（五疳辨治）凡九门
《圣惠》论∶夫小儿托质胞胎，成形气血。诞生之后，骨肉轻软，肠胃细微。哺乳须是合宜，脏腑自然调适。
若乳母寒温失理，动止乖违，饮食无常，甘肥过度，喜怒气乱，醉饱伤劳，便即乳儿，致成疳也。又小儿百日
以后，五岁以前，乳食渐多，不择生冷，好餐肥腻，恣食甘酸，脏腑不和，并生疳气。凡五疳者∶一曰肝疳，
其候摇头揉目，白膜遮睛，流汗遍身，合面而卧，目中涩痒，肉色青黄，发疏头焦，筋青脑热，腹中积聚，下
痢频多，久而不痊，转甚羸瘦。此是肝疳，亦名风疳也。二曰心疳，其候浑身壮热，吐利无恒，颊赤面黄，
胸膈烦满，鼻干心燥，口舌生疮，痢久不痊，多下脓血。有时盗汗，或乃虚惊。此是心疳，亦名惊疳也。三
曰脾疳，其候腹多筋脉，喘促气粗，乳食不多，心腹胀满，多啼咳逆，面色痿黄，骨立毛焦，形枯力劣，胸膈
壅闷，水谷不消，口鼻常干，好吃泥土，情意不悦，爱暗憎明，肠胃不和，利多酸臭。此是脾疳，亦名食疳也。
四曰肺疳，其候咳嗽气逆，皮毛干焦，饶涕多啼，咽喉不利，揉鼻咬甲，壮热憎寒，口鼻生疮，唇边赤痒，腹
内气胀，乳食渐稀，大肠不调，频频泄利，粪中米出，皮上粟生。此是肺疳，亦名气疳也。五曰肾疳，其候肌
骨消瘦，齿龈生疮，寒热有时，口鼻干燥，脑热如火，脚冷如冰。吐逆既增，乳食减少，泻痢频并，下部开张，
肛门不收，疳疮痒痛。此是肾疳，亦名急疳也。今以一方同疗之，故曰五疳也。
汉东王先生《家宝》治五疳论∶小儿五疳，因过食甘甜，或因惊气入腹，或缘患后不长肌肉，致成疳疾。
不思乳食，朝好暮恶，或发潮热，四肢羸瘦，腹急气喘，头发稀疏，喜食泥土，变成疳劳。宜进鸡肉煎丸（方见疳
劳门中），及消疳芦荟丸（方见五疳可治、不可治门中），兼服调胃气观音散（方见胃气不和门中）并
四顺散。（方见温壮门。葛氏《肘后》四味饮同。）
钱乙论五疳论∶肝疳，白膜遮睛，当补肝，地黄丸主之（方见虚寒门中）。心疳，面黄颊赤，心壮热，当补心，安神
丸主之（方见虚热门中）。脾疳，体黄腹大，食泥土，当补脾，益黄散主之（方见胃虚不和门中）。肾疳，
极瘦，身有疮疥，当补肾，地黄丸主之。肺疳，气喘，口鼻生疮，当补脾肺，益黄散主之。（二方见同。）
《婴童宝鉴》五脏五疳论∶心脏生疳，状如大人劳疾，两颊赤色，面色黄白，身体壮热，胸中满闷，鼻口生
疮，气喘呕逆，脓黑痢赤，虚汗饶多，渐加消瘦，此心疳也。肝脏受疳，目生白膜，面色青黄，夜汗饶多，时
加气拥，摇头鼻痒，毛立发稀，覆地而卧，腹中症块，下痢无时，常加羸瘦，此肝疳也。脾脏受疳，粪中有米，
臭气糟酸，好食泥土，心腹胀满，肚有青脉，咳嗽恶心，口鼻干焦，情怀不乐，憎明好暗，肌肉内消，此脾疳
候也。肺脏受疳，咳嗽气喘，鼻下生疮，咬指捻眉，吐利冷沫，腹满不食，壮热憎寒，皮上粟生，喉中嗌塞，
洞赤白泔，皮肤燥涩，此肺疳候也。肾脏受疳，下冷上热，洞泄脱肛，下部开张，更加疳 ，浑身疮癣，时发
憎寒，奶食不消，夜多啼叫，小便如水，胸胁似汤，日渐 羸，久而沉困，此是肾疳候也。凡上件疳，皆属五
脏六腑也。
（五疳辨治）共九门
《圣惠方》论述：小儿依托母体胞胎孕育，形成形体与气血。出生之后，骨肉轻软，肠胃细微。哺乳必须适宜，脏腑自然调和适应。
如果乳母寒温失调，行为举止违背常理，饮食没有规律，过于甘甜肥腻，喜怒情绪导致气机紊乱，醉酒饱食后过度劳累，便立即给婴儿哺乳，致使形成疳病。另外，小儿在百日以后、五岁以前，乳食逐渐增多，不选择生冷食物，喜好食用肥腻之物，放纵食用甘酸食物，导致脏腑不和，都产生疳气。所谓五疳：一是肝疳，其表现为摇头揉眼，白膜遮蔽眼睛，全身出汗，侧身而卧，眼中涩痒，肌肉颜色青黄，头发稀疏头顶焦枯，筋脉显露脑部发热，腹中有积块，腹泻频繁，久治不愈，逐渐变得极度消瘦。这是肝疳，也称为风疳。二是心疳，其表现为全身高热，呕吐腹泻无常，脸颊红面色黄，胸膈烦闷胀满，鼻干心燥，口舌生疮，痢疾日久不愈，多排出脓血。有时盗汗，或者出现虚惊。这是心疳，也称为惊疳。三是脾疳，其表现为腹部多见筋脉，喘促气粗，吃奶进食不多，心胸腹胀满，多啼哭咳嗽气逆，面色萎黄，骨骼突出毛发焦枯，形体枯槁力气衰弱，胸膈壅塞闷痛，水谷不能消化，口鼻经常干燥，喜欢吃泥土，心情不愉快，喜欢黑暗厌恶光亮，肠胃不和，腹泻多且气味酸臭。这是脾疳，也称为食疳。四是肺疳，其表现为咳嗽气逆，皮毛干枯焦躁，鼻涕多啼哭多，咽喉不利，揉鼻子咬指甲，高热恶寒，口鼻生疮，嘴唇边缘赤色瘙痒，腹内气胀，吃奶进食逐渐减少，大肠不调，频频泄泻，粪便中有未消化的米粒，皮肤上生出粟粒状皮疹。这是肺疳，也称为气疳。五是肾疳，其表现为肌肉骨骼消瘦，齿龈生疮，寒热定时发作，口鼻干燥，脑部发热如火，脚冷如冰。呕吐逆反增加，吃奶进食减少，泻痢频繁并发，下部开张，肛门不收摄，疳疮瘙痒疼痛。这是肾疳，也称为急疳。现在用一方共同治疗，所以称为五疳。
