Pediatric+Developmental+and+Constitutional+problems

**A. The Five Slows – Wu Chi -** Slower than normal standing, movement, hair growth, teeth growth and speaking **1. Liver and Kidney Deficiency –** Weakness of sinews and bones, obviously abnormally slow development sitting up, standing and moving erect, slow development of the teeth //Jia Wei Liu Wei Di Huang Wan// **2. Heart Blood Xu –**Intelligence not complete, listlessness, no speech after several years, speech not clear and intelligible, pale skin color, withered and yellowish hair, poor appetite, constipation T: no coating //Chang Pu Wan:// Dang Shen, Dang //Gui, Chuan Xiong, Yuan Zhi, Shi Chang Pu//

**B. Five Softs - Wu Ruan –** soft head, and neck, a weak mouth,soft hair, weak feet and soft muscles **1. Spleen and Kidney Xu** – Head and neck soft and weak, neck not able to hold the head upright, soft mouth, and weak gums, not able to suckle, flowing drool, soft hair, weak feet and inability to stand up, no strength in movement //Bu Shen Di Huang Wan + Buzhong Yi Qi Tang//

**2. Qi and blood xu –** Soft, weak body and limbs, soft joints, listlessness, slow intelligence, pale complexion, lack of warmth in the 4 limbs, opening mouth and tongue lolls out, pale lips, and not much tongue coat. //Ba Zhen Tang// GV20, Si Shen Cong, GV14, AnMian, GV 15, PC6, YinTang, Li4, St36

**36. Cerebral Palsy and infantile paralysis** DESCRIPTION A term used to decribe a group of patients with a non-progressive disorder of movement or posture that is a result of a central nervous system abnormality that occurred prenatally, perinatally, or during the first three years of life. HERBS OF CHOICE //**Lu Rong - Cornu Cervi Pantotrichum**// //Invigorate kidney-yang, supplement essence and blood and strengthen the tendons and bones// //**Pharmacological Actions:**// //(a). It is a tonic, promoting gastrointestinal peristalsis, accelerating the healing of ulcer or wound, and increasing the level of red blood cell, hemoglobin and reticulocyte. (b). Increasing myocardial contractility, heart rate and cardic output. (c).Exerts a gonadotropic effect.// //**Gou Qi Zi:-Fructus Lycii**//: //Nourish yin, enrich blood, benefit essence and improve visual acuity: For deficiency of liver-yin and kidney-yin and insufficiency of essence and blood manifested as dizziness, blurring of vision, hypopsia, tinnitus, emission and soreness of the loin and extremities; also for diabetes.// //**Pharmacological Actions:**// //It contains vitamins C, B1 and B2, carotene, nicotinic acid, ß-sitosterol and betaine, and can relieve the liver damage induced by CCl4 in mice.//

<span style="font-family: Times New Roman,serif;">//(a) Warm the kidney and strengthen yang: For deficiency of kidney-yang manifested as impotence, emission, enuresis, frequent micturition and sterility. (b). Strengthen the tendons and bones, expel cold and dampness: For hypofunction of liver and kidney manifested as weakness of extremities, lessitude and cold pain of the waist and knees; or chronic rheumatism with arthralgia, weakness, cold pain of the joints, fatigue and pale tongue.// //**Pharmacological Actions:**// //(a). Exerting androgen-like effect. (b). Promoting the luteinizing action of the hypothalamus-pituitary-ovary system. (c). Promoting the development of immature granulocytes.//
 * <span style="font-family: Times New Roman,serif;">//**Ba Ji Tian - Radix Morindae Officinalis**//

<span style="font-family: Times New Roman,serif;">//**Shu Di Huang - Radix Rehmanniae Praeparata**// <span style="font-family: Times New Roman,serif;">//Produce essence and enrich blood: For insufficiency of essence and blood manifested as sallow complexion, fatigue, dizziness, palpitation, menoxenia and metrorrhagia. (b). Nourish yin and moisturize dryness: For deficiency of liver-yin and kidney-uin manifestes as hectic fever, night sweat, emission and diabetes; also used for prurigo due to dryness of blood, muscular spasm due to blood-deficiency or yin-deficiency, and constipation due to insufficiency of blood fluid and blood. (c). Invigorate the liver and kidney: For backache with knee aching due to deficiency of liver and kidney, such as chronic limbar strain, hyperplasia of lumbar vertebra, etc.; for endemic osteoarthritis deformans, also for dyspnea and chronic cough of kidney-deficiency type. Recently used singly for hypertension and hypercholesterinemia.// //**Pharmacological Actions:**// //(a). Exerting an anti-exudative and anti-inflammatory effect on inflammatory granulation in rats. (b). Cardiotonic, hypotensive and diuretic. (c). Catalpol, one of its active component, is an anti-diabetic.// //**Caution:**// //Contraindicated for those with loose stools and accumulation of dampness.//

