丹溪曰小儿脏腑娇嫩饱则易伤乳哺饮食一或失常不为疳者鲜矣皆因饮食不调甘肥无节而
作也
或婴幼阙乳粥饭太早耗伤形气则疳之根生延及岁月五疳病成钱氏曰疳皆脾胃耗伤亡津液之所
作也故小儿脏腑柔脆有疾不可痛击太下必亡津液凡有可下宜量大小虚实而下之则不致为疳也
但见目涩或生白膜唇赤身黄喜卧冷地爱食泥土泻痢无常腹肚胀满耳鼻生疮头发作穗脚弱项小
肌瘦饮水者皆其候也
曾氏曰小儿疳证有五心肝脾肺肾是也其切牙舒舌舌上生疮爱饮冷水唇红面赤喜伏眠于地
名曰
心疳目生眵泪发际左脸多青或目睛微黄泻痢夹水或如苔色名曰肝疳爱吃泥土冷物引饮无度身
面俱黄发稀作穗头大项小腹胀脚软间或酿泻肌瘦目慢昼凉夜热不思乳食名曰脾疳鼻下黑 手
足枯细口有腥气或作喘嗽右腮 白名曰肺疳两耳内外生疮脚如鹤膝头缝不合或未能行牙齿生
迟其缝臭烂传作走马疳之类名曰肾疳大抵疳之为病皆因过食饮食于脾家一脏有积不治传之余
脏而成五疳之疾若脾家病去则余脏皆安矣
按洁古曰疳者小儿病癖或久吐泻医者妄投过转之药小儿易为虚实致令胃虚而亡津液内发虚
热外
消肌肉一脏虚则诸脏皆弱其病目胞肿腹肚胀满利色无常渐加瘦瘠久不痊 是肠胃有风积法当
用宣风散导之后各根据本脏补其母
《脉诀启蒙》说:小儿脉象单细,是疳劳的表现。虎口部位的脉络纹路呈现白色,也是疳证的表现。
丹溪说:小儿脏腑娇嫩,饱食后容易受伤;乳食喂养如果一旦失常,不患疳证的很少了。这都是因为饮食不调,甘肥无度而造成的。
或者婴幼儿断奶过早,吃粥饭太早,耗伤了形体和气,那么疳证的根源就产生了,拖延岁月,五疳的病就形成了。钱氏说:疳证都是脾胃耗伤、亡失津液所造成的。所以小儿脏腑柔脆,有病不可猛烈攻下,否则必然亡失津液。凡是可以攻下的情况,应当根据大小和虚实来适度攻下,这样就不会导致疳证。
只要见到眼睛干涩或生白膜,嘴唇红,身体黄,喜欢睡在冷地上,爱吃泥土,泻痢无常,腹部胀满,耳朵鼻子生疮,头发结成穗状,脚弱项小,肌肉消瘦,想喝水的,都是疳证的征候。
曾氏说:小儿疳证有五种,即心、肝、脾、肺、肾疳。其中切牙伸舌,舌上生疮,爱喝冷水,嘴唇红面赤,喜欢趴在地上睡觉的,名叫心疳。眼睛分泌物多流泪,发际左侧脸多青色,或者眼珠微黄,泻痢夹水或者像苔色一样的,名叫肝疳。爱吃泥土冷物,饮水无度,身面都黄,头发稀疏结成穗状,头大项小,腹胀脚软,间或腹泻,肌肉消瘦,眼睛眯着,白天凉晚上热,不想吃乳食的,名叫脾疳。鼻子下面黑,手足枯细,口中有腥气,或者作喘嗽,右腮发白的,名叫肺疳。两耳内外生疮,脚像鹤膝,头缝不合,或者不能行走,牙齿生长迟慢,其缝隙臭烂,传染成为走马疳之类的,名叫肾疳。大体上疳这种病,都是因为过食损伤了脾脏这一脏,有积滞不治疗,传变到其余各脏,从而形成五疳的疾病。如果脾脏的病去除了,那么其余各脏也就安定了。
按洁古说:疳,是小儿的病癖,或者久吐泻,医生胡乱投用过于猛烈的药物,小儿容易虚实夹杂,致使胃虚而亡失津液,内部发生虚热,外部消耗肌肉。一脏虚弱则诸脏都弱,其病症表现为眼睑肿,腹部胀满,大便颜色无常,逐渐消瘦,长久不痊愈。这是肠胃有风积,法度上应当用宣风散疏导之后,再根据本脏补益其母脏。
*Mai Jue Qi Meng* (Enlightenment on Pulse Formulas) states: A thin and fine pulse in children indicates *Gan Lao* (Consumption due to Gan syndrome). A white color in the finger vein pattern at the Tiger's Mouth area also indicates *Gan* syndrome.
