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After ulceration, if nocturnal emission occurs leading to the loss of essence, a sinus tract (a chronic draining channel) will form. If the patient has had this condition previously, first cure it with Jiawei Liuwei Wan (Modified Six-Ingredient Rehmannia Pill) [General Formula 46], and then treat the sinus tract. The method involves using moxibustion with Aconite Cake or Fermented Soybean Cake (both see General Moxibustion Methods) according to the size of the lesion, applying heat until slightly warm but not painful, replacing the cake when dry. Apply 20–30 moxa cones per session. After moxibustion, insert Xiaoguan Ding (Sinus-Clearing Stick) [General Formula 64] or Zhentou San (Needle-Head Powder) [General Formula 65] into the tract to dissolve necrotic tissue. If the depth is unknown, probe first with a pig bristle, then roll medicinal powder in cotton paper to make a medicated wick, inserting it according to size and depth, changing and reinserting daily until healed.

This condition can occur in people of any age, mostly on the gums, under the chin, hands, feet, legs, and arms. Because prolonged ulceration allows toxic factors to linger, and external cold pathogens invade due to lack of protection, if no bone fragments are expelled after one week of exposure to wind, it indicates there are no deep bone sequestra. Administer strong warming and tonifying agents that resolve phlegm to prevent recurrence.
In infants, hard-like structures resembling brittle bones may be felt within the flesh, caused by the intermingling of essence and blood during conception. When the individual grows up, if these areas break open, remove them. The treatment methods are the same.

When severe sores allow toxic factors to attack internally, it is often due to medication errors, specifically poisoning from purgative drugs, leading to symptoms such as coma, restlessness, nausea, and vomiting. Immediately use Sheng Gancao Yi Xiao Wan (Raw Licorice One-Reduction Pill) [General Formula 47] to suppress the severity.

Wind-stroke following trauma (Po Shang Feng) results from skin and flesh injuries caused by falls or metal blades, or from old and new ulcers failing to close due to inadequate care, allowing wind pathogens to invade the meridians through deficiency. Urgent action is required; otherwise, rescue is impossible. Key is early intervention: initial symptoms include fever, aversion to wind, muscle spasms, trismus (lockjaw), rustiness and swelling at the wound site, or millet-grain-like itching around the area. This indicates wind-heat still stagnating in the exterior. Immediately administer Yuzhen San (Jade True Powder) [General Formula 40], two qian, mixed with warm wine, cover with blankets, and sleep for about an hour to dissipate the pathogen. If the pathogen penetrates deeply, presenting with stiff tongue, locked jaw, opisthotonos (arching of the back), foaming at the mouth, unconsciousness, and continuous limb convulsions, take three qian of Yuzhen San mixed with child’s urine (Tong Bian). Even with blood stasis, it will heal. In cases of apparent death where the heart and abdomen remain warm, quickly administer two doses of Yuzhen San to preserve life. Clean the wound with hot child’s urine, apply powdered raw Tian Nan Xing (Arisaema Rhizome) topically or mixed with water; discharge of fluid is ideal. Once the wind-pathogen subsides, proceed with Bazhen Tang (Eight-Treasure Decoction) [General Formula 25] to nourish qi and blood.