身体壮热，或时憎寒，舌涩口干，睡多盗汗，皮肤枯燥，发立毛焦，乳食虽多，
肌肉消瘦，四肢无力，好睡昏昏，日往月来，转加 瘁，是其候也。瘦瘁少血，舌
干多啼，其病在心。目不转睛，虽啼无泪，其病在肝。身热尿干，手足清冷，其病
在肾。声焦皮燥，大便干结，其病在肺。搭口痴眠，胸脘干渴，其病在脾。
《仙人水鉴》独治干疳方
天灵盖 生鳖甲 波斯青黛 黄盐（以上各一分。陶隐居云，北海黄盐草粒粗，以作鱼 及咸菹）
上并同研令细。日服一字，空心熟水下。若是湿疳，不治，干疳，治之不过三服，神效。
《圣惠》天竺黄散 治小儿干疳，心脏烦热，眼目赤涩，皮肤干燥，夜多盗汗，羸瘦不能乳食。
天竺黄（半两） 牛黄 雄黄 朱砂 芦荟 麝香（各细研） 蟾头（炙令焦黄） 胡黄连 犀角
（屑） 木香 甘草（炙微赤，锉） 钓藤（各一分） 龙脑（一钱，细研）
上件药捣，细罗为散，都研令匀。每服，以温水调半钱，日三服，量儿大小，以意加减。
治小儿干疳体瘦烦热眠卧不安方
牛黄 雄黄 芦荟 青黛（各细研） 丁香 黄连（去须） 熊胆（研入） 蛇蜕皮（灰） 天竺黄
天浆子（微炒） 犀角（屑。各一分） 胡黄连（半两） 蟾酥（半钱，研入） 麝香（一钱，细研）
上件药捣，罗为末，更研令匀，以炼蜜和丸，如绿豆大。每服，以粥饮下三丸，
日三服，量儿大小，以意加减。
青黛丸 治小儿干疳，肌体羸瘦，皮毛干焦，发歇寒热，昏昏多睡。
青黛（三分，细研） 牛黄 芦荟 朱砂 麝香 雄黄（各细研） 胡黄连 蛇蜕皮（灰） 龙胆
（去芦头） 蝉壳（微炒。各一分） 蟾（一枚，涂酥炙焦黄）
上件药捣，罗为末，都研令匀，用面糊和丸，如黍米大。每服以粥饮下三丸，
日三服，量儿大小，临时增减。
牛黄丸 治小儿干疳，烦渴壮热，皮肤枯燥，日渐羸瘦。
牛黄（半钱，细研） 雄黄（细研） 黄连（去须） 芦荟 天竺黄（各一分） 龙脑 麝香（各一钱，细研）
甘草（半分，炙微赤，锉）
上件药捣，罗为末，都研令匀，用糯米饭和丸，如绿豆大。每一岁，以粥饮下一丸。
胡黄连丸 治小儿干疳，瘦弱不能乳食，发立脑干，肌体柴瘦。
胡黄连（末，半两） 朱砂 波斯青黛 芦荟（各三分） 麝香（一分） 蛇蜕皮（一条，烧灰） 蟾酥（一杏仁
大）
上件药，都研为末，用猪胆一枚，取法酒一盏和药末，都于铫子内熬如膏，
丸如绿豆大。五岁至七岁，以粥饮下五丸，日三服，三岁以下三丸。
青黛散 治小儿干疳，日久不瘥，骨立形枯，诸治无效者。
青黛 朱砂 芦荟 地龙 夜明砂（各微炒） 干虾蟆（灰） 熊胆（各一分） 麝香（二分）
上件药，都细研为散。每服半钱，空心以粥饮调下，更用少许药吹入鼻中。后
以桃枝汤看冷热浴儿，衣盖，有虫子出为效也。
牛黄丸 治小儿干疳，体热羸瘦，心神烦躁，少得眠卧。
牛黄（细研） 朱砂（细研，水飞过） 子芩 犀角（屑。各半两） 麝香（一分，细研）
上件药捣，罗为末，都研令匀，以糯米饭和丸，如麻子大。每服、用粥饮下三
丸，量儿大小，增减服之。
按∶干疳既是五脏之涸，则当以人参白术散、加减八味丸之类补而濡之，若
专恃以上诸丸药，恐无愈理。
The body has persistent high fever, sometimes with aversion to cold. The tongue is dry and rough with a dry mouth. There is excessive sleepiness and night sweats. The skin is dry and rough, and the hair stands upright and becomes brittle. Although milk and food intake are abundant, muscles emaciate, and the four limbs lack strength. The child is lethargic and drowsy. As days and months pass, the condition deteriorates into severe emaciation; this is the presentation of *Gan Gan* (Dry Malnutrition). Severe emaciation, blood deficiency, dry tongue, and frequent crying indicate the pathology is in the Heart. The eyes are fixed and do not move; even when crying, there are no tears, indicating the pathology is in the Liver. Body heat, dry and scanty urine, and cold hands and feet indicate the pathology is in the Kidney. Hoarse voice, dry skin, and dry, constipated stool indicate the pathology is in the Lung. Perioral ulcers, lethargy, and dryness/thirst in the chest and epigastrium indicate the pathology is in the Spleen.
