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The "Five Gan Syndromes" in children refer to Liver Gan, Heart Gan, Spleen Gan, Lung Gan, and Kidney Gan. This theory was initiated by Qian Yi (Qianshi), attributing the condition to the tenderness of the Zang-Fu organs and the insufficiency of Qi and Blood in infants. It arises from improper care after illness or irregular diet (overeating or hunger), which damages the Spleen and Stomach, leading to Gan syndrome. The internal depletion of Body Fluids causes deficient Fire to flare up randomly. Depending on which Zang-Fu organ is damaged, different diseases manifest with distinct physical signs and symptoms.

Liver Gan, also known as Wind Gan, presents with a white membrane obscuring the pupil, bloody diarrhea, and emaciation.
Heart Gan presents with red obstructions in both eyes, a sallow complexion, and flushed cheeks.
Spleen Gan, also known as Fat Gan, presents with swelling of the upper eyelids, abdominal distension, and a craving for sweet foods.
Lung Gan, also known as Qi Gan, presents with wrinkling and opacities on the sclera, wheezing, coughing, and shortness of breath.
Kidney Gan, also known as Bone Gan, presents with irregular shapes of the pupil and a preference for lying on damp ground.

The treatment methods for the five Zang organs are numerous and cannot be fully summarized here. However, the general principle does not deviate from tonifying the Spleen and strengthening its transportive function. When the Spleen and Stomach are robust, clear and turbid Qi separate naturally, the Middle Earth (Spleen) maintains its authority, and vital energy increases daily. Yi Gong San (Isogong Decoction) is used as the principal formula, modified according to specific symptoms. For example, Gouqi (Lycii Fructus) and Baishao (Paeoniae Radix Alba) are used to tonify the Liver; Shanyao (Dioscoreae Rhizoma) and Ejiao (Colla Corii Asini) to tonify the Lungs; Danggui Shen (Angelicae Sinensis Radix) and Zaoren (Ziziphi Spinosae Semen) to tonify the Heart; Huangqi (Astragali Radix) and Hongzao (Jujubae Fructus) to tonify the Spleen; Shudi (Rehmanniae Radix Preparata) and Tusizi (Cuscutae Semen) to tonify the Kidney. Once the Spleen and Stomach are slightly strengthened and Yin-Blood gradually replenished, Dihuang Tang (Rehmannia Decoction) is administered subsequently to nourish Yin and conclude the treatment. Is this not an excellent approach?

The term "Gan" implies dryness, caused by internal heat steaming and consuming Body Fluids. However, one must not use bitter-cold herbs merely because of the presence of heat, as this would further hinder Spleen-Yang and severely damage Stomach-Qi. The lay public often refers to it as "Gan Accumulation," assuming that Gan always involves accumulation, and indiscriminately using digestive and purgative methods. They fail to realize that Gan is a deficiency syndrome; even tonification may fall short, so reckless attack and depletion will surely prevent recovery.

There is also Worm Gan, where worms resembling silk threads emerge between the head, neck, abdomen, and back. Those that are yellow, white, or red are easy to treat, while those that are green or black are difficult. Roundworm Gan presents with furrowed eyebrows, frequent crying, and vomiting of clear froth. Spine Gan presents with a resonant sound upon patting the back and a spine protruding like a turtle's shell. Brain Gan presents with tight, shiny scalp skin and brain heat feeling like fire. Although these symptoms are varied, they do not exceed the scope of the Five Zang organs and should be treated with the aforementioned methods. Among the Five Gan syndromes, Heart and Kidney Gan are rare, whereas Liver, Spleen, and Lung Gan are common. I have also frequently encountered Worm Gan. I list only the essentials here for the attention of future students.