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Ulcers in the vagina of women are mostly caused by the downward pouring of damp-heat, or fire generated from emotional stagnation, or heat-toxin invasion due to excessive application of medications. The external manifestations include: tissue protruding from the vagina like a snake's head, termed "Yin Ting" (vaginal prolapse); lesions resembling mushrooms, termed "Yin Jun"; lesions resembling chicken combs; presence of parasites with dampness and itching; or internal ulceration with swelling, rotting, pain, and frequent discharge of toxic pus. The internal manifestations include: fatigue and internal heat sensation, irregular menstruation; poor appetite and afternoon tidal fever; abdominal distension and fullness, discomfort in the waist and hypochondrium; dribbling urination, and mixed leukorrhea with blood (red and white discharge).

Regarding treatment methods for these conditions: If there is swelling, pain, and ulceration both internally and externally, Shaoyao Jili Decoction (Peony and Tribulus Decoction) is the best choice. Alternatively, Siwu Tang (Four Substances Decoction) can be used with added Gardenia, Moutan Cortex, Gentian Root, and Schizonepeta. Or Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) may be employed. If the primary symptom is dampness and itching, Shaoyao Jili Decoction is suitable, or Guipi Tang (Restore the Spleen Decoction) with added Bupleurum, Gardenia, and Moutan Cortex. For urinary dribbling and涩 (astringency), Longdan Xiegan Tang (Gentian Liver-Draining Decoction) with added Atractylodes Macrocephala Rhizome and Moutan Cortex is indicated. If accompanied by intense heat, pain, and distension, Dali Qingyin (Great Purification Drink) or Chouxin Yin (Draw Out the Fire Drink) should be used. For swelling with a bearing-down sensation and toxicity, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Gardenia and Moutan Cortex is appropriate. For external washing, Baicao Jian (Hundred Herbs Decoction) can be used. For external application, Piaoxiao San (Sepia Powder) or Wanchuang San (Complete Ulcer Powder) is recommended.

Shetui San (Snake Slough Powder): Treats vaginal ulcers in women. First, fumigate and wash the area with a decoction of Schizonepeta and Cnidium Fruit, dry it, and then apply the medicine.
Ingredients: Shetui (Snake Slough, one strip, calcined to retain its properties), Mingfan (Alum), Huangdan (Lead Monoxide), Lubucao (Polygonum Aviculare Herb), Jingben (Ligusticum Chuanxiong Rhizome) (each 1 liang), Liuhuang (Sulfur), Jingjiesui (Schizonepeta Spike), Chuangzi (Cnidium Fruit) (each 5 qian).
Preparation and Usage: Grind all ingredients into a fine powder. Mix with sesame oil for topical application; if the area is wet, sprinkle the dry powder directly.

Vaginal itching in women must involve vaginal parasites. Mild cases present with itching, while severe cases involve pain, possibly with purulent discharge. This condition, often transformed from damp-heat, is named "Yin Shi" (Vital Erosion). Internal treatment should clear Liver Fire, primarily using Longdan Xiegan Tang (Gentian Liver-Draining Decoction) and Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). External treatment involves grinding Peach Kernel into a paste, mixing it with Realgar powder, or inserting it along with Nangan Gan (likely a typo for a specific liver preparation or herb, interpreted here as animal liver preparation) into the vagina to control the parasites. However, applying Yin Zhu Yan (Silver Cinnabar Smoke residue) on Chicken Liver and inserting it is particularly effective.

Jiaozhu Tang (Pepper and Evodia Decoction): Treats unbearable vaginal itching in women. The hot water is so hot that one cannot keep their hands in it.
Ingredients: Huajiao (Sichuan Pepper), Wuzhuyu (Evodia Fruit), Chuangzi (Cnidium Fruit) (each 1 liang), Lilu (Veratrum Rhizome) (0.5 liang), Chencha (Aged Tea) (a pinch), Chaoyan (Stir-fried Salt) (2 liang).
Preparation and Usage: Boil in five sheng of water to make a decoction. Fumigate and wash while hot.

Xingren Gao (Apricot Kernel Paste): Treats unbearable vaginal itching.
Ingredients: Xingren (Apricot Kernel, calcined to retain its properties), Shexiang (Musk) (a small amount).
Preparation and Usage: Grind into powder. Wrap in old cloth, secure it, heat over fire, and insert into the vagina.

Chungenpi Tang (Toosendan Bark Decoction): Treats vaginal itching with protrusion.
Ingredients: Chouqunpi (Ailanthus Bark), Jingjiesui (Schizonepeta Spike), Huoxiang (Patchouli Herb) (equal parts).
Preparation and Usage: Cut into pieces, boil in water for fumigation and washing. Itching stops and protrusion retracts.

Another prescription: Treats gan parasites eroding the lower body. Apply a mixture of Pulhuang (Lygodium Spore) and Shuiyin (Mercury) evenly. Externally, fumigate and wash with a decoction of Heshi Cao (Nemesis Herb).

Zhigan San (Roasted Liver Powder): Treats vaginal itching and parasitic erosion in women. Use beef liver or pork liver, cut into three-cun long slices, size of a coin, roast until cooked, and insert into the vagina to draw out parasites completely, leading to recovery.

Another prescription: Treats parasitic itching in the vagina. Crush peach leaves, wrap in cotton, and insert into the vagina. Change three to four times daily.

Another prescription: Treats vaginal itching. Use one liang of Chuangzi (Cnidium Fruit) and five qian of Baijian (White Alum). Boil in water for douching/washing.