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Gucao Feng (a surgical disease characterized by pain in the preauricular and cheek regions, with rotting of bones and sinews) involves fire pathogens of the Sanjiao (Triple Burner) and Stomach meridians. It presents as a dull pain in the area anterior to the ear and the cheeks. If it suppurates and ulcerates, the bones and sinews remain stiff and painful, accompanied by trismus (lockjaw), which is caused by the invasion of pathogenic wind.

[Note] This condition is also known as "Yacha Fa" or "Chuansai Fa." It arises from wind-fire pathogens of the Hand-Shaoyang Sanjiao Meridian and the Foot-Yangming Stomach Meridian. The pathology begins anterior to the ear and extends to the cheeks, causing dull pain in the bones and sinews. Over time, it suppurates and ulcerates; the bones and sinews inside and outside the cheek remain diffusely swollen, hard, and painful, with trismus. These symptoms are all due to pathogenic wind deeply invading the bones and sinews. Since this condition resides in the Yin aspect of the bones and sinews, the initial swelling and hardness are difficult to dissipate, and after ulceration, the wound fails to heal, often leading to death.

In the early stage, if heat is not severe, internally administer Qingyang Sanhuo Tang (Clear Yang and Disperse Fire Decoction). Externally, use Qingwei San (Stomach-Clearing Powder) to rub the teeth, and apply Zhenjun Miaotie San (True Lord's Miraculous Paste Powder) to the cheek. If, after releasing the exterior in the early stage, the patient is robust and fire pathogens are blazing, use Cishi (Spines of Trichosanthes Fruit), Dahuang (Rhubarb Root), Gancaojie (Ganoderma Lucidum Stem End), Baizhi (Angelicae Dahuricae Radix), and Jiangcan (Bombyx Batryticatus) to purge. Subsequently, reduce the dosage of Dahuang and add Sheng Shigao (Gypsum Fibrosum) to clear heat. However, cold-cooling herbs should not be overused, lest they cause coagulation. If there is hard swelling that has persisted for a long time due to neglected treatment and cannot fully dissipate, and pus formation is imminent, use Zhonghe Tang (Harmonizing Decoction) to support the healthy qi and expel toxins. For cases already ulcerated, follow the treatment methods outlined in the Ulcerative Sores section. There are also cases where excessive consumption of cold-cooling herbs leads to muscles becoming hard, solid, rotten, and foul-smelling. In such cases, Lizhong Tang (Regulate the Middle Decoction) combined with Fuzi (Aconite Lateral Root) is required to restore Yang, and Jiangcan (Bombyx Batryticatus) is needed to search out wind. Following this treatment, most symptoms will subside. However, if trismus persists and the mouth cannot open, place slices of fresh ginger on the Jiache acupoint (located 0.5 cun below the earlobe in the depression) and moxibustion should be applied for 14 moxa cones (Zhuang). Perform moxibustion daily. Additionally, prick the area at the end of the teeth inside the mouth to induce bleeding, which will relieve the trismus. If chills and fever persist, the body becomes emaciated and withered, phlegm is profuse and eating is impossible, or oral rot occurs, even penetrating the cheek and causing tooth loss, these are all adverse signs (indicating poor prognosis). When rot first begins, the treatment is similar to that for Yagan (Gangrenous Gingivitis/Stomatitis); it is merely an attempt to do one's utmost.

Qingwei San (Stomach-Clearing Powder)
Ingredients: Jianghuang (Curcuma Longae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Xixin (Asari Radix et Rhizoma), Chuanxiong (Ligusticum Chuanxiong Rhizoma), in equal parts, ground into fine powder. First rinse the mouth with salt water, then rub the powder on the painful teeth.
[Fang Ge - Prescription Verse] Qingwei San rubbed on the teeth treats swelling and pain; composed of Jianghuang, Baizhi, Xixin, and Chuanxiong. Grind together, rinse with salt water first, then apply this medicine externally for miraculous efficacy.

Zhonghe Tang (Harmonizing Decoction)
Ingredients: Baizhi (Angelicae Dahuricae Radix), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix), Huangqi (Astragali Membranacei Radix) (each 1 qian), Huoxiang (Pogostemonis Herba) (0.5 qian), Rougui (Cinnamomi Cortex) (0.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Chuanxiong (Ligusticum Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba, wine-fried) (each 1 qian), Maimendong (Ophiopogonis Radix, heart removed) (0.5 qian).
Preparation: Add two cups of water, three slices of fresh ginger, and two jujubes. Decoct until reduced to 0.8 cup. Add one cup of wine and take after meals.
[Fang Ge - Prescription Verse] Zhonghe Tang treats Gucao Feng, for long-standing cases not resolving, about to form pus. Contains Baizhi, Jiegeng, Renshen, Huoxiang, Rougui, Gancao, Baizhu, Chuanxiong, Danggui, Baishao, and Maimendong.

Lizhong Tang (Regulate the Middle Decoction) (See Ulcerative Sores Section)
Zhenjun Miaotie San (True Lord's Miraculous Paste Powder) (See Swollen Ulcers Section)
Shengyang Sanhuo Tang (Raise Yang and Disperse Fire Decoction) (Formula seen in Cheek Ulcers Section)