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Heel abscess (Zu Gen Ju) arises at the heel, commonly known as "Jiao Luan Gen" (foot spasm root), presenting with a purple-red appearance resembling a rabbit bite. This condition is caused by accumulated heat in the Yang Qiao Mai (Yang Heel Vessel), leading to ulceration that is difficult to heal; early treatment should involve frequent moxibustion with garlic slices (Ge Suan Jiu).

[Note] This lesion occurs on the heel, colloquially called "Jiao Luan Gen." It results from accumulated heat in the Zang-Fu organs, exposure to water while sweating, and injury to the tendons from long-distance walking. Initially, there is swelling, redness, purplish discoloration, and pain. Upon ulceration, pus drains continuously, and the shape resembles a rabbit bite. The Classics state: "The 'rabbit bite' sore resembles a red bean; if it reaches the bone, urgent treatment is required, otherwise it will harm the patient." This refers to the depth and malignancy of the toxin. The disease belongs to the Foot-Taiyang Bladder Meridian, specifically the Shenmai (BL62) acupoint, which is the source of the Yang Qiao Mai (Yang Heel Vessel) and also a pathway for the Kidney Meridian. If the wound remains unhealed for a long time, the Qi of the Yang Qiao Mai cannot surge forth, causing Kidney Qi to leak, thereby exacerbating the patient's deficiency. In the early stage, moxibustion with garlic slices is indicated, along with the administration of Xian Fang Huo Ming Yin (Immortal Life Elixir Decoction) supplemented with Rou Gui (Cinnamon Bark) and Niu Xi (Achyranthes Root). After ulceration, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Ren Shen Yang Rong Tang (Ginseng Nourishing the Nutritive Decoction), and Gui Fu Di Huang Wan (Cinnamon and Aconite Rehmannia Pill) should be prescribed according to symptoms to nourish and tonify.

Commentary: In the section on Carbuncles and Ulcers, Haizang (Zhang Yuansu) stated: "For 'rabbit bite' sores that do not heal over time, wash with salt water, apply powdered Bai Zhu (Atractylodes Macrocephala Rhizome) to the area, change every two days, and strictly avoid all exertion for effectiveness."

Image of Heel Abscess

Moxibustion with Garlic Slices (see Moxibustion Methods in Volume 1)

Xian Fang Huo Ming Yin (Immortal Life Elixir Decoction) (see Swollen Ulcer Section)

Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction); Ren Shen Yang Rong Tang (Ginseng Nourishing the Nutritive Decoction) (both see Ulcerated Ulcer Section)

Gui Fu Di Huang Wan (Cinnamon and Aconite Rehmannia Pill) (see Facial Cheek Ulcer Section)

Li Yong (Fierce Carbuncle) is small in size and arises beside the foot; Si Yin (Four Extremities) condenses above and below the foot. Gangrene (Ju) resulting from the deficiency of the Three Yin meridians is severe; Carbuncle (Yong) arising from damp-heat in the Three Yang meridians is mild.

[Note] The *Ling Shu* states: "Arising above and below the foot, it is named Si Yin (Four Extremities); its presentation is a large carbuncle, requiring urgent treatment, or death within one hundred days. Arising beside the foot, it is named Li Yong (Fierce Carbuncle); its presentation is not large, requiring urgent treatment to remove black necrotic tissue. If it does not subside but worsens, and is untreated, death occurs within one hundred days." Both conditions result from the deficiency of the Foot-Sanyin meridians; those classified as Gangrene are severe. If accompanied by damp-heat pouring downward from the Foot-Sanyang meridians, forming a Carbuncle, the condition is milder. If there is redness, swelling, pain, and pus upon ulceration, with sloughing off of dead tissue and no spreading black gas, it indicates predominant damp-heat, representing a favorable syndrome that is easy to treat. If there is slight redness and swelling, with pus drainage indicating congealed Yin Qi unable to transform into pus, it represents a dangerous syndrome that is difficult to treat. If there is dark, diffuse swelling, pain without suppuration, accompanied by irritability, fever, thirst, and dribbling urination, it is a malignant syndrome of Yin collapse, representing an unfavorable syndrome. Si Yin has no distinct borders, and Li Yong resembles Dun Ju (Dun Gangrene). In the early stage, both are suitable for Xian Fang Huo Ming Yin (Immortal Life Elixir Decoction) internally and garlic slice moxibustion externally to disseminate stagnant toxins. As ulceration approaches, Ren Shen Yang Rong Tang (Ginseng Nourishing the Nutritive Decoction) should be taken, combined with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) for nourishment. If the color is dark and painless, the Sang Chai Hong Fa (Mulberry Wood Roasting Method) should be used to move stagnation and assist Yang Qi. Additionally, Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) combined with Gui Fu Di Huang Wan (Cinnamon and Aconite Rehmannia Pill) should be used to strengthen the Spleen and nourish Water, which may lead to success. The reckless use of bitter-cold draining herbs often leads to untreatable conditions. External treatments are the same as for Dun Ju.

Image of Li Yong

Image of Si Yin

Xian Fang Huo Ming Yin (Immortal Life Elixir Decoction) (see Swollen Ulcer Section)

Moxibustion with Garlic Slices (see Moxibustion Methods in Volume 1)

Ren Shen Yang Rong Tang (Ginseng Nourishing the Nutritive Decoction); Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) (both see Ulcerated Ulcer Section)

Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) (see Facial Freckle Section)

Sang Chai Hong Fa (Mulberry Wood Roasting Method) (see Volume 1)

Gui Fu Di Huang Wan (Cinnamon and Aconite Rehmannia Pill) (see Facial Cheek Ulcer Section)