脉诀启蒙曰。小儿脉单细为疳劳。虎口纹白色。面白者为疳。
夫疳者。甘肥无节。乳哺不调。或禀赋怯弱。血气不足。盖十五岁以前为疳。以后为劳
也。
书载五疳病关五脏。要亦脾家有积。一脏失治。而传其余也。脾家病去。余脏皆已。症虽分
乎冷热。治当以补为先。宜用地黄丸、五疳膏、肥儿丸之类。
一论小儿疳病。面黄肌瘦。肚大青筋。大便色白。小便混浊。或澄之如米泔。此疳病也
消疳汤
山楂（去子） 白芍（炒） 黄连（姜汁炒） 白茯苓 白术（去芦） 泽泻（各一钱） 青皮（
四分） 甘草（生三分）
上锉一剂。姜、枣煎服。
一治小儿疳积发热。肚大青筋。骨瘦如柴。
消疳退热散
山楂（去子） 乌药 灯心 竹茹 槟榔尖 使君子 芜荑仁 淮木通 黑牵牛 大黄
柴胡 莪术（煨） 枳壳（去穣） 黄芩 甜葶苈
上锉。水煎。温服。
一论肝胆经热毒瘰 。或耳内耳下生疮。发热潮热。或肝经湿热下注。囊痈便毒肿溃。
或小腹胁股结核。凡肝胆经部分。一切疮疡发热。并用之。
九味柴胡汤
柴胡 黄芩（炒各五分） 人参 山栀 半夏 龙胆草 当归 芍药（各三分） 甘草（二
分）
水煎服。
一论小儿肝疳。白膜遮睛。肝经虚热血燥。或风客淫气。而患瘰 结核。或四肢发搐。
眼目
忽抽动。痰涎上壅。凡伤损出血多抽搐发热。又治肾肝脑热消瘦。手足如冰。寒热往来。滑
泄肚
胀。口臭干渴。齿龈溃烂。爪黑面黧。遍身两耳生疮。或耳内出水。或发热自汗盗汗。或便
血诸血失喑。或小便淋闭。咳嗽吐血。或咽喉燥痛。口舌疮裂。或禀赋不足。肢体瘦弱。
解
颅鹤节。五迟五软。或畏明下窜。或早近女色。精血亏耗。五脏齐损。凡属肝肾诸虚不足之
症。皆宜用之。以滋化源。其功不能尽述。
六味地黄丸
怀生地黄（酒浸砂锅内瓷碗盛蒸至极黑捣碎入石臼捣如泥成膏八两） 山茱萸（酒蒸去核
取肉） 干山药（各四两） 牡丹皮（去骨） 白茯苓（去皮） 福泽泻（去毛各三两）
上忌铁器。为细末。和地黄膏。加炼蜜为丸。如梧子大。每服三五十丸。空心。白滚水
下。
一治小儿五疳潮热。面黄肌瘦烦渴。肚大青筋。手足如柴。精神困倦。历试有效。无疾
预服此药。则诸病不生。元气虚者。服半月。身体健壮。
保婴五疳膏
青皮（麸炒二钱） 橘红（五钱） 白术（去芦蜜水炒一两半） 白茯苓（七钱半） 麦门冬（
去心
一两） 使君子肉（锉炒七钱五分） 山楂肉（五钱） 麦芽（炒五钱） 金樱子肉（各炒五钱）
芡实仁（二钱半） 莲心肉（隔纸炒五钱） 甘草（二钱）
上为末和匀。重七两。每次用药末一两。炼蜜四两。调和成膏。每日中晌晚间。各服一
二茶
匙。温水漱口。身热咳嗽。加地骨皮、百部。肚腹饱胀。大便为稀水。腹鸣作声。或因虫出
不知。加槟榔二钱。木香一钱。禀受气弱。加人参二钱半。
一论消疳化积。磨癖清热。伐肝补脾。进食杀虫。润肌肤。养元气。真王道也。
肥儿丸
人参（三钱半） 白术（去芦） 白茯苓（去皮各三钱） 黄连（姜炒钱半） 胡黄连（五钱）
使君
子（去壳四钱） 神曲（炒） 麦芽（炒） 山楂肉（各三钱半） 甘草（炙三钱） 芦荟（二钱半碗
盛泥封固置坑中四面谷糠火煨透用）
上为末。黄米糊为饼。白汤化下。或作丸黍米大。每服二三十丸。看儿大小。米汤下。
《脉诀启蒙》记载：小儿脉象单细，是疳劳的表现；虎口纹呈白色，面色苍白，属于疳病。
疳病，是由于饮食甘肥无节制，乳食喂养不规律，或者先天禀赋怯弱，导致血气不足。一般来说，十五岁以前患此病称为疳，十五岁以后则称为劳。
医书记载五疳病与五脏相关，关键在于脾脏有积滞，一脏失治，便会传变至其他脏腑。只要脾脏的病症去除，其余脏腑的病症也会随之痊愈。症状虽然分为冷疳和热疳，但治疗应当以补益为先。适宜使用地黄丸、五疳膏、肥儿丸等方剂。
有一篇论述小儿疳病的文章提到：患儿面色发黄，肌肉消瘦，腹部胀大且可见青筋暴露，大便颜色发白，小便浑浊，或者沉淀后像淘米水一样。这是疳病的表现。
消疳汤
