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Whenever I discuss a formula or a medicinal product, I often receive many comments like, “I have a phlegm-damp constitution, is it suitable for me?” or “I have a yang deficiency constitution, what should I pay attention to?” It seems that everyone is quite clear about the characteristics of adult constitutions, but what about children’s constitutions? What are their characteristics? What should we pay attention to in their care? How can we prevent diseases by understanding their constitution?
Today, we will discuss the various aspects of children’s constitutions.
Balanced Constitution
Constitution Characteristics: Children with a balanced constitution develop normally, have a well-proportioned body, are lively and responsive, have a rosy complexion, bright eyes, a strong voice, firm muscles, normal appetite, and regular bowel movements. Children over one year old can sleep through the night, adapt well to climate changes, rarely get sick, and are not prone to allergies. Their tongue is light red with a thin white coating, and their fingerprints are neither too red nor too pale, subtly visible.
Formation Factors: Adequate congenital endowment and proper postnatal nourishment.
Health Care and Treatment: These children grow and develop normally, have sufficient nutrition, and possess strong resistance to external pathogens. However, since they are still in the growth phase, their organ functions and vital substances are not fully developed. Care should be taken to ensure they have a balanced diet, avoid picky eating, maintain regular routines, and engage in appropriate physical activity to supplement their nutritional needs and strengthen their bodies. If they occasionally experience external pathogens (wind, cold, heat, dampness, dryness, fire) or dietary irregularities, they commonly present with lung and spleen-related symptoms. Treatment should focus on expelling pathogens and appropriately adjusting spleen and stomach functions, avoiding excessive tonification. Overuse of warming tonics can generate internal heat, while inappropriate use of cold substances can damage yang energy. Children with a balanced constitution have strong recovery abilities; as long as the triggering factors are removed and organ functions are adjusted, recovery is usually straightforward, as the saying goes, “When the organs are clear, recovery is easy.”
Phlegm-Damp Constitution
Constitution Characteristics: Children with a phlegm-damp constitution may appear slightly overweight, with some having high body weight while others have soft muscles that make them look plump despite normal weight. They often have a pale complexion lacking rosy hues, show limited facial expressions, and exhibit slow movements, preferring stillness over activity. They tend to feel cold and sweat easily, often having colder hands and feet than their peers, even when dressed similarly. They enjoy sleeping, and some may snore lightly. They prefer sweet and fried snacks, have poor appetites during meals, and may experience bloating if overfed. Their bowel movements are sticky, and they tend to have more coughs and phlegm during colds, making recovery more difficult. Their lips and tongue are pale, sometimes showing teeth marks (scalloped tongue), with a white, slippery, or thick coating, and their fingerprints are bluish and sluggish.
Formation Factors: Insufficient congenital endowment, weak yang energy, and inadequate spleen yang to transform and transport; improper postnatal nourishment leading to internal accumulation of phlegm-damp.
Health Care and Treatment: These children are prone to phlegm-damp and have weak spleens that struggle to transform and transport, making them more susceptible to cold-damp pathogens and dietary issues. It is advisable to increase outdoor activities to invigorate yang energy, reduce the intake of greasy and sticky foods, limit sweets and oily items, and encourage the consumption of light, fresh fruits and vegetables. When the tongue coating is thick and there are teeth marks, it may be appropriate to take Six Gentlemen Pills (Liu Jun Zi Wan) or Fragrant Sand Six Gentlemen Pills (Xiang Sha Liu Jun Zi Wan) to strengthen the spleen and resolve dampness.
Qi Deficiency Constitution
Constitution Characteristics: Children with a qi deficiency constitution often appear frail, resembling a “weak scholar”. They tend to be slightly underweight, rarely make loud noises, speak softly, and do not enjoy high-energy sports. They feel cold easily and sweat frequently, have poor appetites, and may experience diarrhea if they eat poorly. Their bowel movements often take a long time, and they are more susceptible to colds, with longer recovery times. The saying goes, “Wherever evil gathers, qi must be deficient,” which describes this situation. Their tongue is pale, with little coating, and their fingerprints are faint.
Formation Factors: Often due to insufficient congenital endowment, improper postnatal care, or recovery from a serious illness where spleen and kidney qi has not been restored.
Health Care and Treatment: These children have weaker constitutions and are more susceptible to pathogens, making them more vulnerable to cold attacks. Care should be taken, especially after illness, as they often present with a mix of deficiency and excess. Treatment should focus on supporting the body’s defenses while also addressing deficiencies, ensuring that “expelling pathogens does not harm the righteous, and tonifying deficiencies does not leave pathogens behind.” Avoid excessive use of bitter and cold attacking substances. Additionally, it is important to keep warm and avoid exposure to cold. During fluctuating temperatures and flu seasons, it may be appropriate to take Yao Ping Feng San, Four Gentlemen Pills (Si Jun Zi Wan), or Yi Gong San.
