Library

The classics state: Accumulations in the five zang organs are called "Ji" (Accumulation), while accumulations in the six fu organs are called "Ju" (Gathering). In children, stagnation or pain arising from food retention is caused by irregular breastfeeding or feeding, excessive consumption of raw and cold foods, leading to the spleen and stomach's inability to digest and transform, causing food to stagnate in the Zhongwan region. Over time, this forms an accumulation. Alternatively, lying down immediately after a full meal causes the spleen to lose its transformative function, leaving food behind to form an accumulation. Symptoms include yellowish swelling of the face and eyes, abdominal pain and distension, high fever with cold feet, lethargy, and refusal to breastfeed or eat. Stools may be sour-smelling or constipated and difficult to pass, and urine may resemble oil. If milk is vomited or diarrhea produces sour-smelling discharge, it is classified as Milk Retention (stagnation of milk). If abdominal distension is accompanied by diarrhea, vomiting, and belching, it is classified as Food Retention (stagnation of solid food). In the early stage, when vital qi has not yet been damaged, if there is abdominal distension and pain with difficulty in urination and defecation, first administer Baibing Zi (White Pill) or Muxiang Binglang Wan (Aucklandia and Betel Nut Pill) to purge. After purging, harmonize the spleen and stomach using Baizhu San (Atractylodes Powder) or Wuyi Yigong San (Five-Ingredient Powder for Extraordinary Efficacy). Add Ge Gen (Kudzu Root) for thirst, and Ban Xia (Pinellia Tuber) for vomiting. If heat persists after purging, or if vomiting, diarrhea, and loss of appetite occur, this indicates damage to both the spleen and stomach; use Liujunzi Tang (Six-Gentleman Decoction). If the fingers and toes are cold and the child prefers hot drinks, this indicates deficiency-cold of the spleen and stomach; add Pao Jiang (Prepared Ginger) and Mu Xiang (Aucklandia Root) to the previous formula. If the complexion is yellowish-white and the eyes lack luster, this indicates deficiency of both the spleen and lung; use Sijunzi Tang (Four-Gentleman Decoction) added with Chai Hu (Bupleurum Root) and Sheng Ma (Cimicifuga Rhizome). If there is abdominal pain, dysentery with a sensation of heaviness in the anus, or difficulty in urination, use Sini San (Frigid Extremities Powder). If there is fever, particularly in the late afternoon, or persistent diarrhea, this indicates sinking of spleen qi; if there is tidal fever, thirst, and irregular bowel movements suggesting a transition into Infantile Malnutrition (Gan Syndrome), use Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting Qi) assisted by Fei'er Wan (Child-Nourishing Pill). The classics say: Where pathogenic factors gather, vital qi must be deficient. If they remain and do not depart, the disease becomes excess. Treatment must focus primarily on regulating the spleen, assisting with digestion and elimination. This aligns with the ancient principle that nurturing the upright qi will naturally eliminate stagnation.

Clinical Cases:
A child who suffered from food stagnation developed red rashes on the body and was cured using Qingzhong Jieyu Tang (Decoction to Clear the Middle and Resolve Depression). Later, the child exhibited head shaking, teeth grinding, profuse phlegm, and convulsions, vomiting sour and putrid matter. After waiting for the vomiting to cease completely, Qiw Wei Baizhu San (Seven-Ingredient Atractylodes Powder) was administered the next day, followed by Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder). The condition did not recur. If the child is stable after vomiting, no further medication is necessary.

A child suffering from vomiting and fever due to food stagnation took digestive agents. Although the food stagnation resolved, the fever persisted. I diagnosed this as deficiency-heat in the Stomach meridian and prescribed Liujunzi Tang, Sheng Ma, and Chai Hu, each two fen. After four doses, the child recovered.

A seven-year-old child experienced abdominal pain after food stagnation. Taking harsh purgatives exacerbated the pain, but pressing on the abdomen did not elicit pain, indicating further injury to the spleen qi. The child was cured using Liujunzi Tang. Later, upon re-injuring the stomach with food, the child took Baohe Wan (Harmonize the Stomach Pill) along with San Leng (Curcuma Zedoaria Rhizome) and Bing Lang (Areca Seed), which worsened the abdominal pain. Taking Xiehuang San (Drain Yellow Powder) resulted in heavy limbs and frequent belching, indicating spleen qi deficiency with sinking. The child was cured using Liujunzi Tang added with Sheng Ma, Chai Hu, and Mu Xiang.

A child of several years old had taken harsh purgative drugs every time food stagnated. Subsequently, the abdomen became distended with vomiting and diarrhea. Six-Junzi Tang was used first, gradually resolving the symptoms; then Buzhong Yiqi Tang was used to stabilize the condition.

