肝疳面目爪甲青，眼生眵泪涩难睁，摇头揉目合面卧，耳流浓水湿疮生，
腹大青筋身羸瘦，燥渴烦急粪带青，清热柴胡同芦荟，调养逍遥抑肝灵．
[注]
肝属木，包青主筋，故肝疳则见面目爪甲皆青，眼生眵泪，
隐涩难睁，摇头揉目，合面睡卧，耳疮流脓，腹大青筋，身体羸瘦，
燥渴烦急，粪青如苔之证也，
治宜先清其热，用柴胡清肝散，芦荟肥儿丸主之，
治病势稍退，当以逍遥散抑肝扶脾汤调理。
(柴胡清肝散) 银柴胡 栀子微炒 连翘去心 生地黄 胡黄连 赤芍
龙胆草 青皮炒 甘草生．引用灯心竹叶水煎。
(方歌)
柴胡清肝治肝疳，银柴栀子翘胡连，生地赤芍龙胆草，青皮甘草一同煎。
(芦荟肥儿丸) 五谷虫二两炒 芦荟生 胡黄连姜 川黄连各一两姜炒
银柴胡一两二钱炒 扁豆炒 山药各二两炒 南山查二两半 虾蟆四个煆
肉豆蔻七钱煨 槟榔五钱 使君子二两半炒 神麴三两炒 麦芽一两六钱炒
鹤虱八钱炒 芜荑一两炒 朱砂二钱飞 麝香二钱 共研细末，醋糊为丸，
如黍米大，每服一钱，米饮下。
(加味逍遥散) 茯苓 白术炒 当归 白芍炒 柴胡 薄荷 炙甘草
丹皮 栀子炒 引用姜枣水煎服。
(方歌)
加味逍遥散如神，茯苓白术当归身，白芍柴胡薄荷草，再加丹皮栀子仁。
(抑肝扶脾汤)
人参 白术土炒 黄连姜炒 柴胡酒炒 茯苓 青皮醋炒 陈皮 白芥子
龙胆草 山查 神麴炒 炙甘草 引用姜枣水煎服。
(方歌)
调理抑肝扶脾汤，参术黄连柴苓良，青陈白芥龙胆草，山查神麴甘草尝。
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疳证门
The symptoms of Gan syndrome of the Liver (Gan Zheng of the Liver) manifest as bluish discoloration of the face, eyes, and fingernails; ocular discharge with tearing, dryness, and difficulty in opening the eyes; head shaking, eye rubbing, and sleeping with the face turned inward; purulent otorrhea accompanied by wet sores; abdominal distension with visible subcutaneous veins; emaciation; dry mouth and thirst; irritability and restlessness; and stools containing greenish matter. Treatment should focus on clearing heat, utilizing Chaihu Qinggan San (Bupleurum Decoction to Clear the Liver) combined with Lushui Fei'er Wan (Aloe Pill to Enlarge the Intestines). For convalescence, Xiaoyao San (Free and Easy Wanderer Powder) combined with Yi Gan Fu Pi Tang (Decoction to Soothe the Liver and Support the Spleen) is used.
[Note]
In Five-Element theory, the Liver belongs to Wood, its color is primarily blue-green, and it governs the sinews. Therefore, Gan syndrome of the Liver presents with bluish discoloration of the face, eyes, and nails; ocular discharge and tearing; eyelid dryness and difficulty in opening; head shaking and eye rubbing; sleeping with the face turned inward; ear sores with purulent discharge; abdominal distension with visible veins; emaciation; dry mouth and thirst; irritability and restlessness; and greenish stools resembling moss. The treatment principle is to first clear heat, using Chaihu Qinggan San (Bupleurum Decoction to Clear the Liver) and Lushui Fei'er Wan (Aloe Pill to Enlarge the Intestines) as the primary formulas. Once the pathological condition subsides slightly, regulation should be conducted using Xiaoyao San (Free and Easy Wanderer Powder) and Yi Gan Fu Pi Tang (Decoction to Soothe the Liver and Support the Spleen).
(Chaihu Qinggan San / Bupleurum Decoction to Clear the Liver)
Ingredients: Yin Chai Hu (Radix Stellariae), Zhi Zi (Fructus Gardeniae, lightly stir-fried), Lian Qiao (Fructus Forsythiae, heart removed), Sheng Di Huang (Radix Rehmanniae Preparata), Hu Huang Lian (Rhizoma Coptidis or similar bitter cold herb, often referring to Picrorhiza or Coptis depending on context, here likely Coptis or related), Chi Shao (Radix Paeoniae Rubra), Long Dan Cao (Radix Gentianae), Qing Pi (Pericarpium Citri Reticulatae Viride, stir-fried), Gan Cao (Radix Glycyrrhizae, raw). Decoct with Deng Xin Cao (Medulla Junci) and Zhu Ye (Folium Bambusae) as guiding herbs.
