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[Formula Song] The general term "Gan Chuang" (Chancre) has three main origins: unfulfilled sexual desire leading to difficult and dribbling urination; use of sexual techniques with applied medicines causing rashes, itching, and purplish discoloration; and infection with Syphilis, presenting as bright, red, and swollen lesions.

[Note] This condition is generally called Gan Chuang, also known as Du Jing Chuang (Jealousy Semen Chancre), occurring at the anterior yin (genitals). The Classics state: The anterior yin is the gathering place of the Zong Jin (tendons), governed by the Du Mai (Governor Vessel) meridian, which traverses the genitalia and converges at the Cuan Jian (perineum). It is also stated that the Kidney opens into the two yins (anterior and posterior orifices); therefore, sores arising here belong to the Liver, Du Mai, and Kidney meridians. Although names differ, forms vary. Sores occurring below the Ma Kou (urethral meatus) are named Xia Gan (Lower Chancre); those above the penis are named Zhu Gan (Borer Chancre); sores on the penis with swollen skin wrapping around them are named Xiu Kou Gan (Cuff Chancre); chancre persisting for a long time with widespread ulceration is named La Zhu Gan (Candle Chancre); pain radiating to the testicles with scrotal swelling and heaviness is named Ji Deng Gan (Chicken Chancre); painful, itchy, shallow ulcers resembling peeled rotten apricots are named Sao Gan (Itching Chancre); sores beside the urethral meatus with pores like palm eyes, itchy inside, exuding slight pus upon pressure, are named Xuan Gen Gan (Rotating Root Chancre); when suffering from Yang Mei Chuang (Syphilitic Chancre), or mistakenly using fumigation and topical applications causing rotting like a mortar, it is named Yang Mei Gan (Syphilis Chancre); furthermore, when taking Jie Yao (drastic purgatives/antisyphilitics made of Calomel and Mercury) during Syphilis, causing stinging pain in urination and defecation, it is named Yang Mei Nei Gan (Internal Syphilis Chancre). The origins of various Gans are mainly threefold: First, due to aroused male desire and rampant lust not released, leading to stagnation of spoiled semen and turbid blood forming swellings; initially presenting with dribbling, painful urination, followed by discharge of yellow turbid semen, gradual damage to the penis, swelling, pain, and rotting of the shaft; treatment should disperse and drain Liver and Kidney pathogenic fire, primarily using Ba Zheng San (Eight Righteousness Decoction) or Qing Gan Dao Zhi Tang (Clear Liver and Guide Out Stagnation Decoction). Second, due to hot medicines used in sexual techniques applied to the Yu Jing (penis), washing and rubbing the genitals, seeking prolonged potency without ejaculation for a long time, leading to fire stagnation and swelling; initially presenting with itchy, painful, hard penis, gradually developing nodules, purple and rotting color, dripping blood and fluid, frequent erections; treatment should drain fire and resolve toxicity, primarily using Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity) or Lu Hui Wan (Aloe Pill). Third, due to intercourse with prostitutes whose vaginal secretions contain stagnant semen and turbid qi, transmitting Syphilis through sexual contact; initially presenting with swollen, bright red skin, transparent like crystal, breaking to flow foul-smelling fluid, intermittent numbness and itching, increasing daily pain and swelling; treatment should resolve toxicity, primarily using Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver), followed by Er Zi Xiao Du San (Two Seeds Decoction to Eliminate Toxicity), externally washed with Da Dou Gan Cao Tang (Soybean and Licorice Decoction); for redness, swelling, heat, and pain, apply Carp Bile externally; for broken and rotting sores, apply Feng Yi San (Phoenix Skin Powder), Han Luo San (Dry Snail Powder), Zhen Zhu San (Pearl Powder), Yin Fen San (Silver Powder), or Hui Chun Tuo Gan San (Revive Spring Chancre-Removing Powder) according to the syndrome. For Yang Mei Gan and Yang Mei Nei Gan specifically, taking Wu Bao San (Five Treasures Powder) frequently is very effective.

Formula: Ba Zheng San (Eight Righteousness Decoction)
Composition: Qian Hu (Persicariae Herba) and Sheng Jun (Rhei Radix et Rhizoma, raw) 1 qian each; Hua Shi (Talcum) 2 qian; Qu Mai (Dianthi Herba), Gan Cao (Licorizae Radix et Rhizoma, raw), Che Qian Zi (Plantaginis Semen), Zhi Zi (Gardeniae Fructus), Mu Tong (Akebiae Caulis) 1 qian each.
Decoct 2 zhong of water to 8 fen, take before meals.

