钱仲阳云∶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。五脏之疳不同,当各分辨。肝疳者,一名
风疳,其症白膜遮睛,或泻血羸瘦。心疳者,其症面黄颊赤,身体壮热。脾疳者,一名肥疳
,其症肢体黄瘦,皮肤干涩,多生疮疥,腹大食土。肺疳者,一名气疳,其症喘嗽不已,口
鼻生疮。肾疳者,一名骨疳,其症肢体削瘦,遍身疮疥,喜卧湿地。杨氏云∶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
,青黑者难疗。蛔疳者,皱眉多啼,呕吐青沫,腹中作痛,肚腹青筋,唇口紫黑,头摇齿痒
。脊疳者,身热羸黄,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,毛焦唇含,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,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。无辜
疳者,脑后颈边有核如弹丸,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。相传儿衣夜露,为鸱鸟羽所污亦致此症。若手足
极细,项小骨高,尻削体痿,腹大脐突,号哭胸陷,名丁奚。若虚热往来,头骨分开,翻食
吐虫,烦渴呕秽,名哺露。若牙齿蚀烂,名走马疳。盖齿属肾,肾虚受热,疳火上炎,致口
臭齿黑,甚则龈烂牙宣。大抵其症虽多,要不出于五脏。治法∶肝疳,用地黄丸以生肾。心
疳,用安神丸以治心;异功散以补脾。脾疳,用四味肥儿丸以治疳;五味异功散以生土。肺
疳,用清肺饮以治肺;益气汤以生金。脑疳,亦用地黄丸。无辜疳,用大芜荑汤、蟾蜍丸。丁
奚、哺露,用肥儿丸、大芦荟丸。走马疳,敷雄黄散;服蟾蜍丸。若作渴泻痢,肿胀劳瘵等类
,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
以调补胃气为主。
治验(更参肛门作痒)
陈职方孙三岁,面颊患疮,沿蚀两目,肚大青筋,小便澄白,此肝疳之症也,用大芜荑汤二
剂而愈。
陈司厅子,遍身生疮,面色痿黄,腹胀内热,大便不调,饮食少思,倦怠口干,为肝脾疳症
,用大芦荟丸,不月而痊。
陈工部长孙,腹内一块,小便不调,或用行气破血等药,发热口干,体瘦懒食,面黄兼青,
几成瘵症,以补中益气汤煎送大芦荟丸四服,又用前汤加车前子煎送六味丸四服,又用清肝
生血之药而痊。
一女子十二岁,目生白翳,面黄浮肿,口干作泻,用四味肥儿丸而痊。
一小儿头摇目札,口渴下血,此肝经血虚风热也,用地黄丸而痊。若肝经湿热,兼用泻青丸
。盖虚则补其母,实则泻其子也。
一小儿十一岁,两耳后脑下各结一核,色不变不痛,而面色痿黄,体倦口干,去后不调,用
芦荟丸治之,诸症顿愈。
一小儿鼻外生疮,不时揉擦,延及两耳。又一小儿视物不明,鼻内或痒或生疮,用四味肥儿
丸并愈。
一小儿水入耳内,耳外生疮,脓水淋漓,经岁不愈,余谓肝火上炎,用大芦荟丸而愈。
一小儿遍身如疥,或痒或痛,肌体消瘦,日夜发热,口干作渴,大便不调,年余不愈。用九
味芦荟丸而愈。
一小儿数岁,脑后并结二核,肉色如故,亦不觉痛,用大芦荟丸以清肝脾,佐以地黄丸补肾
水,形体健而核自消。
一小儿腹内结块,小便不调,此肝经内疳也,用龙胆泻肝汤及大味芦荟丸而痊。
一小儿自生后两目赤肿,或作痒,或生翳,此胎禀肝火,用芦荟丸、六味地黄丸而痊。
一小儿患瘰 ,小便频数,两目连札,作呕少食,泄泻后重。用补中益气汤、六味地黄丸渐
愈,佐以芦荟丸而痊。
一小儿食泥土,困睡泄泻,遍身如疥,此脾经内外疳也,用六君子汤、肥儿丸而愈。
一小儿面黄颊赤,发热作渴,睡中惊悸,此心经内外疳也,用秘旨安神丸而痊。
一小儿患前症,兼掌心发热,遍身如疥,用安神、肥儿二丸而愈。
一小儿咳嗽寒热,咽喉不利,鼻上有疮,久而不结痂,此肺经疳症也,用地黄清肺饮而痊。
一小儿下疳溃痛,爪黑面黧,遍身生疥,此肝经内外疳也,用地黄、芦荟二丸而愈。
史少参幼子二岁,项后结核,不时仰叫,或以为热疮内溃,用针决之,服消毒之药后,曲腰
啼哭,余谓此名无辜疳,仰身而哭,外 症也;腰哭而啼,内 症也,元气败矣,果殁。
一小儿四肢消瘦,肚腹渐大,寒热嗜卧,作渴引饮,此肝脾疳也。名丁奚哺露,用白术散为
主,佐以十全丹,月余诸症渐愈,乃以异功散加当归及六味丸而痊。
一小儿患疳,虚症悉具,热如火炙,病状不能尽述,朝用异功散,夕用四味肥儿丸,月余诸
症稍愈,佐以九味地黄丸,自能行立。遂朝以六味地黄丸,夕以异功散及蚵蟆丸而痊。
一小儿四肢消瘦,肚腹胀大,行步不能,作渴发热,去后臭秽,以十全丹数服,诸症渐愈,
又用异功散、肥儿丸,调理渐愈。
大芦荟丸 治疳杀虫,和胃止泻。
胡黄连 黄连 白芜荑(去扇) 芦荟 木香 青皮 白雷丸(破开,赤者不用) 鹤虱(微炒。各半
两) 麝香(二钱,另研)
上为末,粟米饭丸,绿豆大。每服一二十丸,米饮下。
愚按∶前方肝脾疳积,食积发热,目生云翳;或疳热,颈项结核;或耳内生疮,肌体消瘦,
发热作渴,饮食少思,肚腹膨胀;或牙龈蚀落,项腮腐烂,阴囊、玉茎生疮;或胸胁小腹作
痛,并效。内青皮以龙胆草代之,麝香不用尤效。
六味肥儿丸 消疳、化虫、退热。
黄连 陈皮 川楝子(去核炒) 神曲(炒) 麦 (炒。各一两) 白芜荑(半两)
上为末,糊丸,麻子大。每服一二十丸,空心米饮吞下。
愚按∶前方又治脾疳,饮食少思,肌肉消瘦,肚大颈细,发稀成穗,项间结核,发热作渴,
精神倦怠,大便酸臭,嗜食泥土;或口鼻头疮,肚见青筋,啮齿下痢,便白五疳。用此丸加
