《惠眼观证》防己丸 治疳嗽不止方。
汉防己 牵牛子 马兜铃（炒） 甜葶苈（别研）
上各等分为末，枣肉为丸，如此○大。每服十丸，煎糯米饮下。与温肺散相间服。
《惠眼观证》又方温肺散
栝蒌根（半两） 甘草（炙，一分）
上为末。每服一钱，蜂糖熟水调下。
茅先生∶有小儿中疳积候。面带青黄色，身瘦肚膨胀，头发立，浑身或热，肚中微痛。此因疳盛而传此候。
所治者先用匀气散（方见胃气不和门中）、醒脾散（方见慢脾风门中）调理一日，后下青金丹取下疳积（方见积聚门中），
再下匀气醒脾散补，常服保童丸（方见一切门中）即愈。
《玉诀》疳气腹胀潮热候∶先与调胃气，后与取虚积药，次服疳药也。
《玉诀》五积疳候歌∶
小儿五积病，还因乳母生。生因伤腹肚，以渐面虚盈。多睡须舍地，小便带油清。发黄多滑泻，吐逆乱交横。
《灵苑独圣》青金丸 治小儿疳积方。
川巴豆（三两，净肉） 硫黄（二两，不研。二味同用生绢袋盛，悬于瓷罐中，不得着底，以水煮三日三夜，如水
竭即旋添，熟汤取出，弃硫黄，只用巴豆，去皮、心） 独活 柴胡 桔梗 干姜（炮） 防风（五味各一两，生） 青
黛（三两）
上件为末及细者，以水煮面糊为丸如绿豆大。每服一丸至二丸。食伤虚肿用橘皮汤下；霍乱吐泻及赤痢用
甘草汤下；白痢用干姜汤下；赤白痢用干姜甘草汤下；水泻用冷水下；小便不通用灯心汤下；大便不通米饮
下；妇人血气当归酒下；元气炒茴香酒下；腰痛茱萸汤下；小儿疳积用米饮下；气疾橘皮汤下；气块症癖用
热酒下；伤寒头痛甘草汤下，并用临卧时服。如脏腑实热，临时更加减丸数。
钱乙牛黄丸 治小儿疳积方。
雄黄（研，水飞） 天竺黄（各二钱半） 牵牛（末，一钱）
上同再研，面糊为丸粟米大。每服三丸至五丸，食后薄荷水下。兼治疳消积，常服尤佳。大者加丸数。
张涣遗方 褐丸子 治小儿疳气，腹胀如鼓，及奶癖、食癖。
萝卜子（一两半，炒） 黑牵牛（一两，炒） 胡椒（一分半） 木香（一两） 蓬莪术（湿纸裹煨，切作片子，
半两）
上为细末，面糊为丸粟米大。每服二十丸，煎仙人骨汤下。
《张氏家传》金砂丸 壮元气，治脾胃虚弱，经年积滞冷气，蛊毒诸疾；去久虚积气，消食壮气，理诸般风气，
脱肛下血，左瘫右痪；治一切风，筋骨中风气等疾；妇人血风攻赖刺，月候不调，四肢倦怠，头面浮虚，气冲喘急；
小儿疳气，头渐无发，腹大，脚小无力，履地不得者，并皆治之。（山长老方。）
针砂（四两，用水淘洗五十余次，用好米醋八盏入熟铁铫内，煮干，以铁匙抄烟尽，水星出，即倾下） 苍术（米
泔浸一宿，去粗，秤、切） 木香（面裹煨熟，去面不用） 白术（切。各半两） 附子（炮，去皮尖） 蓬莪术（洗，
切） 甘草（切 。各一两） 陈橘皮（米泔浸一宿，去瓤，净取二两）
上件为末，醋糊丸如绿豆大。每服二十丸至三十、四十丸，常服，米饮下。治脾生姜汤下；治风气酒下；
被饮食所伤，用所伤物下；若饮食罢，用所羹汁下三二十丸。解积进食，大有所益，不拘时服。
《庄氏家传》参苓散 治小儿因积成疳，久致脾胃虚弱，不思饮食方。
人参 茯苓 川芎（各一两） 甘草（炙） 芍药 黄 （各半两） 青皮（一分，不用白）
上为末。每服一钱，水一小盏，煎三五分，去滓，温服。
《庄氏家传》香甲丸 治小儿积疳，潮热盗汗，羸瘦烦渴，手足心热，服之皆效，轻骨长肌方。蔡梦翁、家翁
苦黄瘦，不食，多汗，喜叫哭，服之效。
木香（一分） 鳖甲（去裙 ，醋炙） 槟榔 使君子（用肉） 柴胡（去芦） 黄连（去须。各半两）
上为末， 猪胆和丸绿豆大。每服二十丸，日中临卧米饮下。久发潮热，多汗无力者，服之即效。
《孔氏家传》胡黄连丸 治肌瘦，肥肠，消积气方。
黄连（半两） 木香（一分） 麝香（半钱） 槟榔（一个）
