虫食脊膂，身热羸黄，积中生热，烦渴下利，拍背如鼓鸣，脊骨如锯齿，或十
指皆疮，频啮爪甲是也。
《圣惠》金蟾散 治小儿脊疳，头大项细，四肢黄瘦，肚大胸高，毛发干立。
蟾（一枚、大者，涂酥、炙令焦黄） 夜明砂（微炒） 桃白皮 樗根白皮 地榆 黄柏（各锉） 诃梨
勒（煨，用皮） 百合 白芜荑（微炒） 人参（去芦头） 川大黄（锉碎，微炒） 黄连（去须。各三分） 胡粉
（三钱） 丁香（三七粒） 槟榔（一分）
上件药捣，细罗为散。每服、用粥饮调下半钱，日三服。
地骨皮丸 治小儿脊疳，渐渐黄瘦，以手指击之，背如鼓响，脊骨高是也。此因奶热所致。
地骨皮 紫参 黄 （锉） 川大黄（锉碎，微炒） 郁李仁（汤浸，去皮尖，微炒。各半两） 龙胆（去芦头）
子芩 枳壳（麸炒微黄，去瓤） 木香 猪苓（去黑皮） 海蛤（细研。各一分）
上件药捣，罗为末，炼蜜和丸，如绿豆大，每服以温水研下五丸，日三服，量
儿大小加减服之。常得微利为效。
杀疳丸 治小儿脊疳，日渐羸瘦，腹中有虫。
没石子 瓜蒂 鹤虱（并细研，各半两） 蟾头（炙令焦黄） 芦荟 青黛（并细研，各半两） 麝香（细研） 腻
粉（研入。各一分）
上件药捣，罗为末，以糯米饭和丸，如黍米大。每服，以粥饮下五丸，日三服，
量儿大小，以意加减。
芦荟丸 治小儿脊疳，腹内有虫上攻，背膂脊骨渐高，肌体羸瘦。
芦荟 青黛 朱砂 麝香（各细研） 熊胆（研入） 胡黄连 贯众 地龙（微炒） 黄连（去须）
蝉壳（微炒，去足） 雷丸（各半两） 虾蟆（一枚，涂酥炙，令焦黄）
上件药捣，罗为末，用蜗牛肉研和，丸如麻子大。每服，以粥饮下五丸，日三
服，量儿大小，增减服之。
青黛丸 治小儿脊疳，四肢瘦弱，腹胀壮热，头发干疏，时时烦渴，脊骨如锯。
青黛 朱砂（各细研） 夜明砂（微炒） 定粉（各一分） 蟾酥（研入） 熊胆（细研） 羚羊角（屑） 犀角
（屑。各半分） 黄连（半两，去须） 麝香（一钱，细研）
上件药捣，罗为末，用软饭和丸，如绿豆大。每一岁以粥饮下二丸。
第五脊疳，十指爪甲痒痛，头发焦干，肚腹虚鸣，脊骨如锯，时时下痢，状如青淀
或脓或血。
朱砂丸
天灵盖（炙，一个） 柴胡 白术 麝香（各一钱） 槟榔（一个）
上件，枣肉为丸如麻子大。每服三丸，米饮枣汤下。
〔朱氏〕治小儿脊疳泻血不止方
定粉 好枣（十个，捣碎） 头发（少许，剪碎）
上件为团，砖衬，火 通赤，细研。米饮下半钱。
〔庄氏〕治小儿久下血不止谓之历脊疳方
用穿山甲，米醋浸炙，为末。每服一钱，米饮调下，食空服。
Insect-eating the spine (spinal column), body heat, emaciation and sallow complexion, accumulation generating internal heat, irritability and thirst with diarrhea, percussion of the back sounds like a drum, spinal bones protruding like saw teeth, or sores on all ten fingers, frequent biting of fingernails—this is Ji Gan (Spinal Malnutrition).
Jin Chan San (Toad Powder) from *Shenghui Fang*: Treats pediatric Ji Gan (Spinal Malnutrition), characterized by a large head and thin neck, yellow and emaciated limbs, distended abdomen and high chest, dry and erect hair.
Ingredients: Chan Su (Toad Venom, one piece, large size, coated with butter, roasted until scorched yellow); Ye Ming Sha (Stool Vespertilionis, slightly stir-fried); Tao Bai Pi (Inner Bark of Peach Root); Chu Gen Bai Pi (Bark of Chinese Toona Root); Di Yu (Sanguisorbae Radix); Huang Bo (Phellodendri Cortex, each chopped); He Li Le (Terminalia Chebula Retz., baked, using only the peel); Bai He (Lilii Bulbus); Bai Wu Yi (Xanthii Fructus, slightly stir-fried); Ren Shen (Ginseng Radix et Rhizoma, remove rhizome); Chuan Da Huang (Rhei Radix et Rhizoma, chopped, slightly stir-fried); Huang Lian (Coptidis Rhizoma, remove stamens, each 3 fen); Hu Fen (Lead Carbonate, 3 qian); Ding Xiang (Caryophylli Flos, 37 grains); Bing Lang (Arecae Semen, 1 fen).
Preparation and Administration: Pound the above ingredients, sift finely to make a powder. Each dose uses half a qian, mixed with rice water for oral administration, three times daily.
Digupi Wan (Cortex Lycii Pill): Treats pediatric Ji Gan (Spinal Malnutrition), gradually becoming yellow and emaciated; percussion of the back sounds like a drum, with high spinal bones. This is caused by milk heat.
