Library

*Mai Jue Qi Meng* (Enlightenment on Pulse Formulas) states: A thin and fine pulse in children indicates *Gan Lao* (Consumption due to Gan syndrome). A white color in the finger vein pattern at the Tiger's Mouth area also indicates *Gan* syndrome.

Danxi stated: Children's Zang-Fu organs are delicate and tender; they are easily injured when overfed. If breastfeeding or dietary intake is irregular, it is rare for them not to develop *Gan* syndrome. This is all caused by improper diet and excessive consumption of sweet and fatty foods.

Alternatively, if infants are weaned too early or introduced to porridge and rice too soon, their physical form and Qi will be depleted, giving rise to the root of *Gan* syndrome. After months and years, the Five Types of *Gan* disease manifest. Qian stated: *Gan* syndrome is caused by the depletion of the Spleen and Stomach and the loss of body fluids. Therefore, because children's Zang-Fu organs are soft and fragile, severe purgation must be avoided when treating illness, as it will inevitably deplete body fluids. In cases where purgation is indicated, one should assess the child's size and the excess/deficiency patterns to administer appropriate treatment, thereby avoiding the development of *Gan*.

Symptoms such as dry eyes or the formation of a white membrane, red lips, yellowish complexion, preference for lying on cold ground, craving for eating soil, irregular diarrhea and dysentery, abdominal distension, sores on the ears and nose, hair matted into tufts, weak legs, small neck, emaciation, and thirst are all signs of *Gan* syndrome.

Zeng stated: There are five types of pediatric *Gan* syndrome: Heart, Liver, Spleen, Lung, and Kidney *Gan*. Grinding teeth, protruding the tongue, ulcers on the tongue, craving for cold water, red lips and face, and a preference for lying prone on the ground characterize **Heart *Gan***. Excessive eye discharge, tearing, bluish discoloration on the left side of the face near the hairline, or slightly yellow sclera, along with watery diarrhea or stool resembling moss color, characterize **Liver *Gan***. Craving for soil and cold items, excessive drinking, yellowish complexion all over the body, sparse hair matted into tufts, large head with a thin neck, abdominal distension, weak legs, intermittent diarrhea, emaciation, squinting eyes, feeling cool during the day and hot at night, and refusal to nurse characterize **Spleen *Gan***. Blackness under the nose, withered and thin hands and feet, foul odor from the mouth, wheezing or coughing, and whitening of the right cheek characterize **Lung *Gan***. Sores inside and outside both ears, knees resembling those of a crane (swollen joints), unfused cranial sutures, inability to walk, delayed tooth eruption, and foul-smelling rotting gums which may transmit to conditions like *Zou Ma Gan* (flying horse gangrene) characterize **Kidney *Gan***. Generally, *Gan* disease arises from overeating damaging the Spleen. If this accumulation in the Spleen is not treated, it transmits to other Zang organs, forming the Five Types of *Gan*. If the Spleen pathology is resolved, the other Zang organs will be stabilized.

According to Jiegu: *Gan* refers to pediatric food stagnation or chronic vomiting and diarrhea. When physicians recklessly administer overly harsh medications, children, being susceptible to both excess and deficiency patterns, suffer from Stomach deficiency and fluid depletion. This leads to internal empty heat and external muscle wasting. When one Zang is deficient, all Zangs become weak. Symptoms include swollen eyelids, abdominal distension, variable stool color, gradual emaciation, and prolonged non-healing. This indicates wind-stagnation in the intestines and stomach. The method dictates using *Xuan Feng San* (Ventilate Wind Powder) to guide out the stagnation first, followed by tonifying the mother organ according to the specific affected Zang.