Chapter 745: Pediatric Pathogenesis

Chapter 745: Chapter 745: Pediatric Pathogenesis

"Come, open your mouth. Let Uncle take a look."

Li Xu leaned in close to the child and turned on his small penlight.

The little boy glanced at Li Xu, instinctively shrinking his neck back and pressing his lips tightly shut in refusal.

"Open your mouth, be a good boy."

Seeing this, the boy’s mother became a bit anxious, her tone immediately turning stern. "What did I tell you in the car on the way here? You have to listen to the doctor. Hurry up."

Scolded by his mother, the little boy’s eyes instantly turned red, on the verge of tears.

"It’s fine, it’s fine." Li Xu waved his hand to stop her. "Ma’am, please don’t yell at him. Especially when seeing a doctor, children are already nervous and scared. If you scold him, his Qi flow will become even more chaotic. Uneasiness of the mind will alter his pulse, which will actually affect my diagnosis."

Saying that, Li Xu pulled a cartoon sticker out of his drawer like magic and waved it in front of the little boy. "Little man, don’t be afraid. Uncle won’t give you any shots or make you take bitter pills. Uncle just wants to see how your little tongue is doing and if it’s as fierce as this little tiger. Just one look, and this sticker is yours. How does that sound?"

Looking at the beautiful tiger sticker, the little boy hesitated for a moment before finally opening his mouth slowly.

Li Xu leaned in for a look.

The tongue body was on the thin side, and its overall color was pale pink, but the tip appeared a deeper red. The tongue coating was thin, yellow, and slightly greasy.

"Great job, the sticker is yours. Come on, put your little arm up here, just like when you’re measuring your height."

Li Xu guided the child to place his wrist on the pulse pillow and gently placed three fingers over it.

The pulse was fine, rapid, and slightly floating.

Having observed the tongue coating, taken the pulse, and combined it with the previous inquiry, Li Xu already had a clear clinical picture of the child’s condition in his mind. He didn’t rush to write a prescription. Instead, he turned to look at Li Lin and Wang Xue standing nearby.

"You both study medicine," Li Xu tested them. "Tell me, why does this child get sick so easily, with recurring coughs and night sweats?"

Since there were no other patients waiting in the clinic at the moment, and Li Lin and Wang Xue were both acquaintances and his juniors, Li Xu treated this as an on-the-spot teaching moment.

Wang Xue thought for a moment and was the first to answer. "Traditional Chinese Medicine says that children have a ’tender Yin and tender Yang’ constitution. Their physique is weak, and the development of their internal organs is not yet complete. Specifically, the lungs and spleen are relatively weak, leading to an ’unsecured exterior defense.’ Therefore, once there is pathogenic wind-cold or wind-heat, they are easily invaded by illness, resulting in colds and coughs."

Li Lin nodded in agreement.

This was the standard textbook answer.

Why do children get sick easily? Most people, including many grassroots Western medicine doctors, believe it’s because "children have poor immunity" or "weak resistance."

This answer certainly wasn’t wrong. However, in Li Xu’s view, it was too generalized, lacking detail, and failed to accurately touch upon the microscopic level of the TCM concept of "the dynamic movement of Qi."

"Wang Xue makes a valid point, but it’s not thorough enough." Li Xu began to break it down. "Actually, we can use the analogy of a ’thief entering a house’ to vividly explain many children’s respiratory and immune system diseases.

"If we compare the human body’s skin and muscles to a large house, the pores through which the body sweats and breathes—what we call the ’striae and interstices’ in TCM..." Li Xu pointed to his own arm, "...they are like the windows and doors of this house.

"When a person is healthy and has sufficient Righteous Qi, their mind and Defensive Qi can freely and acutely control the opening and closing of these ’doors and windows.’ When it gets hot inside the house and you need to sweat, it opens the windows to let out the heat. When it gets cold outside, or the wind picks up, it quickly closes the windows to keep warm, preventing internal heat from escaping and external cold air from entering.

"Comparatively speaking, an adult’s body, mind, and Qi and blood are already fully developed. It’s like a strong, experienced adult living in the house who knows exactly when to close the windows and when to open the doors. That’s why adults don’t catch colds so easily.

"But children are different." Li Xu looked at the little boy, who was now focused on playing with the sticker, and smiled. "Not only are a child’s internal organs delicate, but their mental faculties and Defensive Qi systems are also like ’careless little kids’—just like the child himself. They are insensitive to subtle changes in temperature and often open or close doors and windows haphazardly.

"For example, just now he might have been running around covered in sweat, and suddenly a cold wind blew by, or he walked into an air-conditioned room. His Defensive Qi reacts slowly and fails to ’close’ his pores in time. Consequently, the external pathogenic wind-cold is like a thief who has staked out the place, easily infiltrating the body straight through the open doors and windows.

"Furthermore, as Wang Xue mentioned, children grow rapidly and are full of vitality. But this rapid development also exposes the weakness of having ’delicate organs and immature form and Qi.’

"Qian Yi, the great pediatrician of the Northern Song Dynasty, pointed this out brilliantly in his text, ’Key to Therapeutics of Children’s Diseases’: A child’s ’internal organs are formed but incomplete... complete but not robust.’

"For this child, his coughing and sweating symptoms always linger and recur. The root cause is his constitutional deficiency, which makes the ’doors and windows’ of his house constantly fail to close tightly, letting in drafts. Whether the weather cools down slightly, he gets too much air-conditioning, or he takes off his clothes when sweating from the heat, the pathogenic thief slips in through the open windows time and time again.

"What’s even more troublesome," Li Xu’s tone grew solemn, "is that these pathogens that sneak into the body often possess a strong latency. TCM refers to them as ’Hidden Evils.’

"Hidden Evils are like ticking time bombs hidden under the bed. They might sneak in during the summer—for instance, when consuming too many cold drinks damages the Spleen Yang—but only erupt when exposed to cold in the winter. Or they might sneak in during the winter—catching a chill that wasn’t fully expelled—and only turn into a warm-pathogen disease when the Yang Qi rises in the spring and summer..."

Li Xu explained the profound concepts in simple terms while Li Lin and Wang Xue listened with rapt attention, even pulling out their small notebooks to rapidly jot down notes.

Having attended Li Xu’s large lecture at school previously, Wang Xue knew that this young senior’s expertise was unfathomably deep. That was why she had highly recommended her cousin bring her nephew here this time. She herself had tagged along with the goal of practical learning.

Li Xu’s explanation left Wang Xue utterly fascinated. His ability to perfectly integrate obscure TCM theories with everyday common sense effortlessly laid bare the underlying logic of why children got sick so often, bringing a sudden flash of insight to anyone listening.

"Among these Hidden Evils, there is cold evil and heat evil. Sometimes, a situation arises where ’newly contracted pathogens trigger Hidden Evils.’ In other words, these pathogenic energies don’t just lie dormant deep within the internal organs for long periods; they can also ’seize the right opportunity’ to wreak havoc."