杨氏云∶由乳哺不调，脏腑伏热所致也。凡甘味入于脾而动虫，虫动则侵蚀脏
腑，遂使孩提心下扰闷，若上蚀齿龈则口疮出血，齿色紫黑，下蚀肠胃则下痢肛烂，
湿痒生疮，疗治不早，精髓消耗，难以有瘳，虫者 也，目为湿 ，多因疳伤久痢，
肠胃受湿得之。状如狐惑伤寒齿蚀之证，或以走马命名，盖齿属肾，肾主虚，才受
热邪，疳气直奔上焦，故以走马为喻，初作口气，名曰臭息。次第齿黑，名曰崩砂。
盛则龈烂，名曰溃槽。热血迸出，名曰宣露。甚者齿皆脱落，名曰腐根，其根既腐，
纵得全活，齿不复生。外证，脑热肌削，手足如冰，寒热时来，滑泄肚痛，口臭干
渴，齿龈生疮，爪黑面黧，身多疮疥是也。钱氏，地黄丸主之。仍当于生脉散中
多加黄 以补肺。曾氏，用调元散。
调元散 主禀受元气不足，颅囟开解，肌肉消瘦，腹大如肿，致语迟行迟，手足如
分。同神色昏慢，齿生迟，服之效。
干山药（去黑皮，五钱） 人参（去芦） 白茯苓（去皮） 茯神（去皮根） 白术 白芍药 熟地黄（酒洗）
当归（酒洗） 黄 （蜜水炙。各二钱半） 川芎 甘草（炙。各三钱） 石膏
上碎。每服二钱，水一盏，姜二片，枣一枚，煎七分，无时温服。如婴孩幼嫩，
与乳母同服。
九味地黄丸 治肾疳。
熟地黄（四钱五分） 赤茯苓 山茱萸肉 川楝子 当归 川芎 牡丹皮 山药 使
君子肉（二钱）
上为末，蜜丸桐子大。每服八十丸，空心温酒下。
〔张涣〕熊胆散 治急疳虫伤脏腑，上蚀口齿，生疮赤烂，世呼为走马疳。
莨宕子（炒、令微黑） 虾蟆灰 白矾（各半两） 生硫黄（一分。以上捣罗为细末，次用） 熊胆（半两，细研）
麝香 雄黄 芦荟（各一分，并细研）
上件药一处拌匀，为细末。每服一字，煎荆芥汤调下。如有疮处宜薄敷之。如
鼻痒，即取少许逐日吹鼻中，日三两上。
熊胆膏 截急疳病。
真熊胆（半两，研） 蚺蛇胆（为末） 芦荟（研） 牛黄（研。各一分） 龙脑 麝香（各一钱，并研细）
上件药都细研，以井华水一小盏搅和匀，以瓷器盛，重汤慢火熬成膏。每服一
豆大，薄荷汤化下，兼涂患处。
立圣膏 治急疳侵蚀。
人乳汁（半合） 黄矾（一栗大） 白矾（一枣大） 石胆（一豆大）
上件药都研细，以绵裹，纳乳汁中浸经一宿，看汁有味，慢火熬成膏。每用少
许涂于口里。如鼻中有疮，滴入少许。若有肿处，先以三棱针刺破，除去血，然后即涂此药。
二金散 治急疳毒盛。
砒霜（一分） 麝香（半两）
上件药，先将砒霜去纸上炒过，后入麝香同研令细。每用一字，以鸡羽掠在疮
上，日使三两度，随时展去药，无令咽津。
治小儿肾疳并疝气偏坠寒热方
没药（炮） 甘草（各二分） 硫黄 木香（炮） 胡黄连（各一分）
上为末，用蒸枣肉丸，如麻子大。苁蓉汤下三丸，可两服。（庄氏第七候用此方。）
杨氏说：这是由于乳食喂养不当，导致脏腑内伏藏热邪所致。凡是甘味食物进入脾脏就会生虫，虫动则侵蚀脏腑，于是使幼儿心下烦闷扰攘；如果向上侵蚀齿龈，就会出现口疮出血、牙齿颜色紫黑；向下侵蚀肠胃，则出现腹泻痢疾、肛门溃烂、湿痒生疮。治疗如果不及时，精髓耗损，就难以痊愈。所谓“疳”，是指眼睛浑浊如雾（目为湿翳），多因疳证日久导致久痢，肠胃受湿邪侵袭而得病。其症状类似狐惑病或伤寒中牙齿被腐蚀的证候，有的以“走马”命名，因为牙齿属于肾，肾主虚，刚受热邪，疳气便直奔上焦，所以用“走马”来比喻其发展迅速。初起时口气臭秽，名叫“臭息”；接着牙齿变黑，名叫“崩砂”；严重时牙龈腐烂，名叫“溃槽”；热血迸出，名叫“宣露”；更严重的牙齿全部脱落，名叫“腐根”，牙根既然腐烂，即使得以保全性命，牙齿也不再生长。外在证候表现为：头脑发热、肌肉消瘦、手脚冰凉、寒热交替发作、滑泄腹痛、口臭口干渴、齿龈生疮、指甲发黑、面色黧黑、身上多有疮疥等。钱乙主张用地黄丸主治。同时应当在生脉散中多加黄芪以补益肺气。曾世荣主张使用调元散。
调元散 主治先天禀赋元气不足，颅囟不合（头颅骨缝未闭合），肌肉消瘦，腹部胀大如肿，导致说话迟、行走迟，手足分开不能并拢。伴有神色昏沉怠慢，牙齿生长迟缓，服用此药有效。
干山药（去除黑皮，五钱） 人参（去芦头） 白茯苓（去皮） 茯神（去皮根） 白术 白芍药 熟地黄（酒洗） 当归（酒洗） 黄芪（蜜水炙。各二钱半） 川芎 甘草（炙。各三钱） 石膏
以上药物捣碎。每次服用二钱，用水一盏，生姜两片，大枣一枚，煎至七分，不拘时候温服。如果是幼嫩的婴儿，可与乳母同服。
熟地黄（四钱五分） 赤茯苓 山茱萸肉 川楝子 当归 川芎 牡丹皮 山药 使君子肉（二钱）
以上药物研为细末，用蜂蜜制成梧桐子大小的丸剂。每次服用八十丸，空腹时用温酒送服。
〔张涣〕熊胆散 治疗急疳虫伤脏腑，向上侵蚀口齿，生疮红肿溃烂，世人称之为走马疳。
莨菪子（炒至微黑） 蛤蟆灰 白矾（各半两） 生硫黄（一分。以上捣罗成细末，备用） 熊胆（半两，细研） 麝香 雄黄 芦荟（各一分，并细研）
以上药物混合均匀，研为细末。每次服用一字量，用荆芥汤调服。如果有疮处，宜薄薄敷上。如果鼻子痒，就取少许每日吹入鼻中，每天三到五次。
熊胆膏 截断急疳病症。
真熊胆（半两，研） 蚺蛇胆（研为末） 芦荟（研） 牛黄（研。各一分） 龙脑 麝香（各一钱，并研细）
以上药物都细研，用井华水一小盏搅和均匀，用瓷器盛装，隔水慢火熬成膏状。每次服用一粒豆大小，用薄荷汤化开送服，兼涂患处。
立圣膏 治疗急疳侵蚀。
人乳汁（半合） 黄矾（如一栗子大） 白矾（如一枣核大） 石胆（如一豆大）
