Child Health Care
Health care and medical therapy for children is a special branch of medicine. Pediatric departments were in use in ancient
1. Hand massage for child health care:
1-Wuzhijie (five interphalangeal joints) 2-Hegu (LI 4) 3-Weiling 4-Yiwofeng 5-Outer Bagua 6-Outer Laogong 7-Jingning 8-Shangmen 9-Ershanmen 10-Right Duanzheng ll-Laolong 12-Left Duanzheng.
The acupoints and areas on the hands of children ( Fig. 6 - 1, 6-2 and 6-3) are different from those of adults.
1-Spleen 2-Stomach 3-Inner Bagua 4-Yunshui Rum (transporting water into earth) 5-Yuntu Rushui (transporting earth into water) 6-Small intestine 7-Kidney 8-Lung 9-Heart 10-Liver 11-Colon.
The spleen is on the pad of the thumb; and the liver, heart, lungs and kidneys are on the pads of the index, middle, ring and little fingers respectively. The colon is on the radial border of the index finger from the tip to the web border of this finger; the small intestine is on the ulnar border of the little finger from the tip to the proximal end of this finger; the tip of little finger is Sbending (vertex of kidney) and the distal palmar interphalangeal crease is called Shenwen (kidney crease); the proximal palmar interphalangeal creases of the index, middle, ring and little fingers are called Sihengwen (4 creases) ; the pal-mar metacarpophalangeal creases of 4 fingers are called Xiao-
bengwen (small crease); the palmar crease proximal to the Xiaobengwen is called Zhang Xiaohengwen (small palmar crease); and the stomach is on the palmar side of metacarpo-phalangeal joint. In addition, the palmar surface of thenar prominence is called Banmen, the center of the palm is called Inner Laogong (PC 8) at a point between the tips of the middle and ring fingers when they are flexed to touch the palm; the Inner Bagua is a circle at the central part of the palm two-thirds of the distance between the center of the palm and proximal end of the middle finger as its radius; the Small Tianxin is in a depression between thenar and hypothenar prominences; the arc of Yunshui Rum is drawn from proximal end of the little finger to proximal end of the thumb and the arc of Yuntu Rushui is drawn along the opposite direction; the Zongjin is at the midpoint of palmar carpal crease, the same as Daling acupoint (PC 7) ; the palmar carpal crease is also called Dahengwen (big crease), its radial end is called Yangchi (LI 5) and its ulnar end is called Yinchi; Shiwang at the tips of all fingers is also called Shixuan; Laolong is at a point 1 fen proximal to the nail of the middle finger; Duanzheng is at the proximal corner of nail of the middle finger, the one on the radial side is called left Duanzheng and the other, on the ulnar side, is called fight Duanzheng; the dorsal creases of proximal interphalangeal joints of the 5 fingers are called Wuzhijie (5 interphalangeal creases); the points in the depressions beside the proximal end of the middle finger are called Ershanmen; Shangmen is in the depression between the proximal ends of the ring and little fingers; the Outer Laogong is on the dorsum of the hand and just opposite to the Inner Laogong; Weiling is in the interosseous space between the 2nd and 3rd metacarpal bones, and Jingning is in the interosseous space between the 4th and 5th metacarpal bones; the Outer Bagua is on the dorsum of the hand and opposite to the Inner Bagua; and Yiwofeng is at the midpoint of dorsal carpal crease.
For child health care massage, the kneading, pinching or pinching with grinding maneuvers may be applied at the tips of all fingers; kneading maneuver applied to the pads of all fingers; and the pushing or grinding with pushing maneuvers applied along radial or ulnar borders of the fingers. The local grinding and pushing maneuvers applied to the correspondent reflecting areas of internal organs are a toning technique; and the vertical pushing maneuver applied along fingers is a reducing technique. The vertical pushing maneuver proximally applied along colon and small intestine reflecting areas is a toning technique and the distally applied is a reducing technique. The pressing with kneading and pinching with grinding maneuvers are usually applied over reflecting areas; and the pinching and pushing maneuvers applied at acupoints.
