疳者，干而瘦也。由小儿禀赋气血虚弱，脏腑柔脆，或乳食过饱，或肥甘无节，停滞中
脘，传
化迟滞，肠胃渐伤，则生积热，热盛成疳，则消耗气血，煎灼津液。凡疳疾初起，尿如米泔
，午后潮热，或因吐泻疟痢，日久失治，以及久热、久汗、久咳、久疮，致令青筋暴露，肚
大坚硬，面色青黄，肌肉消瘦，皮毛憔悴，而疳证成矣。然当分其所属而治之。心疳，则面
红便赤， 壮热烦渴，切牙弄舌；肝疳，则面目爪甲皆青，目胞赤肿，翳生泪多，白膜遮睛
，粪青如苔；脾疳，则黄瘦，头大胫细，或喜吃米，吃茶叶，吃泥土，或吐泻烦渴，大便腥
粘；肺疳，则面白咳逆，毛发焦枯，肌肤干燥，憎寒发热，常流清涕，鼻颊生疮也；肾疳，
则面色黧黑，齿龈出血，口臭足冷，骨瘦腹痛，泄泻，啼哭不已，汤药宜分经治之。
分阴阳，(二百遍。)推三关，(一百遍。)退六腑，(一百遍。)推脾土补清，(各二百遍
。)推肾水，(一百遍。)揉肚，(一百遍。)摩脐左右旋。(各一百遍。)
按∶疳疾一证，身多发热，宜分别轻重虚实治之。《医宗金鉴》于疳证分列各名，方法
俱在，勿拘于外治也。(惕厉子)
吐证有三，曰呕、曰吐、曰哕。哕、即干呕也。先贤谓呕属阳明，有声有物，气血俱病
也。
吐属太阳，有物无声，血病也。哕属少阳，有声无物，气病也。独李东垣谓呕、吐、哕，俱
属脾胃虚弱。洁古老人又从三焦以分气，积，寒之三因，然皆不外诸逆上冲也。宜分虚实、
寒热以治之。
热吐 小儿为稚阳之体，邪热易感，或则乳母过食浓味，以致热积胃中，将热乳吮儿，
或则
小儿过食煎爆之物，以及辛热诸品，遂令食入即吐。其证面赤唇红，口渴饮冷，身热便赤，
吐次虽少而所出甚多，乳汁化而色黄也。内治，以温胆加黄连麦冬主之。
分阳阴，(二百遍。)推三关，(一百遍。)退六腑，(一百遍。)推肺经，(一百遍。)推脾
经，
(一百遍。)运水入土，(一百遍。)运八卦，(一百遍。)赤凤摇头，(五十遍。)掐十王穴，(
二十四遍。)掐右端正，(二十四遍。)揉总经，(八十遍。)揉斗肘。(八十遍。)
寒吐 因小儿过食生冷，或乳母当风取凉，使寒气入乳，将寒乳吮儿，以致胃虚不纳，
乳汁
不化。其证喜热恶寒，面唇色白，四肢逆冷，朝食暮吐。吐出之物，不臭不酸，吐次多而所
出少也。内治宜温中主之。
分阴阳，(二百遍。)推三关，(一百遍。)退六腑，(一百遍。)推补脾土，(一百遍。)推
肺经
，(八十遍。)运八卦，(一百遍。)掐右端正，(三十六遍。)黄蜂入洞，(二十四遍。)赤凤摇
头，(二十四遍。)摇斗肘。(五十遍。)
实吐 内伤食滞，胃不能纳，每吐必有酸臭之味，身发潮热，见食则恶，胸腹胀满，二
便秘涩，痞硬疼痛，口渴思饮寒凉也。内治以下法主之。
分阴阳，(二百遍。)推三关，(一百遍。)退六腑，(一百遍。)推脾土，(一百遍。)运八
卦，
(八十遍。)掐五指尖，(二十四遍。)掐右端正，(二十四遍。)捞明月，(三十六遍。)打马过
天河，(三十六遍。)摇斗肘。(五十遍。)
虚吐 胃气虚弱，不能消纳乳食。其证精神困倦，囟门煽动，睡卧露睛，自利不渴，时
常呕吐者是也。内治以四君加丁香、沉香主之。
分阴阳，(二百遍。)推三关，(一百遍。)退六腑，(一百遍。)运八卦，(八十遍。)推补
脾
土，(二百遍。)掐右端正，(二十四遍。)运土入水，(八十遍。)赤凤摇头，(二十四遍。)推
补大肠，(五十遍。)揉斗肘，(八十遍。)推补五经。(八十遍。)
按∶《灵枢》足厥阴所生病者，胸满呕逆，呕吐，证虽属胃气失降，而多由肝逆冲胃致
之。
故汤药治法，宜泄肝安胃，以苦降辛通，佐以酸泄主之。甚至呕而绝粒者，取生鹅血热饮。
每食必吐者，煮羊血熟食之，皆主之。则虽有按摩外治之法，特其一端耳。司命者，当博采
旁搜，于每证必须有审证之法，极效之方，庶几无愧。(惕厉子)
疳疾，是指身体干枯消瘦。这是由于小儿先天禀赋气血虚弱，脏腑娇嫩脆弱，或者哺乳饮食过饱，或者肥腻甘甜食物没有节制，导致食物停滞在中脘部位，传导消化迟缓滞涩，肠胃逐渐受损，从而产生积热；热势旺盛形成疳疾，就会消耗气血，煎熬灼伤津液。凡是疳疾初起时，小便像米泔水一样浑浊，午后出现潮热，或者因为呕吐、腹泻、疟疾、痢疾，日久失治，以及长期发热、长期出汗、长期咳嗽、长期疮疡，导致青筋暴露，腹部胀大坚硬，面色青黄，肌肉消瘦，皮毛憔悴，这样疳证就形成了。然而应当根据所属脏腑不同而分别治疗。心疳，则见面红、大便赤色、高热烦躁口渴、咬切牙齿、弄舌；肝疳，则见面目爪甲皆青色，眼睑红肿，生翳流泪多，白膜遮蔽眼睛，粪便青绿如苔藓；脾疳，则见发黄消瘦，头大腿细，或者喜欢吃米饭、茶叶、泥土，或者呕吐腹泻、烦躁口渴，大便腥粘；肺疳，则见面白咳嗽气逆，毛发焦枯，肌肤干燥，怕冷发热，经常流清鼻涕，鼻颊部生疮；肾疳，则见面色黧黑，齿龈出血，口臭脚冷，骨瘦腹痛，泄泻，啼哭不止，汤药应当分经治疗。
操作：分阴阳（二百遍），推三关（一百遍），退六腑（一百遍），推脾土补法与清法（各二百遍），推肾水（一百遍），揉肚子（一百遍），摩脐左右旋转（各一百遍）。
按语：疳疾这一病证，身体大多发热，应当分别轻重虚实进行治疗。《医宗金鉴》对疳证分列各种名称，方法都在书中，不要拘泥于外治法。（惕厉子）
