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Leprosy (Mafen) is generally caused by toxic pestilential qi. Its etiology involves three main factors: wind and soil generation, contagion, and improper self-care. The appearance of five types of "damage" syndromes and five types of "death" syndromes constitutes a true malignant prognosis; however, if treatment is adhered to strictly at the onset, survival may be possible.

[Note] This condition was formerly known as "Li Feng" (Pestilential Wind), which refers to wind pathogenic factors possessing toxicity. The Classics state: "Wind entering the vessels leads to Li," and also: "Li Feng arises from heat and corruption of Ying Qi (Nutritive Qi), causing turbid Qi, resulting in the collapse of the nasal bridge, deterioration of complexion, and ulceration of the skin. When toxic wind lodges in the vessels and does not depart, it is called Li Feng," now commonly referred to as Leprosy (Mafen). The first etiological factor is wind and soil generation; this condition is rare in Central China but common in miasma-prone areas. The second factor is contagion, such as contact with individuals suffering from Leprosy, or transmission among parents, spouses, or family members, or negligence outside, or exposure to unclean latrines, living quarters, bedding, or clothing. The third factor is improper self-care, such as bathing or cooling off for pleasure, sleeping exposed to wind, or lying on damp ground, allowing toxic wind to invade the blood vessels. Although these three etiologies have different names, they all belong to the pestilential Qi of Heaven and Earth. Upon infection, one is unaware, and failure to vent the pathogen leads to its accumulation and eventual manifestation. Symptoms include numbness over the entire body, followed by the appearance of white scales and red macules, spreading like petechiae, resembling snake skin, and peeling off in patches. In the initial stage, progression from top to bottom is considered favorable (Shun), while progression from bottom to top is unfavorable (Ni); gradual onset is treatable, whereas sudden onset is difficult to cure. When wind-toxin enters the interior and transforms into worms, these worms erode the Zang organs, leading to five types of physical damage: Lung involvement causes eyebrow loss first; Liver involvement causes purple spots on the face; Kidney involvement causes perforation of the soles of the feet first; Spleen involvement causes tinea-like lesions over the body; Heart involvement damages the eyes first. These are critical conditions. There are also five types of death syndromes: Numbness and insensitivity indicate Skin Death; lack of pain upon cutting indicates Flesh Death; ulceration without pus indicates Blood Death; detachment of hands and feet indicates Sinew Death; collapse of the nasal bridge, rupture of the eyelids, eversion of the lips, and hoarseness indicate Bone Death. If any one of the five death syndromes appears, it signifies a deteriorating, malignant, and incurable state. At the initial sensation of the disease, administer Wan Ling Dan (Ten Thousand Spirit Pill) to induce sweating. Subsequently, Shen Ying Xiao Feng San (Divine Response Wind-Dispersing Powder), Zhui Feng San (Wind-Chasing Powder), and Mo Feng Wan (Wind-Grinding Pills) should be administered in sequence. For bleeding gums, decoct equal parts of Huang Lian (Coptis Rhizome) and Guan Zhong (Cyrtomium Rhizome) and use the decoction for rinsing. Externally apply Lei Ju Qu Feng San (Accumulated Collection Wind-Expelling Powder), and simultaneously bathe and fumigate with a decoction of Di Gu Pi (Lycium Bark), Jing Jie (Schizonepeta), Ku Shen (Sophora Root), and Xi Xin (Asarum), each two liang, prepared in river water. For cases involving damage and deterioration, if located in the upper part of the body, administer Zui Xian San (Immortal Drunken Powder); if in the lower part, administer Tong Tian Zai Zao San (Heaven-Penetrating Rebirth Powder). If the nasal bridge has collapsed, administer Huan Ji San (Muscle-Replacing Powder) internally. If the patient shows slight signs of deficiency, administer Bu Qi Xie Rong Tang (Tonify Qi and Drain Ying Decoction), and concurrently drink He Shou Wu Jiu (Polygonum Wine). If one can maintain a pure heart, reduce desires, observe dietary restrictions, and treat early, there may be hope for survival; however, if dietary preferences cannot be lightened and sexual desires cannot be curbed, recurrence is inevitable even after recovery, ultimately leading to death.

Shen Ying Xiao Feng San (Divine Response Wind-Dispersing Powder)
Quan Xie (Scorpion), Bai Zhi (Angelicae Dahuricae Radix), Ren Shen (Ginseng Radix et Rhizoma) (each 1 liang).
Grind into fine powder. Take 2 qian each time. Do not eat dinner. On the following day, take on an empty stomach mixed with warm wine. Mild restlessness of the body indicates efficacy.
[Formula Song] Shen Ying Xiao Feng San treats Pestilential Wind, body numbness with white scales and red macules appear; Scorpion, Angelica, and Ginseng each one liang, taken with wine on an empty stomach to calm numbness.

