谷气积成疳，肝强木火炎，烁金而克土，五脏已伤三，腹大肌肤瘦，声干秘结兼，目盲命亦致，医者请详参。
疳者甘也，盖肥腻美味致病之名。疳积兼寒苦而言。凡小儿并无伤寒、疟疾，却发热烦渴，肌肉渐渐消瘦，
筋青发竖，腹满不利，白珠带青，或黄，或枯瘁，黑睛混浊，色如
死后，抱轮微红，怕亮不睁，眼睫频眨，眵泪如糊，最后风轮上有白膜，膜上旋起黑晕，遂失明。次第如此，疳
眼无疑也。病根于土，土燥则郁木，木受郁则风火无从而泄，以故脏腑皆受其害，酿成此祸。先辈谓饮食过倍，
即困土，复妨肝，肥儿用神曲，芜荑为丸，正恐其成疳也。若面不甚黄瘦，睑能开合，晕膜浅者，勿治其目。保
婴丸、治中宣化丸竟治其疳，疳去目徐瘥。虽然疳亦难期瘥日，为子也母者，勿以多不为意，毋以少而娇养。为
子也父者，不防未然于必然，而以后车蹈前车，致小儿瞽而毕命，全不哀悼，伤哉！
疳有肥瘦，无分冷热。肥者形气充盈，胸腹不甚热，二便常利；瘦者手足细甚，项小尻削，二便不通。总由
脾胃虚败，不能营运饮食，或饮食不常，得损及脾胃，生痰生热，转风转虫。务宜消积、消毒、杀虫，循次乘除，
间亦有获痊者。方书有冷疳之名，无肥疳之辨。冷主藏寒，是必热治；肥疑气虚，定忧泄利，既补且固，则助益
病，能速其死矣。
谷气积聚形成疳证，导致肝气过强、木火炎上，灼伤肺金并克制脾土，致使五脏受损。其症状表现为腹部胀大而肌肤消瘦，声音嘶哑且大便干结，严重者可致失明甚至危及生命，医者需详细参详。
“疳”字通“甘”，是指因食用肥腻美味食物而致病的一种名称。疳积常与寒苦之症相对而言。凡是小儿并无伤寒或疟疾等外感病，却出现发热、烦躁口渴，肌肉逐渐消瘦，筋脉显露、头发竖立，腹部胀满且排便不畅，眼白部分带青色、黄色或干枯憔悴，黑睛混浊如死后之色，抱轮（角膜周围）微红，畏光不睁眼，眼睑频繁眨动，眼屎和泪水像糊状，最后风轮（黑睛/角膜）上出现白膜，膜上旋起黑晕，最终导致失明。病情依次发展如此，确为疳眼无疑。此病根源在于脾土，脾土燥热则郁滞肝木，肝木受郁则风火无法宣泄，因此脏腑皆受其害，酿成此祸。先辈认为饮食过量，就会困阻脾土，进而妨碍肝气，使用神曲、芜荑制成丸药以健脾胃、消积食，正是为了防止其发展为疳证。如果患儿面色不甚黄瘦，眼睑能正常开合，晕膜较浅者，不要只治疗眼睛。应使用保婴丸、治中宣化丸直接治疗疳积，疳积去除后，眼部症状自然会慢慢痊愈。虽然疳证难以期望迅速痊愈，但作为母亲，不要因为孩子多病就不在意，也不要因为孩子少病就娇惯溺爱。作为父亲，如果不防患于未然，而是重蹈覆辙，导致小儿失明乃至丧命，完全不感到哀悼悲痛，真是令人伤感啊！
疳证有肥疳和瘦疳之分，不分寒热。肥疳者形体气息充盈，胸腹部不太热，大小便通常通畅；瘦疳者手足非常细弱，颈部细小、臀部削薄，大小便不通畅。总归是由于脾胃虚弱败坏，不能运化饮食，或者饮食不规律，损伤脾胃，产生痰湿和热邪，进而转化为风邪或虫积。务必采用消积、解毒、杀虫的方法，循序渐进地调理，偶尔也有痊愈的。医书中虽有“冷疳”之名，但没有对“肥疳”进行辨析。冷疳主藏寒，必须用热法治疗；肥疳疑似气虚，定要注意防止泄泻痢疾，如果既补又固涩，反而会助长病邪，加速死亡。
Accumulation of grain qi forms *gan* (malnutrition syndrome), leading to hyperactive liver qi and flaming wood-fire, which scorches lung metal and overacts on spleen earth, damaging the five zang organs. Symptoms include abdominal distension with emaciated muscles, hoarse voice accompanied by constipation, and in severe cases, blindness and death; physicians must examine these details carefully.
The term "Gan" is homophonous with "Gan" (sweet/greasy), referring to a disease named after the consumption of rich, greasy, and delicious foods. Gan accumulation is often discussed in contrast to cold-bitter conditions. In infants who do not suffer from exterior syndromes such as Cold Damage (*Shanghan*) or Malaria, yet present with fever, irritability, and thirst, gradual emaciation of muscles, visible tendons, erect hair, abdominal fullness with difficult defecation, sclera showing blue, yellow, or dry/withered hues, corneal opacity resembling post-mortem appearance, slight redness around the limbus, photophobia with inability to open eyes, frequent blinking of eyelids, and sticky discharge like paste, followed finally by a white membrane appearing on the wind wheel (cornea) with black halos rotating upon it, ultimately resulting in blindness. The progression follows this sequence, confirming the diagnosis of Gan eye without doubt. The root of this disease lies in spleen earth; when spleen earth becomes dry and hot, it stagnates liver wood; when liver wood is stagnated, wind and fire cannot dissipate, thereby harming all zang-fu organs and酿 (brewing) this disaster. Predecessors stated that excessive food intake confounds spleen earth and subsequently hinders liver qi; using *Quzhi Wan* (Medicated Leaven Pills) containing *Qu* (Medicated Leaven) and *Wuyi* (Pseudolarix Bark) aims to prevent the development of Gan. If the face is not significantly sallow or thin, eyelids can open and close normally, and the membrane/halo is shallow, one should not treat only the eyes. Instead, use *Baoying Wan* (Infant Protection Pills) or *Zhizhong Xuanhua Wan* (Regulate Middle and Transform Stagnation Pills) to directly treat Gan; once Gan is resolved, the eye condition will gradually heal. Although Gan is difficult to expect rapid recovery, mothers should not disregard frequent illnesses nor indulge children due to rare illnesses. Fathers, if they fail to prevent potential disasters before they occur, repeating past mistakes, leading to infant blindness and death without mourning, is truly lamentable!
Gan presents as either fat-type or thin-type, regardless of cold or heat patterns. Fat-type Gan features robust physique and qi, minimal chest/abdominal heat, and usually unobstructed urination and defecation; Thin-type Gan features very slender limbs, thin neck, and flat buttocks, with obstructed urination and defecation. Ultimately, both stem from spleen-stomach deficiency and failure to transport and transform dietary nutrients, or irregular eating habits damaging the spleen-stomach, generating phlegm and heat, which transform into wind or parasites. Treatment must focus on resolving accumulation, clearing toxicity, and expelling parasites, proceeding step-by-step; occasional recoveries do occur. Medical texts mention "Cold Gan" but lack differentiation for "Fat Gan." Cold Gan involves internal cold, requiring hot treatment; Fat Gan suggests qi deficiency, necessitating caution against diarrhea/dysentery; applying both tonification and astringency would aid the pathogen and accelerate death.