干蟾一两,芜荑五钱尤妙。
蚵蟆丸 治无辜疳症,一服虚热退;二服烦渴止;三服泻痢住。
蟾蜍(一枚,夏月沟渠中腹大、不跳、不鸣、身多癞 者)
上取粪蛆一杓置桶中,以尿浸之,桶上要干,不令虫走出,却将蟾蜍扑死,投蛆中食一昼夜
,以布袋盛置,浸急水中一宿,取出瓦上焙为末,入麝一字,粳米饭揉丸,麻子大。每服二
十丸,米饮下。
愚按∶前方又治无辜疳症,面黄壮热不食,舌下有虫;或脑后有核,软而不痛,中有粉虫,
随气流散,侵蚀脏腑,便滑脓血,日渐黄瘦,头大发竖,手足细软,变生天 ;猢狲鹅口,
木舌悬痈,重 着噤,脐风撮口重舌,龟背龟胸,一十二种败症。急用蟾蜍丸、大芜荑汤治
之,多有生者。
生熟地黄汤 治疳眼闭合不开。
生地黄 熟地黄(各半两) 川芎 赤茯苓 枳壳(制) 杏仁(去皮) 川黄连 半夏曲 天麻 地骨
皮甘草(炙。各二钱五分)
上每服二钱,黑豆十五粒、姜水煎服。
嚏疳散 治疳。
芦荟 黄连(各一钱) 瓜蒂 猪牙皂角 虾蟆灰(各五分) 麝香(少许)
上为末,吹入鼻,嚏则可疗。
脂连丸 治五疳潮热,腹胀发焦。
胡黄连(半两) 五灵脂(一两)
上为末, 猪胆汁丸,麻子大,米饮下。
茯苓丸 治心疳惊疳。
茯神 芦荟 琥珀 川黄连(净) 赤茯苓(各三钱) 钩藤皮 远志肉 虾蟆灰(各三钱) 石菖蒲(一
钱) 麝香(少许)
上为末,粟米丸麻子大,薄荷汤下。
神效换肌丸 治脾疳肌瘦,潮热盗汗,泄泻糟粕,头大腹急。
川黄连(炒) 鳖甲(酒炙) 肉豆蔻(煨) 使君子(面裹煨) 神曲(炒) 麦芽(炒。各半两) 诃子肉(一
钱半)
上为末,糊丸芥子大,米汤下。
天麻丸 治肝疳、风疳、疳眼。
青黛 川黄连 天麻 五灵脂 夜明砂(微炒) 川芎 芦荟(各二钱) 龙胆草 防风 蝉蜕(去足
,各一钱半) 全蝎(二枚,焙) 麝香(少许) 干蟾头(炙焦,三钱)
上为末,猪胆汁浸糕丸麻子大。每服十丸,薄荷汤下。
化 丸 治诸疳生虫,不时啼哭,呕吐清水,肚腹胀痛,唇口紫黑,肠头湿 。
芜荑 芦荟 青黛干 川芎 白芷稍 胡黄连 川黄连 虾蟆灰(各等分)
上为末,猪胆汁浸糕糊丸,麻子大。每服一二十丸,食后临卧,杏仁煎汤下。其鼻常用熊胆
煎汤,笔蘸洗,俟前药各进数服,却用青黛、当归、赤小豆、瓜蒂、地榆、黄连、芦荟、雄黄
为末,入鼻疮敛。
灵脂丸 治脾疳、食疳。
白豆蔻 麦芽(炒) 五灵脂 宿砂 蓬术(煨) 青皮 橘红 使君子(焙。各二钱) 虾蟆(炙焦,三
钱)
上为末,米糊丸,麻子大。每服十丸,米汤下。
下虫丸 治疳蛔诸虫
新白苦楝根皮(酒浸焙) 绿包贯众 木香 桃仁(浸去皮焙) 芜荑(焙) 鸡心槟榔(各二钱) 鹤虱(炒
,一钱) 轻粉(五分) 干虾蟆(炙焦,三钱) 使君子(五十,取肉煨)
上为末,面糊丸麻子大。每服一二十丸,天明清肉汁下,内加当归、川连各二钱五分。
龙胆丸 治脑疳,脑热疮。
龙胆草 升麻 苦楝根皮(焙) 赤茯苓 防风 芦荟 油发灰(各二钱) 青黛(干) 黄连(净。各三
上为末,狁猪胆汁浸糕糊丸,麻子大,薄荷汤下,仍以芦荟末入鼻。
黄连丸 治疳劳。
黄连(半两,净狁胆汁浸晒) 石莲 栝蒌根 杏仁(浸,去皮焙) 乌梅肉(各二钱)
上为末,牛胆汁浸糕糊丸,麻子大,煎乌梅、姜、蜜汤下。
香蔻丸 治疳泻。
黄连(三钱,炒) 肉豆蔻 木香 诃子肉(煨) 砂仁 茯苓(各二钱)
上为末,饭丸麻子大,米饮下。
木香丸 治疳痢。
黄连(净,三钱) 木香 紫浓朴(制) 夜明砂(隔纸炒。各二钱) 诃子肉(炒,一钱)
上为末,饭丸麻子大,干艾生姜煎汤,食前下。
十全丹 治丁奚哺露。
青皮 陈皮(各去白) 川芎 五灵脂 白豆蔻仁 鸡心槟榔 芦荟(各五钱) 木香 使君子(焙)
虾蟆灰(各三分)
上为末,猪胆汁浸糕糊丸,麻子大。每服一二十丸,米饮下;有热,薄荷汤下。
汤氏十全丹 治前症。
槟榔 枳壳(汤浸去穣,麸炒) 青皮 陈皮(去白) 丁香 木香(炮,各二钱五分) 香附子(炒,一
上为末,神曲糊丸黍米大,每服三十丸,空心食前米饮下。
愚按∶前症因乳哺不调,伤损脾胃,不思饮食,气血日损,四肢日瘦,肚腹渐大,是名丁奚
。呼吸少气,汲汲苦热,谓之哺露。属形病俱虚,虽用前药,宜佐以异功散,壮脾胃以行药
势。
鳖血煎 治疳劳。
芜荑 柴胡 川芎(各二两) 人参(半两) 使君子(二十一个) 胡黄连 宣黄连
上用鳖血一盏,吴茱萸一两和二黄连淹一宿,次早炒干,去茱萸并血,用二连入余药末,粟
米糊丸麻子大,食前热水下。
地黄清肺饮 治肺热疳饮穿孔,或生 肉,或鼻外生疮。
桑白皮(炒,半两) 紫苏 前胡 赤茯苓 防风 黄芩 当归 天门冬(去心) 连翘 桔梗 生
地黄 甘草(炙。各二钱)
上每服二钱,水煎服,次用化 丸。
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。
东垣大芜荑汤(一名栀子茯苓汤) 治黄疳土色,为湿为热,当利小便,今反利(知黄色中为燥胃
经热也),发黄脱落(知膀胱、肾俱受土邪乃大湿热之症)鼻下断作疮(上逆行营气伏火也)能乳
(胃中有热也,寒则食不入)喜食土(胃不足也),面黑色(为寒为痹)大便清(寒也)褐色(热蓄血中)
间黄色(肠胃有热)治当滋荣润燥,外致津液。
山栀仁(三分) 黄柏 甘草(炙。各二分) 大芜荑(五分) 黄连 麻黄根(一分) 姜活(二分) 柴胡(三
分) 防风(一分) 白术 茯苓(各五分) 当归(四分)
上水煎服。
朱砂安神丸 治心疳怔忡,心中痞闷。
朱砂(四钱) 黄连 生地黄(各半两) 生甘草(二钱半) 兰香叶(二钱,烧灰) 铜青 轻粉(各五分)
上为末,干敷上。
