钱仲阳曰∶小儿诸疳，皆因病后脾胃亏损，或用药过伤，不能传化乳食，内亡津液，虚火妄动
，或乳母六淫七情，饮食起居失宜，致儿为患。凡疳在内者，目肿腹胀，泻痢青白，体渐瘦弱；疳
在外者，鼻下赤烂，频揉鼻耳，或肢体生疮。大抵其证虽多，要不出于五脏，而五脏之疳不同，当
各分辨治之。肝疳者，一名筋疳，亦名风疳。其证白膜遮睛，或泻血而瘦，宜用地黄丸以生肾。心
疳者，面黄颊赤，身体壮热，宜用朱砂安神丸以治心，异功散以补脾。脾疳者，一名肥疳，体黄瘦
削，皮肤干涩而有疮疥，腹大嗜土，宜用四味肥儿丸以治疳，五味异功散以生土，或用益黄散。肺
疳者，一名气疳，喘嗽气促，口鼻生疮，宜用人参清肺汤以治肺，益气汤以生金。肾疳者，一名骨
疳，肢体瘦削，遍生疮疥，喜卧湿地，用地黄丸。鼻疮用兰香散。诸疮用白粉散。若患潮热，当先
补肝，后泻心，若妄以硝黄等药利之，则成疳。若患癖，当消磨，若误以巴豆、硼砂下之，或伤寒
误下，皆能成疳。其初病者为热疳，用黄连丸。久病者为冷疳，用木香丸。冷热相兼者，用如圣丸
。津液短少者，用七味白术散。凡此皆因大病，脾胃亏损，内亡津液所致，当固脾胃为主，而早为
施治，则不变败证也。
杨氏曰∶无辜疳者，脑后项边有核如弹丸，按之转动，软而不疼，其内有虫，不速针出，则内
食脏腑，肢体痈疽，便利脓血，壮热羸瘦，头露骨高，宜用大芜荑汤、蟾蜍丸。丁奚者，手足极细
，项小骨高，尻削体痿，腹大脐突，号哭胸陷，宜用肥儿丸、大芦荟丸。哺露者，虚热往来，头骨
分开，翻会吐虫，烦渴呕哕，宜用肥儿丸、大芦荟丸。走马疳者，于齿蚀烂。盖齿属肾，肾虚受热
，痰火上炎，致口臭齿黑，甚则龈烂牙宣。宜敷雄黄散，服蟾蜍丸。若作渴泻痢肿胀、劳瘵等证，
当详参方论而治之。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，总宜以
调补胃气为主。
又，杨氏曰∶又有疳伤者，五脏虫疳也，其名甚多，姑举其要。虫疳者，其虫如丝，出于头项
腹背之间。黄白赤者可治，青黑者难治。蛔疳者，皱眉多啼，呕吐青沫，腹中作痛，肚胀青筋，唇
口紫黑，头摇齿痒。脊
疳者，身热赢黄，烦渴下利，拍背有声，脊骨如锯齿，十指皆疮，频啮指甲。脑疳者，头皮光急，
满头并疮，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。疳利者，停积宿滞，水谷不聚，泻下恶物
。疳肿者，虚中有积，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，肚硬如石，面色如银。大抵其证虽多，要不出于五脏，总宜以五脏
之法治之。
景岳曰∶按杨氏云∶疳者，干也，在小儿为五疳，在大人为五劳。然既云为干，又云为劳，岂
非精血败竭之证乎？察前诸法，俱从热治，多用清凉，虽此证真热者固多，而元气既败，则假热者
尤多也。即前所用，亦有地黄丸、异功散、益黄散、益气汤之类，恐此数方有不足以尽之。其或血
气俱损，有非大补不可者；阴虚假热，脾败肾亏，又有非温补不可者。贵在临证酌宜，仍当以虚损
治劳之法参用，庶得尽善。
薛氏曰∶按疳证或以哺食太早，或嗜食甘肥，或服峻厉之药，重亡津液，虚火炽盛，或因禀赋
，或乳母浓味七情致之，各当调治其内。若口舌蚀烂，身体壮热，腮唇赤色，或作肿痛，腹膈烦闷
，或掌热咽干，作渴饮，水，便赤盗汗，啮齿虚惊，此心经内外疳也，宜安神丸之类主之。若鼻外
