凡治小儿五痫，皆当随脏治之。每脏各有一兽所属。如犬痫，
反折上窜，犬叫，肝也。牛痫，目直视，腹满，牛叫，脾也。鸡痫，惊
跳，反折，手纵，鸡叫，肺也。猪痫，如尸吐沫，猪叫，肾也。羊痫，目
瞪吐舌，羊叫，心也。五痫重者死，病后甚者亦死，治法并用五色丸主之。
五色丸
朱砂（另研） 珍珠末（各五钱） 雄黄（一两，一作三两） 水银（二钱半，一作二两） 黑铅（二两，同水银
熬）
按∶用黑铅二两，水银当作二两者为是，无疑矣。
上炼蜜丸如麻子大，每服三、四丸，煎金银薄荷汤下。
论
《内经》曰∶数食肥，令人内热；数食甘，令人中满。盖其病因肥甘所致，故命名曰疳。若夫襁褓中之乳子，与四
五岁之孩提，乳哺未息，胃气未全，而谷气尚未充也。父母不能调摄，惟务姑息，舐犊之爱，遂令恣食肥甘，与夫瓜果
生冷，及一切烹饪调和之味，朝餐暮食，渐成积滞胶固，以致身热体瘦，面色痿黄，或肚大青筋，虫痛泻利，而诸疳之
证作矣。钱仲阳曰∶小儿病疳，多因大病后或吐泻后以药下之，致脾胃虚损亡津液而成，盖此证实由愚医之所害耳。斯
言也，特一端耳，未可悉以为然，其所谓大病吐泻，岂非饮食之所致欤？夫仲阳为儿医之祖，岂有误邪？其所论诸疳形
证治法，班班可考，学人不可不审。如疳在肝，则白膜遮睛，法当补肝，地黄丸主之。疳在心，则面颊赤，身体壮热，
法当补心，安神丸主之。疳在脾，则体黄腹大，好食泥土，法当补脾，益黄散主之，疳在肺，则气喘，口鼻生疮，亦当
补脾，益黄散主之，此虚者补其母也。疳在肾，则极瘦而身生疮疥，法当补肾，地黄丸主之。筋疳则泻血而瘦，当服补
肝地黄丸。骨疳，喜卧冷地，当服补肾地黄丸。内疳则目肿腹胀，利色无常，或沫青白，渐而瘦弱，此冷证也，宜服木
香丸。外疳，鼻下赤烂，自揉鼻头，有疮不结痂，绕耳而生，当用治疮烂兰香散、白粉散等药。法曰∶诸疳皆根据本脏而
补其母，则子自安。假令日中潮热，是心经虚热也，肝为心之母，宜先补肝，肝实而后泻心，心得母气则内平而潮热愈
矣。余皆仿此。大抵疳病当辨冷热肥瘦而治，其初病者为肥热疳，久病者为瘦冷疳，冷则用木香丸，热则当用胡黄连丸，
冷热疳并宜用如圣丸之类。惟小儿之腑脏柔弱，不可痛击大下，必亡津液而成疳证。为儿医者，常当以幼幼之心为心而
善调之，毋纵巨胆，妄为施治，以绝人之嗣续，幸甚！
脉法
（并见前总章。）
方法
地黄丸（补肝肾虚） 治肝疳白膜遮睛，筋疳泻血，肾疳身瘦疮疥，骨疳喜卧冷地。又治胃怯、不言、解颅。小
儿年长不能行者，专服神效。
熟地黄（酒洗，八钱） 山茱萸 干山药（各四钱） 泽泻 牡丹皮 白茯苓（各三钱）
上为细末，炼蜜为丸，如梧桐子大，三岁以下儿三丸至五丸，熟水空心化下。年长者，量增丸数。
安神丸 治邪热惊啼，心疳面黄颊赤壮热。（方见惊风门。）
益黄散（又名补脾散）治小儿脾胃虚寒，脾疳体黄腹大，好食泥土，肺疳气喘，口鼻生疮等证。
陈皮（一钱） 青皮 诃子皮 甘草（炙，各五分） 丁香（二分）
上作一服细切，水一盏，煎至六分，温服（愚每于本方加参、术各一钱效）。
木香丸 治瘦冷疳。
木香 青皮 槟榔 肉豆蔻（各二钱半） 麝香（一钱，另研） 续随子
（一两，去油） 虾蟆（大壮者，一名蟾酥，俗名风鸡，三个，烧存性）
上为细末，炼蜜丸如绿豆大，每服三、五丸至一、二十丸，薄荷汤送下。
胡黄连丸 治肥热疳。
胡黄连 宣黄连（各五钱） 朱砂（二钱半，另研）
上为细末和匀，填入 猪胆内，用淡浆煮，以杖子加铫子上，用线钓之，勿着底，候一炊时取出，研入芦荟、麝香
各一分，饭丸如麻子大，每服五、七丸至一、二十丸，米饮下。
一方 去足虾蟆五钱，焙干不烧。
兰香散 治外疳鼻下赤烂。
兰香叶（收二钱，烧存性） 铜青 轻粉（各五分）
上为细末，干敷之。
白粉散 治疳疮。
乌贼鱼骨末（七钱） 白芨末（三钱） 轻粉（一钱）
上为末和匀，先用清浆水洗疮，拭干敷之。
如圣丸 治冷热疳泻。
使君子（一两，去壳） 胡黄连 川黄连 白芜荑（去皮，炒，各二两） 麝香（五分，另研） 干虾蟆（五个，
酒煮捣膏）
上为细末，以虾蟆膏和丸，如麻子大，二、三岁儿五、七丸，以上十丸至十五丸，人参汤下，不拘时服。
香蟾丸 治疳消、食积、虫积、肉积，及治腹胀大。
三棱（醋浸炒） 蓬莪术（醋浸炒） 青皮（去白） 神曲（炒） 麦 曲（炒） 草龙胆（酒浸炒） 槟榔（各
