积热生虫蚀脊膂，于击其背若鼓呜，羸瘦脊骨锯齿状，身热下利烦渴璔，
十指皆疮啮爪甲，此名脊疳病热凶，芦荟丸同金蟾散，急急调治莫从容．
[注]
脊疳者，因积热生虫上蚀脊膂也，
以手击其背，必空若鼓鸣，脊骨羸瘦，状若锯齿，始为脊疳外证，
亦身体发热，下利烦渴，十指皆疮，频啮爪甲，其证最为可畏，
须先以芦荟丸杀其虫，
继用金蟾散消其疳，随时调治，或可愈也。
(芦荟丸) 生芦荟 青黛 朱碎 熊胆 胡黄连 贯众 地龙微炒
川黄连 蝉蜕去足 雷丸各五钱 麝香一钱 虾蟆一个酥涂炙焦
以上为细末，用蜗角肉研和，丸如麻子大，
每服五丸，粥饮下，量儿大小与之。
(金蟾散) 蟾一枚酥涂炙焦夜明沙炒 桃白皮 樗根白皮 地堬 黄蘖
诃黎勒皮煨百合 人参 大黄 白芜荑炒 胡粉各三钱 槟榔一钱
丁香三十七粒 以上为细末，每服五分粥饮调下。
%
疳证门
过食腻冷并肥甘，湿热生蛔腹内缠，时烦多啼时腹痛，口唇色变溢清涎，
腹胀青筋肛湿痒，史君散治莫迟延，不愈下虫丸极效，蛔退补脾肥儿丸。
[注]
蛔疳者，因过食生冷油腻肥甘之物，以致湿热生蛔，腹中扰动，
故有时烦燥多啼，有时肚腹搅痛，口唇或红或白，
口溢清涎，腹胀青筋，肛门湿痒也，
先用史君子散治之，不愈下虫丸主之，
若蛔退，又当调补其脾，肥儿丸主之
(史君子散) 史君子十个瓦上炒为末 苦楝子五个泡去核
白芜荑 甘草各一钱胆汁浸一宿 以上为末，每服一钱，水调服。
(下虫丸) 苦楝根皮新白者佳酒浸焙 木香 桃仁浸去皮尖 绿色贯众
芜荑焙 鸡心槟榔各二钱 轻粉五分 鹤虱一钱炒 干虾蟆三钱炒黑
史君子三钱取肉煨 以上为末，面糊成丸，如麻子大，每服二十丸，滚白水下。
(肥儿丸) 方见脾疳。
%
疳证门
积热内生导致寄生虫侵蚀脊柱和胸骨，用手敲击背部时声音如同击鼓般空洞，身体消瘦且脊骨突出呈锯齿状，伴有身体发热、腹泻、烦躁及口渴等症状，
十个手指都生疮疡并啃咬指甲，这被称为脊疳病，病情凶险，
应使用芦荟丸配合金蟾散，紧急调理治疗，不可拖延。
[注]
脊疳，是因为体内积热滋生寄生虫，向上侵蚀脊柱和胸骨所致，
用手敲击其背部，必然有空洞感如击鼓鸣响，脊骨因肌肉萎缩而瘦削，形状像锯齿一样，这才是脊疳的外部证候，
同时也伴有身体发热、腹泻、烦躁口渴，十个手指均生疮疡，频繁啃咬指甲，这种病症最为可怕，
必须先使用芦荟丸杀灭寄生虫，
随后使用金蟾散消除疳积，根据病情随时调整治疗，或许可以痊愈。
(芦荟丸) 由生芦荟、青黛、朱砂（碎）、熊胆、胡黄连、贯众、地龙（微炒）、川黄连、蝉蜕（去足）、雷丸各五钱，麝香一钱，以及一个用酥油涂抹后炙至焦黄的虾蟆组成。
以上药物研成细末，用蜗角肉研磨混合，制成如麻子大小的药丸，
每次服用五丸，用米粥汤送下，根据患儿年龄大小调整剂量。
(金蟾散) 由一枚用酥油涂抹后炙至焦黄的蟾蜍、夜明沙（炒）、桃白皮、樗根白皮、地堬、黄蘖、诃黎勒皮（煨）、百合、人参、大黄、白芜荑（炒）、胡粉各三钱，槟榔一钱，丁香三十七粒组成。
以上药物研成细末，每次服用五分，用米粥汤调服。
过食油腻生冷以及肥甘厚味之物，导致湿热内生并在腹部缠绕蛔虫，时而烦躁啼哭，时而腹痛，口唇颜色改变并流出清稀涎液，
腹部胀大且有青筋暴露，肛门潮湿瘙痒，
应用史君散治疗，不可迟延，若无效则使用下虫丸效果极佳，蛔虫退去后需补益脾胃，使用肥儿丸。
[注]
蛔疳，是因为过量食用生冷油腻及肥甘厚味之物，致使湿热滋生蛔虫，在腹中扰动，
所以有时烦躁多啼，有时腹部绞痛，口唇或红或白，
口中溢出清稀涎液，腹部胀大可见青筋，肛门潮湿瘙痒，
先用史君子散进行治疗，若无效则以下虫丸为主治方，
若蛔虫退去，又应当调理补益脾胃，以肥儿丸主治。
(史君子散) 由十个在瓦上炒制的史君子研末，五个泡制去核的苦楝子，以及白芜荑、甘草各一钱（用胆汁浸泡一夜）组成。
以上药物研成细末，每次服用一钱，用水调服。
(下虫丸) 由新的白色苦楝根皮（佳者，酒浸焙干）、木香、桃仁（浸去皮尖）、绿色贯众、芜荑（焙干）、鸡心槟榔各二钱，轻粉五分，鹤虱（炒）一钱，干虾蟆（炒黑）三钱，史君子（取肉煨）三钱组成。
以上药物研成细末，用面糊制成如麻子大小的药丸，每次服用二十丸，用滚开的白水送下。
(肥儿丸) 方剂见脾疳章节。
