〔丹〕有一邻人，三十余，性狡而躁。素患下疳疮，或作或止。夏初，患白痢，膈上微闷，医
与理中汤四帖，昏闷若死，片时而苏。予脉之，两手皆涩，重取略弦似数。予曰∶此下疳疮之深重
者。与当归龙荟丸去麝，四帖而利减，与小柴胡去半夏，加黄连、芍药、川芎、生姜煎，五六帖
而安。
一男子近三十岁，有下疳疮，虽屡求治，以其不能忌口却之。忽一日头痛、发热、自汗，
众作伤寒阳证治之反剧。予诊其脉弦甚七至，重按则涩。予曰∶此症在厥阴，药与症不相应。遂
作小柴胡汤加草龙胆、黄连、胡黄连。带热服，四帖而病脱然。
治男子耻疮，或痛在茎之窍，或痛在茎之标。皆手足太阳不利，热毒下传，入于足厥阴，故变
紫黑色，作蚀疮，毁其茎而死。宜以子和泄水丸散导其湿毒，无不愈者。若已成疮，先泄其根，次
从标而治，外以葱白、黑豆汁渫洗，拭干。以黄连、木香、密陀僧、干胭脂之类，细末搽之。
如内溃脓不出，以追脓散上之，又用子和泄水丸。如后窍脓少，可用黄连、木香、胭脂等贴之。
〔子和〕泄水丸一名大智丸。
大戟 芫花 甘遂 海带（洗） 海藻（洗） 郁李仁 续随子（以上各半两） 樟柳根（一两）
上为细末，水煮枣肉为丸，如小豆大。每服五七十丸，熟水下。
治下疳疮。先用张子和泄水丸去根，后用此药干上。
黄连 滑石（各半两） 定粉（三钱） 轻粉（少许） 乳香（一钱） 密陀僧（二钱）
上细末，干上，或加干胭脂，或加木香、槟榔。
〔丹〕下疳散
蛤粉 蜡茶 苦参 青黛 密陀僧
上用腊脂调涂，河水洗净，并治 疮。
〔世〕又方
青黛 海蛤 密陀僧 黄连
上为末，敷上。
〔丹〕一切热毒恶疮及下疳疮，用密陀僧、黄柏皮末各一分半，腻粉一钱，麝香少许。先洗疮，
拭干传之。甚者三四次。
治下疳疮，雄黄、黄连等分为末，湿者干掺；干者油调敷。先用荆芥、射干煎汤洗，却敷之妙。
一方，用地骨皮末敷，神效。
〔海〕追脓锭子脓内溃不出，以此药追之。
雄黄（二钱） 巴豆（一钱半） 轻粉（一字）
尝治一男子下疳疮，每恣饮酒则发。医与小柴胡汤加黄连数帖不效；又与玉烛散下之反剧。
予以甘草节、小建中各半煎汤服之，下咽痛止。后以四物汤、建中、甘草等分，与之渐安。
〔丹〕阴头疮。蜜煎甘草敷之安。（《外台秘要》）又方，用头发以盐水洗净去油，再用米
泔洗净，又用清汤洗，晒干烧灰，敷疮上便结靥。
〔世〕苍耳叶为末，掺之。
治下疳疮。黑彤兔为末，敷上神妙。（一名乌吊土，一名孩儿沙。）
〔海〕治下疳疮久不愈。橡斗子二个，各盛黄丹令满相合，以乱发缠定，烧烟尽为度，同研为末。
先以葱白热浆水洗疮，脓尽，次上药。甚者不过三次如神。
〔《肘》〕疗人阴生疮，脓出成坎。取高昌白矾、麻仁等分，研，炼猪脂相和成膏。槐白皮作汤洗疮，
拭令干，即涂膏，然后以楸叶贴其上，不过三五度瘥。
〔《山》〕下疳疮。用五倍子末敷之。
[Zhu Danxi] A neighbor, over thirty years old, was cunning and irritable. He had suffered from chancre (genital ulcer) for a long time, which came and went. In early summer, he developed white dysentery with slight chest fullness. The physician prescribed Lizhong Tang (Regulate the Middle Decoction) for four doses. The patient fell into a coma as if dead, reviving only after a short while. I palpated his pulse: both hands were choppy (Se), and on heavy pressure, slightly wiry (Xian) and resembling rapid (Shu). I said: This is a severe case of chancre. I administered Danggui Longhui Wan (Angelica Sinensis and Gardenia Pill) with musk removed. After four doses, the dysentery subsided. Then I prescribed Xiaochaihu Tang (Minor Bupleurum Decoction) without Banxia, adding Huanglian, Shaoyao, Chuanxiong, and Shengjiang, decocted together. After five or six doses, he recovered.
A man near thirty years old had chancre. Although he sought treatment repeatedly, I refused him because he could not observe dietary restrictions. Suddenly, one day he suffered from headache, fever, and spontaneous sweating. The crowd treated it as a Yang syndrome of Shanghan (Cold Damage), but the condition worsened. I diagnosed his pulse as extremely wiry, exceeding seven beats per breath cycle, and choppy on deep pressure. I said: This pathology lies in the Jueyin channel; the medication does not correspond to the symptoms. Therefore, I used Xiaochaihu Tang (Minor Bupleurum Decoction) added with Caolongdan, Huanglian, and Hu Huanglian. Taken while warm, the disease was completely resolved after four doses.