Ingredients: Di Gu Pi (Cortex Lycii); Zi Shen (Scutellaria Barbata D.Don); Huang Qin (Scutellariae Radix, chopped); Chuan Da Huang (Rhei Radix et Rhizoma, chopped, slightly stir-fried); Yu Li Ren (Prunus Lasiocarpa Seed, soaked in water, remove skin and tip, slightly stir-fried, each 0.5 liang); Long Dan (Gentianae Radix, remove rhizome); Zi Qin (Scutellariae Radix); Zhi Qiao (Aurantii Fructus, bran-stir-fried until slightly yellow, remove pith); Mu Xiang (Aucklandiae Radix); Zhu Ling (Polyporus, remove black skin); Hai Ge (Concha Meretrix, finely ground, each 1 fen).
Preparation and Administration: Pound the above ingredients, sift into powder, mix with refined honey to form pills the size of mung beans. Each dose is five pills, taken with warm water, three times daily. Adjust dosage according to the child's age. Mild purgation is considered effective.
Sha Gan Wan (Kill Parasite Pill): Treats pediatric Ji Gan (Spinal Malnutrition), progressive emaciation, presence of parasites in the abdomen.
Ingredients: Mo Shi Zi (Myrobalan Fruit); Gua Di (Melonis Fructus Seed); He Si (Chenopodii Semen, both finely ground, each 0.5 liang); Chan Tou (Toad Head, roasted until scorched yellow); Lu Hui (Aloe); Qing Dai (Indigo Naturalis, both finely ground, each 0.5 liang); She Xiang (Moschus, finely ground); Ni Fen (Calomelas, ground in, each 1 fen).
Preparation and Administration: Pound the above ingredients, sift into powder, mix with glutinous rice paste to form pills the size of millet seeds. Each dose is five pills, taken with rice water, three times daily. Adjust dosage according to the child's age.
Lu Hui Wan (Aloe Pill): Treats pediatric Ji Gan (Spinal Malnutrition), abdominal parasites attacking upward, gradual elevation of the dorsal spine, emaciated body.
Ingredients: Lu Hui (Aloe); Qing Dai (Indigo Naturalis); Zhu Sha (Cinnabar); She Xiang (Moschus, each finely ground); Xiong Dan (Ursi Bile, ground in); Hu Huang Lian (Coptidis Rhizoma alternative, i.e., Picrorhizae Rhizoma); Guan Zhong (Cyathulae Radix); Di Long (Pheretima, slightly stir-fried); Huang Lian (Coptidis Rhizoma, remove stamens); Chan Ke (Cicadae Periostracum, slightly stir-fried, remove legs); Lei Wan (Waningiae Semen, each 0.5 liang); Xia Ma (Bufo Bufo gargarizans Cantor, one piece, coated with butter, roasted until scorched yellow).
Preparation and Administration: Pound the above ingredients, sift into powder, mix with snail meat paste to form pills the size of hemp seeds. Each dose is five pills, taken with rice water, three times daily. Adjust dosage according to the child's age.
Qing Dai Wan (Indigo Naturalis Pill): Treats pediatric Ji Gan (Spinal Malnutrition), weak and emaciated limbs, abdominal distension with high fever, dry and sparse hair, frequent irritability and thirst, spinal bones like saw teeth.
Ingredients: Qing Dai (Indigo Naturalis); Zhu Sha (Cinnabar, each finely ground); Ye Ming Sha (Stool Vespertilionis, slightly stir-fried); Ding Fen (Lead Carbonate, each 1 fen); Chan Su (Toad Venom, ground in); Xiong Dan (Ursi Bile, finely ground); Ling Yang Jiao (Saiga Tatarica Cornu, shaved); Xi Jiao (Rhino Horn, shaved, each 0.5 fen); Huang Lian (Coptidis Rhizoma, 0.5 liang, remove stamens); She Xiang (Moschus, 1 qian, finely ground).
Preparation and Administration: Pound the above ingredients, sift into powder, mix with soft cooked rice to form pills the size of mung beans. For each year of age, administer two pills with rice water.
Fifth type of Ji Gan (Spinal Malnutrition): Itching and pain in the ten fingers and nails, scorched and dry hair, empty rumbling in the abdomen, spinal bones like saw teeth, frequent dysentery, stool resembling indigo dye, pus, or blood.
Zhu Sha Wan (Cinnabar Pill):
Ingredients: Tian Ling Gai (Human Skull Cap, roasted, one piece); Chai Hu (Bupleuri Radix); Bai Zhu (Atractylodis Macrocephalae Rhizoma); She Xiang (Moschus, each 1 qian); Bing Lang (Arecae Semen, one piece).
Preparation and Administration: Mix with jujube flesh to form pills the size of hemp seeds. Each dose is three pills, taken with rice drink and jujube soup.
[Zhushi] Formula for treating persistent bloody diarrhea in pediatric Ji Gan (Spinal Malnutrition):
Ingredients: Ding Fen (Lead Carbonate); Hao Zao (Good Jujubes, ten pieces, crushed); Tou Fa (Human Hair, a small amount, cut into pieces).
Preparation and Administration: Form into balls, place on bricks, fire until red hot, grind finely. Take half a qian with rice drink.
[Zhuangshi] Formula for treating prolonged bloody discharge known as Li Ji Gan (Progressive Spinal Malnutrition):
Use Chuan Shan Jia (Manis Squama), soak in rice vinegar and roast, then grind into powder. Each dose is one qian, taken with rice drink, on an empty stomach.