杨氏云∶由乳哺不调，脏腑伏热所致也。凡甘味入于脾而动虫，虫动则侵蚀脏
腑，遂使孩提心下扰闷，若上蚀齿龈则口疮出血，齿色紫黑，下蚀肠胃则下痢肛烂，
湿痒生疮，疗治不早，精髓消耗，难以有瘳，虫者 也，目为湿 ，多因疳伤久痢，
肠胃受湿得之。状如狐惑伤寒齿蚀之证，或以走马命名，盖齿属肾，肾主虚，才受
热邪，疳气直奔上焦，故以走马为喻，初作口气，名曰臭息。次第齿黑，名曰崩砂。
盛则龈烂，名曰溃槽。热血迸出，名曰宣露。甚者齿皆脱落，名曰腐根，其根既腐，
纵得全活，齿不复生。外证，脑热肌削，手足如冰，寒热时来，滑泄肚痛，口臭干
渴，齿龈生疮，爪黑面黧，身多疮疥是也。钱氏，地黄丸主之。仍当于生脉散中
多加黄 以补肺。曾氏，用调元散。
调元散 主禀受元气不足，颅囟开解，肌肉消瘦，腹大如肿，致语迟行迟，手足如
分。同神色昏慢，齿生迟，服之效。
干山药（去黑皮，五钱） 人参（去芦） 白茯苓（去皮） 茯神（去皮根） 白术 白芍药 熟地黄（酒洗）
当归（酒洗） 黄 （蜜水炙。各二钱半） 川芎 甘草（炙。各三钱） 石膏
上碎。每服二钱，水一盏，姜二片，枣一枚，煎七分，无时温服。如婴孩幼嫩，
与乳母同服。
九味地黄丸 治肾疳。
熟地黄（四钱五分） 赤茯苓 山茱萸肉 川楝子 当归 川芎 牡丹皮 山药 使
君子肉（二钱）
上为末，蜜丸桐子大。每服八十丸，空心温酒下。
〔张涣〕熊胆散 治急疳虫伤脏腑，上蚀口齿，生疮赤烂，世呼为走马疳。
莨宕子（炒、令微黑） 虾蟆灰 白矾（各半两） 生硫黄（一分。以上捣罗为细末，次用） 熊胆（半两，细研）
麝香 雄黄 芦荟（各一分，并细研）
上件药一处拌匀，为细末。每服一字，煎荆芥汤调下。如有疮处宜薄敷之。如
鼻痒，即取少许逐日吹鼻中，日三两上。
熊胆膏 截急疳病。
真熊胆（半两，研） 蚺蛇胆（为末） 芦荟（研） 牛黄（研。各一分） 龙脑 麝香（各一钱，并研细）
上件药都细研，以井华水一小盏搅和匀，以瓷器盛，重汤慢火熬成膏。每服一
豆大，薄荷汤化下，兼涂患处。
立圣膏 治急疳侵蚀。
人乳汁（半合） 黄矾（一栗大） 白矾（一枣大） 石胆（一豆大）
上件药都研细，以绵裹，纳乳汁中浸经一宿，看汁有味，慢火熬成膏。每用少
许涂于口里。如鼻中有疮，滴入少许。若有肿处，先以三棱针刺破，除去血，然后即涂此药。
二金散 治急疳毒盛。
砒霜（一分） 麝香（半两）
上件药，先将砒霜去纸上炒过，后入麝香同研令细。每用一字，以鸡羽掠在疮
上，日使三两度，随时展去药，无令咽津。
治小儿肾疳并疝气偏坠寒热方
没药（炮） 甘草（各二分） 硫黄 木香（炮） 胡黄连（各一分）
上为末，用蒸枣肉丸，如麻子大。苁蓉汤下三丸，可两服。（庄氏第七候用此方。）
杨氏说：这是由于乳食喂养不协调，导致脏腑内有伏热所致。凡是甘味食物进入脾脏就会生虫，虫动则侵蚀脏腑，于是使幼儿心下烦闷扰攘；如果向上侵蚀齿龈，就会出现口疮出血、牙齿颜色紫黑；向下侵蚀肠胃，则出现下痢、肛门腐烂、湿痒生疮。治疗如果不及时，精髓就会消耗，难以痊愈。这种病称为“疳”，眼睛表现为湿翳（角膜浑浊），多因疳疾损伤或久痢，肠胃受湿邪侵袭而得。症状类似狐惑病和伤寒中牙齿被腐蚀的证候，有的以“走马”命名，大概是因为牙齿属于肾，肾主虚，刚受热邪，疳气便直奔上焦，所以用“走马”来比喻其迅速。初期发作口臭，名叫“臭息”。接着牙齿变黑，名叫“崩砂”。严重时牙龈腐烂，名叫“溃槽”。热血迸出，名叫“宣露”。更严重的牙齿全部脱落，名叫“腐根”，牙根既然腐烂，即使得以存活，牙齿也不再生长。外证表现为脑热肌肉消瘦，手足像冰一样冷，寒热交替发作，滑泄腹痛，口臭口干渴，齿龈生疮，指甲发黑面色黧黑，身上多有疮疥。钱乙主张用地黄丸主治。还应当在地黄散中多加黄芪以补肺气。曾世荣主张用调元散。
调元散主治先天禀受元气不足，囟门迟开，肌肉消瘦，腹部胀大如肿，导致说话晚、走路晚，手足分开无力。同时伴有神色昏沉缓慢，牙齿生长迟缓，服用此药有效。
干山药（去除黑皮，五钱） 人参（去芦头） 白茯苓（去皮） 茯神（去皮根） 白术 白芍药 熟地黄（酒洗） 当归（酒洗） 黄芪（蜜水炙。各二钱半） 川芎 甘草（炙。各三钱） 石膏
以上药物捣碎。每次服用二钱，用水一盏，生姜两片，大枣一枚，煎至七分，不拘时候温服。如果是幼嫩婴儿，可与乳母同服。
熟地黄（四钱五分） 赤茯苓 山茱萸肉 川楝子 当归 川芎 牡丹皮 山药 使君子肉（二钱）
以上药物研为细末，蜂蜜炼制成梧桐子大小的丸剂。每次服用八十丸，空腹时用温酒送下。
〔张涣〕熊胆散 治疗急疳虫伤脏腑，向上侵蚀口齿，生疮红肿糜烂，世人称之为走马疳。
莨菪子（炒至微黑） 蛤蟆灰 白矾（各半两） 生硫黄（一分。以上捣罗成细末，备用） 熊胆（半两，细研） 麝香 雄黄 芦荟（各一分，并细研）
以上药物混合均匀，研为细末。每次服用一字量，用荆芥汤调服。如果有疮处宜薄薄敷上。如果鼻子痒，就取少许每日吹入鼻中，每天三到五次。
真熊胆（半两，研） 蚺蛇胆（为末） 芦荟（研） 牛黄（研。各一分） 龙脑 麝香（各一钱，并研细）
以上药物都细研，用井华水一小盏搅和均匀，用瓷器盛装，隔水慢火熬成膏状。每次服用一粒豆大小，用薄荷汤化开送服，兼涂患处。
人乳汁（半合） 黄矾（一栗子大） 白矾（一枣核大） 石胆（一豆大）
以上药物都研细，用棉布包裹，放入乳汁中浸泡一夜，看汁液有味后，用慢火熬成膏状。每次用少许涂于口中。如果鼻中有疮，滴入少许。如果有肿胀处，先用三棱针刺破，放出血液，然后立即涂上此药。
