〔《经》〕治小儿吃泥及KT 肚。腻粉一分，用砂糖搜丸如麻子大。空心米饮下一丸，泻出土瘥。（KT ，
如掌切，胀也。）
〔钱〕初病疳，津液少者，当生胃之津液，白术散主之，唯多则妙。
龙粉丸 治疳渴。
草龙胆 定粉（微炒） 乌梅肉（焙） 黄连（各二分）
上为细末，炼蜜丸如麻子大，米饮下一二十丸，无时。
〔汤〕三棱散 治小儿尿白浊，久则成疳，宜疏脾土，消食化滞。
三棱 蓬术（炒） 益智仁 甘草（各一两） 神曲（炒） 麦芽（炒） 橘红（各半两）
上为末，白汤调下。
〔世〕黄龙丸 治停食，化积磨积。
三棱 蓬术（各三两） 青皮 陈皮（各一两半） 山楂 干姜（各七钱半） 槟榔（半两）
上晒干为末，糊丸黍米大。三岁儿每二十丸，食后姜汤下，食前乌犀丸，相间服。此治小儿疳积
等证，无不效者。（乌犀丸方见疳热条。）
〔钱〕胆矾丸 治疳消癖，进食止泻，和胃追虫。
绿矾（真者，二两） 胆矾（真者，为粗末，一钱） 大枣（四十个，去核） 好醋（一升）
以上四物，同熬令枣烂，候和后药∶
使君子（去壳，二两） 枳实（炒，三两） 黄连 诃子（去核，各为粗末。各一两） 巴豆（二十七个，去
皮，破之）
以上五味，同炒黑，约三分干，入后药∶
夜明砂 虾蟆（烧存性，各一两） 苦楝根皮（五钱）
以上三味，再入炒候干，同前四物杵罗为末，同前膏和入臼中杵千下。如未成，旋入熟枣肉，亦不可多，
恐服之难化。太干即入温水亦可，丸如绿豆大。每服二三十丸，米饮温水下，不拘时。
〔丹〕肥儿丸 治小儿疳积。
芦荟（另研） 胡黄连（各二钱） 神曲（四钱） 黄连 白术 山楂（炒。各半两） 芜荑（炒，二钱半）
上为末，将芦荟末拌匀，猪胆汁丸如粟米大。每服六十丸，食前白汤下。
〔《本》〕芦荟丸 治小儿疳积秘方。
芦荟 荆芥 黑丑 青皮（各等分）
上治炮为末，面糊丸如粟米大。一岁儿以下一丸，或二丸亦不妨，量大小加减。
〔钱〕肺疳气喘，口鼻生疮，当补脾肺，益黄散主之。（方见治虚实法。）
肾疳极瘦，身有疮疥，当补肾，地黄丸主之。（方见劳瘵，即六味地黄丸。）
〔汤〕肾疳，齿爪黑。
上肾疳羸瘦疮疥治法，当与虚羸门相参用之。
〔钱〕骨疳，喜卧冷地。
〔汤〕木香丸治渴，好卧冷地。
〔世〕五疳保童丸 治小儿乳食不择冷热，好餐肥腻，恣食甘咸，脏腑不和，生疳。
青黛 苦楝根皮 夜明砂 五倍子 芦荟 黄连 龙胆草 白芜荑 干蟾（各一分） 麝香（少）
蝉蜕（去嘴爪，一分） 猪胆（大者五个，拌诸药焙干）
上件粟米煮糊，为丸如麻子大。一岁儿三丸，不拘时，米饮下，日三服。忌猪肉。
〔《圣》〕治小儿脑疳，鼻痒，毛发作穗，面黄羸瘦，益脑。用鲫鱼胆滴于鼻中，连滴三五日效。
〔汤〕小儿脑疳者，是胎热所为，但头皮光急，头发作穗，或有头疮。肿至囟，囟肿则多损眼。此
疾因儿在胎中，母临月房事不已而成。项软倒，肥而不瘦。（天柱骨倒也。）
附子（生，去皮脐） 南星
上末，生姜自然汁调摊贴患处，次服防风丸并泻青丸。
〔世〕小儿久患疳疾体虚，久不进饮食，患久诸候退，只是天柱骨无力，医者不识，谓之五软。用白
僵蚕真者去丝炒为末，每服五分或一钱，薄荷酒调下，日三。更须贴药。
贴药生筋散
木鳖子（三个） 蓖麻子（三十粒）
上各取肉同研，用一钱，津调，先烘上令热，贴之。
上疳五软盖痿属也。不若用地黄丸及黄柏龟板之类为愈。
〔世〕小儿无辜疳者，其候面黄发直，时时壮热，饮食不生肌肤，积经日月，遂致死者，谓之无辜疳也。
言天有鸟，名曰无辜，昼伏夜游，洗浣衣褥，露之经宿，或遇此鸟，飞从上过，将衣褥与小儿穿卧，便令儿有
此疾。如禽兽生下有噤虫，若不速去，当损其命。又脑后有核，初生软而不觉痛，其中有虫如米粉，得热气渐
长大，则筋结定，虫随气血流散，所以停留。子母相生，侵蚀脏腑，肌肉作疮，或大便泄脓血，致使小儿渐渐
黄瘦，头大发竖，手足细弱，生十二件无辜疾症∶天吊、胡孙噤、鹅口、木舌、悬痈、重 、着噤、脐风、撮
口、重舌、乳渊、龟胸。
鳖甲散
