（历脊疳附）
《圣惠》∶夫小儿脊疳者，由乳哺不调，甘肥过度，肉生于虫，攻于脊膂，渐渐黄瘦，时时下痢，覆地而
卧，毛发干焦，身体壮热，烦渴不止，脊骨如锯，谓之脊疳也。
《圣惠》治小儿脊疳，头大项细，四肢黄瘦，肚大胸高，毛发干立。金蟾散方
蟾（一枚大者，涂酥炙令焦黄） 夜明砂（微炒） 桃白皮 樗根白皮 地榆 黄柏（各锉） 诃
黎勒（煨，用皮） 百合 白芜荑（微炒）
人参（去芦头） 川大黄（锉碎，微炒） 黄连（去须。各三分） 胡粉（三钱） 丁香（三七粒） 槟榔（一分）
上件药捣，细罗为散。每服用粥饮调下半钱，日三服。量儿大小以意增减。
《圣惠》治小儿脊疳，渐渐黄瘦。以手指击之，背如鼓响，脊骨高是也。此因奶热所致。宜服地骨皮丸方
地骨皮 紫参 黄 （锉） 川大黄（锉碎，微炒） 郁李仁（汤浸，去皮尖，微炒。各半两） 龙
胆（去芦头） 子芩 枳壳（麸炒微黄，去瓤） 木香 猪苓（去黑皮） 海蛤（细研。各一分）
上件药捣，罗为末，炼蜜和丸如绿豆大。每服以温水研下五丸，日三服。量儿大小加减服之。常得微利为效。
《圣惠》治小儿脊疳，肌肤羸瘦，背脊骨高，身体寒热，面无颜色。宜服胡黄连丸方
胡黄连 青黛（细研） 地龙（微炒） 黄连（去须。各半两） 朱砂 麝香 芦荟 牛黄
（各细研） 当归 干蝎（各微炒） 木香 犀
角（屑） 蛇蜕皮（烧为灰） 独活（以上各一分） 蟾酥（一钱，研入） 蜣螂（五枚，微炒，去翅
足） 槟榔（一分） 猪牙皂角（五挺，去皮，涂酥炙焦黄） 蜗牛（二七枚，炒令微黄）
上件药捣，罗为末，以猪胆汁和丸如绿豆大。每服以粥饮下五丸，日三服。量儿大小增减服之。
《圣惠》治小儿心肺久热，致成脊疳，渐渐羸瘦。牛黄丸方
牛黄 朱砂 麝香（各细研） 真珠（末） 杏仁（汤浸，去皮尖、双仁，麸炒微黄） 赤
芍药 赤茯苓 甘草（炙微赤，锉） 牡蛎粉 虾
蟆（灰。各一分） 犀角（屑，半分） 巴豆（十枚，去皮、心，研，纸裹压去油）
上件药捣，罗为末，入研了药更研令匀，用糯米饭和丸如绿豆大。每日早晨以荆芥汤下二丸。
量儿大小增减服之。
《圣惠》治小儿脊疳，日渐羸瘦，腹中有虫。杀疳丸方
没石子 瓜蒂 鹤虱 蟾头（炙令焦黄） 芦荟 青黛（并细研。各半两） 麝香（细
研） 腻粉（研入。各一分）
上件药捣，罗为末，以糯米饭和丸如黍米大。每服以粥饮下五丸，日三服。量儿大小以意加减。
《圣惠》治小儿脊疳，腹内有虫，上攻背膂，脊骨渐高，肌体羸瘦。芦荟丸方
芦荟 青黛 朱砂 麝香（各细研） 熊胆（研入） 胡黄连 贯众 地龙（微炒） 黄
连（去须） 蝉壳（微炒，去足） 雷丸（各半两） 虾蟆（一枚，涂酥，炙令焦黄）
上件药捣，罗为末，用蜗牛肉研和丸如麻子大。每服以粥饮下五丸，日三服。量儿大小增减服之。
《圣惠》治小儿脊疳，四肢瘦弱，腹胀壮热，头发干疏，时烦渴，脊骨如锯。青黛丸方
青黛 朱砂（各细研） 夜明砂（微炒） 定粉（各一分） 蟾酥（研入） 熊胆（细研） 羚
羊角（屑） 犀角（屑。各半分） 黄连（半两，去须） 麝香（一钱，细研）
上件药捣，罗为末，用软饭和丸如绿豆大。每一岁以粥饮下二丸。
《圣惠》治小儿脊疳，虫攻背膂，渐渐骨高、瘦弱。化疳丸方
腻粉（研入） 胡粉 胡黄连 雷丸 鹤虱 蜣螂（去翅足，微炒） 地龙（微炒。各一分）
上件药捣，罗为末，以鸡子白和，用竹筒内盛，于炊饭处蒸饭熟为度，用熊胆汁和丸如绿豆大。每服以清
粥饮下三丸，日三服。量儿大小以意加减。
《圣惠》治小儿脊疳，下痢羸瘦。白矾丸方
白矾（灰，三钱） 田父（三分，烧灰） 蛇蜕皮（一条，炒令焦黄） 青黛 朱砂 芦荟（各细研） 鹤
虱莨菪子（水淘去浮者，水煮令芽出，炒黑色。各一分） 麝香（一钱，研）
上件药捣，罗为末，同研令匀，以烧饭和丸如绿豆大。每一岁儿以粥饮下二丸。
《圣惠》治小儿脊疳，体热瘦悴，心烦多渴，不欲乳食。青黛丸方
青黛 芦荟 朱砂（各细研） 鹤虱 熊胆（研入。各一分） 胡黄连（半两） 麝香（一分，细研）
上件药捣，罗为末，同研令匀，炼蜜和丸如绿豆大。每服用温水下三丸，日三服。量儿大小加减服之。
《朱氏家传》治小儿脊疳，泻血不止方。
定粉 好枣（十个，捣碎） 头发（少许，剪碎）
上件为团砖衬，火 通赤，细研，米饮下半钱。
《庄氏家传》治小儿久下血不止，谓之历脊疳方。
上用穿山甲，米醋浸，炙为末。每服一钱，米饮调下，食后服。
(Attached: Li Ji Gan)
*Shenghui Fang* records: The so-called pediatric Ji Gan (Spinal Malnutrition Syndrome) is caused by improper breastfeeding and feeding, excessive intake of sweet and fatty foods, leading to the generation of parasites within the body. These parasites invade the spinal region, gradually causing sallow complexion, emaciation, frequent dysentery, a tendency to lie prone, dry and brittle hair, high fever, restlessness, unquenchable thirst, and a spine that protrudes like a saw blade. This condition is termed Ji Gan.
