大人为劳小儿疳，乳食伤脾是病原，甘肥失节生积热，气血津液被熬煎。初患尿泔午潮热，日久青筋肚大坚，面色
青黄肌肉瘦，皮毛憔悴眼睛HT 。
【注】大人者，十五岁以上也，病则为劳；若十五岁以下者，皆名为疳。缘所禀之气血
虚弱，脏腑娇嫩，易于受伤。或因乳食过饱，或因肥甘无节，停滞中脘，传化迟滞，肠胃
渐伤，则生积热。热盛成疳，则消耗气血，煎灼津液。凡疳病初起，尿如米泔，午后潮热。
日久失治，致令青筋暴露，肚大坚硬，面色青黄，肌肉消瘦，皮毛憔悴，眼睛发HT ，而疳
证成矣。然当分其所属而治之，庶不致有误也。
脾疳面黄肌消瘦，身热困倦喜睡眠，心下痞硬满肿胀，卧冷食泥腹痛坚，头大颈细食懒进，吐泻烦渴便腥粘，攻积
消疳肥儿治，补脾参苓白术先。
【注】脾属土，色黄主肌肉。故脾疳则见面黄，肌肉消瘦，身体发热，困倦喜睡，心
下痞硬，乳食懒进，睡卧喜冷，好食泥土，肚腹坚硬疼痛，头大颈细，有时吐泻，口干烦
渴，大便腥粘之证也。宜先攻其积，用消疳理脾汤、肥儿丸主之。积退然后调理其脾，以
参苓白术散主之。
消疳理脾汤
芜荑 三棱 莪术 青皮（炒） 陈皮 芦荟 槟榔 使君子肉 甘草（生） 川黄连 胡黄连 麦
芽（炒） 神曲（炒）
引用灯心，水煎服。
【方歌】消疳理脾用芜荑，三棱莪术青陈皮，芦荟槟榔使君草，川连胡连麦芽曲。
肥儿丸
人参（二钱半） 白术（土炒，五钱） 茯苓（三钱） 黄连（二钱） 胡黄连（五钱） 使君子肉
（四钱） 神曲（炒） 麦芽（炒） 山楂肉（各三钱半） 甘草（炙，钱半） 芦荟（煨，二钱半）
上为末，黄米糊丸，如黍米大，每服二三十丸，米汤化下。
参苓白术散
人参（二钱） 茯苓 白术（土炒） 扁豆（炒） 薏米（炒） 山药（炒，各五钱） 陈皮（三
钱） 缩砂 桔梗（各二钱） 甘草（炙，一钱） 建莲子（去心，五钱）
共为细末，每服一钱，老米汤调服。
Adults' fatigue can cause children to suffer from *Gan* syndrome (chronic malnutrition and digestive disorder in children), with the etiology lying in milk and food damaging the Spleen and Stomach. Indulgence in sweet, greasy, and rich foods without moderation generates internal accumulation of heat, which boils and consumes Qi, Blood, and Body Fluids. In the early stage, urine is turbid like rice wash water, and tidal fever occurs in the afternoon; if the disease persists, epigastric veins may become prominent, the abdomen becomes distended and hard, the complexion is yellowish-green, muscles emaciate, skin and hair become dry and withered, and eyes appear sunken.
[Note] "Adults" refers to those over fifteen years old; illness in this group is termed "Fatigue" (Lao). Those under fifteen are all classified as having "Gan" syndrome. This is because children have innate deficiency of Qi and Blood, delicate Zang-Fu organs, and are prone to injury. It may be due to overfeeding or excessive intake of rich and greasy foods, causing food stagnation in the Middle Jiao (epigastrium), sluggish digestion and transportation, gradual damage to the intestines and stomach, and subsequent generation of accumulated heat. Excessive heat leads to Gan syndrome, consuming Qi and Blood and scorching Body Fluids. At the onset of Gan disease, urine is turbid like rice water, accompanied by afternoon tidal fever. If left untreated for a long time, it results in prominent abdominal veins, a large and hard abdomen, yellowish-green complexion, muscle wasting, withered skin and hair, and sunken eyes, thus forming Gan syndrome. However, treatment must be differentiated according to the affected organ to avoid errors.
