成疳。治疳之法，量候轻重，理其脏腑，和其中脘，顺其三焦，使胃气温而纳食，
益脾元壮以消化，则脏腑自然调贴，令气脉与血脉相参，壮筋力与骨力俱健，神清
气爽，疳消虫化，渐次安愈。若以药攻之五脏，疏却肠胃，下去积毒，取出虫子，
虽曰医疗，即非治法，盖小儿脏腑虚则生虫，虚则积滞，虚则疳羸，虚则胀满，何
更利下，若更转动肠胃致虚，由虚成疳，疳虚证候，乃作无辜，无辜之孩，难救矣。
〔薛〕疳者，干也，因脾胃津液干涸而患，在小儿为五疳，在大人为五劳，总以调补胃气为主。
后列诸方，其证候庞杂，不能名为何等疳者，即于通治诸疳方内检之，若证候
的与五疳等条下证候对者，即检本疳方，分寒热虚实，择而用之，常须识此，勿令误也。
杨氏云∶肝疳者，由乳食不调，肝脏受热所致也。若乳母寒温不调，滋味不节，
或外感风寒，内伤喜怒，邪气未散，遽以乳儿，多成风疳。肝者，眼之候，上膈伏
热，痰涎壅滞，以致肝风入眼，赤肿翳生，眵泪烂眶，痛痒揉擦，昏暗雀盲，甚至
经月合眼，亦名疳眼。外证摇头揉目，白膜遮睛，眼青泪多，头焦发竖，筋青脑热，
甲痒筋挛，燥渴汗多，下痢疮癣是也。钱氏以地黄丸主之（肾）。杨氏以天麻丸、生
熟地黄汤、主之。曾氏调肝，用 归汤。
天麻丸 治肝疳、风疳、疳眼。
青黛 川黄连 天麻 五灵脂 夜明砂（微炒） 川芎 芦荟（各二钱） 龙胆草 防风
蝉蜕（去足。各一钱半） 全蝎（二枚，焙） 麝香（少许） 干蟾头（炙焦，三钱）
上为末，猪胆汁浸糕，丸麻子大。每服十丸，薄荷汤下。
生熟地黄汤 治疳眼闭合不开，内有朦雾。
生地黄 熟地黄（各半两） 川芎 赤茯苓 枳壳（炒） 杏仁（水浸，去皮） 川黄连 半夏曲
天麻 地骨皮 甘草（炙） 当归（各二钱半）
上锉散。每服二钱，生姜三片，黑豆十五粒，水煎，温服。
归汤 治小儿禀赋素弱，豆疮出不快者。及肝虚目视不明。
黄 （一两，蜜水涂炙） 当归（酒洗焙干） 白芍药 川芎（各半两） 甘草（三钱，炙）
上件， 咀。每服二钱，水一盏，煎七分，无时温服。
〔张涣〕熊胆天麻丹 治风疳羸瘦，摇头揉目，百脉拘急。
天麻 羌活 真熊胆 蝉壳 使君子（去壳） 胡黄连（各一两） 芦荟 干蟾（酥炙黄，各半两）
上件捣，罗为细末，粳米饭和，如黍米大。每服十粒，煎荆芥汤下，量儿大小加减。
乌蟾丹
乌蛇（酒浸去皮骨，炙令黄） 干蟾（酥、炙黄） 蛇蜕皮（烧灰。各一两） 胡黄连（半两，以上，捣罗为细末，
次用） 真芦荟 麝香 熊胆（各二钱半并细研）
上件，同拌匀，以粟米饮和，如黍米大。每服十粒，煎薄荷汤下，乳前。
《庄氏家传》治小儿风疳，顺肝气，进饮食。芦荟丸
芦荟（一钱，别研秤，或只以皂角水磨） 草龙胆（一两，净洗，锉、焙干秤）
上件药一处捣罗为末，用不 皂角三铤，以水二升 汁，用生绢滤去滓，入银
器内慢火熬成膏，入前二味药调和得所，丸如绿豆大。每服三丸至五丸，薄荷汤吞下。
《汉东王先生家宝》治小儿风疳，气攻项下生核子。皂角膏方
皂角（大者、一茎，烧，存性） 糯米（一合，炒黑色） 草乌头（二钱，生） 黄皮（一钱，炒黑色）
上为末。每用不拘多少，以井华水调贴。如未安，须用水精丹取后，用调气、
观音、人参散、等药补，仍再贴，兼与疳药相间服。
神妙观音散 补虚，调胃气，进乳食，止吐泻，久不进食。
白扁豆（微炒） 石莲肉（炒，去心） 人参（焙。各一分） 茯苓（一钱半，焙） 甘草（炙） 香白芷 绵黄
（捶碎，用蜜水拌炙） 木香（炒。各一钱） 神曲（二钱）
上为末。每服婴孩一字，二三岁半钱，四五岁一钱，用水一药注或半银盏，枣
子半片，煎十数沸，服。
人参散 补虚，谓胃气，进乳食，止吐泻。
人参 茯苓 莲肉（去心、炒。各一分） 黄 （半两，捶，蜜水拌炙） 甘草（二钱，炙）
上为末。每服婴孩一字，二三岁半钱，四五岁一钱，以水一药注或半银盏，入
枣子半片，煎十数沸，服。
庄氏第六候头生疮，毛发稀焦，是肝疳方
肉豆蔻 蟾灰（全者。各一个） 桔梗（炮） 茯苓（煨） 大黄（煨。各一两） 龙脑 麝香（各一钱）
上，为末，软饭丸，如麻子大。粟米饮下三丸。只可两服。
治小儿手足动，眼目不开，有时语笑，或即嗔怒，兼多惊，手指甲青，状形似死，妄称天 。
通神丸
茯苓 龙齿（各。煨半两） 铅丹 胡黄连（各一分） 银箔（五片） 麝香（一钱） 钓藤（一两，煨）
上为末，炼蜜丸，麻子大。每十丸，米饮下。（庄氏第二十二候用此方）
第三风疳，小儿手足拘挛，眼目不开，有时自笑，或嗔怒惊叫，手爪甲青，状似鬼
形，已似天 。须服金箔茯苓散
金箔（五片） 茯苓 牛膝 胡黄连（各一两） 龙骨（一分） 木香 麝香（各一钱）
上件为末。每服一字，米饮下，日二服。忌油腻。
Formation of Gan syndrome (malnutrition syndrome). The method for treating Gan syndrome involves assessing the severity, regulating the Zang-Fu organs, harmonizing the Zhongwan (Middle Jiao/Spleen and Stomach), and smoothing the Sanjiao (Triple Burner/Qi mechanism of upper, middle, and lower jiao), so that the Stomach Qi becomes mild and capable of accepting food, and the Spleen Yuan is strengthened to aid digestion. Consequently, the Zang-Fu organs will naturally coordinate, Qi and blood vessels will interconnect, sinews and bones will become strong, spirit clear, Gan accumulation eliminated, parasites transformed, and gradual recovery achieved. If one uses drugs to attack the Five Zang organs, drain the intestines and stomach, purge accumulated