疳热攻肺成鼻疳，鼻塞赤痒痛难堪，浸淫溃烂连唇际，欬嗽气促发毛干，
热盛清金化毒效，疳虫蚀鼻化虫丸，调敷须用鼻疳散，吹鼻蝉壳效通仙。
[注]
鼻疳者，因疳热攻肺而成，盖鼻为肺窍，
故发时鼻塞赤痒，疼痛浸淫溃烂，下连唇际成疮，欬嗽气促，毛发焦枯也，
热盛者，宜清金散，蒋氏化毒丹主之，
虫蚀者，用化虫丸主之，
外用鼻疳散敷之，或以吹鼻蝉壳散吹入鼻内。
(清金散) 生栀子 黄芩 枇杷叶蜜炙 生地黄 花粉 连翘去心
麦冬去心 薄荷 元参 生甘草 桔梗 引用灯心水煎服。
(方歌)
清金散治肺壅热，栀子黄芩枇杷叶，生地花粉翘麦冬，薄荷元参甘草桔。
(蒋氏化毒丹) 方见胎赤。
(化虫丸)芜荑 芦荟生 青黛 川芎 白芷梢 胡黄连 川黄连 虾蟆各等分灰
以上为细末，猪胆汁浸糊为丸，如麻子大，每服二十丸，食后杏仁煎汤下。
(鼻疳散) 青黛一钱 麝香少许 熊胆五分 以上为细末，干者，
用猪骨髓调贴，湿者干上。
(吹鼻蝉壳散) 蝉壳微炒 青黛研 蛇蜕皮灰 滑石 麝香各等分细研
以上为细末，每用菉豆大，吹人鼻中，日三用之，疳虫尽出。
%
疳证门
疳成毒热内攻胃，上发龈肉赤烂疼，口鼻血出牙枯落，穿腮蚀唇命多倾，
攻毒消疳芜荑效，继以芦荟肥儿灵，外用牙疳散时上，能食堪药始能生．
[注]
牙疳者，因毒热攻胃而成，
故热毒上发，龈肉赤烂痛疼，口臭血出，牙枯脱落，穿腮蚀唇，
病势危急，急用消疳芜荑汤泻其毒热，
继以芦荟肥儿丸清其余热，
外用牙疳散时时敷之自愈，
总之此证必胃能强食，堪胜峻药，始有生机，否则难治也。
(消疳芜荑汤) 大黄 芒硝 芜荑 芦荟生 川连 胡黄连 黄芩
雄黄 水煎服，服后便软及不食者，去大黄芒硝，加石膏羚羊角。
(方歌)
芜荑消疳大黄硝，芦荟芜荑二连标，黄芩雄黄一同入，能清积热牙疳消。
(芦荟肥儿丸) 方见肝疳。
(牙疳散) 人中白煆存性 绿矾烧红 五倍子各等分炒黑 冰片少许
以上为极细末，先用水拭净牙齿，再以此散敷之，有虫者加槟榔。
%
疳证门
Heat from Gan (malnutrition syndrome) attacking the Lung forms Bi Gan (nasal gan). The nose is blocked, red, itchy, and painful beyond endurance. The erosion spreads and ulcerates, connecting to the lips. Coughing, shortness of breath, and dry hair occur.
When heat is excessive, clearing Metal (Lung) and resolving toxicity are effective. For Gan worms eroding the nose, Hua Chong Wan (Worm-Expelling Pill) is used. For external application, Bi Gan San (Nasal Gan Powder) must be applied. Blowing Cicada Slough Powder into the nose yields excellent results.
[Note]
Bi Gan (Nasal Gan) arises because Gan heat attacks the Lung. Since the nose is the orifice of the Lung,
upon onset, there is nasal blockage, redness, itching, pain, spreading erosion, and ulceration, extending downwards to the lips to form sores, accompanied by coughing, shortness of breath, and scorched, withered hair.
For cases with excessive heat, Qing Jin San (Clear Metal Powder) should be used, primarily Jiang Shi Hua Du Dan (Master Jiang’s Toxin-Resolving Pill).
For cases with worm erosion, Hua Chong Wan (Worm-Expelling Pill) is primarily used.
Externally, apply Bi Gan San (Nasal Gan Powder), or blow Chui Bi Chan Ke San (Blowing Nasal Cicada Slough Powder) into the nostrils.
