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Ulcers should be distinguished by their location on the medial or lateral aspects. Those on the lateral aspect are easy to treat, while those on the medial aspect are difficult to cure. The lateral aspect belongs to the accumulation of damp-heat in the Yang-meridians (Three Yang meridians), and the medial aspect belongs to the entanglement of deficiency-heat in the Yin-meridians (Three Yin meridians). The treatment method should involve searching for wind, removing dampness, clearing heat, and applying Sanxiang Jiazhi Gao externally.

[Note] This condition arises on the inner and outer sides of the tibia of both lower legs. The lateral aspect belongs to the accumulation of damp-heat in the Foot Three Yang meridians; early treatment yields quick results. The medial aspect involves dampness in the Three Yin meridians combined with deficiency-heat in the blood level. Additionally, the skin and flesh over the tibial bone are thin, making it difficult to achieve results, and the condition is extremely lingering. Initially, there is itching followed by pain, redness, swelling forming patches, and upon rupture, purple fluid oozes out. For newly onset cases, apply Sanxiang Gao; if the color is purple, apply Jiazhi Gao. If the ulcer has persisted for a long time with a purple-black color, apply Jiedu Zijin Gao. For chronic stubborn ulcers where the skin is black, sunken, and foul-smelling, use the Wugong Qian method to dispel wind-toxin and resolve stasis and putrefaction, covering it with Huangla Gao until gradual improvement occurs. For initial stages, take Huang Wan; for prolonged cases, take Sisheng Wan; for those with deficiency-cold of the Lower Yuan (Lower Burner/Kidney system), Hujian Wan is suitable, which is very effective with regular use. However, since the lower legs are located below the point of Supreme Yin (Zhiyin), patients with leg ulcers must avoid labor and triggering foods (Fa Wu); otherwise, the condition may not heal.

Sanxiang Gao
Qingfen (Calomelas)
Ruxiang (Olibanum / Frankincense)
Songxiang (Pini Resina / Pine Rosin)
(Equal parts)
Grind all into fine powder, mix with sesame oil to a thick consistency. Take a piece of paper sandwiched between two layers, prick it densely with a needle to create small holes. Apply the medicine inside the paper layer. First, wash the affected area with scallion water. Then, apply the medicinal paper with the pricked side facing the ulcer. Change every three days.

[Fang Ge/Song] Sanxiang, Qingfen, Ruxiang, Songxiang, ground to powder mixed with oil and hidden in paper; wash the affected area with scallion water before applying; this is excellent for early-stage ulcers.

Jiazhi Gao
Huandan (Cinnabar calcined / Lead Monoxide prepared)
Qingfen (Calomelas)
Ercha (Terminalia chebula Retz.)
Moyao (Myrrha / Myrrh)
Xionghuang (Realgar)
Xuejie (Santalum album L. heartwood)
Wubeizi (Galla Chinensis)
Yinzhu (Vermilion / Mercury sulfide)
Kufan (Alumen Exsiccatum / Calcined Alum)
(Equal parts)
Grind all into fine powder. Cut two sheets of oiled paper according to the size of the ulcer. Place the medicine between the papers and seal the edges with wheat paste. Prick holes in the top paper. First, wash and dry the ulcer with a decoction of scallions and pepper. Then paste it, bind with cloth, wash every three days, and reapply fresh medicine.

[Fang Ge/Song] Jiazhi Gao applied to broken ulcers; Huandan, Qingfen, Ercha, Moyao, Xionghuang, Xuejie, Wubeizi, Yinzhu, Kufan; paste with oiled paper to detach necrotic tissue.

Jiedu Zijin Gao
Mingjing Songxiang (Clear Pine Rosin)
Zaofan (Melanterite / Ferrous sulfate heptahydrate calcined red)
(Each one jin)
Grind into extremely fine powder, mix with sesame oil to a thick consistency. First, wash the affected area with a decoction of scallions, mugwort, and licorice root. Then apply this medicine, cover with oiled paper, and tie tightly with soft cloth. Change every three days. This medicine is also effective for Chancre (Syphilitic sore) toxicity, rotting and foul-smelling with dripping pus.

[Fang Ge/Song] Jiedu Zijin treats rotten ulcers; Mingjing Songxiang and Zaofan ground to powder mixed with oil; wash the affected area first with scallion, mugwort, and licorice soup.

Wugong Qian
Wugong (Scolopendra subspinipes mutilans)
Gancao (Glycyrrhizae Radix et Rhizoma / Licorice Root)
Duhuo (Angelicae Pubescentis Radix / Pubescent Angelica Root)
Baizhi (Angelicae Dahuricae Radix / Dahurian Angelica Root)
(Each one qian)
Two liang of Tung oil. Boil the herbs in the oil. First, wash the ulcer with rice washing water. Make a ring of dough using water and white flour, place it around the four sides of the ulcer to prevent leakage. Keep the leg flat. Use a tea spoon to ladle hot oil gradually until full. When the oil cools, remove it. Thereafter, wind-toxin will dissipate naturally, and necrotic flesh will shed gradually. The effect is very rapid.

