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(Five Types of Gan Syndrome: Differentiation and Treatment) Nine Sections in Total

*Taiping Shenghui Fang* (Comprehensive Record of Holy Benefit) discusses: Infants rely on the maternal womb for gestation, forming their physical structure and Qi-Blood. After birth, their bones and flesh are light and soft, and their intestines and stomach are delicate. Breastfeeding must be appropriate so that the Zang-Fu organs naturally harmonize and adapt.
If the nursing mother suffers from disharmony of cold and warmth, behaves improperly, has irregular eating habits, consumes excessive sweet and fatty foods, experiences emotional disturbances causing Qi chaos, or is injured by labor after drunkenness and overeating, and immediately breastfeeds the infant, it leads to the formation of Gan syndrome. Furthermore, between one hundred days and five years of age, as infants consume more milk and food, if they do not avoid raw and cold foods, prefer fatty and greasy items, indulge in sweet and sour foods, it causes disharmony of the Zang-Fu organs, generating Gan Qi. The Five Types of Gan are: First is Liver Gan, characterized by shaking the head and rubbing the eyes, a white membrane obscuring the pupils, sweating all over the body, sleeping face down, dry and itchy eyes, yellowish-green muscle color, sparse and scorched hair, visible tendons and hot brain, abdominal accumulation, frequent diarrhea, which persists for a long time without healing, gradually turning into extreme emaciation. This is Liver Gan, also known as Wind Gan. Second is Heart Gan, characterized by high fever throughout the body, unpredictable vomiting and diarrhea, red cheeks and yellow face, irritability and fullness in the chest and diaphragm, dry nose and restless heart, sores in the mouth and tongue, chronic dysentery often discharging pus and blood, occasional night sweats, or false fright. This is Heart Gan, also known as Fright Gan. Third is Spleen Gan, characterized by visible veins on the abdomen, panting and coarse breathing, poor appetite for milk and food, chest and abdominal distension, frequent crying and coughing with rebellious Qi, sallow complexion, protruding bones and scorched hair, withered form and weak strength, stuffiness and oppression in the chest and diaphragm, inability to digest water and grain, dry mouth and nose, craving for eating soil, unhappy mood, preference for darkness and aversion to light, disharmony of the intestines and stomach, frequent diarrhea with sour and foul odor. This is Spleen Gan, also known as Food Gan. Fourth is Lung Gan, characterized by coughing and rebellious Qi, dry and scorched skin and hair, abundant nasal discharge and frequent crying, throat discomfort, rubbing the nose and biting nails, high fever with aversion to cold, sores in the mouth and nose, red and itchy lips, abdominal bloating, gradually decreasing milk intake, intestinal dysfunction, frequent loose stools with undigested rice grains, and millet-like rashes on the skin. This is Lung Gan, also known as Qi Gan. Fifth is Kidney Gan, characterized by emaciation of muscles and bones, sores on the gums, periodic chills and fever, dry mouth and nose, brain heat like fire, and cold feet like ice. Increased vomiting and reduced milk intake, concurrent frequent diarrhea and dysentery, opening of the lower orifices, prolapse of the anus, and itching and pain from Gan sores. This is Kidney Gan, also known as Urgent Gan. Currently, one formula is used to treat them all, hence called Five Gan.

Mr. Wang from Handong in *Jiabao* discusses the treatment of Five Gan: The Five Gan in children arise from excessive consumption of sweets, or from fright Qi entering the abdomen, or from failure to gain muscle mass after illness, leading to Gan disease. Loss of appetite for milk and food, varying preferences from morning to evening, tidal fever, emaciated limbs, urgent abdomen with panting, sparse hair, craving for eating soil, transforming into Gan Consumption. It is suitable to administer Chicken Decoction Pills (see section on Gan Consumption), Xinggan Lushui Wan (Aloe Pill for Resolving Gan, see section on Treatable and Untreatable Five Gan), along with Tiaoweiqi Guanyin San (Guanyin Powder for Regulating Stomach Qi, see section on Disharmony of Stomach Qi) and Sishun San (Four Smooth Powder). (See section on Warm Fever. Ge Hong's *Zhouhou Beiji Fang* Four-Ingredient Drink is similar.)

Qian Yi discusses Five Gan: Liver Gan, with a white membrane obscuring the eyes, requires tonifying the Liver, treated primarily with Dihuang Wan (Rehmannia Pill, see section on Deficiency-Cold). Heart Gan, with a yellow face and red cheeks, and intense Heart heat, requires tonifying the Heart, treated primarily with Anshen Wan (Calming Spirit Pill, see section on Deficiency-Heat). Spleen Gan, with a yellow body and large abdomen, eating soil, requires tonifying the Spleen, treated primarily with Yihuang San (Yellow-Boosting Powder, see section on Stomach Deficiency and Disharmony). Kidney Gan, extremely emaciated with sores and scabies on the body, requires tonifying the Kidney, treated with Dihuang Wan. Lung Gan, with panting and sores in the mouth and nose, requires tonifying the Spleen and Lungs, treated with Yihuang San. (Both formulas see above.)

*Yingtong Baojian* discusses the Five Gan of the Five Zang Organs: When the Heart generates Gan, the condition resembles consumptive diseases in adults, with red cheeks, yellowish-white complexion, high fever, chest fullness and oppression, sores in the nose and mouth, panting and vomiting, black pus in dysentery with red stool, profuse spontaneous sweating, and gradual emaciation; this is Heart Gan. When the Liver receives Gan, white membranes grow in the eyes, the complexion is greenish-yellow, night sweats are profuse, occasionally accompanied by Qi stagnation, head shaking and nasal itching, erect hair and thinning scalp hair, lying prone on the ground, abdominal masses, unregulated diarrhea, and increasing emaciation; this is Liver Gan. When the Spleen receives Gan, rice grains appear in feces, the odor is sour and rotten, there is a craving for eating soil, chest and abdominal distension, blue veins on the belly, coughing and nausea, dry and scorched mouth and nose, unhappiness, aversion to light and preference for darkness, and internal wasting of muscle; this is the presentation of Spleen Gan. When the Lung receives Gan, there is coughing and panting, sores under the nose, biting fingers and rubbing eyebrows, vomiting and diarrhea of cold froth, abdominal fullness and refusal to eat, high fever with aversion to cold, millet-like rashes on the skin, throat obstruction, dysentery with red and white fluids, dry and rough skin; this is the presentation of Lung Gan. When the Kidney receives Gan, there is cold below and heat above, severe diarrhea with rectal prolapse, opening of the lower orifices, worsening Gan sores, whole-body tinea and ringworm, intermittent aversion to cold, indigestion of milk and food, frequent crying at night, urine like water, chest and hypochondrium feeling like boiling water, gradual emaciation, and deep fatigue over time; this is the presentation of Kidney Gan. All the aforementioned Gan syndromes belong to the Five Zang and Six Fu organs.