生疮，眼目赤烂，肢体似癣，两耳前后、项侧、缺盆、两腋结核，或小腹、内股、玉茎、阴囊、睾
丸肿溃，小便不调，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
，此肝经内外疳也，用地黄、芦荟二丸主之。若头不生发，或生疮痂，或发成穗，或人中口吻赤烂
，腹痛吐逆，乳食不化，口干嗜土、泻下酸臭，小便白浊，或合目昏睡，恶闻木音，此脾经内外疳
也，用肥儿丸主之。若鼻外生疮，咽喉不利，颈肿齿痛，咳嗽寒热，皮肤皱错，欠伸少气，鼻痒出
涕，衄血目黄，小便频数，此肺经内外疳也，用地黄清肺饮主之。若脑热吐痰，手足逆冷，寒热往
来，滑泄肚痛，口臭作渴，齿龈溃烂，爪黑面黧，身耳生疮，或耳出水，或食自发，此肾经内外疳
也，用地黄丸主之。凡疳热上攻，或痘毒上升，为患甚速，名为走马疳，急敷雄黄散、搽牙散、马
鸣散、择而用之，服蟾蜍丸。轻则于龈腐烂，唇吻肿痛，可治；甚则牙龈蚀落，腮颊透烂，不治。
钱仲阳说：小儿的各种疳证，都是由于生病后脾胃受损，或者用药过度损伤了正气，导致无法运化乳食，体内津液耗竭，虚火妄动；或者是乳母受到六淫（风、寒、暑、湿、燥、火）和七情（喜、怒、忧、思、悲、恐、惊）的影响，饮食起居不当，从而连累婴儿致病。凡是疳邪在体内的，表现为眼睛肿胀、腹部胀大、腹泻痢疾且大便呈青白色，身体逐渐消瘦虚弱；疳邪在体表的，表现为鼻子下方红肿溃烂，频繁揉搓鼻子和耳朵，或者肢体上生出疮疡。大体来说，虽然症状繁多，但总归离不开五脏，而五脏的疳证各不相同，应当分别辨别并治疗。肝疳，又名筋疳，也叫风疳。其症状为白膜遮盖瞳孔，或者便血而消瘦，适宜用地黄丸（Rehmannia Pill）来滋养肾脏。心疳，表现为面色发黄、两颊潮红、身体高热，适宜用朱砂安神丸（Cinnabar Calming the Spirit Pill）来清心安神，用异功散（Yi Gong Powder）来补益脾土。脾疳，又名肥疳，身体发黄消瘦，皮肤干燥粗糙且有疮疥，腹部膨大、嗜食泥土，适宜用四味肥儿丸（Siwei Fei'er Pill）来治疗疳积，用五味异功散（Wuwei Yigong Powder）来培补脾土，或者使用益黄散（Yihuang Powder）。肺疳，又名气疳，表现为气喘咳嗽、呼吸急促，口鼻生疮，适宜用人参清肺汤（Renshen Qingfei Decoction）来清泻肺热，用益气汤（Yiqi Decoction）来补益肺气。肾疳，又名骨疳，肢体消瘦，全身生出疮疥，喜欢睡在潮湿的地方，适宜用地黄丸。鼻部疮疡使用兰香散（Lanxiang Powder）。各种疮疡使用白粉散（Baifen Powder）。如果患有潮热，应当先补肝，后泻心，如果错误地使用芒硝、大黄等药物进行攻下利导，就会演变成疳证。如果患有癖积，应当采用消磨积滞的方法，如果错误地用巴豆、硼砂等峻猛药物攻下，或者伤寒病误用攻下法，都能导致疳证。初起患病的热性疳证，使用黄连丸（Huanglian Pill）。久病的冷性疳证，使用木香丸（Muxiang Pill）。冷热夹杂的疳证，使用如圣丸（Rusheng Pill）。津液短少者，使用七味白术散（Qiwei Baizhu Powder）。这些情况都是因为大病之后，脾胃亏损，体内津液耗竭所致，应当以固护脾胃为主，及早施治，就不会转变为败坏难治的证候。
