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。
虫蚀脊膂（脊柱），身体发热，形体消瘦且面色萎黄，积滞郁而化热，心烦口渴，腹泻，拍打背部声音如鼓鸣，脊骨突起如锯齿状，或者十个手指都生疮，频繁啃咬指甲，这就是脊疳的症状。
《圣惠方》中的金蟾散：治疗小儿脊疳，头部大颈部细，四肢黄瘦，腹部胀大胸部高耸，毛发干枯直立。
药材组成：蟾酥（一枚，选大的，涂酥油，炙烤至焦黄色）、夜明砂（微炒）、桃白皮、樗根白皮、地榆、黄柏（各切碎）、诃梨勒（煨制，只用皮）、百合、白芜荑（微炒）、人参（去芦头）、川大黄（切碎，微炒）、黄连（去须，以上各三分）、胡粉（三钱）、丁香（三七粒）、槟榔（一分）。
制法与用法：将上述药物捣碎，过细筛制成散剂。每次服用半钱，用米粥汤调服，每日三次。
地骨皮丸：治疗小儿脊疳，逐渐变得黄瘦，用手指敲击背部，声音如鼓响，脊骨高突。这是由于奶热所致。
药材组成：地骨皮、紫参、黄芩（切碎）、川大黄（切碎，微炒）、郁李仁（热水浸泡，去皮尖，微炒，以上各半两）、龙胆（去芦头）、子芩、枳壳（麸炒至微黄，去瓤）、木香、猪苓（去黑皮）、海蛤（细研，以上各一分）。
制法与用法：将上述药物捣碎，过筛制成粉末，用炼蜜调和制成丸药，大小如绿豆。每次用温水送服五丸，每日三次，根据患儿年龄大小调整剂量。通常以轻微腹泻为见效标准。
杀疳丸：治疗小儿脊疳，日渐消瘦，腹中有虫。
药材组成：没石子、瓜蒂、鹤虱（均细研，各半两）、蟾头（炙烤至焦黄色）、芦荟、青黛（均细研，各半两）、麝香（细研）、腻粉（研入，以上各一分）。
制法与用法：将上述药物捣碎，过筛制成粉末，用糯米饭调和制成丸药，大小如黍米。每次用米粥汤送服五丸，每日三次，根据患儿年龄大小酌情增减。
芦荟丸：治疗小儿脊疳，腹内寄生虫上攻，背脊骨逐渐高突，肌肉身体消瘦。
药材组成：芦荟、青黛、朱砂、麝香（均细研）、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（以上各半两）、虾蟆（一枚，涂酥油炙烤至焦黄色）。
制法与用法：将上述药物捣碎，过筛制成粉末，用蜗牛肉研烂调和，制成丸药，大小如麻子。每次用米粥汤送服五丸，每日三次，根据患儿年龄大小增减剂量。
青黛丸：治疗小儿脊疳，四肢瘦弱，腹部胀满壮热，头发干枯稀疏，时常心烦口渴，脊骨如锯。
药材组成：青黛、朱砂（均细研）、夜明砂（微炒）、定粉（以上各一分）、蟾酥（研入）、熊胆（细研）、羚羊角（锉屑）、犀角（锉屑，以上各半分）、黄连（半两，去须）、麝香（一钱，细研）。
制法与用法：将上述药物捣碎，过筛制成粉末，用软饭调和制成丸药，大小如绿豆。每岁患儿用米粥汤送服二丸。
第五种脊疳症状：十个手指和指甲痒痛，头发焦干，腹部虚鸣，脊骨如锯齿状，时常腹泻，大便性状像靛蓝染料或脓血。
朱砂丸：
药材组成：天灵盖（炙烤，一个）、柴胡、白术、麝香（各一钱）、槟榔（一个）。
制法与用法：用枣肉调和制成丸药，大小如麻子。每次服用三丸，用米饮枣汤送服。
〔朱氏〕治疗小儿脊疳泻血不止的方子：
药材组成：定粉、好枣（十个，捣碎）、头发（少许，剪碎）。
制法与用法：将上述药物做成团块，垫砖在火中烧透，细研成粉。用米饮送服半钱。
〔庄氏〕治疗小儿久下血不止称为历脊疳的方子：
使用穿山甲，用米醋浸泡后炙烤，制成粉末。每次服用一钱，用米饮调下，空腹服用。
Insect-eating the spine (spinal column), body heat, emaciation and sallow complexion, accumulation generating internal heat, irritability and thirst with diarrhea, percussion of the back sounds like a drum, spinal bones protruding like saw teeth, or sores on all ten fingers, frequent biting of fingernails—this is Ji Gan (Spinal Malnutrition).
