巢氏云∶疳湿之病，多因久利，脾胃虚弱，肠胃之间虫动侵蚀五脏，使人心烦
懊闷，其上蚀者，则口鼻齿龈生疮，其下蚀者，则肛门伤烂，皆难治。或因久利，
或因脏热嗜眠，或好食甘美之食，并令虫动，致生此病也。《圣惠》夫小儿嗜食甘
味多而动肠胃间诸虫，致令侵蚀脏腑，此犹是 也。凡食五味之物，皆入于胃，其
气随其腑脏之味而归之，脾与胃为表里，俱象土，其味甘，而甘味柔润于脾胃，脾
胃润则虫动，虫动则侵蚀成疳也，但虫因甘而动故名之为疳也。若虫蚀下部，则肛
门生疮烂开，急者数日便死，宜速疗之。夫小儿乳食不节，冷热相乖，伤于脏腑，
致疳气也。若脾胃虚弱，则哺乳不消，大肠虚寒，遂变泄痢，因其久痢不止，肠胃
俱虚，为水湿所乘，腹内虫动，侵蚀下部，故名疳痢湿 也。
《千金》除热结肠丸 断小儿热，下黄赤汁沫及鱼脑杂血，肛中疮烂，坐 生虫。
黄连 柏皮 苦参 鬼臼 独活 橘皮 芍药 阿胶（各半两）
上八味，末之，以蓝汁及蜜丸，如小豆。日服五丸至十丸。（冬无蓝汁，可用蓝子一合，舂蜜和丸。）
姜蜜汤（《千金》）治湿 。
生姜汁（五合） 白蜜（三合） 黄连（三两）
上三味，以水二升别煮黄连，取一升，去滓，纳姜、蜜更煎，取一升二合。五岁
儿平旦空腹服四合，日二。
杏仁汤（《千金》）治 。
杏仁（五十枚） 苦酒（二升） 盐（一合）
上三味和煮，取五合。顿服之，小儿以意量服。
治虫蚀下部方
胡粉 雄黄
上二味，各等分，末。着谷道中。亦治小儿。
〔张涣〕桃白散 治肠胃俱虚，腹内虫动，侵蚀下部，疳痢湿 。
桃木白皮 黄柏（蜜炙，锉） 黄连（去须，炒。各一两） 蛇蜕皮（半两，烧灰） 干蜗牛（一分，烧灰） 青
州枣（五十枚，去核，烧灰）
上件同捣，罗为细末，入定粉、麝香各一分，同研匀。每服一字，粥饮调下，乳食前。
如圣丹
干蟾（七枚，烧灰） 蝉壳（半两） 蚺蛇胆 大枣（去核，烧灰。各一分。以上捣罗为细末，次用） 黄丹
定粉 麝香（并细研。各一分）
上件同拌匀，用好醋一大盏，都捣一二百下成膏，如黍米大。每服五粒至七粒，
米饮下，量儿大小加减，或化三两粒涂患处。若虫出乃愈。
〔钱乙〕金华散 治小儿一切湿疮癣疳。
黄柏 黄连（各半两，并为细末） 黄丹（一两，火飞） 轻粉（一钱） 麝香（一字，别研）
上同研匀。先以温水洗后贴之。
化 丸 治诸疳生虫，不时啼哭，呕吐清水，肚腹胀痛，唇口紫黑，肠头湿 。
芜荑 芦荟 青黛（干） 川芎 白芷梢 胡黄连 川黄连 虾蟆灰（各等分）
上为末，猪胆汁浸糕糊丸，麻子大。每服一二十丸，食后临卧杏仁煎汤下。其
鼻常用熊胆煎汤，笔蘸洗。俟前药各进数服，却用青黛、当归、赤小豆、瓜蒂、
地榆、黄连、芦荟、雄黄为末，入鼻疮敛。
巢元方说：疳湿病，多因长期腹泻，导致脾胃虚弱，肠胃之间的寄生虫活动并侵蚀五脏，使人心中烦乱、懊恼闷塞。如果虫向上侵蚀，则口、鼻、齿龈生疮；如果向下侵蚀，则肛门损伤腐烂，这些都难以治疗。有的因为长期腹泻，有的因为脏腑有热而嗜睡，或者喜欢吃甘甜美味的食物，都会导致虫动，从而引发此病。《太平圣惠方》记载：小儿喜欢吃甜食多且容易使肠胃间的各种虫子活动，导致侵蚀脏腑，这仍然是属于疳病。凡是吃五味食物，都进入胃中，其气随着脏腑对应的味道而归于相应的脏腑。脾与胃互为表里，都象征土，其味为甘，甘味柔润于脾胃，脾胃湿润则虫动，虫动则侵蚀成疳病，但因为虫子因甘味而动，所以命名为疳病。如果虫子侵蚀下部，则肛门生疮腐烂，病情急的几天就会死亡，应该迅速治疗。小儿乳食没有节制，冷热失调，损伤脏腑，导致疳气。如果脾胃虚弱，则哺乳不能消化，大肠虚寒，于是变成泄泻痢疾，因为长期痢疾不止，肠胃都虚弱，被水湿所乘，腹内虫动，侵蚀下部，所以名叫疳痢湿。
《千金方》除热结肠丸：用于断绝小儿热邪，排出黄赤色汁沫及鱼脑状杂血，治疗肛门疮烂，坐处生虫。
药材：黄连、黄柏皮、苦参、鬼臼、独活、橘皮、芍药、阿胶（各半两）。
以上八味药，研成末，用蓝汁和蜂蜜制成丸药，如小豆大小。每天服用五丸到十丸。（冬天没有蓝汁，可以用蓝子一合，捣碎蜂蜜和丸。）
姜蜜汤（出自《千金方》）：治疗湿疳。
药材：生姜汁（五合）、白蜜（三合）、黄连（三两）。
以上三味药，用水二升单独煮黄连，取一升药液，去渣，加入姜汁、蜂蜜再煎，取一升二合药液。五岁儿童清晨空腹服用四合，每天两次。
杏仁汤（出自《千金方》）：治疗湿疳。
药材：杏仁（五十枚）、醋（二升）、盐（一合）。
以上三味药混合煮，取五合药液。一次性服下，小儿根据情况酌情服用。
治疗虫蚀下部方的方剂：
药材：胡粉、雄黄。
以上两味药，各等分，研成末。纳入肛门中。也适用于小儿。
