疳积一证，因小儿脾胃虚弱，凡食生冷油腻，停滞不化，初起为积，积久成疳，遂致五
脏受病，形状难看。初起体实，以集圣五疳丸为主，复载五脏病状，察其虚实阴阳，各自加
减。体虚者总以参苓白术散，或肥儿丸调之，以补为消可也。
小儿切牙，舌红舌上生疮，爱饮凉水，唇红面白，喜伏于地，此心疳也。
集圣宁心丸
芦荟 灵脂 夜明砂 使君子（各二钱） 当归 洋参（各四钱） 黄连 干蟾蜍（各一钱） 生地
茯苓（各二钱） 胆星 朱砂 甘草（各七分）
共为末，炼蜜为丸，如龙眼大，每服二丸，开水化服。末药冲服亦可。
小儿面青目生白膜，泄泻青粪，此肝疳也。
集圣平肝丸
芦荟 灵脂 夜明砂 使君子（各二钱） 当归 川芎 党参（各四钱） 黄连 蟾蜍 胆草
栀子 防风 天麻 蝉蜕去头足 青黛（各一钱） 和丸如前。
小儿鼻下赤烂，手足枯细，口中腥臭，或作喘嗽，此肺疳也。
集圣清肺丸
芦荟 灵砂 夜明砂 广皮 使君子（各二钱） 当归 沙参（各四钱） 黄连 蟾蜍 桑皮
桔梗 苏叶 阿胶（各二钱） 炙草（一钱） 和丸如前。
鼻烂用泽兰、扫粉、铜绿等分，细末调猪油擦之。
小儿耳内生疮，脚如鹤膝，或齿缝臭烂，变成走马疳者，服∶
集圣补肾丸
芦荟 夜明砂 使君子 当归 条参（各四钱） 黄连 蟾蜍（各一钱） 熟地（五钱） 茯苓 枣
仁（各二钱） 粉丹 泽泻（各一钱） 和丸如前。
小儿爱食泥土冷物，饮食无度，身面俱黄，头大项小，腹胀脚弱，间或泄泻，昼凉夜热
，不思乳食，此脾疳也。服∶
集圣醒脾丸
芦荟（酒蒸） 灵脂（炒） 夜明砂（炒） 广皮（各二钱） 青皮 莪术（各一钱） 使君肉（二钱） 木香（八
分） 当归 川芎 条参（各四钱） 黄连 西砂（各一钱）
上为细末，用公猪胆一个，取汁将药和匀，粟米糊丸如龙眼大，每服二丸，米饮调服。
以下之证以为为主。
食积久而成疳，其症形瘦腹紧，时发潮热，羞见生人则哭。本方去芦荟、灵脂，加党参
、黄 、焦术、茯苓、法夏、枳实、紫朴、炙草、神曲、麦芽、鳖甲、三棱各二钱。
久泻不止，胃虚成疳，此疳泻也。本方去芦荟、莪术、灵脂，加白术、茯苓、肉蔻（去
油）、诃子、条参各二钱。
久痢不止，胃虚成疳，此疳痢也。本方去芦荟、莪术、青皮、灵脂、加诃子、肉蔻、建
莲肉各三钱，合为丸。
疟久不止，胃虚成疳，此必有癖，谓之疳疟。本方去芦荟、灵脂，加箭 、炙鳖甲、柴
胡、半夏、神曲、三棱各一钱，党参五钱，和为丸。
余则脑疳、脊疳、蛔疳、下奚疳、无辜疳，无外照经，虚实寒热，用药加减，谅其小儿
元气浓薄用之可也。此证悉载《幼幼集成》。
参苓白术散 见泄泻门。
肥儿丸 治一切久病成疳，总归虚处，不可以前法治之，只宜以此久服，以补为消，无
不愈者。
条参 箭 焦术 茯苓 广皮 当归（各一两） 青皮 炙鳖甲 川连 木香 使君肉
蟾蜍 炙草（各五分）
上为细末，以山药四两，打糊为丸，量小儿大小，加减日日服之，米饮送下，病愈药止
。
一方小儿疳积，面黄饮水，久而不愈。可用鸡内金二张，蜗牛五个，焙干细末，以猪
贴破开，将末药KT 上菜叶，包好火煨熟，与尔子食之自愈。根据法制食，真有神效。
疳积这一病证，是由于小儿脾胃虚弱，凡是食用生冷或油腻食物，导致停滞不消化。初期表现为积滞，积滞日久转化为疳证，进而导致五脏受累，患儿形体消瘦、面容枯槁难看。若患儿初起体质尚实，以集圣五疳丸为主方，并参考五脏病变的具体症状，根据虚实阴阳进行加减化裁。若患儿体质虚弱，总以参苓白术散或肥儿丸调理，采用“以补为消”的方法即可。
小儿磨牙，舌质红且舌上生疮，喜欢喝凉水，嘴唇红而面色白，喜欢趴在地上，这是心疳的表现。
集圣宁心丸
芦荟、五灵脂、夜明砂、使君子（各二钱），当归、西洋参（各四钱），黄连、干蟾蜍（各一钱），生地、茯苓（各二钱），胆南星、朱砂、甘草（各七分）。
以上药物共研为细末，用炼蜜制成梧桐子大小的药丸，每次服用两丸，用开水送服化开。将药末直接冲服也可以。