[Formula Song] Ba Zheng San clears accumulated excessive fire, treating urinary strangulation and painful swelling; Qian Hu, Jun, Hua Shi, Qu Mai, and Gan Cao, along with Che Qian Zi, Zhi Zi, and Mu Tong, are efficacious.

Another Formula: Qing Gan Dao Zhi Tang (Clear Liver and Guide Out Stagnation Decoction)
Composition: Qian Hu 4 qian; Hua Shi 2 qian; Gan Cao (raw) 1 qian; Da Huang (for constipation) 2 qian; Qu Mai 3 qian.
Decoct 2 zhong of water with 50 cun of Deng Xin Cao (Junci Medulla) to 8 fen, take on an empty stomach.

[Formula Song] Qing Gan Dao Zhi Tang clears Liver heat, treating penile swelling/pain and scanty urine; Qian Hu, Hua Shi, Gan Cao, Da Huang, Deng Xin Cao, and Qu Mai ensure thorough permeation.

Another Formula: Er Zi Xiao Du San (Two Seeds Decoction to Eliminate Toxicity)
Composition: Tu Fu Ling (Smilacis Glabrae Rhizoma) 8 liang; Zhu Zhi (Porcine Adipose Tissue, chopped) 2 liang; Xing Ren (Armeniacae Semen Amarum, stir-fried, skin and tip removed); Jiang Can (Bombyx Batryticatus, stir-fried); Chan Tui (Cicadae Periostracum) 7 each; Niu Xi (Achyranthis Bidentatae Radix); Jing Jie (Schizonepetae Herba); Fang Feng (Saposhnikoviae Radix) 1 qian each; Zao Jiao Zi (Ziziphus Spinosae Semen) 7; Jin Yin Hua (Lonicerae Japonicae Flos) 3 qian; Fei Zao Zi (Soapberry Fruit) 7; Zhu Ya Zao Jiao (Gleditsiae Sinensis Fructus Spina) 1 piece.
Decoct 8 bowls of water to 3 bowls, take in three doses; if for Jie Du (condyloma/gumma), taking it for 3-7 days leads to self-healing.
For Xiu Kou Gan, add Huang Bai (Phellodendri Cortex) 1 qian, double the Fei Zao Zi. For Yang Mei Gan, add Yi Yi Ren (Coicis Semen) and Zao Ci (Gleditsiae Spina) 1 qian each, Ce Bai Ye (Platycladi Cacumen), Lv Dou (Phaseoli Radiati Semen), and Nuomi (Oryza Sativa Glutinosa) 3 qian each. For Yang Mei Nei Gan, add Hai Jin Sha (Lygodii Spora), Wu Jia Pi (Acanthopanacis Cortex), and Bai Chou (Brayerae Semen) 1.5 qian each.

[Formula Song] Er Zi Xiao Du San treats Syphilis Chancre; Tu Fu Ling, Zhu Zhi, Xing Ren, Jiang Can, Chan Tui, Niu Xi, Jing Jie, Fang Feng, Zao Jiao Zi, Jin Yin Hua, Fei Zao Zi, and Zhu Ya Zao Jiao are decocted together.

Another Formula: Da Dou Gan Cao Tang (Soybean and Licorice Decoction)
Composition: Hei Dou (Sojae Semen Nigrum) 1 he; Gan Cao (raw) 1 liang; Chi Pi Cong (Allii Cepae Bulbus with red skin) 3 stems; Huai Tiao (Salix Matsudana Twig) 60 cun.
Decoct strongly in water, clarify the liquid, let cool to warm, wash twice daily.

[Formula Song] Da Dou Gan Cao Tang is a divine formula, excellent for washing various Gan conditions, stopping itch, relieving pain, and resolving toxicity; Chi Cong and Huai Tiao are boiled together.

Another Formula: Feng Yi San (Phoenix Skin Powder)
Composition: Feng Huang Yi (Ovi Corium Testudinis - eggshell membrane from hatched eggs) 1 qian; Qing Fen (Calomelas) 4 fen; Bing Pian (Borneolum Syntheticum) 2 fen; Huang Dan (Lithargyrum) 1 qian.
Grind into fine powder, mix with Duck Egg White for topical application, or sprinkle dry.

[Formula Song] Feng Yi San applies to ulcerated chancre; Qing Fen, Bing Pian, and Huang Dan together transform necrosis, generate flesh, and stop itch; mixed with duck egg white, pain is immediately relieved.

Another Formula: Han Luo San (Dry Snail Powder)
Composition: Bai Tian Luo Ke (Concha Meretrix, calcined) 3 qian; Qing Fen 1 qian; Bing Pian and She Xiang (Moschus) 3 fen each.
Grind into fine powder, mix with Sesame Oil for topical application.

