杨氏云。疳者腑藏虫疳也。其名甚多。姑举其要。虫疳者其虫如丝。出于头项胸背之间。黄白
赤者可治。青黑者难疗。蛔疳者。皱眉多啼。呕吐清沫。中脘作痛。腹胀青筋。唇口紫黑。头摇齿
痒。脊疳者。身热羸瘦。烦渴下利。拍背有声。脊骨如锯齿。十指皆疮。频啮爪甲。脑疳者。头
皮光急。满头俱疮。脑热如火。发结如穗。遍身多汗。腮肿囟高。疳渴者。日则烦渴。饮水不食。
夜则渴止。疳泻者。毛焦唇白。额上青纹。肚胀肠鸣。泻下糟粕。疳痢者。停积宿滞。水谷不聚。
泻下恶物。疳肿者。胃中有积。肚腹紧胀。脾复受湿。则头面手足虚浮。疳劳者。潮热往来。五
心烦热。盗汗骨蒸。嗽喘枯悴。渴泻饮水。肛硬如石。面色如银。无辜疳者。脑后项边。有核如
弹丸。按之转动。软而不疼。壮热羸瘦。头露骨高。乃乏乳所致。丁奚疳者。手足极细。项小骨
高。尻削体痿。腹大脐突。号哭胸陷。哺露疳者。虚热往来。头骨分开。翻食吐虫。烦渴呕哕。
走马疳者。疳热上攻。速如走马。或痘毒上攻。则牙齿蚀烂。盖齿属肾。肾虚受热。疳火上炎。
致口臭齿黑。轻则牙龈腐烂。唇吻肿痛可治。重则牙龈蚀落。腮颊透烂不治。其证虽多。要不出
于五脏治法。肝疳。则颊左生疮。眼目赤烂。肢体似癣。两耳前后项侧缺盆两股结核。或小腹内
股。茎囊睾丸肿溃。便溺癃闭。或出白津。或咬指甲。摇头侧目。白膜遮睛。羞明畏日。肚大青
筋。口干下血。用芦荟丸以杀虫。地黄丸以滋肾。心疳。则口舌蚀烂。身体壮热。面黄颊赤。或
作肿痛。腹满膈闷。或掌热咽干。饮水便出盗汗。啮齿虚惊。用胡黄连丸以治心。异功散以补脾。
脾疳。则体黄而瘦皮肤干涩。头不生发。或生疮痂。或人中口吻赤烂。吐逆乳食。嗜土腹大脐突。
泻下酸臭。小便浊白。或合目昏睡。恶闻水音。用肥儿丸以治疳。五味异功散或益黄散以生土。
肺疳。则鼻外生疮。咽喉不利。颈肿齿痛。喘嗽气促。寒热少气。皮肤皱揭。鼻痒出涕。衄血目
黄。小便混浊而频数。用加味陷胸丸以治肺。补中益气汤以生金。肾疳。则脑热吐痰。手足逆冷。肢体
瘦削。夜则微寒发热。滑泄腹痛。口臭作渴。齿龈溃烂。爪黑而黧。尻耳生疮。或耳出水。用蟾
蜍丸以去疳。地黄丸以补肾。其无辜疳。用保元汤、蟾蜍丸。丁奚哺露。用六味丸、蟾蜍丸。走
马疳。敷马鸣散。服蟾蜍丸。若作渴泻利。肿胀劳瘵等类。详参方论而治之。盖疳者干也。因脾
胃津液干涸而患。在小儿为五疳。在大人为五劳。总以调补脾胃为主。凡小儿疳在内。目肿腹胀。
脐突溺稠。泻利青白。体渐瘦弱。疳在外。鼻下赤烂。频揉鼻耳。或肢体生疮。鼻疮。兰香散。
诸疮。白粉散。热疳。如圣丸。冷疳。木香丸。冷热交错。元气久亏。温脾丸最宜。疳病害眼者。
用芜荑仁、青葙子细末。各一钱。不经水骟鸡肝一具。研烂入白酒酿。饭上蒸熟食之。不过五七服必愈。
杨氏说：疳病是脏腑虫疳。它的名称非常多，姑且列举其中重要的几种。
虫疳：这种虫子像丝线一样，从头部、颈部、胸部和背部之间生出。颜色黄白的是可治之症，青黑的是难治之症。
蛔疳：患儿皱眉多啼哭，呕吐清稀泡沫，中脘部疼痛，腹部胀大且有青筋暴露，嘴唇和口角紫黑，头部摇动，牙齿发痒。
脊疳：身体发热，形体消瘦，烦躁口渴，腹泻，拍打背部有声响，脊柱骨节突出如锯齿状，十个手指都生疮，频繁咬指甲。
脑疳：头皮光亮紧绷，满头都是疮疡，脑部发热如火，头发结成穗状，全身多汗，腮部肿胀，囟门高突。
疳渴：白天烦躁口渴，喝水但不进食；夜晚口渴停止。
疳泻：毛发焦枯，嘴唇苍白，额头出现青纹，肚腹胀满，肠鸣音亢进，排泄物为未消化的糟粕。
疳肿：胃中有积滞，肚腹紧胀，脾脏再次受湿邪侵袭，则头面及手足虚浮肿胀。
疳劳：潮热往来，五心烦热（手心、脚心及心胸烦热），盗汗，骨蒸潮热，咳嗽气喘，形体枯槁憔悴，口渴腹泻，饮水后肛门口干硬如石，面色苍白如银。
无辜疳：脑后项边有核块如弹丸大小，按压时可转动，质地软而不痛，高热消瘦，头颅显露骨骼高耸，这是由于缺乏乳汁喂养所致。
丁奚疳：四肢极其细瘦，颈部细小而骨骼高耸，臀部削薄，身体痿弱，腹部膨大，肚脐突出，号哭时胸部凹陷。
哺露疳：虚热往来，头骨缝隙分开，反胃吐虫，烦躁口渴，呕吐呃逆。
走马疳：疳热向上攻冲，病情进展迅速如跑马一般。或者是痘毒上攻，导致牙齿蚀烂。因为牙齿属于肾，肾虚受热，疳火上炎，导致口臭、牙齿变黑。轻症则牙龈腐烂，唇吻肿痛，尚可治疗；重症则牙龈蚀落，腮颊穿透腐烂，无法治愈。
这些证候虽然繁多，但总不出五脏治法的范围。
肝疳：左侧脸颊生疮，眼睛红肿溃烂，肢体皮肤似癣，两耳前后、颈部侧面、缺盆穴处、大腿内侧或股间、阴茎囊及睾丸肿胀溃破，小便淋漓不通，或者流出白色津液，或者咬指甲，摇头侧目，白膜遮蔽瞳孔，畏光羞明，肚大青筋，口干，便血。用芦荟丸以杀虫，用地黄丸以滋补肾阴。
