The "Simple Questions" describes the changes taking place in our life every 7 years in women and every 8 in men. Women's life cycles are dominated by the number 7 so that there are profound changes every 7 years; men's cycles are dominated by the number 8 and there are profound changes every 8 years. It says in Chapter 1: "In a girl at 14 the Heavenly Gui [menstrual blood] arrives, the Ren Mai is open, the Chong Mai flourishes, her periods arrive and she can conceive. At 21 the Kidneys energy is like that of an adult and her teeth complete their growth...In a boy at 16 Kidney-Qi is abundant, the Heavenly Gui arrives, the Essence lets its overabundance flow, Yin and Yang are harmonized and the boy can beget children. At 24 Kidney-Qi is equivalent to that of an adult, sinew and bones are strong and his teeth complete their growth." In this article, I shall concentrate on the physiology, aetiology and pathology of the ages between 14 and 21 in girls and between 16 and 24 in boys.

PHYSIOLOGY
As the above statement indicates, in the ages between 14 and 21 and between 16 and 24 in girls and boys respectively, the Kidney energy matures and the becomes abundant and indeed overflowing, which leads to ejaculation in men and to the first onset of the period in women. The teeth come to complete maturity with the appearance of the wisdom teeth and this indicates the flourishing of the Kidney energy and bones. During adolescence and young age, the physiology of girls and boys is at its peak and the Kidneys are at their strongest. For this reason, young people at this age are very strong, can withstand a high use of energy and can "get away" with a life-style that would make older people ill.

However, Western boys and girls of this age are also prone to infections (such as glandular fever and herpes), feel frequently tired and are also often depressed and unmotivated.

AETIOLOGY
Young people's lives are increasingly difficult and subject to many stresses. The adolescence period is a very vulnerable period of our life both on a physical and emotional level, especially for girls. A careful history taking will often reveal the onset of a particular problem during adolescence. For example, if a girl has been suffering from headaches since the onset of the menarche (which can be established only with very careful questioning) this most probably indicates Liver-Blood deficiency (giving rise to Liver-Yang rising) and a weakness of the Chong and Ren Mai as the main cause of the problem.

Skin problems from this age may also be due to the aggravation of Blood deficiency with the onset of the menarche. If a young woman has been suffering from painful period ever since their onset, this almost certainly points to invasion of Cold in the Uterus during early adolescence when the Uterus is in a particularly vulnerable state.

Adolescence is also vulnerable time from the emotional point of view and deep emotional problems in a young adult often stem from that time. Indeed, any emotional problem occurring during adolescence will have more serious and long-lasting repercussions than emotional problems occurring later in life.

Excessive physical work during puberty and adolescence also has a profound repercussion in later years especially in girls: it weakens the Spleen and Heart and an irregular heart beat in young people is often due to this cause.

Diet
Dietary causes of disease very often stem from the adolescence time: in fact, it is at this time or soon after that many young people leave home and their diet becomes very irregular and often poor in nourishment. Another factor at this time of life is a sudden conversion to vegetarianism. Of course, a vegetarian diet may be perfectly healthy but it does require a relatively sophisticated knowledge of food combining which is beyond most young people of that age. Thus, most young people who become vegetarian at this age, eat a lot of cheese to replace animal protein and a lot of salads. As we know, from a Chinese dietary perspective, cheese may tend to lead to the formation of Dampness while the excessive consumption of vegetables may lead to internal Cold and may weaken the Spleen. Such a misguided vegetarian diet weakens the Spleen and may lead to Qi and Blood deficiency, especially in girls.

Emotional stress
Adolescence is a very emotional and vulnerable time of our life because it is a time of profound hormonal changes which come relatively suddenly. Especially in difficult family situations, adolescence is a very difficult time from the emotional point of view and many young people of this age suffer from depression and lack of motivation. Emotional problems occurring during puberty have a deeper and more long-lasting effect than those occurring at other times.

REMEDIES

Calm the Spirit
Calm the Spirit is a variation of Gui Pi Tang Tonifying the Spleen Decoction: it tonifies Qi and Blood of the Spleen and Heart. It is an excellent remedy to tonify Qi and Blood and calm the Mind in adolescents suffering from emotional problems deriving from sadness or grief. A central Heart crack is a strong indication for the use of this remedy (see figure 1.)

Ease the Muscles
Ease the Muscles resolves Dampness and clears Heat from the Middle Burner and the muscles. It is the remedy of choice for post-viral fatigue syndrome or glandular fever (mononucleosis) manifesting primarily with symptoms of Damp-Heat. Post-viral fatigue syndrome is becoming more and more common in young people and it often strikes during adolescence. The main manifestations indicating the use of Ease the Muscles are an ache in the muscles, tiredness, lassitude, a feeling of heaviness, a sticky-yellow tongue coating and a slippery pulse.

Tonify Qi and Ease the Muscles
Tonify Qi and Ease the Muscles tonifies and raises Qi and resolves Dampness. It is the remedy of choice for post-viral fatigue syndrome or the chronic stage of glandular fever (mononucleosis) manifesting primarily with symptoms of Deficiency with only a slight Dampness. The main manifestations indicating the use of Tonify Qi and Ease the Muscle are lassitude, tiredness, depression, a slight feeling of heat in the afternoon, a thin tongue coating and a weak pulse.

Soothe the Centre
Soothe the Centre tonifies Spleen-Qi, moves Qi and resolves Dampness in the Middle Burner. It is indicated for young people suffering from a Spleen deficiency and digestive upsets deriving from an irregular diet and a diet too rich in dairy foods and greasy foods.

Central Mansion
Central Mansion, a variation of Shen Ling Bai Zhu San Ginseng-Poria-Atractylodes Powder tonifies Spleen-Qi and Spleen-Yin, tonifies Stomach-Qi and Stomach-Yin and resolves Dampness. The tongue that most indicates the use of this remedy is one that lacks a coating in the centre or has a rootless coating in the centre with a slightly sticky coating elsewhere; it may also have a central Stomach crack or scattered Stomach cracks (see figures 2 and 3).



Release Constraint
Release Constraint pacifies the Liver, eliminates stagnation, calms the Mind and settles the Ethereal Soul. It is the remedy of choice for mental depression deriving from stagnation of Liver-Qi.

Adolescents and young people are often subject to considerable emotional stress due sometimes to pressures of school and college, sometimes to relationship problems and in general to the difficult transition time from childhood to adulthood. The typical signs that point to the use of this remedy is depression and tiredness with red sides of the tongue and a Wiry pulse.

One of the typical signs for the use of this remedy is a certain contrast between the appearance of the young person, appearing tired, depressed, often pale, walking slowly and talking with a low voice and the pulse which is Full and Wiry in all positions. Thus, the pulse is a very important sign for selecting this remedy.

Warm the Menses
Warm the Menses expels Cold and warms the Uterus: in adolescents and young women, Cold in the Uterus is a major cause of dysmenorrhoea.

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