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To treat children suffering from chest and diaphragm distension due to overeating, with obstructed Qi mechanism, stagnation, mental confusion, low mood, severe cases presenting with asthma, inability to digest forced food intake, thirst, irritability, restlessness in sitting or lying down, limb fatigue, and abdominal and hypochondriac pain, the Da Zhuyu Wan (Large Zanthoxylum Pill) is suitable.

Excellent Prescription: Peng'ezhu (Curcumae Rhizoma), Jingsanleng (Sparganii Rhizoma) (each 1 fen, boiled in vinegar), Ganjiang (Zingiberis Rhizoma Praeparatum, roasted), Qingpi (Aurantii Fructus Immaturus), Chenpi (Citri Reticulatae Pericarpium) (both remove white pith), Muxiang (Aucklandiae Radix), Dingxiang (Caryophylli Flos) (each 2 liang), Badou (Crotonis Fructus, 21 seeds, remove shell, heart, and membrane, press out oil), Yuanxiaoxi Zhuyu (Fructus Zanthoxyli, 2 qian).
Grind the above into powder, make pills using vinegar paste, size of hemp seeds. Take 7 to 10 pills per dose; for older children, administer with Ginger and Jujube Decoction.

Discussion: The causes of Pi (Glomus/Obstruction), Yu (Stagnation), Jie (Nodulation), and Zhu (Transmission Disease) stem from Spleen-Stomach dysfunction due to cold, raw, sticky, and greasy foods, leading to accumulated Qi failing to transform and stagnating in the chest and diaphragm. This is a general term. The upper part is referred to as Sanjiao (Triple Burner), and the lower part as Sanhuan. They connect vertically and invade each other. Pathogens affect weak areas and manifest where deficiency exists, causing disease primarily due to long-term failure to digest.
This formula warms the middle, eliminates Fan (Childhood Malnutrition), grinds away accumulations, stops vomiting and diarrhea, and improves appetite. Its efficacy is miraculous. Careful syndrome differentiation is essential.

Discussion: The onset of this syndrome resembles Cold Accumulation or Deficiency Accumulation of Spleen Qi. However, when a child's abdomen is tight and distended, vomits saliva in the morning, and feels slightly relieved only after eating soup or meat, it indicates a Hui Chong (Roundworm) syndrome. Cold Spleen Qi often presents with dysphagia and inability to eat, with accumulation within deficiency. The abdomen is tight and pulling painful, cold accumulation causes distension, and the chest and abdomen are uncomfortable, making sitting or lying down difficult. Pain pierces from both hypochondria and above/below the heart and diaphragm. If internal worms cause pain and distension, first administer Xia Chong Wan (Worm-Expelling Pill) to kill the worms. Once the worms are weakened, administer Shuijing Wan (Crystal Pill) to expel residual pathogens. For other symptoms, administer medicines to regulate Stomach Qi, then expel the accumulation. The Xiao'er Chenxiang Jian Wan (Children's Agarwood Decoction Pill) is suitable.

Excellent Prescription: Ruxiang (Boswelliae Resina), Chenxiang (Aquilariae Lignum Resinatum) (each 1 qian), Roudoukou (Myristicae Semen, one, roasted), Xingren (Armeniacae Semen Amarum, 1 liang, stir-fried), Baicaoshuang (Fulis Carbonis Pulvis, 1 fen), Muxiang (Aucklandiae Radix), Dingxiang (Caryophylli Flos) (each 1 liang), Badou (Crotonis Fructus, 14 seeds, pressed until oil resembles frost).
Grind the above into powder, seal the head while boiling in wine, mix with wax to form pills the size of mung beans. Take 3 to 5 pills per dose with light Ginger Decoction. If abdominal pain persists, this formula is effective. Regular use should aim for unobstructed flow.

Discussion: This prescription is based on Yinggan Wan (Responsive Pill) with the addition of Chenxiang (Aquilariae Lignum Resinatum) and Ruxiang (Boswelliae Resina). It treats pediatric deficiency-with-accumulation syndromes, fixed masses, Fan diseases, cold accumulation, food accumulation, Spleen-Chi milk accumulation, chronic gastrointestinal deficiency, disharmony of the Middle Jiao, Pi Qi stagnation, diarrhea, dysentery, vomiting, hiccups, abdominal pain, and extreme physical weakness preventing movement. All these conditions can be treated with it. Compared to formulas like Zhenzhu Wan (Pearl Pill), this formula differs significantly in its approach to resolving accumulation. One may worry that the medicine fails to promote unobstructed flow; if it succeeds, it is fortunate. This represents the work of Zeng Sui in preserving reality, harmonizing the Spleen, and generating Stomach Qi, with no superior alternative.