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Fox Urine Thorn (Hú Niào Cì) arises between the hands and feet, presenting with stifling swelling, pain, redness, and purple-black macules. This condition is caused by the accumulation of toxic fluid from mantises mating in midsummer; when human hands or feet accidentally touch these contaminated objects, the skin is damaged, causing severe pain that prevents sleep.

[Note] In *Waike Dacheng* (Comprehensive Treatise on Surgery), this condition is named "Fox Thorn" (Hú Lí Cì); in *Waitai Miyao* (Essential Prescriptions of the Imperial Library) and *Zonglu* (General Records), it is named "Fox Urine Thorn" (Hú Niào Cì). The etiology involves mantises copulating during the height of summer, their seminal fluid staining various objects, which becomes toxic after drying for a long time. Accidental contact by human extremities induces this disease. Initially, red-purple spots appear, the skin is dry, accompanied by stifling swelling and pain leading to insomnia. After ten days, the lesion ulcerates and necrotizes, with the wound widening daily. Internal treatment should involve taking Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity). Externally, prepare a strong decoction of Dandelion (Taraxaci Herba) including roots, and wash the affected area while warm. If fresh Dandelion is available, crushing it to extract juice for application yields better results. The name derives from the fact that the mantis is also known as "Wild Fox Nasal Discharge," hence the nomenclature. For management prior to ulceration, refer to the section on Ulcerative Sores and Carbuncles.

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Huanglian Jiedu Tang (See Black Boil of the Ear Section)

Goose Palm Wind (É Zhǎng Fēng) arises in the palm, characterized by dry, cracked skin presenting with purple and white macules. This condition often results from residual toxins of Yangmei Chuang (Syphilitic Chancre) not fully cleared, combined with blood dryness generating heat, and further complicated by wind-toxin invasion, leading to qi and blood stagnation. Initially, purple-white spots appear, with layers of white scales rising, becoming hard and thickened, dry, brittle, and fissured, potentially spreading across the entire hand. Externally, wash the affected area with Er Fan San (Two Alum Powder) and apply San You Gao (Three Ointment). Internally, use the formula for Qufeng Dihuang Wan (Wind-Expelling Rehmannia Pill) modified with Tufuling (Smilacis Glabrae Rhizoma), Baixianpi (Dictamni Cortex), and Danggui (Angelicae Sinensis Radix) as adjuvants, processed into pills for administration, which proves effective. If the condition persists for years and evolves into tinea (xuǎn), it becomes difficult to cure. Additionally, there are cases not resulting from syphilis sequelae, where the palm inexplicably becomes dry, itchy, and scaly, progressing to dry cracking with mild pain, termed "Palm Wind" (Zhǎng Xīn Fēng). This is due to heat in the spleen and stomach, blood dryness generating wind, and blood failing to nourish the skin. It is suitable to take Qufeng Dihuang Wan externally with Runji Gao (Moisturizing Skin Ointment), applying it over time until healing occurs.

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Qufeng Dihuang Wan (Wind-Expelling Rehmannia Pill)
Shengdi (Rehmanniae Radix Recens) and Shudi (Rehmanniae Radix Preparata) (each 4 liang), Bajieli (Tribuli Fructus), Chuan Niuxi (Achyranthis Bidentatae Radix, washed in wine) (each 3 liang), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Gouqizi (Lycii Fructus) (each 2 liang), Tusizi (Cuscutae Semen, prepared in wine), Du Huo (Angelicae Pubescentis Radix) (each 1 liang).
Grind all ingredients into fine powder, mix with refined honey to form pills the size of sophora seeds. Take 3 qian per dose, administered with yellow wine; in summer, administer with light salt water.

[Pill Formula Song] Qufeng Dihuang clears blood heat, Goose Palm Wind heals upon ingestion, Zhi Mu, Huang Bai, Ji Li, Niu Xi, Tu Si Zi, Du Huo and Gou Qi are ground together and mixed with refined honey.

Er Fan San (Two Alum Powder)
Baifan (Alumen) and Zaofan (Melanterite) (each 4 liang), Ercha (Catechu) (5 qian), Ce Baiye (Biota Top Swath Leaf) (8 liang).
Boil in ten bowls of water until simmering several times, then set aside. First, apply Tung Oil (Verniciae Folii Oleum) to the affected area. Then, soak a paper wick in tung oil, ignite it, and fumigate the affected area for a period. Next, pour the aforementioned hot decoction into a clean wooden bucket. Place hands over the bucket opening, cover tightly with cloth to prevent steam leakage, and fumigate the hands with the medicinal vapor. When the liquid cools slightly, pour it into a basin and soak/wash the hands for an extended period; one session may suffice. Strictly avoid contact with plain water for seven days.

[Pill Formula Song] Two Alums treat purple-white spots on palms, Alum, Catechu, and Biota leaves are boiled, first apply tung oil to the lesion, fumigate with oiled wick before washing cures.

San You Gao (Three Ointment)
Niuyou (Bovis Caudalis Adipis), Diqingli (Bitumen), Xiangyou (Sesame Oil), Yinzhu (Cinnabar) (each 1 liang), Guanfen (Lead Carbonate), Shexiang (Moschus, finely ground) (each 2 qian).
Melt the three oils together over fire, add 1 liang of Beeswax (Cera Flava), dissolve completely, then remove from heat. Add powders of Cinnabar, Moschus, and Lead Carbonate, stir evenly to form an ointment. Apply to the affected area and bake with fire until the oil dries but the skin remains moist.

[Pill Formula Song] San You Gao moisturizes Goose Palm Wind, initial spots gradually crack with dry itching, Beef fat, Biota, Sesame oil, Cinnabar, Powder, Moschus, wax boiled applied to lesion baked on fire.

Runji Gao (Moisturizing Skin Ointment) (See White Scale Wind of the Head Section)