小儿面色青，眼睛生出白膜，腹泻排出青色粪便，这是肝疳的表现。
集圣平肝丸
芦荟、五灵脂、夜明砂、使君子（各二钱），当归、川芎、党参（各四钱），黄连、蟾蜍、胆草、栀子、防风、天麻、蝉蜕（去头足）、青黛（各一钱）。
和以前一样制成药丸。
小儿鼻下红肿溃烂，手足干枯细小，口中散发腥臭味，或者出现喘息咳嗽，这是肺疳的表现。
集圣清肺丸
芦荟、炉甘石（此处原文为“灵砂”，疑为炉甘石或代赭石之误，依原文译作灵砂）、夜明砂、陈皮、使君子（各二钱），当归、沙参（各四钱），黄连、蟾蜍、桑白皮、桔梗、苏叶、阿胶（各二钱），炙甘草（一钱）。
和以前一样制成药丸。
对于鼻部溃烂，可用泽兰、扫粉、铜绿等量，研成细末，调和猪油涂抹患处。
小儿耳内生疮，小腿肿胀如鹤膝状，或者齿缝臭烂，演变成走马疳的，服用：
集圣补肾丸
芦荟、夜明砂、使君子、当归、人参（条参）（各四钱），黄连、蟾蜍（各一钱），熟地黄（五钱），茯苓、酸枣仁（各二钱），牡丹皮、泽泻（各一钱）。
和以前一样制成药丸。
小儿喜欢吃泥土和冷物，饮食没有节制，全身及面部发黄，头大脖子细，腹部胀满，下肢软弱无力，偶尔腹泻，白天发凉晚上发热，不想吃奶和食物，这是脾疳的表现。服用：
集圣醒脾丸
芦荟（酒蒸）、五灵脂（炒）、夜明砂（炒）、陈皮（各二钱），青皮、莪术（各一钱），使君子肉（二钱），木香（八分），当归、川芎、人参（条参）（各四钱），黄连、西砂仁（各一钱）。
以上药物研成细末，取一个公猪胆囊，取出胆汁将药粉拌匀，用粟米糊制成梧桐子大小的药丸，每次服用两丸，用米汤调服。
以下这些证候以此方为基础进行加减：
食积日久形成疳证，症状表现为形体消瘦、腹部紧绷，时常发作潮热，见到陌生人就哭。本方去掉芦荟、五灵脂，加入党参、黄芪、焦白术、茯苓、法半夏、枳实、厚朴、炙甘草、神曲、麦芽、鳖甲、三棱，各二钱。
长期腹泻不止，胃虚导致疳证，这称为疳泻。本方去掉芦荟、莪术、五灵脂，加入白术、茯苓、肉豆蔻（去油）、诃子、人参（条参），各二钱。
长期痢疾不止，胃虚导致疳证，这称为疳痢。本方去掉芦荟、莪术、青皮、五灵脂，加入诃子、肉豆蔻、建莲肉，各三钱，合在一起制成药丸。
疟疾日久不止，胃虚导致疳证，这必定伴有痞块，称为疳疟。本方去掉芦荟、五灵脂，加入箭杆风（此处原文为“箭”，结合语境及常用配伍，可能指某种祛风湿或截疟药，暂保留原字或意译，此处依原文提取实体）、炙鳖甲、柴胡、半夏、神曲、三棱，各一钱，党参五钱，合在一起制成药丸。
其余还有脑疳、脊疳、蛔疳、下疳、无辜疳等，没有外在的经典依据，需根据虚实寒热情况，推测小儿元气的浓薄来用药加减。这些证候全部记载在《幼幼集成》中。
参苓白术散 见泄泻门。
肥儿丸 治疗一切久病形成的疳证，最终都归于虚损，不能用前面的方法治疗，只宜长期服用此方，以补益来达到消除积滞的目的，没有不痊愈的。
人参（条参）、箭杆风（原文“箭”）、焦白术、茯苓、陈皮、当归（各一两），青皮、炙鳖甲、川黄连、木香、使君子肉、蟾蜍、炙甘草（各五分）。
以上药物研成细末，用山药四两，打糊制成药丸，根据小儿的大小，每日调整剂量服用，用米汤送下，病愈后停药。
另一个方子：小儿疳积，面色黄，想喝水，日久不愈。可用鸡内金两张，蜗牛五个，焙干研成细末，将猪肚剖开，把药末撒在菜叶上，包好用火煨熟，给患儿吃下即可自愈。按照这种方法制作食物，确实有神奇的效果。
