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Gan disease (Pediatric malnutrition syndrome with parasitic involvement) arises from excessive consumption of sweet foods in daily diet, causing abnormal peristalsis of the intestines and stomach. Consequently, parasites are generated, eroding the zang-fu organs. This is the origin of Gan disease. All five-flavor foods enter the stomach; their qi follows the flavors corresponding to the zang-fu and returns to the Spleen. Since the Spleen and Stomach are exteriorly-interiorly related, if the diet is rich and sweet, the qi steams and causes the parasites to move. When the parasites move, they erode the body forming Gan disease. Because the parasites move due to sweetness, it is named Gan disease. The initial symptoms include vexation and pain in the hands and feet, weakness in the waist and spine, restlessness during sleep, drowsiness, dry and dim eyes, inverted dreams at night, and loss of taste for food. Upon waking, there may be dizziness and heavy body sensation. Erosion of the intestines and stomach leads to black bloody diarrhea, ulceration and rotting of the anus, and rebellious Stomach qi causing vomiting and hiccups. In acute cases, death occurs within a few days. In chronic cases, symptoms include taciturnity, painful and heavy limbs, reduced appetite, lack of luster in the complexion, internal erosion, and eventually, after several years, upward erosion causing ulcers in the mouth and teeth, and downward erosion leading to anal damage and death. There is also a classification of Five Gans: 1. White Gan, causing dry and rough skin and loss of facial luster; 2. Red Gan, internally eroding the Five Zang organs, causing brittle and dry hair; 3. Ascaris Gan, eroding the spinal marrow, wandering among the Five Zang organs, causing heaviness of the body; 4. Gan [Character missing], causing itching in the lower part and stiffness/spasm of the waist and spine; 5. Black Gan, eroding the Five Zang organs, causing frequent passage of black blood, leading to death within a few days. Among the five Gans, White Gan is the mildest, followed by Red Gan, then Ascaris Gan, then [Character missing] Gan, and Black Gan is the most severe. All types involve upward erosion from the intestines to the throat and gums with ulceration, and downward erosion to the rectum/anus with rotting and dysentery containing pus and blood. Symptoms include heat in the palms and soles, lower back pain, and somnolence; the condition is milder in autumn and winter, and more severe in spring and summer. Another view states that a greenish face with red cheeks, dull eyes, dry and cracked lips, abdominal distension with masses, and progressive emaciation indicate Gan disease eroding the Five Zang organs, often unnoticed until death. It is also said that chronic Gan disease may transform into Five Steaming disorders.

Formulas
Dingxiang San (Clove Powder), treating Five Gans steaming with dysentery.
Ingredients: Dingxiang (Caryophylli Flos), Shexiang (Moschus), Shidai (Lapis Lazuli), Shiyan (Halite), Shanyuren (Semen Ulmi Japonicae), Xiaobapi (Cortex Platycladi), Guixin (Cinnamomi Ramulus), Ganjiang (Zingiberis Rhizoma), Qingfanshi (Vitriolum), Toufa Hui (Ash of Human Hair). Equal parts.
Process: Grind into powder. Mix with warm腊月 pork fat (Note: Original text suggests mixing with dried苍耳子 or similar, translation follows literal " Cang Zhi Gan Zhe" which might be a textual error for preparation method, interpreted as mixing with pork fat for administration). Take warm. Treats Nine Steaming diseases resulting from post-epidemic illness, consumption of mutton/fatty foods/alcohol, or sexual intercourse, which ultimately transform into Gan disease. Must treat the lower part; do not neglect. Avoid raw scallions. Effective.

Wuzi Fan San (Alum Powder), treating chronic Gan dysentery unresponsive to treatment.
Ingredients: Wuzi Fan (Alumen), Huanglian (Coptidis Rhizoma), Baifan (Alumen), Longgu (Fossilia Ossis Mastodi), Yunmu Fen (Muscovite Powder), Shexiang (Moschus), Wushizi (Chebulae Fructus).
Process: Grind into powder. Take 3 Qianbi (approx. 1.5-2g) mixed with fresh ginger juice on an empty stomach, twice daily.

