疳者，干也，人所共知。不知干生于湿，湿生于土虚，土虚生于饮食不节，饮食不节，生于儿之
父母爱其子，惟恐其儿之饥渴也。盖小儿之脏腑薄弱，能化一合者，与一合有半，即不能化，而脾气
郁矣。再小儿初能饮食，见食即爱，不择精粗，不知满足，及脾气已郁而不舒，有拘急之象，儿之父
母，犹认为饥渴而强与之。日复一日，脾因郁而水谷之气不化。水谷之气不化而脾愈郁，不为胃行
津液，湿斯停矣。土恶湿，湿停而脾胃俱病矣。中焦受气，取汁变化而赤，是谓血，中焦不受水谷之
气，无以生血而血干矣。再水谷之精气，内入五
脏，为五脏之汁；水谷之悍气，循太阳外出，捍卫外侮之邪而为卫气。中焦受伤，无以散精气，则五脏
之汁亦干；无以行悍气，而卫气亦馁，卫气馁故多汗，汗多而营血愈虚，血虚故肢体日瘦，中焦湿聚
不化而腹满，腹日满而肢愈瘦，故曰干生于湿也。医者诚能识得干生于湿，湿生于土虚，且扶土之不
暇，犹敢恣用苦寒，峻伤其胃气，重泄其脾气哉！治法允推东垣、钱氏、陈氏、薛氏、叶氏，诚得仲景
之心法者也。疏补中焦，第一妙法；升降胃气，第二妙法；升陷下之脾阳，第三妙法；甘淡养胃，第四
妙法；调和营卫，第五妙法；食后击鼓，以鼓动脾阳，第六妙法（即古者以乐侑食之义，鼓荡阳气，使
之运用也）；《难经》谓伤其脾胃者，调其饮食，第七妙法；如果生有疳虫，再少用苦寒酸辛，如芦荟、胡
黄连、乌梅、使君、川椒之类，此第八妙法；若见疳即与苦寒杀虫便误矣，考洁古、东垣，每用丸药缓
运脾阳，缓宣胃气，盖有取乎渣质有形，与汤药异岐，亦第九妙法也。
近日都下相传一方，以全蝎三钱，烘干为末，每用精牛肉四两，作肉团数枚，加蝎末少许，蒸熟
令儿逐日食之，以全蝎末完为度，治疳疾有殊功。愚思蝎色青，属木，肝经之虫，善窜而疏土，其性
阴，兼通阴络，疏脾郁之久病在络者最良，然其性
剽悍有毒。牛肉甘温，得坤土之精，最善补土，禀牡马之贞，其性健顺，既能补脾之体，又能运脾之
用。牛肉得全蝎而愈健，全蝎得牛肉而不悍，一通一补，相需成功，亦可备用。一味金鸡散亦妙（用
鸡内金不经水洗者，不拘多少，烘干为末，不拘何食物皆加之，性能杀虫磨积，即鸡之脾，能复脾之
本性）。小儿疳疾，有爱食生米、黄土、锻石、纸、布之类者，皆因小儿无知，初饮食时，不拘何物即食
之，脾不能运，久而生虫，愈爱食之矣。全在提携之者，有以谨之于先；若既病治法，亦惟有暂运脾
阳，有虫者兼与杀虫，断勿令再食，以新推陈，换其脏腑之性，复其本来之真方妙。
疳病，所谓的“干”，是众人皆知的。但人们不知道，“干”是由“湿”产生的，“湿”是由于脾土虚弱产生的，脾土虚弱是由于饮食没有节制产生的，而饮食没有节制，则是由于孩子的父母疼爱孩子，唯恐孩子挨饿受渴造成的。大概小儿的脏腑功能薄弱，能够消化一合（容量单位）的食物，如果给到一合半，就不能消化，从而导致脾气郁结。再者，小儿刚开始能吃东西时，见到食物就喜爱，不选择精细或粗糙的食物，也不知道满足；等到脾气已经郁结而不舒展，出现拘急的症状时，孩子的父母仍然认为是饥饿口渴而强行喂食。日复一日，脾因郁结而导致水谷之气不能运化。水谷之气不能运化，脾更加郁结，不能为胃传输津液，湿气于是停滞了。土厌恶湿气，湿气停滞，脾胃都生病了。中焦接受水谷之气，提取汁液变化成红色，这就叫做血；中焦如果不能接受水谷之气，就无法生成血液，血液就会干枯。再者，水谷的精气，向内进入五脏，成为五脏的汁液；水谷的悍气，沿着太阳经向外运行，抵御外来的邪气，从而成为卫气。中焦受伤，无法散布精气，那么五脏的汁液也会干枯；无法运行悍气，卫气也会衰弱，卫气衰弱所以容易出汗，汗出多了营血更加虚弱，血虚所以肢体日渐消瘦，中焦湿气聚集不能运化导致腹部胀满，腹部日渐胀满而四肢更加消瘦，所以说“干生于湿”。医生如果能认识到“干生于湿”，“湿生于土虚”，并且忙于扶正补土尚且来不及，怎么还敢肆意使用苦寒药物，严重损伤胃气，过度泄泻脾气呢！治疗方法应当推崇李东垣、钱乙、陈文中、薛己、叶天士等人的学说，他们确实是得到了张仲景心法的人。疏通补益中焦，是第一妙法；升降胃气，是第二妙法；提升下陷的脾阳，是第三妙法；甘淡养胃，是第四妙法；调和营卫，是第五妙法；饭后击鼓，以鼓动脾阳，是第六妙法（这就是古人用音乐辅助进食的意义，鼓荡阳气，使其运用）；《难经》说伤害脾胃的，要调理饮食，是第七妙法；如果确实生了疳虫，再少量使用苦寒酸辛的药物，如芦荟、胡黄连、乌梅、使君子、川椒之类的，这是第八妙法；如果一见疳疾就用苦寒药杀虫就错了，考察洁古（张元素）、东垣（李杲），每用丸药缓慢运化脾阳，缓慢宣通胃气，大概是取丸药渣质有形，与汤药不同之理，这也是第九妙法。
近日京城流传一个方子，用全蝎三钱，烘干研成末，每次用精牛肉四两，做成几个肉团，加入少许蝎末，蒸熟后让孩子每天吃，直到全蝎末吃完为止，治疗疳疾有奇效。我思考蝎子颜色青，属木，是肝经的虫类，善于钻窜而疏理脾土，其性阴，兼通阴络，对于疏解脾郁日久病在络脉的情况最为良善，然而其性剽悍有毒。牛肉味甘性温，得到坤土的精气，最善于补土，禀受牡马的正气，其性健顺，既能补益脾的形体，又能运化脾的功能。牛肉得到全蝎而更加强健，全蝎得到牛肉而不显剽悍，一通一补，相互需要而成功，也可以备用。一味金鸡散也很好（使用鸡内金不经水洗的，不论多少，烘干研成末，不论什么食物都可以加入其中，性能杀虫磨积，鸡内金即鸡的脾胃，能恢复脾的本性）。小儿疳疾，有的爱吃生米、黄土、锻石、纸、布之类的东西，都是因为小儿无知，刚开始饮食时，不管什么东西就吃，脾不能运化，久了而生虫，越发爱吃这些东西了。这完全在于照顾孩子的人，要在事前谨慎引导；如果已经生病，治疗方法，也只有暂时运化脾阳，有虫的兼用杀虫药，千万不要让孩子再吃那些东西，以新推陈，改变脏腑的性质，恢复其本来的真气才是妙法。
Gan disease, referred to as "dryness," is well known to everyone. However, people do not know that "dryness" arises from "dampness," "dampness" arises from the deficiency of Spleen Earth (Pi Tu), and the deficiency of Spleen Earth arises from irregular diet. The irregular diet, in turn, stems from parents' love for their children, fearing they might go hungry or thirsty. Generally, infants have weak Zang-Fu organs; if they can digest one He (a unit of capacity) of food, providing one and a half He will exceed their