As the summer gives way to fall and the lingering challenges posed by the current pandemic remain, we as parents and practitioners are naturally focused on protecting our children's health and well-being. Whether our concerns focus on the usual seasonal illnesses, or more specifically on COVID-19, the foundations of strengthening our children are the same. Naturally, prevention is our first line of defense, and the public safety guidelines already in place bode well for significantly lessening children's sick days from the usual seasonal colds and flu.
In TCM terms, the defense against illness is referred to as Wei Qi. The Spleen is the origin of Wei Qi, and the Lungs are responsible for its spreading and distribution out to the surface of the body. Children by nature have immature Spleens, and as a result their Wei Qi is also less well-developed. In addition, many children are finicky eaters, posing further challenges to strong Wei Qi. Thus, doing what we can to enhance strong Spleen and Stomach Qi, and maintain a healthy balanced diet can go a long way to prevent illness. As the famous Yuan Dynasty physician Li Dong Yuan remarked, "All diseases start with Spleen and Stomach deficiency."
Chinese Herbal Medicine
Traditional Chinese herbal medicine can be an extremely effective tool for bolstering children’s resistance to illness. By giving children herbs that tonify the Spleen and Wei Qi, they can more quickly eliminate the influences of external Evil Qi and return to optimal health. Here are a few of my favorite formulas for children, as follows.
Qi Tonifying Prescriptions to build Wei Qi
Shen Ling Bai Zhu San
This gentle Spleen Qi tonic is ideal for younger children with weak Spleen Qi and delicate digestive systems prone to dampness, Qi stagnation, loose stools and low energy. The formula tonifies the Spleen Qi, dries Dampness, strengthens the Stomach, benefits the Lung, and consolidates loose stools. It is ideal for the delicate child with low energy, weak digestion, and a lack of thriving. With improvement, consider transitioning the child to Xiang Sha Liu Jun Zi Tang.
Contraindications: Acute external pathogens, and excess Heat conditions.
Xiang Sha Liu Jun Zi Tang
This classic modification of Si Jun Zi Tang is very similar to Shen Ling Bai Zhu San, but is stronger in tonifying the Qi, and eliminating Dampness and Qi stagnation. It is more suitable for older children with symptoms of low energy, weak digestion, loose stools and low resistance to colds and flus.
Contraindications: Acute external pathogens, excess Heat conditions and Yin deficiency.
Shen Qi Da Bu Tang
With only two ingredients, Dang shen and Huang qi, this formula is ideal for quickly restoring the Lung, Spleen and Wei Qi. An excellent choice for moderate to significant Qi deficiency without specific digestive symptoms, it is often used for increased susceptibility to Evil Qi, spontaneous perspiration, shortness of breath, and significant fatigue. As it strongly tonifies the Qi, caution should be used in prescribing this formula, especially in younger children.
Contraindications: Acute external pathogens, excess Heat conditions and patients with Wind or Yang rising.
Yu Ping Feng San
Jade Screen Powder stands out as a unique prescription for strengthening the Wei Qi and enhancing resistance to external Evil Qi. This formula tonifies the Wei Qi, strengthens the Spleen Qi, stabilizes the exterior, and reduces inappropriate perspiration. It is an ideal prescription for patients who suffer from frequent external Wind-Cold or Wind-Heat, and those prone to spontaneous or excessive perspiration due to Qi deficiency. This is an excellent prescription for strengthening resistance to external Evil Qi in school age children!
Contraindications: Acute external conditions such as Wind Cold or Wind Heat. Use with caution is patients with Liver Wind or Yang rising.
Prevention and early stage External Wind Heat Pathogens
Yin Qiao Jie Du San
This well-known herbal formula is extraordinarily effective when used correctly. Wu Ju-Tong's prescription for treating early stage external Wind Heat is rather weak when used to treat patients who have already succumbed to external Wind Heat for several days. In my opinion, this prescription works best when utilized as a preventative treatment. For children, I recommend its use during the fall and winter, prescribing it when patients are not sick but are likely to be exposed to Evil Qi at home, or school. I recommend using it for 3 days, then off 4 days, repeating this cycle as needed. It can also be used alternately with Wei Qi supporting prescriptions like Yu Ping Feng San for the purpose of prevention.