五钱） 木香（二钱） 川楝子（去核，酒煮） 使君子（去壳） 胡黄连 川黄连（各四钱） 陈皮（五钱） 白术
（二两，一作一钱） 干蟾（五个）
上以白术以上药俱研为细末，以干蟾用醋煮烂，捣成膏和药，如干再加醋，糊为丸如麻子大，每服十五丸，清米汤
送下。
芦荟丸 治小儿疳气，腹胀骨热。
芦荟（另研） 木香 槟榔（各二钱半） 虾蟆（酒浸炙黄，去骨） 黄连（各
一两） 芜荑（去皮） 青皮（去白） 陈皮（各五钱） 巴豆（三七粒，去壳，同上四味炒黄，去豆）
上为细末，猪胆汁丸，如小豆大，三岁儿三十丸，米汤下。
又方 治疳积腹大。
胡黄连（去疳积、果积） 阿魏（醋浸，去肉积，各五分） 麝香（当门子四
粒） 神曲（炒，去食积） 川黄连（炒，去热积，又去酒积，各二钱）
上为细末，猪胆汁和丸，如麻子大，每服三十丸，白术汤送下。
一方有芦荟五分。
又方 治小儿疳病。
黄连 白术 山楂肉（各五钱） 胡黄连 芦荟（各三钱，另研） 芜荑（二钱五分） 神曲（炒，二钱）
上为细末，猪胆汁为丸，如麻子大，量儿大小，加减丸数与之。
（祖传方）
槟榔丸 小儿疳病，积气成块，腹大有虫等证，其效如神。
槟榔（一两） 三棱（煨去毛，切，醋炒） 蓬莪术（醋炒，各五钱） 青皮（去
穣，麸炒黄色） 陈皮（去白，各五钱） 雷丸（去壳，五钱） 芜荑（水洗净，二钱半）
鹤虱（三钱，略炒） 干漆（五钱，炒无烟） 木香（三钱，不见火） 砂仁（一钱） 良
姜（二钱，东壁土同炒） 麦 面（五钱，炒） 胡黄连（三钱） 甘草（三钱，炙） 神曲（五钱，炒黄色） 山楂
肉（五钱）
上为细末，醋糊为丸，如绿豆大，每服三、五十丸，空心淡姜汤送下。
Whenever treating the five types of epilepsy (epilepsy) in children, one should treat according to the affected Zang organ. Each Zang organ is associated with a specific animal. For instance, Canine Epilepsy (Dog-type Epilepsy), characterized by body opisthotonos and upward jumping, barking like a dog, is related to the Liver; Bovine Epilepsy (Ox-type Epilepsy), characterized by staring eyes, abdominal distension, and mooing like an ox, is related to the Spleen; Gallus Epilepsy (Chicken-type Epilepsy), characterized by startled jumping, opisthotonos, relaxed hands, and crowing like a chicken, is related to the Lung; Porcine Epilency (Pig-type Epilepsy), characterized by foaming at the mouth resembling a corpse and grunting like a pig, is related to the Kidney; Ovine Epilepsy (Sheep-type Epilepsy), characterized by staring eyes, protruding tongue, and bleating like a sheep, is related to the Heart. Severe cases of the five epilepsies result in death, as do cases where symptoms worsen after the illness; the treatment method for all involves using Wu Se Wan (Five-Color Pill) as the principal formula.