杨氏说：无辜疳，表现为脑后项边有肿块像弹丸一样，按压时可以转动，质地软而不疼痛，里面有虫，如果不迅速针刺排出，虫子就会向内侵蚀脏腑，导致肢体痈疽，大小便脓血，高热消瘦，头骨突出显露，适宜使用大芜荑汤（Da Wuyi Decoction）、蟾蜍丸（Chanchu Pill）。丁奚疳，表现为手足极细，颈部细小骨头突出，臀部削瘦身体痿弱，腹部膨大肚脐突起，号哭时胸部凹陷，适宜使用肥儿丸、大芦荟丸（Dalu Hui Pill）。哺露疳，表现为虚热往来，头骨缝分开，呕吐出虫子，烦躁口渴、呕吐呃逆，适宜使用肥儿丸、大芦荟丸。走马疳，表现为牙齿被腐蚀腐烂。因为牙齿属于肾，肾虚受热，痰火上炎，导致口臭牙齿变黑，甚至牙龈腐烂、牙宣暴露。适宜外敷雄黄散（Xionghuang Powder），内服蟾蜍丸。如果出现口渴、腹泻痢疾、肿胀、劳瘵等症状，应当详细参考方论进行治疗。大概疳的意思就是“干”，是因为脾胃津液干涸所致，在小儿称为五疳，在大人称为五劳，总宜以调补胃气为主。
另外，杨氏说：还有疳伤这种病症，是五脏虫疳，名称很多，姑且列举主要的。虫疳，其虫像丝线一样，出现在头项腹背之间。颜色黄白赤色的可以治愈，青黑色的难以治愈。蛔疳，表现为皱眉多啼哭，呕吐青色泡沫，腹中疼痛，肚子胀大有青筋暴露，嘴唇口角紫黑，摇头牙齿发痒。脊疳，表现为身体发热、肌肉消瘦色黄，烦躁口渴、腹泻，拍打背部有声，脊骨像锯齿一样，十个手指都有疮疡，频繁咬指甲。脑疳，表现为头皮光亮紧绷，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，表现为白天烦躁口渴，喝水但不进食，晚上口渴停止。疳泻，表现为毛发焦枯、嘴唇苍白，额头有青纹，肚子胀肠鸣，泻下未消化的食物残渣。疳利，表现为停积宿食停滞，水谷不能聚化，泻下恶臭污物。疳肿，表现为虚中有积滞，肚腹紧胀，脾脏再次受湿气影响，则头面手足虚浮。疳劳，表现为潮热往来，五心烦热，盗汗骨蒸，咳嗽气喘、形体枯槁憔悴，口渴腹泻饮水，肚子硬如石头，面色苍白如银。大体来说，虽然症状繁多，但总归离不开五脏，总宜以治疗五脏的方法来施治。
景岳说：考察杨氏所说：疳的意思是“干”，在小儿称为五疳，在大人称为五劳。既然说是“干”，又说是“劳”，难道不是精血败竭的证候吗？观察前面的各种治疗方法，都是从热证论治，多用清凉药物，虽然此证确实热证居多，但元气既然已经败坏，那么假热证尤其多见。即使前面所用的方剂，也有地黄丸、异功散、益黄散、益气汤之类，恐怕这几张方子不足以涵盖所有情况。如果是气血俱损，有大补不可的情况；阴虚假热，脾败肾亏，又有非温补不可的情况。贵在临证时酌情适宜，仍应当参考治疗虚损劳证的法则加以运用，才能尽善尽美。
薛氏说：考察疳证，有的因为喂养过早，有的嗜好食用甘甜肥腻之物，有的服用峻烈之药，严重耗伤津液，导致虚火炽盛；或者因为禀赋不足，或者乳母饮食浓味、情绪波动所致，各自应当调理内在脏腑。如果口舌蚀烂，身体高热，腮唇红色，或者肿痛，胸膈烦闷，或者手掌发热咽干，口渴饮水，小便赤涩、盗汗，磨牙虚惊，这是心经内外疳，适宜用安神丸之类主方治疗。如果鼻外生疮，眼目赤烂，肢体似癣，两耳前后、项侧、缺盆、两腋出现结核，或小腹、大腿内侧、阴茎、阴囊、睾丸肿胀溃破，小便不调，或者流出白色津液，或者咬指甲，摇头侧目，白膜遮盖瞳孔，羞明畏日，肚子大青筋暴露，口干下血，这是肝经内外疳，用地黄丸、芦荟丸主方治疗。