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Xue Lizhai stated: Warts (cutaneous growths) belong to the Liver and Gallbladder meridians. They are caused by wind-heat combined with blood dryness, or by anger stirring up Liver fire, or by pathogenic qi invading the Liver channel. Since Liver heat depletes Kidney water and Kidney qi fails to nourish, it results in essence depletion and tendon contraction. It is advisable to use Dihuang Wan (Rehmannia Pill) to nourish Kidney water to generate Liver blood, which yields the best results. If one employs external treatments such as wrapping with spider silk, erosion with mantis saliva, or moxibustion, it will inevitably lead to numerous therapeutic errors. Generally speaking, this condition is similar to tubercles caused by blood dryness. Therefore, if corrosive agents are used externally and blood-drying detoxifying herbs are taken internally, essence and blood will be further depleted, Liver tendons will be damaged, wound edges will evert and open, ultimately resulting in intractable complications.

Zhu Hongren, a student at the Prefectural Academy, aged twenty, developed five warts on the dorsum of his right hand near the middle finger. The largest was the size of a soybean, while the others were clustered like millet grains. When pulled, they extended like threads, measuring about three to four cun in length. This indicated blood dryness and tendon contraction. He was treated with Qinggan Yirong Tang (Liver-Clearing and Nourishing Decoction) for over fifty doses and recovered.

Madam Shen Wen, a student's mother at the Prefectural Academy, had a habit of biting her fingernails since childhood, which she could not control as she grew older. I said this was due to Liver fire and blood dryness. She also frequently developed small warts on the side of her neck, which would disperse but recur repeatedly. A lump the size of a mung bean appeared on her arm; if crushed upon touch, it resembled broken bundles of thread, elongating when pulled and shrinking when released. Later, white spots appeared in her temples, prompting her to seek treatment. I said: You have a history of Liver disease, and this area also belongs to the Liver and Gallbladder meridians. Nails are the surplus of tendons, and the Gallbladder meridian runs along the sides of the body, corresponding precisely to symptoms like nail-biting and wart formation. One must nourish Kidney water to generate Liver and Gallbladder qi, whereupon all diseases will heal spontaneously. I prescribed Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) for two years. The white spots receded naturally, and no new warts formed.

A man presented with a mass in his lower abdomen that caused intermittent attacking pain. Treatments involving Qi-moving and phlegm-resolving herbs were ineffective. He believed himself to suffer from "Blood鳖" (a type of blood stasis nodule) and took formulas for moving Qi and expelling blood. Subsequently, a wart formed on the dorsum of his hand, growing to over an inch, shaped like a turtle. Many bean-sized nodules appeared between his joints. Suspecting that a "turtle offspring" had manifested externally, he attempted blood-invigorating treatments. Consequently, deficiency syndromes fully emerged. His left Chi pulse was flooding and rapid, and the Guan pulse was flooding, rapid, and wiry. I diagnosed this as Kidney water failing to nourish Liver wood, leading to Liver fire, blood dryness, and tendon contraction. I administered Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to generate Kidney water and nourish Liver blood. After more than three months, all symptoms resolved.

A woman presented with five or six warts on the dorsum of her left hand and ring finger, resembling ripe mulberries. She suffered from internal heat and afternoon fever, and her menstruation consistently occurred early. I stated this was due to Liver and Spleen blood deficiency with heat. Treatment should regulate and tonify these two meridians so that Yin blood generates and symptoms resolve. Disbelieving this, she underwent moxibustion on her hand, which immediately caused swelling and fever, with all fingers becoming contracted. Warts subsequently appeared on both hypochondriac regions, the neck, chest, and breasts, and her menstruation became irregular. I prescribed Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with a small amount of stir-fried and charred Huanglian (Coptis Rhizome). After several doses, she gradually improved. I then removed Huanglian and added Guipi Tang (Restore the Spleen Decoction). Each lesion gradually healed. After over a hundred doses, her menstruation returned to its regular cycle. Finally, she took three doses of Dihuang Wan (Rehmannia Pill) and made a full recovery. (All cases annotated by Xue Ji)