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The young grandson of Mr. Zhang from Liaoning, aged four, suffered from Slow Spleen Wind (Man Pi Feng).

Etiology: In early autumn, he indulged in eating melons and fruits. Over time, this damaged the Spleen and Stomach, reducing digestive power, yet he did not cease his habits. After the Mid-Autumn Festival, he developed Slow Spleen Wind.

Symptoms: Appetite decreased significantly; even small amounts of forced food could not be digested. Physicians continued to administer formulas for promoting digestion and resolving blood stasis, further weakening the Spleen and Stomach. Gradually, vomiting and diarrhea occurred simultaneously, with occasional limb convulsions. Only then was I consulted for diagnosis. The patient's skin felt hot to the touch, the pulse was faint and thin, nearly imperceptible, he slept deeply with eyes partially open (exposing the pupils), and his spirit and Qi were weak.

Diagnosis: This condition arises from deficiency-cold of the Spleen and Stomach, which fail to properly cook and digest food and fluids, leading to vomiting and diarrhea. Furthermore, ingested food fails to transform into essence to generate Qi and Blood, instead forming cold fluid retention that accumulates in the Stomach and overflows above the diaphragm. This displaces the Yang Qi of the Heart and Lungs outward, causing the sensation of whole-body heat while the pulse becomes faint and thin. This indicates true cold within and false heat on the exterior. The deep sleep with eyes partially open occurs because the eyelids are governed by the Spleen and Stomach; due to their severe deficiency-cold, the eyelids contract tightly, keeping them slightly open even during sleep. The limb convulsions result from Qi and Blood deficiency, preventing them from ascending to the brain to nourish and regulate the brain marrow and nerves (as stated in the *Nei Jing*: "Insufficiency of upper Qi leads to an empty feeling in the brain." Since blood ascends with Qi, less ascending Qi means less ascending blood. Thus, observing infants with unclosed fontanelles suffering from this condition reveals a sunken fontanelle, clear evidence of brain insufficiency and failure of Qi and Blood to ascend). Consequently, the nerves lose their normal function, causing intermittent limb convulsions. Treatment requires warming agents to strengthen and tonify the Spleen and Stomach, dispelling cold fluid retention, after which all symptoms will resolve spontaneously.

Prescription: Red Halloysite (Chishi Zhi) 1 liang, finely ground; Raw Huai Yam (Sheng Huai Shan Yao) 6 qian; Cooked Huai Rehmannia Root (Shu Huai Di Huang) 6 qian; Charred Atractylodes Macrocephala Rhizome (Jiao Bai Zhu) 3 qian; Prepared Aconite Root (Wu Fu Zi) 2 qian; Guang Cinnamon Bark (Guang Rou Gui) 2 qian, coarse bark removed before adding; Dried Ginger (Gan Jiang) 1.5 qian; Large Poria Cocos Sclerotium slices (Da Yun Ling Pian) 1.5 qian; Honey-fried Licorice Root (Zhi Gan Cao) 2 qian; Korean Ginseng (Gao Li Shen) 1.5 qian, crushed into coarse powder.

Ten ingredients in total. Decoct the first nine ingredients in one large cup of water. Take warm in multiple small doses. Each dose should be accompanied by a small amount of ginseng powder.

Formula Analysis: Heavy use of Chishi Zhi is employed because it settles vomiting when acting superiorly and stops diarrhea when acting inferiorly. Administering Ginseng as a powder facilitates treatment of vomiting and diarrhea, as pill and powder formulations are superior to decoctions for these conditions, since the residue of pills/powders adheres longer to the gastrointestinal tract.

Outcome: After completing one dose, vomiting ceased, diarrhea reduced by more than half, convulsions stopped, and fever significantly subsided. Gan Jiang was removed, and Bai Zhu was increased to 4 qian. After another dose, diarrhea also stopped. Subsequently, using the original formula, the dosage of Fu Zi was halved, and 5 qian of Goji Berry (Gou Qi Zi) was added. After two doses, the illness was completely cured.

Note: If vomiting were excessively severe in such cases, one should first use the Formula for Expelling Cold and Dispelling Shock (Zhu Han Dang Jing Tang) from *Fu You Bian* to open up cold fluid retention, allowing tolerance of other medications. However, since vomiting in this case was not severe, it was not used.