小儿疳疾，身多发热，宜分别轻重虚实治之，初起多实者，古法主鳖甲青蒿饮，（如银柴胡、炒鳖甲、青蒿、
生甘草、生地黄、赤芍、胡黄连、炒知母、地骨皮，引用灯芯）。
日久多虚者，主鳖甲散（如人参、炙黄 、炙鳖甲、生地、
熟地、当归、炒白芍、地骨皮等味）。
〔真按〕疳热、由于脾胃虚弱，阳浮于外，气不归元，故生内热，实者用泻肝涤热之法，方用鲜石斛二钱，
生白芍钱半，鸡内金一个，使君子肉一钱，生地钱半，赤芍药一钱，云茯苓二钱，生甘草五分，引用灯芯二十寸。
虚者，方用结洋参钱半，生于术钱半，白茯苓二钱，生甘草八分，怀山药二钱，熟地黄二钱，粉丹皮钱半，
福泽泻一钱。
小儿脑疳，原素受风热，又兼乳哺失调，变生此证，头皮光急，脑生饼疮，头热毛焦，发结如穗，鼻干心
烦，腮囟肿硬，困倦睛暗，自汗身热，诸病状，须分别治之。脑热生疮者，古法主龙胆丸（如龙胆草、升麻、焙
苦楝根皮、赤茯苓、防风、芦荟、油发灰各二钱，青黛、黄连各三钱，共为细末，猪胆汁浸糕糊丸，如麻子大，
薄荷汤下，量儿大小与之）。
烦热羸瘦者，古法主龙脑丸（如龙脑、麝香各五分，雄黄二钱，胡黄连三钱、牛黄一钱，朱砂钱半，生芦荟
三钱，干虾蟆灰四钱，共为细末，熊胆合丸，如麻子大，每服三丸，薄荷汤下）。
外用吹鼻龙脑散（如龙脑、麝香各少许、各研细末，炒黄蜗牛壳、虾膜灰、瓜蒂、黄连、细辛、桔梗各等分，
研极细末，入瓷盒内贮之），每取少许，吹入鼻中，日吹二次。
〔真按〕脑疳如上述诸病状外，更有脑热如火，两眼疼痛者，其病亦在肝，故脑热生疮，方用酒炒龙胆草
钱半，炒黄芩钱半，酒炒栀子五分，泽泻钱半，细木通一钱，车前子八分，细生地钱半，金银花钱半，土茯苓二
钱，生甘草梢五分。
烦热羸瘦，若以脑麝内服，究宜慎用，本方除龙胆草、炒栀子二味，加鲜石斛三钱，西洋参钱半，引用灯芯
三十寸。
外用明松香一两，入葱管内煎过，待干冷后，同飞丹一两，
过头发三钱，研细，菜油调搽疳疮即愈。
Pediatric Gan disease (Gan syndrome, a chronic malnutrition disorder in children) is often accompanied by fever. Treatment should be differentiated based on the severity and the deficiency-excess nature of the condition. In the initial stage, it is mostly excess type; the ancient method advocates using Biejia Qinghao Yin (Turtle Shell and Artemisia Annua Decoction), which includes Yin Chai Hu (Stellariae Radix), Chao Bie Jia (Fried Testudinis Carapax et Plastrum), Qing Hao (Artemisiae Annuae Herba), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), Sheng Di Huang (Rehmanniae Radix), Chi Shao (Paeoniae Radix Rubra), Hu Huang Lian (Coptidis Rhizoma), Chao Zhi Mu (Anemarrhenae Rhizoma fried), Di Gu Pi (Lycii Cortex), with Deng Xin Cao (Junci Medulla) as an adjuvant. When the disease persists for a long time, it becomes mostly deficiency type; the main prescription is Biejia San (Turtle Shell Powder), containing Ren Shen (Ginseng Radix et Rhizoma), Zhi Huang Qi (Astragali Radix honey-fried), Zhi Bie Jia (Testudinis Carapax et Plastrum honey-fried), Sheng Di Huang, Shu Di Huang (Rehmanniae Radix Praeparata), Dang Gui (Angelicae Sinensis Radix), Chao Bai Shao (Paeoniae Radix Alba fried), Di Gu Pi, etc.
