小儿遍身骨露，其状如丁，故名曰丁奚疳，证见肌肉干涩，啼哭不已，手足枯细，面色黧黑，项细腹大，肚
脐突出，尻削身软，精神倦怠，骨蒸潮热，燥渴烦急诸病状，古法主先用五疳消积丸化其滞（如炒使君子肉五
钱，炒麦芽、陈皮、炒神曲、山楂
各一两，白芜荑、黄连、龙胆草各三钱，为末，陈米饭为丸，每服一钱，米饮下）。
继用人参启脾丸理其脾（如人参五钱，土炒白术五钱，茯苓五钱，陈皮四钱，炒扁豆五钱，炒山药五钱，煨
木香二钱，炒谷芽三钱，炒神曲二钱，炙甘草二钱，共研细末，炼蜜为丸，每粒重一钱，以建莲汤化下）。
〔真按〕丁奚疳亦当消补兼施。方用使君子一钱，炒麦芽八分，化州橘红一钱，范志神曲一钱，西洋参钱半，
生金钱术二钱，生谷芽八分，云茯苓二钱，山楂片一钱，炙甘草五分，引用老粳米三钱。
小儿因乳食不节，大伤脾胃，则成哺露疳。其证羸瘦如柴，吐食吐虫，心烦口渴，头骨开张，日晡蒸热，诸
病状。古法主先用集圣丸消其积滞〔如芦荟、炒五灵脂、夜明珠（淘洗烘干）、缩砂、木香、陈皮、莪术、使君
子肉、黄连、川芎、炙干蟾各二钱，当归钱半，青皮二钱，共为细末，用雄猪胆二个，取汁和面糊为丸，每服一
钱，米饮送下〕。
再用肥儿丸清理其脾（如人参二钱半，土炒白术五钱，茯苓三钱，川黄连二钱，胡黄连五钱，使君子四钱，
炒神曲、炒麦芽、山楂肉各三钱半，炙甘草钱半，煨芦荟二钱，共为末，黄米糊丸如黍米大，每服二三十丸，
米汤化下）。
〔真按〕疳症若主先消积，后理脾，儿体本弱，酿成疳症则更弱，纯粹消导之药，非伤正气，即碍脾胃，不
能不十分考量，不敢轻施。方用结洋参二钱，原麦冬钱半，茯苓三钱，炙甘草八分，炙鳖甲研粉钱半，蜜炙桑白
皮六分，炒地骨皮一钱，生谷芽六分，炒黄连五分，川朴花一朵，引用生粳米一撮，每日煎药，宜在下午四点钟
以前服之，过时服则无益。
The infant presents with exposed bones throughout the body, resembling the character "Ding" (丁), hence named Dingxi Gan (丁奚疳, Dingxi Malnutrition). The clinical manifestations include dry and rough muscles, incessant crying, withered and thin extremities, dark complexion, a slender neck with a distended abdomen, protruding umbilicus, emaciated sacrum, soft body, mental fatigue, bone-steaming tidal fever, dry thirst, irritability, and other such symptoms. Ancient methods primarily advocate using Wugan Xiaoji Wan (Five Malnourishment Accumulation-Resolving Pill) to resolve stagnation first (Formula: Stir-fried Semen Quisqualis [Shijunzi] 5 qian, stir-fried Fructus Hordei Germinatus [Maiya], Pericarpium Citri Reticulatae [Chenpi], stir-fried Massae Medicamentae Fermentatae [Shenqu], and Fructus Crataegi [Shanzha] each 1 liang; Bai Wuyi, Rhizoma Coptidis [Huanglian], and Radix Gentianae Longdancao [Longdancao] each 3 qian; ground into powder, formed into pills with aged rice paste, take 1 qian per dose, washed down with rice drink). Subsequently, Renshen Qipi Wan (Ginsplen Spleen-Enabling Pill) is used to regulate the spleen (Formula: Ginseng Radix et Rhizoma [Renshen] 5 qian, earth-stirfried Radix Atractylodis Macrocephalae [Baizhu] 5 qian, Poria [Fuling] 5 qian, Pericarpium Citri Reticulatae [Chenpi] 4 qian, stir-fried Semen Dolichoris [Bian Dou] 5 qian, stir-fried Rhizoma Dioscoreae [Shanyao] 5 qian, calcined Radix Aucklandiae [Muxiang] 2 qian, stir-fried Fructus Hordei Germinatus [Guya] 3 qian, stir-fried Massae Medicamentae Fermentatae [Shenqu] 2 qian, honey-roasted Radix Glycyrrhizae [Gancao] 2 qian; ground into fine powder, formed into pills with refined honey, each pill weighing 1 qian, dissolved and taken with Jianlian Decoction).