白粉散 治疳疮。
海螵蛸(三分) 白芨(二分) 轻粉(一分)
上为末,先用浆水洗拭,干敷。
六君子汤
异功散(二方见内钓)
六味丸(方见肾脏)
四味肥儿丸(方见寒吐)
泻青丸(方见肝脏)
龙胆泻肝汤(方见疝气)
钱仲阳说:小儿的各种疳症,都是由于病后脾胃受损;或者用药过度损伤了脾胃,导致无法运化乳食,体内津液枯竭,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,从而连累婴儿患病。五脏的疳症各不相同,应当分别辨别。肝疳,又名风疳,症状是眼白膜遮盖瞳孔,或者腹泻便血、身体消瘦。心疳,症状是面色黄而两颊红赤,身体高热。脾疳,又名肥疳,症状是肢体黄瘦,皮肤干燥粗糙,容易生疮疥,腹部胀大且喜欢吃泥土。肺疳,又名气疳,症状是咳嗽气喘不止,口鼻生疮。肾疳,又名骨疳,症状是肢体削瘦,全身生疮疥,喜欢躺在潮湿的地方。杨氏说:还有因虫伤引起的疳症,即五脏虫疳,名称很多,这里只列举主要的。虫疳,其虫像丝线一样,从头项腹背之间生出,颜色黄白赤色的可以治疗,青黑色的难治。蛔疳,症状是皱眉多哭,呕吐青色泡沫,腹中疼痛,肚腹上有青筋,嘴唇口角紫黑,摇头牙齿痒。脊疳,症状是身体发热、消瘦发黄,烦躁口渴、腹泻,拍打背部有声音,脊骨像锯齿一样突出,十个手指都生疮,频繁咬指甲。脑疳,症状是头皮光亮紧绷,满头生疮,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,症状是白天烦躁口渴,喝水但不吃东西,晚上口渴停止。疳泻,症状是毛发焦枯、嘴唇干裂,额头上有青纹,肚子胀肠鸣,拉下未消化的食物残渣。疳痢,症状是停滞积存宿食,水谷不能聚合,拉下恶臭之物。疳肿,症状是虚证中有积滞,肚腹紧胀,脾脏再次受湿,则头面手足虚浮。疳劳,症状是潮热往来,五心烦热,盗汗骨蒸,咳嗽气喘、干枯憔悴,口渴腹泻想喝水,肚子硬如石头,面色苍白如银。无辜疳,症状是脑后颈边有核如弹丸大小,按压能转动,软而不痛,里面含有虫子,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,头露骨高。相传是因为婴儿的胎盘在夜间暴露,被猫头鹰羽毛污染所致,也会引起这种病症。如果手脚极细,脖子小骨头高,臀部削瘦身体痿软,肚子大肚脐突出,号哭时胸部凹陷,名叫丁奚。如果虚热往来,头骨分开,反胃吐虫,烦躁口渴呕吐秽物,名叫哺露。如果牙齿蚀烂,名叫走马疳。因为牙齿属于肾,肾虚受热,疳火上炎,导致口臭齿黑,甚至牙龈腐烂、牙齿松动脱落。大抵这些症状虽然多,但总归不出于五脏。治疗方法:肝疳,用地黄丸以滋补肾水。心疳,用安神丸以宁心安神;异功散以补益脾气。脾疳,用四味肥儿丸以治疗疳症;五味异功散以健脾生土。肺疳,用清肺饮以清肺热;益气汤以补肺金。脑疳,也用地黄丸。无辜疳,用大芜荑汤、蟾蜍丸。丁奚、哺露,用肥儿丸、大芦荟丸。走马疳,外敷雄黄散;内服蟾蜍丸。如果出现口渴、腹泻、痢疾、肿胀、劳瘵等类似症状,应当详细参考方论进行治疗。大概疳就是“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,总体都以调补胃气为主。
治验案例(另参看肛门作痒的情况):
陈职方的孙子三岁,面颊患疮,蔓延腐蚀双眼,肚子大且有青筋,小便浑浊色白,这是肝疳的症状,服用大芜荑汤两剂后痊愈。
陈司厅的儿子,全身生疮,面色萎黄,腹胀内热,大便不调,饮食减少,倦怠口干,这是肝脾疳症,服用大芦荟丸,不到一个月痊愈。
陈工部长的孙子,腹内有肿块,小便不调,有人使用行气破血的药物,导致发热口干,身体消瘦懒食,面色黄中带青,几乎成为劳瘵症,用补中益气汤煎送大芦荟丸四服,又用前汤加车前子煎送六味丸四服,再用清肝生血的药物而痊愈。
一个十二岁的女子,眼睛生白翳,面色黄浮肿,口干腹泻,服用四味肥儿丸而痊愈。
一个小儿摇头眨眼,口渴便血,这是肝经血虚风热,服用地黄丸而痊愈。如果是肝经湿热,兼用泻青丸。这是因为虚则补其母,实则泻其子。
一个十一岁的小儿,两耳后脑下各结一个核,颜色不变不痛,但面色萎黄,身体疲倦口干,排便不调,用芦荟丸治疗,诸症顿愈。
一个小儿鼻外生疮,不时揉擦,蔓延至两耳。另一个小儿视物不明,鼻内或痒或生疮,用四味肥儿丸一并治愈。
一个小儿水进入耳朵,耳外生疮,脓水淋漓,一年不愈,我认为这是肝火上炎,用大芦荟丸而愈。
一个小儿全身像疥疮,或痒或痛,肌体消瘦,日夜发热,口干作渴,大便不调,一年多不愈。用九味芦荟丸而愈。
一个几岁的小儿,脑后并结两个核,肉色如故,也不觉得痛,用大芦荟丸以清肝脾,佐以地黄丸补肾水,形体健壮后核自然消退。
一个小儿腹内结块,小便不调,这是肝经内疳,用龙胆泻肝汤及大味芦荟丸而痊愈。
一个小儿出生后两眼红肿,或作痒,或生翳,这是胎禀肝火,用芦荟丸、六味地黄丸而痊愈。
一个小儿患瘰疬,小便频数,两眼连眨,作呕少食,泄泻后重。用补中益气汤、六味地黄丸逐渐好转,佐以芦荟丸而痊愈。
一个小儿吃泥土,困倦嗜睡腹泻,全身像疥疮,这是脾经内外疳,用六君子汤、肥儿丸而愈。
一个小儿面黄颊赤,发热作渴,睡中惊悸,这是心经内外疳,用秘旨安神丸而痊愈。
一个小儿患前述症状,兼掌心发热,全身像疥疮,用安神、肥儿二丸而愈。
一个小儿咳嗽寒热,咽喉不利,鼻上有疮,久而不结痂,这是肺经疳症,用地黄清肺饮而痊愈。
一个小儿下疳溃痛,爪黑面黑,全身生疥,这是肝经内外疳,用地黄、芦荟二丸而愈。
史少参的幼子两岁,项后结核,不时仰头叫喊,有人以为是热疮内溃,用针刺破,服用消毒药后,弯腰啼哭,我说这叫无辜疳,仰身而哭是外症表现;弯腰而啼是内症表现,元气败坏了,果然死亡。