〔张涣〕桃白散：治疗肠胃俱虚，腹内虫动，侵蚀下部，疳痢湿。
药材：桃木白皮、黄柏（蜜炙，锉碎）、黄连（去须，炒。各一两）、蛇蜕皮（半两，烧成灰）、干蜗牛（一分，烧成灰）、青州枣（五十枚，去核，烧成灰）。
以上药材共同捣碎，过筛成细末，加入定粉、麝香各一分，一同研磨均匀。每次服用一字量，用粥饮调下，在吃乳食之前服用。
如圣丹：
药材：干蟾（七枚，烧成灰）、蝉壳（半两）、蚺蛇胆、大枣（去核，烧成灰。各一分。以上先捣罗成细末，备用）、黄丹、定粉、麝香（并细研。各一分）。
以上药材拌匀，用好醋一大盏，一起捣一二百下成为膏状，如黍米大小。每次服用五粒到七粒，用米饮送下，根据孩子大小加减剂量，或者化开两三粒涂抹患处。如果虫子出来就好了。
〔钱乙〕金华散：治疗小儿一切湿疮癣疳。
药材：黄柏、黄连（各半两，并研为细末）、黄丹（一两，火飞处理）、轻粉（一钱）、麝香（一字，另研）。
以上一同研磨均匀。先用温水清洗后贴敷。
化疳丸：治疗各种疳病生虫，不时啼哭，呕吐清水，肚腹胀痛，唇口紫黑，肠头湿疳。
药材：芜荑、芦荟、青黛（干）、川芎、白芷梢、胡黄连、川黄连、虾蟆灰（各等分）。
以上研成末，用猪胆汁浸糕糊制丸，如麻子大小。每次服用一二十丸，饭后临睡前用杏仁煎汤送下。其鼻子常用熊胆煎汤，用笔蘸取清洗。等到前面的药各进服几服后，再用青黛、当归、赤小豆、瓜蒂、地榆、黄连、芦荟、雄黄研成末，纳入鼻中收敛疮口。
Chao Yuanfang stated: The disease of Gan-dampness (Gan with dampness) is mostly caused by prolonged diarrhea, leading to the deficiency and weakness of the Spleen and Stomach. Parasites between the intestines and stomach move and erode the five Zang organs, causing mental restlessness, vexation, and oppression. If the erosion occurs upwards, sores will grow in the mouth, nose, and gums; if downwards, the anus will be damaged and rot. Both are difficult to treat. Some cases arise from prolonged diarrhea, some from internal heat causing lethargy, or a preference for sweet and delicious foods, all of which cause parasites to move and result in this disease. *Taiping Shenghui Fang* records that children who consume too many sweets tend to have various parasites in the intestines and stomach move, leading to the erosion of Zang-Fu organs. This still belongs to Gan disease. All foods of the five flavors enter the Stomach. Their Qi returns to the corresponding organs according to their flavors. The Spleen and Stomach are exterior-interior pairs, both symbolizing Earth, with a sweet flavor. Sweetness moistens the Spleen and Stomach; when the Spleen and Stomach are moist, parasites move. When parasites move, they erode and form Gan disease. Because parasites move due to sweetness, it is named