如果头部不生头发，或者生疮结痂，或者头发结成穗状，或者人中、口吻赤烂，腹痛呕吐，乳食不化，口干嗜食泥土、泻下酸臭，小便白浊，或者闭目昏睡，厌恶听到木头撞击的声音，这是脾经内外疳，用肥儿丸主方治疗。如果鼻外生疮，咽喉不利，颈部肿胀牙齿疼痛，咳嗽寒热，皮肤皱褶错乱，伸欠少气，鼻痒流涕，鼻出血、目黄，小便频数，这是肺经内外疳，用地黄清肺饮主方治疗。如果脑部发热吐痰，手足逆冷，寒热往来，滑泄腹痛，口臭口渴，齿龈溃烂，指甲发黑面色黧黑，身体耳朵生疮，或者耳部出水，或者食物自发腐臭，这是肾经内外疳，用地黄丸主方治疗。凡是疳热向上攻冲，或者痘毒上升，为害非常迅速，名为走马疳，急需外敷雄黄散、搽牙散、马鸣散，择一使用，并内服蟾蜍丸。轻症则牙龈腐烂，唇吻肿痛，可以治愈；重症则牙龈蚀落，腮颊透烂，无法治愈。
Qian Zhongyang stated: Various types of Gan syndrome (wasting-accumulation syndrome) in children all result from spleen and stomach damage after illness, or over-treatment that injures healthy qi, leading to an inability to transform and transport milk and food. This causes internal depletion of body fluids and reckless movement of deficient fire. Alternatively, it may be caused by the wet nurse being affected by the six excesses (wind, cold, summerheat, dampness, dryness, fire) and seven emotions, with improper diet and daily routine, which then harms the infant. When Gan is internal, symptoms include swollen eyes, abdominal distension, diarrhea and dysentery with greenish-white stools, and gradual emaciation. When Gan is external, symptoms include redness and ulceration under the nose, frequent rubbing of the nose and ears, or sores on the limbs. Generally, although there are many manifestations, they all pertain to the five zang organs. Since Gan differs among the five zang organs, each must be differentiated and treated separately.