上为细末。后入麝香，酒糊为丸如绿豆大。熟水下。
《赵氏家传》治小儿青蒿丸 大疳药，偏疗小儿久积疳气，日渐羸瘦，面黄，头发作穗，好食土，咬指甲，捻鼻；兼治骨蒸劳热及取疳虫，退诸脏积热。小儿常服遍身香为效方。
白槟榔（一个） 白芜荑（四十九个） 黄连（去须，十四茎） 夜明砂（一分，以上为末） 太阴玄精石 麝香 小
葱子（炒） 朱砂（各半钱） 芦荟 天竺黄 青黛（各一钱）
上将后七味同研细，与前四味一处再研匀，令极细，取青蒿自然汁半升，慢火熬汁，仍用 猪胆一个，取
汁，同搜药丸，如粟米大。每服五丸至七丸，并用米饮下，酽醋汤亦得。取疳虫，煎酸石榴汤下，二十服取
尽虫。
换骨丹
陈粟米（一合） 陈皮 青皮 黑牵牛（各半两） 巴豆（一分）
一处炒焦黄，去巴豆，入木香半两，为末，糊丸黍大，橘皮汤下十丸。
刘氏∶疳积瘦瘁，项小肚大，脚胫大，行不得。
青黛 芜荑 青礞石 雷丸 芦荟 使君子 黄连
等分，末，雄猪胆盛挂当风处，干焙研，猪胆丸小豆大或粟米大，量服。惊风，薄荷金银汤下十丸。
王氏芦荟丸 治疳积，长肌。
芦荟 胡黄连（各一分） 黄柏（二两） 黄连 青皮（各一两） 青黛（半钱） 巴豆（四十九粒）
同炒赤，去巴豆，末，蒸猪胆汁丸绿豆大，饮量与。吴氏治疳积有虫，常服∶
芦荟（钱半） 黄连（一两） 黄柏（一两） 麝（一钱） 芜荑仁（去膜） 使君子（各半两）
除芦荟、麝，入巴豆二七粒炒焦黄，去巴豆。罗，猪胆糊丸如麻子。饭饮下一、二十丸，食后临卧服。
吉氏蟾酥丸 治疳，消积思食。
蟾蜍 青黛 龙胆草（各一两） 腻粉（半钱） 茴香（一钱） 板青 陈皮 木香 使君子 夜明砂 川黄连（各
半两）
末，粟米粥同猪胆丸如粟，饭饮下五七丸。
豆蔻散 治疳积或冷利，腹大脚小，身热面黄，或惊积。
肉豆蔻（二个） 胡黄连（一钱） 使君子（四个） 青黛 楝根 芜荑（各半两） 夜明砂（钱半） 麝（少许）
末，一钱、半钱，蜜、水或粥饮调。一浓朴、甘草各半两。
Huanji Wan (Stephania Tetrandra Pill) from *Huiyan Guanzheng*: A prescription for treating persistent cough due to gan syndrome (malnutrition syndrome).
*Han Fangji* (*Stephiae Radix*), *Qianniuzi* (*Semen Pharbitidis*, 牵牛子), *Madouling* (*Aristolochiae Fructus*, 马兜铃, stir-fried), *Tian Tingli* (*Semen Lepidii et Descurainiae*, 甜葶苈, separately ground).
The above herbs are taken in equal proportions, ground into powder, and formed into pills with jujube flesh. The size is indicated by the symbol ○ (typically equivalent to wutongzi or similar). Take ten pills per dose, administered with decocted glutinous rice water. Alternate administration with Wenfei San (Warm the Lung Powder).