Accumulated heat generates parasites that erode the spine and sternum; striking the back produces a hollow sound like drumming. The body is emaciated with a serrated appearance of the spinal bones, accompanied by fever, diarrhea, irritability, and thirst.
Ulcers appear on all ten fingers, and the nails are gnawed. This condition is named Ji Gan (Spinal Parasitic Disease), which is critical and dangerous.
Aloe Pill (Lü Hui Wan) should be used together with Golden Toad Powder (Jin Chan San). Urgent treatment is required without delay.
[Note]
Ji Gan (Spinal Parasitic Disease) arises from accumulated heat generating parasites that ascend to erode the spine and sternum.
Striking the back with the hand yields a hollow sensation resembling drumming. The spinal bones become emaciated and take on a serrated shape, which constitutes the external signs of Ji Gan.
It is also accompanied by fever, diarrhea, irritability, and thirst, ulcers on all ten fingers, and frequent gnawing of the nails. This syndrome is most formidable.
One must first use Aloe Pill (Lü Hui Wan) to eliminate the parasites,
followed by Golden Toad Powder (Jin Chan San) to resolve the parasitic accumulation. Treatment should be adjusted according to the condition, and recovery may be possible.
(Aloe Pill / Lü Hui Wan) Composed of Raw Aloe (Lü Hui), Indigo Naturalis (Qing Dai), Cinnabar (Zhu Sha, crushed), Bear Bile (Xiong Dan), Picrorhiza Rhizome (Hu Huang Lian), Cyperus Rhizome (Guan Zhong), Earthworm (Di Long, slightly fried), Coptis Rhizome (Chuan Huang Lian), Cicada Slough (Chan Tui, feet removed), and Ophiopogon/Termite-eating fungus? (Lei Wan) each at 5 qian, Musk (She Xiang) at 1 qian, and one Toad (Xia Ma) coated with butter and roasted until scorched.
