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Accumulated heat generates parasites that erode the spine and sternum; striking the back produces a hollow sound like drumming. The body is emaciated with a serrated appearance of the spinal bones, accompanied by fever, diarrhea, irritability, and thirst.
Ulcers appear on all ten fingers, and the nails are gnawed. This condition is named Ji Gan (Spinal Parasitic Disease), which is critical and dangerous.
Aloe Pill (Lü Hui Wan) should be used together with Golden Toad Powder (Jin Chan San). Urgent treatment is required without delay.
[Note]
Ji Gan (Spinal Parasitic Disease) arises from accumulated heat generating parasites that ascend to erode the spine and sternum.
Striking the back with the hand yields a hollow sensation resembling drumming. The spinal bones become emaciated and take on a serrated shape, which constitutes the external signs of Ji Gan.
It is also accompanied by fever, diarrhea, irritability, and thirst, ulcers on all ten fingers, and frequent gnawing of the nails. This syndrome is most formidable.
One must first use Aloe Pill (Lü Hui Wan) to eliminate the parasites,
followed by Golden Toad Powder (Jin Chan San) to resolve the parasitic accumulation. Treatment should be adjusted according to the condition, and recovery may be possible.
(Aloe Pill / Lü Hui Wan) Composed of Raw Aloe (Lü Hui), Indigo Naturalis (Qing Dai), Cinnabar (Zhu Sha, crushed), Bear Bile (Xiong Dan), Picrorhiza Rhizome (Hu Huang Lian), Cyperus Rhizome (Guan Zhong), Earthworm (Di Long, slightly fried), Coptis Rhizome (Chuan Huang Lian), Cicada Slough (Chan Tui, feet removed), and Ophiopogon/Termite-eating fungus? (Lei Wan) each at 5 qian, Musk (She Xiang) at 1 qian, and one Toad (Xia Ma) coated with butter and roasted until scorched.
The above ingredients are ground into fine powder, mixed with snail shell meat (Wo Jiao Rou) by grinding, and formed into pills the size of hemp seeds.
Each dose consists of 5 pills, taken with rice gruel broth, adjusted according to the child's age and size.
(Golden Toad Powder / Jin Chan San) Composed of one Toad (Chan) coated with butter and roasted until scorched, Night Soil (Ye Ming Sha, fried), Peach White Bark (Tao Bai Pi), Chinese Toona Root Bark (Chu Gen Bai Pi), Terra Doli (Di Tu), Phellodendron Bark (Huang Bo), Chebula Fruit Peel (He Li Le Pi, roasted), Lily Bulb (Bai He), Ginseng (Ren Shen), Rhubarb (Da Huang), White Melia Seed (Bai Wu Yi, fried), Lead Carbonate/White Lead (Hu Fen) each at 3 qian, Areca Nut (Bing Lang) at 1 qian, and Clove (Ding Xiang) 37 grains.
The above ingredients are ground into fine powder. Each dose is 0.5 fen, mixed with rice gruel broth for administration.

Excessive consumption of greasy, cold, and rich/sweet foods leads to damp-heat generating roundworms (Ascaris) entangling in the abdomen. There is intermittent irritability, excessive crying, and abdominal pain. The lips change color, and clear saliva overflows.
Abdominal distension with visible blue veins and dampness/itching at the anus occur.
Shi Jun Zi Powder (Shi Jun Zi San) should be used without delay. If ineffective, Worm Expelling Pill (Xia Chong Wan) is highly effective. After the worms are expelled, the Spleen should be tonified using Fat Child Pill (Fei Er Wan).
[Note]
Hui Gan (Roundworm Parasitic Disease) results from overeating cold, raw, greasy, and rich foods, causing damp-heat to generate roundworms that disturb the abdomen.
Thus, there is sometimes irritability and excessive crying, and sometimes abdominal cramping pain. The lips may be red or white,
and clear saliva overflows from the mouth. Abdominal distension presents with visible blue veins, and the anus is damp and itchy.
First, treat with Shi Jun Zi Powder (Quisqualis Powder). If ineffective, administer Worm Expelling Pill (Xia Chong Wan).
If the roundworms are expelled, the Spleen should then be regulated and tonified, primarily using Fat Child Pill (Fei Er Wan).
(Shi Jun Zi Powder / Shi Jun Zi San) Composed of ten Quisqualis Seeds (Shi Jun Zi) fried on a tile and ground into powder, five Ailanthus Seeds (Ku Lian Zi) soaked and pitted, and White Melia Seed (Bai Wu Yi) and Licorice Root (Gan Cao) each at 1 qian (soaked overnight in bile).
The above ingredients are ground into powder. Each dose is 1 qian, taken with water.
(Worm Expelling Pill / Xia Chong Wan) Composed of fresh white Ailanthus Root Bark (Ku Lian Gen Pi, preferably new, soaked in wine and dried), Costus Root (Mu Xiang), Peach Kernel (Tao Ren, soaked, skin and tip removed), Green Cyperus (Lv Se Guan Zhong), Fried Melia Seed (Wu Yi Bei), Chicken-heart Areca Nut (Ji Xin Bing Lang) each at 2 qian, Calomel/Qing Fen at 5 fen, Cocklebur Fruit (He Shi, fried) at 1 qian, Dried Toad (Gan Xia Ma, roasted black) at 3 qian, and Quisqualis Meat (Shi Jun Zi Rou, roasted) at 3 qian.
The above ingredients are ground into powder, bound with wheat paste into pills the size of hemp seeds. Each dose is 20 pills, taken with boiling plain water.
(Fat Child Pill / Fei Er Wan) See the section on Pi Gan (Spleen Parasitic Disease) for the formula.