toxins downward, or extract parasites, although this may be considered medical treatment, it is not the correct therapeutic method. This is because children's Zang-Fu organs are deficient, leading to parasite generation; deficiency leads to stagnation; deficiency leads to emaciation in Gan syndrome; deficiency leads to distension. Why employ purgative methods? If one further disturbs the intestines and stomach causing more deficiency, deficiency transforms into Gan syndrome, and the deficiency manifestations of Gan syndrome evolve into "Wugu" Gan (a severe form of malnutrition with complications). A child with Wugu Gan is difficult to save.
[Xue Ji] Gan implies dryness; it arises from the depletion of fluids in the Spleen and Stomach. In children, it is called the Five Gans; in adults, it is called the Five Labors (Wu Lao). The primary approach is always to regulate and tonify Stomach Qi.
The formulas listed below address complex symptoms that cannot be clearly categorized as a specific type of Gan. For such cases, consult the general formulas for Gan syndromes. If the symptoms precisely match those described under the sections for the Five Gans, select the specific formula for that Gan, differentiate between cold, heat, excess, and deficiency, and choose accordingly. One must constantly bear this in mind to avoid errors.
Yang Shi stated: Liver Gan is caused by irregular breastfeeding and diet, resulting in heat in the Liver. If the nursing mother has irregular warmth and cold, consumes improper flavors, or suffers from external wind-cold invasion and internal emotional injury (anger or joy), and if the pathogenic factors have not dissipated before breastfeeding the infant, it often results in Wind Gan. The Liver opens into the eyes and manifests in them. Upper diaphragm latent heat and phlegm-saliva obstruction cause Liver wind to enter the eyes, leading to redness, swelling, pterygium formation, discharge, tearing, orbital ulceration, pain, itching, rubbing, dim vision, nyctalopia (night blindness), and even eyes closed for months, also known as Gan Eye. External signs include head shaking, eye rubbing, white membrane covering the pupil, bluish eyes with excessive tears, scorched scalp with erect hair, cyanotic sinews with brain heat, itchy nails with tendon spasms, dry thirst with profuse sweating, dysentery, sores, and tinea. Qian Yi advocated using Dihuang Wan (Rehmannia Pill) as the main treatment (to nourish Kidney Yin). Yang Shiyang advocated Tianma Wan (Gastrodia Pill) and Shengshu Dihuang Tang (Raw and Cooked Rehmannia Decoction). Zeng Shirong advocated regulating the Liver using Siwu Tang (Four Substance Decoction).