The above ingredients are ground into fine powder, mixed with snail shell meat (Wo Jiao Rou) by grinding, and formed into pills the size of hemp seeds.
Each dose consists of 5 pills, taken with rice gruel broth, adjusted according to the child's age and size.
(Golden Toad Powder / Jin Chan San) Composed of one Toad (Chan) coated with butter and roasted until scorched, Night Soil (Ye Ming Sha, fried), Peach White Bark (Tao Bai Pi), Chinese Toona Root Bark (Chu Gen Bai Pi), Terra Doli (Di Tu), Phellodendron Bark (Huang Bo), Chebula Fruit Peel (He Li Le Pi, roasted), Lily Bulb (Bai He), Ginseng (Ren Shen), Rhubarb (Da Huang), White Melia Seed (Bai Wu Yi, fried), Lead Carbonate/White Lead (Hu Fen) each at 3 qian, Areca Nut (Bing Lang) at 1 qian, and Clove (Ding Xiang) 37 grains.
The above ingredients are ground into fine powder. Each dose is 0.5 fen, mixed with rice gruel broth for administration.
Excessive consumption of greasy, cold, and rich/sweet foods leads to damp-heat generating roundworms (Ascaris) entangling in the abdomen. There is intermittent irritability, excessive crying, and abdominal pain. The lips change color, and clear saliva overflows.
Abdominal distension with visible blue veins and dampness/itching at the anus occur.
Shi Jun Zi Powder (Shi Jun Zi San) should be used without delay. If ineffective, Worm Expelling Pill (Xia Chong Wan) is highly effective. After the worms are expelled, the Spleen should be tonified using Fat Child Pill (Fei Er Wan).
[Note]
Hui Gan (Roundworm Parasitic Disease) results from overeating cold, raw, greasy, and rich foods, causing damp-heat to generate roundworms that disturb the abdomen.
Thus, there is sometimes irritability and excessive crying, and sometimes abdominal cramping pain. The lips may be red or white,
and clear saliva overflows from the mouth. Abdominal distension presents with visible blue veins, and the anus is damp and itchy.
First, treat with Shi Jun Zi Powder (Quisqualis Powder). If ineffective, administer Worm Expelling Pill (Xia Chong Wan).
If the roundworms are expelled, the Spleen should then be regulated and tonified, primarily using Fat Child Pill (Fei Er Wan).
(Shi Jun Zi Powder / Shi Jun Zi San) Composed of ten Quisqualis Seeds (Shi Jun Zi) fried on a tile and ground into powder, five Ailanthus Seeds (Ku Lian Zi) soaked and pitted, and White Melia Seed (Bai Wu Yi) and Licorice Root (Gan Cao) each at 1 qian (soaked overnight in bile).
The above ingredients are ground into powder. Each dose is 1 qian, taken with water.
(Worm Expelling Pill / Xia Chong Wan) Composed of fresh white Ailanthus Root Bark (Ku Lian Gen Pi, preferably new, soaked in wine and dried), Costus Root (Mu Xiang), Peach Kernel (Tao Ren, soaked, skin and tip removed), Green Cyperus (Lv Se Guan Zhong), Fried Melia Seed (Wu Yi Bei), Chicken-heart Areca Nut (Ji Xin Bing Lang) each at 2 qian, Calomel/Qing Fen at 5 fen, Cocklebur Fruit (He Shi, fried) at 1 qian, Dried Toad (Gan Xia Ma, roasted black) at 3 qian, and Quisqualis Meat (Shi Jun Zi Rou, roasted) at 3 qian.
The above ingredients are ground into powder, bound with wheat paste into pills the size of hemp seeds. Each dose is 20 pills, taken with boiling plain water.
(Fat Child Pill / Fei Er Wan) See the section on Pi Gan (Spleen Parasitic Disease) for the formula.