虫食脊膂，身热羸黄，积中生热，烦渴下利，拍背如鼓鸣，脊骨如锯齿，或十
指皆疮，频啮爪甲是也。
《圣惠》金蟾散 治小儿脊疳，头大项细，四肢黄瘦，肚大胸高，毛发干立。
蟾（一枚、大者，涂酥、炙令焦黄） 夜明砂（微炒） 桃白皮 樗根白皮 地榆 黄柏（各锉） 诃梨
勒（煨，用皮） 百合 白芜荑（微炒） 人参（去芦头） 川大黄（锉碎，微炒） 黄连（去须。各三分） 胡粉
（三钱） 丁香（三七粒） 槟榔（一分）
上件药捣，细罗为散。每服、用粥饮调下半钱，日三服。
地骨皮丸 治小儿脊疳，渐渐黄瘦，以手指击之，背如鼓响，脊骨高是也。此因奶热所致。
地骨皮 紫参 黄 （锉） 川大黄（锉碎，微炒） 郁李仁（汤浸，去皮尖，微炒。各半两） 龙胆（去芦头）
子芩 枳壳（麸炒微黄，去瓤） 木香 猪苓（去黑皮） 海蛤（细研。各一分）
上件药捣，罗为末，炼蜜和丸，如绿豆大，每服以温水研下五丸，日三服，量
儿大小加减服之。常得微利为效。
杀疳丸 治小儿脊疳，日渐羸瘦，腹中有虫。
没石子 瓜蒂 鹤虱（并细研，各半两） 蟾头（炙令焦黄） 芦荟 青黛（并细研，各半两） 麝香（细研） 腻
粉（研入。各一分）
上件药捣，罗为末，以糯米饭和丸，如黍米大。每服，以粥饮下五丸，日三服，
量儿大小，以意加减。
芦荟丸 治小儿脊疳，腹内有虫上攻，背膂脊骨渐高，肌体羸瘦。
芦荟 青黛 朱砂 麝香（各细研） 熊胆（研入） 胡黄连 贯众 地龙（微炒） 黄连（去须）
蝉壳（微炒，去足） 雷丸（各半两） 虾蟆（一枚，涂酥炙，令焦黄）
上件药捣，罗为末，用蜗牛肉研和，丸如麻子大。每服，以粥饮下五丸，日三
服，量儿大小，增减服之。
青黛丸 治小儿脊疳，四肢瘦弱，腹胀壮热，头发干疏，时时烦渴，脊骨如锯。
青黛 朱砂（各细研） 夜明砂（微炒） 定粉（各一分） 蟾酥（研入） 熊胆（细研） 羚羊角（屑） 犀角
（屑。各半分） 黄连（半两，去须） 麝香（一钱，细研）
上件药捣，罗为末，用软饭和丸，如绿豆大。每一岁以粥饮下二丸。
第五脊疳，十指爪甲痒痛，头发焦干，肚腹虚鸣，脊骨如锯，时时下痢，状如青淀
或脓或血。
朱砂丸
天灵盖（炙，一个） 柴胡 白术 麝香（各一钱） 槟榔（一个）
上件，枣肉为丸如麻子大。每服三丸，米饮枣汤下。
〔朱氏〕治小儿脊疳泻血不止方
定粉 好枣（十个，捣碎） 头发（少许，剪碎）
上件为团，砖衬，火 通赤，细研。米饮下半钱。
〔庄氏〕治小儿久下血不止谓之历脊疳方
用穿山甲，米醋浸炙，为末。每服一钱，米饮调下，食空服。
Insects devour the spine (spinal column), accompanied by fever, emaciation, and sallow complexion. Heat generated from food stagnation causes irritability, thirst, and diarrhea. The back sounds like a drum when slapped, and the spinal processes protrude like saw teeth. Alternatively, there may be sores on all ten fingers and frequent nail-biting. This condition is known as Ji Gan (Spinal Caries).
Jin Chan San (Toad Powder) from *Shenghui Fang* treats pediatric Ji Gan, characterized by a large head with a thin neck, yellow and emaciated limbs, distended abdomen with a high chest, and dry, erect hair.
Ingredients: Toad Venom (one piece, large size, coated with butter, roasted until golden brown); Night Soil (slightly fried); Peach White Bark; Tree of Heaven Root Bark; Sanguisorba Radix; Phellodendri Cortex (all chopped); Chebulae Fructus (roasted, using only the peel); Lilii Bulbus; Xanthoxyli Fructus (slightly fried); Ginseng Radix et Rhizoma (rhizome removed); Rheum Palmatum Radix et Rhizoma (chopped, slightly fried); Coptidis Rhizoma (fibrous roots removed; each 3 qian); Hu Fen (Lead Carbonate; 3 qian); Ting-er Flos (37 grains); Arecae Semen (1 fen).
