Library

The harm caused by Ding (Thorn-like sore) stems from the excessive toxicity in the blood. It forms due to Qi stagnation and heat obstruction, initially appearing purple and turning black; some cases start as white and develop into depression and pain. When pox (smallpox) first appears, it is mostly on the head and face; when it appears in the middle stage, it is mostly on the abdomen and back; when it appears after scabbing, it is mostly on the legs and thighs. If treatment is slightly delayed, it will spread all over the body. As for "Doumu" (Pox Mother), also known as "Zeidou" (Thief Pox) or "Laojiang Dou", these are one or two lesions潜伏 (latent) among normal pox lesions, characterized by swelling, enlargement, waxy yellow color, and distinct appearance from the main pox. Their harm is similar to Ding, and their treatment method is not far from that of Ding.

Whenever a pox lesion grows particularly large alone, or turns black or white, with a swollen and hard base, it is called "Douding" (Pox Thorn). Like solid-type Ding, the pathology strikes deep to the bones and muscles; or there is a slight pointed top within the black depression, resembling solid-type Ding; or many pox lesions cluster together, resembling tinea lesions; or there are black lines connecting them; or there is a single ulcer inside that is extremely foul-smelling and painful—all these are Ding. If these signs are absent, and it is merely a black depression, it is called "Heixian" (Black Depression). However, if the black depression remains hard and clustered for a long time without dispersing, it becomes Douding. This is generally due to the corruption of Qi and Blood, accumulation of heat toxicity, clustering together, combined with invasion by epidemic toxic qi, representing the most malignant condition, hence named "Dingjin" (Ding Prohibition). Once such a Ding occurs, other toxins cannot be released, and the pox cannot form pus. "Ding" means "nail," indicating that the condition is nailed shut and unable to expand. In the initial stage, if constipation is observed, Rhubarb (Dahuang) should be added appropriately to promote bowel movement; externally, an silver needle should be used to pierce the lesion, and the evil blood sucked out and spit into water—if the blood is red, it is treatable; if black, it is difficult to cure. Subsequently, wash the area with human milk, fill the hole with fine Pearl powder, or apply Sisheng San (Four Saints Powder). Another effective method is applying a paste of Smilax glabra rhizome (Shancigu) and Mole cricket (Lougu) flesh to extract the root of the Ding. Alternatively, moxibustion with garlic slices can be used; if the toxin is severe and the patient feels no pain, direct moxibustion on the flesh is performed. If after moxibustion the sore head becomes red and swollen, further moxibustion may be applied. Urgent treatment is essential; otherwise, the color will gradually turn purple and dark, pain will become incessant, old ailments will arise like swarms of bees, pus formation will fail, and death may ensue. If after scabbing the Douding ulcerates into a pit exposing bone and muscle, it is a critical condition. Internal administration of Ginseng (Renshen), Platycodon root (Jiegeng), Licorice root tip (Gancao Shao), Rehmannia glutinosa prepared with wine (Jiu Chao Shengdi), Safflower (Honghua), Forsythia fruit (Lianqiao), Honeysuckle flower (Jinyinhua), Fritillaria thunbergii bulb (Da Beimu), Earthworm (Ren Chong/Di Long), Angelica sinensis (Danggui), Peony root (Baishao), Gleditsia sinensis thorn (Jiaoci), Red Poria (Chifuling), Akebia stem (Mutong), and Bupleurum root (Chaihu) is suitable, along with external applications. If the toxin attacks the Zang-Fu organs internally, becoming a Yin sore, it is incurable. However, in cases where toxin is abundant but the pus is clear, representing a balance of good and bad omens, if the Ding is treated with appropriate tonification and expulsion support, and Qi and Blood recover vigor, the toxin will be expelled through the rupture and pus discharge of the Ding, potentially turning disaster into fortune. Besides detoxification and tonifying/expelling support, the surrounding area should be pierced with a silver needle, dusted with Pearl, pea ash, or fetal hair ash, sealed with oil-based rouge, allowing the root to emerge so that the toxic pathogen can be completely eliminated.

(The book *Yusui* establishes many names for Ding, which is somewhat overly eccentric regarding novelty. The treatment methods of Tianbu are hereby omitted.)