Liver Gan, also known as Jin Gan (sinew Gan) or Feng Gan (wind Gan), presents with a white membrane covering the pupil, or bloody diarrhea with emaciation. It should be treated with Dihuang Wan (Rehmannia Pill) to nourish the kidney. Heart Gan presents with a sallow complexion, red cheeks, and high fever. It should be treated with Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) to calm the heart, and Yigong San (Yi Gong Powder) to tonify the spleen. Spleen Gan, also known as Fei Gan (fat Gan), presents with a yellow, thin body, dry and rough skin with sores and scabies, a large abdomen, and geophagia (craving earth). It should be treated with Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) for Gan, Wuwei Yigong San (Five-Ingredient Yi Gong Powder) to generate earth, or Yihuang San (Yi Huang Powder). Lung Gan, also known as Qi Gan (qi Gan), presents with wheezing, coughing, shortness of breath, and sores in the mouth and nose. It should be treated with Renshen Qingfei Tang (Ginseng Lung-Clearing Decoction) to treat the lung, and Yiqi Tang (Qi-Boosting Decoction) to generate metal. Kidney Gan, also known as Gu Gan (bone Gan), presents with emaciated limbs, widespread sores and scabies, and a preference for lying on damp ground. It should be treated with Dihuang Wan. Nasal sores should be treated with Lanxiang San (Orchid Fragrance Powder). Various sores should be treated with Baifen San (White Powder). If tidal fever occurs, one should first tonify the liver and then drain the heart. If nitre (xiaoshi) and rhubarb (dahuang) are wrongly used to purge, it will become Gan. If pi accumulation (masses) occurs, it should be dissipated. If mistaken use of croton seed (badou) or borax (pengsha) for purging, or mistaken purging in cold damage, can lead to Gan. Early-stage heat Gan is treated with Huanglian Wan (Coptis Pill). Long-standing cold Gan is treated with Muxiang Wan (Aucklandia Pill). Mixed cold and heat Gan is treated with Rusheng Wan (Like-Sage Pill). Shortage of body fluids is treated with Qiwei Baizhu San (Seven-Ingredient Atractylodes Powder). All these arise from spleen and stomach damage after severe illness and internal fluid depletion. The primary approach should be to secure the spleen and stomach; treating early prevents transformation into fatal syndromes.
Yang Shi stated: Wugu Gan (Innocent Gan) presents with nodules like beans behind the neck and at the nape, which move upon pressure, are soft and painless, containing worms. If not promptly pricked to release them, the worms will internally consume the viscera, leading to limb carbuncles, pus and blood in stool and urine, high fever, emaciation, and prominent skull bones. It should be treated with Da Wuyi Tang (Large Coptis Decoction) and Chanchu Wan (Toad Pill). Dingxi Gan presents with extremely thin hands and feet, a small neck with protruding bones, a shrunken buttocks and weak body, a large abdomen with protruding umbilicus, chest depression when crying loudly. It should be treated with Fei'er Wan (Child-Nourishing Pill) and Daluhui Wan (Large Aloe Pill). Bulu Gan presents with alternating deficiency heat, separated cranial sutures, vomiting of worms, irritability, thirst, vomiting, and hiccups. It should be treated with Fei'er Wan and Daluhui Wan. Zouma Gan (Running Horse Gan) involves erosion and rotting of the teeth. Teeth belong to the kidney; kidney deficiency with heat causes phlegm-fire to flare upward, resulting in bad breath and blackened teeth, and even gum erosion and exposed tooth roots. It should be externally applied with Xionghuang San (Realgar Powder) and internally administered with Chanchu Wan. For symptoms such as thirst, diarrhea, dysentery, swelling, and consumption, treatment should follow detailed formula discussions. Gan means "dryness," caused by the drying up of spleen and stomach fluids. In children, it is called Five Gan; in adults, it is called Five Lao (consumption). The general principle is to regulate and tonify stomach qi.
Furthermore, Yang Shi stated: There is also Gan injury, which is worm Gan of the five zang organs, with many names. I will mention only the essentials. Worm Gan features worms like silk threads appearing between the head, neck, abdomen, and back. Yellow, white, and red colors are treatable; blue-black colors are difficult to treat. Hui Gan (Roundworm Gan) presents with frowning and frequent crying, vomiting of green foam, abdominal pain, abdominal distension with visible veins, purple-black lips and mouth, head shaking, and itchy teeth. Ji Gan (Spine Gan) presents with body heat, emaciation, and yellowish color, irritability, thirst, and diarrhea, audible sound upon patting the back, spine resembling sawteeth, sores on all ten fingers, and frequent nail-biting. Nao Gan (Brain Gan) presents with tight, shiny scalp, widespread sores on the head, brain heat like fire, matted hair like tassels, generalized sweating, swollen cheeks, and bulging fontanelle. Gan Ke (Thirst Gan) presents with daytime irritability and thirst, drinking but not eating, and cessation of thirst at night. Gan Xie (Diarrhea Gan) presents with scorched hair, white lips, green lines on the forehead, abdominal distension, borborygmus, and passage of undigested food. Gan Li (Dysentery Gan) presents with retained stagnation, failure of water and grain to consolidate, and passage of foul matter. Gan Zhong (Swelling Gan) presents with deficiency accompanied by accumulation, tight abdominal distension; if the spleen re-acquires dampness, the head, face, hands, and feet become flaccidly swollen. Gan Lao (Consumption Gan) presents with tidal fever, five-palm heat, night sweats, bone-steaming, coughing, asthma, emaciation, thirst, diarrhea, hard abdomen like stone, and silvery-white complexion. Generally, although symptoms are numerous, they do not exceed the five zang organs, and treatment should generally follow methods for the five zang organs.