心疳：口舌蚀烂，身体壮热，面色黄而两颊红赤，有时作痛肿胀，腹部胀满，胸膈闷塞，或者手掌发热，咽喉干燥，饮水后立即吐出，盗汗，磨牙，易受惊吓。用胡黄连丸以清心火，用异功散以补益脾气。
脾疳：身体发黄而消瘦，皮肤干枯涩滞，头上不长头发，或者生疮结痂，或者人中及口角红肿溃烂，吐逆乳食，嗜吃泥土，腹部膨大，肚脐突出，排泄物酸臭，小便浑浊发白，或者闭目昏睡，厌恶听到水声。用肥儿丸以治疗疳病，用五味异功散或益黄散以健脾生土。
肺疳：鼻翼外侧生疮，咽喉不利，颈部肿胀，牙齿疼痛，咳嗽气喘，呼吸急促，寒热交替，气短，皮肤皱裂脱屑，鼻痒流涕，鼻出血，目黄，小便浑浊且频数。用加味陷胸丸以治肺，用补中益气汤以补肺金。
肾疳：脑部发热，吐痰，手足逆冷，肢体消瘦，夜间微寒发热，滑泄腹痛，口臭口渴，齿龈溃烂，指甲黑而晦暗，臀部及耳朵生疮，或者耳朵流水。用蟾蜍丸以去除疳邪，用地黄丸以补肾。
对于无辜疳，用保元汤、蟾蜍丸。对于丁奚疳和哺露疳，用六味地黄丸、蟾蜍丸。对于走马疳，外敷马鸣散，内服蟾蜍丸。如果是口渴、腹泻、肿胀、劳瘵等类似病症，详细参考方论进行治疗。
大概来说，“疳”就是“干”的意思，是因为脾胃津液干涸而患病。在小儿称为五疳，在大人称为五劳。总的原则是以调补脾胃为主。
凡是小儿疳病在内证的，表现为目肿、腹胀、脐突、溺尿稠浊、泻下青色白色粪便、身体逐渐瘦弱。疳病在外证的，表现为鼻下红肿溃烂，频繁揉搓鼻耳，或者肢体生疮。
鼻疮，用兰香散。诸疮，用白粉散。热疳，用如圣丸。冷疳，用木香丸。冷热交错，元气久已亏损，温脾丸最为适宜。
疳病伤害眼睛的，用芜荑仁、青葙子研成细末，各一钱，配合未经过水洗涤的阉割公鸡肝脏一个，研烂后加入白酒酿，放在饭上蒸熟食用。不过服用五到七次必定痊愈。
Yang stated that "gan" (malnutrition syndrome) refers to intestinal parasites and organ-related parasitic conditions. There are many names for it; I will briefly list the important ones.
Parasitic Gan: The parasites resemble silk threads, emerging from between the head, neck, chest, and back. Cases with yellow or white discoloration are treatable, while those with blue-black discoloration are difficult to cure.
Ascaris Gan: The child frowns and cries frequently, vomits clear froth, experiences pain in the Zhongwan (CV12) region, has abdominal distension with visible subcutaneous veins, purple-black lips and mouth corners, head shaking, and itching teeth.
Spinal Gan: The body is feverish and emaciated, accompanied by irritability, thirst, and diarrhea. Slapping the back produces a hollow sound, and the spinal vertebrae protrude like saw teeth. Ulcers appear on all ten fingers, and the child frequently bites their fingernails.
Cranial Gan: The scalp is smooth and tight, covered with ulcers. The brain feels hot as if on fire, hair matts into tufts, there is excessive sweating over the whole body, swelling of the cheeks, and a bulging fontanelle.
Gan-Thirst: During the day, the child is irritable and thirsty, drinking water but refusing food; at night, the thirst subsides.
