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Calcined Calamine (2 qian), Mirror-polished Cinnabar (2 fen), Calculus Bovis (5 li), Pearl (5 li, finely ground).
Grind all together into a fine powder. Apply externally three times daily.

In the spring of the Jisi year, I read in Shanghai's *Welfare Medical Journal* a statement by Mr. Zhang X regarding a case where Tu Huang was mistakenly used to cure "Zouma Yagan" (a rapidly progressing and severe form of necrotizing gingivitis/stomatitis), which seemed quite extraordinary. I hereby record its original text below for the medical community's study:

In March of the Dingmao year, accompanied by several friends, I happened to go to Ren Tang Guan to watch an opera performance. There was a four-year-old boy from the Pan family suffering from Zouma Yagan. The onset had been only three days; his gums were already necrotic, several incisors had fallen out, and his lower lip was ulcerated and perforated. The condition was extremely severe. I asked if there was any hope for rescue. Upon inquiry into the etiology, it was found that this occurred after he had suffered from measles. Essentially, pathogenic heat had entered the Stomach, causing toxic fire to rage uncontrollably once triggered, making the prognosis dangerous. I advised that drinking cool horse milk and frequently washing the area, applying Baituozhong (Human Tooth Ash), and internally administering a large dose of Baihu Tang (White Tiger Decoction) might offer a chance of survival. However, since the lip was already perforated, I could not guarantee efficacy. Therefore, I prescribed a formula containing Raw Gypsum (Shigao), Raw Anemarrhena Rhizome (Zhimu), Raw Calcined Aragonite (Hanshuishi), and Fritillaria Thunbergii Bulb (Xiangbei). Among those present was an old physician, Mr. Ni XX, who suggested to him: "Grind Calculus Bovis into powder and apply it externally to the necrotic areas; this might also be curative." Thus, we parted ways. A few days later, the child had actually recovered, although the lower lip remained defective and could not fully heal. When asked what medication produced such rapid results, he replied that he followed Mr. Ni XX's advice, hastily purchased fragments of Tu Huang (Garcinia Hanburyi Resin) and applied them to the lesion. Indeed, upon application, the progression of necrosis stopped immediately, bleeding and exudate ceased, and scabs gradually formed and fell off within just three days. He had taken the internal prescription of Gypsum and others for only three doses. The child recovered because, due to ignorance, he mistook Calculus Bovis for Tu Huang. Yet, through this error, a critical and severe condition was cured, creating an unprecedented experiment in pharmacology. How can this not be recorded? I previously examined Li Shizhen's *Compendium of Materia Medica*, which mentions Tu Huang under creeping plants but describes its functions briefly. It was Zhao Shuxuan's *Supplement to Compendium of Materia Medica* that detailed it extensively. Although stated as "toxic," it can be taken internally. Citing *Guangdong Gazetteer*, it states that its nature is extremely cold, treating eye diseases; its taste is sour and astringent, treating carbuncles and swellings, stopping bleeding, detoxifying, healing metal wounds, expelling parasites, and when boiled with sesame oil and beeswax into a plaster, it stops pain and promotes wound closure for trauma and burns with miraculous effect. Its uses in binding sores and disinfecting are numerous, indicating that this herb is indeed an excellent medicine for surgery. However, most people do not know how to use it, misled by the two characters "toxic" in Li Shi's *Sea Medicinal Materia Medica*. Furthermore, Zhang Shiwen claimed it treats dental caries, causing teeth to fall off upon application, and falsely attributed this to toxicity damaging bones and kidneys. Consequently, people fear it more than snakes and scorpions, failing to realize that Zhang Shiwen is unreliable. Modern painters often ingest Tu Huang; although it is said that using it with Indigo Naturalis can neutralize its toxicity, I consider this merely theoretical speculation. If its nature is cold, where is the toxicity? Thus, we understand that its ability to cure Yagan is precisely due to its cooling action. Moreover, its sour and astringent taste, along with its abilities to stop bleeding, relieve pain, promote wound closure, and kill parasites, are concrete proofs of its efficacy in treating Yagan.

Note: The causes of Zouma Yagan differ between internal injury and external contraction. Cases arising from internal injury are mild and slow, while those from external contraction are severe and acute. This toddler contracted it after measles; his Stomach harbored epidemic toxins attacking upward, leading to such extensive necrosis within three days. Fortunately, the combination of internal administration of Gypsum and Calcined Aragonite and external application of Tu Huang attacked the disease from both inside and outside, hitting the key points effectively. Thus, the toxin was easily eliminated, and scabbing occurred within three days. If, at the initial stage of Yagan, one can use medication to eliminate the internal accumulated toxic heat, even without external applications, it can be cured. I once treated a toddler from the Yu family in Tianjin, aged six or seven, who had developed measles. After ten days, the fever persisted, and slight gum necrosis appeared. His family was terrified, fearing it would develop into Zouma Yagan, and sought my consultation. His pulse was forceful yet slightly wiry. I determined that although the toxic heat was excess, the prolonged illness had damaged the Qi level. Asking about his bowel movements, he had not defecated for three days. I therefore administered a large dose of Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). The formula contained Raw Gypsum (3 liang), Wild Codonopsis Root (4 qian), and several qian of Forsythia Fruit (Lianqiao) to vent the measles toxin outward. The decoction was divided into three tea cups, to be taken warm in three portions. Additionally, one qian of Antelope Horn (Lingyangjiao) was decocted in a large tea cup of water, to be drunk in divided doses. After completing the dosage, the fever subsided, and the illness resolved. The necrotic areas on the gums also healed spontaneously.