Ganji (Chronic Malnutrition with Accumulation) is a syndrome caused by the weakness of the Spleen and Stomach in children. When they consume raw, cold, or greasy foods that stagnate and fail to digest, it initially presents as accumulation (Ji). Prolonged accumulation transforms into Gan syndrome, subsequently affecting the Five Zang Organs, leading to emaciation and an unattractive appearance. If the child's constitution is initially robust, Jisheng Wugan Wan (Collection Saint Five Gan Pills) is used as the main formula, with modifications based on the specific symptoms of the Five Zang organs and their deficiency/excess and Yin/Yang patterns. If the child's constitution is weak, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) or Fei'er Wan (Flesh-Enriching Pills) are used for regulation, employing the method of "tonification to resolve accumulation."
Teeth grinding, red tongue with sores, preference for cool water, red lips but pale complexion, and a tendency to lie prone on the ground indicate Heart Gan (Heart Malnutrition).
Jisheng Ningxin Wan (Collection Saint Calming Heart Pills)
Aloe Vera (Luhui), Trogopterus Dung (Lingzhi), Bat Guano (Yeming Sha), Quisqualis Fruit (Shijunzi) (each 2 qian), Angelica Sinensis Root (Danggui), American Ginseng (Yangshen) (each 4 qian), Coptis Rhizome (Huanglian), Dried Toad Skin (Ganchan Chu) (each 1 qian), Rehmannia Root (Shengdi), Poria (Fuling) (each 2 qian), Arisaema Cum Bile (Danning), Cinnabar (Zhusha), Licorice Root (Gancao) (each 7 fen).
Grind all ingredients into fine powder, mix with refined honey to make pills the size of longan seeds. Take two pills per dose, dissolved in boiling water. Taking the powder directly with water is also acceptable.
Blueish facial color, white membrane over the eyes, diarrhea with green stools indicate Liver Gan (Liver Malnutrition).
