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[Prescription Verse] Why does Qing Tui Ya Gan (Green Leg and Gangrenous Gingivitis) arise? It is solely due to the lack of communication between the upper and lower parts. Yang fire blazes fiercely while Yin cold closes in, condensing into toxin, thus forming this disease. The legs appear green like clouds, dark purple-black like eggplants; the limbs are fatigued, stubbornly swollen and hard, making walking difficult. The gums swell and bleed with a foul odor; if it penetrates through the cheeks and lips, rotting and turning black, the condition is ominous.

[Note] This syndrome was rarely recorded by name in ancient medical texts. Only during the Yongzheng reign did Tao Qilin, an army physician attached to the northern route, understand its details well. He stated roughly: In the army, whenever there were cases of leg swelling with green coloration, gangrenous gingivitis would inevitably develop above; whenever there were cases of gangrenous gingivitis with bleeding of putrid blood, green leg swelling would inevitably develop below. These two conditions occur sequentially. Tracing the origin, it is all because Yang fire blazes in the upper part while Yin cold stagnates in the lower part, causing the Yin and Yang to fail to communicate between upper and lower. Each becomes cold or hot independently, condensing separately to generate this syndrome. In regions near the interior, it occasionally occurs; although it also exists outside the borders, it is not very common. However, among people from the interior who newly reside outside the borders, those contracting this syndrome account for eight or nine out of ten. Generally, Chinese people are inherently intolerant to the severe cold outside the borders, and they inevitably sit or lie on damp ground. Thus, phlegm generated by cold-dampness arises in the lower body, leading to green and swollen legs. The disease presentation resembles cloud patches, the color is black like eggplant, the flesh is stubbornly hard, hence walking is arduous. Furthermore, due to the scarcity of grains outside the borders, people consume much beef and mutton. The heat combines with dampness, steaming and stasis-forming in the Stomach. Toxic fire flares upward, causing gangrenous gingivitis, gum swelling and putrefaction, and bleeding. If it perforates the cheeks and lips, rotting and turning black, it is a critical sign. Outside the borders, it is traditionally believed that only the method of administering horse milk is effective. When Tao Qilin first arrived at the military camp to examine patients with Qing Tui Ya Ju (Green Leg and Gangrenous Ulcer), he only knew to administer horse milk. After gaining experience, he realized that the power of horse brain is twice as fast-acting as horse milk. He ordered patients to take it, and on that night, profuse sweating occurred, and various symptoms subsided! This is because the brain is the head of all Yang meridians; its nature is warm and it can circulate freely. Concurrently administering Huoluo Liuqi Yin (Activating Collaterals and Regulating Qi Decoction) and Jiawei Ermiao Tang (Modified Two Marvels Decoction) to promote blood and Qi circulation and unblock collaterals prevents toxin condensation. Externally, Bian Fa (scarification therapy) is used to allow evil blood to flow out, thereby killing the toxic pathogen; additionally, slices of beef are applied topically to draw out accumulated toxins, resulting in recovery within a few days. Generally, when black blood flows out, Yin Qi escapes outward, and Yang Qi descends following Yin Qi. The two interact and nourish each other, bringing peace to the upper and lower parts naturally. This became a standard practice, with many cured. Not keeping it secret, it was written down and made public, along with the verified prescriptions detailed below.

Prescription: Method of Drinking Horse Milk
Indication: Treats Qing Tui Ya Gan.
Composition: Use fresh milk from blue or white horses, taken immediately after milking morning, noon, and evening. It is very effective. If blue or white horses are unavailable, mixed-color horses may be used.

Another Prescription: Method of Consuming Horse Brain
Indication: Treats Qing Tui Ya Gan.
Composition: Use one horse brain. Remove the fascia with a bamboo knife, place it in a bowl, stir evenly, then mix with boiling yellow rice wine and drink. One jin or half a jin is acceptable. If it cannot be consumed at once, divide into two doses.