Gan-Diarrhea: Hair becomes brittle and dry, lips turn pale, green lines appear on the forehead, the abdomen is distended with borborygmus, and stools contain undigested food residue.
Gan-Dysentery: Food stagnation and retained pathogenic factors prevent the assimilation of water and grain, resulting in the passage of foul-smelling excrement.
Gan-Swelling: Accumulation exists in the stomach, causing tight abdominal distension. If the spleen is affected by dampness, edema appears on the face, head, hands, and feet.
Gan-Labor (Consumption): Alternating tidal fever, five-palm heat (heat sensation in the palms, soles, and chest), night sweats, bone-steaming fever, coughing and wheezing with emaciation, thirst and diarrhea despite drinking water, hardness of the anus like stone, and a silvery-white complexion.
Innocuous Gan: A nodule the size of a bean appears behind the ear and along the neck side; it is movable upon pressure, soft, and painless. Accompanied by high fever and emaciation, prominent skull bones, this condition is caused by a lack of breast milk.
Dingxi Gan: The limbs are extremely thin, the neck is small with prominent bones, the buttocks are wasted, the body is flaccid, the abdomen is large with an everted umbilicus, and crying causes depression of the chest.
Bulu Gan: Alternating deficiency heat, separation of cranial suture lines, regurgitation with vomiting of worms, irritability, thirst, vomiting, and hiccups.
Running-Horse Gan: Gan-heat attacks upward, progressing rapidly like a running horse. Alternatively, toxin from smallpox/variola attacks upward, causing dental erosion. Since teeth belong to the Kidney, Kidney deficiency combined with heat causes Gan-fire to flare upward, leading to halitosis and blackened teeth. Mild cases involve gingival rot and swollen/painful lips, which are treatable. Severe cases involve loss of gums and perforation of the cheeks, which are untreatable.