Zhui Feng San (Wind-Chasing Powder)
Jin Wen Da Huang (Rhei Radix et Rhizoma, six liang), Chuan Yu Jin (Curcumae Radix, stir-fried, 1 liang 8 qian), Zao Jiao Ci (Gleditsiae Spina) (1 liang 5 qian).
Grind into fine powder. Take 5 qian each time, add 1 qian 5 fen of Da Feng Zi You (Croton Seed Oil) and 1 qian of Po Xiao (Natrii Sulfas). Mix with warm wine and take at dawn (Wu Geng) on an empty stomach. Continue until Chen hour (7-9 AM), then mix medicine again as before, adding a little cooked honey to take, and use honey to cleanse the mouth. Do not lie down. It is acceptable to experience painful diarrhea several times after a long period; replenish with thin congee. If Xiao Feng San is taken on the first day, take this medicine on the second day, and Mo Feng Wan on the third day. Repeat this cycle. For emaciated patients, Zhui Feng San should be used only once within ten days; do not use in elderly or weak patients.
[Formula Song] Zhui Feng San uses Chuan Yu Jin, Gleditsia spine and Rhubarb ground evenly; First take Xiao Feng, then use this, Wind oil, Natrii Sulfas, and wine make it divine.

Mo Feng Wan (Wind-Grinding Pills)
Cao Ben (Dioscoreae Hypoglaucae Rhizoma), Niu Bang Zi (Arctii Fructus, stir-fried), Ma Huang (Ephedrae Herba), Cang Er Cao (Xanthii Herba), Xi Xin (Asari Radix et Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Jing Jie (Schizonepetae Spica), Man Jing Zi (Viticis Fructus), Fang Feng (Saposhnikoviae Radix), Che Qian Zi (Plantaginis Semen), Wei Ling Xian (Clematidis Radix et Rhizoma), Tian Ma (Gastrodiae Rhizoma), He Shou Wu (Polygoni Multiflori Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix) (each 1 liang).
Grind into fine powder, make pills with wine and wheat paste, size of Sophora seeds. Take 60-70 pills each time, swallow with warm wine, twice daily.
[Formula Song] Mo Feng Wan contains Arctii, Ephedra, Xanthium, Asarum, Ligusticum, Angelica, Schizonepeta, Vitex, Saposhnikovia, Plantago, Clematis, Gastrodia, Polygonum, Notopterygium, and Angelica pubescens; Use this formula after taking Wind-Chasing Powder.

Lei Ju Qu Feng San (Accumulated Collection Wind-Expelling Powder)
Liu Huang (Sulfur), Han Shui Shi (Aragonitum), Ku Bai Fan (Alumen Exsiccatum), Guan Zhong (Cyrtomii Rhizoma) (each 2 liang), She Chuang Zi (Cnidii Fructus) (1 liang), Po Xiao (Natrii Sulfas) (5 qian).
Grind into fine powder, mix with lard rendered in the twelfth lunar month, and apply externally.
[Formula Song] Lei Ju Qu Feng San contains Sulfur, Aragonite, Alum, Natrii Sulfas, and Cnidius; Cyrtomium finely ground and mixed with lard, specifically applied to pestilential wind sores all over the body.

Zui Xian San (Immortal Drunken Powder)
Niu Bang Zi (Arctii Fructus, stir-fried), Hu Ma (Sesami Semen), Gou Qi Zi (Lycii Fructus), Man Jing Zi (Viticis Fructus) (each 1 liang), Ku Shen (Sophorae Flavescentis Radix), Bai Ji Li (Tribuli Fructus), Fang Feng (Saposhnikoviae Radix), Hua Fen (Puerariae Radix) (each 5 qian).
Grind into fine powder. Take 1 qian each time, add 1 fen 2 li of Qing Fen (Calomel), grind uniformly, and mix with clear tea liquor. Take once in the morning, noon, and evening. After five to seven days, foul yellow saliva will emerge from the teeth gaps, accompanied by whole-body pain and heaviness as if drunk, followed by the discharge of pus, blood, foul matter, and odor, indicating the removal of the disease root.
[Formula Song] Zui Xian San treats severe upper-body pestilential wind, Arctii, Sesame, Lycium, and Vitex; Sophora, Tribulus, Saposhnikovia, and Pueraria, take with Calomel mixed in clear tea.

Tong Tian Zai Zao San (Heaven-Penetrating Rebirth Powder)
Da Huang (Rhei Radix et Rhizoma, baked, 1 liang), Zao Jiao Ci (Gleditsiae Spina) (1 liang 5 qian), Yu Jin (Curcumae Radix) (5 qian), Bai Qian Niu (Pharbitidis Semen, head powder, half raw, half stir-fried, 6 qian).
Grind into fine powder. Take 2 or 3 qian each time. In the morning, face east, and take with strong wine. Discharge of foul matter, pus, or worms on the same day indicates efficacy.
[Formula Song] Tong Tian Zai Zao treats pestilential wind, attacking degenerative conditions starting from the lower part; Curcuma, Rhubarb, Pharbitis, and Gleditsia, taken in the morning with wine facing east.

