钱乙曰。肝疳亦名风疳。白膜遮睛。亦名筋疳。泻血而瘦。心疳亦名惊疳。面黄颊赤。身壮热。脾疳亦名食疳。面
黄腹大。食泥土。又名肥疳。身瘦虚黄。干而有疮。其候不一。今略举之。目涩或生白膜。唇赤。身干黄或黑。喜卧冷
地。或食泥土。身有疮疥。泻青白黄沫水。利色变易。腹满。发鬓作穗。头大项细。极瘦。饮水。肺疳亦名气疳。气喘。
口鼻生疮。肾疳亦名急疳。极瘦疮疥。亦名骨疳。喜卧冷地。
曾氏曰。肝疳生眵。发际左脸多青。或白睛微黄。泻利夹水。或如苔色。心疳切牙舒舌。爱饮冷水。喜伏眠于地。
脾疳爱食冷物。引饮无度。身面俱黄。发稀作穗。头大项小。腹胀脚弱或泻。肌瘦目慢。昼凉夜热。不思乳食。肺疳鼻
下赤烂。手足枯细。口腥。右腮 白。肾疳两耳内外生疮。脚如鹤膝。头缝不合。或未能行。牙齿生迟。其缝臭烂。传
作走马疳之类。
王汉东曰。凡治疳不必细分五疳。但虚则补之。热则清之。冷则温之。吐则治吐。利则治利。积则治积。虫则治虫。
不出集圣丸一方加减用之。屡试屡效。
圣惠方曰。小儿无辜疳。脑后有核如弹丸。捏之反下转是也。若不速去。当损其命。此核初生软而不痛。中有虫如
米粉。得热气渐长大。大则筋结定。定即虫随血气流散。所有停蓄。子母相生。侵蚀脏腑。肌肉作疮。或大便泄脓血。
致渐黄瘦。头大发直。手足细弱。从兹夭折。
王汉东曰。小儿无辜疳者。盖是饥饱劳役。风惊暑积。入邪所伤。久渐黄瘦。吃食不长肌肉。夜间多哭。身上或
发微热。多渴。不知饥饱。或生疮癣是也。
Qian Yi stated: Liver gan (Liver malnutrition) is also known as Feng gan (Wind malnutrition). The symptom manifests as a white membrane covering the eyes, and it is also called Jin gan (Tendon malnutrition), characterized by bloody diarrhea and emaciation. Heart gan (Heart malnutrition) is also known as Jing gan (Fright malnutrition), with symptoms of sallow complexion, red cheeks, and high fever. Spleen gan (Spleen malnutrition) is also known as Shi gan (Food malnutrition), presenting with a sallow complexion, distended abdomen, and pica for eating dirt; it is also called Fei gan (Fat malnutrition). The body is emaciated, sallow, dry, and accompanied by sores. The manifestations are diverse; here are some brief examples: dry eyes or formation of a white membrane, red lips, dry yellow or black skin, preference for lying on cool ground, or eating dirt, sores and scabies on the body, passage of green, white, or yellow foamy watery stool, change in stool color, abdominal fullness, hair matted into tufts, large head with a thin neck, extreme emaciation, and polydipsia. Lung gan (Lung malnutrition) is also known as Qi gan (Qi malnutrition), characterized by asthma and sores in the mouth and nose. Kidney gan (Kidney malnutrition) is also known as Ji gan (Urgent malnutrition), marked by extreme emaciation and sores/scabies, and is also called Gu gan (Bone malnutrition), with a preference for lying on cool ground.
Zeng Shirong stated: Liver gan produces eye discharge, with bluish discoloration at the hairline and left cheek, or slightly yellow sclera, and diarrhea mixed with water or resembling mossy color. Heart gan involves teeth grinding and tongue protrusion, love for drinking cold water, and a preference for lying prone on the ground. Spleen gan involves craving for cold foods, excessive thirst, sallow complexion of the whole body and face, sparse hair matted into tufts, large head with a small neck, abdominal distension with weak legs or diarrhea, emaciated muscles and lax eyelids, coolness during the day and heat at night, and anorexia for milk and food. Lung gan presents with redness and ulceration under the nose, withered and thin hands and feet, fishy breath, and whiteness of the right cheek. Kidney gan involves sores inside and outside both ears, legs resembling crane knees (genu recurvatum), unclosed cranial sutures, inability to walk, delayed tooth eruption, and foul-smelling, ulcerated sutures, which may transmit to conditions like Zouma gan (Running Horse Malnutrition).
Wang Handong stated: In treating gan generally, there is no need to strictly differentiate the five types of gan. One should tonify deficiency, clear heat, warm cold, treat vomiting when present, treat diarrhea when present, resolve accumulation when present, and expel parasites when present. These can be managed by modifying the Jisheng Wan (Accumulation-Saint Pill) formula, which has proven effective repeatedly.
The *Tai Ping Hui Min He Ji Ju Fang* (Holy Benefit Formulary for the People) states: Pediatric Wugu gan (Innocent Malnutrition) is characterized by a nodule behind the ear like a bean, which moves downward when pinched. If not removed promptly, it will endanger life. Initially, this nodule is soft and painless, containing worms resembling rice flour. With heat, it gradually enlarges; once enlarged, the tendons knot and fixate. Subsequently, the worms disperse with the flow of qi and blood. Accumulating wherever they stop, they generate offspring from parents, eroding the zang-fu organs, causing sores on the muscles, or purulent and bloody stools, leading to progressive sallow emaciation, stiff and upright hair, and weak, thin extremities, resulting in premature death.
Wang Handong stated: Pediatric Wugu gan arises from irregular diet, overwork, and pathogenic factors such as wind, fright, and summer-heat accumulation. After prolonged exposure to pathogens, the child becomes progressively sallow and emaciated, fails to gain muscle mass despite eating, cries frequently at night, may have slight fever, excessive thirst, lack of awareness of hunger and satiety, or develop sores and tinea.