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General Overview: The five types of Gan (Gan Syndrome, a childhood wasting disorder) correspond to the five Zang organs and can be observed from five aspects; detailed deduction of treatment methods is not difficult. If one observes sallow complexion, emaciated muscles, scorched teeth, and erect hair, it is Gan syndrome.

It is also said: When raising children, one should be cautious and avoid bad habits; indulgence in alcohol, meat, and greasy foods easily induces disease. By avoiding cold, raw, hard substances and cold water, one will naturally not suffer from Gan Pi (Gan with accumulation) disorders.

Pulse Diagnosis: A single and fine pulse indicates Gan Lao (Gan consumption); white vein patterns on the Tiger's Mouth (at the base of the thumb) indicate Gan. Cyan color at the Qi Gate resembling a fish bone primarily indicates Gan Lao; red color at the Qi Gate resembling a hanging needle primarily indicates Gan disease, accompanied by accumulated heat in the Lung organ.

The *Neijing* states: Frequent consumption of fatty foods causes internal heat; frequent consumption of sweet foods causes fullness in the middle jiao. The etiology stems from rich and sweet foods, hence named "Gan." As for infants whose milk-feeding has not ceased and whose Stomach Qi is not yet fully developed, if parents fail to provide proper care and instead indulge them out of affection, allowing them to eat freely rich, sweet, cold, and raw foods, stagnation becomes fixed and solidified. This leads to fever, emaciation, sallow complexion, or abdominal distension with visible veins, worm pain, diarrhea, and dysentery, causing various Gan syndromes to manifest.

Qian Zhongyang stated: All types of Gan are diseases of the Spleen and Stomach, arising from the loss of body fluids internally. They often occur after severe illness or following vomiting and diarrhea, when physicians mistakenly use purgatives. This weakens the Spleen and Stomach and depletes internal fluids. Moreover, most cases of pediatric Gan are caused by incompetent physicians. When children present with deficiency heat, one should tonify the mother organ according to the deficient child organ, ensuring the child organ remains peaceful. For instance, tidal fever at noon indicates deficiency heat in the Heart channel. Since the Liver is the mother of the Heart, one should first tonify the Liver; once the Liver is substantial, then drain the Heart. With maternal Qi supporting the Heart, internal balance is restored, and tidal fever resolves. Physicians who see tidal fever may wrongly assume it is excess and use various cold medicines to purge bowels. Excessive purging leads to inability to retain fluids, resulting in the loss of essence and fluids internally, thus forming Gan.

Furthermore, Qian Zhongyang stated: Gan of the Liver, also known as Sinew Gan, presents with white membrane obscuring the eyes or bloody stools with emaciation; treat with Dihuang Wan. Gan of the Heart presents with sallow face, red cheeks, and robust fever; treat with Anshen Wan. Gan of the Spleen, also known as Fat Gan, presents with yellow, thin body, dry skin, facial sores, abdominal distension, and pica (craving earth); treat with Yihuang San. Gan of the Kidney, also known as Bone Gan, presents with emaciated limbs, widespread sores, and preference for lying on wet ground; treat with Dihuang Wan. Gan of the Lung, also known as Qi Gan, presents with wheezing, cough, shortness of breath, and sores in mouth and nose; treat with Yihuang San. Note that Qian Zhongyang's discussion here all employs the method of "tonifying the mother," which should also be referenced.

Additionally, Qian Zhongyang stated: When Gan is internal, symptoms include swollen eyes, abdominal distension, greenish-white diarrhea, and gradual emaciation. When Gan is external, symptoms include redness and erosion under the nose, frequent rubbing of nose and ears, or sores on limbs. For nasal sores, apply Lanxiang San. Take two qian of Lanxiang herb, calcined until carbonized but retaining its nature, mixed with five qian each of Qingdai (Indigo Naturalis) and Qingfen (Calomel), ground into fine powder, and applied dry. Another formula, Baifen San, uses one spoonful of cuttlefish bone powder, two spoonfuls of Biji (Bletilla Rhizome) powder, and one spoonful of Qingfen, mixed evenly. Wash the sore with cold tea, dry it, and apply. This treats external Gan sores.

Infants lacking breast milk and fed porridge or rice too early consume their True Qi, leading to Gan, affecting the five Zang organs. Because stagnation in the Spleen, if untreated, transmits to other organs, forming the five types of Gan, hence the distinction.

Liver Gan, also called Wind Gan, presents with head shaking, eye rubbing, white membrane obscuring vision, cyan face with excessive tearing, scorced and erect hair, and widespread skin sores/ringworm; treat with Tianma Wan.

Heart Gan, also called Fright Gan, presents with high fever, red face, sores in mouth and tongue, heat in palms, soles, and chest (Five Hearts Heat), night sweats, thirst, bruxism, and fright; treat with Fushen Wan.

Spleen Gan, also called Food Gan, presents with yellow face and body, large abdomen with thin legs, vomiting, epigastric fullness, indigestion, sour-smelling stool, prone sleeping, reduced appetite, and eating dirt; treat with Wulingzhi Wan.