**Formula from *Xianren Shuijian* for Treating Dry Malnutrition:**
*Tianlinggai* (Cranial Bone), *Sheng Biejia* (Raw Turtle Shell), *Bosi Qingdai* (Persian Indigo Naturalis), *Huangyan* (Yellow Salt) (each 1 fen. Tao Hongjing stated that yellow salt from the North Sea has coarse granules and is used for making fish paste and pickles).
Grind all ingredients together into a fine powder. Administer "one character" dose daily, taken on an empty stomach with warm water. If it is *Shi Gan* (Damp Malnutrition), it is incurable; if it is *Gan Gan* (Dry Malnutrition), treatment within three doses yields miraculous effects.
**Tianzhu Huang San from *Shenghui Fang*:**
Indicated for pediatric *Gan Gan*, heart vexation and heat, red and gritty eyes, dry skin, frequent night sweats, emaciation, and inability to feed.
*Tianzhu Huang* (Calamina, 0.5 liang), *Niuhuang* (Calculus Bovis), *Xionghuang* (Realgar), *Zhusha* (Cinnabaris), *Luhui* (Aloe), *Shexiang* (Moschus) (each finely ground), *Chantou* (Toad Head, roasted until scorched yellow), *Huhuanglian* (Rhizoma Coptidis), *Xijiao* (Cornu Rhinocerotis, shaved), *Muxiang* (Radix Aucklandiae), *Gancao* (Radix Glycyrrhizae, roasted until slightly reddish and cut), *Diaoteng* (Uncariae Ramulus cum Uncis, each 1 fen), *Longnao* (Borneolum Syntheticum, 1 qian, finely ground).
Pound the above medicines, sift through a fine sieve to make a powder, and grind uniformly. Take half a qian per dose, mixed with warm water, three times daily. Adjust dosage according to the child's age and size.
**Formula for Pediatric Gan Gan with Emaciation, Vexation, Heat, and Restless Sleep:**
*Niuhuang* (Calculus Bovis), *Xionghuang* (Realgar), *Luhui* (Aloe), *Qingdai* (Indigo Naturalis) (each finely ground), *Dingxiang* (Flos Caryophylli), *Huanglian* (Rhizoma Coptidis, remove stamens), *Xiongdan* (Ursi Fel, incorporated by grinding), *Shetuipi* (Ophichthidis Cutis, ash), *Tianzhuhuang* (Spatholobi Caulis), *Tianjiangzi* (Fructus Loranthi, lightly stir-fried), *Xijiao* (Cornu Rhinocerotis, shaved, each 1 fen), *Huhuanglian* (Rhizoma Coptidis, 0.5 liang), *Chansu* (Venenum Bufonis, 0.5 qian, incorporated by grinding), *Shexiang* (Moschus, 1 qian, finely ground).
Pound the above medicines, sift into powder, and grind uniformly. Mix with refined honey to form pills the size of mung beans. Take three pills per dose with rice broth, three times daily. Adjust dosage according to the child's age and size.
**Qingdai Wan:**
Indicated for pediatric *Gan Gan*, emaciated body, dry and brittle hair and skin, alternating chills and fever, and lethargy with excessive sleep.