Spleen Gan presents with a yellow complexion, muscle wasting, body heat, lethargy, and a preference for sleep. There is epigastric fullness, hardness, and swelling; a preference for sleeping on cool surfaces and eating dirt; abdominal pain with a hard abdomen; a large head with a thin neck; poor appetite; vomiting and diarrhea; irritability and thirst; and foul-smelling, sticky stools. Treatment should focus on attacking accumulation and eliminating Gan using Fei'er Wan (Fattening Child Pill); to tonify the Spleen, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) is used first.
[Note] The Spleen belongs to Earth, its color is yellow, and it governs muscles. Therefore, Spleen Gan manifests as a yellow complexion, muscle wasting, body heat, lethargy, and drowsiness; epigastric stuffiness and hardness; reluctance to eat; preference for cool sleeping positions; pica (eating dirt); abdominal hardness and pain; macrocephaly with cervical thinning; occasional vomiting and diarrhea; dry mouth with irritability and thirst; and foul, sticky stools. Initially, one should attack the accumulation using Xiaogan Lipi Tang (Eliminate Gan and Regulate Spleen Decoction) or Fei'er Wan. After the accumulation recedes, the Spleen should be regulated using Shenling Baizhu San.
Xiaogan Lipi Tang (Eliminate Gan and Regulate Spleen Decoction)
Ingredients: Trogopterus Dung (Wuyi), Burreed Rhizome (Sanleng), Turmeric Tuber (Ezhu), Green Tangerine Peel (Qingpi, stir-fried), Tangerine Peel (Chenpi), Aloe (Luhui), Areca Seed (Binglang), Semen Quisqualis (Shijunzi), Licorice Root (Gancao, raw), Coptis Rhizome (Chuanlianhuan), Picrorhiza Rhizome (Huhuanglian), Malt (Maiya, stir-fried), Medicated Leaven (Shenqu, stir-fried).
Preparation: Add Centum Segments Herb (Dengxincao) as an引 (guide), decoct in water, and take orally.
[Prescription Song] Xiaogan Lipi uses Wuyi, Sanleng and Ezhu with Qing and Chen Pi,
Aloe, Binglang, Shijunzi, and Grass, Chuan Lian and Hu Lian with Maiya and Shenqu.
Fei'er Wan (Fattening Child Pill)
Ingredients: Ginseng Radix et Rhizoma (Renshen, 2.5 qian), Atractylodis Macrocephalae Rhizoma (Baizhu, earth-stir-fried, 5 qian), Poria (Fuling, 3 qian), Coptidis Rhizoma (Huanglian, 2 qian), Picrorhizae Rhizoma (Huhuanglian, 5 qian), Semen Quisqualis (Shijunzi, 4 qian), Medicated Leaven (Shenqu, stir-fried), Malt (Maiya, stir-fried), Hawthorn Fruit (Shanzha, each 3.5 qian), Licorice Root (Gancao, honey-roasted, 1.5 qian), Aloe (Luhui, baked, 2.5 qian).
Preparation: Grind into fine powder, make pills with yellow millet paste, size of millet seeds. Take 20-30 pills per dose, dissolved in rice soup.
Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder)
Ingredients: Ginseng Radix et Rhizoma (Renshen, 2 qian), Poria (Fuling), Atractylodis Macrocephalae Rhizoma (Baizhu, earth-stir-fried), Lablab Seed (Bidou, stir-fried), Coix Seed (Yimi, stir-fried), Dioscoreae Rhizoma (Shanyao, stir-fried, each 5 qian), Citri Reticulatae Pericarpium (Chenpi, 3 qian), Amomi Fructus (Suosha), Platycodonis Radix (Jiegeng, each 2 qian), Glycyrrhizae Radix et Rhizoma (Gancao, honey-roasted, 1 qian), Nelumbinis Semen (Jianlianzi, heart removed, 5 qian).
Preparation: Grind together into fine powder. Take 1 qian per dose, mixed with old rice soup.