The procedures for child health care massage are arranged as follows: To tone spleen and reduce stomach for adjusting digestive tract and to reduce heart and liver for adjusting function of lung and kidney; to digit-press, press and knead Banmen and Duanzheng, to transport water into earth and to motivate Bagua; to manage Hengwen (creases) and Zongjin for clearing heat and releasing stasis; and to manage Outer Laogong and points and reflecting areas called Men and Feng for expelling external pathogens; and to manage Tianxin, Laogong and carpal crease for improving the health of children and preventing disease. Other points and reflecting areas can also be selected for use according to necessity and under the guidance of the practitioner. The acupoints and reflecting areas at the distal end of the fingers, such as Shiwang, can be used for emergency treatment. The 'persistent application of health care massage once or twice a day may improve the health of children, prevent disease and promote the development of their intelligence. In addition, children should be trained to constantly use their hands, for example to pick up and hold things, clap. Their hands, and play with building blocks to improve their coordination of movement between hands and brain. Before and after massage, their hands should be soaked in warm water, and they should be trained apt to receive a warm-water soaking of hands and feet. It's a delicate job, and health care should be continuously carried on with hand massage adequately applied with the proper force to avoid injuring the child's tender hands.
2. Foot massage for child health care
The foot massage is also very important for children. The central part of the sole, heel and toes, especially the big toe, are the important places for applying massage, and the joints of the foot, especially the ankle and first metatarsophalangeal joint, are also very important.
The procedures for child foot massage are as follows:
1) Rubbing foot:
The rubbing maneuver may be quickly and gently applied with the whole ulnar border of palm, from the ankle joint over instep (including the medial and laterl borders of the foot) to toes; and then from the heel tendon over heel and sole to toes with a force heavier than that used for the instep. For rubbing the midline of the sole, the lateral border of hypothenar prominence may be used instead. The rubbing maneuver producing a pink color and a hot sensation all over the child's feet may pro-mote their growth and development, clear heat in body, remove food stagnation, induce sweating, and expel pathogens from the body surface.
2) Pushing foot:
The pushing maneuver is forcefully applied from the mid-point of lateral border of the heel along the lateral and medial dorsoplantar boundary of the foot to the little and big toes respectively, and then the gentle rotating, digit-pressing and kneading maneuvers are applied to the little and big toes. The pushing maneuver is useful to clear heat, control convulsions, refresh the mind, open the sense organs, and enhance intelligence.
3) Digit-pressing and kneading joints:
The digit-pressing and kneading maneuvers are applied from the "ankle joint through the 1st to the 5th metatarsophalangeal joints, and finally the gentle digit-pressing maneuver is applied to all interphalangeal joints. The manipulation should be gently and nimbly applied with a proper amplitude of movement. The digit-pressing and kneading manipulation can pro-mote the development of the child's muscular and skeletal sys-tem, and the pinching and digit-pressing manipulation can be used to treat emergency cases of convulsions, but this must be quickly and accurately applied.
4) Grinding and pressing central part of sole:
The quick, gentle and nimble grinding and pressing maneuvers are applied over the central part and the part slightly anterior to the center of the sole for clearing heat, control vomiting, and promoting digestion in the spleen and stomach.
5) Gently pounding heel:
The ulnar borders of both fists are used to quickly and rhythmically pound the heels with a proper and even force for tranquilizing the mind, improving sleep, and controlling convulsions.
6) Rubbing foot:
The first manipulation is repeated as the closing step in this set of manipulations.
The feet should be soaked in warm water before applying the above manipulations, and after the foot bath, the warmth of the feet should be retained because an attack of cold to the feet may cause other diseases. The health care foot massage may be performed alone or combined with hand massage, and the frequency of manipulation may be increased. Young babies should not be forced to begin walking at a very young age because this may disturb the body's development and cause deformity of the bones and joints. Babies should be supported when walking so their legs do not carry all their body weight at the early stages of learning to walk.
Before the practitioner begins the child health care massage on hand and foot, he/she should wash his/her hands in warm water and have his/her nails cut short to avoid injury. People with hard skin, hard scars and scales on the skin, or other lesions on their hands should not use their hands to do this massage. The manipulation should be carefully applied without any violence to avoid injury. If this massage is done at home, it is best done by mothers, because sometimes men may injure the child by applying too much force.
Young children are very susceptible to attacks of pathogens because their body resistance is not yet fully strengthened. At the same time, the development of disease in children may be very rapid, and neglecting the seriousness of their illness may produce an incurable result. Therefore, young parents must not carelessly manage the disease of their children, and they should visit the pediatrician in time.