一个小儿四肢消瘦,肚腹渐大,寒热嗜卧,作渴引饮,这是肝脾疳。名叫丁奚哺露,用白术散为主,佐以十全丹,一个多月诸症渐愈,后用异功散加当归及六味丸而痊愈。
一个小儿患疳,虚症具备,热如火烤,病状不能尽述,早晨用异功散,晚上用四味肥儿丸,一个多月诸症稍愈,佐以九味地黄丸,能自行行走。随后早晨用六味地黄丸,晚上用异功散及蚵蟆丸而痊愈。
一个小儿四肢消瘦,肚腹胀大,行走不能,作渴发热,大便臭秽,用十全丹数服,诸症渐愈,又用异功散、肥儿丸,调理后渐愈。
大芦荟丸 治疗疳症杀虫,和胃止泻。
胡黄连 黄连 白芜荑(去扇) 芦荟 木香 青皮 白雷丸(破开,红色的不用) 鹤虱(微炒。各半两) 麝香(二钱,另研)
以上为末,粟米饭做丸,绿豆大小。每次服用一二十丸,米饮送下。
我按语:前方治疗肝脾疳积,食积发热,眼睛生云翳;或疳热,颈项结核;或耳内生疮,肌体消瘦,发热作渴,饮食减少,肚腹膨胀;或牙龈蚀落,项腮腐烂,阴囊、阴茎生疮;或胸胁小腹作痛,均有效。其中青皮可用龙胆草代替,不用麝香效果更佳。
六味肥儿丸 消疳、化虫、退热。
黄连 陈皮 川楝子(去核炒) 神曲(炒) 麦芽(炒。各一两) 白芜荑(半两)
以上为末,糊丸,麻子大小。每次服用一二十丸,空腹米饮吞下。
我按语:前方又治疗脾疳,饮食减少,肌肉消瘦,肚大颈细,头发稀薄成穗,项间结核,发热作渴,精神倦怠,大便酸臭,嗜食泥土;或口鼻头疮,肚见青筋,咬齿下痢,便白五疳。用此丸加干蟾一两,芜荑五钱尤其妙。
蚵蟆丸 治疗无辜疳症,一服虚热退;二服烦渴止;三服泻痢住。
蟾蜍(一枚,夏季沟渠中腹大、不跳、不鸣、身上多癞者)
以上取粪蛆一杓放入桶中,用尿浸泡它,桶上要盖严,不让虫子爬出,然后将蟾蜍打死,投入蛆中吃一昼夜,用布袋盛放,浸在急水中一夜,取出放在瓦上焙干为末,入麝香一字,粳米饭揉丸,麻子大小。每次服用二十丸,米饮送下。
我按语:前方又治疗无辜疳症,面色黄壮热不吃东西,舌下有虫;或脑后有核,软而不痛,中有粉虫,随气流散,侵蚀脏腑,大便滑脱脓血,日渐黄瘦,头发大头大竖立,手足细软,变生天疱疮;猢狲鹅口,木舌悬痈,重舌着噤,脐风撮口重舌,龟背龟胸,共十二种败症。急用蟾蜍丸、大芜荑汤治疗,多有存活者。
生熟地黄汤 治疗疳眼闭合不开。
生地黄 熟地黄(各半两) 川芎 赤茯苓 枳壳(制) 杏仁(去皮) 川黄连 半夏曲 天麻 地骨皮甘草(炙。各二钱五分)
以上每服二钱,黑豆十五粒、姜水煎服。
嚏疳散 治疗疳症。
芦荟 黄连(各一钱) 瓜蒂 猪牙皂角 虾蟆灰(各五分) 麝香(少许)
以上为末,吹入鼻中,打喷嚏则可疗。
脂连丸 治疗五疳潮热,腹胀发焦。
胡黄连(半两) 五灵脂(一两)
以上为末,用猪胆汁做丸,麻子大小,米饮送下。
茯苓丸 治疗心疳惊疳。
茯神 芦荟 琥珀 川黄连(净) 赤茯苓(各三钱) 钩藤皮 远志肉 虾蟆灰(各三钱) 石菖蒲(一钱) 麝香(少许)
以上为末,粟米丸麻子大小,薄荷汤送下。
神效换肌丸 治疗脾疳肌瘦,潮热盗汗,泄泻糟粕,头大腹急。
川黄连(炒) 鳖甲(酒炙) 肉豆蔻(煨) 使君子(面裹煨) 神曲(炒) 麦芽(炒。各半两) 诃子肉(一钱半)
以上为末,糊丸芥子大小,米汤送下。
天麻丸 治疗肝疳、风疳、疳眼。
青黛 川黄连 天麻 五灵脂 夜明砂(微炒) 川芎 芦荟(各二钱) 龙胆草 防风 蝉蜕(去足,各一钱半) 全蝎(二枚,焙) 麝香(少许) 干蟾头(炙焦,三钱)
以上为末,猪胆汁浸糕丸麻子大小。每次服用十丸,薄荷汤送下。
化虫丸 治疗诸疳生虫,不时啼哭,呕吐清水,肚腹胀痛,唇口紫黑,肠头湿烂。
芜荑 芦荟 青黛干 川芎 白芷稍 胡黄连 川黄连 虾蟆灰(各等分)
以上为末,猪胆汁浸糕糊丸,麻子大小。每次服用一二十丸,食后临卧,杏仁煎汤送下。其鼻常用熊胆煎汤,笔蘸洗,等到前药各进数服后,却用青黛、当归、赤小豆、瓜蒂、地榆、黄连、芦荟、雄黄为末,入鼻疮敛。
灵脂丸 治疗脾疳、食疳。
白豆蔻 麦芽(炒) 五灵脂 宿砂 蓬术(煨) 青皮 橘红 使君子(焙。各二钱) 虾蟆(炙焦,三钱)
以上为末,米糊丸,麻子大小。每次服用十丸,米汤送下。
下虫丸 治疗疳蛔诸虫
新白苦楝根皮(酒浸焙) 绿包贯众 木香 桃仁(浸去皮焙) 芜荑(焙) 鸡心槟榔(各二钱) 鹤虱(炒,一钱) 轻粉(五分) 干虾蟆(炙焦,三钱) 使君子(五十,取肉煨)
以上为末,面糊丸麻子大小。每次服用一二十丸,清晨空腹肉汁送下,内加当归、川连各二钱五分。
龙胆丸 治疗脑疳,脑热疮。
龙胆草 升麻 苦楝根皮(焙) 赤茯苓 防风 芦荟 油发灰(各二钱) 青黛(干) 黄连(净。各三钱)
以上为末,用野猪胆汁浸糕糊丸,麻子大小,薄荷汤送下,仍以芦荟末入鼻。
黄连丸 治疗疳劳。
黄连(半两,净野猪胆汁浸晒) 石莲 栝蒌根 杏仁(浸,去皮焙) 乌梅肉(各二钱)
以上为末,牛胆汁浸糕糊丸,麻子大小,煎乌梅、姜、蜜汤送下。
香蔻丸 治疗疳泻。
黄连(三钱,炒) 肉豆蔻 木香 诃子肉(煨) 砂仁 茯苓(各二钱)
以上为末,饭丸麻子大小,米饮送下。
木香丸 治疗疳痢。
黄连(净,三钱) 木香 紫浓朴(制) 夜明砂(隔纸炒。各二钱) 诃子肉(炒,一钱)
以上为末,饭丸麻子大小,干艾生姜煎汤,食前送下。
十全丹 治疗丁奚哺露。
青皮 陈皮(各去白) 川芎 五灵脂 白豆蔻仁 鸡心槟榔 芦荟(各五钱) 木香 使君子(焙) 虾蟆灰(各三分)
以上为末,猪胆汁浸糕糊丸,麻子大小。每次服用一二十丸,米饮送下;有热,薄荷汤送下。
汤氏十全丹 治疗前述症状。
槟榔 枳壳(汤浸去穣,麸炒) 青皮 陈皮(去白) 丁香 木香(炮,各二钱五分) 香附子(炒,...)