Wu Se Wan (Five-Color Pill)
Cinnabar (Zhu Sha, ground separately) Pearl Powder (Zhen Zhu Mo, each 5 qian) Realgar (Xiong Huang, 1 liang, alternatively 3 liang) Mercury (Shui Yin, 2.5 qian, alternatively 2 liang) Black Lead (Hei Qian, 2 liang, boiled together with mercury)
Note: Using 2 liang of Black Lead implies that 2 liang of Mercury should be used, which is undoubtedly correct.
The above ingredients are processed with refined honey into pills the size of hemp seeds. Each dose consists of 3 or 4 pills, taken down with a decoction of Honeysuckle (Jin Yin Hua) and Mint (Bo He).
Discussion
The *Huang Di Nei Jing* (Yellow Emperor's Inner Canon) states: Frequent consumption of fatty foods causes internal heat; frequent consumption of sweet foods causes fullness in the middle jiao. The etiology of Gan syndrome (malnutrition syndrome) is attributed to rich and sweet foods, hence its name. Regarding infants in swaddling clothes and toddlers aged four or five, breastfeeding has not ceased, Stomach Qi (Stomach energy) is not fully mature, and Gu Qi (Grain Qi/nutritional essence from food) is not yet abundant. Parents fail to regulate their care, indulging excessive affection, allowing children to consume freely fatty and sweet foods, raw fruits and vegetables, and all kinds of cooked and seasoned flavors. Morning meals and evening snacks gradually lead to stagnation becoming fixed and consolidated, resulting in fever, emaciation, sallow complexion, or large abdomen with visible blue veins, intestinal colic, and diarrhea. Thus, various manifestations of Gan syndrome arise. Qian Zhongyang stated: Children suffering from Gan syndrome often do so because after a major illness or vomiting/diarrhea, physicians mistakenly use purgatives, leading to deficiency and damage of the Spleen and Stomach and loss of Jin Ye (body fluids). This reality is indeed harmed by ignorant physicians. This statement covers only one aspect and cannot be accepted entirely; were the major illnesses and vomiting/diarrhea he mentioned not caused by dietary indiscretion? Qian Zhongyang is the ancestor of pediatric medicine; how could he be mistaken? His discussions on the forms, symptoms, and treatments of various Gan syndromes are well-documented; students must examine them carefully. For example, Gan in the Liver presents with white membrane covering the eyes; the treatment principle is to tonify the Liver, primarily using Di Huang Wan (Rehmannia Pill). Gan in the Heart presents with red cheeks and high fever; the treatment principle is to tonify the Heart, primarily using An Shen Wan (Calming the Spirit Pill). Gan in the Spleen presents with yellowish body, abdominal distension, and craving for eating dirt; the treatment principle is to tonify the Spleen, primarily using Yi Huang San (Benefit Yellow Powder). Gan in the Lung presents with asthma and sores in the mouth and nose; it also requires tonifying the Spleen, using Yi Huang San, following the principle of "tonifying the mother when the child is deficient." Gan in the Kidney presents with extreme emaciation and skin sores/scabies; the treatment principle is to tonify the Kidney, primarily using Di Huang Wan. Jin Gan (Sinew Gan) presents with bloody stools and emaciation; one should take Bu Gan Di Huang Wan (Tonify Liver Rehmannia Pill). Gu Gan (Bone Gan) prefers lying on cold ground; one should take Bu Shen Di Huang Wan (Tonify Kidney Rehmannia