National Standard Code
A09.05
GB/T 15657-2021
Category
Pediatric diseases and symptoms

Traditional Chinese Medicine Definition

The "Five Delays and Five Softnesses" is a pediatric disease in traditional Chinese medicine, referring to the delayed growth and development in children, characterized by weak tendons and bones, slow movements, low intelligence, delayed language development, and weak chewing. As recorded in "Internal Medicine of Traditional Chinese Medicine": "The five delays are the softness of the neck, mouth, hands, feet, and muscles; the five softnesses are the same as the five delays." This condition is often caused by insufficient endowment from birth and improper care after birth.

The core pathogenesis of the "Five Delays and Five Softnesses" is deficiency of the liver and kidney, as well as deficiency of the heart and spleen. In clinical practice, common causes of this condition include insufficient endowment, improper nourishment after birth, and the impact of diseases. During the process of differentiation, attention should be paid to distinguishing cold and heat, as well as deficiency and excess. For instance, the liver and kidney deficiency manifests as delayed growth and development, weak tendons and bones, and delayed sitting, standing, and walking compared to peers. The heart and spleen deficiency manifests as delayed intellectual development, slow language, and fatigue with a yellowish complexion. The overall direction of treatment suggests following the principles of reinforcing the kidney and nourishing the liver, strengthening the tendons and bones, invigorating the spleen and heart, and improving intelligence and opening the orifices. In clinical practice, the treatment of the "Five Delays and Five Softnesses" should focus on adjusting the functions of the internal organs, balancing yin and yang, and promoting the growth and development of children.

Common Syndrome Types and Key Points of Differentiation

Deficiency of liver and kidney

Main Manifestations: Delayed growth and development, weak muscles and bones, sitting, standing, and walking are all delayed compared to peers.

Management Approach: Tonify kidney and nourish the liver, strengthen the tendons and bones

Deficiency of both heart and spleen

Main Manifestations: Intellectual development delay, language retardation, fatigue and yellowish complexion

Management Approach: Strengthen the spleen and nourish the heart, benefit intelligence and open the orifices

The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.

Physician's Clinical Insights

Children with "Five Delays and Five Softnesses" often suffer from insufficient endowment from birth. The key to treatment lies in reinforcing the kidney and replenishing essence, as well as invigorating the spleen and benefiting the Qi.

— Chai Xia Yang Traditional Chinese Medicine Practitioner

Reviewed by: Chai Xia Yang (Traditional Chinese Medicine Practitioner) | 2026-07-07 | Version 2

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This page is for the popular science of traditional Chinese medicine knowledge and does not constitute medical advice. Specific diagnosis should be completed by a licensed traditional Chinese medicine practitioner in person.

This article has been reviewed by licensed TCM physicians at Hangzhou Kezhentang TCM Clinic. It is for TCM popular science reference only and does not involve specific treatment plan recommendations.

References: Internal Medicine of TCM (13th Five-Year Plan Textbook), Diagnostic and Therapeutic Effectiveness Standards for TCM Diseases and Syndromes (ZY/T001.1-94), Classification and Codes of TCM Diseases and Syndromes (GB/T 15657-2021)

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