Differentiation Cases attributed to kidney deficiency manifest themselves as flabbiness of the neck with inability to raise the head. Cases attributed to spleen deficiency manifest themselves as flabbiness of mouth, upper and lower extremities and muscles.

B. Therapeutic principles Tonify the spleen and kidneys, benefit qi and nourish blood are the main therapeutic principles for these disorders.

Classification and Treatment

Deficiency of the spleen and kidneys

Manifestations: Softness and weakness of the neck with inability to raise the head, dysmasesia with salivation, wrist drop with inability to clench fist, hypokinesia of lower extremities, muscular flabbiness, pale lips, little tongue coating and feeble pulse.

Therapeutic principles: Tonify the spleen and kidneys.

Prescription: The Modification for Decoction for Strengthening Middle-Jiao and Benefiting Qi and Rehmanniae Decoction for Invigorating the Kidneys

Radix Rehmanniae Praeparata 10 g
Fructus Corni 10 g
Rhizoma Dioscoreae 10 g
Cortex Moutan Radicis 10 g
Poria 10 g
Rhizoma Alismatis 10 g
Cornu Cervi Pantotrichum 10 g
Radix Achyranthis Bidentatae 3 g
Radix Ginseng 10 g
Radix Astragali 15 g
Rhizoma Atractylodis Macrocephalae 10 g
Radix Angelicae Sinensis 10 g
Radix Bupleuri 5 g
Rhizoma Cimicifugae 3 g
Pericarpium Citri Reticulatae 6 g
Radix Glycyrrhizae Praeparata 6 g

Remarks: Add Ramulus Cinnamomi (5 g) and Ramulus Mori (10 g) for cases with flabbiness of upper extremities. Add Cortex Eucommiae (10 g) and Cortex Acanthopanacis Radicis (10 g) for those with flabbiness of lower extremities. For cases with flabbiness of mouth, add Radix Astragali (15 g) to tonify the spleen and benefit qi. For cases with polyhidrosis, add Os Draconis (decocted first, 15 g), Concha Ostreae (decocted first, 15 g) and Fructus Schisandrae to arrest sweating and suppress the hyperactive yang. For cases with restlessness during sleep, add Semen Ziziphi (10 g) and Ramulus Uncariae cum Uncis (10 g) to calm the mind.

Copyright 1995 Hopkins Technology