Although these syndromes are numerous, they ultimately fall within the treatment methods of the Five Zang organs.
Liver Gan: Ulcers appear on the left cheek, eyes are red and ulcerated, skin resembles tinea, lymph node swellings occur around both ears, posterior neck, clavicular fossa (Quepen), inner thighs, or scrotum/testicles. Urination is obstructed or white fluid is discharged. The child may bite nails, shake their head, look sideways, have white membranes covering the pupils, photophobia, abdominal distension with visible veins, dry mouth, and hematochezia. Use Lu Hui Wan (Aloe Pill) to eliminate parasites, and Di Huang Wan (Rehmannia Pill) to nourish the Kidney.
Heart Gan: Oral and lingual erosion, high fever, yellowish complexion with red cheeks, occasional painful swelling, abdominal fullness, chest oppression, palm heat, dry throat, immediate vomiting after drinking water, night sweats, teeth grinding, and fright. Use Hu Huang Lian Wan (Coptis Pill) to treat the Heart, and Yi Gong San (Yi Gong Powder) to tonify the Spleen.
Spleen Gan: Yellowish and emaciated body, dry and rough skin, absence of hair growth or presence of crusts, red/ulcerated philtrum and mouth corners, vomiting of milk/food, geophagia (craving earth), abdominal distension with everted umbilicus, sour/foul diarrhea, turbid white urine, lethargy with closed eyes, and aversion to the sound of water. Use Fei Er Wan (Fatten Child Pill) to treat Gan, and Wu Wei Yi Gong San or Yi Huang San to generate Earth (tonify Spleen).
Lung Gan: Ulcers outside the nose, pharyngeal obstruction, neck swelling, toothache, coughing/wheezing with shortness of breath, alternating chills/fever, Qi deficiency, wrinkled/shedding skin, nasal itching with rhinorrhea, epistaxis, jaundice, and turbid frequent urination. Use Jia Wei Xian Xiong Wan (Modified Chest-Trap Pill) to treat the Lung, and Bu Zhong Yi Qi Tang to generate Metal (tonify Lung).
Kidney Gan: Cranial heat, expectoration, cold extremities, emaciation, mild chills/fever at night, slippery diarrhea with abdominal pain, halitosis/thirst, gingival ulceration, black/dull nails, ulcers on buttocks/ears, or otorrhea. Use Chan Chu Wan (Toad Pill) to remove Gan pathogens, and Di Huang Wan to tonify the Kidney.
For Innocuous Gan, use Bao Yuan Tang and Chan Chu Wan. For Dingxi and Bulu Gan, use Liu Wei Wan and Chan Chu Wan. For Running-Horse Gan, apply Ma Ming San externally and take Chan Chu Wan internally. For symptoms such as thirst, diarrhea, swelling, and consumption-like conditions, refer to detailed formula discussions for treatment.
Generally, "Gan" means "dryness," arising from the depletion of Spleen and Stomach fluids. In children, it is called the Five Gans; in adults, it is called the Five Labors (Wu Lao). The general principle is to regulate and tonify the Spleen and Stomach.
Internal pediatric Gan presents with swollen eyes, abdominal distension, everted umbilicus, thick urine, green/white diarrhea, and gradual emaciation. External pediatric Gan presents with red/ulcerated areas under the nose, frequent rubbing of nose/ears, or limb ulcers.
For nasal ulcers, use Lan Xiang San. For various ulcers, use Bai Fen San. For Heat Gan, use Ru Sheng Wan. For Cold Gan, use Mu Xiang Wan. For mixed cold-heat with chronic Qi/Yuan deficiency, Wen Pi Wan is most suitable.
For Gan affecting the eyes, mix 1 qian each of Yuan Yang Ren (Quisqualis Seed) and Qing Xi Zi (Celosia Seed) into fine powder. Combine with one liver from a castrated rooster not washed with water, mash thoroughly, add rice wine fermentation liquid, steam over rice, and consume. Cure is expected within 5-7 doses.