巢氏云∶疳湿之病，多因久利，脾胃虚弱，肠胃之间虫动侵蚀五脏，使人心烦
懊闷，其上蚀者，则口鼻齿龈生疮，其下蚀者，则肛门伤烂，皆难治。或因久利，
或因脏热嗜眠，或好食甘美之食，并令虫动，致生此病也。《圣惠》夫小儿嗜食甘
味多而动肠胃间诸虫，致令侵蚀脏腑，此犹是 也。凡食五味之物，皆入于胃，其
气随其腑脏之味而归之，脾与胃为表里，俱象土，其味甘，而甘味柔润于脾胃，脾
胃润则虫动，虫动则侵蚀成疳也，但虫因甘而动故名之为疳也。若虫蚀下部，则肛
门生疮烂开，急者数日便死，宜速疗之。夫小儿乳食不节，冷热相乖，伤于脏腑，
致疳气也。若脾胃虚弱，则哺乳不消，大肠虚寒，遂变泄痢，因其久痢不止，肠胃
俱虚，为水湿所乘，腹内虫动，侵蚀下部，故名疳痢湿 也。
《千金》除热结肠丸 断小儿热，下黄赤汁沫及鱼脑杂血，肛中疮烂，坐 生虫。
黄连 柏皮 苦参 鬼臼 独活 橘皮 芍药 阿胶（各半两）
上八味，末之，以蓝汁及蜜丸，如小豆。日服五丸至十丸。（冬无蓝汁，可用蓝子一合，舂蜜和丸。）
姜蜜汤（《千金》）治湿 。
生姜汁（五合） 白蜜（三合） 黄连（三两）
上三味，以水二升别煮黄连，取一升，去滓，纳姜、蜜更煎，取一升二合。五岁
儿平旦空腹服四合，日二。
杏仁汤（《千金》）治 。
杏仁（五十枚） 苦酒（二升） 盐（一合）
上三味和煮，取五合。顿服之，小儿以意量服。
治虫蚀下部方
胡粉 雄黄
上二味，各等分，末。着谷道中。亦治小儿。
〔张涣〕桃白散 治肠胃俱虚，腹内虫动，侵蚀下部，疳痢湿 。
桃木白皮 黄柏（蜜炙，锉） 黄连（去须，炒。各一两） 蛇蜕皮（半两，烧灰） 干蜗牛（一分，烧灰） 青
州枣（五十枚，去核，烧灰）
上件同捣，罗为细末，入定粉、麝香各一分，同研匀。每服一字，粥饮调下，乳食前。
如圣丹
干蟾（七枚，烧灰） 蝉壳（半两） 蚺蛇胆 大枣（去核，烧灰。各一分。以上捣罗为细末，次用） 黄丹
定粉 麝香（并细研。各一分）
上件同拌匀，用好醋一大盏，都捣一二百下成膏，如黍米大。每服五粒至七粒，
米饮下，量儿大小加减，或化三两粒涂患处。若虫出乃愈。
〔钱乙〕金华散 治小儿一切湿疮癣疳。
黄柏 黄连（各半两，并为细末） 黄丹（一两，火飞） 轻粉（一钱） 麝香（一字，别研）
上同研匀。先以温水洗后贴之。
化 丸 治诸疳生虫，不时啼哭，呕吐清水，肚腹胀痛，唇口紫黑，肠头湿 。
芜荑 芦荟 青黛（干） 川芎 白芷梢 胡黄连 川黄连 虾蟆灰（各等分）
上为末，猪胆汁浸糕糊丸，麻子大。每服一二十丸，食后临卧杏仁煎汤下。其
鼻常用熊胆煎汤，笔蘸洗。俟前药各进数服，却用青黛、当归、赤小豆、瓜蒂、
地榆、黄连、芦荟、雄黄为末，入鼻疮敛。
Chao Yuanfang stated: The disease of Gan-dampness (Gan syndrome with dampness) is mostly caused by prolonged diarrhea, leading to the deficiency and weakness of the Spleen and Stomach. Parasites between the intestines and stomach move and erode the five Zang organs, causing mental restlessness, depression, and discomfort. If the erosion occurs upwards, sores will grow in the mouth, nose, and gums; if downwards, the anus will be damaged and ulcerated. Both are difficult to treat. Some cases arise from prolonged diarrhea, some from internal heat causing lethargy, or a preference for sweet and delicious foods, all of which cause parasites to move and induce this disease. *Taiping Shenghui Fang* states that children who have a strong craving for sweets often trigger the movement of various worms in the intestines and stomach, leading to the erosion of Zang-Fu organs; this still belongs to Gan syndrome. All foods of the five flavors enter the Stomach, and their Qi returns to their respective Zang organs according to their flavors. The Spleen and Stomach are exterior-interior partners, both symbolizing Earth, with a sweet flavor. Sweetness moistens and softens the Spleen and Stomach; when the Spleen and Stomach are moist, worms move, and moving worms cause erosion resulting in Gan syndrome. Since the worms move due to sweetness, it is named Gan syndrome. If worms erode the lower part, sores and ulcers develop in the anus; in acute cases, death may occur within a few days, so rapid treatment is necessary. Irregular breastfeeding and diet, along with disharmony of cold and heat, damage the Zang-Fu organs, leading to Gan Qi. If the Spleen and Stomach are weak, milk cannot be digested, and the Large Intestine becomes deficient and cold, turning into diarrhea and dysentery. Due to persistent dysentery, both the intestines and stomach become deficient, allowing water-dampness to invade. Worms move inside the abdomen and erode the lower part, hence the name Gan-li-dampness (Dysenteric Gan with dampness).
