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Its symptoms present with a pulse that is mostly deep and hidden (Fu, 伏) or imperceptible. There is accumulation internally and pathogenic invasion externally; pathogens and healthy qi interfere with each other, causing Yin and Yang to become disjointed and separated. Stagnation occurs in the Zhongwan area (CV12), where Yang fails to ascend and Yin fails to descend, leading to sudden onset of vomiting and diarrhea. If the disease is in the Upper Jiao (Upper Burner), it presents as heart pain accompanied by vomiting. If in the Lower Jiao (Lower Burner), it presents as abdominal pain accompanied by diarrhea. If in the Middle Jiao (Middle Burner), both the epigastrium and abdomen hurt, with simultaneous vomiting and diarrhea. Predominantly Yang patterns tend toward heat, while predominantly Yin patterns tend toward cold. In severe cases, muscle spasms (Zhuanjin, 转筋 - tendon contraction/cramps), abdominal pain, and cold extremities (Jizhi Jueni, 手足厥逆) occur. Furthermore, the Foot-Yangming Stomach Meridian nourishes the Zongjin (General Tendons); sudden violent vomiting and diarrhea cause the Zongjin to lose nourishment, resulting in spasm and tightening. In severe cases, tongue retraction and scrotal retraction occur. This is because the Spleen is invaded by "thief pathogens," representing Wood overacting on Earth (Mu Lai Wu Tu). Once vomiting and diarrhea cease, Yin and Yang harmonize, and recovery ensues. This condition results from dietary injury. One must strictly avoid grains, ginger, pepper, etc. Only after vomiting and diarrhea have completely ceased, and after one or two hours have passed, should thin rice gruel be administered. Dry Huoluan (Dry Cholera) is the most critical condition; the patient cannot vomit nor defecate, leading to closure of Yin and Yang and death. For dry Huoluan, which presents immediate danger, only salt water should be灌 (administered orally) to induce profuse vomiting. Alternatively, dig a pit, pour in fresh well water, stir, take the clarified liquid, and drink it. Or, use fingers to probe the throat to induce vomiting, which is even more effective. If vomiting is indicated, even if vomiting and diarrhea have already occurred, Erchen Tang (Two-Cured Decoction) should still be used to induce vomiting, thereby lifting the Qi mechanism. Additionally, needle Weizhong (BL40) and the ten Shixuan points (EX-UE11) to bleed.

For all Huoluan cases using this vomiting/diarrhea inducing formula: add Chaihu (Bupleuri Radix) and Fangfeng (Saposhnikoviae Radix) for Wind; double the dosage of Banxia (Pinelliae Rhizoma) for Cold; double the dosage of Cangzhu (Atractylodis Rhizoma) and Fangfeng for Dampness; add Huoxiang (Pogostemonis Herba) and Biandou (Dolichoris Semen) for Summerheat; add Zhishi (Aurantii Fructus Immaturus) and Qingpi (Citri Reticulatae Pericarpium Viride) for excess food retention. (To treat Xie Xie [Diarrhea], use Yiyuan San (Beneficial Primordial Powder) plus 1 liang of Baizhu (Atractylodis Macrocephalae Rhizoma) powder; take 1-2 qian per dose, mixed with rice soup.)

"Ji" (Accumulation) is the general term for stagnation and storage. Various texts classify the Five Ji as belonging to the Zang organs, and the Six Ju as belonging to the Fu organs. Diseases of the Fu organs may heal spontaneously without treatment; diseases of the Zang organs require treatment, with Spleen diseases being particularly difficult. Danxi (Zhu Zhenheng) stated only that accumulations are tangible masses: Blood Accumulation (Xue Ji) on the left, Phlegm Accumulation (Tan Ji) on the right, and Food Accumulation (Shi Ji) in the center. Children may have Food Accumulation, Milk Accumulation, Qi Accumulation, Deficiency Accumulation, Excess Accumulation, Shock Accumulation, Heat Accumulation, and Cold Accumulation. In severe cases, these develop into Pi (Parasitic Masses), Pi Jie (Stagnant Knots), or Xia (Irregular Masses). Additionally, Liver Accumulation is called Feiqi (Fat Qi), Spleen Accumulation is called Piqi (Stagnant Qi), Lung Accumulation is called Xiben (Gasp for Breath), Heart Accumulation is called Fuliang (Hidden Beam), and Kidney Accumulation is called Bentun (Rushing Pig); their treatments differ. For children, the goal is simply to remove Food Accumulation from the Spleen. The Stomach is the Sea of Water and Grain. The Spleen attaches beside the Liver. If the Spleen is hot, digestion is rapid and food transforms easily; if the Spleen is cold, digestion is slow and food is hard to digest. Undigested food becomes Cold Accumulation. Generally, the principle is to eliminate food, move Qi, resolve phlegm, and transform blood. One should only use methods to dissolve, transform, and grind; there is no rationale for purging accumulations downward. If accumulation leads to diarrhea, one should first purge with Xiaohei Wan (Little Black Pill), followed by tonification using Renshen (Ginseng Radix) and Baizhu, combined with Binglang (Arecae Semen), Zhishi, Sanleng (Sparganii Rhizoma), and Pengzhu (Curcumae Rhizoma) to grind away accumulation. Children mostly have Food Accumulation, with little Phlegm or Blood Accumulation, and even less of others. However, Food Accumulation is the root of Ganji (Childhood Malnutrition/Gan Syndrome). Before reaching the stage of Gan, cold medicines like Huhuanglian (Coptidis Rhizoma), Yinchaihu (Cistanchis Herba), and Lvhui (Aloe) should not be used. Only mild and warm medicines should be used to transform and open the accumulation; our family's Xiaohei Wan can be used. For long-term use, Fei'er Wan (Child-Nourishing Pill) is appropriate.

