Professor MA Rong believes that a child’s body is pure yang

and it is often with liver in excess and spleen in deficiency

adequate yang in motion and inadequate yin in tranquility. In the meanwhile

the child’s body is also made of tender yin and tender yang

which is prone to be imbalanced. So the fundamental pathogenesis of Tourette syndrome is spleen deficiency with phlegm accumulation and liver-wind stirring. Hence the treatment should take calming liver and suppressing liver-yang hyperactivity as a priority. It could be divided into stages

emphasizing on clearing liver-heat to calm down liver-wind and soothing liver with tonifying spleen

which is reflected in the prescribtion of Tianma Gouteng Decoction with Ganmai Dazao Decoction with adjustments in clinic.