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Gan disease, referred to as "dryness," is well known to everyone. However, people do not know that "dryness" arises from "dampness," "dampness" arises from the deficiency of Spleen Earth (Pi Tu), and the deficiency of Spleen Earth arises from irregular diet. The irregular diet, in turn, stems from parents' love for their children, fearing they might go hungry or thirsty. Generally, infants have weak Zang-Fu organs; if they can digest one He (a unit of capacity) of food, providing one and a half He will exceed their digestive capacity, leading to Qi stagnation in the Spleen. Furthermore, when infants first begin to eat, they love food upon seeing it, indiscriminately choosing between refined and coarse foods, and lacking a sense of satiety. When the Spleen Qi becomes stagnant and unsmooth, presenting symptoms of tension or spasm, parents still mistake this for hunger or thirst and force-feed them. Day by day, the Spleen fails to transform the Qi of water and grain due to stagnation. As the transformation of water and grain Qi fails, the Spleen becomes more stagnant, failing to transport fluids for the Stomach, causing dampness to accumulate. Earth dislikes dampness; thus, when dampness accumulates, both the Spleen and Stomach are diseased. The Middle Jiao receives the Qi of water and grain, extracts its essence, transforms it into red fluid, which is called Blood. If the Middle Jiao cannot receive the Qi of water and grain, it cannot generate Blood, leading to dryness of the Blood. Moreover, the essence of water and grain enters internally to the Five Zang organs, becoming their fluids; the fierce Qi of water and grain travels outward along the Taiyang channel, defending against external pathogens, thereby becoming Wei Qi (Defensive Qi). If the Middle Jiao is injured and cannot scatter the essence, the fluids of the Five Zang organs will also become dry; if it cannot circulate the fierce Qi, Wei Qi will become deficient. Deficient Wei Qi leads to excessive sweating; excessive sweating further depletes Ying Blood (Nutritive Blood). Due to Blood deficiency, the limbs become emaciated day by day. Meanwhile, dampness accumulates in the Middle Jiao without transforming, causing abdominal fullness. As the abdomen becomes fuller daily, the limbs become thinner. Hence, it is said that "dryness arises from dampness." If physicians can recognize that "dryness arises from dampness" and "dampness arises from Spleen Earth deficiency," and are too busy supporting the Earth to even consider using bitter-cold herbs recklessly, which would severely damage Stomach Qi and excessively drain Spleen Qi! Treatment methods should follow the teachings of Li Dongyuan, Qian Yi, Chen Wenzhong, Xue Ji, and Ye Tianshi, who truly inherited the heart-method of Zhang Zhongjing. The first excellent method is to soothe and tonify the Middle Jiao; the second is to regulate the ascending and descending of Stomach Qi; the third is to raise the sinking Spleen Yang; the fourth is to nourish the Stomach with sweet and bland flavors; the fifth is to harmonize Ying and Wei Qi; the sixth is to beat drums after meals to stimulate Spleen Yang (this aligns with the ancient meaning of using music to assist eating, stirring up Yang Qi to facilitate its function); the seventh method, as stated in the Nan Jing (Classic of Difficult Issues), is to regulate diet for those who have injured their Spleen and Stomach; the eighth method, if Gan worms are indeed present, is to use small amounts of bitter-cold, sour, and acrid herbs such as Aloe (Lü Hui), Coptis chinensis var. barbinervis (Hu Huang Lian), Mume fruit (Wu Mei), Quisqualis indica (Shi Jun Zi), and Sichuan pepper (Chuan Jiao); however, using bitter-cold herbs to kill worms immediately upon seeing Gan disease is an error. Examining the works of Zhang Yizhi (Jiegu) and Li Gao (Dongyuan), they often used pill forms to slowly transport Spleen Yang and gently diffuse Stomach Qi, likely because pills have tangible residue, differing from decoctions, which constitutes the ninth method.

Recently, a formula has been circulating in the capital: three qian of whole Scorpion (Quan Xie), dried and powdered. Take four liang of lean beef, form several meatballs, add a small amount of scorpion powder, steam until cooked, and feed to the child daily until the scorpion powder is exhausted. This treats Gan disease with remarkable efficacy. I reason that the scorpion is green, corresponding to Wood, and belongs to the Liver channel. It is good at burrowing and loosening the Earth, possesses Yin nature, and connects with Yin collaterals, making it excellent for treating long-standing Spleen stagnation affecting the collaterals. However, its nature is fierce and toxic. Beef is sweet and warm, receiving the essence of Kun Earth, making it best at tonifying Earth. It inherits the integrity of the stallion, possessing a vigorous and compliant nature, capable of both tonifying the substance of the Spleen and promoting its functional movement. With the scorpion, the beef becomes more vigorous; with the beef, the scorpion loses its fierceness. One unblocks, one tonifies; they complement each other to achieve success, and can be kept as a backup option. A single-herb formula, Golden Chicken Powder (Jin Ji San), is also excellent (using Ji Nei Jin [Gizzard lining] that has not been washed with water, in any quantity, dried and powdered, added to any food; it has the property of killing parasites and grinding accumulation. Ji Nei Jin is the stomach of the chicken and can restore the natural function of the Spleen). Children with Gan disease may crave eating raw rice, yellow earth, smelted stone, paper, cloth, etc. This is because children are ignorant and eat whatever is available when they first start eating. The Spleen cannot transport it, leading to worm generation over time, which increases the craving. This entirely depends on caregivers guiding them cautiously beforehand. If the disease has already occurred, the treatment must temporarily transport Spleen Yang, and if worms are present, administer anti-parasitic herbs concurrently. Crucially, prevent further consumption of these items to push out the old and bring in the new, changing the nature of the Zang-Fu organs and restoring their original true Qi. This is the optimal approach.