Contraindications: Contraindicated for External Wind Cold conditions.
Sang Ju Yin
This subtle formula, also authored by Wu Ju-Tong, was written to address the initial stages of external Wind Heat invasion. In contrast to Yin Qiao San however, Sang Ju Yin treats early stage external Wind Heat with mild cough as the primary symptom. It's inclusion of Sang ye, Ju hua and Bo he also allows the prescription to also address eye complaints such as red, inflamed, itchy eyes due to Wind Heat. This formula can be combined with Chuan Xin Lian Pian to address Toxic Heat (Rè Dú 热毒) more effectively.
Contraindications: External Wind Cold conditions.
Ban Lan Gen Pian
This small but powerful formula of three herbs is indicated for Wind Heat invasions affecting the upper body, head and face, and particularly the throat. Additionally, it addresses Wind Heat affecting the skin in those areas. Nan ban lan gen (Baphicacanthus root, or southern Ban lan gen) is combined with Pu gong ying and Zi hua di ding, which work together to expel Wind Heat while draining Qi or Blood level Heat through urination. This formula enters both the Qi and Blood levels, and the Liver, Stomach and Heart channels. For early stages of a Wind Heat invasion, alternate with Gan Mao Ling or Yin Qiao San. For stronger signs of Heat in the throat, combine with Chuan Xian Lian Pian.
Caution: Use with caution in Spleen or Stomach Qi deficient patients.
Chuan Xin Lian Pian
This modern combination of Chuan xin lian, Pu gong ying and Ban lan gen is a strong prescription for clearing Heat and eliminating Toxins (Dú 毒) due to external Wind Heat or Toxic Heat invasion. It can be combined with other prescriptions to address symptoms specific to the area of complaint such as Xin Yi San and Zhong Gan Ling.
Cautions: Use with caution in patients with Spleen Qi deficiency, hemorrhagic disorders, and those patients on anti-coagulant therapy.
Mayway's Chong Ji remedies are especially useful for kids
It can be challenging to persuade younger children to take pills, capsules, tinctures or strong-tasting herbal teas. One herbal medicine format that I have found particularly helpful in this regard are dissolvable granules called Chong Ji, which are extracted herbs with cane sugar. These herbal remedies can be used for kids or adults, are sweet to the taste, and completely dissolve into a liquid when mixed with hot water.
Gan Mao Jie Du Chong Ji
This formulation treats beginning and intermediate stages of external invasion of Wind Heat (Fēng Rè Dú 风热毒). Symptoms may include a mild sore throat, congestion in the nose and sinuses, mild fever, tender lymph glands, occasional sneezing, and irritability.
Contraindications: External Wind Cold.
Bi Yan Qing Du Chong Ji
The ingredients are very similar to Bi Yan Pian plus Chuan Xin Lian Pian. It opens the sinus and nasal passages, gently dries Phlegm, clears Heat, and relieves mild pain. Specifically formulated to primarily address congestion in the nose and sinuses.
Contraindications: Absence of sinus and nasal congestion; use with caution in patients with hemorrhagic disorders or those on anti-coagulant therapy.
Southern Ban Lan Gen Chong Ji
This Chong Ji is the same formula and has the same functions as the tablet version described above. Southern Ban Lan Gen Chong Ji clears Heat, expels Toxic Heat, benefits the throat, invigorates the Blood, and mobilizes the Wei Qi. Although very useful by itself, it can also be effectively combined with and augments Gan Mao Jie Du Chong Ji.
Zhi Ke Pi Pa Chong Ji
This Loquat leaf drink includes Pi pa ye, Sang bai pi, Bai qian, Bai bu,Jie geng and Bo he nao. Specifically formulated to treat mild dry cough, this soothing and moistening drink cools the Lung, eases cough, and gently moistens dryness in the Lung.
Contraindications: Wind Cold patterns.
A Child's Life
In addition to the many ways TCM can help build strong Wei Qi, there are also important day-to-day practices and strategies that help us with this task that I would like to share.