Treating male genital ulcers: pain may occur at the urethral meatus or at the root of the penis. These are caused by dysfunction of the Foot-Taiyang and Hand-Taiyang channels, where heat-toxin transmits downward into the Foot-Jueyin Liver channel, turning purple-black, forming erosive ulcers that destroy the penis and cause death. It is appropriate to use Zhang Zihe's Xieshui Wan/San (Drain Water Pill/Powder) to guide out damp-toxin; all cases recover. If the ulcer has formed, first eliminate the root cause, then treat the branch symptoms. Externally, wash with Congbai (Scallion White) and Heidou juice, dry thoroughly. Apply fine powder of Huanglian, Muxiang, Miduoseng, and Ganyanzhi. If internal suppuration fails to drain, apply Zhuinong San (Pursue Pus Powder) externally, and internally administer Zhang Zihe's Xieshui Wan. If pus is scant near the anus, apply patches of Huanglian, Muxiang, and Ganyanzhi.
[Zhang Zihe] Xieshui Wan (Drain Water Pill) is also known as Dazhi Wan (Great Wisdom Pill).
Daji, Yuanhua, Gansui, Haidai (washed), Haizao (washed), Yuliren, Suisuiji (each half tael), Zhangliugen (one tael).
Grind into fine powder. Boil Zao Rou (jujube flesh) in water to form pills the size of small beans. Take 50-70 pills each time, washed down with cooked water.
To treat chancre: First use Zhang Zihe's Xieshui Wan to remove the root, then apply this powder externally.
Huanglian, Huashi (each half tael), Dingfen (three qian), Qingfen (a little), Ruxiang (one qian), Miduoseng (two qian).
Grind into fine powder and apply dry externally. Alternatively, add Ganyanzhi, Muxiang, or Binglang.
[Zhu Danxi] Xiagan San (Chancre Powder)
Gefen, Chacha, Kushen, Qingdai, Miduoseng.
Mix with lard (from the twelfth lunar month) and apply. Wash with river water. Also treats carbuncles.
[Worldly/Popular Formula] Another prescription:
Qingdai, Hai Ge, Miduoseng, Huanglian.
Grind into powder and apply.
[Zhu Danxi] For all heat-toxin malignant sores and chancre: Use Miduoseng and Huangbapi (Phellodendron Bark) powder, one-and-a-half fen each; Nifen (calomel) one qian; Musang (musk) a little. Clean the sore first, dry it, then apply. Severe cases require three or four applications.
To treat chancre: Mix Xionghuang and Huanglian in equal parts into powder. For wet sores, sprinkle dry powder; for dry sores, mix with oil and apply. First wash with decoction of Jingjie and Shegan, then apply for excellent results.
Another method: Apply Gudupi (Groundcherry Root Bark) powder; it is miraculous.
[Wang Haicang] Zhuinong Dingzi (Pursue Pus Plug): For internal suppuration that cannot drain, use this medicine to induce drainage.
Xionghuang (two qian), Badou (one-and-a-half qian), Qingfen (one zi).
I once treated a man with chancre that flared up whenever he drank alcohol excessively. Physicians prescribed Xiaochaihu Tang (Minor Bupleurum Decoction) with Huanglian for several doses without effect; then Yu Zhu San (Jade Candle Powder) was used to purge, which worsened the condition. I gave him a decoction of half Gancao Jie (Licorice Joint) and half Xiaojianzhong Tang (Minor Construct the Middle Decoction). Pain ceased upon swallowing. Later, I administered Sizhu Tang (Four Substances Decoction), Jianzhong Tang, and Gancao in equal parts, leading to gradual recovery.
[Zhu Danxi] Yin Tou Chuang (Glans Ulcer). Apply honey-fried Gancao (Licorice); it brings relief. (Waitai Mi Yao) Another method: Wash hair with salt water to remove oil, rinse with rice water, then rinse with clear hot water. Dry and burn to ash. Apply ash to the sore to form a scab.
[Worldly/Popular Formula] Cang'er Ye (Xanthium Leaf) ground into powder, sprinkled on the sore.
To treat chancre: Heixing Tu (Black Earth Rabbit? Note: Text says "Heixing Tu", likely a specific earth/herb name or typo for animal part, literal translation kept) ground into powder, applied externally; it is miraculous. (Also known as Wudiao Tu or Haier Sha.)
[Wang Haicang] To treat chronic chancre that does not heal: Take two Xiangdouzi (Oak Gall/Cupule), fill each with Huangdan (Red Lead) until full, bind them together with loose hair, and burn until smoke ceases. Grind the residue into powder.
First wash the sore with hot Congbai (Scallion White) and starch water. Once pus is gone, apply the medicine. Severe cases resolve within three applications.
[Zhou Hou Bei Ji Fang] Treats genital sores with pus discharge forming cavities. Take Gaochang Baifan (White Alum) and Mahren (Hemp Seed) in equal parts, grind, and mix with refined lard to make an ointment. Wash the sore with Huaimaipi (Sophora Flower/Bark?) decoction, dry, apply ointment, then cover with Qiuye (Hackberry Leaf). Cure occurs within three to five applications.
[Shanjia Qing Gong] Chancre: Apply Wubeizi (Chinese Gallnut) powder.