*Shenghui Fang* treats pediatric Ji Gan with symptoms such as a large head and thin neck, yellow and emaciated limbs, distended abdomen with a high chest, and dry, erect hair. Use the Jin Chan San (Toad Powder) formula:
Chan Su (Cinnabar Toad Venom; one large piece, coated with clarified butter and roasted until golden brown) Ye Ming Sha (Stool Vespertilionis; slightly stir-fried) Tao Bai Pi (Bark of Peach Root; Chu Gen Bai Pi (Bark of Black Locust Root); Di Yu (Radix Sanguisorbae); Huang Bo (Cortex Phellodendri; all cut into pieces) He Li Le (Pericarpium Chebulae; roasted, using only the peel) Bai He (Bulbus Lilii) Bai Wu Ti (Fructus Xanthii; slightly stir-fried)
Ren Shen (Radix Ginseng; remove the rhizome) Chuan Da Huang (Rhizoma Rhei; cut into pieces, slightly stir-fried) Huang Lian (Rhizoma Coptidis; remove roots. Each 3 fen) Hu Fen (Lead Carbonate; 3 qian) Ding Xiang (Flos Caryophylli; 3-7 cloves) Bing Lang (Areca Seed; 1 fen)
Grind the above ingredients finely and sift to make a powder. For each dose, mix half a qian with rice gruel and administer. Take three times daily. Adjust the dosage according to the child's age and size.
*Shenghui Fang* treats pediatric Ji Gan characterized by gradual emaciation. When tapping the back with a finger, it sounds like a drum, and the spinal bones are prominent. This is caused by "milk heat." It is suitable to use Di Gu Pi Wan (Lycium Bark Pill) formula:
Di Gu Pi (Cortex Lycii) Zi Shen (Radix Bupleuri? Note: Context suggests a specific herb, likely referring to a root herb for clearing heat) Huang Qin (Radix Scutellariae; cut into pieces) Chuan Da Huang (Rhizoma Rhei; cut into pieces, slightly stir-fried) Yu Li Ren (Semen Pruni; soaked in water, remove skin and pits, slightly stir-fried. Each 0.5 liang) Long Dan Cao (Radix Gentianae; remove rhizome) Zi Qin (Radix Scutellariae) Zhi Ke (Fructus Aurantii; bran-stir-fried until slightly yellow, remove pith) Mu Xiang (Radix Aucklandiae) Zhu Ling (Poria; remove black skin) Hai Ge (Concha Meretricis; finely ground. Each 1 fen)
Grind the above ingredients, sift into powder, and mix with refined honey to form pills the size of mung beans. For each dose, crush five pills in warm water and swallow. Take three times daily. Adjust dosage based on the child's age. Mild diarrhea is considered an effective sign.
