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Pediatric phlegm obstruction and qi stagnation manifest with stridor-like sounds during respiration. In severe cases, phlegm may diffuse and block the orifices of the heart-mind (Shen), resulting in a dazed or confused state. Phlegm may also obstruct the throat, making it impossible to expectorate or swallow. This condition is particularly common in children. Internal treatment should primarily focus on resolving and transforming phlegm (Huo Tan Hua Tan).

Perform "Dividing Yin and Yang" (Fen Yin Yang) for 100 repetitions; push the Three Gates (Tui San Guan) for 100 repetitions; retreat the Six Fu (Tui Liu Fu) for 100 repetitions; push the Lung Meridian (Tui Fei Jing) for 100 repetitions; push the Heart Meridian (Tui Xin Jing) for 50 repetitions; push the Four Horizontal Lines (Tui Si Heng Wen) for 50 repetitions; rotate the Eight Trigrams (Yun Ba Gua) for 50 repetitions; knead the Inner Laogong (Rou Nei Laogong) for 50 repetitions; perform "Heavenly Gate Entering Tiger's Mouth" (Tian Men Ru Hu Kou) for 50 repetitions; pinch the Five Finger Joints (Qia Wu Zhi Jie) for 24 repetitions. The emetic method (Tu Fa; see Volume 2, page 22) should be applied first. Alternatively, one may dip a chicken feather in lamp wick oil and sweep the throat to induce vomiting. Other methods include the phlegm-guiding method (Yin Tan Fa; see Volume 2, page 40), the meridian-unblocking method (Tong Mai Fa; see Volume 2, page 43), and the orifice-opening method (Kai Bi Fa; see Volume 2, page 39).

For the Qihai acupoint (CV6, Sea of Qi) in children, the practitioner uses the flexed joint of their finger to press against the point and then releases it. Using this technique helps descend the phlegm. This is the method of "guiding and exhausting" (Yin Er Jie Zhi) for pathogens located below.

Pinch from the root to the tip of the child's middle finger several times, then push the Yongquan acupoint (KI1, Gushing Spring) rotating only to the left without kneading. Simultaneously, use the middle finger to press against the Jiache acupoint (ST6, Jawbone) while using an ear pick to scrape the surface of the tongue, which will induce the expulsion of phlegm. This is the method of "following and evacuating" (Yin Er Yue Zhi) for pathogens located above.

Commentary: Phlegm arises from Kidney Yang deficiency, where fire fails to control water, causing water to flood and transform into phlegm and fluid retention that counterflows upward. Consequently, the phlegm is clear and transparent; treatment should focus on unblocking yang and draining dampness, avoiding cloying substances that aid yin. Phlegm also arises from Kidney Yin deficiency, where deficient fire scorches Metal (Lung), leading to fire-condensed phlegm that rises as phlegm-fire. Consequently, the phlegm is thick and turbid; treatment should focus on nourishing yin and clearing heat with moistening agents, avoiding warm and drying substances. Pang Shi stated: "There is no backward-flowing water in the world, driven by wind." Similarly, "There is no upward-counterflowing phlegm in the human body, driven by qi." Phlegm moves up and down with qi, reaching every part of the body. In the Lungs, it causes cough; in the Stomach, vomiting; in the Heart, palpitations; in the head, dizziness; in the back, coldness; in the chest, stuffiness; in the hypochondrium, distension; in the intestines, diarrhea; in the meridians, swelling; in the limbs, bi-syndrome (obstruction); and if phlegm enters the orifices of the Heart-mind, it causes confusion, epilepsy, and convulsions. Each has its specific treatment methods, not limited solely to massage. (Tili Zi)