山楂（去核） 白芍（炒制） 黄连（姜汁炒制） 白茯苓 白术（去芦头） 泽泻（各一钱） 青皮（四分） 甘草（生用三分）
以上药材锉碎为一剂，加生姜、大枣煎服。
有一方治疗小儿疳积发热，腹部胀大且可见青筋暴露，身体瘦骨嶙峋如柴。
消疳退热散
山楂（去核） 乌药 灯心草 竹茹 槟榔尖 使君子 芜荑仁 淮通草 黑牵牛子 大黄
柴胡 莪术（煨制） 枳壳（去瓤） 黄芩 甜葶苈
以上药材锉碎，用水煎煮，温服。
有一篇论述肝胆经热毒引起的瘰疬。或者耳内、耳下生疮，出现发热或潮热；或者是肝经湿热下注，导致囊痈、便毒肿胀溃烂；或者是小腹、胁部、大腿处出现结核肿块。凡是肝胆经循行部位的一切疮疡发热，均可使用此方。
九味柴胡汤
柴胡 黄芩（炒制，各五分） 人参 山栀 半夏 龙胆草 当归 芍药（各三分） 甘草（二分）
用水煎服。
有一篇论述小儿肝疳，表现为白膜遮蔽眼睛，肝经虚热血燥，或者有风邪客居淫气，导致患瘰疬结核，或者四肢抽搐。眼目突然抽动，痰涎上壅。凡是因伤损出血过多导致的抽搐发热，以及治疗肾肝脑热导致的消瘦，手足冰冷，寒热往来，滑泄腹泻，腹胀，口臭干渴，齿龈溃烂，指甲发黑，面色黧黑，遍身及两耳生疮，或者耳内流水，或者发热自汗盗汗，或者便血及其他出血失音，或者小便淋沥闭塞，咳嗽吐血，或者咽喉干燥疼痛，口舌生疮裂开，或者先天禀赋不足，肢体瘦弱，解颅鹤膝，五迟五软，或者畏光向下躲藏，或者过早接近女色，精血亏耗，五脏全面受损。凡属肝肾诸虚不足的病症，都适宜使用此方，以滋养化源，其功效无法详尽叙述。
六味地黄丸
怀庆产的生地黄（酒浸，在砂锅内用瓷碗盛放蒸至极黑，捣碎放入石臼中捣成泥状制成膏，八两） 山茱萸（酒蒸去核取肉） 干山药（各四两） 牡丹皮（去骨） 白茯苓（去皮） 福建泽泻（去毛，各三两）
以上药材忌用铁器，研为细末，用地黄膏调和，加入炼蜜制成丸药，大小如梧桐子。每次服用三五十丸，空腹时，用白开水送服。
有一方治疗小儿五疳潮热，面色发黄，肌肉消瘦，烦躁口渴，腹部胀大且可见青筋暴露，手足瘦削如柴，精神困倦。历经尝试均有效。若无疾病提前服用此药，则各种疾病不会发生。元气虚弱者，服用半个月，身体会变得健壮。
保婴五疳膏
青皮（麸炒二钱） 橘红（五钱） 白术（去芦头，蜜水炒一两半） 白茯苓（七钱半） 麦门冬（去心一两） 使君子肉（锉碎炒制七钱五分） 山楂肉（五钱） 麦芽（炒制五钱） 金樱子肉（各炒制五钱） 芡实仁（二钱半） 莲心肉（隔纸炒制五钱） 甘草（二钱）
以上药材研为细末并混合均匀，总重七两。每次取药末一两，炼蜜四两，调和成膏。每日中午和晚间，各服用一二茶匙，服药后温水漱口。若身体发热咳嗽，加地骨皮、百部；若腹部饱胀，大便稀如水，腹鸣作响，或者因虫出而不知，加槟榔二钱，木香一钱；若先天禀受气弱，加人参二钱半。
有一篇论述消疳化积，磨癖清热，伐肝补脾，增进食欲杀虫，润泽肌肤，养护元气，这真是王道般的治疗方法。
肥儿丸
人参（三钱半） 白术（去芦头） 白茯苓（去皮，各三钱） 黄连（姜炒钱半） 胡黄连（五钱） 使君子（去壳四钱） 神曲（炒制） 麦芽（炒制） 山楂肉（各三钱半） 甘草（炙制三钱） 芦荟（二钱半，用碗盛装泥土封固，置于坑中，四周用谷糠火煨透使用）
以上药材研为细末，用黄米糊做成饼状，用白开水化开服用；或者制成黍米大小的丸药，每次服用二三十丸，根据儿童大小，用米汤送服。
*Jue Jue Qi Meng* (Enlightenment on Pulse Analysis) records: A thin and fine pulse in children indicates *Gan Lao* (Consumption due to Gan disease); a white pattern on the Tiger's Mouth fold and a pale complexion indicate *Gan* disease.