以上药物都研细，用棉布包裹，放入乳汁中浸泡一夜，待汁液有味后，用慢火熬成膏状。每次用少许涂于口中。如果鼻中有疮，滴入少许。如果有肿胀处，先用三棱针刺破，除去血液，然后立即涂上此药。
二金散 治疗急疳毒盛。
以上药物，先将砒霜放在纸上炒过，再加入麝香共同研细。每次用一字量，用鸡羽蘸取擦在疮上，每天三到四次，随时清理掉药物，不要让患者吞咽津液。
Yang Shi stated: This condition arises from improper breastfeeding and feeding, leading to latent heat within the zang-fu organs. Sweet flavors entering the Spleen generate parasites; when these parasites move, they erode the zang-fu organs, causing distress and oppression in the epigastrium of young children. If they erode upwards into the gums, it results in mouth sores with bleeding and purple-black teeth. If they erode downwards into the intestines and stomach, it leads to dysentery, anal erosion, dampness-induced itching, and sores. If treatment is not initiated early, essence and marrow are consumed, making recovery difficult. The term "Gan" (Pediatric Malnutrition Syndrome) refers to eyes clouded like a film (Mu Wei Shi Yi), often caused by prolonged diarrhea due to long-standing Gan syndrome, where the intestines and stomach are affected by dampness. The presentation resembles the tooth-erosion symptoms seen in Huhu Disease (Fox-Hydrargyrus-like disease) or Shanghan (Cold Damage). It is sometimes named "Zouma" (Running Horse) because teeth belong to the Kidney, which governs deficiency; upon exposure to heat pathogens, Gan Qi rushes directly to the Upper Jiao, hence the metaphor of speed. Initially, foul breath occurs, named "Chou Xi". Subsequently, teeth turn black, named "Beng Sha". When severe, gums rot, named "Kui Cao". Blood spurts out, named "Xuan Lu". In extreme cases, all teeth fall out, named "Fu Gen"; once roots rot, even if life is saved, teeth will not regrow. External signs include: hot head, emaciated muscles, cold hands and feet, alternating chills and fever, slippery diarrhea with abdominal pain, bad breath, dry mouth and thirst, gum sores, black nails, sallow complexion, and numerous skin sores and scabies. Qian Yi advocated using Dihuang Wan (Rehmannia Pill) as the primary treatment. Additionally, Huangqi (Astragalus Root) should be added in large amounts to Shengmai San (Generate the Pulse Powder) to tonify Lung Qi. Zeng Shirong advocated using Tiaoyuan San (Regulate Origin Powder).