呕吐症状有三种，称为呕、吐、哕。哕，就是干呕。先贤认为呕属于阳明经，有声有物，是气血都患病；吐属于太阳经，有物无声，是血病；哕属于少阳经，有声无物，是气病。唯独李东垣认为呕、吐、哕，都属于脾胃虚弱。洁古老人又从三焦区分气、积、寒三种病因，但都不外乎诸气逆上冲。应当分虚实、寒热来治疗。
热吐：小儿是稚阳之体，邪热容易感受，或者是乳母过食浓味食物，导致热积在胃中，将带有热气的乳汁喂给婴儿，或者是小儿过食煎炸爆炒之物，以及辛热各类食品，于是导致食物入胃即吐。其症状见面红唇红，口渴想喝冷饮，身热小便赤色，呕吐次数虽少但吐出量很多，乳汁消化后颜色发黄。内服治疗，以温胆汤加黄连、麦冬为主。
操作：分阴阳（二百遍），推三关（一百遍），退六腑（一百遍），推肺经（一百遍），推脾经（一百遍），运水入土（一百遍），运八卦（一百遍），赤凤摇头（五十遍），掐十王穴（二十四遍），掐右端正（二十四遍），揉总经（八十遍），揉斗肘（八十遍）。
寒吐：因为小儿过食生冷，或者乳母当风取凉，使寒气进入乳汁，将寒凉的乳汁喂给婴儿，导致胃虚不能受纳，乳汁不化。其症状喜热恶寒，面唇颜色苍白，四肢逆冷，早晨吃晚上吐。吐出的东西不臭不酸，呕吐次数多但吐出量少。内服治疗宜温中。
操作：分阴阳（二百遍），推三关（一百遍），退六腑（一百遍），推补脾土（一百遍），推肺经（八十遍），运八卦（一百遍），掐右端正（三十六遍），黄蜂入洞（二十四遍），赤凤摇头（二十四遍），摇斗肘（五十遍）。
实吐：内伤食滞，胃不能受纳，每次呕吐必有酸臭味道，身体发潮热，见到食物就厌恶，胸腹胀满，大小便便秘涩滞，痞硬疼痛，口渴想喝凉水。内服治疗以下法为主。
操作：分阴阳（二百遍），推三关（一百遍），退六腑（一百遍），推脾土（一百遍），运八卦（八十遍），掐五指尖（二十四遍），掐右端正（二十四遍），捞明月（三十六遍），打马过天河（三十六遍），摇斗肘（五十遍）。
虚吐：胃气虚弱，不能消纳乳食。其症状精神困倦，囟门煽动，睡卧时眼睛露出，自利不渴，时常呕吐。内服治疗以四君子汤加丁香、沉香为主。
操作：分阴阳（二百遍），推三关（一百遍），退六腑（一百遍），运八卦（八十遍），推补脾土（二百遍），掐右端正（二十四遍），运土入水（八十遍），赤凤摇头（二十四遍），推补大肠（五十遍），揉斗肘（八十遍），推补五经（八十遍）。
按语：《灵枢》记载足厥阴肝经所生的疾病，包括胸满、呕逆、呕吐，虽然证候属于胃气失于下降，但多由肝气逆冲胃部导致。所以汤药治疗方法，宜用泄肝安胃的方法，以苦降辛通为主，佐以酸泄。甚至呕吐严重到绝食的，取生鹅血热饮。每食必吐的，煮羊血熟食食用，都可以主治。那么虽然有按摩外治的方法，只是其中一方面罢了。治病救人的医生，应当广泛采集旁搜资料，对于每种证候必须有审证的方法，极有效的方剂，这样才能无愧于心。（惕厉子）
Gan disease refers to a condition characterized by dryness and emaciation. It arises from congenital deficiency of Qi and Blood in children, with fragile and delicate Zang-Fu organs. Alternatively, it may result from overfeeding or unregulated consumption of rich and sweet foods, causing food stagnation in the Zhongwan (CV12) region. This leads to sluggish digestion and transmission, gradually damaging the intestines and stomach, thereby generating accumulated heat. When heat becomes excessive, Gan disease forms, consuming Qi and Blood and scorching body fluids. Initially, Gan disease presents with urine resembling rice wash water, afternoon tidal fever, or follows prolonged untreated vomiting, diarrhea, malaria, or dysentery, as well as chronic fever, sweating, coughing, or sores. These conditions lead to exposed blue veins, a distended and hard abdomen, bluish-yellow complexion, muscle wasting, and withered skin and hair, thus constituting Gan syndrome. However, treatment should be differentiated