(Fang Ge / Formula Song)
Chaihu Qinggan treats Gan syndrome of the Liver;
Yin Chai Hu, Zhi Zi, Lian Qiao, Hu Huang Lian;
Sheng Di, Chi Shao, Long Dan Cao;
Qing Pi and Gan Cao are decocted together.
(Lushui Fei'er Wan / Aloe Pill to Enlarge the Intestines)
Ingredients: Wu Gu Chong (Larva Bombyx Batryticatus or similar, 2 liang, stir-fried); Lu Hui (Resina Aloes, raw); Hu Huang Lian (Rhizoma Coptidis/Picrorhiza, processed with ginger juice); Chuan Lian Lian (Rhizoma Coptidis, each 1 liang, processed with ginger juice); Yin Chai Hu (Radix Stellariae, 1 liang 2 qian, stir-fried); Bian Dou (Semini Dolichoris Lablabis, stir-fried); Shan Yao (Rhizoma Dioscoreae, each 2 liang, stir-fried); Nan Shan Cha (Fructus Crataegi, 2.5 liang); Ha Ma (Bufo bufo gargarizans or similar, 4 specimens, calcined); Rou Dou Kou (Semen Myristicae, 7 qian, baked); Bing Lang (Arecae Semen, 5 qian); Shi Jun Zi (Fructus Quisqualis, 2.5 liang, stir-fried); Shen Qu (Massa Medicata Fermentata, 3 liang, stir-fried); Mai Ya (Fructus Hordei Germinatus, 1 liang 6 qian, stir-fried); He Shi (Semen Pedilii, 8 qian, stir-fried); Wu Yi (Fructus Terminaliae Chebulae, 1 liang, stir-fried); Zhu Sha (Cinnabaris, 2 qian, washed); She Xiang (Moschus, 2 qian). Grind all into fine powder, bind with vinegar paste to form pills, size of millet seeds. Take 1 qian per dose, administered with rice water.
(Jiawei Xiaoyao San / Modified Free and Easy Wanderer Powder)
Ingredients: Fu Ling (Poria), Bai Zhu (Rhizoma Atractylodae Macrocephalae, stir-fried), Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Paeoniae Alba, stir-fried), Chai Hu (Radix Bupleuri), Bo He (Herba Menthae), Zhi Gan Cao (Radix Glycyrrhizae Preparata), Dan Pi (Cortex Moutan), Zhi Zi (Fructus Gardeniae, stir-fried). Decoct with Sheng Jiang (Rhizoma Zingiberis Recens) and Da Zao (Fructus Jujubae) as guiding herbs.
(Fang Ge / Formula Song)
Jiawei Xiaoyao San is miraculous;
Fu Ling, Bai Zhu, Dang Gui Shen;
Bai Shao, Chai Hu, Bo He, Gan Cao;
Add Dan Pi and Zhi Zi Ren.
(Yi Gan Fu Pi Tang / Decoction to Soothe the Liver and Support the Spleen)
Ingredients: Ren Shen (Radix Ginseng), Bai Zhu (Rhizoma Atractylodae Macrocephalae, stir-fried in earth), Huang Lian (Rhizoma Coptidis, processed with ginger juice), Chai Hu (Radix Bupleuri, processed with wine), Fu Ling (Poria), Qing Pi (Pericarpium Citri Reticulatae Viride, processed with vinegar), Chen Pi (Pericarpium Citri Reticulatae), Bai Jie Zi (Semen Mustardae), Long Dan Cao (Radix Gentianae), Shan Cha (Fructus Crataegi), Shen Qu (Massa Medicata Fermentata, stir-fried), Zhi Gan Cao (Radix Glycyrrhizae Preparata). Decoct with Sheng Jiang (Rhizoma Zingiberis Recens) and Da Zao (Fructus Jujubae) as guiding herbs.
(Fang Ge / Formula Song)
For regulation, Yi Gan Fu Pi Tang;
Ren Shen, Bai Zhu, Huang Lian, Chai Hu, Fu Ling are excellent;
Qing Pi, Chen Pi, Bai Jie Zi, Long Dan Cao;
Shan Cha, Shen Qu, and Gan Cao are tasted.
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Section on Gan Syndrome