Another Prescription: Huoluo Liuqi Yin (Activating Collaterals and Regulating Qi Decoction)
Composition:
Cangzhu (Atractylodis Rhizoma) 2 qian
Mugua (Chaenomelis Fructus) 2 qian
Qianghuo (Notopterygii Rhizoma et Radix) 2 qian
Fuzi (Aconiti Lateralis Radix Praeparata - Raw) 2 qian
Shanzha Rou (Crataegi Fructus) 2 qian
Duhuo (Angelicae Pubescentis Radix) 2 qian
Huainiuxi (Cyathulae Radix) 2 qian
Mahuang (Ephedrae Herba) 2 qian
Huangbai (Phellodendri Cortex) 2 qian
Wuyao (Linderae Radix) 2 qian
Ganjiang (Zingiberis Rhizoma) 1.5 qian
Binglang (Arecae Semen) 1.5 qian
Zhike (Aurantii Fructus) 1.5 qian (bran-fried)
Gancao (Glycyrrhizae Radix et Rhizoma) 0.8 fen
Heidou (Sojae Semen Nigrum) 49 grains
Shengjiang (Zingiberis Rhizoma Recens) 3 slices
Water: 4 zhong, decoct to 1 zhong. Take orally. Dregs: add water 3 zhong, decoct to 0.8 zhong.
If gangrenous gingivitis is severe, remove Ganjiang and Fuzi, add Huhuanglian (Coptidis Rhizoma) 2 qian and Longdancao (Gentianae Radix) 2 qian. If gangrenous gingivitis is mild but leg pain is severe, add Rougui (Cinnamomi Cortex) 2 qian. If chills and fever have subsided, remove Qianghuo and Mahuang, add Weilingxian (Salviae Miltiorrhizae Radix et Rhizoma - *Note: Standard is Saposhnikoviae Radix*) 2 qian and Wujia Pi (Acanthopanacis Cortex) 2 qian.

[Prescription Verse] Huoluo Liuqi Yin dispels wind and strengthens; good for initial use in green swelling and gangrenous gingivitis; removes dampness, clears Stomach, unblocks collaterals; do not stick rigidly to the formula for modifications. Cangzhu, Mugua, Qianghuo, Fuzi; Shanzha, Duhuo, Niuxi, Huangbai, Mahuang; Wuyao, Ganjiang, Binglang, Zhike, Gancao; guide with Heidiou and Shengjiang.

Another Prescription: Jiawei Ermiao Tang (Modified Two Marvels Decoction)
Composition:
Huangbai (Phellodendri Cortex - Raw) 3 qian
Cangzhu (Atractylodis Rhizoma - soaked in rice wash water, fried) 3 qian
Niuxi (Cyathulae Radix) 3 qian
Binglang (Arecae Semen) 2 qian
Zexie (Alismatis Rhizoma) 2 qian
Mugua (Chaenomelis Fructus) 2 qian
Wuyao (Linderae Radix) 2 qian
Danggui Wei (Angelicae Sinensis Radix tail) 1.5 qian
Heidou (Sojae Semen Nigrum) 49 grains
Shengjiang (Zingiberis Rhizoma Recens) 3 slices
Water: 3 zhong, decoct to 1 zhong. Dregs: add water 2.5 zhong, decoct to 0.8 zhong.

[Prescription Verse] Jiawei Ermiao Tang treats difficulty in walking; clears swelling and gangrenous gingivitis of Qing Tui Ya Gan. Huangbai, Cangzhu, Niuxi, Danggui Wei, Binglang, Zexie; Mugua, Wuyao, Heidiou, Shengjiang decocted.

Another Prescription: Bian Ci Chu Xue Fa (Scarification and Bleeding Method)
Method: Use a triangular flat needle, shaped like a cone. On the green-black areas of the leg, regardless of acupoints, depending on the size of the black area, prick to a depth of 1 fen. Ten or twenty pricks are acceptable. Ensure black blood flows out. Externally, apply sliced beef to the puncture sites and black areas. Check the next day; if the black area recedes slightly, repeat pricking and applying. If beef is unavailable, prick the topmost point and use cupping.

Another Prescription: Chaya Niuhuang Qingdai San (Tooth-Anointing Powder of Calculus Bovis and Gentian Violet)
Composition:
Niuhuang (Calculus Bovis) 0.5 fen
Qingdai (Indigo Naturalis) 0.5 fen
Pengsha (Borax) 2 qian
Zhusha (Cinnabaris) [Amount unspecified, implied equal or small dose based on context, usually minimal]
Renzhongbai (Humanis Odoris Depositum - calcined) 1 qian
Longgu (Fossilia Ossis Mastodi - calcined) 1 qian
Bingpian (Borneolum Syntheticum) 0.3 fen
Grind into fine powder. First rinse the mouth thoroughly with Licorice decoction, then apply this powder.

[Prescription Verse] Niuhuang Qingdai San with Pengsha; add Bingpian, Zhusha, Renzhongbai; grind Longgu into fine powder; anoint this medicine for swollen and putrid gangrenous gingivitis.

Another Prescription: One method uses boiled horse meat broth for washing/scalding.
Another method uses sliced sheep liver applied to the black area.
Another method uses mustard seeds ground into powder, mixed with strong liquor, and applied to the black swollen area.

Incurable Cases:
1. Those with衰竭 of form and Qi, with no desire for food, are incurable.
2. Those whose teeth have all fallen out, with purple-black bleeding, putrefaction, and foul odor, are incurable.
3. Those with massive leg swelling and putrefaction, or thin and dry/withered legs, are incurable.