Main complaint: What should I do about breastfed diarrhea, which is green and watery? The child is 7 months old.
At first glance: It seems to be a cold syndrome.
However, we still need to look at the ten questions.
Stool: The child has diarrhea about 5-8 times a day, with green watery stools, occasionally resembling egg drop soup, with a sour smell, consistently sour but not very foul.
Cold and heat: Does not like to be covered with a blanket, often kicks one foot out.
Urine: Urine is yellow, with slightly reduced volume.
Appetite: No significant change in appetite.
Sleep: Tosses and turns while sleeping.
Perspiration: Sweats a lot, especially at the back of the head and back.
Thirst: Likes to drink water.
Body temperature: The palms have always been very hot since a young age.
Other: There is a slight odor in the mouth.
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Normal conditions do not need to be discussed:
2. Does not like to be covered with a blanket, often kicks one foot out.4. No significant change in appetite.
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These indicate internal patterns:
1. Green watery stools.3. Yellow urine with slightly reduced volume.5. Tossing and turning while sleeping.
6. Sweats a lot, especially at the back of the head and back.7. Likes to drink water.8. Palms have always been very hot since a young age.10. There is a slight odor in the mouth.
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Among these, some indicate localized heat due to food stagnation:
3. Yellow urine with slightly reduced volume.5. Tossing and turning while sleeping.
6. Sweats a lot, especially at the back of the head and back.7. Likes to drink water.8. Palms have always been very hot since a young age.10. There is a slight odor in the mouth.
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Green diarrhea is considered evidence of a deficiency-cold syndrome.
Therefore:
3.5.6.7.8.10 all indicate heat due to food stagnation.
1 indicates deficiency-cold evidence.
Thus, our treatment direction should be: food stagnation + internal deficiency-cold.
Baohe Granules (保和颗粒) primarily address food stagnation while also considering a certain degree of deficiency-cold.
The recommendation is to use Baohe Granules, with the dosage being one-third of the adult dosage since the child is 9 months old.
Feedback: After taking Baohe Granules for two days, the child now has diarrhea 2-3 times a day, which is mushy and deep green, not yellow. It was suggested that she no longer needs to take medicine.
In fact, every case consistently revolves around differentiating cold and heat, clarifying the cold and heat patterns, and accurately diagnosing will lead to effective treatment, whether through medication or pediatric tui na (推拿).
If the direction of medication is correct, it is only a matter of speed, and it will not worsen or become more serious, nor will it continue to be ineffective, such as persistent cough, diarrhea, or runny nose. Differentiating between cold and heat is relatively easier, while the judgment of yin-yang cold-heat requires training through many cases, allowing oneself to feel how to synthesize judgments through more information. Judging through more evidence will point to one conclusion, which will not be different, and different individuals will arrive at the same conclusion.
Now let’s take a look at this description:
“After a high fever and convulsions, the child’s father panicked, and they were hospitalized. Upon hospitalization, they administered a neuro-inhibitory drug, resulting in 6 hours of drowsiness, followed by intravenous fluids. After the infusion, the tongue coating was extremely greasy, and all blood cell counts, including white blood cells, red blood cells, hemoglobin, and platelets, were all reduced. After 4 days, the fever subsided, and a rash appeared, with poor spirit, coughing and diarrhea. This indicates a transition to a Taiyin (太阴) (internal deficiency-cold) condition, and only Chinese medicine adjustment helped; she has not had diarrhea for 9 months.”
A series of descriptions point to one judgment, which is a transition to a yin syndrome.
The overall transition indicates internal deficiency-cold, with drowsiness belonging to Shaoyin (少阴) disease (but desiring sleep; of course, Yangming (阳明) can also have drowsiness, but this case is not), and the greasy tongue coating is a manifestation of Taiyin internal deficiency-cold damp stagnation, as is the subsequent diarrhea.
Although a decrease in blood counts cannot be used as a basis for judging internal deficiency-cold, it is consistent with the judgment of internal deficiency-cold, indicating an overall decline in life functions. Nowadays, there are increasing cases of leukemia in children, many of which are actually the result of prolonged intravenous therapy (common for over ten days or longer), which manifests as a transition to a yin syndrome. This is merely a temporary change in blood measurement indicators and does not necessarily mean it is permanent. If timely adjustment through Chinese medicine is sought, recovery is possible. However, if leukemia is treated, it is mostly irreversible.
A friend previously asked about hydrocele and pediatric hernia, which occurs when the small intestine drops from the abdominal cavity into the groin or scrotum. Most clinical cases encountered are due to insufficient Yang Qi (阳气), indicating a yin syndrome and deficiency-cold syndrome. Supporting the righteous Qi through moxibustion and other methods can yield good results, and surgery is not necessarily required. Some can self-heal because the growth process of children is a process of increasing Yang Qi; when Yang Qi is sufficient, it will resolve.
A TCM doctor friend mentioned an interesting case, stating that after recovery, when the child cried or when there was a change in weather, there would be slight relapses.
Why does crying have an impact?
It is actually a simple principle: when crying, the Qi and blood tend to move outward and upward, leading to relative insufficiency of Qi, blood, and body fluids internally, exacerbating internal deficiency-cold, accompanied by increased abdominal pressure, which can cause a relapse. This phenomenon of dropping is referred to in some texts as “organ Qi sinking,” but it is essentially due to insufficient Yang Qi preventing the organs from maintaining their normal position, akin to a soft, limp spring. This internal deficiency-cold can also be addressed with the Nanhuaijin (南怀瑾) navel paste.
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Q&A section
Q: Is green watery stool a sign of Taiyin?A: Watery diarrhea that is not foul-smelling or black can be considered cold.Q: If this internal deficiency-cold is not resolved, is it easy to develop food stagnation + external wind-cold?A: Yes.Q: Does food stagnation generate internal heat, hence the hot palms?A: Correct.Q: Does the internal heat generated by food stagnation resolve simply by eliminating the food stagnation?A: Yes.Q: Is a greasy tongue coating indicative of internal deficiency-cold?A: A greasy tongue coating indicates dampness, which can be either damp-heat or cold-damp; cold-damp is caused by internal deficiency-cold.
Case handling
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Written by: Yang Qiandong
Edited by: Guo Shala
Related reading
Check the cold and heat of the illness before buying medicine, I say.
How to determine if a child has food stagnation.