Gan disease. If parasites erode the lower part, sores and rot develop in the anus. In acute cases, death may occur within a few days, so rapid treatment is necessary. Irregular breastfeeding and diet, imbalance of cold and heat, damage to Zang-Fu organs lead to Gan Qi. If the Spleen and Stomach are weak, milk cannot be digested, the Large Intestine becomes deficient and cold, resulting in diarrhea and dysentery. Due to persistent dysentery, both intestines and stomach become deficient, invaded by water-dampness. Parasites move inside the abdomen, eroding the lower part, hence named Gan-dysentery-dampness.
*Qianjin Fang* Chu Re Jie Chang Wan (Heat-Removing Colon-Binding Pill): Used to eliminate heat in children, discharge yellow-red fluid foam and fish-brain-like bloody mixture, treat anal sores and rot, and worms growing in sitting areas.
Herbs: Coptidis Rhizoma (Huanglian), Phellodendri Cortex (Bopí), Sophorae Flavescentis Radix (Kushen), Acori Tatarinowii Rhizoma (Guijiu), Angelicae Pubescentis Radix (Duhuo), Citri Reticulatae Pericarpium (Jupi), Paeoniae Radix Alba (Shaoyao), Asini Corii Colla (Ejiao) (each half liang).
The above eight herbs are powdered, mixed with Indigofera tinctoria juice (Lanzhi) and honey to form pills the size of small beans. Take 5 to 10 pills daily. (In winter without Lanzhi, one he of Lanzi [Indigofera seeds] can be pounded with honey to make pills.)
Jiang Mi Tang (Ginger-Honey Decoction, from *Qianjin Fang*): Treats damp Gan.
Ingredients: Fresh Ginger Juice (Wuhe), White Honey (Sanhe), Coptidis Rhizoma (Huanglian) (Sanliang).
Boil Huanglian separately in two sheng of water until one sheng remains, strain, add ginger juice and honey, and boil again until one sheng two he remain. Five-year-old children take four he on an empty stomach in the morning, twice a day.
Xing Ren Tang (Apricot Seed Decoction, from *Qianjin Fang*): Treats damp Gan.