[Fang Ge/Song] Wugong Qian treats chronic ulcers; black sunken skin with unbearable odor; boil Gancao, Duhuo, Baizhi in Tung oil; make a white flour ring around the ulcer and scald strongly with oil.

Huangla Gao
Xuejie (Santalum album L. heartwood)
Chishizhi (Halloysitum Rubrum / Red Halloysite)
Longgu (Fossilia Os Mastodi et Cornu / Fossilized Mammal Bone)
(Each three qian)
Grind into fine powder. Use one liang of sesame oil, add a ball of Xueyu (Human hair carbon) the size of a chestnut, burn off dregs. Add one liang of Huangla (Beeswax) and three qian of Baijiaoxiang (Boswellia carterii gum / Olibanum Gum). Melt completely, then remove from fire. Add the powdered herbs, stir evenly, and cool. Store in a porcelain jar. When using, mold into thin slices and apply to the ulcer, binding with silk cloth. After three days, flip and apply to the other side.

[Fang Ge/Song] Huangla, Xueyu, Xuejie, Baijiaoxiang; Chishizhi and Longgu mixed with oil; after Wugong Qian, cover with this ointment; muscles can regenerate and pain disappears naturally.

Huang Wan
Huang (likely referring to a specific processed herb or typo for Huangqi/Huanglian, context suggests toxic/strong herb given ingredients)
Chuan Wutou (Aconiti Radix Preparata / Prepared Aconite Root, peeled and de-veined)
Chixiaodou (Phaseoli Semen Rubrum / Red Adzuki Bean)
Jili (Tribuli Fructus / Tribulus terrestris Fruit, stir-fried, thorns removed)
Dilong (Pheretima / Earthworm, cleaned, stir-fried)
Chuan Lianzi (Toosendan Fructus / Melia Toosendan Fruit, soaked in salt water, pips removed)
Huixiang (Foeniculi Fructus / Fennel Fruit, stir-fried)
Fangfeng (Saposhnikoviae Radix / Saposhnikovia Root, each one liang)
Wuyao (Linderae Radix / Lindera Root, five qian)
Grind all into fine powder. Cook with wine, form pills with wheat paste, sized like wutong seeds. Take fifteen pills per dose, swallowed with warm wine on an empty stomach; salt water is also acceptable. For women, boil vinegar, let cool to warm temperature, and swallow.

[Fang Ge/Song] Huang Wan treats the onset of ulcers; Chuanwu, Chixiaodou, and Jili together; Dilong, Chuanlianzi, stir-fried Huixiang; Fangfeng and Wuyao with wine paste are suitable.

Sisheng Wan
Dilong (Pheretima / Earthworm, cleaned, stir-fried)
Baifuzi (Typhonii Rhizoma / Typhonium Root)
Jiangcan (Bombyx Batryticatus / Silkworm)
Caowu (Aconiti Kusnezoffii Radix / Kusnezoff Monkshood Root, peeled and tip removed, prepared)
Wulingzhi (Trogopterori Faeces / Trogopterus Dung)
(Equal parts)
Grind all into fine powder. Form pills with rice paste, sized like wutong seeds. Take thirty to forty pills per dose, swallowed with tea or wine before meals.

[Fang Ge/Song] Sisheng treats chronic lingering ulcers; bone joints often hurt, movement is difficult; Dilong, Baifu, stir-fried Jiangcan; Caowu and Wulingzhi with rice paste pills.

Hujian Wan
Baiguiban (Testudinis Carapax et Plastrum Preparata / Tortoise Shell prepared with酥 roasting, four liang)
Zhimu (Anemarrhenae Rhizoma / Anemarrhena Rhizome)
Huangbai (Phellodendri Cortex / Phellodendron Bark, these two stir-fried with salt and wine)
Shudi (Rehmanniae Radix Preparata / Prepared Rehmannia Root, each three liang)
Niuxi (Achyranthis Bidentatae Radix / Achyranthes Root, steamed with wine)
Baishao (Paeoniae Radix Alba / White Peony Root, stir-fried with wine)
Chenpi (Citri Reticulatae Pericarpium / Tangerine Peel, moistened with salt water, each two liang)
Suoyang (Cynomorii Herba / Cynomorium Herb, moistened with wine)
Danggui (Angelicae Sinensis Radix / Dong Quai Root, washed with wine, each one liang five qian)
Hujinggu (Pantheris Os / Panther Bone, prepared with酥 roasting, one liang)
Grind all into powder. Cook male sheep meat in wine until tender, mash into paste, mix with the herbal powder to form pills, sized like wutong seeds. Take three qian per dose, swallowed with light salt water on an empty stomach. In winter, add one liang of Ganjiang (Dried Ginger).

[Fang Ge/Song] Hujian Wan treats flaccidity of tendons and bones; deficiency-cold of Lower Yuan, deficiency of essence and blood; Guiban, Suoyang, Niuxi, Hujing; Zhibo, Shaoyao, Chenpi, Shudi, Danggui.