Library

Chan Su Tiao (Cinnabar Toad Venom Strips, i.e., the previously mentioned Chan Su Wan [Toad Venom Pill] shaped into strips and pressed into cakes for use)
Hupo Lafan Wan [Amber Wax Alum Pill], Yuhong Gao [Jade Red Ointment], Ruyi Jinhuang San [Ruyi Golden Yellow Powder], Huxin San [Heart-Protecting Powder], Tuoli Xiaodu San [Interior-Supporting and Toxin-Expelling Powder] (see chapter on Swollen Ulcers)
Bazhen Tang [Eight-Treasure Decoction], Yiqi Yangrong Tang [Qi-Nourishing and Blood-Enriching Decoction], Jiaban Bawei Wan [Modified Eight-Flavor Pill], Renshen Yangrong Tang [Ginseng Qi-Nourishing and Blood-Enriching Decoction] (see chapter on Ulcerated Lesions)
Zhenzhu San [Pearl Powder] (see chapter on Chancre)
Bingsi San [Ice Snail Powder] (see chapter on Scrofula)

Tuojie [Dry Gangrene/De-jie] refers to a condition where the exterior rots while the interior necroses. This is caused by habitual consumption of rich, greasy foods that steam and affect the Zang-Fu organs; or the use of Dan-Shi [cinnabar and stone] tonics that consume Kidney Water; or excessive sexual activity leading to exhaustion of Qi and injury of Essence... Often resulting in the stirring and confusion of Yang Essence, and the rampant flare-up of Yin Fire. The pathogenic factors accumulated within the Zang-Fu eventually transform into Dry Heat-Fire syndromes; the toxins accumulated in the bone marrow ultimately become Ju-Du [carbuncle toxin] and Yin Chuang [Yin sores]. It is indeed like a clever person acting clumsily; who can guard against disaster arising from within? The wise often act foolishly, believing joy comes from heaven, disregarding future calamities. Only when bones wither, marrow dries up, and Zang-Fu organs fail does one realize the cause of today's suffering, yet there is no way to escape it at that point.

Those afflicted with this disease mostly suffer on the hands and feet, as these are the branches and trunks of the Five Zang organs. When the sore first appears, its shape resembles millet grains, with a yellow blister at the head. The skin resembles a boiled red date. Black qi then spreads, affecting all five fingers, and may extend up to the top of the foot. The pain is severe, like hot water poured on fire or burning flames. The physical form shows withered bones and contracted tendons. The odor is foul and difficult to resolve. Even immortal prescriptions cannot save life. Thus, it is said: if blood dies, Heart fails; if tendons die, Liver fails; if flesh dies, Spleen fails; if skin dies, Lung fails; if bones die, Kidney fails. With these five failures, even miraculous pills will only result in death. Therefore, those born with this illness leave their life and death to fate.

Sun Simiao said: "If the lesion is in the muscle, excise the muscle; if in the finger, amputate the finger." This refers to this disease. Treatment must be early. While the pathogen has not yet spread, use more than ten strands of hair to wrap tightly around the proximal interphalangeal joint of the affected finger, winding it over ten times, gradually tightening it, so that toxic vapors do not invade healthy flesh. Then, place a Chan Su Bing [Toad Venom Cake] on the original millet-like spot, apply moxibustion until the flesh is necrotic and the sore dies. The next day, if the entire finger turns black, use a sharp knife to locate the joint seam, and gently remove the affected finger. If bleeding persists, use Jindao Rusheng San [Golden Knife Like Sage Powder] to stop it, and apply Miaotie San [Wonderful Adhesion Powder] to the remaining swelling. If black qi remains on the second day, grind Chan Su Ding [Toad Venom Ingot] into powder, sprinkle it on the lesion, cover with an ointment, and the black qi will recede naturally. Once pus forms, follow standard methods using Yuhong Gao [Jade Red Ointment] and other medicines to generate flesh, protect bone, and close the wound; this is an auspicious sign. Internally, administer decoctions that nourish Kidney Water, tonify Qi and Blood, strengthen the Spleen, and calm the Spirit. If there are no internal complications or external mixed symptoms, three or four out of ten patients may survive. However, if after amputation the blackness still spreads, pain and swelling worsen, the wound is necrotic without pus, the mouth is dry with a stiff tongue, spirit is listless, and taste is lost, death is inevitable.

In treating this disease, one should not rely on personal opinion alone but must consult with eminent physicians and respect the patient's willingness to undergo amputation. Given that the prognosis of this condition varies and changes are unpredictable, surgery should not be used lightly. There are also cases that resemble this disease but are different in nature, or involve true acupoints but different etiologies; detailed notes are provided later for reference.