Pill). Nei Gan (Internal Gan) presents with swollen eyes, abdominal distension, variable stool color, or frothy green/white stools, gradually leading to weakness; this is a Cold pattern, suitable for Mu Xiang Wan (Aucklandia Pill). Wai Gan (External Gan) presents with redness and erosion under the nose, rubbing the nose tip, non-healing sores, and growths around the ears; one should use Zhi Chuang Lan Lan Xiang San (Treat Sores Orchid Fragrance Powder) or Bai Fen San (White Powder). The medical law states: All Gan syndromes should be treated by tonifying the mother organ of the affected Zang, so the child organ becomes peaceful. For instance, tidal fever at noon indicates Deficient Heat in the Heart channel; since the Liver is the mother of the Heart, one should first tonify the Liver, then drain the Heart after the Liver is sufficient. The Heart receives the Qi of its mother, becoming internally balanced, and the tidal fever resolves. The rest follow this logic. Generally, Gan disease should be treated by distinguishing between Cold, Heat, Fat, and Thin. Early-stage disease is Fat-Heat Gan; late-stage disease is Thin-Cold Gan. For Cold patterns, use Mu Xiang Wan; for Heat patterns, use Hu Huang Lian Wan (Picrorhiza Pill); for both Cold and Heat Gans, use Ru Sheng Wan (Like Sage Pill) and similar formulas. Only because children's Zang-Fu organs are delicate should one not use harsh purgatives, lest Jin Ye be lost and Gan syndrome form. Pediatricians must always treat with a heart of caring for the young and manage them well, avoiding reckless boldness in treatment to prevent cutting off human lineage; this would be fortunate!
Pulse Diagnosis
(See the General Chapter above.)
Formulas
Di Huang Wan (Rehmannia Pill) (Tonifies Liver and Kidney Deficiency) Treats Liver Gan with white membrane covering eyes, Jin Gan with bloody stools, Kidney Gan with emaciation and sores, Bone Gan preferring cold ground. Also treats weak Stomach Qi, mutism, and Jie Lu (delayed closure of fontanelles). For children who cannot walk due to old age, exclusive use yields miraculous effects.
Prepared Rehmannia Root (Shu Di Huang, wine-washed, 8 qian) Cornus Fruit (Shan Zhu Yu) Dried Yam (Gan Shan Yao, each 4 qian) Alisma Rhizome (Ze Xie) Moutan Bark (Mu Dan Pi) White Poria (Bai Fu Ling, each 3 qian)
The above are ground into fine powder, mixed with refined honey into pills the size of Chinese wolfberry seeds. Children under three years old take 3 to 5 pills, dissolved in warm water on an empty stomach. Older children increase the dosage accordingly.
An Shen Wan (Calming the Spirit Pill) Treats evil heat causing startled crying, Heart Gan with yellow face, red cheeks, and high fever. (Formula see in Convulsion Section.)
Yi Huang San (Benefit Yellow Powder) (Also known as Bu Pi San / Tonify Spleen Powder) Treats pediatric Spleen-Stomach deficiency-cold, Spleen Gan with yellowish body and abdominal distension, craving for dirt, Lung Gan with asthma and sores in mouth/nose.
Tangerine Peel (Chen Pi, 1 qian) Green Tangerine Peel (Qing Pi) Chebula Fruit Peel (He Zi Pi) Licorice Root (Gan Cao, roasted, each 5 fen) Clove Bud (Ding Xiang, 2 fen)
The above are cut finely as one dose, decocted in one cup of water until reduced to 60%, taken warm. (I usually add Codonopsis and Atractylodes Macrocephala Rhizome, each 1 qian, to this formula for better effect.)
Mu Xiang Wan (Aucklandia Pill) Treats Thin-Cold Gan.
