《圣惠》小儿五疳可治候论∶凡小儿疳在内,眼涩腹胀,痢色无常,或如泔淀,日渐羸瘦,此候可疗。若鼻
下赤烂,自揉其鼻,头上有疮,生痂痛痒,渐渐流引,绕于两耳,时时目赤,头发稀疏,脑皮光紧,头大项
细,肌体羸瘦,亦可治也。若唇口被蚀,齿龈作五色,或尽峭黑,舌下有白疮,上 有窍子,口中时有臭气,
齿渐染欲烂,亦可治也。若下部开张,有时赤烂,痒不可忍,下痢无常,亦可治也。若疳蚀脊膂,十指皆痒,
自咬指甲,头发作穗,脊骨如锯,有时腹胀,有时下痢,若急治之,无不瘥也。
《圣惠》小儿五疳不可治候论∶凡小儿肝脏疳,若目睛带青脉,左胁下硬,多吐涎沫,眼角左右有黑气所冲,
不可治也。心脏疳,若爱惊啼,常好饮水,便食辛味,耳边有脉,舌上有黑靥者,不可治也。脾脏疳,若肚
大唇无血色,人中平满,下痢无度,水谷不消,好吃泥土,皮枯骨露,不可治也。肺脏疳,若咳逆气促,多泻
白米,身上有斑,生如粟米大,色若黑者,不可治也。肾脏疳,若爱食酸咸,饮水无度,小便如乳,牙齿青
黑,耳脑干燥,肩竖骨枯,不可治也。又五疳有五绝候∶一、衬着脚中,指底不觉疼。二、抱着手足,垂弹无力。
三、病未退,遍身不暖。四、脏腑泻青涎及沫不止。五、项筋舒展无力。如此之候,皆不可治也。凡医用药,
切在审详也。
《圣惠方》关于小儿五疳可治与不可治的论述:
凡是小儿患疳病,病邪在体内,表现为眼睛干涩、腹部胀满,痢疾颜色不定,有时像米汤沉淀物一样,身体日渐消瘦,这种证候是可以治疗的。如果鼻子下方发红溃烂,孩子自己揉搓鼻子,头上生疮并结痂,感到疼痛和瘙痒,逐渐流脓蔓延至双耳周围,经常眼睛发红,头发稀疏,头皮光亮紧绷,头大脖子细,肌肉身体消瘦,这种情况也是可以治疗的。如果嘴唇和口腔被腐蚀,牙龈呈现五色或全部焦黑,舌头下面有白色疮疡,上面有小孔,口中时常散发臭气,牙齿逐渐染黑欲腐烂,这种情况也是可以治疗的。如果下部(生殖器或肛门)开张,有时发红溃烂,瘙痒难忍,腹泻无规律,这种情况也是可以治疗的。如果疳毒侵蚀脊柱,十个手指都痒,孩子自己咬指甲,头发结成穗状,脊骨突出如锯齿,有时腹胀,有时腹泻,如果能紧急治疗,没有不痊愈的。
《圣惠方》关于小儿五疳不可治的论述:
凡是小儿肝脏疳,如果眼珠带有青色脉络,左胁下坚硬,经常呕吐涎沫,眼角左右有黑气冲犯,这种情况是不可治的。心脏疳,如果孩子喜欢惊恐啼哭,经常想喝水,喜欢吃辛辣食物,耳后有脉搏跳动明显,舌面上有黑色斑点,这种情况是不可治的。脾脏疳,如果肚子大但嘴唇没有血色,人中穴部位平满,腹泻无度,水谷不能消化,喜欢吃泥土,皮肤干枯骨骼外露,这种情况是不可治的。肺脏疳,如果咳嗽气逆急促,经常排泄白色米粒样大便,身上出现斑点,大小如粟米,颜色发黑,这种情况是不可治的。肾脏疳,如果喜欢食用酸咸食物,饮水无节制,小便像乳汁一样,牙齿青黑,耳朵和头部干燥,肩膀耸起骨骼枯槁,这种情况是不可治的。
另外,五疳有五种绝症候象:第一,脚底衬垫处,脚趾底部感觉不到疼痛;第二,抱着手脚时,肢体下垂且无力弹动;第三,病情未退,全身都不温暖;第四,脏腑泻出青色涎沫且不止;第五,颈部筋脉舒展无力。像这样的证候,都是不可治疗的。凡是用药治病,务必审慎详细地考察。
Discussion on the Treatable and Incurable Conditions of the Five Types of Gan Disease in Children from *Taiping Shenghui Fang*:
Regarding the treatable conditions: When a child suffers from Gan disease (a chronic wasting syndrome often associated with malnutrition) internally, presenting with dry eyes and abdominal distension, dysentery of variable color resembling rice water sediment, and progressive emaciation, this condition is curable. If there is redness and ulceration under the nose, self-rubbing of the nose, sores with crusts on the head causing pain and itching that gradually spread around both ears, frequent redness of the eyes, sparse hair, tight and shiny scalp skin, a large head with a thin neck, and emaciated muscles and body, this condition is also curable. If the lips and mouth are eroded, the gums appear in five colors or entirely blackish, white ulcers form under the tongue with perforations above, foul breath occurs intermittently, and teeth gradually darken and decay, this condition is curable. If the lower orifices are open, sometimes red and ulcerated with unbearable itching, and dysentery is irregular, this condition is curable. If the Gan toxin erodes the spine, all ten fingers itch, the child bites their fingernails, hair forms tufts like bundles, the spinal bones protrude like a saw, accompanied by intermittent abdominal distension and diarrhea, prompt treatment will invariably lead to recovery.
Regarding the incurable conditions: For Liver Gan disease, if the eyeballs show bluish veins, the area below the left hypochondrium is hard, there is frequent vomiting of saliva, and dark qi assaults the corners of the eyes, this condition is incurable. For Heart Gan disease, if the child loves to cry out in fright, constantly desires to drink water, prefers spicy foods, has visible pulsations behind the ears, and black spots appear on the tongue, this condition is incurable. For Spleen Gan disease, if the abdomen is distended but the lips lack blood color, the philtrum is flat and full, diarrhea is incessant, food and water are not digested, the child craves eating soil, the skin is withered with exposed bones, this condition is incurable. For Lung Gan disease, if there is coughing with reverse flow of Qi and shortness of breath, frequent passage of white rice-like stools, macules appear on the body the size of millet seeds and are black in color, this condition is incurable. For Kidney Gan disease, if the child craves sour and salty flavors, drinks water without limit, urine resembles milk, teeth are blue-black, ears and head are dry, shoulders are erect with withered bones, this condition is incurable.
Furthermore, there are five terminal signs among the five types of Gan disease: First, when shoes are placed under the feet, the child feels no pain in the soles; second, when holding the limbs, they hang limp and lack strength to move; third, while the illness persists, the whole body remains cold; fourth, the viscera discharge green saliva and froth incessantly; fifth, the tendons of the neck are loose and weak. Such conditions are all incurable. Physicians must exercise extreme caution and thorough examination when prescribing medication.