王汉东曰。小儿积病。可医者九。面上虚肿是积。积者。脾之所系。脾主身之肌肉。故应于面。故知是脾积。其脾
系土。土无正形。故早晚浮肿不定。多则早浮。其睡则脾不磨。上面作肿。若病后此症。则是虚中积。宜用补脾消积行
气等药。又面合地卧是积。何以合地。其受积在脾。是冷积。何以知之。其脾好土。故知在脾。其冷者属阴。故知伤冷
硬物得之。宜下热药耳。又腹胀是积。其积在肺。何以知之。其肺主于气。才受积。其气便冷。腹胀满。气急。故知在
肺。如腹胀。先宜调气。后用转。转后更宜调气。又小便如油是积。其积在小肠。何以知之。积受于脾。脾当传心。
心不伏。故亦曰虚中积。若惊积取下。则屎青。食积。屎成块子。凡疳中虚积者。因疳病转泻。虚而疳不退。故虚中尔。
所取下粪里白色也。
龚信曰。癖块者。僻于两胁。痞结者。痞于中脘。皆乳哺失节。饮食停滞。邪气相搏而成也。
王肯堂曰。乳积者。其候但是吐下乳来。有酸臭气。因啼叫未已。遽与乳吃。停滞不化而得。兼面青黄。发热作渴。
多睡口疮。渐渐黄瘦。腹内结块不散。茅先生用丁香散开胃后。用牛黄丸取下乳积。后用匀气散。常服健脾散。即愈。
食积者。肚硬而热。或泻或呕。因饮食过饱。饱后即睡而得。茅先生用牛黄丸取积。后用匀气散调理。常服万灵丸即愈。
气积者。面色黄白。不进食。腹痛啼叫。利如蟹渤。此因营卫不和。日久而得。茅先生用万灵丸、匀气散、醒脾散相夹
调理。惊积者。时时泄清水如米泔。是受伤而复有积。烦闷啾唧。常以生嗔。先解散。用百解散。后理积。乌犀丸、三
棱散、醒脾散。宁惊化积。壮气和胃。仍节冷乳。自愈。热积者。大便不通。风毒疮疖。喉闭 腮。咽中涎响。茅先生
用夺命散吐下热涎。后用匀气散、醒脾散调理。常服镇心丸、天竺黄散、愈。
Wang Handong stated: Among pediatric accumulation diseases (Ji Bing, a condition characterized by food stagnation and qi/blood obstruction), nine types are treatable. Facial edema indicates accumulation. Accumulation is closely related to the Spleen. The Spleen governs the muscles of the body, hence the manifestation appears on the face. Thus, it is known as Spleen accumulation. The Spleen corresponds to the Earth element, which has no fixed shape; therefore, the edema varies between morning and evening. If morning swelling is prominent, it is because the Spleen fails to transform during sleep, causing swelling in the upper part (face). If this symptom occurs after an illness, it is a deficiency-type accumulation with retained pathogenic factors, suitable for treatment with herbs that tonify the Spleen, resolve accumulation, and regulate Qi. Additionally, lying with the face pressed to the ground indicates accumulation. Why? Because the accumulation lies in the Spleen, constituting cold accumulation. How do we know? The Spleen favors the Earth nature, indicating the pathology resides in the Spleen. Its cold nature belongs to Yin, indicating it was caused by damaging cold and hard foods. It is suitable to use warm purgative medicines. Furthermore, abdominal distension indicates accumulation. The accumulation lies in the Lung. How do we know? The Lung governs Qi. Upon receiving accumulation, the Qi becomes cold, leading to abdominal fullness and急促 breathing (Qi urgency), thus indicating the pathology lies in the Lung. In cases of abdominal distension, one should first regulate Qi, then apply transformation/resolution methods. After resolution, regulating Qi again is advisable. Moreover, urine resembling oil indicates accumulation. The accumulation lies in the Small Intestine. How do we know? Accumulation originates from the Spleen, which transmits to the Heart. If the Heart does not subdue it, it is also termed deficiency-type accumulation. In cases of Fear accumulation (Jing Ji), stool turns green; in Food accumulation, stool forms clumps. In cases of deficiency accumulation within Gan disease (infantile malnutrition syndrome), due to Gan disease turning into diarrhea, the body becomes weak while the Gan condition persists, hence termed deficiency. The excreted feces contain white substances.
Gong Xin stated: Pi masses (Pi Kuai) are located obliquely in the hypochondrium; Pi knots (Pi Jie) are obstructed in the Zhongwan region. Both result from irregular breastfeeding and feeding, food stagnation, and the struggle between pathogenic factors.
Wang Kentang stated: The symptoms of Milk accumulation (Ru Ji) involve vomiting undigested milk with a sour, foul odor. It arises from feeding immediately after prolonged crying, causing stagnation and failure to digest. Accompanying signs include cyan-yellow complexion, fever, thirst, excessive sleep, mouth ulcers, gradual yellowish emaciation, and unresolvable abdominal masses. Master Mao first used Dingxiang San (Clove Powder) to open the stomach, then employed Niuhuang Wan (Calculus Bovis Pill) to purge milk accumulation, followed by Yunqi San (Regulate Qi Powder) for regulation, and regular intake of Jianpi San (Spleen-Tonifying Powder) leads to recovery. The symptoms of Food accumulation (Shi Ji) include a hard and hot abdomen, either diarrhea or vomiting. It results from overeating followed by immediate sleep. Master Mao used Niuhuang Wan to remove accumulation, followed by Yunqi San for regulation, and regular intake of Wanling Wan leads to recovery. The symptoms of Qi accumulation (Qi Ji) include a yellowish-white complexion, loss of appetite, abdominal pain with crying, and stools resembling crab foam. This arises from disharmony of Ying and Wei nutrients, developing over time. Master Mao regulated using Wanling Wan, Yunqi San, and Xingpi San alternately. The symptoms of Fear accumulation (Jing Ji) involve frequent passage of clear water like rice washings, indicating injury compounded by accumulation. Signs include irritability, whimpering, and frequent anger. First, release the exterior using Baijie San (Hundred-Resolution Powder), then address accumulation using Wuxi Wan (Black Rhinoceros Horn Pill), Sanleng San (Burreed Rhizome Powder), and Xingpi San, to calm fright, resolve accumulation, strengthen Qi, harmonize the Stomach, and control cold milk, leading to self-healing. The symptoms of Heat accumulation (Re Ji) include constipation, wind-toxic sores and boils, throat closure, malar swelling, and rattling saliva in the throat. Master Mao used Duoming San (Life-Snatching Powder) to induce vomiting and purge heat-phlegm, followed by Yunqi San and Xingpi San for regulation, and regular intake of Zhenxin Wan (Heart-Calming Pill) and Tianzhu Huang San (Bamboo Mucilage Powder) leads to recovery.