庄氏家传曰。第一候。泻脓血。日渐瘦。是冷热疳。第二候。脚细肚高。胸前骨生。爱吃泥土酸咸。日久通身黄。
时时吐逆下利。腹内疼痛。是脾疳。第三候。鼻下赤烂。爱揉眼兼血痢。是肺疳。乃因吃热物。或病乳所伤心肺。加之
咳嗽。更服凉冷药过多。便上热下冷。渐渐昏沉。日夜烦哭。第四候。皮虚皱。面无颜色。身上燥痒。心烦。第五候。
毛发稀疏。鼻内生疮。是肺疳。第六候。头生疮。发稀焦。是肝疳。第七候。牙变黄赤不定。是肾疳。第八候。发焦干
鼻下生疮。是肺疳。第九候。咬指甲。毛发作穗。四肢沉重。是心疳。第十候。齿虫蚀。肚上筋生。是骨槽疳。第十一
候。肚逆腹胀。是胃疳。又名奶疳。第十二候。牙龈臭烂。面无颜色。不思食。是脾疳。又名口疳。第十三候。爱合面
卧。多睡如醉。腹胀气急。因曾吃生肉。腹内有虫。是心脾疳。第十四候。鼻内干燥疼痛。口
中臭气。牙根有鲜红血。是肝肺疳。第十五候。脚细肚高并青筋。是脾疳。第十六候。非时生疮。爱吃冷水。是热疳。
第十七候。皮肤上生粟子。粪中米出。是脾冷疳。第十八候。气满腹胀。及口干。是心胃疳。第十九候。爱吃生米面炭
砖瓦。是脾胃疳。第二十候。揉鼻揩眼。咬指甲。爱饮水。是肝渴疳。第二十一候。多寒热。爱卧不起。是骨热疳。第
二十二候。爱饮水。目不开。是肝疳。第二十三候。肌体或热或凉。发渴无时。是急疳。第二十四候。牙根黑。唇懒开。
开则赤。是心疳积热。
According to the Zhuang family tradition:
The first presentation involves diarrhea with pus and blood, and gradual emaciation; this is Cold-Heat Gan (Gan syndrome of cold and heat).
The second presentation involves thin legs and a distended abdomen, protrusion of the chest bones, craving for dirt and sour/salty foods, yellowing of the whole body after a long time, frequent vomiting and diarrhea, and abdominal pain; this is Spleen Gan.
The third presentation involves redness and ulceration under the nose, a desire to rub the eyes accompanied by bloody dysentery; this is Lung Gan. It arises from consuming hot-natured foods or breastfeeding while ill, which damages the Heart and Lungs, compounded by coughing and excessive intake of cold/cooling medicines, leading to upper heat and lower cold, gradual drowsiness, and restlessness with crying day and night.
The fourth presentation involves flaccid, wrinkled skin, lackluster complexion, dry itching over the body, and mental restlessness.
The fifth presentation involves sparse hair and sores inside the nose; this is Lung Gan.
The sixth presentation involves sores on the head, sparse and scorched hair; this is Liver Gan.
The seventh presentation involves teeth changing color, varying between yellow and red; this is Kidney Gan.
The eighth presentation involves scorched, dry hair and sores under the nose; this is Lung Gan.
The ninth presentation involves nail-biting, hair forming tufts, and heavy limbs; this is Heart Gan.
The tenth presentation involves teeth being eaten away by worms and tendons visible on the abdomen; this is Bone Trough Gan.
The eleventh presentation involves rebellious stomach Qi and abdominal distension; this is Stomach Gan, also known as Milk Gan.
The twelfth presentation involves foul-smelling, rotting gums, lackluster complexion, and loss of appetite; this is Spleen Gan, also known as Mouth Gan.
The thirteenth presentation involves a preference for sleeping face down, sleepiness resembling drunkenness, abdominal distension, and rapid breathing. This is due to having consumed raw meat, resulting in intestinal parasites; this is Heart-Spleen Gan.
The fourteenth presentation involves dryness and pain inside the nose, foul breath, and fresh red bleeding from the gum roots; this is Liver-Lung Gan.
The fifteenth presentation involves thin legs, a distended abdomen, and exposed blue veins; this is Spleen Gan.
The sixteenth presentation involves sores appearing out of season and a craving for cold water; this is Heat Gan.
The seventeenth presentation involves millet-like bumps on the skin and undigested rice grains in the stool; this is Cold Spleen Gan.
The eighteenth presentation involves Qi fullness, abdominal distension, and dry mouth; this is Heart-Stomach Gan.
The nineteenth presentation involves cravings for raw rice/flour, charcoal, bricks, and tiles; this is Spleen-Stomach Gan.
The twentieth presentation involves rubbing the nose and eyes, nail-biting, and a desire to drink water; this is Liver-Thirst Gan.
The twenty-first presentation involves alternating chills and fever, and a preference for lying still without rising; this is Bone Heat Gan.
The twenty-second presentation involves a desire to drink water and inability to open the eyes; this is Liver Gan.
The twenty-third presentation involves the body feeling either hot or cold at times, and thirst occurring irregularly; this is Acute Gan.
The twenty-fourth presentation involves blackened gum roots, relaxed lips that are reluctant to open, and redness upon opening; this is Heart Gan with accumulated heat.