Huan Ji San (Muscle-Replacing Powder)
Wu Shao She (Zaocys), Bai Hua She (Bungarus multicinctus), Qiu Yin (Earthworm, cleaned of soil, each 1 liang), Xi Xin (Asari Radix et Rhizoma), Mu Bie Zi (Momordicae Semen), Bai Zhi (Angelicae Dahuricae Radix), Tian Ma (Gastrodiae Rhizoma, with stem), Chi Shao (Paeoniae Radix Rubra), Man Jing Zi (Viticis Fructus), Dang Gui (Angelicae Sinensis Radix), Wei Ling Xian (Clematidis Radix et Rhizoma), Jing Jie Sui (Schizonepetae Spica), Gan Ju Hua (Chrysanthemi Flos), Bu Hui Mu (Asbestum), Zi Shen (Bistortae Rhizoma), Ku Shen (Sophorae Flavescentis Radix), Sha Shen (Glehniae Radix seu Adenophorae Radix), He Shou Wu (Polygoni Multiflori Radix), Shi Chang Pu (Acori Tatarinowii Rhizoma), Mu Zei (Equiseti Herba), Tian Men Dong (Asparagi Radix, dehearted), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Ji Li (Tribuli Fructus), Gan Cao (Liquiritiae Radix, roasted), Hu Ma Ren (Sesami Semen), Cang Zhu (Atractylodis Rhizoma, soaked in rice wash water, stir-fried), Cao Wu (Aconiti Kusnezoffii Radix, boiled, peeled, each 3 qian 5 fen).
Grind into fine powder. Take 5 qian each time, mix with warm wine; more wine is better. Zi Shen and Bu Hui Mu are optional.
[Formula Song] Huan Ji San treats major wind sores, toxin attacks eyebrows causing loss and nasal collapse; Zaocys, Bungarus, Earthworm, Asarum, Momordica, Angelica, Gastrodia, Paeonia, Vitex, Ligusticum, Clematis, Schizonepeta, Chrysanthemum, Asbestum, Bistort, Sophora, Glehnia, Polygonum, Acorus, Equisetum, Asparagus, Ligusticum, Tribulus, Liquorice, Sesame, Atractylodes, and Aconite strengthen.

Bu Qi Xie Rong Tang (Tonify Qi and Drain Ying Decoction)
Lian Qiao (Forsythiae Fructus, dehearted), Sheng Ma (Cimicifugae Rhizoma) (each 6 fen), Jie Geng (Platycodonis Radix) (5 fen), Huang Qin (Scutellariae Radix), Sheng Di Huang (Rehmanniae Radix) (each 4 fen), Huang Lian (Coptidis Rhizoma), Qiu Yin (Earthworm, wine-stir-fried, cleaned of soil), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Su Mu (Sappan Lignum), Quan Xie (Scorpion) (each 3 fen), Ren Shen (Ginseng Radix et Rhizoma), Bai Dou Kou (Amomi Fructus Rotundus) (each 2 fen), Gan Cao (Liquiritiae Radix, raw, 1 fen).
Decoct 2 zhong of water and 1 zhong of wine until 1 zhong remains, remove dregs. Then take 1 fen of Hu Tong Lei (Tectonae Lacrima), 3 stir-fried Leeches (Huishui Zhi), 3 stir-fried Blister Beetles (Meng Chong), 5 li of She Xiang (Moschus), and 3 crushed Peach Kernels (Tao Ren). Grind these into fine powder, add to the medicinal decoction, simmer until 7 fen remains, and take after meals.
[Formula Song] Bu Qi Xie Rong is suitable for pestilential deficiency, Scutellaria, Coptis, Ginseng, Platycodon, Earthworm, Angelica, Astragalus, Rehmannia, Cimicifuga, Scorpion, Forsythia, Amomum, Liquorice, Tectona lacrima, Leech, Blister Beetle, Moschus, and Peach Kernel mud.

He Shou Wu Jiu (Polygonum Wine)
He Shou Wu (Polygoni Multiflori Radix, 4 liang), Dang Gui Shen (Ginseng Radix? No, Angelicae Sinensis Radix - central part), Dang Gui Wei (Angelicae Sinensis Radix - tail tip), Chuan Shan Jia (Manis Squama, roasted), Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Rehmanniae Radix Preparata), Ha Ma (Bufo Toad), Ce Bai Ye (Biota Top), Song Zhen (Pine Needle), Wu Jia Pi (Acanthopanacis Cortex), Chuan Wu (Aconiti Radix, boiled, peeled), Cao Wu (Aconiti Kusnezoffii Radix, boiled, peeled, each 4 qian).
Place herbs in a summer cloth bag, tie tightly. Use 20 jin of yellow wine, place the herb bag in a jar, seal tightly, boil in a double boiler for three incense sticks' worth of time, bury and ferment for seven days. Open the jar, take the wine, drink frequently until slightly intoxicated, induce sweating, and avoid wind.
[Formula Song] He Shou Wu Jiu treats major wind disease, Angelica central/tail, Manis, Pine Needle, Raw/Prepared Rehmannia, Biota, Toad, Acanthopanax, Chuan/Aconite; Wine nourishes Ying and toxins naturally subside.

Wan Ling Dan (See Swelling and Ulcer Section)