Tianma Wan treats Liver Gan, Wind Gan, and Gan Eye.
Qingdai (Indigo Naturalis), Chuan Huanglian (Coptidis Rhizoma), Tianma (Gastrodiae Rhizoma), Wulingzhi (Trogopterori Faeces), Yeming Sha (Pharisiopsis Ocellatae), Chuanxiong (Ligustici Chuanxiong Rhizoma), Lushui (Aloe), each 2 qian; Longdancao (Gentianae Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Chantui (Cicadae Periostracum, feet removed), each 1.5 qian; Quanxie (Scorpio), 2 pieces, roasted; Shexiang (Moscus), a small amount; Ganchan Tou (Bufo bufo head), roasted until charred, 3 qian.
Grind into powder, soak cake in Pig Bile, and make pills the size of hemp seeds. Take 10 pills per dose, washed down with Mint Decoction.
Shengshu Dihuang Tang treats Gan Eye where the eyes remain closed with internal mistiness.
Sheng Dihuagn (Rehmanniae Radix), Shu Dihuang (Prepared Rehmanniae Radix), each 0.5 liang; Chuanxiong (Ligustici Chuanxiong Rhizoma), Chi Fuling (Poria with Red Host), Zhike (Aurantii Fructus, stir-fried), Xingren (Armeniacae Semen Amarum, soaked in water, skin removed), Chuan Huanglian (Coptidis Rhizoma), Banxia Qu (Pinelliae Fermentatum), Tianma (Gastrodiae Rhizoma), Digupi (Lycii Cortex), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted), Danggui (Angelicae Sinensis Radix), each 2.5 qian.
Cut into coarse pieces. Take 2 qian per dose, with 3 slices of fresh ginger and 15 black soybeans, decocted in water, taken warm.
Siwu Tang treats infants with innate weakness who fail to erupt measles/chickenpox properly, and Liver deficiency causing unclear vision.
Huangqi (Astragali Radix, 1 liang, coated with honey water and roasted), Danggui (Angelicae Sinensis Radix, wine-washed and dried), Baishaoyao (Paeoniae Radix Alba), Chuanxiong (Ligustici Chuanxiong Rhizoma), each 0.5 liang; Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian, roasted).
Chop the ingredients. Take 2 qian per dose, decocted in one cup of water until reduced to 70%, taken warm at any time.
[Zhang Huan] Xiongdan Tianma Dan treats Wind Gan with emaciation, head shaking, eye rubbing, and stiffness of all meridians.
Tianma (Gastrodiae Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), True Xiongdan (Ursi Bile), Chanke (Cicadae Periostracum), Shijunzi (Quisqualis Fructus, shelled), Hu Huanglian (Coptidis Rhizoma alternative/Scutellariae Barbatae Herba), each 1 liang; Lushui (Aloe), Ganchan (Bufo bufo, fried in butter until yellow), each 0.5 liang.
Crush and sieve into fine powder, mix with glutinous rice paste, and make pills the size of millet seeds. Take 10 pills per dose, washed down with Schizonepeta Decoction, adjusting dosage according to the child's age and size.
Wutan Dan
Wushe (Zaocys, soaked in wine, skin and bones removed, roasted until yellow), Ganchan (Bufo bufo, fried in butter until yellow), Shetui (Boidis Skin, burnt to ash), each 1 liang; Hu Huanglian (Scutellariae Barbatae Herba), 0.5 liang (crushed and sieved above, reserved); Zhen Lushui (Pure Aloe), Shexiang (Moscus), Xiongdan (Ursi Bile), each 2.5 qian (finely ground).
Mix evenly, bind with millet drink, and make pills the size of millet seeds. Take 10 pills per dose, washed down with Mint Decoction, before milk feeding.
*Zhuang Shi Jia Chuan* treats pediatric Wind Gan, smooths Liver Qi, and promotes appetite. Lushui Wan (Aloe Pill)
Lushui (Aloe, 1 qian, separately ground and weighed, or ground only with soapberry water), Caolongdan (Gentianae Radix et Rhizoma, 1 liang, cleaned, cut, and dried).
Grind these herbs together into powder. Use three non-decaying stalks of Soapberry (Gleditsiae Sinensis Fructus), add two sheng of water, decoct to extract juice, filter through raw silk to remove dregs, and slowly boil in a silver vessel until it forms a paste. Mix with the previous two powders, make pills the size of mung beans. Take 3 to 5 pills per dose, swallowed with Mint Decoction.