鳖甲（醋炙，三分） 槟榔（三个） 沉香（一分） 漏芦 甘草（炙） 牛蒡子（炒） 使君子 赤芍药
诃子（炮，去核。各半两）
上为粗末，每服一钱，水半盏，煎六分，去渣温服。
〔《明》〕多疳者∶囟会（一壮。）疮蚀龈断，臭秽冲人∶劳宫（一壮。）
〔钱〕疳皆脾胃病，亡津液之所作也。因大病或吐泻后，医又以药吐下，致脾胃虚弱，亡失津液。
且小儿病疳，皆愚医之所坏病。假如潮热，是一脏虚一脏实，而内发虚热也，法当补母而泻本脏则愈。假令
日中发潮热，是心虚热也，肝为心母，法宜先补肝母，肝实而后泻心。心得母气，则内平而潮热自愈。医见潮
热，妄谓其实，乃以大黄、牙硝辈诸冷药利之，利既多而不能禁，则津液内亡，渐成疳也。又如癖病发
作寒热，饮水，
胁下有形硬痛，法当用药渐消磨之。医反以巴豆、 砂辈快药下之，小儿易虚易实，下之既过，胃中
津液耗损，渐成疳瘦。又有病伤寒五六日，间有下证，以冷药下之太过，致脾胃虚而津液少，即便引饮不止
而生热也，热气内耗，肌肉外消，他邪相干，证变诸端，亦成疳病。又有吐泻久病，或医妄下之，其虚益
甚，津液燥损，亦能成疳也。
小儿病癖，由乳食不消，伏在腹中，乍凉乍热，饮水不止，或喘而嗽，与潮热相类。若不早治，必成
劳疳。以其有癖症，则令儿不食，致脾胃虚而发热，故引饮也。饮多，即荡涤脾胃，亡失津液，不能传化水
谷，其脉沉细，益不能饮食，致脾胃虚衰，四肢不举，诸邪遂生，羸瘦而成疳矣。肥疳即脾疳也，身瘦虚黄
干而有疮疥，其候不一，种种异端，今略举言之。目涩或生白膜，唇赤，身干黄或黑，喜卧冷地，或食泥土，
身有疮疥，泻青白黄沫水，痢色变易，腹满，身耳鼻皆有疮，发鬓作穗，头大项细，极瘦，饮水，皆其
证也。
〔世〕心疳者，苦要惊啼，常只吃水，少食辛味，耳边有青脉，舌上有焦点者不治。肝疳者，目带青，
左胁下硬，多吐沫，眼、头黑者不治。脾疳者，肚大青筋，唇口无血色，人中平，下痢不止者不治。肺疳
者，咳逆气急，泻白水，身上黑斑者不治。肾疳者，要吃咸醋，吃水不住，小便如粉汁，齿黑有疮，骨
出耳干脑焦不治。
[From the *Classic*] To treat children eating dirt and abdominal distension (KT, pronounced like "zhang", meaning distension). Take one fen of Nifen (Calomel), knead it with white sugar into pills the size of hemp seeds. Administer one pill on an empty stomach with rice water; upon discharge of foul matter, the disease will heal. (KT, pronounced like "zhang", refers to abdominal distension.)
[Qian Yi] For initial stages of Gan syndrome with deficient body fluids, one should generate stomach fluids; Baizhu San (Atractylodes Macrocephala Decoction) is the primary formula, which yields excellent results.
Longfen Wan (Dragon Powder Pill) treats Gan thirst.
Caolongdan (Radix Gentianae), Dingfen (Lead Carbonate, slightly fried), Wumei Rou (Endocarpium Pruni Mume, baked), Huanglian (Rhizoma Coptidis) (each 2 fen).
