Library

Gan disease refers to a condition characterized by dryness and emaciation. It arises from congenital deficiency of Qi and Blood in children, with fragile and delicate Zang-Fu organs. Alternatively, it may result from overfeeding or unregulated consumption of rich and sweet foods, causing food stagnation in the Zhongwan (CV12) region. This leads to sluggish digestion and transmission, gradually damaging the intestines and stomach, thereby generating accumulated heat. When heat becomes excessive, Gan disease forms, consuming Qi and Blood and scorching body fluids. Initially, Gan disease presents with urine resembling rice wash water, afternoon tidal fever, or follows prolonged untreated vomiting, diarrhea, malaria, or dysentery, as well as chronic fever, sweating, coughing, or sores. These conditions lead to exposed blue veins, a distended and hard abdomen, bluish-yellow complexion, muscle wasting, and withered skin and hair, thus constituting Gan syndrome. However, treatment should be differentiated according to the affected organ. Heart Gan manifests as red face, reddish stool, high fever, irritability, thirst, teeth grinding, and tongue protrusion; Liver Gan presents with bluish complexion, eyes, nails, swollen red eyelids, visual obscurations, excessive tearing, white membrane covering the pupil, and green moss-like stool; Spleen Gan shows yellowish emaciation, large head with thin legs, cravings for rice, tea leaves, or soil, vomiting, diarrhea, irritability, thirst, and foul, sticky stools; Lung Gan features pale face, cough with rebellious Qi, scorched and brittle hair, dry skin, aversion to cold with fever, clear nasal discharge, and sores on the nose and cheeks; Kidney Gan is marked by dark complexion, bleeding gums, bad breath, cold feet, skeletal emaciation with abdominal pain, diarrhea, and incessant crying. Decoctions should treat based on the meridian involved.

Techniques: Divide Yin and Yang (200 repetitions), Push San Guan (100 repetitions), Retreat Liu Fu (100 repetitions), Push Pi Tu (Spleen Earth) using tonification and clearing methods (200 repetitions each), Push Shen Shui (Kidney Water) (100 repetitions), Rub Abdomen (100 repetitions), Rub Navel rotating clockwise and counter-clockwise (100 repetitions each).

Note: Gan disease often involves fever; severity and excess/deficiency patterns must be distinguished. *Yi Zong Jin Jian* lists various types of Gan syndromes with methods; do not restrict treatment solely to external therapies. (Ti Li Zi)

Vomiting symptoms are categorized into three types: Ou (vomiting with sound and matter), Tu (spitting without sound but with matter), and Yue (dry heaving). Ancient sages stated that Ou belongs to the Yangming channel, involving both Qi and Blood pathology; Tu belongs to the Taiyang channel, involving Blood pathology; Yue belongs to the Shaoyang channel, involving Qi pathology. Only Li Dongyuan attributed all three to Spleen-Stomach deficiency. Jiegu Laoren differentiated them via the Triple Burner considering Qi, accumulation, and Cold etiologies, yet all involve rebellious upward rushing of Qi. Treatment should differentiate excess/deficiency and cold/heat.

Heat Vomiting: Children have a "tender Yang" constitution, making them susceptible to pathogenic heat. Heat may accumulate in the Stomach due to the mother's rich diet or the child's intake of fried, spicy, or hot foods. If warm milk is given, or if the child consumes such foods, immediate vomiting occurs upon ingestion. Symptoms include red face and lips, thirst for cold drinks, body heat, reddish urine, small volume but frequent expulsion of vomit, and yellowish digested milk. Internal treatment uses Wendan Tang (Warm the Gallbladder Decoction) modified with Huanglian (Coptidis Rhizoma) and Maidong (Ophiopogonis Radix).

Techniques: Divide Yin and Yang (200 reps), Push San Guan (100 reps), Retreat Liu Fu (100 reps), Push Fei Jing (Lung Meridian) (100 reps), Push Pi Jing (Spleen Meridian) (100 reps), Move Water into Earth (100 reps), Operate Eight Trigrams (100 reps), Red Phoenix Shakes Head (50 reps), Pinch Shi Wang Acupoint (24 reps), Pinch Right Duan Zheng (24 reps), Rub Zong Jing (80 reps), Rub Dou Zhou (80 reps).

Cold Vomiting: Caused by excessive raw/cold food intake by the child, or maternal exposure to wind/cold leading to cold qi entering breast milk. The cold milk causes Stomach deficiency, failing to accept or digest milk. Symptoms include preference for warmth, aversion to cold, pale face and lips, cold extremities, morning intake with evening expulsion. Vomit is odorless and non-acidic, with frequent attempts but low volume. Internal treatment focuses on warming the Middle Jiao.

Techniques: Divide Yin and Yang (200 reps), Push San Guan (100 reps), Retreat Liu Fu (100 reps), Tonify Pi Tu (100 reps), Push Fei Jing (80 reps), Operate Eight Trigrams (100 reps), Pinch Right Duan Zheng (36 reps), Yellow Bee Enters Cave (24 reps), Red Phoenix Shakes Head (24 reps), Shake Dou Zhou (50 reps).

Excess Vomiting: Due to internal food stagnation, the Stomach cannot accept food. Vomit has a sour/foul odor, accompanied by tidal fever, food aversion, chest/abdominal fullness, constipation, hardness, pain, and thirst for cold liquids. Internal treatment uses purgative methods.

Techniques: Divide Yin and Yang (200 reps), Push San Guan (100 reps), Retreat Liu Fu (100 reps), Push Pi Tu (100 reps), Operate Eight Trigrams (80 reps), Pinch Five Finger Tips (24 reps), Pinch Right Duan Zheng (24 reps), Scoop Bright Moon (36 reps), Horse Strikes Across Heavenly River (36 reps), Shake Dou Zhou (50 reps).

Deficiency Vomiting: Weak Stomach Qi fails to digest milk/food. Symptoms include mental fatigue, pulsating fontanelle, sleeping with eyes open, spontaneous diarrhea without thirst, and frequent vomiting. Internal treatment uses Sijunzi Tang (Four Gentlemen Decoction) modified with Dingxiang (Caryophylli Flos) and Chenxiang (Aquilariae Lignum Resinatum).

Techniques: Divide Yin and Yang (200 reps), Push San Guan (100 reps), Retreat Liu Fu (100 reps), Operate Eight Trigrams (80 reps), Tonify Pi Tu (200 reps), Pinch Right Duan Zheng (24 reps), Move Earth into Water (80 reps), Red Phoenix Shakes Head (24 reps), Tonify Da Chang (Large Intestine) (50 reps), Rub Dou Zhou (80 reps), Tonify Wu Jing (Five Meridians) (80 reps).

Note: *Ling Shu* states that diseases of the Foot-Jueyin (Liver) meridian include chest fullness, rebellious Qi, vomiting, and retching. Although these belong to Stomach Qi failing to descend, they are often caused by Liver Qi rebelling against the Stomach. Therefore, herbal treatment should drain the Liver and calm the Stomach, using bitter-descending and acrid-unblocking methods, assisted by sour-draining. For severe vomiting preventing food intake, drink hot goose blood. For persistent vomiting after every meal, cook and eat sheep blood. While massage therapy is effective, it is only one aspect. Physicians must extensively research and apply precise diagnostic methods and highly effective prescriptions to fulfill their duty. (Ti Li Zi)