(Ninth)

The *Huoyou Xinshu* (New Book of the Heart's Mirror for Children) states: The diseases suffered by children are all caused by irregular breastfeeding and feeding, excessive consumption of raw, cold, or hard foods. The Spleen and Stomach fail to digest and transform them, leading to stagnation and accumulation in the Zhongwan region (CV12). Alternatively, they may be injured by external Wind-Cold, or due to uncovered sleeping at night, resulting in headache, sallow complexion, body heat, slightly swollen eyelids, abdominal pain and distension, cold feet but a hot abdomen, drowsiness with mental confusion, anorexia, vomiting, hiccups, belching, acid regurgitation, and foul-smelling stools. This is injury caused by food stagnation. Whenever children have food stagnation, they present with yellowish swelling of the face and eyes, a hot and painful/distended abdomen, lethargy and aversion to eating, urine as turbid as grain mash, constipation or loose stools, nighttime crying and irritability, incontinence of stool and urine, and white, sour-smelling feces. These are all signs of stagnation syndromes. However, there are milk stagnation, food stagnation, and Qi stagnation; these must be clearly distinguished. Vomiting milk and passing undigested milk in stool, with a sour and foul odor, occurs when milk is given while the child is still crying from wailing, causing the milk to stagnate and fail to digest; this is called Milk Stagnation. A hard abdomen with heat, thirst, diarrhea, or vomiting occurs due to unregulated diet, overeating, and sleeping immediately after fullness; this is called Food Stagnation. Abdominal pain with crying, and stools resembling crab foam, occurs due to disturbance of Qi, disharmony of Ying and Wei (Nutritive and Defensive levels), persisting for a long time; this is called Qi Stagnation. Occasional passage of clear water like raw grass juice indicates accumulation following fright; irritability and whimpering, often appearing angry, is named Fright Stagnation. Pediatric physicians should treat based on the severity and deficiency/excess patterns.

The *Maijue* (Pulse Classic) states: A deep and slow pulse in children indicates food injury; if the Qi Kou pulse (radial artery at the wrist crease) on the right hand is one to two times larger than the Ying Qiang pulse (carotid artery), it indicates food injury. Undigested retained food presents as a deep and slippery Guan pulse (position corresponding to Spleen/Stomach) on the right side. The Classics state: A slippery pulse indicates retained food. A yellow color in the Tiger Mouth vein pattern indicates accumulation in the Spleen system. The *Maijing* (Pulse Classic) states: A deep pulse in children indicates undigested milk.

Various diseases in children are all caused by unregulated breastfeeding and feeding, excessive fullness injuring the body, leading to failure of digestion and transformation, resulting in retention and accumulation. At the onset, regardless of whether it is milk, food, or Qi stagnation, formulas such as Muxiang Wan (Costus Pill) or Xiaoji Wan (Eliminate Accumulation Pill) are used. For Fright Stagnation, Chensha Gao (Cinnabar Paste) or Qinglong Wan (Green Dragon Pill) are used, guided by severity to dredge and regulate, ultimately aiming for recovery through harmonizing Qi and regulating the Stomach. Generally, a hot, distended, or hard abdomen in children is due to internal excess; the method should be to dredge and purgatively clear. Thus, Li Dongyuan stated: Food is a tangible substance; when injured, it is appropriate to reduce food intake. Next best is using methods to resolve and guide out stagnation, primarily using Dingxiang Lanfan Wan (Clove Mashed Rice Pill) or Zhizhu Wan (Atractylodes and Immature Bitter Orange Pill). For slightly more severe cases, attack and transform using Sanleng Xiaoji Wan (Curcuma Eliminate Accumulation Pill) or Muxiang Jianchou Wan (Costus See-Chagrin Pill). For particularly severe cases, induce vomiting or purge using Gadisan (Melon Pedicle Powder) or Beiji Wan (Emergency Pill), aiming for balance without being excessive. Since the Spleen is already injured, further medicinal damage rarely allows for survival. Qingpi (Immature Citrus Peel) alone can treat pediatric accumulation diseases; while indispensable, it must not be overused, as excess damages True Qi. It induces heavy sweating and is contraindicated in patients who already have sweat.