Fei'er Wan: Chao Chenpi (Fried Tangerine Peel, 4 liang), Nongbo (immersed in rice wash water and fried), Fu Chao Zhishi (bran-fried Aurantium Fruit, 2 liang), Chao Bozi (fried Radish Seed, 2 liang), Chao Qingpi (fried Green Tangerine Peel, 2 liang), Jiang Chao Huanglian (ginger-fried Coptis, 2 liang), Baizhu (2 liang), Binglang (Areca Seed, 2 liang), Shanzha (Hawthorn Fruit, 1.5 liang), Chao Shenqu (fried Medicated Leaven, 1.5 liang), Chao Jiao Maiya (charred fried Barley Sprout, 1.5 liang), Lianqiao (Forsythia Fruit, 1.5 liang), Longdancao (Gentian Root, 1.5 liang), Pengzhu (Curcuma Rhizome, 1.5 liang), Gancao (Licorice Root, 1.5 liang), Xiangfu immersed in rice wash water and fried until fragrant (Cyperus Rhizome, 4 liang). Grind into powder, make pills with honey the size of a quail egg, and dissolve/administer with rice soup.

If Ganji (Malnutrition Accumulation), add Lvhui (Aloe), Huhuanglian (Coptis), and Chaihu (Bupleurum), named Yugan Shendao Wan (Jade Gan Deep Path Pill), also known as Lvhui Wan. These should only be added if the child has night fever and is emaciated like firewood.

Children with accumulation stagnation present with yellowish swollen face and eyes, night fever, severe abdominal heat, abdominal pain preferring prone position, constipation, urine resembling oil and yellow, diarrhea with white sour-smelling stool, and vomiting/regurgitation. Hua Ji Jian Pi Tang (Transform Accumulation Strengthen Spleen Decoction) is suitable.

Hua Ji Jian Pi Tang (also known as Xiao Ji Hua Ju Tang): Chenpi, Nongbo, Cangzhu, Banxia, Xiangfu, Zhishi, Qingpi, Shanzha, Binglang, Fuling (Poria), Gancao. For severe accumulation, add Sanleng, Pengzhu, Caoguo (Black Cardamom). For abdominal pain, add Sharen (Amomum Fruit) and Muxiang (Vladimiria Root). For mass with diarrhea, first use Xiaohei Wan, then take this formula removing Banxia and Binglang, adding Baizhu and Baishao (White Peony Root). If phlegm exists, remove Cangzhu, add Haishi (Floating Quartz) and Shi Jian (Stone Alkali). For Blood Accumulation, remove Nongbo, Cangzhu, Banxia, add Danggui Shao (Tip of Angelica Sinensis Root), Taoren (Peach Kernel), Honghua (Carthamus Flower); in severe cases, add Shanjiajia (Pangolin Scale). For Qi Accumulation, double Xiangfu, add Jiegeng (Platycodon Root) and Sharen. For Excess Heat, add Huanglian; for Cold, add Muxiang and Dingxiang (Clove). For Deficiency Cold, or if accumulation persists after purging, add Dingxiang and Roukou (Nutmeg). If diarrhea leads to deficiency-yellow accumulation, remove Zhike (Aurantium Fruit Mature), Binglang, Qingpi, Baizhu; add Renshen for extreme deficiency. For oliguria and edema, add Zexie (Alisma Rhizome) and Zhuling (Polyporus).

Pi (Parasitic Masses) generally suit the previous formula. Only Pi (Stagnant Knot) presents as abdominal distension and chest fullness, where Ying and Wei (Nutritive and Defensive Qi) fail to circulate; mild purgation with Xiaohei Wan is suitable, or Beiji Wan (Emergency Aid Pill) for severe cases, followed by tonification with Baizhu. If accumulation is in the subcutaneous tissue/membranes, this formula is also suitable. Additionally, alternate administration with Renshen and Baizhu formulas. Shi Shang (Food Injury) requires food transformation using this formula; Xia (Irregular Mass) results from blood injury requiring blood-breaking action, caused by long-standing accumulation; drugs are listed previously. Our family's Fei'er Wan is an accumulation-transforming medicine; it can be taken for mild cases, but for severe cases, add Sanleng and Pengzhu, though one must carefully assess for phlegm and blood to add corresponding herbs.

Xiao Ji Hua Ju Wan (Transform Accumulation Dissolve Aggregation Pill): Sanleng, Baizhu, Huanglian, Fuling, Muxiang, Guiwei (Tail of Angelica Root), Maiya (Barley Sprout), Sharen, Honghua, Maidong (Ophiopogon Tuber), Zhike, Qingpi, Shenqu, Chaihu, Pengzhu, Binglang, Zhi Xiangfu (Prepared Cyperus), Taoren, Biejia (Turtle Shell), Ganqi (Dry Resin), Yizhi (Alpinia Oxyphylla). Honey pills, take 3 qian with rice drink, on an empty stomach.