以上为末,神曲糊丸黍米大小,每次服用三十丸,空心食前米饮送下。
我按语:前述症状因乳哺不调,伤损脾胃,不思饮食,气血日损,四肢日瘦,肚腹渐大,名叫丁奚。呼吸少气,汲汲苦热,叫做哺露。属于形病俱虚,虽然用前药,宜佐以异功散,壮脾胃以行药势。
鳖血煎 治疗疳劳。
芜荑 柴胡 川芎(各二两) 人参(半两) 使君子(二十一个) 胡黄连 宣黄连
以上用鳖血一盏,吴茱萸一两和二黄连淹一宿,次早炒干,去茱萸并血,用二连入余药末,粟米糊丸麻子大小,食前热水送下。
地黄清肺饮 治疗肺热疳饮穿孔,或生息肉,或鼻外生疮。
桑白皮(炒,半两) 紫苏 前胡 赤茯苓 防风 黄芩 当归 天门冬(去心) 连翘 桔梗 生地黄 甘草(炙。各二钱)
以上每服二钱,水煎服,次用化虫丸。
九味地黄丸 治疗肾疳。
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)
以上为末,蜜丸桐子大小。每次服用八十丸,空腹温酒送下。
东垣大芜荑汤(一名栀子茯苓汤) 治疗黄疳土色,为湿为热,当利小便,今反利(知黄色中为燥胃经热也),发黄脱落(知膀胱、肾俱受土邪乃大湿热之症)鼻下断作疮(上逆行营气伏火也)能乳(胃中有热也,寒则食不入)喜食土(胃不足也),面黑色(为寒为痹)大便清(寒也)褐色(热蓄血中)间黄色(肠胃有热)治当滋荣润燥,外致津液。
山栀仁(三分) 黄柏 甘草(炙。各二分) 大芜荑(五分) 黄连 麻黄根(一分) 姜活(二分) 柴胡(三分) 防风(一分) 白术 茯苓(各五分) 当归(四分)
以上水煎服。
朱砂安神丸 治疗心疳怔忡,心中痞闷。
朱砂(四钱) 黄连 生地黄(各半两) 生甘草(二钱半) 兰香叶(二钱,烧灰) 铜青 轻粉(各五分)
以上为末,干敷患处。
Qian Zhongyang stated: Various types of Gan syndrome (malnutrition syndrome characterized by dryness and wasting) in children all result from damage to the Spleen and Stomach after illness; or from excessive medication injuring the organs, leading to an inability to transform and transport milk and food, internal depletion of Body Fluids, and reckless movement of Deficient Fire; or due to the wet nurse being affected by the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright), improper diet and daily routine, thereby causing harm to the infant. The Gan syndromes of the Five Zang Organs differ and should be distinguished respectively. Liver Gan, also known as Wind Gan, presents with a white membrane obscuring the pupil, or diarrhea with blood, emaciation. Heart Gan presents with a yellow complexion, red cheeks, and high fever. Spleen Gan, also known as Fat Gan, presents with yellowish emaciation of the limbs, dry and rough skin, frequent sores and scabies, abdominal distension, and pica for eating earth. Lung Gan, also known as Qi Gan, presents with incessant coughing and wheezing, and sores in the mouth and nose. Kidney Gan, also known as Bone Gan, presents with emaciated limbs, widespread sores and scabies, and a preference for lying on damp ground. Yang Shi said: There is also Gan injury caused by parasites, i.e., Five Zang Parasitic Gan, with many names; here only the main ones are listed. Parasitic Gan involves worms like silk threads emerging between the head, neck, abdomen, and back; those that are yellow, white, or red are treatable, while those that are green or black are difficult to treat. Ascaris Gan presents with frowning and frequent crying, vomiting of green foam, abdominal pain, visible blue veins on the abdomen, purple-black lips and mouth, head shaking, and itchy teeth. Spine Gan presents with fever, emaciation, and yellowish discoloration, irritability, thirst, and diarrhea, a sound upon patting the back, spine protruding like saw teeth, sores on all ten fingers, and frequent nail-biting. Brain Gan presents with shiny and tight scalp, widespread head sores, brain heat feeling like fire, hair matted into tufts, generalized sweating, swollen cheeks, and a bulging fontanelle. Gan Thirst presents with daytime irritability and thirst, drinking water but not eating, and cessation of thirst at night. Gan Diarrhea presents with brittle hair, cracked lips, blue lines on the forehead, abdominal distension, borborygmus, and passage of undigested food residue. Gan Dysentery presents with stagnation of retained food, failure of water and grain to consolidate, and passage of foul matter. Gan Edema presents with deficiency accompanied by accumulation, tight abdominal distension; if the Spleen re-acquires Dampness, then the face, head, hands, and feet become flaccidly swollen. Gan Consumption presents with tidal fever, alternating sensations, five-palm heat, night sweats, bone-steaming fever, coughing and wheezing with emaciation, thirst and diarrhea with desire to drink, hard abdomen like stone, and a silvery-white complexion. Innocuous Gan presents with nodules behind the ears and on the side of the neck, sized like beans, movable upon pressure, soft and painless, containing parasites; if not rapidly punctured to expel them, the parasites will internally consume the Zang-Fu organs, leading to limb carbuncles, pus and blood in stool and urine, high fever, and emaciation. It is transmitted that exposure of the infant's placenta at night, contaminated by owl feathers, can also cause this syndrome. If the hands and feet are extremely thin, the neck small with prominent bones, buttocks wasted with body weakness, large abdomen with protruding umbilicus, and crying with chest depression, it is named Ding Xi. If there is alternating deficient heat, separated cranial sutures, regurgitation with worm vomiting, irritability, thirst, and vomiting of foul matter, it is named Bu Lu. If the teeth are eroded and decayed, it is named Running Horse Gan. Since teeth belong to the Kidney, Kidney deficiency with heat causes Gan Fire to flare upward, resulting in bad breath and blackened teeth, and even gingival rot and loose teeth. Generally, although these symptoms are numerous, they ultimately do not exceed the Five Zang Organs. Treatment methods: For Liver Gan, use Dihuang Wan (Rehmannia Pill) to nourish Kidney Water. For Heart Gan, use Anshen Wan (Calming Spirit Pill) to treat the Heart; Yigong San (Extraordinary Efficacy Powder) to tonify the Spleen. For Spleen Gan, use Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) to treat Gan; Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) to generate Earth. For Lung Gan, use Qingfei Yin (Lung-Clearing Decoction) to treat the Lung; Yiqi Tang (Qi-Boosting Decoction) to generate Metal. For Brain Gan, also use Dihuang Wan. For Innocuous Gan, use Dayuwai Tang (Large Wormwood Decoction) and Chan Chu Wan (Toad Pill). For Ding Xi and Bu Lu, use Fei'er Wan (Child-Nourishing Pill) and Da Lusha Wan (Large Aloe Pill). For Running Horse Gan, apply Xionghuang San (Realgar Powder) externally; take Chan Chu Wan internally. For conditions such as thirst, diarrhea, dysentery, swelling, and consumption, one should consult relevant formulas and theories for treatment. Essentially, "Gan" means dryness; it arises from the depletion of Spleen and Stomach Body Fluids. In children, it is called Five Gans; in adults, it is called Five Consumptions. The general principle is to regulate and tonify Stomach Qi.
Clinical Cases (also refer to anal itching):
The grandson of Vice Director Chen, aged three, had sores on his cheeks that spread and corroded both eyes, with a large abdomen and visible blue veins, and turbid white urine. This was a symptom of Liver Gan. He recovered after two doses of Dayuwai Tang.
The son of Department Director Chen had widespread sores, sallow complexion, abdominal distension with internal heat, irregular bowel movements, poor appetite, fatigue, and dry mouth. This was a Liver-Spleen Gan syndrome. He recovered within a month using Da Lusha Wan.
The grandson of Minister of Works Chen had an abdominal mass and irregular urination. After using Qi-moving and Blood-breaking medicines, he developed fever, dry mouth, emaciation, reluctance to eat, and a yellowish-green complexion, nearly becoming a Consumption case. He was treated with Buzhong Yiqi Tang decocted with four doses of Da Lusha Wan, followed by the previous decoction with Cheqianzi (Plantago Seed) and six doses of Liuwei Wan, and finally cleared with Liver-clearing and Blood-nourishing herbs.
A twelve-year-old girl had white films on her eyes, sallow and puffy face, dry mouth, and diarrhea. She recovered using Siwei Fei'er Wan.