Jin Chan San (Toad Powder) from *Shenghui Fang*: Treats pediatric Ji Gan (Spinal Malnutrition), characterized by a large head and thin neck, yellow and emaciated limbs, distended abdomen and high chest, dry and erect hair.
Ingredients: Chan Su (Toad Venom, one piece, large size, coated with butter, roasted until scorched yellow); Ye Ming Sha (Stool Vespertilionis, slightly stir-fried); Tao Bai Pi (Inner Bark of Peach Root); Chu Gen Bai Pi (Bark of Chinese Toona Root); Di Yu (Sanguisorbae Radix); Huang Bo (Phellodendri Cortex, each chopped); He Li Le (Terminalia Chebula Retz., baked, using only the peel); Bai He (Lilii Bulbus); Bai Wu Yi (Xanthii Fructus, slightly stir-fried); Ren Shen (Ginseng Radix et Rhizoma, remove rhizome); Chuan Da Huang (Rhei Radix et Rhizoma, chopped, slightly stir-fried); Huang Lian (Coptidis Rhizoma, remove stamens, each 3 fen); Hu Fen (Lead Carbonate, 3 qian); Ding Xiang (Caryophylli Flos, 37 grains); Bing Lang (Arecae Semen, 1 fen).
Preparation and Administration: Pound the above ingredients, sift finely to make a powder. Each dose uses half a qian, mixed with rice water for oral administration, three times daily.
Digupi Wan (Cortex Lycii Pill): Treats pediatric Ji Gan (Spinal Malnutrition), gradually becoming yellow and emaciated; percussion of the back sounds like a drum, with high spinal bones. This is caused by milk heat.
Ingredients: Di Gu Pi (Cortex Lycii); Zi Shen (Scutellaria Barbata D.Don); Huang Qin (Scutellariae Radix, chopped); Chuan Da Huang (Rhei Radix et Rhizoma, chopped, slightly stir-fried); Yu Li Ren (Prunus Lasiocarpa Seed, soaked in water, remove skin and tip, slightly stir-fried, each 0.5 liang); Long Dan (Gentianae Radix, remove rhizome); Zi Qin (Scutellariae Radix); Zhi Qiao (Aurantii Fructus, bran-stir-fried until slightly yellow, remove pith); Mu Xiang (Aucklandiae Radix); Zhu Ling (Polyporus, remove black skin); Hai Ge (Concha Meretrix, finely ground, each 1 fen).
Preparation and Administration: Pound the above ingredients, sift into powder, mix with refined honey to form pills the size of mung beans. Each dose is five pills, taken with warm water, three times daily. Adjust dosage according to the child's age. Mild purgation is considered effective.
Sha Gan Wan (Kill Parasite Pill): Treats pediatric Ji Gan (Spinal Malnutrition), progressive emaciation, presence of parasites in the abdomen.
Ingredients: Mo Shi Zi (Myrobalan Fruit); Gua Di (Melonis Fructus Seed); He Si (Chenopodii Semen, both finely ground, each 0.5 liang); Chan Tou (Toad Head, roasted until scorched yellow); Lu Hui (Aloe); Qing Dai (Indigo Naturalis, both finely ground, each 0.5 liang); She Xiang (Moschus, finely ground); Ni Fen (Calomelas, ground in, each 1 fen).
