Library

The *Secret Principles* state: If a child's stool resembles rice-washing water, or if urine becomes turbid like rice-washing water after standing for a short while, this is due to damp-heat in the Spleen and Stomach. If the stool is white like rice-washing water, or resembles fish mucus (gelatinous), or contains red, yellow, or black colors, this indicates damp-heat with food stagnation. Treatment should involve regulating the Spleen, resolving stagnation, clearing damp-heat, and moderating diet. If the color suddenly turns green, it is *Bianzheng* (a physiological developmental process in infants); medication is not necessary. If it persists for a long time without cure, use formulas that tonify the Spleen and subdue the Liver. If the mother suffers from emotional disturbances causing the child's urine to resemble rice-washing water, treat with *Fei'er Wan* (Child-Nourishing Pill). If the stool is green and remains so for a long time, or is accompanied by diarrhea with white color, or abdominal pain, treat with *Liuzijunzi Tang* (Six Gentlemen Decoction) added with *Muxiang* (Aucklandiae Radix). One must still examine the wet nurse's diet and emotional state as the primary cause.

Pediatric food stagnation arises from deficiency-cold of the Spleen and Stomach, where milk and food fail to digest, eventually forming stagnation. The symptoms include fever at night that subsides after dawn, abdominal pain and distension, vomiting with acid regurgitation, cold feet with high body heat, excessive sleepiness with mental confusion, sour-smelling stool, and in severe cases, hematochezia. If accompanied by aversion to cold and fever, it is classified as fever caused by food stagnation. If the food stagnation is in the Stomach, employ the method of digestion/resolution. If there is abdominal pain and fullness that worsens upon pressure, employ the purgative method. If pain persists after purgation but alleviates upon pressure, employ the tonifying method. For Taiyang disease complicated by food stagnation, first resolve the exterior using *Shensu Yin* (Ginseng and Perilla Drink). If heat is severe with constipation, first purge using *Dachaihu Tang* (Major Bupleurum Decoction). If there is no external contraction, but only simple food injury without severity, regulate with *Baohe Wan* (Preserve Harmony Pill). Since the Spleen is an organ of extreme Yin, any Spleen pathology inevitably causes fever at night. Fever accompanied by chills indicates that the conquered element (Spleen Earth) is insulting the conquering element (Kidney Water). If food has not yet digested, apply digestion; then the chills and fever cease. If food has already digested, apply tonification; then the chills and fever are cured. If both hands and feet are cold and the patient prefers hot drinks, this is deficiency-cold of the Middle Jiao; apply warming methods. If there is a sensation of defecation but inability to pass stool, this is sinking of Spleen Qi; apply lifting methods. If diarrhea occurs at night or early morning, this is deficiency of both Spleen and Kidney; treat with *Sishen Wan* (Four Spirits Pill). If both hands and feet are hot with thirst and desire to drink, this is excess-heat in the Spleen and Stomach; treat with *Xiehuang San* (Drain Yellow Powder). If there is severe constipation, use *Dachaihu Tang*. If hands and feet are hot but there is no thirst and stools are unformed, use *Baizhu San* (Atractylodes Macrocephala Powder). If there is blood in the stool, use *Lizhong Tang* (Regulate the Middle Decoction) with *Ganjiang* (Zingiberis Rhizoma) removed, and *Zhishi* (Aurantii Fructus), *Huanglian* (Coptidis Rhizoma), and *Hongqu* (Red Yeast Rice) added.