“The Biggest Lie in the History of Medicine”
“THIS WON’T HURT A BIT!”
How many times have we heard our pediatricians say that to us as children? Even up to now, I sometimes make jokes to patients about what I call the biggest lie in the history of medicine.
“KAGAT LANG ITO NG LANGGAM!” (This is just an ant bite!)
Yeah, right.
Given that this is an acupuncture blog, you’re probably wondering what it’s like administering acupuncture to children. Heck, I’ve wondered if children would like to get revenge on me.
Oh didn’t we wish we could do this? Image by “AKARAKINGDOMS”/ freedigitalphotos.net
Seriously, let’s take a look at the history of Chinese Medicine Pediatrics.
The First Published Book on Pediatrics
Wikipedia, as usual, conveniently forgets to take medicine in ancient China seriously. (link)
A 2nd century AD manuscript by the Greek physician and gynecologist Soranus of Ephesus dealt with neonatal pediatrics. Byzantine physicians; Oribasius, Aëtius of Amida, Alexander Trallianus, and Paulus Aegineta stand out for their contributions to child care. The Byzintines also built brephotrophia, “baby shelters,”or “children’s hospitals.”Islamic writers served as a bridge for Greco-Roman and Byzantine medicine and added ideas of their own especially Haly Abbas, Serapion, Rhazes, Avicenna, and Averroes, The Persian scholar and doctor al-Razi (865–925) published a short treatise on diseases among children. The first printed book on pediatrics was in Italian (1472) – Bagallarder’s Little Book on Disease in Children.
Truth to be told, the first printed book on pediatrics was in Chinese. It is the Xiao Er Yao Zheng Zhi Jue (小儿腰证直决) or Key to the Therapeutics of Children’s Diseases. (Zhu, 2002) It was written by Qian Yi (钱乙), acknowledged to be the greatest pediatrician in Chinese Medicine history.
Qian Yi is the Pioneer in Traditional Chinese Medicine Pediatrics. Picture courtesy of http://www.taijichinesemedicine.com/qianyi.htm
Qian Yi was estimated to have been born in the year 1032 AD, and died in 1113. His style name was Qian Zhongyang (钱仲阳). In 1090 he was appointed court physician. Yet for some reason, he became a pioneer in the treatment of children’s problems. His 40 years of experience was summarized and codified by his student Yan Xiaozhong (阎孝忠) into the Xiao Er Yao Zheng Zhi Jue in 1119. Hence it was printed more than 300 years before Bagallarder.
The Xiao Er Yao Zheng Zhi Jue was composed of three volumes. Volume 1 dealt with diagnostics, volume 2 dealt with proper case recording and volume 3 dealt with prescriptions. Qian Yi was the first to accurately describe and record Chinese medicine treatments for diseases that we now know to be measles, scarlet fever, chicken pox and small pox. (Zhu, 2002)
Liu Wei Di Huang Wan – How a Children’s Formula Became the Most Common Tonic for Old People
Ironically, the greatest contribution of Qian Yi to Chinese Medicine in general is a formula that, in today’s world, is hardly ever thought of as a pediatric formula. Liu Wei Di Huang Wan (Six Flavor Rehmannia Decoction) is the most commonly used tonic formula for nourishing Kidney Yin deficiency. In Traditional Chinese Medicine Theory, Kidney Yin deficiency is usually the problem of elderly patients. So why did Qian Yi come up with this? For the answer, we shall consult Chinese Herbal Medicine: Formulas and Strategies by Bensky and Barolet (1990)
This formula is a variation of Kidney Qi Pill (Shen Qi Wan) from Essentials from the Golden Cabinet… Qian Yi… omitted the yang-tonifying herbs to create a formula for treating Kidney Yin deficiency in children characterized by an open anterior fontanel, lack of spirit, and a shiny, pale complexion. Because of its elegant and well-balanced formulation, it is considered to be an exemplary formula.
In Chinese Medicine, the Kidneys are involved in reproduction, growth and development. Children born with weak Kidney Yin end up with delayed developmental progress, as evidenced by the non closure of the anterior fontanels. However, since the formula treats the Root of the disease and not just the Branch (see my previous blog entry) it can be used to treat any disease that has the root of Kidney Yin Deficiency. Other diseases that Liu Wei Di Huang Wan can treat include weakness, tinnitus, low back pain and more. Of course, a qualified physician must properly diagnose the patient as having their symptoms caused by Kidney Yin Deficiency.
Qian Yi, pediatric pioneer, and geriatrics sage as well!
Resources:
Bensky, Dan and Barolet, Randall. Chinese Herbal Medicine: Formulas & Strategies. 1st ed Eastland Press, 1990
Zhu, Fanxie. Classified Dictionary of Traditional Chinese Medicine. Foreign Languages Press, Beijing, China, 2002