Grind the above ingredients into fine powder, mix with refined honey to form pills the size of hemp seeds. Administer 10-20 pills at any time with rice water.
[Tang Shi] Sanleng San (Burreed Rhizome Powder) treats cloudy white urine in children, which may develop into Gan syndrome over time. It is appropriate to soothe the spleen earth, digest food, and resolve stagnation.
Sanleng (Rhizoma Sparganii), Pengzhu (Rhizoma Curcumae, fried), Yizhiren (Fructus Alpiniae Oxyphyllae), Gancao (Radix Glycyrrhizae, each 1 liang), Shenqu (Massa Medicata Fermentata, fried), Maiya (Fructus Hordei Germinatus, fried), Juhong (Pericarpium Citri Reticulatae, each half liang).
Grind the above into powder, take with boiling water.
[Worldly Physicians] Huanglong Wan (Yellow Dragon Pill) treats retained food, resolving and grinding away accumulations.
Sanleng (Rhizoma Sparganii), Pengzhu (Rhizoma Curcumae) (each 3 liang), Qingpi (Pericarpium Citri Reticulatae Viride), Chenpi (Pericarpium Citri Reticulatae) (each 1.5 liang), Shanzha (Fructus Crataegi), Ganjiang (Rhizoma Zingiberis Recens) (each 7.5 qian), Binglang (Semen Arecae) (half liang).
Dry the above, grind into powder, and make pills the size of millet grains using paste. For a three-year-old child, administer 20 pills after meals with ginger water, and Wu Xi Wan (Black Rhinoceros Horn Pill) before meals, alternating administration. This formula is effective for all cases of pediatric Gan accumulation. (The formula for Wu Xi Wan is found under the section on Gan Heat.)
[Qian Yi] Danfan Wan (Chalcanthite Pill) treats Gan emaciation with masses, promotes appetite, stops diarrhea, harmonizes the stomach, and expels parasites.
Lüfan (Vitamin Green Vitriol, authentic, 2 liang), Danfan (Chalcanthite, authentic, coarse powder, 1 qian), Dazao (Fructus Jujubae, 40 pieces, pitted), Hao Cu (Good Vinegar, 1 sheng).
Simmer the above four items together until the dates are soft. When warm, add the following:
Shijunzi (Fructus Quisqualis, shelled, 2 liang), Zhishi (Fructus Aurantii Immaturus, fried, 3 liang), Huanglian (Rhizoma Coptidis), Hezi (Fructus Chebulae, pitted, coarse powder, each 1 liang), Badou (Semen Crotonis Tiglii, 27 pieces, shelled and broken).
Stir-fry the above five items until black, reducing moisture by about two-thirds, then add:
Yeming Sha (Dracois Faeces), Xama (Bufo bufo, burned to retain properties, each 1 liang), Kulian Genpi (Cortex Meliae Toosendan, 5 qian).
Stir-fry the above three items again until dry, pound them with the previous four items and paste in a mortar for a thousand strokes. If not forming pills properly, add cooked date flesh sparingly, as excessive amounts may hinder digestion. If too dry, add warm water. Form pills the size of mung beans. Administer 20-30 pills with rice water or warm water at any time.
[Zhu Danxi] Fei'er Wan (Fattening Child Pill) treats pediatric Gan accumulation.
Luhui (Resina Aloe), Huhuanglian (Rhizoma Coptidis Chinensis, each 2 qian), Shenqu (Massa Medicata Fermentata, 4 qian), Huanglian (Rhizoma Coptidis), Baizhu (Rhizoma Atractylodis Macrocephalae), Shanzha (Fructus Crataegi, fried, each half liang), Wuyi (Semen Praecogniti, fried, 2.5 qian).
Grind into powder, mix evenly with Luhui powder, and form pills the size of millet grains using pig bile. Administer 60 pills before meals with boiling water.
[From the *Bencao*] Luhui Wan (Aloe Pill) is a secret formula for treating pediatric Gan accumulation.
Luhui (Resina Aloe), Jingjie (Herba Schizonepetae), Heichou (Fructus Phyllanthi Urariae), Qingpi (Pericarpium Citri Reticulatae Viride) (equal parts).
Process and fry the above, grind into powder, and make pills the size of millet grains using flour paste. For infants under one year old, administer one pill, or two if necessary, adjusting dosage according to age and size.