Another prescription from *Huiyan Guanzheng*: Wenfei San (Warm the Lung Powder)
*Gualvagen* (*Trichosanthis Radix*, 栝蒌根, half tael), *Gancao* (*Glycyrrhizae Radix et Rhizoma*, 甘草, honey-fried, one fen).
Grind the above into powder. Take one qian per dose, mixed with honey and boiled water.
Mr. Mao stated: There are children presenting with signs of gan accumulation. The complexion shows a bluish-yellow hue, the body is emaciated while the abdomen is distended, hair stands erect, the whole body may be feverish, and there is slight abdominal pain. This condition arises from severe gan transforming into this syndrome.
Treatment: First, regulate qi using Yunqi San (Harmonize Qi Powder) (see section on Disharmony of Stomach Qi) and Xingpi San (Awaken Spleen Powder) (see section on Slow Liver Wind) for one day. Then, administer Qingjin Dan (Green Gold Pill) to purge gan accumulation (see section on Accumulation and Masses). Subsequently, use Yunqi San and Xingpi San for tonification. Regular consumption of Baotong Wan (Protect Child Pill) (see section on All Categories) leads to recovery.
From *Yujue*, Syndrome of Gan Qi Abdominal Distension and Tidal Fever: First regulate stomach qi, then use medicines to remove deficiency accumulations, followed by medicines for gan syndrome.
Song Verse on Five Accumulations Gan Syndrome from *Yujue*:
The five accumulations disease in children often originates from the nursing mother. It begins with injury to the abdomen, gradually leading to facial emptiness and lack of fullness. Excessive sleep requires lying off the ground; urine contains oily clear fluid. Hair turns yellow with frequent loose stools; vomiting and regurgitation occur chaotically.
Qingjin Dan (Green Gold Pill) from *Lingyuan Dusheng*: A prescription for pediatric gan accumulation.
*Chuan Badou* (*Crotonis Fructus*, 川巴豆, three taels, pure meat only), *Liuhuang* (*Sulfur*, 硫黄, two taels, not ground. Place both ingredients in a raw silk bag, suspend in a porcelain jar without touching the bottom, and boil in water for three days and nights. Add water as needed until dry. Remove, discard sulfur, and use only the croton seed, removing skin and heart). *Duhuo* (*Angelicae Pubescentis Radix*, 独活), *Chaihu* (*Bupleuri Radix*, 柴胡), *Jiegeng* (*Platycodonis Radix*, 桔梗), *Ganjiang* (*Zingiberis Rhizoma*, 干姜, processed), *Fangfeng* (*Saposhnikoviae Radix*, 防风) (each one tael, raw). *Qingdai* (*Indigo Naturalis*, 青黛, three taels).
Grind the above into fine powder. Use water-boiled wheat paste to form pills the size of mung beans. Take one to two pills per dose. For edema due to food injury, take with Tangerine Peel Decoction (*Chenpi Tang*). For cholera-like vomiting/diarrhea and red dysentery, take with Licorice Decoction (*Gancao Tang*). For white dysentery, take with Ginger Decoction (*Ganjiang Tang*). For red-and-white dysentery, take with Ginger-Licorice Decoction (*Ganjiang Gancao Tang*). For watery diarrhea, take with cold water. For urinary retention, take with Centella Decoction (*Dengxin Cao Tang*). For constipation, take with rice drink. For women's blood qi disorders, take with Angelica Wine (*Danggui Jiu*). For deficient yuan qi, take with stir-fried Fennel Wine (*Chao Huixiang Jiu*). For lower back pain, take with Cornus Decoction (*Zhuyu Tang*). For pediatric gan accumulation, take with rice drink. For qi disorders, take with Tangerine Peel Decoction. For qi masses and fixed pains, take with hot wine. For wind-cold headache, take with Licorice Decoction. Administer all at bedtime. Adjust dosage according to excess heat in the zang-fu organs.
Niu Huang Wan (Cattle Gallstone Pill) by Qian Yi: A prescription for pediatric gan accumulation.
*Xionghuang* (*Realgar*, 雄黄, ground and washed with water), *Tianzhuhuang* (*Calamusi Spira*, 天竺黄) (each two qian half), *Qianniu* (*Semen Pharbitidis*, 牵牛子, powdered, one qian).