Danxi stated: Children's Zang-Fu organs are delicate and tender; they are easily injured when overfed. If breastfeeding or dietary intake is irregular, it is rare for them not to develop *Gan* syndrome. This is all caused by improper diet and excessive consumption of sweet and fatty foods.
Alternatively, if infants are weaned too early or introduced to porridge and rice too soon, their physical form and Qi will be depleted, giving rise to the root of *Gan* syndrome. After months and years, the Five Types of *Gan* disease manifest. Qian stated: *Gan* syndrome is caused by the depletion of the Spleen and Stomach and the loss of body fluids. Therefore, because children's Zang-Fu organs are soft and fragile, severe purgation must be avoided when treating illness, as it will inevitably deplete body fluids. In cases where purgation is indicated, one should assess the child's size and the excess/deficiency patterns to administer appropriate treatment, thereby avoiding the development of *Gan*.
Symptoms such as dry eyes or the formation of a white membrane, red lips, yellowish complexion, preference for lying on cold ground, craving for eating soil, irregular diarrhea and dysentery, abdominal distension, sores on the ears and nose, hair matted into tufts, weak legs, small neck, emaciation, and thirst are all signs of *Gan* syndrome.
Zeng stated: There are five types of pediatric *Gan* syndrome: Heart, Liver, Spleen, Lung, and Kidney *Gan*. Grinding teeth, protruding the tongue, ulcers on the tongue, craving for cold water, red lips and face, and a preference for lying prone on the ground characterize **Heart *Gan***. Excessive eye discharge, tearing, bluish discoloration on the left side of the face near the hairline, or slightly yellow sclera, along with watery diarrhea or stool resembling moss color, characterize **Liver *Gan***. Craving for soil and cold items, excessive drinking, yellowish complexion all over the body, sparse hair matted into tufts, large head with a thin neck, abdominal distension, weak legs, intermittent diarrhea, emaciation, squinting eyes, feeling cool during the day and hot at night, and refusal to nurse characterize **Spleen *Gan***. Blackness under the nose, withered and thin hands and feet, foul odor from the mouth, wheezing or coughing, and whitening of the right cheek characterize **Lung *Gan***. Sores inside and outside both ears, knees resembling those of a crane (swollen joints), unfused cranial sutures, inability to walk, delayed tooth eruption, and foul-smelling rotting gums which may transmit to conditions like *Zou Ma Gan* (flying horse gangrene) characterize **Kidney *Gan***. Generally, *Gan* disease arises from overeating damaging the Spleen. If this accumulation in the Spleen is not treated, it transmits to other Zang organs, forming the Five Types of *Gan*. If the Spleen pathology is resolved, the other Zang organs will be stabilized.
According to Jiegu: *Gan* refers to pediatric food stagnation or chronic vomiting and diarrhea. When physicians recklessly administer overly harsh medications, children, being susceptible to both excess and deficiency patterns, suffer from Stomach deficiency and fluid depletion. This leads to internal empty heat and external muscle wasting. When one Zang is deficient, all Zangs become weak. Symptoms include swollen eyelids, abdominal distension, variable stool color, gradual emaciation, and prolonged non-healing. This indicates wind-stagnation in the intestines and stomach. The method dictates using *Xuan Feng San* (Ventilate Wind Powder) to guide out the stagnation first, followed by tonifying the mother organ according to the specific affected Zang.