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Lusheng Wan is used to treat all types of gan syndrome (chronic malnutrition and digestive disorder in children), whether cold or hot, new or chronic, serving as the primary formula.

True Aloe Vera (steamed with wine) 5 qian, Trogopterus Dung (stir-fried) 5 qian, Night-bright Sand (stir-fried) 5 qian, True Guangpi (Citri Reticulatae Pericarpium, stir-fried with wine) 5 qian, Hang Qingpi (Exocarpium Citri Grandis, stir-fried with vinegar) 5 qian, Peng Ezhu (Curcumae Rhizoma, baked) 5 qian, Semen Quisqualis (stir-fried) 5 qian, Nanmuxiang (Vladimiria Root, ground into powder) 5 qian, Bai Danggui (Angelica Sinensis, stir-fried) 5 qian, Zheng Chuanxiong (Ligusticum Chuanxiong, stir-fried with wine) 5 qian; all the above herbs are each 2 qian; Ren Shen (Panax Ginseng, selected high-quality slices, baked dry) 3 qian; Zheng Chuanlian (Coptidis Rhizoma, processed with ginger juice) 3 qian; Gan Chan Yu (Dried Toad Skin, roasted with su oil) 3 qian; Xi Sharen (Amomi Fructus, stir-fried with wine) 2 qian.

Grind the above herbs into a fine powder. Extract the juice from one male pig gallbladder, mix it evenly with the herbal powder, and form pills using millet paste, sized like longan seeds. Take one pill per dose, administered with rice water.

If the child exhibits teeth grinding, tongue protrusion, sores on the tongue, preference for cold water, red lips but pale complexion, and a habit of lying prone on the ground, this is Heart Gan Syndrome. Remove Ezhu, Sharen, Qingpi, Chenpi, Chuanxiong, and Muxiang (six herbs) from the base formula, and add Dihuang, Fuling, and Dansheng, each 2 qian, plus Zhusha and Gancao, each 1 qian.

If the child has a bluish-green complexion, white membrane growth in the eyes, diarrhea mixed with watery or green stools, this is Liver Gan Syndrome. Remove Ezhu, Sharen, Chenpi, and Muxiang (four herbs) from the base formula, and add Longdancao, Zhiren, Fangfeng, Tianma, and Chantui, each 2 qian, plus Qingdai 1.5 qian.

If the child craves eating dirt and cold foods, eats without restraint, presents with yellowing of the body and face, sparse hair matted into tufts, large head with a thin neck, abdominal distension, weak legs, occasional diarrhea, emaciation, coolness during the day and fever at night, and loss of appetite for milk and food, this is Spleen Gan Syndrome. Use the base formula exclusively.

If the child has red erosion under the nose, withered and thin limbs, foul-smelling breath, or wheezing cough, and a pale right cheek, this is Lung Gan Syndrome. Remove Ezhu, Sharen, Qingpi, Chuanxiong, and Muxiang (four herbs) from the base formula, and add Sangbai, Jiegeng, Ziye, Ejiao, and Zhigancao, each 2 qian. Externally, apply equal parts of Zelan Ye, Tonglv, and Qingfen ground into powder to the eroded areas.

If the child develops sores inside and outside both ears, knee-like swelling in the legs, unfused cranial sutures, or foul-smelling rotting gums progressing to "Running Horse Gan" (noma), this is Kidney Gan Syndrome. Remove Ezhu, Sharen, Qingpi, Chenpi, Muxiang, and Wulingzhi (six herbs) from the base formula, and add Shudi, Fuling, Shanyao, and Yurou, each 3 qian, plus Danpi and Zexie, each 2 qian.

If gan syndrome results from prolonged food stagnation, presenting with emaciation, tight abdomen, intermittent tidal fever, fear of strangers (crying upon seeing them), remove Lushen and Wulingzhi (two herbs) from the base formula, and add Renshen, Huangqin, Baizhu, Fuling, Banxia, Zhishi, Houpo, Zhigancao, Shenqu, Maiya, Biejia, and Sanleng, each 2 qian.

If chronic diarrhea persists leading to stomach deficiency and gan syndrome, known as Gan Diarrhea, remove Lushen, Ezhu, and Wulingzhi (three herbs) from the base formula, add Baizhu, Fuling, Roukou, and Hezi, each 2 qian, and add Renshen 3 qian.

If chronic dysentery persists leading to stomach deficiency and gan syndrome, known as Gan Dysentery, remove Lushen, Ezhu, Qingpi, and Wulingzhi (four herbs) from the base formula, add Hezirou and Jianlianrou, each 3 qian.

If malaria persists untreated leading to stomach deficiency and gan syndrome, accompanied by masses, known as Gan Malaria, remove Lushen and Wulingzhi (two herbs) from the base formula, add Huangqin, Biejia, Chaihu, Banxia, Shenqu, and Sanleng, each 2 qian, and double the dosage of Renshen to 3 qian.

For Brain Gan Syndrome, characterized by shiny/tight skin and hair, crusty sores all over the scalp, brain heat like fire, hair matted into tufts, profuse sweating, swollen cheeks, bulging fontanelle, and eye pain due to liver pathology, remove Ezhu, Sharen, Qingpi, and Chenpi (four herbs) from the base formula, and add Longdancao, Chuanxiong, Shengma, Qianghuo, and Fangfeng, each 2 qian.