digestive capacity, leading to Qi stagnation in the Spleen. Furthermore, when infants first begin to eat, they love food upon seeing it, indiscriminately choosing between refined and coarse foods, and lacking a sense of satiety. When the Spleen Qi becomes stagnant and unsmooth, presenting symptoms of tension or spasm, parents still mistake this for hunger or thirst and force-feed them. Day by day, the Spleen fails to transform the Qi of water and grain due to stagnation. As the transformation of water and grain Qi fails, the Spleen becomes more stagnant, failing to transport fluids for the Stomach, causing dampness to accumulate. Earth dislikes dampness; thus, when dampness accumulates, both the Spleen and Stomach are diseased. The Middle Jiao receives the Qi of water and grain, extracts its essence, transforms it into red fluid, which is called Blood. If the Middle Jiao cannot receive the Qi of water and grain, it cannot generate Blood, leading to dryness of the Blood. Moreover, the essence of water and grain enters internally to the Five Zang organs, becoming their fluids; the fierce Qi of water and grain travels outward along the Taiyang channel, defending against external pathogens, thereby becoming Wei Qi (Defensive Qi). If the Middle Jiao is injured and cannot scatter the essence, the fluids of the Five Zang organs will also become dry; if it cannot circulate the fierce Qi, Wei Qi will become deficient. Deficient Wei Qi leads to excessive sweating; excessive sweating further depletes Ying Blood (Nutritive Blood). Due to Blood deficiency, the limbs become emaciated day by day. Meanwhile, dampness accumulates in the Middle Jiao without transforming, causing abdominal fullness. As the abdomen becomes fuller daily, the limbs become thinner. Hence, it is said that "dryness arises from dampness." If physicians can recognize that "dryness arises from dampness" and "dampness arises from Spleen Earth deficiency," and are too busy supporting the Earth to even consider using bitter-cold herbs recklessly, which would severely damage Stomach Qi and excessively drain Spleen Qi! Treatment methods should follow the teachings of Li Dongyuan, Qian Yi, Chen Wenzhong, Xue Ji, and Ye Tianshi, who truly inherited the heart-method of Zhang Zhongjing. The first excellent method is to soothe and tonify the Middle Jiao; the second is to regulate the ascending and descending of Stomach Qi; the third is to raise the sinking Spleen Yang; the fourth is to nourish the Stomach with sweet and bland flavors; the fifth is to harmonize Ying and Wei Qi; the sixth is to beat drums after meals to stimulate Spleen Yang (this aligns with the ancient meaning of using music to assist eating, stirring up Yang Qi to facilitate its function); the seventh method, as stated in the Nan Jing (Classic of Difficult Issues), is to regulate diet for those who have injured their Spleen and Stomach; the