Aucklandia Root (Mu Xiang) Green Tangerine Peel (Qing Pi) Areca Seed (Bing Lang) Nutmeg (Rou Dou Kou, each 2.5 qian) Musk (She Xiang, 1 qian, ground separately) Croton Seed (Xu Sui Zi, 1 liang, oil removed) Toad (Xia Ma, large ones, also called Chan Su, common name Feng Ji, 3 pieces, burned to retain nature)
The above are ground into fine powder, mixed with refined honey into pills the size of mung beans. Each dose is 3 to 5 pills up to 10-20 pills, taken down with Mint Tea.
Hu Huang Lian Wan (Picrorhiza Pill) Treats Fat-Heat Gan.
Picrorhiza Rhizome (Hu Huang Lian) Scutellaria Baicalensis Root (Xuan Huang Lian, each 5 qian) Cinnabar (Zhu Sha, 2.5 qian, ground separately)
The above are ground into fine powder and mixed evenly, stuffed inside Pig Gallbladders. Boil in thin rice wash water. Hang the gallbladder with a thread over a pot supported by a stick, ensuring it does not touch the bottom. After the time it takes to cook a meal, remove it, grind it, and add Aloe Vera (Lu Hui) and Musk (She Xiang), each 1 fen. Form into pills the size of hemp seeds using rice paste. Each dose is 5 to 7 pills up to 10-20 pills, taken down with rice drink.
Alternative prescription: Remove feet from Toads, dry them by roasting without burning (5 qian).
Lan Xiang San (Orchid Fragrance Powder) Treats External Gan with redness and erosion under the nose.
Orchid Leaves (Lan Xiang Ye, collected 2 qian, burned to retain nature) Copper Verdigris (Tong Qing) Calomel (Qing Fen, each 5 fen)
The above are ground into fine powder and applied dry to the lesion.
Bai Fen San (White Powder) Treats Gan sores.
Cuttlefish Bone Powder (Wu Zei Yu Gu Mo, 7 qian) Bletilla Rhizome Powder (Bai Ji Mo, 3 qian) Calomel (Qing Fen, 1 qian)
The above are mixed into powder. First wash the sore with clear rice wash water, dry it, and apply the powder.
Ru Sheng Wan (Like Sage Pill) Treats Cold-Heat Gan diarrhea.
Quinine Tree Fruit (Shi Jun Zi, 1 liang, shelled) Picrorhiza Rhizome (Hu Huang Lian) Scutellaria Baicalensis Root (Chuan Huang Lian) Elaeagnus Seed (Bai Wu Ti, peeled, roasted, each 2 liang) Musk (She Xiang, 5 fen, ground separately) Dried Toad (Gan Xia Ma, 5 pieces, boiled in wine and pounded into paste)
The above are ground into fine powder, mixed with Toad paste into pills the size of hemp seeds. For 2-3 year olds, 5-7 pills; for older children, 10-15 pills, taken down with Codonopsis Decoction. Take at any time.
Xiang Chan Wan (Orchid-Toad Pill) Treats Gan wasting, Food Stagnation, Parasite Accumulation, Flesh Accumulation, and abdominal distension.
Burreed Tuber (San Leng, soaked in vinegar and roasted) Curcuma Longa Rhizome (Peng E Zhu, soaked in vinegar and roasted) Green Tangerine Peel (Qing Pi, pith removed) Medicated Leaven (Shen Qu, roasted) Wheat Sprouts (Mai Ya, roasted) Gentiana Scabra Root (Cao Long Dan, soaked in wine and roasted) Areca Seed (Bing Lang, each 5 qian) Aucklandia Root (Mu Xiang, 2 qian) Prunus Armeniaca Kernel (Chuan Liu Zi, pith removed, boiled in wine) Quinine Tree Fruit (Shi Jun Zi, shelled) Picrorhiza Rhizome (Hu Huang Lian) Scutellaria Baicalensis Root (Chuan Huang Lian, each 4 qian) Tangerine Peel (Chen Pi, 5 qian) Atractylodes Macrocephala Rhizome (Bai Zhu, 2 liang, alternatively 1 qian) Dried Toad (Gan Chan, 5 pieces)
All herbs above Bai Zhu are ground into fine powder. Boil Dried Toad in vinegar until soft, pound into paste, and mix with the powder. If too dry, add more vinegar. Form into pills the size of hemp seeds using paste. Each dose is 15 pills, taken down with clear rice soup.
