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The *Classic of Medicine* states: The Stomach is the sea of water and grain, and the great source of the six fu organs. The qi, blood, and zang-fu organs of the human body are all generated by Stomach Qi. Therefore, in Li Dongyuan's methodology, emphasis is placed primarily on the Spleen and Stomach. The saying "tonifying the Spleen is better than tonifying the Kidney" embodies this very meaning. In infants and children, although they consume milk and food, the qi derived from water and grain is not yet fully developed; they rely heavily on Stomach Qi. If Stomach Qi becomes deficient, the four other zang organs (Liver, Heart, Lung, Kidney) will all lose their nourishment. Thus, Zhu Danxi stated that infants and children often suffer from Liver and Spleen disorders. If the complexion is pale, the eyes lack luster, breath from the mouth feels cold, there is anorexia with vomiting of clear fluid, emaciation, and abdominal pain, these are symptoms of Deficient-Cold of Stomach Qi. The primary treatment should be Wuwei Yigong San (Five-Ingredient Powder for Restoring the Extraordinary) or Liu Junzi Tang (Six-Gentleman Decoction). If the stool is loose and unformed, indicating concurrent Spleen deficiency, add Ganjiang (Dried Ginger) to warm the middle. If there is abdominal fullness and difficulty in defecation, indicating failure of Spleen transportation, add Muxiang (Aucklandia Root) to promote qi movement. If there is a preference for cold drinks and constipation, this indicates Excess-Heat in the Stomach; treat with Xiehuang San (Powder to Drain the Yellow) to cool. If Mingmen Fire (Fire of the Gate of Life) is deficient and unable to generate Earth (warm the Spleen), use Bawei Wan (Eight-Ingredient Pill) to tonify. For congenital insufficiency of Stomach Qi, this pill is also used. When the True Yang of the lower jiao is abundant, it generates Yuan Qi of the Spleen upwards, naturally enabling the warming and steaming digestion of water and grain.

Clinical Cases:
An infant suffered from food stagnation, resulting in incessant vomiting and diarrhea. Later, the stool turned green, the eyes remained half-open during sleep (exposing the pupils), and the fingers and toes were cold. The forehead appeared dark and the lips cyanotic. I reasoned that green stool indicates Wood overacting on Earth; intermittent loose stools indicate Spleen Qi deficiency; a dark forehead and cyanotic lips indicate Cold Water insulting Earth. All these belong to Deficient-Cold of Middle Qi. I prescribed Wuwei Yigong San added with Shengma (Cimicifuga Rhizome), Chaihu (Bupleurum Root), Muxiang, and Fuzi (Prepared Aconite Root). After two doses, the condition resolved.

An infant suffered from vomiting and undigested diarrhea during midsummer. After taking Huanglian Xiangru Yin (Isatis and Mosla Drink with Coptis), the condition worsened. Subsequently, using Baishu Gao Shi Tang (White Tiger Decoction with Gypsum) led to abdominal distension and pain, with cold hands and feet. I reasoned that this was Deficient-Cold of the Spleen, compounded by latent Yin cold within the body during summer. I treated with Wuwei Yigong San added with Muxiang, resulting in recovery.

An infant suffered from damaged milk and food intake. Due to the indiscriminate use of digestive-promoting herbs, the condition transformed into dysentery and persisted for a long time. Initially, Liu Junzi Tang added with Muxiang was used, leading to gradual improvement. Finally, Wuwei Yigong San was administered, leading to complete recovery.

An infant had constantly cold hands and feet, abdominal pain, and difficulty digesting food. I diagnosed this as Deficient-Cold of Stomach Qi. Yi Huang San (Benefit the Yellow Powder) was prescribed first; after two doses, the pain ceased. Then, Liu Junzi Tang was administered for several doses, leading to recovery.

A nine-year-old child was constitutionally afraid of wind and cold, had poor appetite, and in autumn and winter, inhalation caused coldness in the mouth and nose, with coldness penetrating to the abdomen. The hands and feet were ice-cold, and only felt comfortable after drinking ginger soup or burning wine. The pulse was fine and minute, with the Chi positions of both wrists being imperceptible. I diagnosed this as congenital Deficiency of Mingmen Fire. Huanshao Dan (Elixir of Returning to Youth) was ineffective. I switched to Bawei Wan (Eight-Ingredient Pill), and after more than ten days, all symptoms resolved.

Pingwei San (Peace the Stomach Powder): Treats disharmony between the Spleen and Stomach, anorexia, epigastric and abdominal distension and pain, bitter taste in the mouth, shortness of breath, nausea, belching, acid regurgitation, sallow complexion, emaciation, lethargy, body aches, cholera-like vomiting and diarrhea, etc.
Houpo (Magnolia Bark, processed with ginger juice, 5 liang) Chenpi (Aged Tangerine Peel) Gancao (Licorice Root, honey-fried, 1 liang each) Cangzhu (Atractylodes Rhizome, soaked in rice wash water and baked, 8 liang)
Grind into powder. Take 2 qian per dose, decocted with ginger and jujube. It can also be taken by mixing with boiling water. Regular consumption regulates qi, warms the stomach, resolves food stagnation, eliminates phlegm-fluids, and wards off pathogenic factors from the four seasons.

My Commentary: For the aforementioned conditions, if there is food stagnation, belching with a rotten odor, acid regurgitation, vomiting, hiccups, and nausea, this formula is suitable. If the food has been digested but the Spleen and Stomach remain weak, causing vomiting and nausea, Sizijunzi Tang (Four-Gentleman Decoction) is more appropriate.

Tiaozhong Wan (Regulate the Middle Pill): Treats Deficient-Cold of the Spleen and Stomach.
Baizhu (Atractylodes Macrocephala Rhizome) Renshen (Ginseng Root) Gancao (Licorice Root, stir-fried, 5 fen each)

Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill): This is Liujun Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Rougui (Cinnamon Bark) and Fuzi (Prepared Aconite Root), 1 liang each. It treats congenital Deficiency of Mingmen Fire, which fails to warm Earth, resulting in Deficient-Cold of the Spleen Earth.

Qian Shi Yihuang San (Dr. Qian’s Benefit the Yellow Powder, also known as Buspi San): Treats vomiting and diarrhea due to Deficient-Cold of the Spleen and Stomach. (Formula see Chapter on Zang Organs: Spleen)

My Commentary: For the previous formulas, if there is Deficient-Cold of Spleen Earth, or Cold Water insulting Earth, presenting with vomiting and diarrhea, cold hands and feet; or surging phlegm-saliva, sleeping with eyes open, and refusal of milk/food, this formula is suitable. If vomiting and diarrhea are due to Spleen Earth weakness, use Liu Junzi Tang and Chaihu. If ineffective, or if hands and feet are cold, indicating Deficient-Cold, add Muxiang and Paojiang (Fried Ginger). If the condition arises because the nursing mother has Spleen deficiency leading to Liver Wood insulting Earth, treat with the aforementioned medicines. If the nursing mother’s depression and anger cause the child to suffer from the aforementioned symptoms, the mother should concurrently take Jiawei Guipi Tang (Modified Restore the Spleen Decoction).

Xiehuang San (Powder to Drain the Yellow) (See Chapter on Zang Organs: Spleen)
Guanyin San (Guanyin Powder) (See Chapter on Vomiting)
Yinbai San (Silver-White Powder) (See Chapter on Slow Convulsion)
Guipi Tang (Restore the Spleen Decoction)
Yigong San (Restoring the Extraordinary Powder)
Liu Junzi Tang (Six-Gentleman Decoction) (The above three formulas see Chapter on Internal Hook)