eighth method, if Gan worms are indeed present, is to use small amounts of bitter-cold, sour, and acrid herbs such as Aloe (Lü Hui), Coptis chinensis var. barbinervis (Hu Huang Lian), Mume fruit (Wu Mei), Quisqualis indica (Shi Jun Zi), and Sichuan pepper (Chuan Jiao); however, using bitter-cold herbs to kill worms immediately upon seeing Gan disease is an error. Examining the works of Zhang Yizhi (Jiegu) and Li Gao (Dongyuan), they often used pill forms to slowly transport Spleen Yang and gently diffuse Stomach Qi, likely because pills have tangible residue, differing from decoctions, which constitutes the ninth method.
Recently, a formula has been circulating in the capital: three qian of whole Scorpion (Quan Xie), dried and powdered. Take four liang of lean beef, form several meatballs, add a small amount of scorpion powder, steam until cooked, and feed to the child daily until the scorpion powder is exhausted. This treats Gan disease with remarkable efficacy. I reason that the scorpion is green, corresponding to Wood, and belongs to the Liver channel. It is good at burrowing and loosening the Earth, possesses Yin nature, and connects with Yin collaterals, making it excellent for treating long-standing Spleen stagnation affecting the collaterals. However, its nature is fierce and toxic. Beef is sweet and warm, receiving the essence of Kun Earth, making it best at tonifying Earth. It inherits the integrity of the stallion, possessing a vigorous and compliant nature, capable of both tonifying the substance of the Spleen and promoting its functional movement. With the scorpion, the beef becomes more vigorous; with the beef, the scorpion loses its fierceness. One unblocks, one tonifies; they complement each other to achieve success, and can be kept as a backup option. A single-herb formula, Golden Chicken Powder (Jin Ji San), is also excellent (using Ji Nei Jin [Gizzard lining] that has not been washed with water, in any quantity, dried and powdered, added to any food; it has the property of killing parasites and grinding accumulation. Ji Nei Jin is the stomach of the chicken and can restore the natural function of the Spleen). Children with Gan disease may crave eating raw rice, yellow earth, smelted stone, paper, cloth, etc. This is because children are ignorant and eat whatever is available when they first start eating. The Spleen cannot transport it, leading to worm generation over time, which increases the craving. This entirely depends on caregivers guiding them cautiously beforehand. If the disease has already occurred, the treatment must temporarily transport Spleen Yang, and if worms are present, administer anti-parasitic herbs concurrently. Crucially, prevent further consumption of these items to push out the old and bring in the new, changing the nature of the Zang-Fu organs and restoring their original true Qi. This is the optimal approach.