*Handong Wangshi Jiabao* treats pediatric Wind Gan where Qi attacks the neck causing nodules. Zaojiao Gao (Soapberry Paste Formula)
Zaojiao (Gleditsiae Sinensis Fructus, large stalk, 1 piece, burnt to retain properties), Nuomi (Glutinis Rice, 1 he, stir-fried until black), Caowutou (Aconiti Radix lateralis preparata alternative/Aconitum carmichaelii raw), 2 qian, raw; Huangpi (Phellodendri Cortex), 1 qian, stir-fried until black.
Grind into powder. Apply an appropriate amount mixed with well water to the affected area. If not relieved, use Shuijing Dan first, then tonify with Tiaoqi San, Guanyin San, Renshen San, etc., continue applying, and alternate with Gan medicines.
Shenmiao Guanyin San tonifies deficiency, regulates Stomach Qi, promotes milk and food intake, stops vomiting and diarrhea, and addresses prolonged refusal to eat.
Baibiantou (Phaseoli Semen Album, lightly stir-fried), Shilianrou (Nelumbinis Plumula, stir-fried, core removed), Renshen (Ginseng Radix et Rhizoma, baked), each 1 fen; Fuling (Poria), 1.5 qian, baked; Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Xiangbaizhi (Angelicae Dahuricae Radix), Mian Huangqi (Astragali Radix, crushed, mixed with honey water and roasted), Muxiang (Aucklandiae Radix, stir-fried), each 1 qian; Shenqu (Massa Medicata Fermentata), 2 qian.
Grind into powder. Infants take 1 zi, children aged 2-3 take half a qian, children aged 4-5 take 1 qian. Decoct with one medicinal measure or half a silver cup of water, half a date slice, boil for several boils, and take.
Renshen San tonifies deficiency, supports Stomach Qi, promotes milk and food intake, and stops vomiting and diarrhea.
Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Lianrou (Nelumbinis Plumula, core removed, stir-fried), each 1 fen; Huangqi (Astragali Radix, 0.5 liang, crushed, mixed with honey water and roasted), Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian, roasted).
Grind into powder. Infants take 1 zi, children aged 2-3 take half a qian, children aged 4-5 take 1 qian. Decoct with one medicinal measure or half a silver cup of water, add half a date slice, boil for several boils, and take.
Zhuang Shi's Sixth Syndrome: Head sores, sparse and scorched hair. This is a formula for Liver Gan.
Roudoukou (Myristicae Semen), Chan Hui (Bufo Skin Ash, whole), each 1 unit; Jiegeng (Platycodonis Radix, processed), Fuling (Poria, baked), Dahuang (Rhei Radix et Rhizoma, baked), each 1 liang; Longnao (Borneolum Syntheticum), Shexiang (Moscus), each 1 qian.
Grind into powder, bind with soft rice, make pills the size of hemp seeds. Wash down with 3 pills in Millet Drink. Can only be taken twice.
Treats pediatric limb movements, eyes unable to open, occasional talking/laughing, or sudden anger, frequent fright, cyanotic fingernails, appearance resembling death, falsely called Tiandiao (Heavenly Hook). Tongshen Wan (Spirit-Penetrating Pill)
Fuling (Poria), Longchi (Draconis Os, each, baked 0.5 liang), Qiandan (Minii Preparatum), Huhuanglian (Scutellariae Barbatae Herba), each 1 fen; Yinbo (Folium Aurum), 5 pieces; Shexiang (Moscus), 1 qian; Gouteng (Uncariae Ramulus cum Uncis, 1 liang, baked).
Grind into powder, bind with refined honey, make pills the size of hemp seeds. Take 10 pills per dose, washed down with Rice Drink. (Used for Zhuang Shi's Twenty-second Syndrome).
Third Wind Gan: Pediatric limb spasms, eyes unable to open, occasional self-laughter, or angry shouting, cyanotic fingernails, appearance resembling ghostly forms, already resembling Tiandiao. Must take Jinbo Fuling San (Gold Leaf Poria Powder).
Jinbo (Folium Aurum), 5 pieces; Fuling (Poria), Niuxi (Achyranthis Bidentatae Radix), Huhuanglian (Scutellariae Barbatae Herba), each 1 liang; Longgu (Fossilia Ossis Mastodi, 1 fen); Muxiang (Aucklandiae Radix), Shexiang (Moscus), each 1 qian.
Grind into powder. Take 1 zi per dose, washed down with Rice Drink, twice daily. Avoid greasy foods.