*Gan* disease arises from unregulated consumption of sweet and fatty foods, irregular breastfeeding or feeding, or innate weakness leading to insufficient blood and qi. Generally, this condition occurring before the age of fifteen is called *Gan*, while after fifteen it is called *Lao* (Consumptive disease).
Medical texts state that the five types of *Gan* disease relate to the five Zang organs, with the key factor being accumulation in the Spleen. If one organ is not treated properly, the pathology transmits to the others. Once the Spleen's pathology is resolved, the pathologies of the other organs will also cease. Although symptoms are divided into Cold *Gan* and Heat *Gan*, treatment should prioritize tonification. Formulas such as Dihuang Wan (Rehmannia Pill), Wugan Gao (Five-Gan Paste), and Fei'er Wan (Flesh-Enriching Pill) are suitable.
One treatise on pediatric *Gan* disease states: The patient presents with a sallow complexion, emaciation, abdominal distension with visible subcutaneous veins, white-colored stools, and turbid urine that settles like rice wash water. This is *Gan* disease.
Xiao Gan Tang (Decoction for Dissolving Gan)
Shanzha (Hawthorn Fruit, pips removed) Baishao (White Peony Root, stir-fried) Huanglian (Coptis Rhizome, stir-fried with ginger juice) Bai Fuling (Poria, without bark) Baizhu (Atractylodes Macrocephala Rhizome, without rhizome head) Zexie (Alisma Rhizome, each 1 qian) Qingpi (Green Tangerine Peel, 4 fen) Gancao (Licorice Root, raw, 3 fen)
Crush these ingredients for one dose. Decoct with fresh ginger and jujube, and take warm.
One prescription treats pediatric *Gan* accumulation with fever, abdominal distension with visible veins, and extreme emaciation resembling firewood.
Xiao Gan Tui Re San (Powder for Dissolving Gan and Reducing Fever)
Shanzha (Hawthorn Fruit, pips removed) Wuyao (Lindera Root) Dengxin (Juncus Medulla) Zhuru (Bamboo Shavings) Binglang Jian (Areca Seed Tip) Shijunzi (Quinine Fruit) Wuyi Ren (Alpinia Oxyphylla Fruit) Huai Mutong (Akebia Stem) Hei Qianniu (Black Morning Glory Seed) Dahuang (Rhubarb Root and Rhizome)
Chaihu (Bupleurum Root) Ezhu (Curcuma Zedoaria Rhizome, baked) Zhike (Bitter Orange Fruit, without pulp) Huangqin (Scutellaria Root) Tinglizi (Descurainia Seed)
Crush these ingredients. Decoct with water and take warm.
One treatise discusses scrofula caused by heat-toxin in the Liver and Gallbladder meridians. It also covers sores arising inside or below the ear, accompanied by fever or tidal fever; or damp-heat pouring downward from the Liver meridian causing scrotal abscesses, perineal toxicity with swelling and ulceration; or nodules in the lower abdomen, hypochondrium, and thighs. Any sores and ulcers with fever in the regions governed by the Liver and Gallbladder meridians can be treated with this formula.
Jiuwei Chaihu Tang (Nine-Ingredient Bupleurum Decoction)
Chaihu (Bupleurum Root) Huangqin (Scutellaria Root, stir-fried, each 5 fen) Renshen (Ginseng Root) Shanzhi (Gardenia Fruit) Banxia (Pinellia Tuber) Longdancao (Gentiana Root) Danggui (Angelica Sinensis Root) Shaoyao (Peony Root, each 3 fen) Gancao (Licorice Root, 2 fen)
Decoct with water and take.