以上药物，先将砒霜在纸上炒过，再加入麝香共同研磨极细。每次用一字量，用鸡羽蘸药粉扫在疮上，每天使用三到五次，随时清理掉药物，不要让患者吞咽津液。
没药（炮制） 甘草（各二分） 硫黄 木香（炮制） 胡黄连（各一分）
以上药物研为细末，用蒸熟的枣肉制成如麻子大小的丸剂。用肉苁蓉汤送服三丸，可服用两次。（庄氏第七候使用此方。）
Yang Shi stated: This condition arises from irregular breastfeeding and feeding, leading to latent heat within the zang-fu organs. Sweet flavors entering the Spleen generate parasites; when these parasites move, they erode the zang-fu organs, causing the infant to feel restless and stifled in the epigastrium. If the erosion moves upward to the gums, it results in mouth sores with bleeding and purple-black teeth. If it moves downward to the intestines and stomach, it causes dysentery, anal rot, dampness-induced itching, and sores. If treatment is not initiated early, the essence and marrow will be depleted, making recovery difficult. This disease is called "Gan" (Pediatric Malnutrition Syndrome). The eyes present with wet nebula (corneal opacity), often resulting from prolonged Gan damage or chronic dysentery where the intestines and stomach are invaded by dampness. The presentation resembles the tooth-erosion symptoms seen in Huhu Disease (Chancroid-like ulcers) and Cold Damage syndromes. It is sometimes named "Zouma" (Running Horse) because teeth belong to the Kidney, which governs deficiency; upon receiving heat pathogens, the Gan qi rushes directly to the Upper Jiao, hence the metaphor of a running horse indicating its rapid progression. Initially presenting as bad breath, it is named "Chouxi". Subsequently, teeth turn black, named "Bengsha". When severe, gums rot, named "Kuicao". Blood spurts out, named "Xuanlu". In extreme cases, all teeth fall out, named "Fugen"; once the roots rot, even if life is preserved, teeth will not regrow. External signs include heat in the head, emaciation, cold hands and feet, alternating chills and fever, slippery diarrhea with abdominal pain, foul odor, dry mouth and thirst, gum sores, black nails, sallow complexion, and numerous skin sores and scabies. Qian Yi advocated using Dihuang Wan (Rehmannia Pill) as the primary treatment. Additionally, Huangqi (Astragalus Root) should be added in large amounts to the Shengmai San (Generate the Pulse Powder) to tonify Lung Qi. Zeng Shirong advocated using Tiaoyuan San.
