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[Prescription Verse] Guofa (an acute suppurative disease occurring on the palms of hands and feet or in flexion areas of waist and legs) arises from external pathogenic factors. It typically forms masses at sites of limb flexion and extension, presenting as diffuse swelling without a distinct head, accompanied by aversion to cold and fever. The limbs feel heavy, and irritability with thirst increases.

[Annotation] This condition occurs in individuals with weak constitutions due to exposure to abnormal and severe qi (pathogenic factors) from heaven and earth; it is not caused by internal factors. It commonly arises on the palms of the hands and feet, or in the flexion and extension areas of the waist, legs, and buttocks. The pain resembles that of gout, accompanied by diffuse swelling without a head, pale red color, aversion to cold with fever, heaviness of the limbs, irritability, and thirst. In the initial stage, Wanling Dan should be taken to induce sweating and release the exterior. If the swelling does not subside and suppuration is inevitable, Tuoli Xiaodu San should be taken, along with intermittent administration of Hupo Lafan Wan. For cases that have already ulcerated, treatment should follow the methods for ulcers in the Yang-Heat Sores chapter.
Formulas: Wanling Dan, Tuoli Xiaodu San, Hupo Lafan Wan (all see Chapter on Swollen Ulcers)

[Prescription Verse] Biaojü (a disease resembling modern gangrene or severe infection) originates from miasma and pestilential qi. The lesions are small like millet seeds or large as plums. Initially appearing as red spots, they turn black, causing rotting of muscles and bones with unceasing pain.

[Annotation] This condition is also known as Shezhang (Snake Miasma) and is prevalent in regions like Sichuan and Guangdong where miasma exists. It begins as red spots that subsequently turn black. The lesions vary in size from millet seeds to plums and can appear anywhere on the body. The pain is severe, radiating to the heart, leading to rotting of muscles and bones. Upon ulceration, the pus flows out like bean sweat; after wiping it clean today, the pus refills tomorrow. It heals only to recur. In the initial stage, Chansu Bing should be applied topically. If alternating chills and fever occur, Shumi Cunjindan should be taken, or Duoming Dan may also be used. For redness and swelling that wander and are unstable, Ligong Ding should be applied topically, combined with Shen Deng Zhao (Divine Lamp Illumination) moxibustion/fumigation. After ulceration, if there is Spleen Qi deficiency with poor appetite and vomiting, Buzhong Yiqi Tang should be modified with Huanglian and Maidong. If tonification fails, or if thin, foul-smelling discharge appears, it indicates a adverse prognosis (Ni syndrome).
Formulas: Chansu Bing (see Ding Chuang); Shumi Cunjindan, Ligong Ding (both see Chapter on Swollen Ulcers); Duoming Dan (see Back Yin-Yang Two-Qi Ju); Buzhong Yiqi Tang (see Chapter on Ulcers); Shen Deng Zhao Method (see Volume 1)