Preparation and Administration: Pound the above ingredients, sift into powder, mix with glutinous rice paste to form pills the size of millet seeds. Each dose is five pills, taken with rice water, three times daily. Adjust dosage according to the child's age.
Lu Hui Wan (Aloe Pill): Treats pediatric Ji Gan (Spinal Malnutrition), abdominal parasites attacking upward, gradual elevation of the dorsal spine, emaciated body.
Ingredients: Lu Hui (Aloe); Qing Dai (Indigo Naturalis); Zhu Sha (Cinnabar); She Xiang (Moschus, each finely ground); Xiong Dan (Ursi Bile, ground in); Hu Huang Lian (Coptidis Rhizoma alternative, i.e., Picrorhizae Rhizoma); Guan Zhong (Cyathulae Radix); Di Long (Pheretima, slightly stir-fried); Huang Lian (Coptidis Rhizoma, remove stamens); Chan Ke (Cicadae Periostracum, slightly stir-fried, remove legs); Lei Wan (Waningiae Semen, each 0.5 liang); Xia Ma (Bufo Bufo gargarizans Cantor, one piece, coated with butter, roasted until scorched yellow).
Preparation and Administration: Pound the above ingredients, sift into powder, mix with snail meat paste to form pills the size of hemp seeds. Each dose is five pills, taken with rice water, three times daily. Adjust dosage according to the child's age.
Qing Dai Wan (Indigo Naturalis Pill): Treats pediatric Ji Gan (Spinal Malnutrition), weak and emaciated limbs, abdominal distension with high fever, dry and sparse hair, frequent irritability and thirst, spinal bones like saw teeth.
Ingredients: Qing Dai (Indigo Naturalis); Zhu Sha (Cinnabar, each finely ground); Ye Ming Sha (Stool Vespertilionis, slightly stir-fried); Ding Fen (Lead Carbonate, each 1 fen); Chan Su (Toad Venom, ground in); Xiong Dan (Ursi Bile, finely ground); Ling Yang Jiao (Saiga Tatarica Cornu, shaved); Xi Jiao (Rhino Horn, shaved, each 0.5 fen); Huang Lian (Coptidis Rhizoma, 0.5 liang, remove stamens); She Xiang (Moschus, 1 qian, finely ground).
Preparation and Administration: Pound the above ingredients, sift into powder, mix with soft cooked rice to form pills the size of mung beans. For each year of age, administer two pills with rice water.
Fifth type of Ji Gan (Spinal Malnutrition): Itching and pain in the ten fingers and nails, scorched and dry hair, empty rumbling in the abdomen, spinal bones like saw teeth, frequent dysentery, stool resembling indigo dye, pus, or blood.
Zhu Sha Wan (Cinnabar Pill):
Ingredients: Tian Ling Gai (Human Skull Cap, roasted, one piece); Chai Hu (Bupleuri Radix); Bai Zhu (Atractylodis Macrocephalae Rhizoma); She Xiang (Moschus, each 1 qian); Bing Lang (Arecae Semen, one piece).
Preparation and Administration: Mix with jujube flesh to form pills the size of hemp seeds. Each dose is three pills, taken with rice drink and jujube soup.
[Zhushi] Formula for treating persistent bloody diarrhea in pediatric Ji Gan (Spinal Malnutrition):
Ingredients: Ding Fen (Lead Carbonate); Hao Zao (Good Jujubes, ten pieces, crushed); Tou Fa (Human Hair, a small amount, cut into pieces).
Preparation and Administration: Form into balls, place on bricks, fire until red hot, grind finely. Take half a qian with rice drink.
[Zhuangshi] Formula for treating prolonged bloody discharge known as Li Ji Gan (Progressive Spinal Malnutrition):
Use Chuan Shan Jia (Manis Squama), soak in rice vinegar and roast, then grind into powder. Each dose is one qian, taken with rice drink, on an empty stomach.