Lung Gan, also called Qi Gan, presents with cough, wheezing, high fever with aversion to cold, pruritic skin, nasal itching with runny nose, throat obstruction, chin erosion with bloating, frequent diarrhea, scorced hair, and hemoptysis; treat with Hua [Missing Character] Wan.

Kidney Gan, also called Urgent Gan, presents with hot head and emaciated flesh, ice-cold hands and feet, alternating chills and fever, slippery diarrhea with abdominal pain, dry mouth and nose, gingival sores, black nails, dark complexion, and widespread sores; treat with Dihuang Wan.

Generally, signs of Gan include shiny and tight scalp, scorced and sparse hair, sallow face with white lips, sweating, thirst, white urine with sour stool, abdominal distension, and tidal fever.

Ascaris disease results from late weaning or early introduction of meat, causing stagnation that transforms into worms. Symptoms include frowning and crying, vomiting clear fluid, abdominal pain, distended abdomen with visible veins, purple-black lips and mouth, and moist, itchy anus; treat with Huachong Wan.

Spine Gan involves worms eroding the spine, presenting with fever, jaundice and emaciation, heat from stagnation, irritability, thirst, and diarrhea. Back patting sounds like drumming, spine feels like sawteeth, or sores on ten fingers with nail-biting; treat with Xiachong Wan.

Brain Gan arises from prior wind-heat in the brain and irregular feeding after birth. Symptoms include shiny/tight scalp, pancake-like head sores, burning head heat, straight hair like tassels, profuse sweating, swollen cheeks, and bulging fontanelle. Maternal excessive desire during labor can also cause this, easily damaging the infant's eyes; treat with Longdan Wan.

Gan Edema involves deficiency with stagnation, where toxicity and Qi interact, causing tense abdomen. Due to Spleen/Abdomen dampness or cold-heat imbalance, deficiency prevents dissemination, leading to edema of head, face, and limbs; treat with Hezi Wan.

Gan Consumption involves tidal fever, Five Hearts Heat, sores on palms, soles, and chest, night sweats, bone-steaming fever, cough, wheezing, and emaciation. Signs include thirst with diarrhea, aversion to food despite drinking, stone-hard abdomen, and silver-white face, indicating untreatable condition; urgently administer Huang [Missing Character] Tang.

Wugou Gan presents with nodules behind the ear/neck like beans, movable upon pressure, soft and painless, containing worms like rice flour. These must be quickly ruptured and removed to prevent worms from dispersing with heat flow and damaging organs, causing limb abscesses, pus/blood in stool, high fever, emaciation, and prominent skull bones. Puncture with needle, apply plaster, then take Mapi Wan.

Dingxi presents with extremely thin limbs, small neck with high bones, wasted buttocks, flaccid body with large abdomen and protruding umbilicus, chest depression when crying, or grain-like accumulations.

Bulu presents with alternating deficiency heat, separated cranial sutures, regurgitation of worms, irritability, thirst, vomiting, and exposed ribs/emaciation. These result from chronic Spleen/Stomach deficiency failing to digest food/water, depleting spirit and failing to nourish Qi/Blood; treat with Shiquan Dan.

[Regarding specific infant illness]: After birth, if the mother becomes pregnant again, blood and Qi are divided, injuring the fetus and turning milk toxic. The infant suckling becomes ill, qi gathers and郁 (stagnates), injuring spirit. Symptoms include sallow face, abdominal distension, mild diarrhea, alternating chills/fever, hair loss, progressive emaciation, and low spirits due to drinking milk while mother is pregnant. Wean immediately, harmonize Stomach Qi and Blood vessels; treat with Longdan Tang.