*Shenghui Fang* treats pediatric Ji Gan with extreme emaciation of skin and flesh, prominent dorsal vertebrae, alternating chills and fever, and lackluster complexion. It is suitable to use Hu Huang Lian Wan (Coptis Pill) formula:
Hu Huang Lian (Rhizoma Coptidis) Qing Dai (Indigo Naturalis; finely ground) Di Long (Pheretima; slightly stir-fried) Huang Lian (Rhizoma Coptidis; remove roots. Each 0.5 liang) Zhu Sha (Cinnabar) She Xiang (Moschus) Lu Hui (Resin Aloe) Niu Huang (Calculus Bovis)
(each finely ground) Dang Gui (Radix Angelicae Sinensis) Gan Xie (Dry Scorpion; each slightly stir-fried) Mu Xiang (Radix Aucklandiae) Xi Jiao (Cornu Rhinocerotis; shaved) She Tui Pi (Exuvius Bombycis; burned to ash) Du Huo (Radix Angelicae Pubescentis; each 1 fen) Chan Su (Cinnabar Toad Venom; 1 qian, ground in) Qiang Lang (Scarabaeus; five pieces, slightly stir-fried, remove wings and legs) Bing Lang (Areca Seed; 1 fen) Zhu Ya Zao Jiao (Gleditsia Sinensis Fruit; five pods, remove skin, coat with clarified butter and roast until golden brown) Wo Niu (Helix; fourteen pieces, stir-fried until slightly yellow)
Grind the above ingredients, sift into powder, and mix with pig bile to form pills the size of mung beans. For each dose, swallow five pills with rice gruel. Take three times daily. Adjust dosage based on the child's age.
*Shenghui Fang* treats pediatric Ji Gan caused by long-term heat in the heart and lungs, leading to gradual emaciation. Use Niu Huang Wan (Calculus Bovis Pill) formula:
Niu Huang (Calculus Bovis) Zhu Sha (Cinnabar) She Xiang (Moschus) (each finely ground) Zhen Zhu (Pearl; powdered) Xing Ren (Semen Armeniacae; soaked in water, remove skin, pits, and double kernels, bran-stir-fried until slightly yellow) Chi Shao Yao (Radix Paeoniae Rubra) Chi Fu Ling (Poria with Red Heart) Gan Cao (Radix Glycyrrhizae; roasted until slightly red, cut into pieces) Mu Li Fen (Concha Ostreae; powdered) Xia Ma (Bufo bufo gargarizans; ash. Each 1 fen) Xi Jiao (Cornu Rhinocerotis; shaved, 0.5 fen) Ba Dou (Semen Crotonis; ten seeds, remove skin and core, grind, wrap in paper and press to remove oil)
Grind the above ingredients, sift into powder, add the already ground ingredients and mix thoroughly. Form pills the size of mung beans using glutinous rice paste. Every morning, take two pills with Jing Jie Tang (Schizonepeta Decoction). Adjust dosage based on the child's age.
*Shenghui Fang* treats pediatric Ji Gan with progressive emaciation and intestinal parasites. Use Sha Gan Wan (Kill Parasite Pill) formula:
Mo Shi Zi (Agrimonia Fructus? Note: Likely Galla Chinensis or similar astringent fruit in context, literally 'Stone Nut') Gua Di (Fructus Cucumeris) He Shi (Semen Pedalii) Chan Tou (Head of Bufo; roasted until golden brown) Lu Hui (Resin Aloe) Qing Dai (Indigo Naturalis; both finely ground. Each 0.5 liang) She Xiang (Moschus; finely ground) Ni Fen (White Lead Powder; ground in. Each 1 fen)
Grind the above ingredients, sift into powder, and mix with glutinous rice paste to form pills the size of millet grains. For each dose, swallow five pills with rice gruel. Take three times daily. Adjust dosage according to the child's age.
*Shenghui Fang* treats pediatric Ji Gan where intestinal parasites attack the back and spine, causing progressive prominence of spinal bones and muscle wasting. Use Lu Hui Wan (Aloe Pill) formula:
Lu Hui (Resin Aloe) Qing Dai (Indigo Naturalis) Zhu Sha (Cinnabar) She Xiang (Moschus) (each finely ground) Xiong Dan (Ursine Gallbladder; ground in) Hu Huang Lian (Rhizoma Coptidis) Guan Zhong (Rhizoma Dryopteris) Di Long (Pheretima; slightly stir-fried) Huang Lian (Rhizoma Coptidis; remove roots) Chan Qiao (Periostracum Cicadae; slightly stir-fried, remove legs) Lei Wan (Semen Walsurae; each 0.5 liang) Xia Ma (Bufo bufo gargarizans; one piece, coated with clarified butter and roasted until golden brown)
Grind the above ingredients, sift into powder, and mix with snail meat paste to form pills the size of sesame seeds. For each dose, swallow five pills with rice gruel. Take three times daily. Adjust dosage based on the child's age.