Tiaoyuan San (Regulate Origin Powder) treats congenital insufficiency of Yuan Qi (Primary Qi), delayed fontanelle closure, muscle emaciation, abdominal distension resembling swelling, delayed speech and walking, and limbs held apart. It also addresses dull spirit and slow demeanor, delayed tooth eruption, and is effective when taken.
Shanyao (Dioscoreae Rhizoma, peeled, 5 qian) Renshen (Panacis Ginseng Radix, de-stemmed) Baifuling (Poria, peeled) Fushen (Poria with hostwood, de-stemmed) Baizhu (Atractylodis Macrocephalae Rhizoma) Baishaoyao (Paeoniae Radix Alba) Shudihuang (Rehmanniae Radix Praeparata, wine-washed) Danggui (Angelicae Sinensis Radix, wine-washed) Huangqi (Astragali Radix, honey-fried, each 2.5 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma) Gancao (Glycyrrhizae Radix et Rhizoma, roasted, each 3 qian) Shigao (Gypsum Fibrosum)
Crush the above ingredients. Take 2 qian per dose, decoct with one cup of water, two slices of ginger, and one jujube until reduced to 70%. Take warm at any time. For tender infants, administer together with the nursing mother.
Jiuwei Dihuang Wan (Nine-Ingredient Rehmannia Pill) treats Kidney Gan.
Shudihuang (Rehmanniae Radix Praeparata, 4.5 qian) Chi Fuling (Poria rubra) Shanzhuyu (Corni Fructus) Chuanlianzi (Toosendan Fructus) Danggui (Angelicae Sinensis Radix) Chuanxiong (Ligustici Chuanxiong Rhizoma) Mudanpi (Moutan Cortex) Shanyao (Dioscoreae Rhizoma) Shijunzi (Quisqualis Fructus, 2 qian)
Grind into powder, form pills with honey the size of paulownia seeds. Take 80 pills per dose, swallow with warm wine on an empty stomach.
[Zhang Huan] Xiongdan San (Bear Bile Powder) treats acute Gan where parasites damage zang-fu organs, eroding upwards to the mouth and teeth, causing red, swollen, and rotting sores, known in the world as Zouma Gan (Running Horse Gan).
Langdangzi (Semen Hyoscyami, stir-fried until slightly black) Hamagui (Ash of Bufo bufo gargarizans) Baifan (Alumen, each half liang) Sheng Liuhuang (Native Sulfur, 1 fen. Grind the above into fine powder, set aside) Xiongdan (Ursi Fel, half liang, finely ground) Shexiang (Moschus) Xionghuang (Realgar) Lvhua (Aloe, each 1 fen, finely ground)
Mix all ingredients thoroughly and grind into a fine powder. Take one "yi" (a traditional small measure) per dose, mix with Jingjie Tang (Schizonepeta Decoction) and swallow. Apply thinly to sores if present. If the nose itches, blow a small amount into the nostrils daily, three to five times.
Xiongdan Gao (Bear Bile Ointment) halts acute Gan pathology.
Zhen Xiongdan (True Ursi Fel, half liang, ground) Ranchedan (Bungarus multicinctus bile, powdered) Lvhua (Aloe, ground) Niuhuang (Bovis Calculus, ground, each 1 fen) Longnao (Borneolum Syntheticum) Shexiang (Moschus, each 1 qian, finely ground)
Finely grind all ingredients, mix with a small cup of well-water until uniform, store in porcelain, and simmer slowly over a double boiler until it becomes an ointment. Take a bean-sized amount per dose, dissolve in Mint Decoction, and apply to the affected area.
Lisheng Gao (Sage Ointment) treats acute Gan erosion.
Renru (Human Milk, half he) Huangfan (Calcareous Alum, chestnut-sized) Baifan (Alumen, date-pit-sized) Shidan (Melanterite, bean-sized)
Grind all ingredients finely, wrap in cotton, soak in human milk overnight. Once the liquid has flavor, simmer slowly into an ointment. Apply a small amount inside the mouth. If there are sores in the nose, drip a small amount. If there is swelling, first puncture with a Sanleng needle (Spina Tripterygii), drain blood, then apply this medicine.
Erjin San (Two Metals Powder) treats severe toxicity in acute Gan.
Pishuang (Arsenic Trioxide, 1 fen) Shexiang (Moschus, half liang)
First, stir-fry Pishuang on paper, then grind together with Shexiang until extremely fine. Use one "yi" per dose, apply to the sore with a chicken feather, three to five times daily. Remove the medicine promptly to prevent swallowing saliva.
Formula for treating Pediatric Kidney Gan and Hernia with alternating chills and fever
Moyao (Myrrha, processed) Gancao (Glycyrrhizae Radix et Rhizoma, each 2 fen) Liuhuang (Sulfur) Muxiang (Aucklandiae Radix, processed) Huhuanglian (Coptidis Chinensis Rhizoma, each 1 fen)
Grind into powder, form pills with steamed jujube flesh the size of hemp seeds. Take three pills with Congrong Tang (Cynomorii Decoction), can be taken twice. (Used by Zhuang's Seventh Hou.)