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General Overview
For individuals over fifteen years of age, adult illnesses are termed "Lao" (Consumption/Chronic Deficiency); for children under fifteen, pediatric illnesses are termed "Gan" (Malnutrition Syndrome). This is because children possess congenital deficiency in Qi and Blood, with delicate Zang-Fu organs that are easily injured. Etiology may involve excessive feeding causing damage to the Spleen and Stomach. The root of this disease often lies in irregular consumption of rich and sweet foods, leading to stagnation in the Zhongwan (Epigastrium), delayed digestion and transportation, gradual injury to the intestines and stomach, and subsequent generation of accumulated heat. Excessive heat forms Gan syndrome, consuming Qi and Blood and boiling down Essence and Fluids. Initially, Gan syndrome presents with urine turbid like rice wash water and tidal fever in the afternoon. If left untreated for a long time, it leads to exposed subcutaneous veins, abdominal distension and hardness, bluish-yellow complexion, emaciation, withered skin and hair, and red or dry eyes; at this stage, Gan syndrome is fully established.

Spleen Gan
The Spleen belongs to Earth, its color is yellow, and it governs muscles. Therefore, Spleen Gan manifests as sallow complexion, muscle emaciation, body fever, fatigue, frequent desire to sleep, epigastric fullness and hardness, reluctance to nurse or eat, abdominal distension and swelling, preference for cool surfaces during sleep, pica (eating dirt), abdominal pain with hardness, large head and thick neck, occasional vomiting and diarrhea, dry mouth with irritability and thirst, and foul-smelling sticky stools. Treatment should first focus on eliminating accumulation using Xiaogan Lipi Tang (Gan-Resolving Spleen-Regulating Decoction) or Fei'er Wan (Child-Nourishing Pill). After accumulation subsides, tonify Spleen Qi, prioritizing Shenling Baizhu San (Poria, Atractylodes Macrocephala and Licorice Powder).

Gan Diarrhea
Gan diarrhea often results from accumulated heat injuring the Spleen, causing failure to separate clear from turbid fluids, leading to diarrhea. The method should first employ clearing heat and leaching out dampness, followed by tonifying the Spleen, which is the key principle. Initially, Qingre Hezhong Tang (Heat-Clearing and Middle-Regulating Decoction) is indicated. For chronic diarrhea unresponsive to treatment, Shenling Baizhu San is most effective.

Gan Edema
Edema caused by Gan disease, characterized by a puffy and lustrous complexion, often results from impaired transportation leading to dual injury of the Spleen and Lung. Symptoms include rebellious Qi with wheezing and cough, chest and diaphragm stuffiness, and abdominal distension. Yu Yuan Yunqi San (Imperial Garden Qi-Regulating Powder) is recommended for best results.

Gan Dysentery
Long-standing Gan disease with frequent dysentery is often due to heat binding and stagnation in the intestines and stomach. Stools may be red or white, accompanied by urgent abdominal pain. Xianglian Daozhi Tang (Coptis and Aucklandia Stagnation-Guiding Decoction) is an excellent prescription.

Liver Gan
The Liver belongs to Wood, its color is green, and it governs tendons. Thus, Liver Gan presents with greenish hue on the face, eyes, and nails, excessive eye discharge and tearing, gritty sensation making eyes hard to open, head shaking and eye rubbing, sleeping on the side, purulent otorrhea, wet sores, abdominal distension with visible blue veins, emaciation, dry thirst with irritability, and greenish moss-like stools. Treatment should first clear heat using Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) combined with Lushen Fei'er Wan (Aloe Child-Nourishing Pill). As the condition improves, regulate with Xiaoyao San (Free and Easy Wanderer Powder) and Yi Gan Fu Pi Tang (Suppress-Liver Strengthen-Spleen Decoction).

Heart Gan
The Heart belongs to Fire, its color is red, and it governs blood vessels. Heart Gan manifests as ruddy complexion, red meridians, high fever with sweating, frequent irritability and fright, teeth grinding and tongue protrusion, dry mouth and tongue, thirst, oral ulcers, dark red urine, chest stuffiness, preference for prone sleeping, anorexia with emaciation, and frequent vomiting and diarrhea. For excess heat, Xiexin Daochi Tang (Drain-Heart Guide-to-Red Decoction) is used. For heat with fright, Zhenzhu San (Pearl Powder) is applied. For chronic deficiency of the Heart, Fushen Tang (Poria Spirit Decoction) is used for regulation to achieve success.

Gan Thirst
Gan thirst arises from accumulated heat from rich foods frying and consuming the Spleen and Stomach, damaging Body Fluids. It presents with sudden intense thirst and drinking, mental irritability and heat. Qingre Ganlu Yin (Heat-Clearing Sweet Dew Drink) is most appropriate. As heat decreases and fluids regenerate, thirst ceases naturally.

Lung Gan
The Lung belongs to Metal, its color is white, and it governs skin and hair. Lung Gan presents with pale complexion and rebellious Qi, occasional cough, withered and brittle hair, millet-grain-like papules on skin, dry skin, fever and aversion to cold, frequent clear nasal discharge, and sores on nose and cheeks. First, disperse pathogenic factors using Shengdi Qingfei Yin (Rehmannia Lung-Clearing Drink); subsequently clear heat with Ganlu Yin (Sweet Dew Drink). For chronic Lung deficiency, Bufeisan (Lung-Tonifying Powder) is most effective. Adjust according to symptoms without delay.