<span style="font-family: Times New Roman,serif;">//**Rou Cong Rong -Herba Cistanches**// <span style="font-family: Times New Roman,serif;">//(a). Invigorate the kidney and supplement essence: For deficiency of kidney-yang and insufficiency of essence and blood manifested as impotence, emission, prem. ejaculation, sterility, flaccidity of extremities and cold pain of the waist and knees. (b). Moisturize the intestine and relax bowels: For constipation due to dryness of the intestine in the aged, and the diseased, and the puerperant with deficiency of blood and consumption of body fluid.// //**Pharmacological Actions:**// //(a). Hypotensive. (b). Promoting saliva secretion.//

<span style="font-family: Times New Roman,serif;">//**Huang Qi -Semen Astragali Complanati**// <span style="font-family: Times New Roman,serif;">//Warming and reinforcing liver and kidney, arresting seminal discharge, decreasing urination, pronoting vision. Indicated for lumbago due to kidney deficiency, nocturnal emission, premature ejaculation, turbid urine, leukorrhagia, dribbling of urine after urination, dizziness and blurred vision.//

<span style="font-family: Times New Roman,serif;">//**Hu Po -Succinum**// <span style="font-family: Times New Roman,serif;">//(a). Tranquilize the mind: For palpitation and restlessness, insomnia and dreaminess, and amnesia; for acute intantile convulsion and epilepsy, mania, etc. (b). Promote blood circulation to remove blood stasis: For amenia, menalgia, epigastric pain, abdominal mass and trauma with blood-stasis syndrome. (c). Promote diuresis and relieve stranguria: For stranguria complicated by hematuria, stranguria of heat type, urinary stone, and retention of urine.// //Pharmacological Actions:// //Sedative and diuretic.//

<span style="font-family: Times New Roman,serif;">//**Shan Zhu Yu**// //**Fructus Corni**// <span style="font-family: Times New Roman,serif;">//**(a). Invigorate the liver and kidney, supplement the essence and improve visual acuity: For deficiency of the liver and kidney manifested as soreness of the waist and knees, flaccidity of lower limbs, impotence, frequent micturation, sterility, dizziness, tinnitus and blurring of vision. (b). Astringe and preserve essence: For hypofunction of liver and kidney manifested as emission, enuresis, frequent micturation, metrorrhagia, menorrhagia, spontaneous perspiration, night sweat, collapse with profuse perspiration and dyspnea of asthenic type.**// //**Pharmacological Actions:**// //**(a). Relieving cyclophosphamide-induced leukopenia inmice. (b). Diuretic and hypotensive. (c). Inhibiting the growth of Bacillus dysenteriae in vitro.**//

