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[Qianglang Zhu (Dung Beetle Bore)] This condition arises from the accumulation of phlegm-dampness and qi stagnation. It manifests as hard swelling of the finger joints, resembling the abdomen of a cicada. Initially painless, it becomes painful after a long duration; if ulcerated, it discharges clear pus, and prolonged non-healing leads to "chuang lao" (chronic consumptive ulcer).

[Note] This syndrome typically occurs in the finger joints of individuals with weak constitutions, caused by the stagnation of damp-phlegm and cold qi. At the onset, there is no redness, heat, or pain. Gradually, it becomes swollen and hard, shaped like a cicada's abdomen, making flexion and extension difficult. Only after a long time does numbness and pain become apparent. During the initial swelling phase, it is appropriate to first administer Liujunzi Tang (Six Gentlemen Decoction) to tonify qi, eliminate dampness, and resolve phlegm. Externally, Ligong Ding (Palace Separation Plaster) should be ground with ginger juice and applied, or combined with the use of Yangsui Ding (Sun Warming Plaster) for moxibustion on the hard and painful areas, which can cause the swelling to dissipate spontaneously. If treatment is neglected, the swollen area gradually becomes necrotic, discharging clear fluid continuously, while the swelling persists. Since the lesion is located at the joint, prolonged ulceration severely depletes qi and blood, often evolving into "chuang lao" (chronic consumptive ulcer). In this stage, Renshen Yangrong Tang (Ginseng Nourishing Harmony Decoction) should be taken prophylactically to tonify the body, and Chansu Bing (Toad Venom Cake) should be applied externally, supplemented with Tuoseng Gao (Monk Plaster). Young adults can be cured using this method; however, elderly patients or those who are emaciated and weak may not achieve recovery.

[Formula Notes]
Liujunzi Tang: Refers to Xiangsha Liujunzi Tang minus Huoxiang and Sharen. (See Chapter on Ulcerative Diseases)
Ligong Ding: (See Chapter on Ulcerative Diseases)
Yangsui Ding: (See First Volume, Moxibustion Methods)
Renshen Yangrong Tang, Tuoseng Gao: (Both see Chapter on Ulcerated Diseases)
Chansu Bing: (See Chapter on Carbuncles)

[Chuang (Ulcer/Eczema)] This condition frequently occurs in the fingers and palms, appearing symmetrically on both hands, resembling the fruit of the cornel tree. It is accompanied by wind-damp induced itching and pain, discharge of yellowish-white fluids, recurrent episodes, and over time, a sensation of insect infestation.

[Note] This syndrome arises in the fingers and palms, shaped like cornel fruits, growing symmetrically on both hands. Sometimes they cluster together. Initially, yellow-white pustules appear, causing intermittent itching and pain. Upon rupture, yellow fluid drains out. The condition is recurrent and extremely stubborn. It is caused by wind-damp pathogens invading the skin and interstices. It should be treated by applying Runji Gao (Nourishing Muscle Ointment). If it persists without healing, the itching intensifies significantly, implying internal "worm" generation (referring to microbial infection or parasitic pathology). Treatment should focus on eliminating parasites/germs; applying Lilu Gao (Veratrum Ointment) is highly effective. Avoid foods that trigger wind, as well as chicken, goose, and fish, which are considered pungent/fishy foods.

[Preparation of Lilu Gao]
Ingredients:
Lilu (Veratri Radix), Kushen (Sophorae Flavescentis Radix) (each 1 liang)
Zhu Zhiyou (Porcine Lard) 8 liang. Fry the two herbs until scorched, filter out the dregs. Add Songxiang (Pini Resin) 1 liang, melt it, remove from fire, then add Kufan (Alumen) powder and Xionghuang (Realgar) powder, each 1 liang. Stir evenly. Apply when warm, continue until healed.

[Prescription Verse]
Lilu Gao uses Kushen effectively,
Fried in lard, filtered, mixed with Pini Resin.
Add Alumen and Realgar powder, stir well,
Eliminate parasites, stop itching, apply to ulcers.

Runji Gao: (See Chapter on Seborrheic Dermatitis of the Head)