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Pang Anchang stated: Pi (masses in the hypochondrium) refers to blood membranes wrapping around fluid, located laterally beside the hypochondrium, causing intermittent pain. Only Pi can cause fever and generate alternating chills and fever. Therefore, patients with malaria often have yellow fluid accumulating in the Zhongwan (CV12) region. Over time, this leads to abdominal masses (Pi), resulting in persistent chills and fever. Those suffering from this condition do so because of improper breastfeeding or feeding, leading to obstruction of the Sanjiao (Triple Burner) qi mechanism, causing water and fluids to stagnate in the stomach and intestines. As if attacked by cold qi, these fluids condense to form Pi. For mild cases, Jizhi Muxiang Wan (Accumulation Stagnation Costus Pill) is used; for severe cases, Qu Pi Wan (Remove Pi Pill) is prescribed.

Wang Kentang stated: According to Mr. Mao’s discussion, infants from five months to seven years of age may develop abdominal masses. These masses are as large as a plum pit, appearing and disappearing, or as large as an egg yolk, accompanied by frequent crying due to pain. If located under the left hypochondrium, it is called Qi (Qi mass); if under the right hypochondrium, it is called Pi Qi (Pi Qi mass). Taking Peng E Zhu San (Curcuma Longa Powder) combined with Jian Pi Yin (Spleen-Strengthening Decoction) will lead to recovery. However, if the face is dark, eyes are fixed and staring, black blood is passed in stool, mouth, nose, hands, and feet are cold, and the patient cannot eat, death ensues.

The Taiyin Spleen organ stabilizes the whole body. Regarding its functions, it transforms old food and eliminates stale matter, nourishes and enriches the Zang-Fu organs, distributes fluids and disseminates Jin-Ye (body fluids), receives input from the Stomach above, circulates between the interior and exterior, and transports waste downward to the Large Intestine frequently. Earth is the mother of all things, revealing its true nature here. When the Spleen Qi is deficient, deficiency leads to cold. Deficiency and cold interact, or dampness accumulates. The ingested water and grain lack assistance in grinding and digesting. Over time, accumulation forms, causing abdominal pain, distension, acid regurgitation, vomiting, mental confusion, night fevers, heat in the abdomen, and furrowed brows. One must recognize this; this discusses Shi Ji (Food Accumulation). If there is an external pathogenic invasion, discomfort increases, constituting Cold Damage with Food Accumulation (Jia Shi Shang Han), presenting with alternating chills and fever and groaning. First, resolve the food accumulation, then induce sweating profusely (Zhen Zhen), after which the chills and fever will cease naturally. Even if it lasts for ten days, if Spleen and Kidney deficiency and failure occur, diarrhea must invade at dawn (early morning). If there is Spleen and Stomach excess-heat, there will be thirst, dry throat, and dry lips. All these are disasters related to Food Accumulation and Spleen disease. Alternatively, overeating causes Spleen Qi to fail to extend and move freely. Accumulation remains for a long time, leading to deterioration and dampness, transforming into Shi Li (Food-induced Diarrhea). The severity of pus and accumulation is comparable, with slight pain and slight distension, feeling blocked inside the abdomen. The method should follow treating accumulation and stagnation, adhering to regulation and adjustment. Only then can one recover, and the illness return to spring (health).

Shen Jin'ao added: Children's diseases mostly arise from undigested milk and food. Even if illnesses are caused by the Six Excesses (Liu Yin) interfering, they must also involve retained food. Therefore, "Food Accumulation" is listed as a separate category, not mixed within the "Masses and Accumulations" section.