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General Overview
Abdominal distension is primarily governed by the Spleen and Stomach meridians. It presents as either deficiency or excess patterns, which must be distinguished carefully. In cases of Spleen deficiency, it often results from prolonged illness causing internal injury to the Spleen; in cases of Stomach excess, it is mostly due to food stagnation retained in the Stomach. For deficiency, treatment should focus on fortifying the Spleen while regulating Qi; for excess (food stagnation), treatment should focus on digesting food and promoting drainage, thereby restoring harmony naturally.

Deficiency Distension
When a child suffers from prolonged illness leading to Spleen deficiency and loss of normal transportation and transformation functions, or when vomiting and diarrhea suddenly injure the Spleen Qi, digestion fails. This manifests as poor appetite with abdominal fullness even after small amounts of food, mental fatigue, sallow complexion, and emaciation. Xiangpo Sijunzi Tang (Fragrant Magnolia Bark and Four Gentlemen Decoction) is indicated.

Excess Distension
Overeating in children damages Stomach Qi internally, causing food stagnation in the Stomach. This leads to abdominal distension, constipation, tidal fever (periodic fever), irritability, thirst, and robust physical constitution. For mild cases, Jiawei Pingwei San (Modified Powder for Calming the Stomach) is the primary formula; for severe cases, Xiaochengqi Tang (Minor Order the Yellow Decoction) is more effective.

General Overview
Pediatric fever varies by exterior/interior and deficiency/excess patterns. Treatments differ by sweating, purging, tonifying, and draining methods, requiring careful differentiation. One must observe the patient's form and complexion, identify the etiology, examine symptoms, and palpate the pulse to ensure no clinical details are overlooked.

Exterior Heat
The Exterior Heat pattern in children arises from external contraction of Cold pathogenic factors. Symptoms include floating pulse, fever, aversion to wind and cold, headache, body ache, and absence of sweating. Shishen Tang (Ten Deities Decoction) is indicated. If accompanied by interior heat, Shuangjie Tongsheng San (Double-Resolving Universal Harmony Powder) should be used first.

Interior Heat
The Interior Heat pattern results from excessive consumption of rich and sweet foods, generating internal heat. Symptoms include generalized steaming fever, scanty dark red urine, flushed face, cracked lips, dry tongue with thirst, and a forceful, excess pulse. Tiaowei Chengqi Tang (Regulate the Stomach Order the Yellow Decoction) should be administered to purge; if ineffective, Baihu Tang (White Tiger Decoction) or Huanglian Jiedu Tang (Coptis Detoxification Decoction) may be used to clear heat.

Deficiency Heat
Deficiency Heat occurs post-illness in children due to weakness of Ying (Nutritive) and Wei (Defensive) Qi and unharmonized Blood and Qi. Symptoms include mental fatigue and lack of energy, treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If accompanied by thirst with desire to drink and vomiting, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is indicated. Additionally, in cases where Yin excess repels Yang, causing Yang to float externally and manifest as fever, the face may appear red, but urine will be clear and cold, and limbs cold. Bainong Tang (Bai Tong Decoction) is used to consolidate floating Yang; the fever subsides spontaneously thereafter.

Excess Heat
Excess Heat in children stems from accumulated residual heat, causing tidal fever (afternoon fever), profuse sweating, abdominal distension, red urine, difficult defecation, irritability, thirst, crying, mouth and tongue ulcers, flushed cheeks, and a surging, rapid, and forceful pulse. The method involves clearing heat and promoting free flow. For constant fever, Liangge San (Cool the Diaphragm Powder) is indicated; for afternoon tidal fever, Dachaihu Tang (Major Bupleurum Decoction) is used, yielding miraculous results.