*Shenghui Fang* treats pediatric Ji Gan with weak and emaciated limbs, abdominal distension with high fever, dry and sparse hair, frequent restlessness and thirst, and a spine like a saw blade. Use Qing Dai Wan (Indigo Pill) formula:
Qing Dai (Indigo Naturalis) Zhu Sha (Cinnabar) (each finely ground) Ye Ming Sha (Stool Vespertilionis; slightly stir-fried) Ding Fen (Lead Carbonate; each 1 fen) Chan Su (Cinnabar Toad Venom; ground in) Xiong Dan (Ursine Gallbladder; finely ground) Ling Yang Jiao (Cornu Saigae Tataricae; shaved) Xi Jiao (Cornu Rhinocerotis; shaved. Each 0.5 fen) Huang Lian (Rhizoma Coptidis; 0.5 liang, remove roots) She Xiang (Moschus; 1 qian, finely ground)
Grind the above ingredients, sift into powder, and mix with soft cooked rice to form pills the size of mung beans. For each year of age, take two pills with rice gruel.
*Shenghui Fang* treats pediatric Ji Gan where parasites attack the back and spine, causing progressive bone prominence and weakness. Use Hua Gan Wan (Resolve Parasite Pill) formula:
Ni Fen (White Lead Powder; ground in) Hu Fen (Lead Carbonate) Hu Huang Lian (Rhizoma Coptidis) Lei Wan (Semen Walsurae) He Shi (Semen Pedalii) Qiang Lang (Scarabaeus; remove wings and legs, slightly stir-fried) Di Long (Pheretima; slightly stir-fried. Each 1 fen)
Grind the above ingredients, sift into powder, and mix with egg white. Place in a bamboo tube and steam alongside rice until the rice is cooked. Mix with bear bile to form pills the size of mung beans. For each dose, take three pills with clear rice gruel. Take three times daily. Adjust dosage according to the child's age.
*Shenghui Fang* treats pediatric Ji Gan with dysentery and emaciation. Use Bai Fan Wan (Alum Pill) formula:
Bai Fan (Alumen; calcined to ash, 3 qian) Tian Fu (Note: Text says 'Tian Fu', likely a typo for a specific herb or mineral, possibly related to earth/mineral substances in ancient texts, kept as literal translation) (3 fen, burned to ash) She Tui Pi (Exuvius Bombycis; one strip, stir-fried until golden brown) Qing Dai (Indigo Naturalis) Zhu Sha (Cinnabar) Lu Hui (Resin Aloe) (each finely ground) He Shi (Semen Pedalii) Lang Dang Zi (Semen Daturae; wash with water to remove floating seeds, boil until sprouted, stir-fry until black. Each 1 fen) She Xiang (Moschus; 1 qian, ground)
Grind the above ingredients, sift into powder, and mix thoroughly. Form pills the size of mung beans using burnt rice paste. For each year of age, take two pills with rice gruel.
*Shenghui Fang* treats pediatric Ji Gan with body heat, emaciation, mental restlessness, excessive thirst, and refusal of milk/food. Use Qing Dai Wan (Indigo Pill) formula:
Qing Dai (Indigo Naturalis) Lu Hui (Resin Aloe) Zhu Sha (Cinnabar) (each finely ground) He Shi (Semen Pedalii) Xiong Dan (Ursine Gallbladder; ground in. Each 1 fen) Hu Huang Lian (Rhizoma Coptidis; 0.5 liang) She Xiang (Moschus; 1 fen, finely ground)
Grind the above ingredients, sift into powder, and mix thoroughly. Form pills the size of mung beans with refined honey. For each dose, take three pills with warm water. Take three times daily. Adjust dosage based on the child's age.
*Zhu Shi Jia Chuan* treats pediatric Ji Gan with continuous bloody diarrhea.
Ding Fen (Lead Carbonate) Hao Zao (Good Jujube; ten pieces, crushed) Tou Fa (Human Hair; a small amount, cut into pieces)
Form the above into a ball, place on a brick, and fire until red hot. Grind finely and take half a qian with rice drink.
*Zhuang Shi Jia Chuan* treats pediatric chronic bloody diarrhea, termed Li Ji Gan.
Use Shan Jian Jia (Pangolin Scales), soak in rice vinegar, roast, and grind into powder. Take one qian per dose, mixed with rice drink, after meals.