<span style="font-family: Times New Roman,serif;">//**Ren Shen Radix Ginseng**// <span style="font-family: Times New Roman,serif;">//**(a). Invigorate vital energy and relieve collapse-syndrome: For collapse-syndrome with listlessness. weak respiration and indistinct pulse; single use for exhaustion of vital energy or blood; for yin-exhaustion; for yang-exhaustion. Recently, also used for heart failure and shock. (b). Invigorate spleen-energy: For spleen-deficiency syndrome manifested as poor appetite, fatigue and emaciation, hemorrhagic diseases, prolapse of uterus and rectum, visceroptosis and anemia. (c). Promote the production of body fluid to quench thirst: For febrile diseases with consumption of body fluid, and diabetes. (d). Invigorate lung-energy: For deficiency of lung-energy manifested as shortness of breath, dyspnea, cough, night sweat, and susceptibility to common cold. (e). Invigorate wei-energy: For common cold in debilitated patient, pyogenic skin infection and carbuncle of yin type. (f). Supplement vital energy and calm the mind: For deficiency of heart energy manifested as palpitation, amnesia, insomnia, absent-mindedness, spontaneo**////us, perspiration, cardiodynia, etc. In addition, also for impotence, sterility, emission, ejaculatio praecox, enuresis, etc.// //**Pharmacological Actions:**// //It contains many ginsenosides, such as ginsenoside R0, Ra, Rb1, Rb2, Rc, Rd, Re, Rf, Rg1, Rg2, Rg3, etc. (a). Action on the central nervous system including excitation and inhibition processes. (b). Exerting significant cardiotonic and hypertensive effects on acute circulatory failure after heavy blood loss. (c). Decreasing the level of blood sugar. (d). Promoting phagocytosis and enhancing lymphocyte-blastogenesis rate.// <span style="font-family: Times New Roman,serif;">CLINICAL SUCCESS IN CHINA Chinese herbal doctors have reported some successful applications of these herbal combinations. During observation on 42 patients receiving treatment with herbal remedy, 12 cases were judged as significant improvement in mental, 25 cases other moderate improvement. 16 cases were judged as significant improvement in movement, 18 cases other moderate improvement. Physicians judged the clinical efficacy to be good or excellent in 84.5%, 81.0% in mental and movement respectively || <span style="font-family: Times New Roman,serif;">In cerebral palsy (CP), faulty development or damage to motor areas in the brain impair the body's ability to control movement and posture. This results in a number of chronic neurological disorders. Cerebral palsy is usually associated with events that occur before or during birth, but may be acquired during the first few months or years of life as the result of head trauma or infection. <span style="font-family: Times New Roman,serif;">Cerebral palsy is neither contagious nor inherited, nor is it progressive. The symptoms of cerebral palsy differ from person to person and change as children and their nervous systems mature. <span style="font-family: Times New Roman,serif;">Some persons with severe cerebral palsy are completely disabled and require lifelong care, while others display only slight awkwardness and need no special assistance. Complications associated with cerebral palsy include learning disabilities, gastrointestinal dysfunction, tooth decay (dental caries), sensory deficits, and seizures. <span style="font-family: Times New Roman,serif;">In about 70 percent of cases, cerebral palsy results from events occurring before birth that can disrupt normal development of the brain. Contrary to common belief, lack of oxygen reaching the fetus during labor and delivery contributes to only a small minority of cases of cerebral palsy, according to a 2003 report by the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP). A small number of babies also develop brain injuries in the first months or years of life that can result in cerebral palsy. In many cases, the cause of cerebral palsy in a child is not known.
 * |||| <span style="font-family: Times New Roman,serif;">Cases |||| <span style="font-family: Times New Roman,serif;">Significant improvement  || <span style="font-family: Times New Roman,serif;">Moderate improvement  |||| <span style="font-family: Times New Roman,serif;">Total  ||||   ||
 * <span style="font-family: Times New Roman,serif;">cases |||| <span style="font-family: Times New Roman,serif;">%  ||||^   ||
 * <span style="font-family: Times New Roman,serif;">42 |||| <span style="font-family: Times New Roman,serif;">mental  |||||| <span style="font-family: Times New Roman,serif;">12  |||| <span style="font-family: Times New Roman,serif;">25  || <span style="font-family: Times New Roman,serif;">37  ||
 * ^  |||| <span style="font-family: Times New Roman,serif;">movement  |||||| <span style="font-family: Times New Roman,serif;">16  |||| <span style="font-family: Times New Roman,serif;">18  || <span style="font-family: Times New Roman,serif;">34
 * ^  |||| <span style="font-family: Times New Roman,serif;">movement  |||||| <span style="font-family: Times New Roman,serif;">16  |||| <span style="font-family: Times New Roman,serif;">18  || <span style="font-family: Times New Roman,serif;">34