Pulverize the above ingredients and sift into a fine powder. Take half a qian per dose, mixed with rice gruel, three times daily.
Digupi Wan (Phellodendri Cortex Pill) treats pediatric Ji Gan, where the child gradually becomes yellow and emaciated. Striking the back produces a drum-like sound, and the spine is prominent. This is caused by heat from milk retention.
Ingredients: Cortex Lycii Radicis; Zishen (likely *Bupleuri Radix* or similar, contextually distinct); Huang Qin (Scutellariae Radix, chopped); Rheum Palmatum Radix et Rhizoma (chopped, slightly fried); Pruni Semen (soaked in water, skin and tip removed, slightly fried; each 0.5 liang); Gentianae Radix (rhizome removed); Ziqin (Scutellariae Radix); Zhiqiao Aurantii Fructus Pericarpium (bran-fried until slightly yellow, pith removed); Aucklandiae Radix; Polyporus (black skin removed); Concha Meretricis (finely ground; each 1 fen).
Pulverize the above ingredients and sieve into powder. Mix with refined honey to form pills the size of mung beans. Take five pills per dose, washed down with warm water, three times daily. Adjust dosage according to the child's age. Mild diarrhea indicates efficacy.
Sha Gan Wan (Kill Parasite Pill) treats pediatric Ji Gan, characterized by progressive emaciation and intestinal parasites.
Ingredients: Myrobalan Fruit; Melon Seed; Chrysanthemi Indici Flos (all finely ground; each 0.5 liang); Toad Head (roasted until golden brown); Aloe; Indigo Naturalis (both finely ground; each 0.5 liang); Moschus (finely ground); Nifen (Calomel; added during grinding; each 1 fen).
Pulverize the above ingredients and sieve into powder. Mix with glutinous rice paste to form pills the size of millet seeds. Take five pills per dose, washed down with rice gruel, three times daily. Adjust dosage according to the child's age.
Luhui Wan (Aloe Pill) treats pediatric Ji Gan, where intestinal parasites attack upwards, causing the spine to become progressively prominent and the body to emaciate.
Ingredients: Aloe; Indigo Naturalis; Cinnabaris; Moschus (all finely ground); Ursi Bile; Picrorhizae Rhizoma; Cyathulae Radix; Earthworm (slightly fried); Coptidis Rhizoma (fibrous roots removed); Cicadae Periostracum (slightly fried, legs removed); Omphaliae Spora (each 0.5 liang); Bufo (one piece, coated with butter, roasted until golden brown).
Pulverize the above ingredients and sieve into powder. Mix with snail meat paste to form pills the size of sesame seeds. Take five pills per dose, washed down with rice gruel, three times daily. Adjust dosage according to the child's age.
Qingdai Wan (Indigo Naturalis Pill) treats pediatric Ji Gan, characterized by weak and emaciated limbs, abdominal distension with high fever, dry and sparse hair, frequent irritability and thirst, and a spine like a saw.
Ingredients: Indigo Naturalis; Cinnabaris (both finely ground); Night Soil (slightly fried); Dingfen (White Lead Powder; each 1 fen); Toad Venom (added during grinding); Ursi Bile (finely ground); Antilopis Cornu (shavings); Rhinocerotis Cornu (shavings; each 0.5 fen); Coptidis Rhizoma (0.5 liang, fibrous roots removed); Moschus (1 qian, finely ground).
Pulverize the above ingredients and sieve into powder. Mix with soft rice to form pills the size of mung beans. For each year of age, take two pills, washed down with rice gruel.
Fifth type of Ji Gan: Itching and pain in the fingernails, dry and scorched hair, hollow rumbling in the abdomen, spine like a saw, frequent dysentery with stool resembling indigo dye, pus, or blood.
Zhusha Wan (Cinnabar Pill)
Ingredients: Tianlinggai (Human Skull Cap, roasted, one piece); Bupleuri Radix; Atractylodis Macrocephalae Rhizoma; Moschus (each 1 qian); Arecae Semen (one piece).
Mix with jujube pulp to form pills the size of sesame seeds. Take three pills per dose, washed down with rice drink and jujube soup.
[Shi Jia] Prescription for treating persistent bloody diarrhea in pediatric Ji Gan:
Ingredients: Dingfen (White Lead Powder); Good Jujubes (ten pieces, crushed); Human Hair (a small amount, cut into pieces).
Form into a lump, place on brick, and fire until red hot. Grind into fine powder. Take half a qian with rice drink.
[Zhuang Shi] Prescription for treating chronic bloody diarrhea known as Li Ji Gan (Traversing Spinal Caries):
Use Manis Squama (Pangolin Scale), soaked in rice vinegar and roasted, then powdered. Take one qian per dose, mixed with rice drink, taken on an empty stomach.