Tiaoyuan San (Regulate Origin Powder) treats congenital insufficiency of Yuan Qi (Original Qi), open fontanelles, emaciation, distended abdomen resembling swelling, delayed speech and walking, and hands/feet held apart. Accompanied by dull spirit and slow demeanor, delayed tooth eruption; effective after administration.
Shanyao (Dioscoreae Rhizoma, dried, black skin removed, 5 qian) Renshen (Panax Ginseng Radix et Rhizoma, radix removed) Baifuling (Poria, peel removed) Fushen (Poria with Hostwood, peel and roots removed) Baizhu (Atractylodis Macrocephalae Rhizoma) Baishao (Paeoniae Radix Alba) Shudihuang (Rehmanniae Radix Praeparata, wine-washed) Danggui (Angelicae Sinensis Radix, wine-washed) Huangqi (Astragali Radix, honey-fried. Each 2.5 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma) Gancao (Glycyrrhizae Radix et Rhizoma, roasted. Each 3 qian) Shigao (Gypsum Fibrosum)
Crush the above ingredients. Take 2 qian per dose, add one cup of water, two slices of ginger, and one jujube. Decoct until reduced to 70%. Warm and take at any time. For tender infants, administer together with the nursing mother.
Jiuwei Dihuang Wan (Nine-Ingredient Rehmannia Pill) treats Kidney Gan.
Shudihuang (Rehmanniae Radix Praeparata, 4.5 qian) Chi Fuling (Poria with Red Coir) Shanzhuyu (Corni Fructus) Chuanlianzi (Toosendan Fructus) Danggui (Angelicae Sinensis Radix) Chuanxiong (Ligustici Chuanxiong Rhizoma) Mudanpi (Moutan Cortex) Shanyao (Dioscoreae Rhizoma) Shijunzirou (Quisqualis Semen Endocarp, 2 qian)
Grind into powder, make pills with honey the size of tung seeds. Take 80 pills per dose, swallow with warm wine on an empty stomach.
[Zhang Huan] Xiongdan San (Bear Bile Powder) treats acute Gan where parasites damage zang-fu, eroding upwards into mouth and teeth, causing red, swollen, and rotten sores, known in the world as Zouma Gan (Running Horse Gan).
Langdangzi (Semen Daturae, stir-fried until slightly black) Hamagui (Ash of Toad) Baifan (Alumen, each half liang) Sheng Liuhuang (Native Sulphur, 1 fen. Above ingredients pounded and sifted into fine powder, then used) Xiongdan (Ursi Fel, half liang, finely ground) Shexiang (Moschus) Xionghuang (Realgar) Lvhua (Aloe, each 1 fen, finely ground)
Mix all ingredients evenly, grind into fine powder. Take one zi measure per dose, mix with Jingjie Tang (Schizonepeta Decoction) and swallow. Apply thinly to sores if present. If nose itches, blow a small amount into the nostrils daily, three to five times.
Xiongdan Gao (Bear Bile Ointment) arrests acute Gan disease.
Zhen Xiongdan (True Ursi Fel, half liang, ground) Ranchedan (Bungarus Caeruleus Gallbladder, powdered) Lvhua (Aloe, ground) Niuhuang (Bovis Calculus, ground. Each 1 fen) Longnao (Borneolum Syntheticum) Shexiang (Moschus. Each 1 qian, finely ground)
Finely grind all ingredients, mix with a small cup of well-water until uniform. Store in porcelain, simmer slowly over a double boiler until ointment forms. Take a bean-sized amount per dose, dissolve in Bohe Tang (Mentha Decoction), and apply to affected areas.
Lisheng Gao (Supreme Sage Ointment) treats acute Gan erosion.
Renruji (Human Breast Milk, half he) Huangfan (Calcareous Alum, size of a chestnut) Baifan (Alumen, size of a jujube pit) Shidan (Melanterite, size of a bean)
Finely grind all ingredients, wrap in cotton, soak in breast milk overnight. When the liquid has flavor, simmer slowly into an ointment. Apply a small amount inside the mouth. If there are sores in the nose, drip a small amount. If swelling exists, first puncture with a Sanleng needle (Spina Tripterygii), drain blood, then apply this medicine immediately.
Erjin San (Two Metals Powder) treats acute Gan with severe toxicity.
Pishuang (Arsenic Trioxide, 1 fen) Shexiang (Moschus, half liang)
First, roast Pishuang on paper, then mix with Shexiang and grind finely. Use one zi measure per application, brush onto sores with a chicken feather, three to four times daily. Remove medication promptly; do not allow swallowing of saliva.
Formula for treating Pediatric Kidney Gan and Hernia with Cold and Fever
Moyao (Myrrha, processed) Gancao (Glycyrrhizae Radix et Rhizoma. Each 2 fen) Liuhuang (Sulphur) Muxiang (Aucklandiae Radix, processed) Huhuanglian (Coptidis Chinensis Rhizoma. Each 1 fen)
Grind into powder, form pills with steamed jujube flesh the size of hemp seeds. Take three pills with Congrong Tang (Cynomorii Decoction); may be taken twice. (Used by Zhuang Shi's Seventh Stage protocol.)