Marasmus and stagnation are the general terms for the two different pathological stages of marasmus and stagnation. Stagnation is a gastrointestinal disorder in infants caused by damage to the spleen and stomach due to excessive milk intake. It results in the accumulation of food in the middle abdomen, which cannot be digested and absorbed properly. Marasmus, on the other hand, refers to a chronic condition in which the spleen and stomach are weak, leading to long-term dysfunction in digestion and absorption. This results in poor nourishment of the organs, dehydration, emaciation, and hindered growth and development.
Etiology and Pathogenesis
Clinical Manifestations
1. Stagnation of the spleen and stomach (stagnation)
Yellowish complexion, emaciation, fatigue, poor appetite, abdominal pain and distension, refusal of touch on the abdomen, vomiting sour or rancid food or regurgitation of milk, sour and foul breath, irritability and crying, restless sleep, sometimes with redness of the cheeks at night, dry or loose and foul-smelling stools, cloudy urine resembling rice water, red tongue with thick greasy coating, wiry or slippery and rapid pulse, and purple stagnation of fingerprints.
2. Weakness of the spleen and stomach (marasmus)
Pale or yellowish complexion, dry and sparse hair, emaciation, listlessness, fatigue, irritability and crying, restless sleep with open eyes, cold limbs, poor appetite, concave abdomen, delayed development, loose stools, pale tongue with thin coating, weak and feeble pulse, and pale fingerprints.
Tui Na Treatment
1. Treatment principles: Tonify the spleen and stomach, eliminate stagnation, and nourish qi and blood.
2. Techniques and prescriptions: Tonify the spleen meridian, rub the Gate of Abdomen, push the four horizontal lines, perform Ba Gua manipulation internally, rub Zhong Wan, massage the abdomen, knead Zu San Li, and pinch the spine.
3. Methodology: Tonify the spleen meridian, rub the Gate of Abdomen, rub Zhong Wan, perform Ba Gua manipulation internally - tonify the spleen and stimulate appetite, assist digestion and harmonize the middle burner. The Ba Gua manipulation internally regulates qi and harmonizes the middle burner, ensuring smooth flow of qi in the middle burner. Push the four horizontal lines, massage the abdomen - regulate qi, eliminate stagnation, and disperse accumulation. Knead Zu San Li, pinch the spine - tonify the spleen, strengthen the body, and nourish qi and blood. This method is one of the specialized treatments for marasmus and stagnation.
4. Modifications
(a) Stagnation caused by dietary factors: Add rubbing Tian Shu, divide the abdomen into yin and yang regions, and perform string rubbing and kneading to enhance the function of digestion and elimination.
(b) Marasmus caused by spleen and stomach weakness: a. If there is deficiency heat, add Qing Tian He Shui, tonify the kidney meridian, perform "Water Bottom Fishing for the Bright Moon" manipulation, and rub points Er Ren Shang Ma to nourish yin and clear heat. b. If there is deficiency cold, add pushing San Guan, rubbing Wai Lao Gong, tonify the kidney meridian, and rub Guan Yuan to warm yang and dispel cold, nourish the origin, and strengthen the foundation.
