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Wang Lü stated: Zhang Zhongjing mentioned that if the Cun Kou (inch position) pulse is floating and large, but feels choppy upon deep pressure, one can deduce the presence of retained food. The treatment should involve purgation, and Da Cheng Qi Tang (Major Order the Qi Decoction) is appropriate. However, although both present with fever, in cases of food injury, the heat sensation in the abdomen is most prominent, and the feces have an extremely sour and foul odor. Tidal fever at night is also a clear sign of food retention. In children, retained food fails to digest because the Stomach receives water and grain, while the Spleen transforms and transports them. Children initially do not know how to moderate their intake; the amount of food received by the Stomach exceeds the capacity of the Spleen Qi to transform it, thus leading to indigestion. Qian Yi discussed food retention failing to digest, attributing it to cold deficiency of the Spleen and Stomach, and advocated tonifying the Spleen, using Yi Huang San (Benefit Yellow Powder) as the primary formula, which is correct.

Chu Yushi stated: Pediatric food accumulation arises from deficiency-cold of the Spleen and Stomach, where milk and food fail to digest, eventually forming accumulation over time. Its symptoms include fever at night with normalization of temperature at dawn; abdominal pain and distension; vomiting with acid regurgitation; cold feet and a hot abdomen; a preference for sleep and mental lethargy; and sour, foul-smelling stools. If these symptoms are accompanied by alternating chills and fever, it is named "Food Accumulation with Chills and Fever." If food stagnates at the upper opening of the Stomach, emesis should be induced; if it stagnates at the lower opening of the Stomach, digestion-promoting methods should be used. If there is abdominal pain and fullness that worsens upon pressure, purgation should be employed. If pain persists after purgation but is relieved by pressure, tonification should be applied. For Taiyang disease complicated by food accumulation, exterior-releasing methods should be used first, such as Shen Su Yin (Ginseng and Perilla Decoction). If heat is severe accompanied by constipation, purgation should be used first, such as Da Chai Hu Tang (Major Bupleurum Decoction). If there is no external pathogenic invasion, only food injury, and the condition is not severe, Bao He Wan (Preserve Harmony Pill) should be used for regulation. Since the Spleen is an organ of extreme Yin, patients with Spleen diseases inevitably experience fever at night. If fever is accompanied by chills, it indicates that the conquered element is insulting the unconquered element (a pathological interaction in Five Phase theory). For undigested food, applying digestion-promoting methods will naturally stop the chills and fever; for resolved accumulation requiring recovery, applying tonification will naturally cure the chills and fever. If all four extremities are cold and the patient prefers warm drinks, this indicates deficiency-cold of the Middle Jiao, and warming methods should be applied uniformly. If there is an urge to defecate but inability to do so, it is due to sinking of Spleen Qi, and lifting methods should be applied. If diarrhea occurs at night or early morning, it indicates deficiency of both the Spleen and Kidney, and Si Shen Wan (Four Spirit Pill) is indicated. If the extremities are hot and accompanied by thirst and desire to drink water, this indicates excess-heat of the Spleen and Stomach, and Xie Huang San (Drain Yellow Powder) is indicated. If the extremities are hot but without thirst and with loose stools, Bai Zhu San (Atractylodes Macrocephala Powder) is indicated. Treatment should still refer to the management of abdominal pain, abdominal distension, accumulation pain, and food stagnation.