Internal Heat Constitution
Constitution Characteristics: Children with an internal heat constitution are often described as “skinny but energetic”. They are lively, playful, and appear to have boundless energy, often showing a bit of impatience. They generally have good appetites and do not require much encouragement to eat or drink. Sometimes, they may have bad breath, and their stools can be dry, with some children only having bowel movements every few days.
Their tongue is red, with a yellow coating, and their fingerprints are red and purple.
Formation Factors: Often due to congenital heat or accumulation of internal stagnation.
Health Care and Treatment: These children are easily influenced by warm and heat pathogens. During colds, they often exhibit more pronounced heat symptoms. Poor care can lead to internal pathogens that consume fluids. Treatment should focus on clearing internal heat while also incorporating digestive aids to help expel pathogens. In the later stages of treatment, it may be beneficial to supplement with Liu Wei Di Huang Wan or Qi Ju Di Huang Wan.
Qi and Yin Deficiency Constitution
Constitution Characteristics: Children with this constitution resemble the “pensive Lin Mei Mei”, appearing weak and lacking energy. They often show little interest in most activities, have difficulty concentrating, and experience slower growth and development compared to peers. They eat less, have dry skin, and their palms and soles may be red. Their sleep is often restless, and their lips are pale and dry, with a red tongue and little moisture, and their fingerprints are red and purple.
Formation Factors: Insufficient congenital endowment and inadequate postnatal care after illness.
Health Care and Treatment: These children are prone to illness and difficult to nourish. Improper treatment can easily lead to imbalances in constitution. It is advisable to incorporate foods that strengthen the spleen and nourish the stomach, such as yam and lotus seeds, into their daily diet (for example, using yam instead of potatoes in cooking). In winter, it may also be appropriate to take Sheng Mai Yin or Yu Ling Gao for a period.
Medicinal Products Mentioned
✦ Four Gentlemen Pills (Si Jun Zi Wan): Specializes in tonifying qi and strengthening the spleen. (Ingredients: Ginseng, Poria, Atractylodes, Licorice.)
✦ Yi Gong San: Tonifies qi and strengthens the spleen, and can also promote qi and resolve stagnation. (Ingredients: Four Gentlemen Decoction + Chen Pi.)
✦ Six Gentlemen Pills (Liu Jun Zi Wan): Tonifies qi and strengthens the spleen, while also drying dampness and resolving phlegm. (Ingredients: Four Gentlemen Decoction + Chen Pi, Ban Xia.)
✦ Fragrant Sand Six Gentlemen Pills (Xiang Sha Liu Jun Zi Wan): Tonifies qi, resolves phlegm, and warms the middle. (Ingredients: Six Gentlemen Decoction + Mu Xiang, Sha Ren.)
✦ Yao Ping Feng San: Tonifies qi and stabilizes the exterior. (Ingredients: Prepared Astragalus, Fang Feng, Atractylodes.)
✦ Liu Wei Di Huang Wan: Specializes in nourishing yin. (Ingredients: Prepared Rehmannia, Cornus, Dioscorea, Alisma, Peony, Poria.)
✦ Qi Ju Di Huang Wan: Nourishes yin and disperses fire. (Ingredients: Liu Wei Di Huang Wan + Chrysanthemum, Goji Berries.)
✦ Sheng Mai Yin: Tonifies qi, nourishes yin, and restrains sweating. (Ingredients: Ginseng, Ophiopogon, Schisandra.)
✦ Yu Ling Gao: Tonifies qi and blood. (Ingredients: Longan flesh, American ginseng.)
If you are wondering why I haven’t mentioned yin deficiency, yang deficiency, or blood deficiency constitutions, I believe that children’s constitutions have stage-specific characteristics. It is rare to see pure yin deficiency without internal heat, or pure yang deficiency without phlegm-damp. Unless there are congenital diseases, pure blood deficiency in children is also quite uncommon. However, to nourish blood, one can also use qi tonification methods, as “qi is the commander of blood”. By nurturing spleen qi, one can achieve the goal of generating and nourishing blood.
So, have you learned something? As the saying goes in traditional Chinese medicine, “The best doctor treats the disease before it occurs.” While we may not be able to be the best doctors, we can be proactive mothers, addressing health issues before they arise by understanding our children’s constitutions!
References:
1 Zhu Jinshan, “50 Lectures on Pediatric Clinical Practice”.
Author
Introduction
Xiang Rou
TCM Physician
Master’s Student in Endocrinology at Liaoning University of Traditional Chinese Medicine
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