Jisheng Pinggan Wan (Collection Saint Pacifying Liver Pills)
Aloe Vera (Luhui), Trogopterus Dung (Lingzhi), Bat Guano (Yeming Sha), Quisqualis Fruit (Shijunzi) (each 2 qian), Angelica Sinensis Root (Danggui), Ligusticum Chuanxiong Rhizome (Chuanxiong), Codonopsis Root (Dangshen) (each 4 qian), Coptis Rhizome (Huanglian), Toad (Chan Chu), Scutellaria Root (Dancao), Gardenia Fruit (Zhizi), Saposhnikovia Root (Fangfeng), Gastrodia Tuber (Tianma), Cicada Slough (Chantui, remove head and feet), Indigo Naturalis (Qingdai) (each 1 qian).
Prepare pills as described previously.
Redness and ulceration under the nose, dry and thin limbs, foul-smelling breath, or wheezing and coughing indicate Lung Gan (Lung Malnutrition).
Jisheng Qingfei Wan (Collection Saint Clearing Lung Pills)
Aloe Vera (Luhui), Calcined Alum/Lapis Lazuli (Lingsha - *Note: Text says Lingsha, likely referring to a mineral drug*), Bat Guano (Yeming Sha), Tangerine Peel (Guangpi), Quisqualis Fruit (Shijunzi) (each 2 qian), Angelica Sinensis Root (Danggui), Glehnia Root (Shashen) (each 4 qian), Coptis Rhizome (Huanglian), Toad (Chan Chu), Mulberry Bark (Sangpi), Platycodon Root (Jiegeng), Perilla Leaf (Suye), Donkey-hide Gelatin (Ejiao) (each 2 qian), Honey-fried Licorice Root (Zhi Cao) (1 qian).
Prepare pills as described previously.
For nasal ulceration, use equal parts of Lythrum Fructus (Zelan), Scutellaria Powder (Saofen), and Verdigris (Tonglv), grind into fine powder, mix with pig fat, and apply externally.
Sores inside the ears, swelling of the legs resembling crane's knees (*Xue Xi*), or foul-smelling and rotting gums progressing to Running Horse Gan (Zou Ma Gan), should be treated with:
Jisheng Bushen Wan (Collection Saint Tonifying Kidney Pills)
Aloe Vera (Luhui), Bat Guano (Yeming Sha), Quisqualis Fruit (Shijunzi), Angelica Sinensis Root (Danggui), Codonopsis Root (Tiaoshen) (each 4 qian), Coptis Rhizome (Huanglian), Toad (Chan Chu) (each 1 qian), Prepared Rehmannia Root (Shudi) (5 qian), Poria (Fuling), Sour Jujube Seed (Zaoren) (each 2 qian), Moutan Cortex (Fendan), Alisma Rhizome (Zexie) (each 1 qian).
Prepare pills as described previously.
Craving dirt and cold items, uncontrolled eating, yellowish discoloration of the body and face, large head with a thin neck, abdominal distension, weak legs, occasional diarrhea, feeling cool during the day and feverish at night, and loss of appetite for milk and food indicate Spleen Gan (Spleen Malnutrition). Take:
Jisheng Xingpi Wan (Collection Saint Awakening Spleen Pills)
Aloe Vera (Steamed with wine), Trogopterus Dung (Stir-fried), Bat Guano (Stir-fried), Tangerine Peel (Guangpi) (each 2 qian), Green Tangerine Peel (Qingpi), Curcuma Zedoary Rhizome (Ezhu) (each 1 qian), Quisqualis Kernel (Shijun Rou) (2 qian), Aucklandia Root (Muxiang) (8 fen), Angelica Sinensis Root (Danggui), Ligusticum Chuanxiong Rhizome (Chuanxiong), Codonopsis Root (Tiaoshen) (each 4 qian), Coptis Rhizome (Huanglian), Amomum Fruit (Xisha) (each 1 qian).
Grind the above ingredients into fine powder. Take one male pig gallbladder, extract the juice, and mix evenly with the medicine. Use millet paste to form pills the size of longan seeds. Take two pills per dose, administered with rice drink.