Lu Hui Wan (Aloe Vera Pill) Treats pediatric Gan Qi, abdominal distension, and bone heat.
Aloe Vera (Lu Hui, ground separately) Aucklandia Root (Mu Xiang) Areca Seed (Bing Lang, each 2.5 qian) Toad (Xia Ma, soaked in wine, roasted yellow, bones removed) Scutellaria Baicalensis Root (Huang Lian, each 1 liang) Elaeagnus Seed (Wu Ti, peeled) Green Tangerine Peel (Qing Pi, pith removed) Tangerine Peel (Chen Pi, each 5 qian) Croton Seed (Ba Dou, 3-7 grains, shelled, roasted yellow with the previous four ingredients, remove beans)
The above are ground into fine powder, formed into pills the size of small beans using Pig Gallbladder juice. For three-year-olds, 30 pills, taken down with rice soup.
Another Prescription Treats Gan accumulation with abdominal distension.
Picrorhiza Rhizome (Hu Huang Lian, removes Gan accumulation and fruit accumulation) Asafetida (A Wei, soaked in vinegar, removes meat accumulation, each 5 fen) Musk (She Xiang, 4 grains of Dang Men Zi) Medicated Leaven (Shen Qu, roasted, removes food accumulation) Scutellaria Baicalensis Root (Chuan Huang Lian, roasted, removes heat accumulation and alcohol accumulation, each 2 qian)
The above are ground into fine powder, formed into pills the size of hemp seeds using Pig Gallbladder juice. Each dose is 30 pills, taken down with Atractylodes Macrocephala Rhizome Decoction.
Another version contains 5 fen of Aloe Vera.
Another Prescription Treats pediatric Gan disease.
Scutellaria Baicalensis Root (Huang Lian) Atractylodes Macrocephala Rhizome (Bai Zhu) Hawthorn Flesh (Shan Zha Rou, each 5 qian) Picrorhiza Rhizome (Hu Huang Lian) Aloe Vera (Lu Hui, each 3 qian, ground separately) Elaeagnus Seed (Wu Ti, 2.5 qian) Medicated Leaven (Shen Qu, roasted, 2 qian)
The above are ground into fine powder, formed into pills the size of hemp seeds using Pig Gallbladder juice. Adjust the number of pills based on the child's size.
(Ancestral Prescription)
Bing Lang Wan (Areca Seed Pill) For pediatric Gan disease, Qi accumulation forming masses, abdominal distension with parasites, etc., its efficacy is miraculous.
Areca Seed (Bing Lang, 1 liang) Burreed Tuber (San Leng, baked to remove hairs, sliced, vinegar-roasted) Curcuma Longa Rhizome (Peng E Zhu, vinegar-roasted, each 5 qian) Green Tangerine Peel (Qing Pi, pith removed, bran-roasted to yellow) Tangerine Peel (Chen Pi, pith removed, each 5 qian) Omphalia Lapidea (Lei Wan, shelled, 5 qian) Elaeagnus Seed (Wu Ti, washed with water, 2.5 qian)
Chrysanthemum Carpesium Fruit (He Shi, 3 qian, lightly roasted) Dry Lacquer (Gan Qi, 5 qian, roasted until no smoke) Aucklandia Root (Mu Xiang, 3 qian, avoid fire) Amomum Fructus (Sha Ren, 1 qian) Galangal (Liang Jiang, 2 qian, roasted with earth from east-facing wall) Wheat Flour (Mai Mian, 5 qian, roasted) Picrorhiza Rhizome (Hu Huang Lian, 3 qian) Licorice Root (Gan Cao, roasted, 3 qian) Medicated Leaven (Shen Qu, roasted to yellow, 5 qian) Hawthorn Flesh (Shan Zha Rou, 5 qian)
The above are ground into fine powder, formed into pills the size of mung beans using vinegar paste. Each dose is 30-50 pills, taken on an empty stomach with light Ginger Decoction.