汉东王先生《家宝》治疗五疳论述：小儿五疳，因为过食甘甜，或因受惊气入腹，或因为患病后不长肌肉，致使形成疳疾。不想吃奶进食，早上好晚上坏，或者发潮热，四肢消瘦，腹部紧急气喘，头发稀疏，喜食泥土，变成疳劳。宜服用鸡肉煎丸（方剂见疳劳门中），以及消疳芦荟丸（方剂见五疳可治、不可治门中），兼服调胃气观音散（方剂见胃气不和门中）并四顺散。（方剂见温壮门。葛氏《肘后备急方》的四味饮相同。）
钱乙论述五疳：肝疳，白膜遮蔽眼睛，应当补肝，用地黄丸主治（方剂见虚寒门中）。心疳，面黄颊赤，心脏壮热，应当补心，用安神丸主治（方剂见虚热门中）。脾疳，身体黄腹部大，吃泥土，应当补脾，用益黄散主治（方剂见胃虚不和门中）。肾疳，极度消瘦，身上有疮疥，应当补肾，用地黄丸主治。肺疳，气喘，口鼻生疮，应当补脾肺，用益黄散主治。（两个方剂见同上。）
《婴童宝鉴》五脏五疳论述：心脏生疳，症状像大人的劳损疾病，两颊红色，面色黄白，身体高热，胸中满闷，鼻口生疮，气喘呕逆，脓黑痢赤，虚汗很多，逐渐消瘦，这是心疳。肝脏受疳，眼睛生白膜，面色青黄，夜间出汗很多，时常加气拥，摇头鼻痒，毛立发稀，趴地而卧，腹中有症块，下痢无时，常加羸瘦，这是肝疳。脾脏受疳，粪便中有米，臭气糟酸，好食泥土，心腹胀满，肚有青脉，咳嗽恶心，口鼻干焦，情怀不乐，憎明好暗，肌肉内消，这是脾疳候也。肺脏受疳，咳嗽气喘，鼻下生疮，咬指捻眉，吐利冷沫，腹满不食，壮热憎寒，皮上粟生，喉中嗌塞，洞赤白泔，皮肤燥涩，这是肺疳候也。肾脏受疳，下冷上热，洞泄脱肛，下部开张，更加疳 ，浑身疮癣，时发憎寒，奶食不消，夜多啼叫，小便如水，胸胁似汤，日渐 羸，久而沉困，这是肾疳候也。凡上件疳，皆属五脏六腑也。
(Five Types of Gan Syndrome: Differentiation and Treatment) Nine Sections in Total
*Taiping Shenghui Fang* (Comprehensive Record of Holy Benefit) discusses: Infants rely on the maternal womb for gestation, forming their physical structure and Qi-Blood. After birth, their bones and flesh are light and soft, and their intestines and stomach are delicate. Breastfeeding must be appropriate so that the Zang-Fu organs naturally harmonize and adapt.
If the nursing mother suffers from disharmony of cold and warmth, behaves improperly, has irregular eating habits, consumes excessive sweet and fatty foods, experiences emotional disturbances causing Qi chaos, or is injured by labor after drunkenness and overeating, and immediately breastfeeds the infant, it leads to the formation of Gan syndrome. Furthermore, between one hundred days and five years of age, as infants consume more milk and food, if they do not avoid raw and cold foods, prefer fatty and greasy items, indulge in sweet and sour foods, it causes disharmony of the Zang-Fu organs, generating Gan Qi. The Five Types of Gan are: First is Liver Gan, characterized by shaking the head and rubbing the eyes, a white membrane obscuring the pupils, sweating all over the body, sleeping face down, dry and itchy eyes, yellowish-green muscle color, sparse and scorched hair, visible tendons and hot brain, abdominal accumulation, frequent diarrhea, which persists for a long time without