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The complexion is pale and lusterless, the breath from the mouth is cold, there is no desire to eat, and water is vomited. The Spleen should be tonified, with Yihuang San (Benefiting Yellow Powder) as the primary formula.

The complexion is white but weak in luster, accompanied by abdominal pain and loss of appetite. The Spleen should be tonified, with Yihuang San (Benefiting Yellow Powder) as the primary formula. If diarrhea occurs, Tiaozhong Wan (Regulating Middle Pill) should be used as the primary formula.

If the breath from the mouth is warm, the complexion is yellowish-white, the eyes lack luster, or the whites of the eyes are prominent, along with excessive sleepiness, aversion to eating, or sour-smelling stool, stagnation should be dispersed. Xiaojie Wan (Eliminating Stagnation Pill) is appropriate; for severe cases, Baibing Zi (White Cake Pills) should be used to purge. Afterwards, the Stomach Qi should be harmonized.

(Attached: Deficiency-Excess Abdominal Pain)
The complexion is pale, with heart and abdominal pain, saliva and clear fluid flowing from the mouth, and pain occurring at specific times. Anchong San (Calming Parasites Powder) is the primary formula. Children who are naturally timid often suffer from this disease. Pain due to accumulation, food stagnation, and deficiency are largely similar with minor differences. Only parasitic pain presents with a bland taste in the mouth and spontaneous salivation; treatment should follow the specific syndrome.

Children are naturally timid; thus, when Stomach Qi is deficient and cold, parasites move causing heart pain, which is slightly similar to epilepsy, but without deviation of the eyes or twitching of the hands. Anchong San (Calming Parasites Powder) is the primary formula.

Frequent puckering of the lips indicates a need to regulate Qi, with Yihuang San (Benefiting Yellow Powder) as the primary formula.

Coldness in the Spleen and Stomach prevents digestion. The Spleen should be tonified, with Yihuang San (Benefiting Yellow Powder) as the primary formula.

Not eating, but only drinking milk, is the condition described. Baibing Zi (White Cake Pills) should be gradually used to purge.

Pediatric pi accumulation arises from undigested milk and food lying latent in the abdomen, alternating between cold and heat, drinking water, or wheezing and coughing, resembling tidal fever. If not treated early, it will inevitably develop into gan syndrome. Because of the pi accumulation, the child refuses to eat, leading to Spleen and Stomach deficiency and internal heat generation, causing excessive water intake. This purges the intestines and stomach, depleting body fluids. The Spleen and Stomach fail to transport and transform water and grain; the pulse is deep and fine. With further refusal to eat, Spleen and Stomach deficiency worsens, limbs become immobile, various pathogens arise, and few escape becoming emaciated and developing gan syndrome. I have discussed this in the Gan Syndrome section.

(Attached: Swelling)
Abdominal distension is caused by Spleen and Stomach deficiency and attacking Qi. In excess patterns, there is chest oppression, restlessness, wheezing, and fullness, which can be purged using Zishuang Wan (Purple Frost Pill) or Baibing Zi (White Cake Pills). If there is no wheezing, it is a deficiency pattern, and purging is contraindicated. If mistakenly purged, Spleen Qi becomes deficient, and deficient Qi ascends to attach to the Lung and follows its movement. Both Lung and Spleen, being mother and child organs, become deficient. The Lung governs the eyelids and cheeks; the Spleen governs the four limbs. When maternal Qi (Spleen) is extremely deficient, eyelid and cheek swelling occur. A yellow complexion belongs to the Spleen. Treatment uses Taqi Wan (Settling Qi Pill) to gradually resolve it. If not cured, gradually increase the number of pills. Do not treat with strongly warming and dispersing herbs such as Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), Chuanpiao (Tangerine Peel), and Doukou (Cardamomi Fructus). Why? When Spleen deficiency exists and Qi has not yet escaped, causing abdominal distension without wheezing, powder formulations can be used to disperse Qi. By dispersing Qi from above and below, recovery occurs. If deficient Qi has already escaped and attached to the Lung, internal Spleen and Stomach weakness persists, generating frequent deficient Qi that enters the limbs and face.

Children are prone to deficiency-excess complexities. Spleen deficiency cannot tolerate either cold or warmth; administering cold herbs generates cold conditions, while administering warm herbs generates heat. One must recognize this to avoid error. Long-term Stomach deficiency heat often leads to jaundice or incessant thirst. Spleen deficiency fails to control the Kidney; following Lung Qi, it ascends to the four limbs like water; Kidney Qi infiltrates and floats up to the Lung, causing severe wheezing. This requires Taqi Wan (Settling Qi Pill). If the complexion remains unrosy after cure, it is because deficiency has not yet recovered.

Treating abdominal distension is like waging war against bandits in a forest. If the bandits have not left the forest, attacking them with troops will surely capture them; if they have left the forest, one must not attack hastily, as an attack will result in losses. One should gradually subdue them with strategy, which is favorable.

To treat deficiency-type abdominal distension, first administer Taqi Wan (Settling Qi Pill). If not cured, and there is food accumulation and fecal impaction in the abdomen, yellow urine, occasional mild wheezing, a deep and forceful pulse, frequent thirst, and ability to eat, purging may be used. This is because the Spleen was initially deficient and later developed accumulation. Treatment should first tonify the Spleen, then purge, and then tonify the Spleen again for recovery. Tonifying the Lung may induce deficiency wheezing.