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Accumulation of grain qi forms *gan* (malnutrition syndrome), leading to hyperactive liver qi and flaming wood-fire, which scorches lung metal and overacts on spleen earth, damaging the five zang organs. Symptoms include abdominal distension with emaciated muscles, hoarse voice accompanied by constipation, and in severe cases, blindness and death; physicians must examine these details carefully.

The term "Gan" is homophonous with "Gan" (sweet/greasy), referring to a disease named after the consumption of rich, greasy, and delicious foods. Gan accumulation is often discussed in contrast to cold-bitter conditions. In infants who do not suffer from exterior syndromes such as Cold Damage (*Shanghan*) or Malaria, yet present with fever, irritability, and thirst, gradual emaciation of muscles, visible tendons, erect hair, abdominal fullness with difficult defecation, sclera showing blue, yellow, or dry/withered hues, corneal opacity resembling post-mortem appearance, slight redness around the limbus, photophobia with inability to open eyes, frequent blinking of eyelids, and sticky discharge like paste, followed finally by a white membrane appearing on the wind wheel (cornea) with black halos rotating upon it, ultimately resulting in blindness. The progression follows this sequence, confirming the diagnosis of Gan eye without doubt. The root of this disease lies in spleen earth; when spleen earth becomes dry and hot, it stagnates liver wood; when liver wood is stagnated, wind and fire cannot dissipate, thereby harming all zang-fu organs and酿 (brewing) this disaster. Predecessors stated that excessive food intake confounds spleen earth and subsequently hinders liver qi; using *Quzhi Wan* (Medicated Leaven Pills) containing *Qu* (Medicated Leaven) and *Wuyi* (Pseudolarix Bark) aims to prevent the development of Gan. If the face is not significantly sallow or thin, eyelids can open and close normally, and the membrane/halo is shallow, one should not treat only the eyes. Instead, use *Baoying Wan* (Infant Protection Pills) or *Zhizhong Xuanhua Wan* (Regulate Middle and Transform Stagnation Pills) to directly treat Gan; once Gan is resolved, the eye condition will gradually heal. Although Gan is difficult to expect rapid recovery, mothers should not disregard frequent illnesses nor indulge children due to rare illnesses. Fathers, if they fail to prevent potential disasters before they occur, repeating past mistakes, leading to infant blindness and death without mourning, is truly lamentable!

Gan presents as either fat-type or thin-type, regardless of cold or heat patterns. Fat-type Gan features robust physique and qi, minimal chest/abdominal heat, and usually unobstructed urination and defecation; Thin-type Gan features very slender limbs, thin neck, and flat buttocks, with obstructed urination and defecation. Ultimately, both stem from spleen-stomach deficiency and failure to transport and transform dietary nutrients, or irregular eating habits damaging the spleen-stomach, generating phlegm and heat, which transform into wind or parasites. Treatment must focus on resolving accumulation, clearing toxicity, and expelling parasites, proceeding step-by-step; occasional recoveries do occur. Medical texts mention "Cold Gan" but lack differentiation for "Fat Gan." Cold Gan involves internal cold, requiring hot treatment; Fat Gan suggests qi deficiency, necessitating caution against diarrhea/dysentery; applying both tonification and astringency would aid the pathogen and accelerate death.