according to the affected organ. Heart Gan manifests as red face, reddish stool, high fever, irritability, thirst, teeth grinding, and tongue protrusion; Liver Gan presents with bluish complexion, eyes, nails, swollen red eyelids, visual obscurations, excessive tearing, white membrane covering the pupil, and green moss-like stool; Spleen Gan shows yellowish emaciation, large head with thin legs, cravings for rice, tea leaves, or soil, vomiting, diarrhea, irritability, thirst, and foul, sticky stools; Lung Gan features pale face, cough with rebellious Qi, scorched and brittle hair, dry skin, aversion to cold with fever, clear nasal discharge, and sores on the nose and cheeks; Kidney Gan is marked by dark complexion, bleeding gums, bad breath, cold feet, skeletal emaciation with abdominal pain, diarrhea, and incessant crying. Decoctions should treat based on the meridian involved.
Techniques: Divide Yin and Yang (200 repetitions), Push San Guan (100 repetitions), Retreat Liu Fu (100 repetitions), Push Pi Tu (Spleen Earth) using tonification and clearing methods (200 repetitions each), Push Shen Shui (Kidney Water) (100 repetitions), Rub Abdomen (100 repetitions), Rub Navel rotating clockwise and counter-clockwise (100 repetitions each).
Note: Gan disease often involves fever; severity and excess/deficiency patterns must be distinguished. *Yi Zong Jin Jian* lists various types of Gan syndromes with methods; do not restrict treatment solely to external therapies. (Ti Li Zi)
Vomiting symptoms are categorized into three types: Ou (vomiting with sound and matter), Tu (spitting without sound but with matter), and Yue (dry heaving). Ancient sages stated that Ou belongs to the Yangming channel, involving both Qi and Blood pathology; Tu belongs to the Taiyang channel, involving Blood pathology; Yue belongs to the Shaoyang channel, involving Qi pathology. Only Li Dongyuan attributed all three to Spleen-Stomach deficiency. Jiegu Laoren differentiated them via the Triple Burner considering Qi, accumulation, and Cold etiologies, yet all involve rebellious upward rushing of Qi. Treatment should differentiate excess/deficiency and cold/heat.