The following syndromes are modified from the base formula:
Accumulation transforming into Gan due to prolonged retention, characterized by emaciation, tight abdomen, intermittent tidal fever, and crying when seeing strangers. Remove Aloe Vera (Luhui) and Trogopterus Dung (Lingzhi) from the base formula; add Codonopsis Root (Dangshen), Astragalus Root (Huangqi), Fried Atractylodes Macrocephala Rhizome (Jiaozhu), Poria (Fuling), Processed Pinellia Tuber (Faxia), Immature Bitter Orange (Zhishi), Magnolia Bark (Zhipu), Honey-fried Licorice Root (Zhi Cao), Medicated Leaven (Shenqu), Malt (Maiya), Turtle Carapace (Biejia), and Sparganium Rhizome (Sanleng), each 2 qian.
Persistent diarrhea leading to stomach deficiency and Gan, known as Gan Diarrhea. Remove Aloe Vera (Luhui), Curcuma Zedoary Rhizome (Ezhu), and Trogopterus Dung (Lingzhi) from the base formula; add Atractylodes Macrocephala Rhizome (Baizhu), Poria (Fuling), Nutmeg (Roukou, remove oil), Chebula Fruit (Hezi), and Codonopsis Root (Tiaoshen), each 2 qian.
Persistent dysentery leading to stomach deficiency and Gan, known as Gan Dysentery. Remove Aloe Vera (Luhui), Curcuma Zedoary Rhizome (Ezhu), Green Tangerine Peel (Qingpi), and Trogopterus Dung (Lingzhi) from the base formula; add Chebula Fruit (Hezi), Nutmeg (Roukou), and Jian Lotus Seeds (Jianlianrou), each 3 qian, and combine to make pills.
Prolonged malaria leading to stomach deficiency and Gan, necessarily accompanied by masses, known as Gan Malaria. Remove Aloe Vera (Luhui) and Trogopterus Dung (Lingzhi) from the base formula; add Arrow Reed Rhizome (Jian - *likely referring to a specific herb like Artemisia or similar contextually*, kept as literal translation for entity extraction), Honey-fried Turtle Carapace (Zhibiejia), Bupleurum Root (Chaihu), Pinellia Tuber (Banxia), Medicated Leaven (Shenqu), and Sparganium Rhizome (Sanleng), each 1 qian, and Codonopsis Root (Dangshen) 5 qian, and combine to make pills.
Other types include Brain Gan, Spine Gan, Roundworm Gan, Lower Gan, and Innocent Gan. Without external classic references, modifications should be made based on deficiency/excess and cold/heat patterns, estimating the thickness or thinness of the child's Yuan Qi (Original Qi). These syndromes are fully recorded in *Youyou Jicheng* (Complete Essentials for Children).
Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) See Diarrhea Section.
Fei'er Wan (Flesh-Enriching Pills) Treats all chronic illnesses transforming into Gan, which ultimately return to deficiency. It cannot be treated with previous methods; only long-term use of this formula, tonifying to resolve accumulation, ensures recovery.
Codonopsis Root (Tiaoshen), Arrow Reed Rhizome (Jian), Fried Atractylodes Macrocephala Rhizome (Jiaozhu), Poria (Fuling), Tangerine Peel (Guangpi), Angelica Sinensis Root (Danggui) (each 1 liang), Green Tangerine Peel (Qingpi), Honey-fried Turtle Carapace (Zhibiejia), Coptis Rhizome (Chuanlian), Aucklandia Root (Muxiang), Quisqualis Kernel (Shijun Rou), Toad (Chan Chu), Honey-fried Licorice Root (Zhi Cao) (each 5 fen).
Grind into fine powder. Use 4 liang of Chinese Yam (Shanyao) to make a paste for forming pills. Adjust the daily dosage according to the child's size. Administer with rice drink. Stop medication upon recovery.
Another prescription for pediatric Ganji with yellowish face and thirst, persisting for a long time: Use two pieces of Chicken Gizzard Membrane (Jineijin) and five snails, bake until dry, and grind into fine powder. Cut open a pig's stomach, place the powder on vegetable leaves, wrap them together, and roast over fire until cooked. Feed this to the child for self-healing. Following this method of dietary preparation yields miraculous effects.