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Zouma Gan (Horse-Racing Gangrene, a rapidly progressing form of necrotizing ulcerative gingivitis/stomatitis) refers to the condition's rapid progression and the necessity for immediate treatment without delay. This disease is mostly caused by residual toxins from Sha Dou (exanthematous diseases such as smallpox and measles), or it may arise from extreme heat in other miscellaneous diseases. The symptoms manifest as rotting of the gum roots, which subsequently turn black, become necrotic, and emit a foul odor. In severe cases, the gum roots fall out, and the alveolar bone turns black and decays; within a few days, it may penetrate the cheek and rupture the lips, truly constituting an incurable condition. At the initial stage, one should administer Lushao Xiaogan Yin (Aloe Vera Decoction for Eliminating Gangrene) internally, and apply Renzhongbai San (Human Urine Deposit Powder) or Bingpeng San externally to the affected area. If the black necrotic tissue is removed and red flesh with bleeding appears, it is a favorable sign. However, if during the removal process, stubborn granulation tissue does not detach, the necrosis gradually spreads, swelling disperses outward, the foul odor persists, and fever remains unrelieved, these are all signs of untreatability.

Lushao Xiaogan Yin (Aloe Vera Decoction for Eliminating Gangrene)
Prescription Verse: Lushao Xiaogan Yin Bohe, Xuanshen Gancao Gong Chaihu, Shengma Niuzi Lingyangjiao, Zhizi Huanglian Zhuye Fu.
Indications: Treats pediatric Zouma Yagan (Horse-Racing Dental Gangrene), characterized by fever, coarse breathing, gum rot, foul odor, and complications such as cheek penetration and lip rupture. It can be taken for all such cases.
Ingredients: Lushao (Aloes), Yinchaihu (Stellariae Radix), Huhuanglian (Coptidis Rhizoma var. chinense), Chuan Huanglian (Coptidis Rhizoma), Niubangzi (Arctii Fructus), Xuanshen (Scrophulariae Radix), Jiegeng (Platycodonis Radix), Shanzhi (Gardeniae Fructus), Shigao (Gypsum Fibrosum), Bohe (Menthae Haplocalycis Herba), Lingyangjiao (Saiga Tataricae Cornu) (each 0.5 fen); Gancao (Glycyrrhizae Radix et Rhizoma), Shengma (Cimicifugae Rhizoma) (each 0.3 fen).
Administration: Use two zhong of water and ten slices of Dan Zhuye (Lophatheri Herba), decoct until reduced to six-tenths, and take after meals.

RenZhongbai San (Human Urine Deposit Powder)
Prescription Verse: Renzhongbai San Gong Qijue, Huangbai Ercha Qingdai Lie, Bohe Bingpian Yao Jingyan, Kougan Chan Shang Tang Woxue.
Indications: Extremely effective for pediatric Kougan (Oral Gangrene), Zouma Gan, and gum rot with blackening and foul odor.
Ingredients: Renzhongbai (Human urine deposit; those from urinals are preferred, calcined until red, 2 liang), Ercha (Child's tea/Catechu, 1 liang), Huangbai (Phellodendri Cortex), Bohe (Menthae Haplocalycis Herba), Qingdai (Indigo Naturalis) (each ground into powder, 6 qian), Bingpian (Borneolum Syntheticum) (0.5 fen).
Administration: Grind all ingredients together into an extremely fine powder. First, rinse the mouth clean with warm water. Then, blow the powder onto the gan lesions. Apply 6-7 times daily. If saliva flows out from the exterior after application, it is a favorable sign; if the toxin is retained internally, it is an ominous sign.

Bingpeng San (See the Throat Chapter)

Five Untreatable Conditions of Yagan (Dental Gangrene):
1. Foul breath and turbid saliva: Untreatable (1st).
2. Black necrotic tissue that does not detach: Untreatable (2nd).
3. Tooth loss without bleeding: Untreatable (3rd).
4. Penetration of the cheek and rupture of the lips: Untreatable (4th).
5. Ineffectiveness of medication: Untreatable (5th).