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Shechuangzi Wash Method and Lülü Application Method

12. Yin ting xia tuo (uterine or vaginal wall prolapse), also known in ancient texts as "?? shan", presents with a protruding mass resembling a snake or a mushroom. If due to damp-heat, symptoms include swelling, pain, and scanty, red, frequent urination; if due to qi deficiency, symptoms include a sensation of heavy bearing down and clear, long urine. For qi deficiency, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Qingpi (Green Tangerina Peel) and Zhizi (Gardeniae Fructus) should be used; for damp-heat, Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction) is indicated. Externally, wash with a decoction of Shechuangzi (Cnidii Fructus) and Wumei (Mume Fructus), and apply Lülü (Veratri Rhizoma) powder mixed with lard, which will cause the prolapsed tissue to retract spontaneously.

[Note] Yin ting (uterine or vaginal wall prolapse) in women may result from damage to the Bao Luo (uterine collaterals), excessive exertion during childbirth, sinking of qi due to deficiency, or downward pouring of damp-heat. This causes a protrusion from the vagina resembling a snake, mushroom, or cockscomb, which belongs to the category of ancient "?? shan" diseases. Cases attributed to heat are characterized by swelling, pain, and red, frequent urination, and are treated with Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction); cases attributed to deficiency are characterized by a sensation of heavy bearing down and clear, long urine, and are treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Qingpi (Green Tangerina Peel) and Zhizi (Gardeniae Fructus). Externally, fumigate and wash with water boiled from Shechuangzi (Cnidii Fructus) and Wumei (Mume Fructus). Then apply Lülü (Veratri Rhizoma) powder mixed with lard to the affected area; such treatments are invariably curative.
Xiao Yao San (Free and Easy Wanderer Powder; see Formula at the beginning of Volume 1), Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction; see formula under the section on Yin Swelling previously).

Jiawei Siwu Tang (Modified Four Substances Decoction)

13. ?? erosion leading to sores with dripping pus and serous fluid, intermittent pain and itching with a sensation like insects crawling, distension and fullness in the lower abdomen, scanty and painful urination, poor appetite, physical fatigue, and steaming bone fever in the late afternoon. Treatment involves Siwu Tang (Four Substances Decoction) added with Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus), and Longdancao (Gentianae Radix); for ulcerated and putrid lesions, use Xiao Yao San (Free and Easy Wanderer Powder); for cases with a sensation of bearing down, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).

[Note] Female yin chuang (vulvar sores), named "??", arises from emotional stagnation transforming into fire, damaging the Liver and Spleen, causing qi and blood stagnation, and downward pouring of damp-heat. Over time, parasites generate and erode the tissue, forming sores with dripping pus and serous fluid, intermittent pain and itching with a sensation like insects crawling, distension and fullness in the lower abdomen, red and frequent urination, poor appetite, physical fatigue, internal heat and afternoon tidal fever, irregular menstruation, and red and white leukorrhea. Given this variety of symptoms, treatment should be differentiated. For swelling and pain, use Siwu Tang (Four Substances Decoction) added with Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus), and Longdancao (Gentianae Radix); for ulcerated sores with oozing and pain, use Jiawei Xiao Yao San (Modified Free and Easy Wanderer Powder); for cases with a sensation of bearing down, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).
Jiawei Xiao Yao San (Modified Free and Easy Wanderer Powder; see formula under the section on Yin Pain previously), Siwu Tang (Four Substances Decoction), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction; all formulas see Volume 1).