Having raised three children, I know all too well the complexities of raising healthy kids. At times we have to let go of the "ideal" regarding exercise, diet and free-time activities, and just try to keep them out of harm's way and roughly on track. Kids love cheese and butter and sugar and milk and carbs, watching TV, and playing video games. Certainly, these things are not considered ideal for optimal health. None-the-less, knowing the many little things that support strong bodies lets us sneak in the healthy recommendations in when they're not looking! Here's a few things to consider.
Exercise strengthens the Lungs, Spleen and Stomach. It builds the Wei Qi, Zhong Qi, and benefits appetite and elimination. It helps to free up constrained emotions, burns off fat and strengthens the muscles. It vitalizes the blood, eliminates stagnant dampness, and clears phlegm. It awakens the Shen of the Lungs, Spleen, Heart and Liver. And perhaps most importantly in the busy household, it burns off lingering mischief!
Too much can be almost as bad as too little, and the adage "Early to bed and early to rise makes a person healthy, wealthy and wise." is still true today. Though kids often love to stay up late, especially pre-teens and teens, this is not ideal. It's well understood that the non-REM sleep that occurs between 9 pm and 2 am is the most restorative and healing type of sleep for both mind and body. For kids, the best time for healthy sleep starts between 9 and 10 pm, and according to TCM, being deeply asleep during the Liver time of 1-3 am is considered essential.
Children between the ages of 3-10 years old have a general tendency to generate more phlegm than adults. And it's certainly not surprising as kids adore pasta, sugar, butter, milk, cheese, bread, crackers, and everything in between. The Spleen remains immature until preadolescence, and because of this, children naturally produce excess phlegm. This can lead to chronic sinus and nasal congestion, lingering coughs, morning runny noses and sneezing, recurrent ear infections, and a tendency for more frequent colds and flus. In terms of TCM preventative strategies, doing our best to limit dampening foods and substituting whole grains and alternative carbohydrates for white bread and pasta can help reduce excess Phlegm. Likewise, making sure there are plenty of fresh vegetables and healthy protein ensures that all the building blocks for healthy bodies are available.
Vitamins & Minerals
With the complexities of children's tastes and tendencies, it's wise to consider a children's multi vitamin and mineral complex be taken regularly. Those vitamins that are of particular importance for strong immunity include Vitamins A, C, D, E, folic acid, iron, selenium and zinc.
Play is essential for both children and adults alike. It is a means of forgetting the stresses and pressure of daily life, as well as having significant developmental and health benefits. Besides just being just fun, play enhances sensory development, fine motor skill development, hand-eye coordination, creativity and imagination, social and language skills, and boosts immunity. Research has shown that kids who play outdoors in the grass, sand or dirt have healthier immune systems than children not exposed to these natural environments. Play naturally relieves stress, which can significantly undermine the resilience needed for a strong immune system.
As an essential part of human life, love has significant health benefits as well. Recent studies have shown that loving relationships lead to fewer doctor's visits, less depression, lower blood pressure, reduced anxiety, reduced pain perception, fewer colds and flu, faster healing, and a longer and happier life. And well, it just feels good to love and be loved.
As practitioners of traditional Chinese medicine, we have been given a unique view into the many factors and treatment strategies that support optimum health. In building the Wei Qi there is there singular primary treatment. Strong immunity is the result of a dynamic balance of mutually reinforcing factors. In this sense our approach is truly holistic.
- Bensky, D. & Barolet, R., Formulas & Strategies, Eastland Press: 1990.
- Bensky, D. et al., Chinese Herbal Medicine Materia Medica, 3rd ed., Eastland Press: 2004.
- Chen, J. & Chen, T., Chinese Medical Herbology and Pharmacology, Art of Medicine Press: 2004.
- Maclean, Will, Clinical Manual of Chinese Herbal Patent Medicines, Pangolin Press: 2003
- Wrinkle, A. et al., A Practitioner’s Formula Guide, Elemental Essentials Press: 2008.
Mark W. Frost, MSTCM, L.Ac. is chair of the Herbal Medicine Department at the American College of Traditional Chinese Medicine in San Francisco, California. Professor Frost teaches in both the Masters and Doctoral Programs, serves as a clinical supervisor in colleges Community Clinic, and has had a private practice in San Francisco for over 30 years. He is the author of numerous articles on Chinese herbal medicine and has presented at several TCM conferences since 2014.