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Abdominal pain in children is mostly caused by food stagnation (Food Stagnation). The pain due to food stagnation is mostly attributed to cold (Cold). This is because the transformation of heaven and earth follows the principle that heat causes dispersion and free flow, while cold causes condensation and obstruction. After food is swallowed, the yang qi of the stomach and intestines fails to perform its functions of transformation and transportation, causing grains, meats, fruits, and vegetables to linger within the gastrointestinal tract. Consequently, pain arises depending on the location where the food remains.

If the food is still in the stomach and retains its original form, with pain located at the epigastrium, emesis (Emesis) is indicated, following the principle "where the pathogen is high, use vomiting to expel it." Guadi San (Melon Pedicle Powder) is the primary formula.

If the food has reached the small intestine, although partially digested, it remains as dregs, with pain located below the epigastrium and above the umbilicus. Acrid-warm herbs that promote purgation are indicated. Dingxiang Pi Ji Wan (Clove Spleen Accumulation Pill) is the primary formula.

A one-year-old child began eating meat too early, leading to chronic accumulation, progressive emaciation, and anorexia for milk and food. His father, Sha Xi, sought my treatment. I prescribed Qu Ji Wan (Remove Accumulation Pill) for three days first, followed by Pi Ji Wan (Spleen Accumulation Pill), administered with chicken broth. A piece of undigested chicken was expelled. Subsequently, Yang Pi Wan (Nourish Spleen Pill) was used for regulation, resulting in recovery.

If the accumulation is in the large intestine, where water and grain have separated and transmission to the broad intestine is impaired, pain occurs above the umbilicus. Bitter-cold herbs for purgation are indicated. Muxiang Binglang Wan (Aucklandia and Betel Nut Pill) is the primary formula.

If emesis is suitable, the method of inducing vomiting with salt water probe is particularly effective. If pain occurs in the stomach region after eating, emesis is indicated. However, if pain is caused by old accumulations, emesis should be avoided to prevent damaging stomach qi. Xiaoxianxiong Wan (Small Chest-Piercing Pill) is indicated.

Ingredients: Zhishi (Bran-fried Fried Immature Bitter Orange, 2 qian), Banxia (Pinelliae Rhizoma, 2 qian), Huanglian (Ginger-juice fried Coptidis Rhizoma, 2 qian), Caodoukou (Fried Cardamom Seed, 0.5 qian). Grind into powder, make pills with Shenqu paste, size of hemp seeds, administer with ginger decoction.

Wang Xiaoting suffered from epigastric pain at the heart center for seven days without relief. Upon palpating his chest and abdomen and asking for the precise location, I found that the area over the heart was tender to touch (refusal to press). I admitted, "My diagnosis was flawed; no wonder the previous medicine failed." Generally, abdominal pain that can be pressed indicates deficiency pain (Deficiency Pain); pain that cannot be pressed indicates excess pain (Excess Pain). Excess pain is due to either stagnation or phlegm-fluid, hence tenderness. I immediately formulated a prescription combining elements from Zhishi Daozhi Wan (Immature Bitter Orange Regulating Stagnation Pill) and Kongxian Dan (Draining Fluids Pill): Zhishi (2 qian), Huanglian (2 qian), Banxia (2 qian), Muxiang (Aucklandiae Radix), Toumo Heiqianniu (Black Morning Glory Seed), Baizijie (Stir-fried White Mustard Seed), and Gancao (Licorice Root) in equal parts. These were ground into powder, mixed with fresh ginger juice and Shenqu to form pills the size of hemp seeds. Administered with water infused with Chenxiang (Aquilariae Lignum Resinatum), Muxiang, and Binglang (Arecae Semen). Initial dose: 21 pills. Shortly after, pain shifted to the Zhongwan point. Second dose: 7 pills. Pain moved to below the umbilicus. Third dose: 5 pills. Clear fluid stool ensued, and pain ceased. It was then determined to be spleen pain. Zhizhu Wan (Atractylodes and Citrus Pill) was compounded with Qingpi (Green Tangerine Peel), Chenpi (Aged Tangerine Peel), Muxiang, Sharen (Amomi Fructus), Shenqu, Maiya (Hordei Fructus Germinatus), and Shanzha (Crataegi Fructus) for regulation, leading to stability. One must not neglect the treatment of pain.

Accumulative pain in the abdomen is confined to the stomach and intestines. The stomach and intestines are like a market, gathering substances. The spleen governs rotting and ripening but does not receive directly; thus, without external invasion or internal injury, pain does not occur. For spleen pain, the ancestral San Sheng San (Three Saints Powder) is indicated.

Ingredients: Cangzhu (Salt-stir-fried Atractylodis Rhizoma), Xiangfuzi (Salt-stir-fried Cyperi Rhizoma), Liangjiang (Clear-oil stir-fried Galangal Rhizome). Grind into fine powder, take with hot wine.