Grind together again, form pills with wheat paste the size of millet grains. Take three to five pills per dose after meals with mint water. Also treats gan wasting and accumulation removal; regular use is especially beneficial. Increase dosage for older children/adults.
He Wan Zi (Brown Pills) from Zhang Huan’s Legacy: Treats pediatric gan qi, abdominal distension like a drum, as well as milk stasis and food stasis.
*Luobozi* (*Brassicae Semens*, 萝卜子, one tael half, stir-fried), *Hei Qianniu* (*Semen Pharbitidis Nigri*, 黑牵牛, one tael, stir-fried), *Hujiao* (*Piperis Longi Fructus*, 胡椒, one fen half), *Muxiang* (*Aucklandiae Radix*, 木香, one tael), *Peng Ezhu* (*Curcumae Zedoariae Rhizoma*, 蓬莪术, wrapped in wet paper and baked, sliced, half tael).
Grind into fine powder, form pills with wheat paste the size of millet grains. Take twenty pills per dose with Immortal Bone Decoction (*Xianren Gu Tang*).
Jinsha Wan (Gold Sand Pill) from *Zhang Family Tradition*: Strengthens yuan qi, treats spleen-stomach deficiency, chronic stagnation of cold qi, gu poison and various diseases; removes long-standing deficiency qi accumulation, promotes digestion and strengthens qi, regulates various wind conditions, prolapse of rectum with bleeding, left hemiplegia and right paralysis; treats all wind pathogens, wind-dampness in bones and sinews; women’s blood-wind attacking sides, irregular menstruation, limb fatigue, facial edema, rushing qi with panting; pediatric gan qi with gradual hair loss on head, large abdomen, small weak legs unable to walk—all are treated. (Prescription by Elder Shan.)
*Zhen Sha* (*Magnetitum*, 针砂, four taels, washed over fifty times with water, boiled in eight cups of good rice vinegar in a熟 iron pot until dry, smoke cleared with iron spoon until mercury stars appear, then poured out). *Cangzhu* (*Atractylodis Rhizoma*, 苍术, soaked in rice wash overnight, coarse skin removed, weighed, sliced). *Muxiang* (*Aucklandiae Radix*, 木香, wrapped in flour and baked熟, flour discarded). *Baizhu* (*Atractylodis Macrocephalae Rhizoma*, 白术, sliced) (each half tael). *Fuzi* (*Aconiti Lateralis Radix Praeparata*, 附子, processed, skin and bud removed). *Peng Ezhu* (*Curcumae Zedoariae Rhizoma*, 蓬莪术, washed, sliced). *Gancao* (*Glycyrrhizae Radix et Rhizoma*, 甘草, sliced) (each one tael). *Chenju pi* (*Citri Reticulatae Pericarpium*, 陈橘皮, soaked in rice wash overnight, pith removed, two taels net weight).
Grind into powder, form pills with vinegar paste the size of mung beans. Take twenty to thirty or forty pills regularly with rice drink. For spleen issues, take with ginger tea; for wind conditions, take with wine; if injured by specific foods, take with decoction of that food; if digestion is complete, take with soup broth three to twenty pills. Resolves accumulation and promotes appetite, very beneficial, take anytime.
Shen Ling San (Ginseng and Poria Powder) from *Zhuang Family Tradition*: Treats pediatric gan resulting from accumulation, causing long-term spleen-stomach deficiency and anorexia.
*Renshen* (*Ginseng Radix*, 人参), *Fuling* (*Poria*, 茯苓), *Chuanxiong* (*Chuanxiong Rhizome*, 川芎) (each one tael), *Gancao* (*Glycyrrhizae Radix et Rhizoma*, 甘草, honey-fried), *Shaoyao* (*Paeoniae Radix Alba*, 芍药), *Huangqi* (*Astragali Radix*, 黄芪) (each half tael), *Qingpi* (*Citri Reticulatae Pericarpium Viride*, 青皮, one fen, exclude white part).
Grind into powder. Take one qian per dose with one cup of water, decoct to one-third, strain, and take warm.