Jingyue stated: Examining Yang Shi's statement: Gan means "dryness"; in children, it is Five Gan; in adults, it is Five Lao. If it is called "dry" and also "consumption," is it not a syndrome of exhaustion of essence and blood? Observing previous methods, they all treat heat, using mostly cooling agents. Although true heat cases are indeed common, once healthy qi is damaged, false heat cases are particularly numerous. Even the previously mentioned formulas, such as Dihuang Wan, Yigong San, Yihuang San, and Yiqi Tang, may not cover all cases. If both qi and blood are damaged, major tonification is required; if yin deficiency generates false heat with spleen failure and kidney decline, warming tonification is required. The key lies in clinical discretion, referring to methods for treating deficiency and consumption, to achieve perfection.
Xue Shi stated: Examining Gan syndrome: it may result from feeding too early, craving sweet and fatty foods, taking harsh medicines causing severe fluid loss and vigorous deficient fire, or due to constitutional factors, or the wet nurse's rich diet and emotional disturbances. Each case requires internal regulation. If there is oral and lingual erosion, high fever, red cheeks and lips, swelling and pain, chest oppression, palm heat, dry throat, thirst, dark urine, night sweats, bruxism, and fright, this is Heart Meridian internal and external Gan, treated mainly with Anshen Wan (Calming Spirit Pill). If there are sores outside the nose, red and rotten eyes, skin lesions resembling tinea, lymph node swellings behind the ears, at the nape, clavicle, axillae, lower abdomen, inner thighs, penis, scrotum, and testicles, irregular urination, discharge of white fluid, nail-biting, head shaking, squinting, white membrane covering the pupil, photophobia, large abdomen with visible veins, dry mouth, and bloody stools, this is Liver Meridian internal and external Gan, treated mainly with Dihuang Wan and Luhui Wan (Aloe Pill). If there is lack of hair growth, sores and crusts, matted hair, red and rotten philtrum and mouth corners, abdominal pain, vomiting, indigestion, dry mouth, geophagia, sour-smelling diarrhea, turbid white urine, drowsiness with closed eyes, and aversion to wooden sounds, this is Spleen Meridian internal and external Gan, treated mainly with Fei'er Wan. If there are sores outside the nose, throat discomfort, neck swelling, toothache, cough with chills and fever, wrinkled skin, yawning with shortness of breath, nasal itching with runny nose, epistaxis, yellow eyes, and frequent urination, this is Lung Meridian internal and external Gan, treated mainly with Dihuang Qingfei Yin (Rehmannia Lung-Clearing Decoction). If there is brain heat with expectoration, cold extremities, alternating chills and fever, slippery diarrhea with abdominal pain, bad breath and thirst, gum ulceration, black nails, sallow complexion, sores on body and ears, ear discharge, or spontaneously rotting food, this is Kidney Meridian internal and external Gan, treated mainly with Dihuang Wan. Whenever Gan heat attacks upward, or pox toxins rise, causing rapid harm, it is named Zouma Gan (Running Horse Gan). Urgently apply Xionghuang San, Ya Cha San (Teeth-Rubbing Powder), or Ming San (Brightening Powder), choosing one, and administer Chanchu Wan. Mild cases involve gum erosion and lip/mouth swelling/pain, which are treatable; severe cases involve gum necrosis and cheek perforation, which are untreatable.