healing, gradually turning into extreme emaciation. This is Liver Gan, also known as Wind Gan. Second is Heart Gan, characterized by high fever throughout the body, unpredictable vomiting and diarrhea, red cheeks and yellow face, irritability and fullness in the chest and diaphragm, dry nose and restless heart, sores in the mouth and tongue, chronic dysentery often discharging pus and blood, occasional night sweats, or false fright. This is Heart Gan, also known as Fright Gan. Third is Spleen Gan, characterized by visible veins on the abdomen, panting and coarse breathing, poor appetite for milk and food, chest and abdominal distension, frequent crying and coughing with rebellious Qi, sallow complexion, protruding bones and scorched hair, withered form and weak strength, stuffiness and oppression in the chest and diaphragm, inability to digest water and grain, dry mouth and nose, craving for eating soil, unhappy mood, preference for darkness and aversion to light, disharmony of the intestines and stomach, frequent diarrhea with sour and foul odor. This is Spleen Gan, also known as Food Gan. Fourth is Lung Gan, characterized by coughing and rebellious Qi, dry and scorched skin and hair, abundant nasal discharge and frequent crying, throat discomfort, rubbing the nose and biting nails, high fever with aversion to cold, sores in the mouth and nose, red and itchy lips, abdominal bloating, gradually decreasing milk intake, intestinal dysfunction, frequent loose stools with undigested rice grains, and millet-like rashes on the skin. This is Lung Gan, also known as Qi Gan. Fifth is Kidney Gan, characterized by emaciation of muscles and bones, sores on the gums, periodic chills and fever, dry mouth and nose, brain heat like fire, and cold feet like ice. Increased vomiting and reduced milk intake, concurrent frequent diarrhea and dysentery, opening of the lower orifices, prolapse of the anus, and itching and pain from Gan sores. This is Kidney Gan, also known as Urgent Gan. Currently, one formula is used to treat them all, hence called Five Gan.