*Qianjin Fang*'s Chu Re Jie Chang Wan (Heat-Removing Colon-Binding Pill) stops heat in children, expels yellow-red juices and froth mixed with fish-brain-like blood, treats ulcers in the anus, and addresses worms growing in sitting areas.
Herbs: Huanglian (Coptidis Rhizoma), Bopi (Phellodendri Cortex), Kushen (Sophorae Flavescentis Radix), Guijiu (Podophylli Fructus), Duhuo (Angelicae Pubescentis Radix), Ju Pi (Citri Reticulatae Pericarpium), Shaoyao (Paeoniae Radix), Ejiao (Asini Corii Colla) (each 0.5 liang).
The above eight herbs are powdered, formed into pills using Indigofera tinctoria juice (Lanzhi) and honey, sized like small beans. Take 5 to 10 pills daily. (In winter without Lanzhi, one he of Lanzi [Indigo plant] can be pounded and mixed with honey to form pills.)
Jiang Mi Tang (Ginger-Honey Decoction, from *Qianjin Fang*) treats damp Gan.
Ingredients: Fresh Ginger Juice (Wuhe), White Honey (Sanhe), Huanglian (Coptidis Rhizoma) (3 liang).
Boil Huanglian separately in two sheng of water to obtain one sheng of liquid, remove dregs, add ginger juice and honey, and boil again to obtain one sheng and two he of liquid. A five-year-old child should take four he on an empty stomach in the morning, twice a day.
Xingren Tang (Apricot Seed Decoction, from *Qianjin Fang*) treats Gan syndrome.
Ingredients: Xingren (Armeniacae Semen Amarum) (50 seeds), Cu (Vinegar) (2 sheng), Yan (Salt) (1 he).
Boil the three ingredients together to obtain five he. Take in one dose. For children, adjust the dosage appropriately.
Formula for treating worm erosion of the lower part:
Ingredients: Hufen (Cerussa), Xionghuang (Realgar).
Powder the two ingredients in equal parts. Insert into the anus. Also suitable for children.
[Zhang Huan] Tao Bai San (Peach Bark Powder) treats deficiency of both intestines and stomach, movement of worms in the abdomen, erosion of the lower part, and Gan-li-dampness.
Ingredients: Taomu Baipi (White bark of Peach Wood), Huangbai (Phellodendri Cortex) (honey-fried, crushed), Huanglian (Coptidis Rhizoma) (deveined, stir-fried) (each 1 liang), Shetui (Ophichthidis Cutis Coriacea) (0.5 liang, burnt to ash), Gan Woniú (Dry Snail) (1 fen, burnt to ash), Qingzhou Zao (Jujubae Fructus from Qingzhou) (50 fruits, pitted, burnt to ash).
Pound the above ingredients together, sift into fine powder, add Dingfen (Minium) and Shexiang (Moschus) each 1 fen, and grind uniformly. Take one "yi zi" amount per dose, administered with millet gruel drink, before breastfeeding or meals.
Ru Sheng Dan (Like-Sage Pill)
Ingredients: Ganchan (Toad Skin, burnt to ash) (7 pieces), Chanqiao (Cicada Slough) (0.5 liang), Ran She Dan (Python Gallbladder), Dazao (Jujubae Fructus) (pitted, burnt to ash) (each 1 fen. Pound and sieve these into fine powder first, then use), Huangdan (Minium), Dingfen (Minium), Shexiang (Moschus) (all finely ground, each 1 fen).
Mix the above ingredients well, add one large cup of good vinegar, pound 100-200 times until it becomes a paste, sized like millet grains. Take 5 to 7 pills per dose with rice drink, adjusting according to the child's size. Alternatively, dissolve 2-3 pills and apply topically to the affected area. Recovery occurs when the worms exit.
[Qian Yi] Jin Hua San (Golden Flower Powder) treats all types of damp sores, tinea, and Gan in children.
Ingredients: Huangbai (Phellodendri Cortex), Huanglian (Coptidis Rhizoma) (each 0.5 liang, made into fine powder), Huangdan (Minium) (1 liang, fire-refined), Qingfen (Calomelas), Shexiang (Moschus) (one "yi zi", separately ground).
Grind uniformly. Wash the area with warm water first, then apply.
Hua Gan Wan (Gan-Dissolving Pill) treats various Gan syndromes with worms, frequent crying, vomiting clear fluid, abdominal distension and pain, purple-black lips and mouth, and damp Gan of the prolapsed rectum.
Ingredients: Wuyi (Euodiae Fructus), Lvhui (Aloe), Qingdai (Indigo Naturalis, dried), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi Shao (Peucedani Radix tip), Huhuanglian (Scutellariae Barbatae Rhizoma), Chuan Huanglian (Coptidis Rhizoma), Xia Ma Hui (Bufo Toad Ash) (equal parts).
Make into powder, soak cake paste in Pig Bile, and form pills sized like hemp seeds. Take 10-20 pills per dose after meals and before sleep, with Apricot Seed decoction. For nasal issues, frequently wash with Bear Gallbladder decoction applied with a brush. After administering several doses of the previous medicines, use Qingdai (Indigo Naturalis), Danggui (Angelicae Sinensis Radix), Chixiaodou (Adzuki Bean), Gudi (Momordicae Fructus), Diyü (Sanguisorbae Radix), Huanglian (Coptidis Rhizoma), Lvhui (Aloe), and Xionghuang (Realgar) as powder to insert into nasal sores to promote healing.