Ingredients: Armeniacae Semen Amarum (Xingren) (50 pieces), Vinegar (Ersheng), Salt (Yihe).
Boil the three ingredients together until five he remain. Take in one dose. Children should adjust the dosage according to their condition.
Formula for Treating Parasite Erosion of the Lower Part:
Ingredients: Minium (substitute for Huafen, often referring to basic lead carbonate historically used externally) (Hufen), Realgar (Xionghuang).
Powder the two ingredients in equal parts. Apply into the anus. Also suitable for children.
[Zhang Huan] Tao Bai San (Peach Bark Powder): Treats deficiency of both intestines and stomach, movement of parasites in the abdomen, erosion of the lower part, Gan-dysentery-dampness.
Ingredients: Cortex Persicae Albus (Taomu Baipi), Phellodendri Cortex (Huangbai) (honey-fried, chopped), Coptidis Rhizoma (Huanglian) (deveined, stir-fried) (each one liang), Ophichthidis Cutis Squamata (Shetui Pi) (half liang, burnt to ash), Dry Helix Pomatia (Gannuowan) (one fen, burnt to ash), Qingzhou Dates (Qingzhou Zao) (50 pieces, pitted, burnt to ash).
Pound the above ingredients together, sieve into fine powder, add Mingfan (Lead Oxide/Minium) and Moschus (Shexiang) each one fen, grind evenly. Take one zi amount per dose, mixed with porridge drink, before breastfeeding or meals.
Ru Sheng Dan (Like-Sage Pill):
Ingredients: Bufo bufo gargarizans (Ganchan) (7 pieces, burnt to ash), Cicada Slough (Chanqiao) (half liang), Bungarus multicinctus Gallbladder (Ranshedan), Dates (Zao) (pitted, burnt to ash) (each one fen. Pound these into fine powder first). Then add Hongdan (Minium), Mingfan (Lead Oxide), and Moschus (Shexiang) (all finely ground, each one fen).
Mix well, add one large cup of good vinegar, pound 100-200 times until it becomes a paste, shaped like millet grains. Take 5 to 7 pills per dose with rice drink, adjusting based on the child's size. Alternatively, dissolve 2-3 pills and apply to the affected area. Recovery occurs when parasites exit.
[Qian Yi] Jin Hua San (Golden Flower Powder): Treats all types of damp sores, tinea, and Gan in children.
Ingredients: Phellodendri Cortex (Huangbai), Coptidis Rhizoma (Huanglian) (each half liang, ground to fine powder), Minium (Hongdan) (one liang, fire-refined), Calomelas (Qingfen) (one qian), Moschus (Shexiang) (one zi, separately ground).
Grind uniformly. Wash with warm water first, then apply.
Hua Gan Wan (Gan-Dissolving Pill): Treats various Gan diseases with parasites, frequent crying, vomiting clear water, abdominal distension and pain, purple-black lips and mouth, and wet Gan of the prolapsed rectum.
Ingredients: Xanthoceras Fruit (Wuyi), Aloe (Luhui), Indigo Naturalis (Qingdai) (dry), Ligusticum Chuanxiong (Chuanxiong), Angelica Dahurica Root Tip (Baizhi Shao), Picrorhiza Rhizome (Huhuanglian), Coptis Chinensis Rhizome (Chuanhuilian), Toad Ash (Xiamahui) (equal parts).
Grind into powder, mix with pig bile and steamed cake paste to form pills the size of hemp seeds. Take 10-20 pills per dose after meals and before bed, with Apricot Seed decoction. For nasal issues, frequently use Bear Gallbladder decoction, dip a brush, and wash. After taking the previous medicines for several doses, use Qingdai, Angelica Sinensis (Danggui), Adzuki Bean (Chixiaodou), Melon Seed (Goudi), Sanguisorba Root (Diyu), Coptis Rhizome (Huanglian), Aloe (Luhui), and Realgar (Xionghuang) ground into powder, insufflate into the nose to heal sores.