Shengjiang Wan (Fresh Ginger Pill), treating red and white dysentery caused by febrile epidemic qi, transforming into Gan disease.
Ingredients: Shengjiang (Zingiberis Rhizoma Recens), Lilu (Veratri Radix), Wutou (Aconiti Radix), Guixin (Cinnamomi Ramulus), Huanglian (Coptidis Rhizoma), Yunshi (Terebinthiae Resina), Daizhe (Haematitum). Equal parts.
Process: Make into powder, mix with honey to form pills the size of Sophora seeds. Take 2 pills to induce severe diarrhea. Fast the previous night. Take with cold water in the early morning; avoid food/drink afterwards. Resume eating after noon. If effective, repeat the next morning. Can be taken long-term. For weak and emaciated patients, even if passing pus and blood 100 times day and night, it will heal.

Shiliu Wan (Pomegranate Pill), treating chronic dysentery becoming Gan disease, passing white discharge, where food fails to nourish the flesh.
Ingredients: Shilipi (Pericarpium Granati), Xianshi (Quercus Conidium), Fuzi (Aconiti Lateralis Radix Praeparata), Wushizi (Chebulae Fructus), Houpo (Magnoliae Officinalis Cortex), Ganjiang (Zingiberis Rhizoma).
Process: Grind into powder, mix with rice water, roll into pills the size of Sophora seeds. Take 30 pills before meals with fresh ginger decoction, once in the morning and again later.

Kushen Gancao Tang (Sophora and Licorice Decoction), treating persistent Gan dysentery.
Ingredients: Kushen (Sophorae Flavescentis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Xunhuang (Realgar), Chi (Puerariae Flos), Congbai (Allii Fistulosi Bulbus), Shujiao (Zanthoxyli Pericarpium).
Process: Sieve the three main herbs separately. Boil Congbai, Chi, and Shujiao in 5 sheng of water to obtain 3 sheng. Add one pinch each of Kushen powder etc. to the liquid. Temperature should match body temperature. Weak patients should first sip a little Chi decoction, then lie down and slowly instill the medicine. Remain lying down for a long time; retention is best. If urgent expulsion occurs, do so on clean ground. Expect worm-like discharges resembling white horse tails with black heads, indicating efficacy. For heavy bodies or obesity, cauterize the head wrapped in willow branches. Continue taking the decoction. Cauterization near the spine, up to 30 times, leads to cure. Divine efficacy.

Treating Gan disease lasting years without cure.
Burn Wenha (mosquito larvae/clams?) to ash, mix with腊月 pig fat, and apply externally. Highly effective.

Divine Formula for Treating Wet Gan Dysentery
Ingredients: Huanglian (Coptidis Rhizoma), Linglingxiang (Lingzhi Fragrance), Xijiaoxie (Rhinocerotis Cornu Fragment), Dingxiang (Caryophylli Flos), Shexiang (Moschus), Niuhuang (Bovis Calculus).
Process: Wash Huanglian, Linglingxiang, and Dingxiang, clarify and remove dregs. Add water to make 9 sheng. Boil these four herbs for two boils. Then add Niuhuang and Shexiang, boil once. Obtain 1 sheng of liquid. Divide into three doses. If not finished, take the remainder the next day. Avoid raw/cold, sour, slippery foods, pork, and fish. No vegetables for three days.

Shexiang Wan (Musk Pill), treating chronic Gan disease with ulcers in the lower part.
Ingredients: Shexiang (Moschus), Ganjiang (Zingiberis Rhizoma), Duchen Fen (Feces of Woodworm), Kuijing (Stem of Abelmoschus), Baifan (Alumen), Xama (Bufo).
Process: Grind into powder, mix with vinegar and wheat paste to form pills the size of Sophora seeds. Take 10 pills before meals with mugwort decoction.

Wupi Tang (Five Barks Decoction), treating chronic red and white dysentery and various wet Gan diseases.
Ingredients: Huaipi (Cortex Sophorae), Taopi (Cortex Persicae), Chugenbaipi (Cortex Ailanti), Liupi (Cortex Salicis), Zaopi (Cortex Zizyphi).
Process: Finely chop. Boil 2 cups of water to 1 cup. Strain and take warm. Repeat if necessary.