A child with abdominal distension experienced immediate diarrhea after eating, with inverted coldness in the hands and feet. This indicated deficiency-cold of the spleen qi. Ren Shen Lizhong Wan (Ginseng and Zingiber Pill for Regulating the Middle) was used first, followed by Liujunzi Tang, resulting in recovery.

A child with abdominal pain experienced intensified pain upon manual pressure, indicating stagnation of milk and food. One qian of Baohe Wan powder and three fen of Bing Lang powder were administered. After passing sour-smelling stools, the child was relieved. Later, the child suffered abdominal pain again and took other harsh purgatives, worsening the pain. However, manual pressure alleviated the pain, and the complexion was yellowish-white. This was due to improper diet causing spleen qi dysfunction, where earth deficiency failed to generate metal (spleen deficiency affecting the lung). Liujunzi Tang was used, and the child recovered.

A child suffered from chronic abdominal pain. Examination of the mother revealed a wiry and moderate pulse at the right guan position, indicating wood overacting on earth (liver wood invading spleen earth). Liujunzi Tang added with Mu Xiang and Chai Hu was administered to both mother and child, resulting in recovery.

A child with food stagnation and abdominal pain had a white complexion, scant black pupils, constant coldness in the hands and feet, loose stools, inhalation through the mouth and nose, and a cold sensation in the abdomen. This indicated congenital deficiency of Mingmen Fire (Fire of the Gate of Life), failing to warm and vaporize the qi of the middle jiao, resulting in spleen-stomach deficiency-cold. Bawei Wan (Eight-Ingredient Pill) and Buzhong Yiqi Tang were used, and the child recovered.

A child with the aforementioned symptoms took expulsive agents, leading to aversion to cold and fever. I prescribed Buzhong Yiqi Tang in the morning and Wuyi Yigong San in the evening, leading to quick recovery. Later, food stagnation caused abdominal pain and constipation. Other draining agents were used, resulting in morning chills and evening fevers, with frequent stools. I used Wuyi Yigong San. Over a month, dietary intake gradually improved, so I supplemented with Bazhen Tang (Eight-Treasure Decoction), with Shaoyao (Peony Root) stir-fried until charred and a small amount of Chuanxiong (Ligusticum Chuanxiong Rhizome). After another two months, the chills and fever gradually resolved. Later, a wind-cold invasion occurred. Can Su Yin (Ginseng and Perilla Drink) was taken, leading to sweating, wheezing, coughing, and fever. Heat-clearing and phlegm-resolving agents were taken, causing increased irritability, insomnia, and aimless picking at clothes/air. Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) decocted in water was used first, rapidly retreating all symptoms; two more doses brought peace. Then, Wuyi Yigong San and Bazhen Tang were used for complete recovery. Later, food stagnation caused vomiting and diarrhea, with stool urgency without passage. Buzhong Yiqi Tang was tried first for several doses with no effect. The prescription was changed to Ren Shen (Ginseng Root) 5 qian, Bai Zhu (Atractylodes Macrocephala Rhizome) 3 qian, Chen Pi (Tangerine Peel) and Gan Cao (Licorice Root) 7 fen each, Sheng Ma 4 fen, and Ge Gen 5 fen. After three doses, the hands and feet became cold. Urgently, Ren Shen 1 liang and Fu Zi (Aconite Lateralis Radix Praeparata) 5 fen were decocted with fresh ginger and dates, administered twice daily. The hands and feet warmed up. After two more doses, symptoms gradually receded. The original prescription with Ren Shen 5 qian was resumed, and the child recovered.

Qiw Wei Baizhu San (Seven-Ingredient Atractylodes Powder): Treats vomiting, diarrhea, and thirst.
Ren Shen (2.5 qian), Bai Fu Ling (Poria), Bai Zhu, Huo Xiang Ye (Agastache Leaf) (each 0.5 liang), Mu Xiang (2 qian), Gan Cao (1 qian), Ge Gen (0.5 liang, increase to 1 liang if thirsty).
Take 1-2 qian per dose, decoct in water. Remove Mu Xiang if heat and thirst are severe; add Shaoyao if abdominal pain occurs.

Sini San (Frigid Extremities Powder): Treats Shaoyin disease, or abdominal pain, dysentery with heaviness in the anus.
Zhi Shi (Immature Bitter Orange Fruit, stir-fried until yellow), Gan Cao (stir-fried), Chai Hu, Shaoyao.
Grind into fine powder. Take 2 qian per dose, mix with rice water on an empty stomach.

Baibing Zi (White Pill) (See formula under Convulsions).
Muxiang Binglang Wan (Aucklandia and Betel Nut Pill) (See formula under Food Stagnation).
Wuyi Yigong San (Five-Ingredient Powder for Extraordinary Efficacy).
Liujunzi Tang (Six-Gentleman Decoction) (Both formulas see under Internal Hook).
Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting Qi) (See formula under Emaciation).