[Formula Song] Han Luo San easily generates flesh, treating ulcerated chancre itch and pain; Calcined snail shell, Qing Fen, Bing Pian, and She Xiang mixed with sesame oil are suitable for removing necrosis.

Another Formula: Zhen Zhu San (Pearl Powder)
Composition: Zhen Zhu (Margarita); Huang Lian (Coptidis Rhizoma, powder); Huang Bai (Phellodendri Cortex, powder); Ding Fen (Cerussa); Qing Fen; Xiang Ya (Elephantis Dentis Massa, powder); Wu Bei Zi (Galla Chinensis, stir-fried); Er Cha (Catechu); Mo Yao (Myrrha); Ru Xiang (Olibanum) in equal parts.
Grind into extremely fine powder. First wash the affected area with Mi Tan Shui (rice water), then sprinkle this powder; highly effective.

[Formula Song] Zhen Zhu San treats lower chancre, clearing heat, removing stasis, and strongly expelling necrosis; Huang Lian, Huang Bai, Er Cha, Qing Fen, Ding Fen, Wu Bei Zi, Xiang Ya, Mo Yao, and Ru Xiang.

Another Formula: Yin Fen San (Silver Powder)
Composition: Take 6 qian of high-quality Tin, melt by fire, add 2 qian of Zhu Sha (Cinnabar) powder, stir-fry until cinnabar is burnt out, remove cinnabar leaving tin; remelt, add 1 liang of Shui Yin (Hydrargyrum), mix evenly, pour out for use. Grind 1 liang of Ding Fen (Cerussa) into extremely fine powder, spread on cotton paper, roll into a strip, ignite one end, roast until paper is consumed; blow away paper ash, mix powder with the previous tin-mercury alloy, add 1 liang of Qing Fen, grind all into extremely fine powder. First wash the affected area with Gan Cao Tang, dry, then sprinkle freely. This medicine effectively generates flesh, stops pain, and astringes.

[Formula Song] Yin Fen San treats chancre corrosion, penile injury, and syphilitic rot; Tin fried with cinnabar, mercury added, Ding Fen and Qing Fen ground together.

Another Formula: Hui Chun Tuo Gan San (Revive Spring Chancre-Removing Powder)
Composition: Melt 5 qian of Hei Qian (Plumbum) by fire, add 2.5 qian of Shui Yin, grind until no star-like particles remain; add 3.5 qian of Han Shui Shi (Halloysitum Rubrum), 2.5 qian of Qing Fen, 1 qian of Peng Sha (Borax), grind into fine powder. First wash the affected area with a decoction of Cong (Scallion), Ai Ye (Artemisiae Argyi Folium), and Hua Jiao (Zanthoxyli Pericarpium), then sprinkle this powder.

[Formula Song] Hui Chun San first melts black lead, then adds mercury for fine grinding; add Han Shui Shi, Peng Sha, and Qing Fen; sprinkle on lower chancre erosion for cure.

Another Formula: Wu Bao San (Five Treasures Powder)
Composition: Shi Zhong Ru (Gypsum Concretum - authentic ones hang like nipples, break easily like dragonfly wings) 4 qian; Zhu Sha 1 qian; Zhen Zhu (Pearl, boiled in tofu for half a joss-stick time, taken out) 2 qian; Bing Pian 1 qian; Hu Po (Amber) 2 qian.
Grind each into extremely fine powder, mix and grind hundreds of times, store tightly in a porcelain jar; take 2 qian of this powder, add 8 qian of Fei Luo Mian (fine sifted wheat flour), grind and mix evenly. Take 1 jin of Tu Fu Ling, 8 bowls of water, decoct to 5 bowls, filter dregs, divide into five doses. Each dose add 1 fen of Wu Bao San, mix well. Dosage depends on disease location (upper/lower), take 10 times daily; if nose is rotting, add 3 qian of Xin Yi (Magnoliae Flos) to the Tu Fu Ling decoction daily to guide medicine upward. Avoid seafood, beef, mutton, goose meat, strong alcohol, fried foods, and sexual intercourse.

[Formula Song] Wu Bao San contains Zhu Sha, Zhong Ru, Zhen Zhu, Bing Pian, Hu Po, and Fei Luo Mian finely mixed; for Syphilis Chancre and condyloma, taking it with Tu Fu Ling decoction is most miraculous.

Another Formula: Huang Lian Jie Du Tang (See Ear Section: Black Carbuncle)
Lu Hui Wan (See Dental Section: Gingival Bleeding)
Long Dan Xie Gan Tang (See Waist Section: Flank Fire Snake)