Chubaipi San (Ailantus Bark Powder), enema formula for chronic dysentery becoming Gan disease.
Ingredients: Chugenbaipi (Cortex Ailanti), Dahan You (Hemp Seed Oil), Cu Jiang Dian (Sediment of Vinegar-Rice Water), Jiao (Zanthoxyli Pericarpium), Chi (Puerariae Flos).
Process: Boil Jiao and Chi in 5 sheng of water, strain to get 2 sheng. Mix with Chubaipi juice, Hemp oil, and sediment. Divide into two portions. Instill one portion into the lower part. After one day, instill the remaining portion. Use warm medicine. Diet: Only eat cooked scallions, well-cooked turnips, mustard greens, etc., for 50-60 days. Afterwards, eat with deer jerky.

Secret Formula for Treating Gan Erosion and Chronic Bloody Dysentery.
Ingredients: Gan Xiama (Dried Toad), Renshi Hui (Ash of Human Excrement), Jin Yin Tuwo (Earth Snail), Shexiang (Moschus), Yinmo (Silver Powder). Each 5 liang.
Process: Process and sieve. Apply to ulcers. Immediate cure. Avoid raw/cold and toxic foods.

For husbands, wives, and children with chronic dysentery becoming Gan disease, unresponsive to hundred medicines.
Ingredients: Dingxiang (Caryophylli Flos), Shexiang (Moschus), Huanglian (Coptidis Rhizoma).
Process: Grind into powder. Blow 1 qian into the lower part using a bamboo tube. Reduce dose for children. Cure within 3-4 applications. Alternative: Take 2 qian mixed with porridge drink before meals.

Treating Five Gans Steaming Dysentery
Ingredients: Qingdai (Indigo Naturalis), Dingxiang (Caryophylli Flos), Huanglian (Coptidis Rhizoma). Equal parts.
Process: Sieve. Mix with rice water sediment to form pills. Hold in mouth if oral ulcers exist. If lower ulcers exist, wrap in cotton... (Text incomplete).

Kushen Wan (Sophora Pill), treating Gan disease with millet-sized ulcers inside the upper lip, mental restlessness, abdominal distension, sallow complexion, somnolence, heaviness, and parasites eating the Five Zang organs.
Ingredients: Kushen (Sophorae Flavescentis Radix, 1 liang), Taobaipi (Cortex Persicae Alburnum, 3 fen), Huaibaipi (Cortex Sophorae Alburnum, 3 fen).
Process: Finely chop. Boil 3 large cups of water to 2 large cups. Strain and take before meals... (Text incomplete).

Huangfan San (Yellow Alum Powder), treating prolapse of the rectum due to Gan disease.
Ingredients: Huangfan (Calcareous Vitriol, 1 liang), Ganjiang (Zingiberis Rhizoma, 1 liang), Geliman (Creeper Stem, 1 liang).
Process: Grind into powder. Mix with melted yellow beeswax to form pills the size of jujube pits. Wrap in thin silk and insert into the lower part. Change 3 times daily. Effective.

Treating Persistent Gan Dysentery. (From *Qianjin Fang*)
Ingredients: Dama Zi (Cannabis Seed), Huma (Sesamum Seed). Each 1.5 sheng.
Process: Fry until yellow. Place in a 3-sheng clay jar sealed with thick mud. Fill with seeds. Insert 4-5 reed tubes into the mouth. Seal with honey mud. Dig a pit furnace, invert the jar over it. Catch distillate in a vessel below. Burn continuously until dawn. Cool to appropriate temperature and instill. For Gan warmth, instill 1 he into the lower part. Feeling pine aroma in the throat is good. Do not overdose. Instill every other day. Severe cases may require multiple instillations from morning to evening. Fatigue is normal. Also washes/applies to various sores, tinea, and ringworm.

Treating Gan Parasites Eroding Lower Lip with Ulcers, Somnolence, Intermittent Facial Swelling, and Unstopping Hemorrhoids Pain. (From *Shenghui Fang*)
Ingredients: Jizi (Egg), Hao Qi (Good Lacquer). 1 he of lacquer.
Process: Mix evenly. Take on an empty stomach while tilting head back. Vomiting worms indicates cure.

Treating Rectal Prolapse due to Gan Disease
Ingredients: Tao Ye (Peach Leaf, 2 liang), Fu Quan Gu (Decayed Dog Bone, 2 liang).
Process: Grind finely. Take 2 qian before meals with porridge drink.

Another Formula (From *Shenghui Fang*)
Ingredients: Gan Xiama (Dried Toad, 1 piece), Tu Fen (Rabbit Feces, 0.5 liang).
Process: Grind finely. Wrap in silk like a lotus seed. Insert into lower part. Easy to use and effective.