[Qian Yi] For Lung Gan with asthma and sores in the mouth and nose, tonify the spleen and lung; Yihuang San (Benefit Yellow Powder) is the primary formula. (Formula found in the section on treating deficiency and excess.)
For Kidney Gan with extreme emaciation and skin sores, tonify the kidney; Dihuang Wan (Rehmannia Pill) is the primary formula. (Formula found in the section on Consumption, i.e., Liuwei Dihuang Wan.)
[Tang Shi] Kidney Gan presents with black teeth and nails.
The treatment methods for Kidney Gan with emaciation and sores should be used in conjunction with those in the Section on Emaciation and Weakness.
[Qian Yi] Bone Gan presents with a preference for lying on cold ground.
[Tang Shi] Muxiang Wan (Costus Root Pill) treats thirst and preference for lying on cold ground.
[Worldly Physicians] Wugan Baotong Wan (Five Gans Protecting Child Pill) treats Gan caused by indiscriminate eating of hot and cold foods, preference for greasy foods, excessive consumption of sweet and salty flavors, leading to disharmony of the zang-fu organs.
Qingdai (Indigo Naturalis), Kulian Genpi (Cortex Meliae Toosendan), Yeming Sha (Dracois Faeces), Wubeizi (Galla Chinensis), Luhui (Resina Aloe), Huanglian (Rhizoma Coptidis), Longdancao (Radix Gentianae), Bai Wuyi (Semen Praecogniti, white), Ganchan (Toad Skin, each 1 fen), Shexiang (Moschus, small amount), Chantui (Periostracum Cicadae, remove head and claws, 1 fen), Zhu Dan (Pig Gallbladder, 5 large ones, mixed with herbs and baked dry).
Cook millet to make paste, form pills the size of hemp seeds. For a one-year-old child, administer 3 pills at any time with rice water, three times daily. Avoid pork.
[From the *Shengji Zonglu*] To treat Brain Gan in children, characterized by nasal itching, hair forming tufts, sallow and emaciated complexion, benefiting the brain. Apply gall from a crucian carp into the nostrils; continuous application for 3-5 days is effective.
[Tang Shi] Pediatric Brain Gan is caused by fetal heat. Symptoms include tight, shiny scalp, hair forming tufts, or head sores. Swelling extends to the fontanelle; fontanelle swelling often damages the eyes. This disease arises from excessive sexual activity by the mother near delivery. The neck is weak and collapses; the body is fat but not thin. (Collapse of the Tianzhu bone/neck.)
Fuzi (Raw, peeled and navel removed), Nanxing (Rhizoma Arisaematis).
Grind into powder, mix with fresh ginger juice, apply to the affected area. Subsequently, administer Fangfeng Wan (Saposhnikovia Pill) and Xieqing Wan (Drain Green Pill).
[Worldly Physicians] Children suffering long-term Gan disease with weakness, unable to eat for a long time, where other symptoms have subsided but only the Tianzhu bone (neck) remains weak, is unrecognized by physicians and called "Five Softnesses." Use authentic Bai Jiangcan (Bombyx Batryticatus), remove silk, fry, and grind into powder. Administer 5 fen or 1 qian, mixed with mint wine, three times daily. External application is also required.
External Application: Shengjin San (Generate Tendons Powder)
Mubiezi (Semen Strychnos), Bimazi (Semen Ricini) (30 grains).
Extract the meat from each, grind together. Take 1 qian, mix with saliva, heat the application site first, then apply.
The Five Softnesses associated with Gan belong to Wei syndrome. It is better to treat with Dihuang Wan (Rehmannia Pill) and herbs such as Huangbai (Cortex Phellodendri) and Guiban (Carapax et Plastrum Testudinis).
[Worldly Physicians] Innocent Gan in children presents with sallow complexion, straight hair, frequent high fever, inability of food to nourish muscles, and eventual death after prolonged duration. It is said that there is a bird named "Innocent" in heaven, active at night, washing bedding left out overnight. If this bird flies over and deposits its influence on bedding used by a child, the child contracts this disease. Similar to animals born with "Jin worms," if not quickly expelled, it threatens life. Additionally, a lump appears behind the head, initially soft and painless, containing worm-like substances resembling rice flour. With heat, they grow larger, tendons knot, and worms disperse via blood and qi, remaining stationary. They multiply and erode zang-fu organs, cause muscle sores, or bloody/purulent diarrhea, leading to gradual emaciation, erect hair, thin limbs, and twelve Innocent Diseases: Tiandiao (Upward Gazing), Husunjing (Monkey Jaw Lock), Ekou (Goat Mouth), Mushe (Wooden Tongue), Xuanyong (Hanging Abscess), Chongchi (Double Palate), Zhuojin (Fixed Jaw Lock), Qifeng (Umbilical Wind), Cuokou (Grabbing Mouth), Chongshe (Double Tongue), Ru Yuan (Breast Abyss), Xiong (Turtle Chest).