For Spine Gan Syndrome, where parasites eat the spine, causing fever, jaundice, emaciation, internal heat from accumulation, irritability, thirst, and dysentery, with a drum-like sound when patting the back and serrated-looking spine, or sores on all ten fingers with frequent nail biting, use Anchong Wan. Generally, among the five types of gan, food stagnation may lead to accumulation and subsequent parasite generation. Parasites may resemble silk threads or horse tails, often appearing between the head, neck, back, and abdomen. Those that are yellow, white, or red are treatable; those that are blue-black are difficult to treat. Anchong Wan is formulated by removing Ezhu, Sharen, Qingpi, Chenpi, Danggui, and Chuanxiong (six herbs) from the base formula, and adding Kulian Gen Baipi, Guanzhong, Wuyi, and Binglang, each 2 qian.

For Ascariasis Gan Syndrome, characterized by frowning, excessive crying, vomiting clear foam, sudden abdominal pain with palpable masses, exposed abdominal veins, purple-black lips and mouth, and anal itching, if roundworms exit via mouth or nose, prognosis is poor. Use Anchong Wan, which is the aforementioned formula.

For Dingxi Gan Syndrome, characterized by extremely thin limbs, small neck with prominent bones, wasted buttocks, emaciated body, large abdomen with protruding umbilicus, and chest depression during crying, use Jisheng Wan, which is the base formula (Lusheng Wan).

For Bulu Gan Syndrome, characterized by alternating deficiency-heat, separated cranial bones, regurgitation of worms, irritability, and vomiting, use Jisheng Wan, which is the base formula (Lusheng Wan).

For Wugu Gan Syndrome, caused by exposure to laundry washed at night contaminated by feathers from "Wugu" birds. If ingested by children, it causes fever, progressive yellowing and emaciation, and elastic-sized nodes behind the ears/neck that move upon pressure, are soft, painless, and contain rice-flour-like parasites. Puncture the node and apply plaster externally. Internally, use the base formula removing Ezhu, Sharen, and Wulingzhi (three herbs), adding Huangqin, Biejia, and Binglang, each 2 qian.

For Gan Heat, caused by spleen/stomach weakness with floating yang qi failing to return to its source, treatment focuses on tonifying the spleen to收敛 (consolidate) yang qi, allowing heat to subside naturally. Shenling Baizhu San is recommended for frequent use. For cases with concurrent spleen yin deficiency, intermittently administer Liuwei Dihuang Wan.

For Gan Thirst, caused by sinking of stomach qi and failure to generate fluids, treatment involves tonifying the stomach to raise clear yang and gradually generate fluids, stopping thirst naturally. Use Qiwei Baizhu San.

For Running Horse Gan (Noma), a parasitic disease. Teeth belong to the Kidney, and the Kidney governs deficiency. Upon exposure to heat pathogens, the pathogen rushes to the Upper Jiao. Initial halitosis is called "Chouxi"; subsequent blackening of teeth is called "Bengsha"; severe gum rot is called "Kuicao"; bleeding is called "Xuanlu"; complete tooth loss is called "Fugen". Even if survival occurs, teeth do not regrow. External signs include brain heat, emaciation, ice-cold extremities, alternating chills/fever, slippery diarrhea, abdominal pain, halitosis, dry thirst, rotten gums/black nails, and widespread sores. This condition often follows smallpox/variolola and is incurable because the toxin resides in the Kidney. Early stages are treated with Qingwei San (see Dental section for details).

For "Zhi Ru" Disease: When an infant nearing one year old continues breastfeeding while the mother is pregnant, it is called "Zhi Ru" (sound: Zhi), leading to this condition. Alternatively, if the mother suffers from other diseases, the infant may contract similar symptoms through breast milk. Harmonious maternal blood/qi produces nourishing milk; diseased maternal blood/qi becomes the root of illness. During pregnancy, essence descends, blocking the Chong and Ren meridians from ascending, causing qi stagnation (heat) and blood stasis (toxin). Children's spirit/qi is incomplete and easily affected. Symptoms include alternating chills/fever, mild diarrhea, hair loss, irritability, severe cases showing sallow complexion, abdominal distension with visible veins, green diarrhea with vomiting, progressive emaciation, eventually becoming gan syndrome. Folklore attributes this to fetal jealousy ("Tai Du") due to the infant drinking milk while pregnant. Use Longdan Tang.

For Bone-steaming Disease, originating in the Stomach. Initially, evil fire rushes upward allowing eating, then consumes energy causing hunger. The Stomach is the sea of blood/qi; insufficiency leads to evil fire digesting food rapidly. Insufficient essence from food/water fails to nourish, leading to foul breath, irritability, night fever/morning coolness, dry hair/thirst, shortness of breath, night sweats, and skeletal emaciation, termed "Xiaodan". If stool frequency exceeds ten times daily with limb emaciation, abdominal distension, and frequent hunger despite eating, it is termed "Shibing". These result from evil fire damaging fluids. Use Dafei'er Wan.