A child shook his head and blinked, with thirst and hematochezia. This was Liver Meridian Blood deficiency with Wind-Heat. He recovered using Dihuang Wan. If it were Liver Meridian Damp-Heat, Xieqing Wan would be used concurrently. This follows the principle: tonify the Mother when deficient, drain the Son when excess.
An eleven-year-old child had nodules behind each ear and below the mastoid process, unchanged in color and painless, but with a sallow complexion, fatigue, dry mouth, and irregular defecation. He was treated with Lusha Wan, and all symptoms resolved immediately.
A child had sores outside the nose, frequently rubbed, spreading to both ears. Another child had blurred vision, nasal itching or sores. Both were cured using Siwei Fei'er Wan.
A child had water enter the ear, causing external ear sores with dripping pus for over a year. I diagnosed Liver Fire flaming upward and treated him with Da Lusha Wan, resulting in recovery.
A child had body-wide sores resembling scabies, either itchy or painful, with emaciation, day-and-night fever, dry mouth and thirst, and irregular bowels, lasting over a year without cure. He recovered using Jiwei Lusha Wan.
A few-year-old child had two nodules behind the head, normal skin color and painless. He was treated with Da Lusha Wan to clear the Liver and Spleen, assisted by Dihuang Wan to tonify Kidney Water. His physique became robust and the nodules disappeared spontaneously.
A child had an abdominal mass and irregular urination. This was Internal Gan of the Liver Meridian. He recovered using Longdan Xiegan Tang and Dawei Lusha Wan.
A child had red and swollen eyes since birth, sometimes itchy, sometimes developing films. This was congenital Liver Fire. He recovered using Lusha Wan and Liuwei Dihuang Wan.
A child suffered from scrofula, frequent urination, eye blinking, nausea, poor appetite, diarrhea with tenesmus. He gradually improved using Buzhong Yiqi Tang and Liuwei Dihuang Wan, assisted by Lusha Wan to recover.
A child ate dirt, was drowsy with diarrhea, and had body-wide sores resembling scabies. This was Internal-External Gan of the Spleen Meridian. He recovered using Liujunzi Tang and Fei'er Wan.
A child had a sallow face with red cheeks, fever, thirst, and startle palpitations during sleep. This was Internal-External Gan of the Heart Meridian. He recovered using Mizhi Anshen Wan.
A child with the aforementioned symptoms additionally had hot palms and body-wide sores resembling scabies. He recovered using Anshen Wan and Fei'er Wan.
A child had coughing with chills and fever, uncomfortable throat, and sores on the nose that did not crust over for a long time. This was Lung Meridian Gan syndrome. He recovered using Dihuang Qingfei Yin.
A child had lower Gan ulceration and pain, black nails, dark complexion, and body-wide sores. This was Internal-External Gan of the Liver Meridian. He recovered using Dihuang Wan and Lusha Wan.
The young son of Vice Minister Shi, aged two, had neck nodules and cried while tilting his head back. Someone thought it was an internal rupture of heat sores and punctured it. After taking detoxifying medicine, he cried with a curved waist. I said this is named Innocuous Gan; crying while extending the body indicates an external manifestation; crying while bending the waist indicates an internal manifestation. The Original Qi was exhausted, and indeed, he died.
A child had emaciated limbs, gradually enlarging abdomen, chills and fever with lethargy, thirst with desire to drink. This was Liver-Spleen Gan, named Ding Xi Bu Lu. He was primarily treated with Baizhu San, assisted by Shiquan Dan. After more than a month, symptoms gradually improved, and he recovered using Yigong San added with Danggui and Liuwei Wan.
A child with Gan presented with all deficiency symptoms, heat like burning, and unenumerable signs. Morning: Yigong San; Evening: Siwei Fei'er Wan. After more than a month, symptoms slightly improved. Assisted by Jiwei Dihuang Wan, he could walk and stand independently. Subsequently, morning: Liuwei Dihuang Wan; Evening: Yigong San and Ema Wan. He recovered.
A child had emaciated limbs, distended abdomen, inability to walk, thirst, fever, and foul-smelling stool. After several doses of Shiquan Dan, symptoms gradually improved. Then, using Yigong San and Fei'er Wan, he recovered through regulation.
Da Lusha Wan (Large Aloe Pill): Treats Gan, kills parasites, harmonizes the Stomach, and stops diarrhea.
Hu Huanglian (Scutellaria Barbatae Radix et Rhizoma), Huanglian (Coptidis Rhizoma), Bai Wuyi (Meliae Semen), Lusha (Aloe), Muxiang (Aucklandiae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Bai Leiwang (Polyporus Umbellatus - broken open, red ones not used), Heshi (Chrysanthemi Indici Flos - lightly stir-fried). Each half tael. Shexiang (Musk). Two qian, separately ground.
Grind into powder, make pills with millet rice paste, size of mung beans. Take 10-20 pills per dose, with rice wash.
My Commentary: The above formula treats Liver-Spleen Gan accumulation, food accumulation with fever, cloudiness in the eyes; or Gan heat, neck nodules; or otitis interna, emaciation, fever with thirst, poor appetite, abdominal distension; or gingival erosion, neck and cheek rot, sores on scrotum and penis; or pain in chest, hypochondrium, and lower abdomen. All are effective. Replacing Qingpi with Longdancao (Gentianae Radix) and omitting Shexiang yields even better results.
Liujian Fei'er Wan (Six-Ingredient Child-Nourishing Pill): Eliminates Gan, transforms parasites, reduces heat.
Huanglian (Coptidis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Chuan Lianzi (Toosendan Fructus - pitted and stir-fried), Shenqu (Massae Fermentatae Medicatae - stir-fried), Maiya (Hordei Fructus Germinatus - stir-fried). Each one tael. Bai Wuyi (Meliae Semen). Half tael.
Grind into powder, make pills with paste, size of hemp seeds. Take 10-20 pills per dose, swallowed with rice wash on an empty stomach.
My Commentary: The above formula also treats Spleen Gan, poor appetite, muscle emaciation, large abdomen with thin neck, sparse hair forming tufts, neck nodules, fever with thirst, mental fatigue, sour-smelling stool, craving for dirt; or sores on mouth, nose, and head, visible blue veins on abdomen, teeth grinding, dysentery, white stool, Five Gans. Adding one tael of Gan Chan (Dry Toad) and five qian of Wuyi to this pill is especially excellent.
Ema Wan (Toad Pill): Treats Innocuous Gan. One dose reduces deficient heat; two doses stop irritability and thirst; three doses stop diarrhea and dysentery.
Chan Chu (Bufo Bufo Skin). One piece (in summer, from ditches, large belly, non-jumping, non-croaking, with many warts).
Take one scoop of maggot excrement into a bucket, soak it in urine. Keep the bucket top sealed so insects cannot escape. Then kill the toad and throw it into the maggots to feed for a day and night. Place in a cloth bag, soak in fast-flowing water overnight. Remove, dry on tiles, grind into powder. Add Shexiang (Musk) one zi. Knead with japonica rice paste into pills, size of hemp seeds. Take 20 pills per dose, with rice wash.
My Commentary: The above formula also treats Innocuous Gan, sallow face, high fever, anorexia, worms under the tongue; or nodules behind the head, soft and painless, containing powdery worms that disperse with Qi flow, eroding Zang-Fu organs, slippery stool with pus and blood, gradual yellowish emaciation, large head with erect hair, thin and soft hands and feet, transformation into Tian Pao (Heaven Blister); Monkey Mouth Goose Tongue, Wooden Tongue Hanging Tonsil, Heavy Tongue Lock-Jaw, Umbilical Wind Grasping Mouth Heavy Tongue, Turtle Back Turtle Chest. Twelve types of fatal conditions. Urgently treat with Chan Chu Wan and Dayuwai Tang; many survive.