Heat Vomiting: Children have a "tender Yang" constitution, making them susceptible to pathogenic heat. Heat may accumulate in the Stomach due to the mother's rich diet or the child's intake of fried, spicy, or hot foods. If warm milk is given, or if the child consumes such foods, immediate vomiting occurs upon ingestion. Symptoms include red face and lips, thirst for cold drinks, body heat, reddish urine, small volume but frequent expulsion of vomit, and yellowish digested milk. Internal treatment uses Wendan Tang (Warm the Gallbladder Decoction) modified with Huanglian (Coptidis Rhizoma) and Maidong (Ophiopogonis Radix).
Techniques: Divide Yin and Yang (200 reps), Push San Guan (100 reps), Retreat Liu Fu (100 reps), Push Fei Jing (Lung Meridian) (100 reps), Push Pi Jing (Spleen Meridian) (100 reps), Move Water into Earth (100 reps), Operate Eight Trigrams (100 reps), Red Phoenix Shakes Head (50 reps), Pinch Shi Wang Acupoint (24 reps), Pinch Right Duan Zheng (24 reps), Rub Zong Jing (80 reps), Rub Dou Zhou (80 reps).
Cold Vomiting: Caused by excessive raw/cold food intake by the child, or maternal exposure to wind/cold leading to cold qi entering breast milk. The cold milk causes Stomach deficiency, failing to accept or digest milk. Symptoms include preference for warmth, aversion to cold, pale face and lips, cold extremities, morning intake with evening expulsion. Vomit is odorless and non-acidic, with frequent attempts but low volume. Internal treatment focuses on warming the Middle Jiao.
Techniques: Divide Yin and Yang (200 reps), Push San Guan (100 reps), Retreat Liu Fu (100 reps), Tonify Pi Tu (100 reps), Push Fei Jing (80 reps), Operate Eight Trigrams (100 reps), Pinch Right Duan Zheng (36 reps), Yellow Bee Enters Cave (24 reps), Red Phoenix Shakes Head (24 reps), Shake Dou Zhou (50 reps).
Excess Vomiting: Due to internal food stagnation, the Stomach cannot accept food. Vomit has a sour/foul odor, accompanied by tidal fever, food aversion, chest/abdominal fullness, constipation, hardness, pain, and thirst for cold liquids. Internal treatment uses purgative methods.
Techniques: Divide Yin and Yang (200 reps), Push San Guan (100 reps), Retreat Liu Fu (100 reps), Push Pi Tu (100 reps), Operate Eight Trigrams (80 reps), Pinch Five Finger Tips (24 reps), Pinch Right Duan Zheng (24 reps), Scoop Bright Moon (36 reps), Horse Strikes Across Heavenly River (36 reps), Shake Dou Zhou (50 reps).
Deficiency Vomiting: Weak Stomach Qi fails to digest milk/food. Symptoms include mental fatigue, pulsating fontanelle, sleeping with eyes open, spontaneous diarrhea without thirst, and frequent vomiting. Internal treatment uses Sijunzi Tang (Four Gentlemen Decoction) modified with Dingxiang (Caryophylli Flos) and Chenxiang (Aquilariae Lignum Resinatum).
Techniques: Divide Yin and Yang (200 reps), Push San Guan (100 reps), Retreat Liu Fu (100 reps), Operate Eight Trigrams (80 reps), Tonify Pi Tu (200 reps), Pinch Right Duan Zheng (24 reps), Move Earth into Water (80 reps), Red Phoenix Shakes Head (24 reps), Tonify Da Chang (Large Intestine) (50 reps), Rub Dou Zhou (80 reps), Tonify Wu Jing (Five Meridians) (80 reps).
Note: *Ling Shu* states that diseases of the Foot-Jueyin (Liver) meridian include chest fullness, rebellious Qi, vomiting, and retching. Although these belong to Stomach Qi failing to descend, they are often caused by Liver Qi rebelling against the Stomach. Therefore, herbal treatment should drain the Liver and calm the Stomach, using bitter-descending and acrid-unblocking methods, assisted by sour-draining. For severe vomiting preventing food intake, drink hot goose blood. For persistent vomiting after every meal, cook and eat sheep blood. While massage therapy is effective, it is only one aspect. Physicians must extensively research and apply precise diagnostic methods and highly effective prescriptions to fulfill their duty. (Ti Li Zi)