(Qing Jin San / Clear Metal Powder) Raw Gardenia, Scutellaria Root, Loquat Leaf honey-fried, Raw Rehmannia Root, Trichosanthes Root, Forsythia Fruit (heart removed), Ophiopogon Root (heart removed), Mint, Scrophularia Root, Raw Licorice Root, Platycodon Root. Use Juncus Effusus (Water of Lamp Heart) as a guide for decoction in water and take orally.
(Prescription Song)
Qing Jin San treats Lung congestion and heat; Gardenia, Scutellaria, and Loquat Leaf.
Raw Rehmannia, Trichosanthes, Forsythia, and Ophiopogon; Mint, Scrophularia, Licorice, and Platycodon.
(Jiang Shi Hua Du Dan / Master Jiang’s Toxin-Resolving Pill) See Prescriptions for Neonatal Erythema.
(Hua Chong Wan / Worm-Expelling Pill) Membranipora (Wu Yi), Raw Aloe, Indigo Naturalis, Ligusticum Chuanxiong, Angelica Dahurica (tip), Picrorhiza Rhizome, Coptis Chinensis, Toad. All in equal parts, calcined to ash.
Grind all into fine powder. Soak in pig bile to make a paste, form pills the size of sesame seeds. Take 20 pills per dose after meals, washed down with an apricot kernel decoction.
(Bi Gan San / Nasal Gan Powder) Indigo Naturalis one qian, Musk a small amount, Bear Gallbladder five fen. Grind all into fine powder. If dry, mix with pig marrow for application; if wet, sprinkle powder on top.
(Chui Bi Chan Ke San / Blowing Nasal Cicada Slough Powder) Cicada Slough lightly stir-fried, Indigo Naturalis ground, Snake Molt calcined to ash, Talcum, Musk. All in equal parts, finely ground.
Grind all into fine powder. Use an amount the size of a mung bean each time, blow into the nose. Apply three times daily until all Gan worms are expelled.
Gan Syndrome Section
Gan transforms into toxic heat that internally attacks the Stomach, manifesting upwards as red, rotten, and painful gingiva. Blood flows from the mouth and nose, teeth become withered and fall out, cheeks are perforated, and lips are eroded, often leading to death.
To attack toxicity and eliminate Gan, Wu Yi (Membranipora) is effective. Follow with Lu Hui Fei Er Wan (Aloe Child-Nourishing Pill). Externally apply Ya Gan San (Dental Gan Powder) frequently. Only when appetite is strong enough to tolerate harsh medicines can life be saved.
[Note]
Ya Gan (Dental Gan) arises because toxic heat attacks the Stomach.
Thus, heat and toxicity manifest upwards, causing red, rotten, painful gingiva, foul breath, bleeding, withered and falling teeth, cheek perforation, and lip erosion.
The condition is critical; urgently use Xiao Gan Wu Yi Tang (Eliminate Gan Membranipora Decoction) to purge toxic heat.
Follow with Lu Hui Fei Er Wan (Aloe Child-Nourishing Pill) to clear residual heat.
Externally, apply Ya Gan San (Dental Gan Powder) frequently for self-healing.
In summary, this condition requires the Stomach to have strong appetite and the ability to withstand harsh medicines to have a chance of survival; otherwise, it is difficult to treat.
(Xiao Gan Wu Yi Tang / Eliminate Gan Membranipora Decoction) Rhubarb, Mirabilite, Membranipora, Raw Aloe, Coptis Chinensis, Picrorhiza Rhizome, Scutellaria Root, Realgar. Decoct in water and take orally. After taking, if stool becomes soft or appetite is lost, remove Rhubarb and Mirabilite, add Gypsum and Antelope Horn.
(Prescription Song)
Wu Yi eliminates Gan with Rhubarb and Mirabilite; Aloe and Membranipora mark the beginning of Coptis pair.
Scutellaria and Realgar enter together; able to clear accumulated heat and eliminate Dental Gan.
(Lu Hui Fei Er Wan / Aloe Child-Nourishing Pill) See Prescriptions for Liver Gan.
(Ya Gan San / Dental Gan Powder) Human Tooth Ash preserved by calcination, Green Vitriol burned red, Chinese Gall in equal parts stir-fried black, Borneol a small amount.
Grind all into extremely fine powder. First clean the teeth with water, then apply this powder. If worms are present, add Areca Seed.
Gan Syndrome Section