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Xia Shiju (Lower Stone Abscess) arises above the knee, with a mass hard as stone causing tendon-pulling pain. The skin color remains normal, yet it is difficult to suppurate and heal. This condition results from blood stasis and external cold coagulation.

[Note] This condition occurs in the inter-knee region; whether at the patella or on either side, it can manifest. The mass is hard as stone, causing tendon-pulling pain, swelling like an egg. The skin color does not change, there is no heat sensation, it is difficult to dissipate and difficult to suppurate, and even after suppuration, it is difficult to granulate and close. It is most stubborn and persistent. It is caused by body deficiency and deep invasion of cold pathogens, leading to blood stasis and coagulation, resulting in swelling and ulceration. Internal and external treatment methods should refer to Zhong Shiju (Middle Stone Abscess). However, since this condition presents as cold during both swelling and suppuration phases, if the cold transforms into heat and favorable signs appear, it is auspicious; if unfavorable signs persist, recovery is difficult.

Huan Ju (Slow Abscess) also stems from blood stasis and external cold coagulation. The swelling is hard like a steamed bun, arising above the knee. The color is purple-dark, suppuration is delayed often accompanied by heat, and prolonged swelling leads to gradual rotting of the skin and flesh, causing pain.

[Note] This condition is formed by deep invasion of external cold and blood stasis. It arises above both knees or on the sides of the knees. The swelling is hard like a steamed bun, with numbness and pain increasing daily. The color is purple-dark, and it does not suppurate after many days. The clinical presentation is similar to Xia Shiju, except for the presence of heat. Prolonged swelling causes rotting of muscles and skin. Initially, Danggui Nian Tong Tang (Angelica Ligustichi Chuanxiong Decoction) is administered to diffuse damp-heat. Subsequently, treat according to the methods for Zhong Shiju: internally use warming tonification, externally apply moxibustion. For severe deficiency, combine with Shiquan Dabu Tang (Ten Complete Tonifying Decoction).

Wei Zhong Du (Poison at Weizhong) arises at the popliteal crease. Flexion and extension cause numbness, stiffness, slight swelling, and redness. This is due to Gallbladder heat flowing into the Bladder meridian and being obstructed. One should promptly use Huoxue Sanyu Tang (Blood-Invigorating and Stasis-Expelling Decoction) and puncture Weizhong.

[Note] This condition arises at the Weizhong acupoint, located in the depression of the arterial pulse at the center of the popliteal crease behind the knee. The "creased line" refers to the fold, also known as Xuexi (Blood Pool). The point belongs to the Bladder Meridian, commonly called the leg hollow. The classics state that this disease is caused by accumulated heat in the Gallbladder meridian flowing into the Bladder meridian, where it becomes congested and stagnant. Symptoms include numbness, hardness, swelling, pain, slight redness, and difficulty in flexion and extension. Treatment requires prompt use of Huoxue Sanyu Tang to expel evil blood from below for efficacy; delay will lead to tendon contraction and disability. All books state that puncturing Weizhong to bleed will cause spontaneous resolution. However, puncture is only indicated when accompanied by lower back pain and inability to turn the body. Even then, bleeding must not be excessive; excessive bleeding may cause fainting and pallor. Other internal and external treatments follow the protocols for Yong Ju (Carbuncle and Ulcer) swelling and ulcer sections. Cases with severe pain, bright red color, and rapid suppuration are caused by damp-heat coagulation and are treated according to the swelling and ulcer sections.

Huoxue Sanyu Tang (Blood-Invigorating and Stasis-Expelling Decoction)
Dangguiwei (Radix Angelicae Sinensis Cauda), Chishao (Radix Paeoniae Rubra), Taoren (Semen Persicae, peeled and de-husked), Dahuang (Radix et Rhizoma Rhei, wine-fried), each 2 qian; Chuanxiong (Rhizoma Chuanxiong), Sumu (Lignum Sappan), each 1.5 qian; Danpi (Cortex Moutan), Zhike (Fructus Aurantii Immaturus, bran-fried), Gualouren (Semen Benincasae, each 1 qian); Binglang (Areca Seed) 6 fen.
Boil in two sheng of water until reduced to eight fen. Take on an empty stomach; decoct the dregs again and take.

[Prescription Song] Huoxue Sanyu treats Wei Zhong Du, all due to accumulated heat swelling the area; Danggui, Chishao, Danpi, Taoren, Zhike, Binglang, Gualou, Dahuang, Chuanxiong, Sumu.