Treating Chronic Gan Ulcers, Emaciation approaching death. (From *Shengji Zonglu*)
Use 1 sheng of fresh sheep dung, soak in 1 sheng of water overnight. Squeeze juice next morning and take in one dose. Eat normal rice porridge at noon. Severe cases need no more than 3 doses.

Xie Bai Bing (Scallion Cake), treating Gan dysentery and various dysenteries. (From *Xu Yijian Fang*)
Take a handful of Xie Bai (Scallion White), crush raw into paste. Mix with rice flour and honey. Form cakes, roast until cooked. Take 2-3 doses. Alternative: Cook as porridge with vinegar for bloody dysentery. For patients with colorless teeth, white tongue, somnolence, dull eyes insensitive to pain/itch, or dysentery, urgently treat the lower part. Those who only attack the upper part ignore the root. Parasites in the lower part eat the anus, rotting to expose the Five Zang organs. Use hoof ash mixed with pig fat on silk, insert into lower part 2-3 times daily for cure.

Formula for Cold Gan Dysentery
Fry Langdang Zi (Datura Seed) until yellow, grind to powder. Mix with腊月 pig fat, knead well, form pills the size of jujube pits wrapped in silk. Insert into lower part. Due to... (Text incomplete).

Treating Dysentery starting with colic, then pus/blood, turning pure white or fish-brain like. Chronic cases >50 years or 1-2 years unhealed transform into Gan. Discharge like rice water sediment... (Text incomplete).
Use 1 raw lamb liver, peel membrane, slice. Take on empty stomach in the morning. Stop if heart feels stifled; continue if not. Ideally, fast from porridge/rice for one day consuming only this liver. Otherwise, eat with ginger relish. One liver daily for 2-3 days leads to permanent cure.

Kushen San (Sophora Powder) (From *Shengji Zonglu*), treating Gan disease eroding the lower part, affecting all Five Zang organs, dysentery with pus/blood, general discomfort, body pain, facial... (Text incomplete).
Ingredients: Kushen (Sophorae Flavescentis Radix), Fanshi (Alumen calcined until dry), Qingxiangzi (Celosiae Semen). Each 0.5 liang. Lilu (Veratri Radix, 1 fen).
Process: Grind to powder. Take approx. 2 qian, blow into lower part via bamboo tube, 2-3 times daily. Children take 1 qian.

Zhudan Jian (Pig Gall Bladder Decoction) (From *Shengji Zonglu*), treating Gan disease attacking from lower part, clearing heat and killing parasites.
Ingredients: Zhudan (Pig Gall Bladder, 1 piece), Mi Cu (Rice Vinegar, 5 he).
Process: Boil vinegar until rolling boil. Add gall bladder juice, boil 3-5 times. Drink full mouthful. Parasites die, cure achieved.

Treating Gan Disease. Regardless of location, all treated. (From *Shengji Zonglu*)
Burn dead toads to ash, grind to powder. Apply with oil to ulcers. Alternative: Mix with good vinegar and apply, 3-5 times daily for cure.

Treating Day and Night Non-stop Gan Dysentery. (From *Ben Cao*)
Instill approx. one eggshell of concentrated Ailantus root juice mixed with one egg of millet rice water into the lower part. Cure after second application. Verification is divine. Reduce dose for children. Very... (Text incomplete).

Treating Severe Gan Dysentery
Grind Chubaipi (Ailantus Bark) into flour, mix into small pellets, sun-dry briefly, mix again. Repeat water-soaking/mixing three times. Boil until cooked. Add salt, vinegar, and 1 cup of wine. Take frequently.

Treating Chronic Dysentery Becoming Gan Disease
Take Hufen (Lead Carbonate) mixed with water and egg white. Stop when stool turns black, to kill parasites and stop dysentery.

Treating Gan Parasites, also treating Intestinal Wind, Epileptic Blood, and Hot Dysentery.
Fry Kushen (Sophorae Flavescentis Radix) until smoking, grind to powder. Take with rice drink.

Treating Gan Dysentery
Boil Sour Millet Rice Water with Stinky Ailantus Bark.

Treating Various Ulcers in Abdomen due to Gan Dysentery
Boil Chai Pi (Jackal Skin) to make decoction to drink. Or burn to ash, mix with wine to take. Ash can be applied to gum ulcers.