Xiang Jia Wan (Wood Fragrance and Turtle Shell Pill) from *Zhuang Family Tradition*: Treats pediatric accumulation-gan, tidal fever, night sweats, emaciation with thirst, heat in palms and soles; effective for all these symptoms, lightens the body and builds muscle. Cai Mengweng and family elders suffered from sallow thinness, anorexia, excessive sweating, crying and screaming; effective upon taking.
*Muxiang* (*Aucklandiae Radix*, 木香, one fen), *Biejia* (*Testudinis Carapax et Plastrum*, 鳖甲, remove skirt edge, vinegar-fried), *Binglang* (*Arecae Semen*, 槟榔), *Shijunzi* (*Quisqualis Fructus*, 使君子, meat only), *Chaihu* (*Bupleuri Radix*, 柴胡, remove rhizome), *Huanglian* (*Coptidis Rhizoma*, 黄连, remove roots) (each half tael).
Grind into powder, mix with pig bile to form pills the size of mung beans. Take twenty pills at noon and before bed with rice drink. Effective for prolonged tidal fever, excessive sweating, and weakness.
Hu Huanglian Wan (Picrorhiza and Coptis Pill) from *Kong Family Tradition*: Treats emaciation, fatty intestines, and resolves accumulation qi.
*Huanglian* (*Coptidis Rhizoma*, 黄连, half tael), *Muxiang* (*Aucklandiae Radix*, 木香, one fen), *Shexiang* (*Moschus*, 麝香, half qian), *Binglang* (*Arecae Semen*, 槟榔, one piece).
Grind into fine powder. Add musk later, form pills with wine paste the size of mung beans. Take with cooked water.
Qinghao Wan (Artemisia Annua Pill) from *Zhao Family Tradition*: A major gan medicine, specifically for pediatric chronic accumulation-gan qi, progressive emaciation, sallow face, hair forming tufts, geophagia, nail-biting, nose-picking; also treats bone-steaming consumptive fever and expels gan parasites, clears heat from all zang organs. Regular use by children results in a fragrant body odor.
*Bai Binglang* (*Arecae Semen Album*, 白槟榔, one piece), *Bai Wuyi* (*Alpiniae Katsumadai Fructus*, 白芜荑, forty-nine pieces), *Huanglian* (*Coptidis Rhizoma*, 黄连, remove roots, fourteen stems), *Yeming Sha* (*Stercoris Noctuae*, 夜明砂, one fen, above ground into powder), *Taiyin Xuanjing Shi* (*Calcitum*, 太阴玄精石), *Shexiang* (*Moschus*, 麝香), *Xiao Congzi* (*Allii Fistulosi Semen*, 小葱子, stir-fried), *Zhusha* (*Cinnabaris*, 朱砂) (each half qian), *Lvhui* (*Aloe*, 芦荟), *Tianzhuhuang* (*Calamusi Spira*, 天竺黄), *Qingdai* (*Indigo Naturalis*, 青黛) (each one qian).
First grind the latter seven ingredients finely, then mix with the former four and grind uniformly to extreme fineness. Take half sheng of fresh juice from Qinghao (*Artemisiae Annuae Herba*, 青蒿), simmer slowly to reduce. Mix with juice from one pig gallbladder to form pills the size of millet grains. Take five to seven pills per dose with rice drink; strong vinegar water is also acceptable. To expel gan parasites, take with sour pomegranate decoction; twenty doses will eliminate parasites completely.
Huangu Dan (Bone-Changing Pill)
*Chen Sumi* (*Setaria Italica*, 陈粟米, one he), *Chenpi* (*Citri Reticulatae Pericarpium*, 陈皮), *Qingpi* (*Citri Reticulatae Pericarpium Viride*, 青皮), *Hei Qianniu* (*Semen Pharbitidis Nigri*, 黑牵牛) (each half tael), *Badou* (*Crotonis Fructus*, 巴豆, one fen).
Stir-fry together until scorched yellow, remove Badou, add Banxiang (*Aucklandiae Radix*, 木香) half tael, grind into powder, form pills with paste the size of millet seeds. Take ten pills with Chenpi Tang (Tangerine Peel Decoction).
Mr. Liu stated: Gan accumulation causes emaciation, small neck, large abdomen, swollen calves, and inability to walk.