Sheng Shu Dihuang Tang (Raw and Cooked Rehmannia Decoction): Treats Gan Eye closure inability.
Sheng Dihuang (Raw Rehmanniae Radix), Shu Dihuang (Cooked Rehmanniae Radix). Each half tael. Chuanxiong (Ligustici Chuanxiong Rhizoma), Chi Fuling (Red Polyporus), Zhike (Aurantii Fructus - processed), Xingren (Pruni Semen - peeled), Chuan Huanglian (Coptidis Rhizoma), Banxia Qu (Pinelliae Bulbus Fermentatus), Tianma (Gastrodiae Rhizoma), Digupi (Lycii Cortex). Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma). Each two qian five fen.
Take two qian per dose, with fifteen black soybeans, decocted in ginger water.
Tigan San (Sneeze Gan Powder): Treats Gan.
Lusha (Aloe), Huanglian (Coptidis Rhizoma). Each one qian. Guadi (Momordicae Fructus), Zhuya Zaojiao (Gleditsiae Sinensis Spina), Xama Hui (Ash of Toad). Each five fen. Shexiang (Musk). A little.
Grind into powder, insufflate into the nose. Sneezing indicates curative effect.
Zhilian Wan (Wulingzhi-Huanglian Pill): Treats Five Gans tidal fever, abdominal distension with scorched sensation.
Hu Huanglian (Scutellaria Barbatae Radix et Rhizoma). Half tael. Wulingzhi (Trogopterori Faeces). One tael.
Grind into powder, make pills with pig bile, size of hemp seeds. Take with rice wash.
Fuling Wan (Poria Pill): Treats Heart Gan and Startle Gan.
Fushen (Poria with Pine Root), Lusha (Aloe), Hupo (Fossilized Wood), Chuan Huanglian (Coptidis Rhizoma - purified), Chi Fuling (Red Polyporus). Each three qian. Gouteng Pi (Uncariae Ramulus cum Uncis Cortex), Yuanzhi Rou (Polygalae Radix Cortex), Xama Hui (Ash of Toad). Each three qian. Shichangpu (Acori Tatarinowii Rhizoma). One qian. Shexiang (Musk). A little.
Grind into powder, make pills with millet paste, size of hemp seeds. Take with mint decoction.
Shenxiao Huanji Wan (Miraculous Muscle-Replacement Pill): Treats Spleen Gan muscle emaciation, tidal fever and night sweats, diarrhea of undigested food, large head and urgent abdomen.
Chuan Huanglian (Coptidis Rhizoma - stir-fried), Biejia (Trionycis Carapax - wine-fried), Roudoukou (Myristicae Semen - baked), Shijunzi (Quisqualis Fructus - wrapped in flour and baked), Shenqu (Massae Fermentatae Medicatae - stir-fried), Maiya (Hordei Fructus Germinatus - stir-fried). Each half tael. Hezi Rou (Terminaliae Chebulae Fructus Flesh). One qian half.
Grind into powder, make pills with paste, size of mustard seeds. Take with rice soup.
Tianma Wan (Gastrodia Pill): Treats Liver Gan, Wind Gan, Gan Eye.
Qingdai (Indigo Naturalis), Chuan Huanglian (Coptidis Rhizoma), Tianma (Gastrodiae Rhizoma), Wulingzhi (Trogopterori Faeces), Yeming Sha (Nyctibiidae Alumen - lightly stir-fried), Chuanxiong (Ligustici Chuanxiong Rhizoma), Lusha (Aloe). Each two qian. Longdancao (Gentianae Radix), Fangfeng (Saposhnikoviae Radix), Chantui (Cicadae Periostracum - legs removed). Each one qian half. Quanxie (Scorpio). Two pieces, roasted. Shexiang (Musk). A little. Gan Chan Tou (Dried Toad Head - roasted until charred). Three qian.
Grind into powder, soak cake in pig bile to make pills, size of hemp seeds. Take ten pills per dose, with mint decoction.
Huachong Wan (Parasite-Transforming Pill): Treats various Gans producing parasites, frequent crying, vomiting clear fluid, abdominal distension and pain, purple-black lips and mouth, wet and rotten anus.
Wuyi (Meliae Semen), Lusha (Aloe), Qingdai Gan (Dry Indigo Naturalis), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi Shao (Angelicae Dahuricae Radix Tip), Hu Huanglian (Scutellaria Barbatae Radix et Rhizoma), Chuan Huanglian (Coptidis Rhizoma), Xama Hui (Ash of Toad). Equal parts.
Grind into powder, soak cake in pig bile and paste to make pills, size of hemp seeds. Take 10-20 pills per dose, after meals and before bed, with apricot kernel decoction. Frequently wash the nose with bear gallbladder decoction using a brush. After taking the above medicines for several doses, use Qingdai, Danggui, Xiaohongdou, Guadi, Diyü, Huanglian, Lusha, Xionghuang ground into powder, insufflate into nasal sores to heal.
Lingzhi Wan (Wulingzhi Pill): Treats Spleen Gan, Food Gan.
Baidoukou (Amomi Fructus Rotundus), Maiya (Hordei Fructus Germinatus - stir-fried), Wulingzhi (Trogopterori Faeces), Susa (Arecae Semen), Pengzhu (Curcumae Rhizoma - baked), Qingpi (Citri Reticulatae Pericarpium Viride), Juhong (Citri Reticulatae Pericarpium), Shijunzi (Quisqualis Fructus - roasted). Each two qian. Xama (Toad - roasted until charred). Three qian.
Grind into powder, make pills with rice paste, size of hemp seeds. Take ten pills per dose, with rice soup.
Xia Chong Wan (Parasite-Expelling Pill): Treats Gan Ascaris and other parasites.
Xin Bai Kulian Genpi (New White Melia Root Bark - wine-soaked and roasted), Lübao Guanzhong (Cyathulae Radix), Muxiang (Aucklandiae Radix), Taoren (Persicae Semen - soaked, peeled, roasted), Wuyi (Meliae Semen - roasted), Jixin Binglang (Arecae Semen Cordiforme). Each two qian. Heshi (Chrysanthemi Indici Flos - stir-fried). One qian. Qingfen (Calomelas). Five fen. Gan Xama (Dried Toad - roasted until charred). Three qian. Shijunzi (Quisqualis Fructus). Fifty, flesh taken and baked.
Grind into powder, make pills with flour paste, size of hemp seeds. Take 10-20 pills per dose, early morning on empty stomach with meat juice. Add Danggui and Chuanlian each two qian five fen internally.
Longdan Wan (Gentian Pill): Treats Brain Gan, Brain Heat Sores.
Longdancao (Gentianae Radix), Shengma (Cimicifugae Rhizoma), Kulian Genpi (Meliae Cortex), Chi Fuling (Red Polyporus), Fangfeng (Saposhnikoviae Radix), Lusha (Aloe), Youfa Hui (Ash of Oily Hair). Each two qian. Qingdai (Indigo Naturalis - dry), Huanglian (Coptidis Rhizoma - purified). Each three qian.
Grind into powder, soak cake in wild boar bile paste to make pills, size of hemp seeds. Take with mint decoction. Also insufflate Lusha powder into the nose.
Huanglian Wan (Coptis Pill): Treats Gan Consumption.
Huanglian (Coptidis Rhizoma). Half tael, purified and soaked in wild boar bile then dried. Shilian (Nelumbinis Nucillus), Gualougen (Trichosanthis Radix), Xingren (Pruni Semen - soaked, peeled, roasted), Wumei Rou (Mume Fructus Flesh). Each two qian.