<span style="font-family: Times New Roman,serif;">Some of the known causes of cerebral palsy include: <span style="font-family: Times New Roman,serif;">There are three major types of cerebral palsy, and some individuals may have symptoms of more than one type. <span style="line-height: 100%; margin-bottom: 0.02in; margin-left: 0.25in; margin-top: 0.02in; orphans: 2; widows: 2;">//<span style="font-family: Times New Roman,serif;">Flaccid Pattern: //<span style="font-family: Times New Roman,serif;"> Tonify Sp & K: St36, Sp6, Li4, Bl23, Bl20. GV16 //<span style="font-family: Times New Roman,serif;">Spastic pattern: //<span style="font-family: Times New Roman,serif;"> Li4, Liv3, Abd Pain CV12 //<span style="font-family: Times New Roman,serif;">Li 15, TW14, Li14, 11, 4, TW 5, Si3, // //<span style="font-family: Times New Roman,serif;">St 31, 34, 36, 39, 41, Sp10, Sp6, 4, Liv8, Liv5, 4, 3, K7, 3, Bl54, 57, 60, GB points too // //<span style="font-family: Times New Roman,serif;">Scalp: Dr. Dao, Ju, Tan… // //<span style="font-family: Times New Roman,serif;">**Infantile Paralysis-** ////<span style="font-family: Times New Roman,serif;">Hua Tuo Jia Ji – good prognosis // <span style="font-family: Times New Roman,serif;">**Week10 – finish up – if time – requests accepted**
 * //<span style="font-family: Times New Roman,serif;">Infections during pregnancy: //<span style="font-family: Times New Roman,serif;"> Certain infections in the mother, including rubella (German measles), cytomegalovirus (a usually mild viral infection) and toxoplasmosis (a usually mild parasitic infection) can cause brain damage and result in cerebral palsy. Recent studies suggest that maternal infections involving the placental membranes (chorioamnionitis) may contribute to cerebral palsy in full-term as well as preterm babies (those born before 37 completed weeks of pregnancy). A 2003 study at the University of California at San Francisco found that full-term babies were four times more likely to develop cerebral palsy if they were exposed to chorioamnionitis in the womb. Reproductive/urinary tract infections also may increase the risk of preterm delivery, another risk factor for cerebral palsy.
 * //<span style="font-family: Times New Roman,serif;">Insufficient oxygen reaching the fetus: //<span style="font-family: Times New Roman,serif;">For example, when the placenta is not functioning properly or it tears away from the wall of the uterus before delivery, the fetus may not receive sufficient oxygen.
 * //<span style="font-family: Times New Roman,serif;">Prematurity: //<span style="font-family: Times New Roman,serif;">Premature babies who weigh less than 3 1/3 pounds are up to 30 times more likely to develop cerebral palsy than full-term babies. Many of these tiny babies suffer from bleeding in the brain, which can damage delicate brain tissue, or develop periventricular leukomalacia, destruction of nerves around the fluid-filled cavities (ventricles) in the brain.
 * //<span style="font-family: Times New Roman,serif;">Asphyxia during labor and delivery: //<span style="font-family: Times New Roman,serif;"> Until recently, it was widely believed that asphyxia (lack of oxygen) during a difficult delivery was the cause of most cases of cerebral palsy. The ACOG/AAP report shows that fewer than 10 percent of the type of brain injuries that can result in cerebral palsy are caused by asphyxia.
 * //<span style="font-family: Times New Roman,serif;">Blood Diseases: //<span style="font-family: Times New Roman,serif;">Rh disease, an incompatibility between the blood of the mother and her fetus, can cause severe jaundice and brain damage, resulting in cerebral palsy. Rh disease usually can be prevented by giving an Rh-negative woman an injection of a blood product called Rh immune globulin around the 28th week of pregnancy and again after the birth of an Rh-positive baby. Blood clotting disorders (thrombophilias) in either mother or baby also may increase the risk.
 * //<span style="font-family: Times New Roman,serif;">Severe jaundice: //<span style="font-family: Times New Roman,serif;">Jaundice, yellowing of the skin and the whites of the eyes caused by the build-up of a pigment called bilirubin in the blood, occasionally becomes severe. Without treatment, severe jaundice can pose a risk of permanent brain damage resulting in athetoid cerebral palsy.
 * //<span style="font-family: Times New Roman,serif;">Other birth defects: //<span style="font-family: Times New Roman,serif;">Babies with brain malformations, numerous genetic diseases and other physical birth defects are at increased risk of cerebral palsy.
 * //<span style="font-family: Times New Roman,serif;">Acquired cerebral palsy: //<span style="font-family: Times New Roman,serif;">About 10 percent of children with cerebral palsy acquire it after birth due to brain injuries that occur during the first two years of life. The most common causes of such injuries are brain infections (such as meningitis) and head injuries.
 * //<span style="font-family: Times New Roman,serif;">Spastic cerebral palsy (SCP): //<span style="font-family: Times New Roman,serif;">About 70 to 80 percent of affected individuals have spastic cerebral palsy, in which muscles are stiff, making movement difficult. When both legs are affected (spastic diplegia), a child may have difficulty walking because tight muscles in the hips and legs cause legs to turn inward and cross at the knees (called scissoring). In other cases, only one side of the body is affected (spastic hemiplegia), often with the arm more severely affected than the leg. Most severe is spastic quadriplegia, in which all four limbs and the trunk are affected, often along with the muscles controlling the mouth and tongue. Children with spastic quadriplegia often have mental retardation and other problems.
 * //<span style="font-family: Times New Roman,serif;">Athetoid or dyskinetic cerebral palsy (DCP): //<span style="font-family: Times New Roman,serif;"> About 10 to 20 percent of affected individuals have the athetoid form, which affects the entire body. It is characterized by fluctuations in muscle tone (varying from too tight to too loose) and sometimes is associated with uncontrolled movements (which can be slow and writhing or rapid and jerky). Children often have trouble learning to control their bodies well enough to sit and walk. Because muscles of the face and tongue can be affected, there also can be difficulties with sucking, swallowing and speech.
 * //<span style="font-family: Times New Roman,serif;">Ataxic cerebral palsy (ACP): //<span style="font-family: Times New Roman,serif;">About 5 to 10 percent of affected individuals have the ataxic form, which affects balance and coordination. They may walk with an unsteady gait with feet far apart, and they have difficulty with motions that require precise coordination, such as writing.