This is the basic formula for reducing food stagnation. There is some disagreement among commentators about the extent to which heat is present in this pattern. The use of this formula is most appropriate in the early stages of food stagnation, or for relatively mild disorders. It is commonly used for treating the diarrhea associated with this disorder in children, and for childhood nutritional impairment. In some respects, the formula may be regarded as a variation of Two-Cured Decoction (er chen tang) with the addition of ingredients that reduce food stagnation. The notion that overeating can cause disease was first mentioned in Basic Questions (chapter 43): "Drinking or eating to twice one\\'s capacity injures the Intestines and Stomach." When food stagnation or accumulation occurs in the upper burner, the appropriate strategy is to induce vomiting; when it occurs in the lower burner, it should be purged; and when it occurs in the middle burner (by far the most common type of food stagnation), a moderate reducing strategy is most effective. This [formula] is [for] the typical presentation of food stagnation that occurs from eating contaminated food, or from gross overeating and drinking. Excessive consumption of alcohol, meat, and fatty foods in particular may inhibit the ability of the Spleen and Stomach to properly receive, transform, and transport food. This results in stagnation and accumulation of undigested food which obstructs the qi mechanisms of the middle burner, leading to focal distention and fullness in the chest and epigastrium, and abdominal distention. When it is severe, pain ensues. Food stagnation also disrupts the ascending and descending functions of the Spleen and Stomach. When the turbid-yin products of digestion do not properly descend, there is foul-smelling belching, acid regurgitation, nausea, and vomiting. When the Spleen qi is unable to rise, there is diarrhea. When the Stomach takes in more food that it can digest, there is an aversion to food. Stagnation is the digestive system is reflected in the greasy tongue and slippery pulse. The yellow coating reflects the presence of heat in the interior caused by the constraint from food stagnation. --Bensky: Chinese Herbal Medicine Formulas & Strategies*

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