Biejia San (Softshell Turtle Shell Powder)
Biejia (Carapax et Plastrum Testudinis, vinegar-fried, 3 fen), Binglang (Semen Arecae, 3 pieces), Chenxiang (Lignum Aquilariae Resinatum, 1 fen), Loulu (Radix Euphorbiae Humifusae), Gancao (Radix Glycyrrhizae, fried), Niubangzi (Fructus Arctii, fried), Shijunzi (Fructus Quisqualis), Chishaoyao (Radix Paeoniae Rubra), Hezi (Fructus Chebulae, fried, pitted, each half liang).
Grind into coarse powder. Take 1 qian, add half zhan of water, decoct to six-tenths, strain, and take warm.
[From the *Mingyi Zhizhang*] For multiple Gan manifestations: Xinhui acupoint (moxibustion 1 cone). Sores eroding gums, foul odor: Laogong acupoint (moxibustion 1 cone).
[Qian Yi] Gan diseases are all spleen and stomach disorders, resulting from the loss of body fluids. After severe illness or vomiting/diarrhea, physicians mistakenly use emetics and purgatives, causing spleen-stomach weakness and fluid depletion.
Pediatric Gan is often iatrogenic. For instance, tidal fever indicates one organ is deficient and another excess, generating internal deficient heat. The method requires tonifying the mother organ and draining the affected organ to cure. If tidal fever occurs at noon, it is heart deficient heat. Since liver is the mother of heart, one should first tonify the liver. Once the liver is sufficient, drain the heart. With maternal qi support, the interior balances and tidal fever resolves. Physicians seeing tidal fever wrongly assume excess and use cold purgatives like Dahuang (Radix et Rhizoma Rhei) and Yaxiao (Natrii Sulfas). Excessive purging depletes internal fluids, gradually forming Gan. Similarly, Pi disease (accumulation) presenting with alternating chills/fever, thirst, and hard painful hypochondriac masses should be treated with gradual resolution. Physicians wrongly use harsh purgatives like Badou (Semen Crotonis Tiglii) and Naosha (Natrii Chloridum). Children are prone to deficiency and excess; over-purging consumes stomach fluids, gradually forming Gan emaciation. Also, after five-six days of Cold Damage with possible downward indications, excessive use of cold purgatives damages spleen-stomach and depletes fluids, causing unquenchable thirst and internal heat. Internal heat consumes muscles, external pathogens interfere, transforming into various syndromes, forming Gan. Prolonged vomiting/diarrhea or mistaken purging further depletes fluids, also forming Gan.
Pediatric Pi disease (accumulation) stems from undigested milk and food lingering in the abdomen, causing alternating cold/heat, unquenchable thirst, or coughing/wheezing similar to tidal fever. If untreated early, it becomes Labor Gan. The presence of Pi prevents eating, causing spleen-stomach weakness and fever, leading to thirst. Excessive drinking washes out the spleen-stomach, depleting fluids and impairing transformation of food and water. The pulse is deep and fine, further reducing appetite, causing spleen-stomach decline, immobility of limbs, generation of pathogens, emaciation, and formation of Gan. Fei Gan (Fatty Gan) is Spleen Gan, characterized by emaciation, sallow dry skin, and sores. Symptoms vary: dry eyes or white membranes, red lips, dry yellow or black skin, preference for cold ground, eating dirt, skin sores, passing green/white/yellow frothy stool, altered dysentery color, abdominal fullness, sores on body/ears/nose, hair forming tufts, large head with thin neck, extreme emaciation, and thirst.
[Worldly Physicians] Heart Gan: distressed by fright crying, craving only water, avoiding pungent flavors, blue veins visible behind ears, focal points on tongue—these are untreatable. Liver Gan: eyes appear bluish, hardness below left hypochondrium, frequent spitting of foam, black eyes/head—untreatable. Spleen Gan: distended abdomen with visible blue veins, pale lips/mouth, flat philtrum, intractable diarrhea—untreatable. Lung Gan: coughing, reverse qi, rapid breathing, passing white watery stool, black spots on body—untreatable. Kidney Gan: craving salty/vinegar tastes, unquenchable thirst, urine like rice water, black teeth with sores, protruding bones, dry ears, scorched brain—untreatable.