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[Song]
The five types of Gan disease (Gan syndrome, a chronic malnutrition disorder in children) affecting the Heart, Lung, Liver, Spleen, and Kidney present with emaciation and dry hair. The limbs are withered and thin, urine is milky, the abdomen is distended with visible subcutaneous veins, and there is excessive appetite.
Heart Gan: Dry mouth, frequent high fever, frightfulness, red face, and irritability.
Liver Gan: Shaking head, rubbing eyes, formation of corneal membranes, erect hair, and cyanotic tendons.
Lung Gan: Cough, coarse breathing, frequent asthma, rattling phlegm in the lungs, alternating chills and fever.
Kidney Gan: Sores and scabies all over the body, ghost-like appearance, cold feet, and receding gums.
Spleen Gan: Abdominal fullness, coarse breathing, frequent diarrhea, craving for eating soil due to Spleen deficiency.
Labor Gan (Lao Gan): Tidal fever, bone-steaming fever, night sweats, emaciation, and yellowish complexion.
Spine Gan: Pain in the spine like being sawed, sores on the backs of fingers.
Brain Gan: Heat in the head, bulging fontanelle.
Dry Gan: Dry mouth and thirst, difficult defecation.
Heat Gan: Scanty and painful urination, body feeling like fire, frequent diarrhea (to be distinguished as Cold Gan).
Intestinal Roundworm Gan: Itchy teeth, frequent crying, purple lips and mouth, roundworms coiled in the intestines and stomach.
Dingxi Gan: Thin neck, sunken fontanelle, wasted muscles, preference for sitting high, everted umbilicus.
Bulu Gan: Severe alternating deficient heat, splitting of cranial sutures, vomiting, and gastric obstruction.
Wugu Gan: Lumps behind the ears and on the neck; if not ruptured, treatment is difficult.

[Dissertation]
Children's Zang-Fu organs are tender and delicate, and their intestines and stomachs are fragile. They are easily injured by diet. Once dysregulated, few escape developing Gan disease. Generally, indulgent eating of sweet and fatty foods damages the Spleen and Stomach. When the Spleen and Stomach become deficient, food cannot be transported and transformed. Undigested food leads to abdominal distension, diarrhea, generation of heat, accumulation, and phlegm. Consequently, muscles waste away daily, Qi and Blood diminish daily, and Yuan Qi (Original Qi) is damaged, leading to bone-heat and vexatious steaming. Alternatively, young children lacking breast milk who are fed porridge or drinks too early consume their Form and Qi. These two factors initiate Gan disease. If prolonged, it often becomes incurable.
The manifestations of Gan disease vary. Ancient texts mention "Five Gans," referring to transmission into the Five Zang organs.
Heart Gan: Yellow face, red cheeks, vexation, fullness, high fever, irritability, fright, and mouth ulcers.
Liver Gan: Shaking head, rubbing eyes, white membrane covering the pupil, sleeping face-down, sweating, green-yellow complexion, erect hair, cyanotic tendons, brain heat, and emaciation.
Spleen Gan: Abdominal distension, coarse breathing, sour-smelling diarrhea, craving for eating soil.
Lung Gan: Cough, rebellious Qi, frequent asthma, rubbing nose, grinding teeth, alternating chills and fever.
Kidney Gan: Extreme emaciation, sores and scabies all over the body, swollen teeth, receding gums, even gum ulceration and detachment (commonly known as Running Horse Gan), accompanied by chills/fever, hot head, and cold feet. These constitute the Five Gans.
Beyond the Five Gans, there is Heat Gan: Tidal fever like fire, constipation.
Cold Gan: Frequent diarrhea with abdominal pain, incessant deficient sweating.
Gan Labor (Gan Lao): Bone-steaming tidal fever, night sweats, abdominal urgency, yellow face, emaciation, food failing to nourish the flesh.
Spine Gan: Worms eroding the spine, hot yellow emaciation, vexatious heat with dysentery, spine feeling like a saw, sores on ten fingers, frequent nail-biting.
Brain Gan: Head stuffiness and heat, sores all over the head, sweating, swollen fontanelle.
Dry Gan: Emaciation with blood deficiency, dry tongue, immobile pupils, dry crying with body heat, cold hands and feet, dry skin, constipation, drooping mouth, and dull eyes.
Gan Thirst: Wind-heat Gan pathogen in the viscera, exacerbated by the nursing mother consuming pungent spices, alcohol, wheat products, and fried foods, causing congestion and heat in the child's Heart and Lung. During the day, excessive thirst and drinking water occur, with poor appetite; at night, thirst ceases.
Gan Diarrhea: Scorched hair, white lips, blue lines on the forehead, abdominal distension, borborygmus, and diarrhea.
Gan Dysentery: Accompanied by external pathogens or retained stagnation, frequent passage of foul dysentery.
Gan Edema: Deficiency with accumulation, toxin combined with Qi, causing edema of the abdomen, head, face, and limbs.
Roundworm Gan: Frequent crying, vomiting clear fluid, abdominal pain and distension, purple-black lips and mouth, itching of the anus and teeth.
Dingxi Gan: Extremely thin extremities, thin neck, preference for sitting high, wasted muscles, protruding umbilicus, crying, sunken chest, or formation of grain-like masses, craving raw rice.
Bulu Gan: Alternating deficient heat, splitting cranial bones, regurgitation and vomiting worms, vexatious thirst, vomiting, and hiccupping.
Wugu Gan: Lump like a bean behind the ear and on the neck, movable upon pressure, soft and painless, containing worm-like particles resembling rice flour. If not promptly ruptured, the worms scatter with the heat pathogen, corroding the viscera, leading to limb abscesses, pus and blood in stool, high fever, emaciation, exposed skull bones. Initially, puncture with a needle and apply plaster. This disease arises from washing clothes and leaving them under the eaves, where they are contaminated by feathers from the "Wugu" bird; when the child wears these clothes, worms enter the skin. If clothes are dried with fire, this risk is avoided. All such cases belong to Gan syndromes.