Kidney Gan
The Kidney belongs to Water, its color is black, and it governs bones. Patients initially present with Jiechu (delayed closure of fontanelles) and Hexian (crane-knee deformity), delayed tooth eruption and walking, indicating Kidney Qi deficiency. Combined with irregular diet, this gradually becomes Kidney Gan. Symptoms include skeletal emaciation, dark complexion, bleeding gums, foul breath, cold feet, abdominal pain and diarrhea, and incessant crying. Use Jinchan Wan (Golden Cicada Pill) first to treat Gan, followed by Jiwei Dihuang Wan (Eight-Ingredient Rehmannia Pill with Additions) for tonification. For congenital Kidney Qi weakness, Tiaoyuan San (Regulate-Origin Powder) is indicated without delay.

Gan Fever
Pediatric Gan disease often presents with body fever. Treatment must distinguish severity and deficiency/excess. For early-stage excess patterns, Qinghao Biejia Yin (Artemisia Annua and Turtle Shell Drink) is suitable. For long-term deficiency patterns, Biejia San (Turtle Shell Powder) is most effective.

Brain Gan
Brain Gan often stems from innate wind-heat susceptibility combined with improper feeding. Symptoms include tight shiny scalp, brain sores resembling cakes, hot head with withered hair, matted hair, dry nose with irritability, swollen and hard cheeks and fontanelles, fatigue with dull eyes, spontaneous sweating, and limb heat. For brain heat sores, Longdan Wan (Gentian Pill) is used. For irritability, fever, and emaciation, Longnao Wan (Borneol Pill) is best. Externally, apply Longnao San (Borneol Powder) via nasal insufflation for rapid effect.

Eye Gan
Gan heat attacking the eyes causes Eye Gan. Symptoms include itching, grittiness, redness, and ulceration, swollen and painful eyelids, corneal opacity gradually covering the pupil, tearing, photophobia, and inability to open eyes. First, disperse using Xiegan San (Drain-Liver Powder); then eliminate opacity with Qingretuiyi Tang (Heat-Clearing Opacity-Removing Decoction). For chronic cases, regulate and tonify with Xiaoyao San and Yanggan San (Sheep Liver Powder).

Nose Gan
Gan heat attacking the Lung causes Nose Gan, as the nose is the opening of the Lung. Symptoms include nasal congestion, redness, itching, unbearable pain, oozing ulcers extending to lips, cough, shortness of breath, and dry hair. For excess heat, use Qingjin San (Metal-Clearing Powder) or Jiangshi Huadu Dan (Jiang's Toxin-Resolving Pellet). For Gan worms eroding the nose, use Huachong Wan (Worm-Expelling Pill). Externally, apply Bi'gan San (Nose Gan Powder) or Chuanke San (Cicada Molt Powder) via insufflation for miraculous effects.

Tooth Gan
Tooth Gan results from toxic heat attacking the Stomach internally. Toxic heat rises, causing bleeding, redness, ulceration, and pain in gums, bleeding from mouth and nose, withered and loose teeth, and cheek/lip erosion. This condition is often fatal. Urgently eliminate toxicity using Xiaogan Wuyi San (Gan-Resolving Melia Powder); follow with Lushen Fei'er Wan to clear heat. Externally apply Yagan San (Tooth Gan Powder) frequently for self-healing. This condition requires strong Stomach function to tolerate harsh medicines for survival.

Spine Gan
Pediatric accumulated heat generates worms that erode the spine upward. Percussion of the back produces a hollow drum-like sound. The spine is emaciated and serrated. External signs include fever, worsening diarrhea and thirst, sores on all ten fingers, and frequent nail-biting. This is Spine Gan, a severe condition. First, kill worms with Lushen Wan (Aloe Pill), then combine with Jinchan San (Golden Cicada Powder) to resolve Gan. Treat urgently without delay.

Ascaris Gan
Ascaris Gan results from excessive intake of greasy, raw, cold, and rich foods, generating damp-heat and roundworms that disturb the abdomen. Symptoms include intermittent irritability and crying, abdominal colic, changing lip color (red or white), drooling, abdominal distension with visible veins, and anal itching. Use Shijunzi San (Quince Seed Powder) urgently. If ineffective, use Xiachong Wan (Worm-Expelling Pill). After worm expulsion, tonify the Spleen with Fei'er Wan.

Wugou Gan
Wugou Gan has two etiologies: contamination by feathers from "Wugou" birds falling on laundry worn by infants, or transmission from sick wet nurses. Symptoms include neck sores or movable, soft, non-tender nodules containing rice-flake-like worms. If not promptly treated, worms erode viscera, causing bloody/purulent stool, emaciation, sallow feverish complexion, and Gan disease. Clear heat first with Chaihu Yin (Bupleurum Drink); then resolve Gan with Lushen Fei'er Wan for miraculous effects.

Dingxi Gan
Characterized by prominent bones resembling the character "Ding," hence the name. Symptoms include dry rough skin, incessant day-and-night crying, thin limbs, dark complexion, thin neck with distended abdomen and umbilical hernia, flat buttocks, weak body, fatigue, bone-steaming tidal fever, dry thirst, and irritability. Resolve stagnation first with Wugan Xiaoji Wan (Five-Gan Accumulation-Resolving Pill); then regulate Spleen and tonify with Renshen Qipi Wan (Ginseng Spleen-Initiating Pill).

Bulu Gan
Caused by irregular feeding severely damaging Spleen and Stomach. Presents with extreme emaciation, vomiting food and worms, irritability and thirst, open cranial sutures, and afternoon fever. Use Jisheng Wan (Saintly Collection Pill) to resolve accumulation first; follow with Fei'er Wan to clear and regulate the Spleen. For chronic Bulu Gan with abdominal distension and visible veins, employ simultaneous clearing and tonifying with Renshen Wan (Ginseng Pill).