The infantile weak zang organs and ignorance of self adaptabity to the change of temperature lead to susceptability to attack by wind and cold. Wind and cold invade me stomach internally. Cold, a yin pathogen, impairs yang qi readily. The contraction nature of cold makes qi and blood condensed and obstructed, giving rise to epigastralgia; or the pathogenic summer-heat, and dampness accumulate in the middle energizer, scorch and disturb the stomach, resulting in epigastralgia.

Infantile constant insufficiency of the spleen and ingnorance of proper diet, excessive ingestion of cold, raw, fat and sweet food, or crapulence impairs the spleen and stomach, makes dampness and heat obstruct in the middle energizer, or makes food stagnate in the stomach, leading to epigastralgia; or the spleen and stomach are impaired when the patient is congenitally weak, and lose nourishment postnatally, or if the patient suffers from chronic diseases without recovery, and fails to be recuperated.

In this case, the asthenic and cold spleen and stomach fail to transport and transform food, make the gastric collateral lose its nourishment, bringing about dull epigastralgia; or the excessive fire due to yin deficiency makes gastric yin deficient and the stomach lose its nourishment, causing dull and burning pain in the epigastric region. Besides, emotional factors like worry, vexation and anger can stagnate the liver qi that invades the spleen and stomach, makes qi obstructed, giving rise to Epigastric pain.