Fushen Pill
Treats Heart Gan and Fright Gan.
Fushen, Hupo (Amber), Huanglian, Lvhui, Chifuling (each 3 qian), Yuanzhi (processed with ginger), Changpu (each 1 qian), Shexiang (a little), Xiamembrane (roasted), Goutengpi (each 2 qian).
Grind into powder, make pills with rice paste, size of hemp seeds. Take 10 pills per dose, washed down with Mint Decoction.

Da Lvhui Pill
Treats Liver Gan, kills parasites, harmonizes the Stomach, stops diarrhea, and also treats Spine Gan.
Lvhui (ground), Hulian, Chuanlian, Wuyi (de-seeded), Qingpi, Muxiang, Leshe (lightly stir-fried), Leiwan (broken open, white ones are good, red ones are toxic and should not be used; equal parts), Shexiang (a little), Sharen (half dose).
Grind into powder, make pills with rice paste, size of mung beans. Take 10-20 pills per dose, washed down with Rice Drink.

Qingfei Yin
Treats Lung Gan, heat penetrating the nostrils, foul-smelling discharge, or growth of fleshy polyps.
Zisu, Qianhu, Huangqin, Danggui, Lianqiao, Fangfeng, Chifuling, Shengdi, Tiandong (heart removed), Gancao (roasted), Jiegeng (each 1 liang), Sangpi (stir-fried, 0.5 liang).
Finely chop, take 2 qian per dose, decoct in water, take after meals.

Fei'er Pill
Treats Spleen Gan and Food Gan. For treating all types of Gan, see modification methods below.
Maiya, Shenqu, Shijun, Hulian, Muxiang, Binglang, Rouguo.
If parasites: add Leshe, Leiwan, Hufen, Kulougen.
If excess accumulation: add Sanleng, Pengru, Zhishi, Houpo.
If eye pain: add Muzei, Longdan, Cheqian.
If abdominal distension: add Luobozhong, Hamagan.
If edema: add Chifuling, Huashi, Sangpi.
If Spleen deficiency with diarrhea and failure to gain weight: add Sizijunzi Tang.
If Lung heat with cough, tidal fever, bone-steaming, epistaxis, night sweats: add Baishao, Shengdi, Huangqin, Zhimu, Yinchaihu, Diguteng, Maidong.
If thirst: add Tianhuafen, Wumei.
If Blood deficiency with weak pulse and spirit fatigue: add Danggui, Shudi, Renshen, Ziheche.
Grind into powder, make pills size of longan seeds. Take one pill per dose, dissolve in aged rice soup on an empty stomach.

Jiuwei Dihuang Wan
Treats Kidney Gan.
Shudi (4 liang), Chifuling, Shanzhuyu, Chuanlianzi, Danggui, Chuanxiong, Danpi, Shijunzirou, Shanyao (each 2 liang).
Grind into powder, make honey pills size of wutong seeds. Take 70-80 pills per dose, wash down with warm wine on an empty stomach.

Zouma Yagan Formula (Authentic Transmission by Teng)
Wubeizi (roasted), Renzhongbai (calcined), Kufan, Feidan (roasted until purple), Qingfen (a little), Piannao (a little).
Grind together evenly, apply to the affected area.

Buru Disease (Appendix)
When a nursing infant is still breastfeeding while the mother is pregnant, the infant may suffer from emaciation, skeletal prominence, yellowish complexion, high fever, and irregular bowel movements. This is called Buru Disease. Also, carrying another child during pregnancy can cause this. First, wean the infant, then administer Xiaoru Wan (see Bianzheng chapter) and Yigong San.

Yigong San
Consists of Sizijunzi Tang plus Chenpi.