One treatise discusses pediatric Liver *Gan*, characterized by a white membrane obscuring the eyes, deficiency-blood dryness in the Liver meridian, or wind pathogens invading due to excessive fluids, leading to scrofula and nodules, or convulsions of the four limbs. Sudden twitching of the eyes and throat, with phlegm-saliva obstructing upward. This also treats convulsions and fever resulting from excessive bleeding due to injury, as well as wasting due to brain-heat in the Kidney and Liver, cold hands and feet, alternating chills and fever, slippery diarrhea, abdominal distension, bad breath, dry mouth and thirst, ulceration of gums, black nails, dark complexion, sores all over the body and ears, fluid discharge from ears, spontaneous sweating, night sweats, hematochezia and other hemorrhages leading to aphonia, stranguria and urinary retention, cough with hemoptysis, dry and painful throat, cracked mouth and tongue, innate insufficiency leading to limb emaciation, fontanelle dehiscence and rachitic knees, developmental delays (five retardations) and flaccidity (five softnesses), photophobia with crouching, premature sexual activity, depletion of essence and blood, comprehensive damage to the five Zang organs. For any conditions belonging to deficiency and insufficiency of the Liver and Kidney, this formula is suitable to nourish the source of transformation. Its merits cannot be fully described.
Liujun Dihuang Wan (Six-Ingredient Rehmannia Pill)
Huai Shengdihuang (Prepared Rehmannia Root, soaked in wine, steamed in a porcelain bowl within a clay pot until extremely black, pounded into mud and made into paste, 8 liang) Shanzhuyu (Cornus Fruit, steamed in wine, pips removed, flesh taken) Ganshashen (Dried Yam Rhizome, each 4 liang) Mudanpi (Tree Peony Bark, bone removed) Bai Fuling (Poria, skin removed) Fu Zexie (Alisma Rhizome, hairs removed, each 3 liang)
Avoid iron vessels. Grind into fine powder. Mix with the Shengdihuang paste. Add refined honey to form pills the size of sophora seeds. Take 30–50 pills per dose, on an empty stomach, with plain boiled water.
One prescription treats tidal fever in the five types of pediatric *Gan*, sallow complexion, emaciation, irritability and thirst, abdominal distension with visible veins, emaciated limbs resembling firewood, and mental fatigue. It has proven effective through repeated trials. Taking this medicine prophylactically when healthy prevents various diseases. Those with deficient Yuan Qi will become robust after half a month of use.
Baoying Wugan Gao (Infant-Protecting Five-Gan Paste)
Qingpi (Green Tangerine Peel, bran-stir-fried, 2 qian) Juhong (Aged Tangerine Peel, 5 qian) Baizhu (Atractylodes Macrocephala Rhizome, without rhizome head, stir-fried with honey water, 1.5 liang) Bai Fuling (Poria, 7.5 qian) Maimendong (Ophiopogon Tuber, heart removed, 1 liang) Shijunzirou (Quinine Fruit Flesh, crushed and stir-fried, 7.5 qian) Shanzharou (Hawthorn Fruit Flesh, 5 qian) Maiya (Barley Sprout, stir-fried, 5 qian) Jinyingzirou (Rosa Laevigata Fruit Flesh, stir-fried, each 5 qian) Qianshiren (Euryale Seed, 2.5 qian) Lianxinerou (Lotus Plumule Flesh, stir-fried between paper, 5 qian) Gancao (Licorice Root, 2 qian)
Grind all ingredients into a uniform powder, weighing a total of 7 liang. For each dose, take 1 liang of the powder and mix with 4 liang of refined honey to form a paste. Take 1–2 tea spoons at noon and evening. Rinse mouth with warm water after taking. If there is body heat and cough, add Digupi (Groundcherry Bark) and Baibu (Stemona Root). If there is abdominal fullness, watery diarrhea, and borborygmus, or unknown passage of worms, add Binglang (Areca Seed, 2 qian) and Muxiang (Costus Root, 1 qian). If innate Qi is weak, add Renshen (Ginseng Root, 2.5 qian).
One treatise discusses dissolving *Gan* and resolving accumulations, grinding away stagnation and clearing heat, suppressing the Liver and tonifying the Spleen, promoting appetite and expelling parasites, moistening the skin, and nourishing Yuan Qi. This is truly the "Kingly Way" of treatment.
Fei'er Wan (Flesh-Enriching Pill)
Renshen (Ginseng Root, 3.5 qian) Baizhu (Atractylodes Macrocephala Rhizome, without rhizome head) Bai Fuling (Poria, without bark, each 3 qian) Huanglian (Coptis Rhizome, stir-fried with ginger, 1.5 qian) Huhuanglian (Coptis Chinensis Rhizome, 5 qian) Shijunzi (Quinine Fruit, shelled, 4 qian) Shenqu (Medicated Leaven, stir-fried) Maiya (Barley Sprout, stir-fried) Shanzharou (Hawthorn Fruit Flesh, each 3.5 qian) Gancao (Licorice Root, honey-roasted, 3 qian) Lushui (Aloe Resin, 2.5 qian, sealed in a bowl with mud, buried in a pit, and roasted thoroughly using bran fire)
Grind into powder. Use yellow millet paste to make cakes, which are dissolved in white water for ingestion; or form pills the size of millet seeds. Take 20–30 pills per dose according to the child's age, with millet soup.