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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Wind pathogenic factors enter together with the Taiyang (Greater Yang) channel, circulate through various meridians, and their acupoint qi scatters between the muscle layers. It interferes with the Wei Qi (Defensive Qi), causing obstruction in the pathways, thus leading to discoloration and numbness of the muscles. The *Ling Shu* (Spiritual Pivot) advocates using sharp needles to puncture swollen areas to discharge evil blood. Modern predecessors stated that this condition is caused by contracting the harsh and malignant qi of heaven and earth. If symptoms appear first or predominantly on the upper body, the toxin is located above; if they appear first or predominantly on the lower body, the toxin is located below. Generally, when Qi is affected, pathology manifests more in the upper body; when Blood is affected, it manifests more in the lower body; when both Qi and Blood are affected, it manifests simultaneously in both upper and lower parts. If the eyebrows fall out first, the toxin is in the Lung; if purple blisters appear on the face, the toxin is in the Liver; if pain or ulceration starts on the soles of the feet, the toxin is in the Kidney; if the whole body resembles tinea (ringworm), the toxin is in the Spleen; if the eyes are damaged first, the toxin is in the Heart. These represent severe afflictions of the Five Zang Organs. The first type is "Skin Death," characterized by numbness and insensitivity; the second is "Flesh Death," where needle pricks cause no pain; the third is "Blood Death," characterized by rotting and ulceration; the fourth is "Tendon Death," characterized by finger detachment; the fifth is "Bone Death," characterized by the collapse of the nasal bridge. These five conditions represent irreversible damage to the Five Zang Organs. Hoarseness and blindness are particularly difficult to treat. Broadly speaking, this disease often results from labor-induced injury to Qi and Blood, loose interstices (pores), sexual activity after drunkenness or bathing, or climbing mountains and wading through water, allowing external pathogens to invade. The Wei Qi battles with the pathogens, damp-heat interacts with Ministerial Fire, and Blood transforms due to fire, leading to the disease. Therefore, it is common in Huaiyang, Lingnan, and Fujian regions. Treatment must differentiate the primary syndrome, accompanying syndromes, transformed syndromes, and similar syndromes, as well as Yin-Yang and Deficiency-Excess patterns. If dry and hot herbs are mistakenly administered, resulting in dripping pus and fluid, the Liver Blood will become drier, Wind-Heat will intensify, Kidney Water will be further injured, and Ministerial Fire will flare up, leading to a critical condition.

First, Leprosy (*Li Yang*) affects not just one Zang organ, but its Qi and Blood are invariably injured, and accompanying syndromes are invariably mixed. Moreover, since it accumulates over years before manifesting externally, one must distinguish the meridians. The Classics state: Depletion of True Qi constitutes Deficiency; Excess of Pathogenic Qi constitutes Excess. Whenever a disease is described as having "surplus" (Excess), it should be recognized as "insufficient" (Deficiency).

Second, one must understand that Leprosy has different transformed and similar syndromes, and treatment methods vary among sweating, purging, scarification, attacking, and tonifying. For accompanying syndromes, one must assess severity; for transformed syndromes, one must [differentiate]. Generally, Deficiency refers to the deficiency of Form and Qi, while Excess refers to the excess of Pathogenic Qi while Form and Qi remain deficient.

Third, regarding the scarification method for Leprosy, Zhang Hezi (Zhang Congzheng) said that one instance of sweating is equivalent to a thousand needle pricks. This is because discharging blood via scarification is less comprehensive than inducing sweating. However, inducing sweat is akin to discharging blood. If toxins are accumulated within the Zang organs, internal purification is required for recovery. If toxins are on the exterior, one must apply scarification to all affected areas on the body, as well as prick the spaces between fingers on both arms and legs, wrists, hands, and feet to discharge evil blood, otherwise the toxin cannot dissipate. If both interior and exterior are infected, external scarification and internal drainage are necessary to resolve it. If the upper body is predominantly affected, use *Zui Xian San* (Intoxicating Immortal Powder) to induce the discharge of accumulated evil blood from the gum margins, and prick the finger webs and arm/wrist areas to remove superficial toxic blood. If the lower body is predominantly affected, use *Zai Zao San* (Recreation Powder) to induce the discharge of evil blood and old worms from the anus, and still prick the toe webs and leg/wrist areas. Repeat the pricking every one or two days until the blood turns bright red. If symptoms such as chills, fever, and headache occur, one should greatly tonify Qi and Blood.

Fourth, if patients taking preparations containing Calomel (*Qing Fen*) experience abdominal pain and pass pus-like fecal matter, do not use medication to stop diarrhea. If there is swelling and pain in the mouth and tongue, with continuous flow of foul fluid, accompanied by thirst and heat in the Blood level, and constipation, this indicates internal flooding of Heat-Toxin. Use *Huang Lian Jie Du Tang* (Coptis Decoction to Relieve Toxicity). If bowel movements are normal, use *Ji Sheng Xi Jiao Di Huang Tang* (Rhino Horn and Rehmannia Decoction from the Medical Creation). If the foul fluid has ceased but the mouth and tongue do not heal, or if there is fever and thirst without desire for cold drinks, this is Deficient Heat. Use *Qi Wei Bai Zhu San* (Seven-Ingredient Atractylodes Macrocephala Powder).

Fifth, if limbs, arms, or fingers of Leprosy patients are contracted into fists, it is due to blazing Ministorial Fire injuring Qi and Blood. Use *Jia Wei Xiao Yao San* (Modified Free Wanderer Powder) with *Sheng Di Huang* (Rehmanniae Radix) and *Huan Ji San* (Muscle-Recovery Powder) taken concurrently.

Sixth, worm infestation in Leprosy is caused by the convergence of wind pathogens from the five directions, Ministerial Fire suppressing Metal (Lung), and excessive Wood generating worms. These worms consume the Five Zang internally and manifest externally. Use *Sheng Ma* (Cimicifugae Rhizoma)... [Text fragment]. If there is Deficient Heat in the Liver Channel, assist with *Jia Wei Xiao Yao San* and *Liu Wei Di Huang Wan* (Six-Ingredient Pill with Rehmannia).

Seventh, chronic Leprosy that does not heal may result from improper diet and lifestyle causing erratic internal fire; from damaged Zang-Fu organs and exhausted Qi and Blood; from the use of attacking drugs causing further depletion of Qi and Blood; from inappropriate medication due to failure to distinguish mixed accompanying and transformed syndromes; or from patients hiding their illness and avoiding medical treatment.

Eighth, recurrence of cured Leprosy may result from failing to avoid rich foods, causing internal heat to injure the Spleen; from failing to abstain from sexual activity, causing fire to move and injure the Kidney; from failing to regulate the Seven Emotions, leading to... [Text fragment] disturbance of Qi and Blood.