*Qingdai* (*Indigo Naturalis*, 青黛), *Wuyi* (*Alpiniae Katsumadai Fructus*, 芜荑), *Qingmengshi* (*Calamitis*, 青礞石), *Leiwan* (*Polyporus Umbellatus*, 雷丸), *Lvhui* (*Aloe*, 芦荟), *Shijunzi* (*Quisqualis Fructus*, 使君子), *Huanglian* (*Coptidis Rhizoma*, 黄连).
Equal parts, ground into powder. Hang in a male pig gallbladder in a ventilated place, dry-roast, grind finely, form pills with pig bile the size of mung beans or millet grains. Dosage varies. For convulsions, take ten pills with Mint and Silver Needle Decoction (*Bohe Yinjin Tang*).
Wang’s Lvhui Wan (Aloe Pill): Treats gan accumulation, builds muscle.
*Lvhui* (*Aloe*, 芦荟), *Huhuanglian* (*Phyllodiscospermum Schindleri*, 胡黄连) (each one fen), *Huangbai* (*Phellodendri Cortex*, 黄柏, two taels), *Huanglian* (*Coptidis Rhizoma*, 黄连), *Qingpi* (*Citri Reticulatae Pericarpium Viride*, 青皮) (each one tael), *Qingdai* (*Indigo Naturalis*, 青黛, half qian), *Badou* (*Crotonis Fructus*, 巴豆, forty-nine grains).
Stir-fry together until red, remove Badou, grind into powder, form pills with steamed pig bile the size of mung beans. Take appropriate amount with drink. Wu’s treatment for gan accumulation with parasites, for regular use:
*Lvhui* (*Aloe*, 芦荟, one qian half), *Huanglian* (*Coptidis Rhizoma*, 黄连, one tael), *Huangbai* (*Phellodendri Cortex*, 黄柏, one tael), *She* (*Moschus*, 麝, one qian), *Wuyi Ren* (*Alpiniae Katsumadai Semen*, 芜荑仁, remove membrane), *Shijunzi* (*Quisqualis Fructus*, 使君子) (each half tael).
Exclude Lvhui and She, add fourteen grains of Badou stir-fried until yellow, remove Badou. Sieve, form pills with pig bile paste the size of hemp seeds. Take ten to twenty pills with rice drink after meals and before bed.
Ji’s Chansu Wan (Toad Venom Pill): Treats gan, resolves accumulation, stimulates appetite.
*Chantu* (*Bufonis Venenum*, 蟾蜍, actually refers to processed venom/skin), *Qingdai* (*Indigo Naturalis*, 青黛), *Longdancao* (*Gentianae Radix*, 龙胆草) (each one tael), *Nifen* (*Calomel*, 腻粉, half qian), *Huixiang* (*Foeniculi Fructus*, 茴香, one qian), *Banqing* (*Isatidis Folium*, 板青, likely *Banlangen* root or leaf), *Chenpi* (*Citri Reticulatae Pericarpium*, 陈皮), *Muxiang* (*Aucklandiae Radix*, 木香), *Shijunzi* (*Quisqualis Fructus*, 使君子), *Yeming Sha* (*Stercoris Noctuae*, 夜明砂), *Chuan Huanglian* (*Coptidis Rhizoma*, 川黄连) (each half tael).
Grind into powder, form pills with millet porridge and pig bile the size of millet grains. Take five to seven pills with rice drink.
Doukou San (Cardamom Powder): Treats gan accumulation or cold diarrhea, large abdomen with small legs, feverish body with sallow face, or convulsive accumulation.
*Roudoukou* (*Myristicae Semen*, 肉豆蔻, two pieces), *Huhuanglian* (*Phyllodiscospermum Schindleri*, 胡黄连, one qian), *Shijunzi* (*Quisqualis Fructus*, 使君子, four pieces), *Qingdai* (*Indigo Naturalis*, 青黛), *Lian Gen* (*Meliosmae Radix*, 楝根), *Wuyi* (*Alpiniae Katsumadai Fructus*, 芜荑) (each half tael), *Yeming Sha* (*Stercoris Noctuae*, 夜明砂, one qian half), *She* (*Moschus*, 麝, a little).
Grind into powder. Take one qian or half qian, mixed with honey, water, or porridge drink. Additionally, add Houpo (*Magnoliae Officinalis Cortex*, 浓朴) and Gancao (*Glycyrrhizae Radix et Rhizoma*, 甘草) each half tael.