[Attached Formulas]
Anshen Wan: Ophiopogonis Radix (Maidong), Natrii Sulfas (Mayaxiao), Poria (Fuling), Dioscoreae Rhizoma (Shanyao), Calcitum (Hanshuishi), Glycyrrhizae Radix et Rhizoma (Gancao), Cinnabar (Zhusha), Borneolum Syntheticum (Pian Nao). Grind and form pills.
Yihuang San: Citri Reticulatae Pericarpium (Chenpi, 1 qian), Citri Reticulatae Viride (Qingpi), Terminalia Chebulae Fructus (Heqizi), Glycyrrhizae Radix et Rhizoma (Gancao, 0.5 qian each), Saussureae Radix (Dingxiang, 0.2 qian). Grind to powder, decoct in water. Add Ginseng Radix (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu, 1 qian each) for better effect.
Tianma Wan: Indigo Naturalis (Qingdai), Coptidis Rhizoma (Huanglian), Gastrodiae Rhizoma (Tianma), Aloe (Luhui), Gentianae Radix (Dancao), Saposhnikoviae Radix (Fangfeng), Chuanxiong Rhizoma (Chuanxiong), Cicadae Periostracum (Chanqiao), Scorpio (Quanxie), Moschus (Shexiang), Trogopterori Faeces (Wulingzhi), Phalaenopsis Residue (Yeming Sha).
Fushen Wan: Poria Cum Radix Xylomi (Fushen), Aloe (Luhui), Succinum (Hupo), Polyporus (Chifuling), Uncariae Ramulus cum Uncis (Gouteng), Moschus (Shexiang), Polygalae Radix (Yuanzhi), Bufo vulgaris (Xama), Coptidis Rhizoma (Huanglian), Acori Tatarinowii Rhizoma (Changpu).
Wulingzhi Wan: Amomi Fructus Rotundus (Sharen), Cardamomi Fructus (Baiko), Hordeum Vulgare (Maiya), Curcumae Zedoariae Rhizoma (Ezhu), Citri Reticulatae Viride (Qingpi), Citri Reticulatae Pericarpium (Chenpi), Quisqualis Fructus (Shijunzi), Bufo vulgaris (Xama), Trogopterori Faeces (Wulingzhi).
Hua [Missing] Wan: Myrobalanus Chebulae (Wuyi), Aloe (Luhui), Indigo Naturalis (Qingdai), Chuanxiong Rhizoma (Chuanxiong), Angelicae Dahuricae Radix (Baizhi), Bufo vulgaris ash (Xama hui), Picrorhizae Rhizoma (Huhuanglian).
Dihuang Wan: Rehmanniae Radix Preparata (Shudi), Polyporus (Chifuling), Dioscoreae Rhizoma (Shanyao), Moutan Cortex (Danpi), Corni Fructus (Shanzhuyu), Quisqualis Fructus (Shijunrou), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), Toosendan Fructus (Chuanlianzi).
Huachong Wan: Myrobalanus Chebulae (Wuyi), Pyrethri Flos (Heshi), Arecae Semen (Binglang), Bufo vulgaris (Xama), Aloe (Luhui).
Xiachong Wan: Aucklandiae Radix (Muxiang), Persicae Semen (Taoren), Myrobalanus Chebulae (Wuyi), Arecae Semen (Binglang), Pyrethri Flos (Heshi), Calomel (Qingfen), Bufo vulgaris (Xama), Quisqualis Fructus (Shijunrou), new Meliae Cortex (Kualgenpi).
Longdan Wan: Gentianae Radix (Dancao), Ephedrae Herba (Shengma), Saposhnikoviae Radix (Fangfeng), Polyporus (Chifuling), Human Hair Charcoal (Youfa), Indigo Naturalis (Qingdai), Coptidis Rhizoma (Huanglian), Aloe (Luhui), Meliae Cortex (Kuilangen).
Hezi Wan: Raphani Semen (Bozi), Citri Reticulatae Pericarpium (Chenpi), Citri Reticulatae Viride (Qingpi), Arecae Semen (Binglang), Morning Glory Seed (Heichou), Polyporus (Chifuling), Curcumae Zedoariae Rhizoma (Ezhu), Aucklandiae Radix (Muxiang), Trogopterori Faeces (Wulingzhi). Alternative: Sanleng, Huajiao, Shenqu, without Heichou, Chifuling, Wulingzhi.
Huang [Missing] Tang: Huang [Missing], Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), Paeoniae Radix Alba (Shaoyao), Rehmanniae Radix (Shengdi), Bufo vulgaris (Xama), Testudinis Carapax et Plastrum (Biejia), Ginseng Radix (Renshen), Poria (Fuling), Citri Reticulatae Pericarpium (Chenpi), Bupleuri Radix (Chaihu), Pinelliae Rhizoma (Banxia), Quisqualis Fructus (Shijunrou).
Mapi Wan: One Bufo vulgaris (large belly, non-singing, non-jumping, warty). Collect maggots in a bucket, kill the toad, place in maggots to feed for one day and night. Wrap maggots in cloth bag, soak in fast-flowing water overnight. Roast on tile to powder, add one spoonful of Moschus (Shexiang), mix with rice paste to form pills. Take 20 pills per dose.
Shiquan Dan: Citri Reticulatae Pericarpium (Chenpi), Citri Reticulatae Viride (Qingpi), Curcumae Zedoariae Rhizoma (Ezhu), Chuanxiong Rhizoma (Chuanxiong), Cardamomi Fructus (Baiko), Arecae Semen (Binglang), Aloe (Luhui), Bufo vulgaris (Xama), Trogopterori Faeces (Wulingzhi), Aucklandiae Radix (Muxiang), Quisqualis Fructus (Shijunzi).
Longdan Tang: Gentianae Radix (Dancao), Uncariae Ramulus cum Uncis (Gouteng), Bupleuri Radix (Chaihu), Platycodonis Radix (Jiegeng), Paeoniae Radix Alba (Shaoyao), Chuanxiong Rhizoma (Chuanxiong), Poria (Fuling), Ginseng Radix (Renshen), Rheii Radix et Rhizoma (Dahuang), Glycyrrhizae Radix et Rhizoma (Gancao).