Grind into powder, soak cake in ox bile paste to make pills, size of hemp seeds. Take with decoction of Wumei, ginger, and honey.
Xiangkou Wan (Cardamom Pill): Treats Gan Diarrhea.
Huanglian (Coptidis Rhizoma). Three qian, stir-fried. Roudoukou (Myristicae Semen), Muxiang (Aucklandiae Radix), Hezi Rou (Terminaliae Chebulae Fructus Flesh - baked), Sharen (Amomi Fructus), Fuling (Poria). Each two qian.
Grind into powder, make pills with cooked rice, size of hemp seeds. Take with rice wash.
Muxiang Wan (Aucklandia Pill): Treats Gan Dysentery.
Huanglian (Coptidis Rhizoma - purified). Three qian. Muxiang (Aucklandiae Radix), Zi Nongpo (Magnoliae Officinalis Cortex - processed), Yeming Sha (Nyctibiidae Alumen - stir-fried between papers). Each two qian. Hezi Rou (Terminaliae Chebulae Fructus Flesh - stir-fried). One qian.
Grind into powder, make pills with cooked rice, size of hemp seeds. Take with decoction of dried mugwort and fresh ginger before meals.
Shiquan Dan (Ten Complete Pellets): Treats Ding Xi Bu Lu.
Qingpi (Citri Reticulatae Pericarpium Viride - peel removed), Chenpi (Citri Reticulatae Pericarpium - peel removed), Chuanxiong (Ligustici Chuanxiong Rhizoma), Wulingzhi (Trogopterori Faeces), Baidoukou Ren (Amomi Fructus Rotundus Seed), Jixin Binglang (Arecae Semen Cordiforme), Lusha (Aloe). Each five qian. Muxiang (Aucklandiae Radix), Shijunzi (Quisqualis Fructus - roasted), Xama Hui (Ash of Toad). Each three fen.
Grind into powder, soak cake in pig bile paste to make pills, size of hemp seeds. Take 10-20 pills per dose, with rice wash; if heat is present, take with mint decoction.
Tangshi Shiquan Dan (Tang's Ten Complete Pellets): Treats the aforementioned condition.
Binglang (Arecae Semen), Zhike (Aurantii Fructus - soaked in water, pulp removed, bran-roasted), Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium - peel removed), Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix - roasted). Each two qian five fen. Xiangfu Zi (Cyperi Rhizoma - stir-fried)...
Grind into powder, make pills with fermented dough paste, size of millet seeds. Take thirty pills per dose, on an empty stomach before meals with rice wash.
My Commentary: The aforementioned condition arises from irregular breastfeeding damaging the Spleen and Stomach, loss of appetite, daily depletion of Qi and Blood, daily emaciation of limbs, and gradual abdominal enlargement, named Ding Xi. Shortness of breath, anxiety with heat, is called Bu Lu. It belongs to simultaneous deficiency of Form and Disease. Although using the above medicines, it is advisable to assist with Yigong San to strengthen the Spleen and Stomach to facilitate the action of the medicines.
Bie Xue Jian (Turtle Blood Decoction): Treats Gan Consumption.
Wuyi (Meliae Semen), Chaihu (Bupleuri Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma). Each two liang. Renshen (Ginseng Radix et Rhizoma). Half tael. Shijunzi (Quisqualis Fructus). Twenty-one pieces. Hu Huanglian (Scutellaria Barbatae Radix et Rhizoma), Xuan Huanglian (Scutellariae Radix).
Use one cup of turtle blood, mix with one tael of Wuzhuyu and two Huanglians, soak overnight. Stir-fry dry the next morning, remove Wuzhuyu and blood. Use the two Huanglians with the remaining herbs ground into powder. Make pills with millet paste, size of hemp seeds. Take with hot water before meals.
Dihuang Qingfei Yin (Rehmannia Lung-Clearing Decoction): Treats Lung Heat Gan Drink perforating, or polyp formation, or sores outside the nose.
Sangbaipi (Mori Cortex - stir-fried). Half tael. Zisu (Perillae Folium), Qianhu (Peucedani Radix), Chi Fuling (Red Polyporus), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Tiandong (Asparagi Radix - heart removed), Lianqiao (Forsythiae Fructus), Jiegeng (Platycodonis Radix), Sheng Dihuang (Raw Rehmanniae Radix), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma). Each two qian.
Take two qian per dose, decoct in water. Follow with Huachong Wan.
Jiuwei Dihuang Wan (Nine-Ingredient Rehmannia Pill): Treats Kidney Gan.
Shu Dihuang (Cooked Rehmanniae Radix). Four qian five fen. Chi Fuling (Red Polyporus), Shanzhuyu (Corni Fructus), Chuan Lianzi (Toosendan Fructus), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Mudanpi (Moutan Cortex), Shanyao (Dioscoreae Rhizoma), Shijunzi Rou (Quisqualis Fructus Flesh). Two qian.
Grind into powder, make pills with honey, size of tung tree seeds. Take eighty pills per dose, with warm wine on an empty stomach.
Dongyuan Dayuwai Tang (Dongyuan's Large Wormwood Decoction, also known as Zhizi Fuling Tang): Treats Yellow Gan with earth-like color, caused by Dampness and Heat. Urination should be promoted. Now it is反而利 (abnormal frequency/urgency) (indicating dryness and Stomach Meridian Heat causing yellow color); yellowing and hair loss (indicating Bladder and Kidney both affected by Earth Evil, a major Damp-Heat syndrome); sores breaking out under the nose (indicating counterflow of Ying Qi and latent Fire); ability to suckle (indicating Heat in Stomach; cold prevents food intake); craving for dirt (indicating Stomach deficiency); black face (indicating Cold and Bi); clear stool (Cold); brown stool (Heat accumulating in Blood); intermittent yellow stool (Heat in Intestines and Stomach). Treatment should nourish Essence and moisten dryness, and generate fluids externally.
Shanzhiren (Gardeniae Fructus Seed). Three fen. Huangbai (Phellodendri Cortex), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma). Each two fen. Dayuwai (Large Wormwood/Meliae Semen). Five fen. Huanglian (Coptidis Rhizoma), Mahuanggen (Ephedrae Herba Root), Jianghuo (Notopterygii Rhizoma et Radix). Two fen. Chaihu (Bupleuri Radix). Three fen. Fangfeng (Saposhnikoviae Radix). One fen. Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria). Each five fen. Danggui (Angelicae Sinensis Radix). Four fen.
Decoct in water and take.
Zhusha Anshen Wan (Cinnabar Calming Spirit Pill): Treats Heart Gan palpitations, chest oppression.
Zhusha (Cinnabar). Four qian. Huanglian (Coptidis Rhizoma), Sheng Dihuang (Raw Rehmanniae Radix). Each half tael. Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma). Two qian half. Lanxiangye (Litseae Folium - burnt to ash). Two qian. Tongqing (Chalcanthitum), Qingfen (Calomelas). Each five fen.
Grind into powder, apply dryly to the affected area.
Baifen San (White Powder): Treats Gan Sores.
Haipiaoxiao (Sepiae Endoconcha). Three fen. Baiji (Bletillae Rhizoma). Two fen. Qingfen (Calomelas). One fen.
Grind into powder. First wash with bean water, wipe dry, then apply dryly.
Liujunzi Tang (Six Gentlemen Decoction)
Yigong San (Extraordinary Efficacy Powder) (See Nei Diao)
Liuwei Wan (Six-Ingredient Pill) (See Kidney)
Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) (See Cold Vomiting)
Xieqing Wan (Drain Green Pill) (See Liver)
Longdan Xiegan Tang (Gentian Liver-Draining Decoction) (See Hernia)