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Si Wu Tang (Four Substances Decoction), Ba Wei Wan (Eight-Ingredient Pill with Rehmannia), Ba Zhen Tang (Eight Treasure Decoction) (all seen in the Ulcer Section)
San Yin Sheng Jun Wan (Three Causes Victory Pill) (seen in the Osteomyelitis Section)

The condition referred to as "Fish Mouth and Anal Swelling" (Yu Bian): the left side is called "Fish Mouth" (Yu Kou), and the right side is called "Anal Swelling" (Bian Du). Generally, it is caused by the intermingling of essence and blood, resulting in a swelling formed between the junction of the two thighs. If it occurs nearby below the lower abdomen, beside the pubic hair, forming a swelling, it is named "Heng Xuan" (Transverse Abscess), also known as "Wai Shan" (External Hernia). This disease arises from retaining semen during intercourse, forcibly holding back ejaculation, or having sexual desire aroused but stopping without completion, leading to the stagnation and coagulation of moving essence and blood, which knots into a swelling. Treatment should focus on dispersing stagnation, promoting blood circulation, and unblocking both large and small intestines. Formulas such as Jiu Long Dan (Nine Dragons Pill) and Shan Jia Nei Xiao San (Pangolin Internal Resolution Powder) are used. After seven days, taking these medicines strengthens the root; fearing suppuration, it is advisable to puncture with fire needles, which is also effective. For those who have already discharged pus, taking Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) facilitates healing. Delaying treatment risks developing other difficult-to-cure complications.

If at the onset there is a swelling that is not red, slightly warm, walking is slightly convenient, and there is no alternating chills and fever, it is a mild case. If it has progressed to redness, swelling, heat, pain, difficulty in movement, and worsening at night, it is relatively easier to treat (compared to severe cases). If after ulceration the pus is thick, the flesh color is vibrant red, swelling subsides, pain stops, new flesh grows easily, and itching occurs, it is a favorable prognosis. If at the onset the swelling is hard as stone, causing pulling and stabbing pain, inconvenience in rising and sitting, accompanied by chills and fever, it is a severe case. If after ulceration there is rotting, persistent swelling and pain, thin purulent discharge, deep ulcers with wide openings that do not heal, it is a dangerous case.

At the onset with diffuse swelling, painful nodules, pulling stiffness in both groin areas, and systemic chills and fever, one should disperse exterior pathogens. If it becomes hard, with fever, pain, internal heat, dry mouth, and constipation of urine and stool, one should promote urination and bowel movements. After dispersing and purging, if swelling and pain persist and suppuration is desired, one should use the method of supporting the interior and detoxifying. If swelling and heat persist for a long time with severe distending pain, indicating internal pus formation, urgent incision and drainage are required. After ulceration, if pus does not dry up and new flesh grows slowly without closing, strengthen the spleen and stomach, and tonify qi and blood.

A male patient presented with swelling and pain in the left groin, accompanied by chills and fever, and a wiry and rapid pulse. One dose of Ren Shen Bai Du San (Ginseng Detoxification Powder) resolved all exterior symptoms, followed by two doses of Shan Jia Nei Xiao San (Pangolin Internal Resolution Powder) leading to complete resolution.
A male patient suffered from Heng Xuan (Transverse Abscess) with hard swelling and pain, and obstructed urination and defecation. One dose of Jiu Long Dan (Nine Dragons Pill) promoted bowel movement and slightly reduced swelling and pain; another dose taken every other day led to free urination and defecation and resolution of the swelling.
A male patient had this condition for over ten days, with established severity and increasing daily swelling and pain. Due to urgent official business, he went out and could not walk. He was treated with fire needle acupuncture, draining about one bell-full of dark purple blood. External application of ointment drew out a small amount of pus, and oral administration of Tuo Li Xiao Du San (Interior-Supporting Detoxification Powder) allowed him to walk again, leading to a speedy recovery.
A male patient had an ulcerated wound with a wide opening that failed to heal, due to prior misuse of purgative drugs. He was treated with Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) plus Ze Xie (Alisma Rhizome) and Mu Dan Pi (Moutan Cortex) for over ten doses, and external application of Yu Hong Gao (Jade Red Ointment) for over a month until healed.
A male patient first developed Chan Chuang (Chancre) which did not heal for a long time, later developing Heng Xuan (Transverse Abscess) with swelling and pain starting after ten days. I intended to use interior-supporting methods to induce suppuration and expel toxic factors, but he desired internal resolution and self-administered Huai Hua Jiu (Sophora Flower Wine), Wu Gong (Centipede), and Quan Xie (Scorpion). The swelling did not subside, his healthy qi was damaged, leading to bone and joint pain and difficulty in movement. He sought treatment again. His body was emaciated, and his pulse was deficient and rapid, indicating injury to the primordial qi with pathogenic invasion. Although tonification was necessary, he would eventually need to develop a Chan Chuang (chancre) to recover. Disbelieving this, he continued taking Bai Du Xiao Feng San (Detoxification and Wind-Dispersing Powder), further depleting his qi, losing appetite, suffering severe bone/joint pain, and insomnia. He sought treatment again. First, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with doubled Ginseng and Astragalus was given for six doses, slightly restoring his qi. Then, Ba Zhen Tang (Eight Treasure Decoction) plus Mai Men Dong (Ophiopogon Tuber), Wu Wei Zi (Schisandra Fruit), Yuan Zhi (Polygala Root), Suan Zao Ren (Ziziphus Seed), and Mu Dan Pi (Moutan Cortex) was administered for over ten doses, allowing him to sleep at night, though pain remained significant. This indicated internal deficiency with sinking of toxic sores, making efficacy difficult. Morning doses of Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and noon doses of Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) were given for over ten doses, after which red spots appeared all over his body. This indicated the toxic sore was trying to erupt. Continuing the previous medicine, the red spots raised and formed pustule-like structures. Once the toxic sore erupted, pain decreased instantly, and qi gradually recovered. Further administration of Ba Zhen Tang (Eight Treasure Decoction) plus Yi Yi Ren (Coix Seed), Jin Yin Hua (Honeysuckle Flower), and Tu Fu Ling (Smilax Glabra Rhizome) for half a year finally led to gradual recovery. He regretted his stubborn adherence to fixed formulas and finally believed in the wisdom of prescribing according to the specific disease.