*Qingdai* (Indigo Naturalis, 3 fen, finely ground), *Niuhuang* (Calculus Bovis), *Luhui* (Aloe), *Zhusha* (Cinnabaris), *Shexiang* (Moschus), *Xionghuang* (Realgar) (each finely ground), *Huhuanglian* (Rhizoma Coptidis), *Shetuipi* (Ophichthidis Cutis, ash), *Longdan* (Radix Gentianae, remove rhizome), *Chanke* (Periostracum Cicadae, lightly stir-fried, each 1 fen), *Chan* (Toad, one piece, coated with butter and roasted until scorched yellow).
Pound the above medicines, sift into powder, and grind uniformly. Mix with wheat paste to form pills the size of millet seeds. Take three pills per dose with rice broth, three times daily. Adjust dosage temporarily according to the child's age and size.
**Niuhuang Wan:**
Indicated for pediatric *Gan Gan*, vexation, thirst, high fever, dry skin, and progressive emaciation.
*Niuhuang* (Calculus Bovis, 0.5 qian, finely ground), *Xionghuang* (Realgar, finely ground), *Huanglian* (Rhizoma Coptidis, remove stamens), *Luhui* (Aloe), *Tianzhuhuang* (Spatholobi Caulis, each 1 fen), *Longnao* (Borneolum Syntheticum), *Shexiang* (Moschus, each 1 qian, finely ground), *Gancao* (Radix Glycyrrhizae, 0.5 fen, roasted until slightly reddish and cut).
Pound the above medicines, sift into powder, and grind uniformly. Mix with glutinous rice to form pills the size of mung beans. One pill per year of age, taken with rice broth.
**Huhuanglian Wan:**
Indicated for pediatric *Gan Gan*, emaciation and weakness preventing feeding, erect hair, dry head, and woody emaciation of the body.
*Huhuanglian* (Rhizoma Coptidis, powder, 0.5 liang), *Zhusha* (Cinnabaris), *Bosi Qingdai* (Persian Indigo Naturalis), *Luhui* (Aloe) (each 3 fen), *Shexiang* (Moschus, 1 fen), *Shetuipi* (Ophichthidis Cutis, one strip, burned to ash), *Chansu* (Venenum Bufonis, size of an almond).
Grind all medicines into powder. Take one pig gallbladder and one cup of medicinal wine to mix with the powder. Boil in a pot until it forms a paste. Form into pills the size of mung beans. For children aged five to seven, take five pills with rice broth, three times daily; for children under three years old, take three pills.
**Qingdai San:**
Indicated for pediatric *Gan Gan* lasting long without recovery, skeletal emaciation, where other treatments have failed.
*Qingdai* (Indigo Naturalis), *Zhusha* (Cinnabaris), *Luhui* (Aloe), *Dilong* (Pheretima), *Yeming Sha* (Stercoris Tabetae) (each lightly stir-fried), *Gan Xiamatu* (Bufo, burned to ash), *Xiongdan* (Ursi Fel, each 1 fen), *Shexiang* (Moschus, 2 fen).
Grind all medicines finely into a powder. Take half a qian per dose, mixed with rice broth on an empty stomach. Also, blow a small amount of the powder into the nose. Subsequently, bathe the child in peach branch decoction at a comfortable temperature, cover with clothing, and expulsion of parasites indicates efficacy.
**Niuhuang Wan:**
Indicated for pediatric *Gan Gan*, body heat, emaciation, mental restlessness, and insomnia.
*Niuhuang* (Calculus Bovis, finely ground), *Zhusha* (Cinnabaris, finely ground, water-floating processed), *Ziqin* (Scutellariae Radix), *Xijiao* (Cornu Rhinocerotis, shaved, each 0.5 liang), *Shexiang* (Moschus, 1 fen, finely ground).
Pound the above medicines, sift into powder, and grind uniformly. Mix with glutinous rice to form pills the size of sesame seeds. Take three pills per dose with rice broth. Adjust dosage according to the child's age and size.
**Commentary:** Since *Gan Gan* (Dry Malnutrition) results from the depletion of the Five Zang organs, it should be treated with tonifying and moistening formulas such as *Renshen Baizhu San* (Ginseng and Atractylodes Macrocephala Powder) or *Jiajian Bawei Wan* (Modified Eight-Ingredient Pill). Relying solely on the aforementioned pill formulas is unlikely to lead to a cure.