Mr. Wang from Handong in *Jiabao* discusses the treatment of Five Gan: The Five Gan in children arise from excessive consumption of sweets, or from fright Qi entering the abdomen, or from failure to gain muscle mass after illness, leading to Gan disease. Loss of appetite for milk and food, varying preferences from morning to evening, tidal fever, emaciated limbs, urgent abdomen with panting, sparse hair, craving for eating soil, transforming into Gan Consumption. It is suitable to administer Chicken Decoction Pills (see section on Gan Consumption), Xinggan Lushui Wan (Aloe Pill for Resolving Gan, see section on Treatable and Untreatable Five Gan), along with Tiaoweiqi Guanyin San (Guanyin Powder for Regulating Stomach Qi, see section on Disharmony of Stomach Qi) and Sishun San (Four Smooth Powder). (See section on Warm Fever. Ge Hong's *Zhouhou Beiji Fang* Four-Ingredient Drink is similar.)
Qian Yi discusses Five Gan: Liver Gan, with a white membrane obscuring the eyes, requires tonifying the Liver, treated primarily with Dihuang Wan (Rehmannia Pill, see section on Deficiency-Cold). Heart Gan, with a yellow face and red cheeks, and intense Heart heat, requires tonifying the Heart, treated primarily with Anshen Wan (Calming Spirit Pill, see section on Deficiency-Heat). Spleen Gan, with a yellow body and large abdomen, eating soil, requires tonifying the Spleen, treated primarily with Yihuang San (Yellow-Boosting Powder, see section on Stomach Deficiency and Disharmony). Kidney Gan, extremely emaciated with sores and scabies on the body, requires tonifying the Kidney, treated with Dihuang Wan. Lung Gan, with panting and sores in the mouth and nose, requires tonifying the Spleen and Lungs, treated with Yihuang San. (Both formulas see above.)
*Yingtong Baojian* discusses the Five Gan of the Five Zang Organs: When the Heart generates Gan, the condition resembles consumptive diseases in adults, with red cheeks, yellowish-white complexion, high fever, chest fullness and oppression, sores in the nose and mouth, panting and vomiting, black pus in dysentery with red stool, profuse spontaneous sweating, and gradual emaciation; this is Heart Gan. When the Liver receives Gan, white membranes grow in the eyes, the complexion is greenish-yellow, night sweats are profuse, occasionally accompanied by Qi stagnation, head shaking and nasal itching, erect hair and thinning scalp hair, lying prone on the ground, abdominal masses, unregulated diarrhea, and increasing emaciation; this is Liver Gan. When the Spleen receives Gan, rice grains appear in feces, the odor is sour and rotten, there is a craving for eating soil, chest and abdominal distension, blue veins on the belly, coughing and nausea, dry and scorched mouth and nose, unhappiness, aversion to light and preference for darkness, and internal wasting of muscle; this is the presentation of Spleen Gan. When the Lung receives Gan, there is coughing and panting, sores under the nose, biting fingers and rubbing eyebrows, vomiting and diarrhea of cold froth, abdominal fullness and refusal to eat, high fever with aversion to cold, millet-like rashes on the skin, throat obstruction, dysentery with red and white fluids, dry and rough skin; this is the presentation of Lung Gan. When the Kidney receives Gan, there is cold below and heat above, severe diarrhea with rectal prolapse, opening of the lower orifices, worsening Gan sores, whole-body tinea and ringworm, intermittent aversion to cold, indigestion of milk and food, frequent crying at night, urine like water, chest and hypochondrium feeling like boiling water, gradual emaciation, and deep fatigue over time; this is the presentation of Kidney Gan. All the aforementioned Gan syndromes belong to the Five Zang and Six Fu organs.