漏疮之症，因禀气血不足，或久病血气虚弱，或儿肝脾食积内热，不能生肌，或乳母七情不和，脾气不能收敛。当
审其所因，调补元气，佐以如圣饼、葱熨之类为善。若用流气破血追蚀等药，反为败症矣。余当参各门主之。
一小儿患在臂间，肿硬不消，面色痿黄，脓水清稀，此元气亏损之症，用八珍汤为主，六君子汤为佐，渐愈。因饮
食失节，恶寒发热，用六君子加升麻、柴胡而安，用益气汤加异功散而敛。
一小儿腿内侧患之，寒热发渴，此肝脾二经气血虚症也，盖胃为五脏之本，先用五味异功散加升麻、柴胡，月余
胃气始复；乃用地黄丸补肾水以生肝血而愈。
一小儿臂间漫肿，按之至肉方痛，肉色不变，形体消瘦，面目多白，余谓此禀肾经虚症，当补脾肺以滋化源。反
用寒凉克伐之药，脾气大虚，患处肉死；又用追蚀之药，死肉虽去，疮口不敛而殁。
一小儿四岁，尚解颅，余用地黄丸而颅阖，至十六颐间肿硬，发热唾痰，余谓属肾经气不足，水泛而为痰，气伤而
为肿。不信，反用火针败毒，破而出水。余曰∶肾主骨，骨而为痈，元气亏败，余何能为？后果殁。惜哉！
─小儿患在臂外侧，疮口开张，肿硬色黯，发热恶寒，手足时冷，此少阳经阳气虚寒，不能生肌收敛也，当助胃
气。不信，仍行攻疮而殁。
一小儿十五岁，足跟患之，二年不愈，日出清脓数滴，余谓禀肾气虚弱也。不信，毕姻后，肿硬寒热，仍用攻伐之
药，而殁。
如圣饼
葱熨法（二方见流注）
八珍汤（方见发热不止）
六君子汤（方见肠痈）
补中益气汤（方见肌肉不生）
六味地黄丸（方见作渴不止）
The condition of *Lou Chuang* (Fistula and Ulcer) arises from congenital deficiency of Qi and Blood, or chronic illness leading to weakness of Qi and Blood. It may also result from food stagnation and internal heat in the Liver and Spleen of a child, preventing tissue regeneration, or from emotional disharmony in the nursing mother, causing the Spleen Qi to fail in its astringent function. One must investigate the etiology, regulate and tonify Yuan Qi (Original Qi), and assist with methods such as Rusheng Bing (Sage Cake) and Cong Yun (Scallion Moxibustion). If one employs drugs that circulate Qi, break Blood, or cause erosion/corrosion, it will instead lead to a "Bai Zheng" (Defeat Syndrome/Severe deterioration). I refer readers to the main principles in respective chapters for further guidance.
A child presented with swelling and induration in the arm that did not subside, sallow complexion, and thin, clear pus. This is a syndrome of Yuan Qi deficiency. The primary formula used was Bazhen Tang (Eight-Treasure Decoction), assisted by Liujunzi Tang (Six-Gentlemen Decoction), leading to gradual recovery. Due to irregular diet, symptoms of aversion to cold and fever appeared; treatment with Liujunzi Tang plus Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) stabilized the condition, followed by Yiqi Tang (Qi-Boosting Decoction) combined with Yigong San (Yigong Powder) to promote healing and closure.
A child presented with lesions on the inner thigh, accompanied by alternating chills and fever, and thirst. This is a deficiency of Qi and Blood in the Liver and Spleen meridians. Since the Stomach is the root of the five Zang organs, Wuyi Yigong San (Five-Aromatic Yigong Powder) plus Shengma and Chaihu was administered first. After more than a month, Stomach Qi recovered. Subsequently, Dihuang Wan (Rehmannia Pill) was used to tonify Kidney Water to generate Liver Blood, resulting in cure.
A child presented with diffuse swelling in the arm, pain only upon deep pressure into the muscle, unchanged skin color, emaciation, and a pale face and eyes. I diagnosed this as a congenital deficiency of the Kidney Meridian, recommending tonification of the Spleen and Lungs to nourish the source of transformation. However, cold-natured and draining drugs were used instead, causing severe Spleen Qi deficiency and necrosis of the tissue at the lesion site. Further use of erosive agents removed the necrotic tissue, but the wound failed to heal, leading to death.
A four-year-old child had an open fontanelle (Jie Lu). I treated with Dihuang Wan, which closed the fontanelle. At age sixteen, the child developed swelling and induration near the jaw, fever, and expectoration of phlegm. I attributed this to insufficiency of Kidney Qi, where water overflowed to form phlegm, and Qi injury led to swelling. The family did not believe this and instead used fire needles to detoxify, puncturing the area to drain fluid. I stated, "The Kidneys govern bone; if an abscess forms in the bone, the Yuan Qi is critically depleted. What can I do?" The child subsequently died. Regrettable!
A child presented with an open ulcer on the lateral aspect of the arm, characterized by swelling, induration, dark discoloration, fever, aversion to cold, and cold extremities. This indicates deficiency-cold of Yang Qi in the Shaoyang Meridian, unable to regenerate tissue and close the wound. Treatment should have focused on supporting Stomach Qi. The family refused, opting for aggressive ulcer treatments, leading to death.
A fifteen-year-old child suffered from a heel lesion for two years without healing, exuding a few drops of clear pus daily. I diagnosed this as congenital weakness of Kidney Qi. The family disregarded this advice. After marriage, the child developed swelling, induration, chills, and fever, and continued to use draining drugs, resulting in death.
Rusheng Bing (Sage Cake)
Cong Yun Fa (Scallion Moxibustion Method) [See these two formulas under "Liu Zhu"]
Bazhen Tang (Eight-Treasure Decoction) [See formula under "Unremitting Fever"]
Liujunzi Tang (Six-Gentlemen Decoction) [See formula under "Chang Yong / Intestinal Abscess"]
Buzhong Yiqi Tang (Tonify the Middle and Boost Qi Decoction) [See formula under "Failure of Muscle Regeneration"]
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) [See formula under "Unremitting Thirst"]