[Chen Shouzhen's Note] Gan heat arises from spleen and stomach weakness, with yang floating outward and qi failing to return to its root, thus generating internal heat. For excess patterns, the method of draining liver fire and clearing heat is used. The formula consists of Xian Shi Hu (Dendrobii Officinalis Caulis, 2 qian), Sheng Bai Shao (Paeoniae Radix Alba raw, 1.5 qian), Ji Nei Jin (Galli Gigerii Endothelium Corneum, 1 piece), Shi Jun Zi Rou (Quisqualis Semen flesh, 1 qian), Sheng Di Huang (1.5 qian), Chi Shao Yao (1 qian), Yun Fu Ling (Poria, 2 qian), Sheng Gan Cao (0.5 qian), with 20 cun of Deng Xin Cao as an adjuvant. For deficiency patterns, the formula uses Jie Yang Shen (Panacis Quinquefolii Radix, 1.5 qian), Sheng Yu Zhu (Atractylodis Macrocephalae Rhizoma raw, 1.5 qian), Bai Fu Ling (Poria, 2 qian), Sheng Gan Cao (0.8 qian), Huai Shan Yao (Dioscoreae Rhizoma, 2 qian), Shu Di Huang (2 qian), Fen Dan Pi (Moutan Cortex, 1.5 qian), Fu Ze Xie (Alismatis Rhizoma, 1 qian).
Pediatric Nao Gan (Brain Gan) originates from prior exposure to wind-heat pathogens, compounded by improper breastfeeding or feeding, leading to this condition. Symptoms include shiny and tight scalp, cake-like sores on the head, hot head with scorched hair, hair matted into tufts like grain ears, dry nose with mental restlessness, swollen and hard cheeks and fontanelles, lethargy with dull eyes, spontaneous sweating, and body fever. These various manifestations must be treated differently. For sores caused by brain heat, the ancient method prescribes Long Dan Wan (Gentiana Pill), containing Long Dan Cao (Gentianae Radix), Sheng Ma (Cimicifugae Rhizoma), Bei Ku Lian Gen Pi (Meliae Cortex fried), Chi Fu Ling (Poria with red wood), Fang Feng (Saposhnikoviae Radix), Lu Hui (Aloe), You Fa Hui (Charred human hair grease), each 2 qian; Qing Dai (Indigo Naturalis) and Huang Lian (Coptidis Rhizoma), each 3 qian. These are ground into fine powder, mixed with pig bile and rice paste to form pills the size of hemp seeds, taken with Bo He Tang (Mint Decoction), dosage adjusted according to the child's age. For those with irritability, heat, and emaciation, the ancient method prescribes Long Nao Wan (Borneol Pill), containing Long Nao (Borneolum Syntheticum), She Xiang (Moschus), each 5 fen; Xiong Huang (Realgar), 2 qian; Hu Huang Lian, 3 qian; Niu Huang (Bovis Calculus), 1 qian; Zhu Sha (Cinnabaris), 1.5 qian; Sheng Lu Hui, 3 qian; Gan Xia Ma Hui (Charred dry toad ash), 4 qian. These are ground into fine powder, combined with Xiong Dan (Ursi Bile) to form pills the size of hemp seeds, three pills per dose, taken with Bo He Tang. Externally, use Long Nao San (Borneol Powder) blown into the nose, containing small amounts of Long Nao and She Xiang (each finely ground); Chao Huang Wo Niao Ke (Fried snail shell), Xia Mo Hui (Charred shrimp membrane ash), Gua Di (Thladianthae Fructus), Huang Lian, Xi Xin (Asari Radix et Rhizoma), Jie Geng (Platycodonis Radix), all in equal parts. Grind to an extremely fine powder, store in a porcelain box. Take a small amount, blow into the nose twice daily.
[Chen Shouzhen's Note] Besides the aforementioned symptoms of Nao Gan, if there is intense heat in the head like fire burning and pain in both eyes, the pathology also resides in the liver. Therefore, for treating sores due to brain heat, the formula uses Jiu Chao Long Dan Cao (Gentianae Radix wine-fried), 1.5 qian; Chao Huang Qin (Scutellariae Radix fried), 1.5 qian; Jiu Chao Zhi Zi (Gardeniae Fructus wine-fried), 5 fen; Ze Xie, 1.5 qian; Xi Mu Tong (Akebiae Caulis), 1 qian; Che Qian Zi (Plantaginis Semen), 8 fen; Xi Sheng Di Huang (Rehmanniae Radix raw), 1.5 qian; Jin Yin Hua (Lonicerae Japonicae Flos), 1.5 qian; Tu Fu Ling (Smilacis Glabrae Rhizoma), 2 qian; Sheng Gan Cao Shao (Tip of Glycyrrhizae Radix et Rhizoma raw), 5 fen.
For irritability, heat, and emaciation, internal use of formulas containing Long Nao (Borneol) and She Xiang (Moschus) should be used with caution. This modified formula removes Long Dan Cao and Chao Zhi Zi, adding Xian Shi Hu (3 qian) and Xi Yang Shen (Western Ginseng, 1.5 qian), with 30 cun of Deng Xin Cao as an adjuvant.
Externally, use Ming Song Xiang (Clear Pine Resin), 1 liang, boiled inside a scallion tube. After cooling and drying, mix with Fei Dan (Calamina processed by sublimation?), 1 liang, and Tou Fa (Human hair passed through fire), 3 qian. Grind into a fine powder, mix with vegetable oil, and apply to the Gan sores until healed.