[True's Commentary] Dingxi Gan should also be treated with a combination of resolving accumulation and tonifying deficiency. The prescription uses: Semen Quisqualis [Shijunzi] 1 qian, stir-fried Fructus Hordei Germinatus [Maiya] 8 fen, Huazhou Pericarpium Citri Reticulatae [Juhong] 1 qian, Fan Zhi Massae Medicamentae Fermentatae [Shenqu] 1 qian, American Ginseng Radix et Rhizoma [Xiyangshen] 1.5 qian, raw Jinianshu 2 qian, raw Fructus Hordei Germinatus [Guya] 8 fen, Yun Poria [Fuling] 2 qian, sliced Fructus Crataegi [Shanzha] 1 qian, honey-roasted Radix Glycyrrhizae [Gancao] 5 fen, with old Jingmi (Oryza sativa var. japonica) 3 qian as the guiding substance.
Infants develop Bulu Gan (哺露疳, Bulu Malnutrition) due to irregular breastfeeding or diet, which severely damages the spleen and stomach. Symptoms include extreme emaciation like firewood, vomiting food or worms, restlessness, thirst, open cranial sutures, and afternoon tidal fever. Ancient methods primarily advocate using Jisheng Wan (Accumulation-Saint Pill) to eliminate stagnation first (Formula: Aloe [Lushen], stir-fried Respingua Trogopterori [Wulingzhi], Ye Mingzhu [cleaned, dried], Suisha, Radix Aucklandiae [Muxiang], Pericarpium Citri Reticulatae [Chenpi], Rhizoma Curcumae [Ezhu], Semen Quisqualis [Shijunzi], Rhizoma Coptidis [Huanglian], Radix Chuanxiong [Chuanxiong], honey-roasted Bufo bufo gargarizans [Ganchan] each 2 qian, Radix Angelicae Sinensis [Danggui] 1.5 qian, Pericarpium Citri Reticulatae Viride [Qingpi] 2 qian; ground into fine powder, mixed with juice from two male pig gallbladders and flour paste to form pills, take 1 qian per dose, washed down with rice drink). Then, Fei'er Wan (Child-Nourishing Pill) is used to clear and regulate the spleen (Formula: Ginseng Radix et Rhizoma [Renshen] 2.5 qian, earth-stirfried Radix Atractylodis Macrocephalae [Baizhu] 5 qian, Poria [Fuling] 3 qian, Chuan Rhizoma Coptidis [Huanglian] 2 qian, Radix Picrorhizae Scrophulariiflorae [Huhuanglian] 5 qian, Semen Quisqualis [Shijunzi] 4 qian, stir-fried Massae Medicamentae Fermentatae [Shenqu], stir-fried Fructus Hordei Germinatus [Maiya], and sliced Fructus Crataegi [Shanzha] each 3.5 qian, honey-roasted Radix Glycyrrhizae [Gancao] 1.5 qian, calcined Aloe [Lushen] 2 qian; ground into powder, formed into pills the size of millet seeds with yellow rice paste, take 20-30 pills per dose, dissolved in rice soup).
[True's Commentary] If the treatment of Gan malnutrition prioritizes resolving accumulation before regulating the spleen, considering that the child's constitution is originally weak and becomes even weaker after developing Gan, purely using digestive-resolving drugs will either damage the healthy qi or hinder the spleen and stomach function. Therefore, careful consideration is essential, and one dare not administer them lightly. The prescription uses: Jie Yangshen (American Ginseng) 2 qian, original Ophiopogonis Radix [Maidong] 1.5 qian, Poria [Fuling] 3 qian, honey-roasted Radix Glycyrrhizae [Gancao] 8 fen, honey-roasted Carapax et Plastrum Testudinis [Biejia] ground into powder 1.5 qian, honey-roasted Cortex Mori Radicis [Sangbaipi] 6 fen, stir-fried Cortex Lycii radicis [Digupi] 1 qian, raw Fructus Hordei Germinatus [Guya] 6 fen, stir-fried Rhizoma Coptidis [Huanglian] 5 fen, one flower of Magnolia biondii [Puhua], with a pinch of raw Jingmi (Oryza sativa var. japonica) as the guiding substance. The decoction should be administered daily before 4:00 PM; taking it later than this time yields no benefit.