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Jiang Shiji stated: There is also gangrene of the extremities (Tuo Ju) occurring on the hands and feet or face, where life is difficult to preserve. (*Shuo Yue*)

Hu Gongbi stated: Lip and mouth gangrene (Chun Kou Ju) is essentially Tuo Ju. Initially, it appears like millet grains, with a brownish color, or resembling jujube skin, gradually turning black, cracking, and enlarging. It is insensible to pain and itching, and emits a foul odor difficult to bear. In children, it is mostly caused by accumulated heat toxins; in adults, it is often due to excessive consumption of acrid-warm and drying agents. Although ancients had excision methods, most patients died within six or seven days.

Qi Tian Shi stated: There are cases where sores appear on the lips, and after a long time, tooth-like structures grow from the sore on the lips. This is caused by emotional depression and turmoil, leading to fire generating teeth, which is an unusual disease. (*Mi Lu*)

Decoction Formula (Qi Tian Shi):
Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Chai Hu (Bupleuri Radix) [each 3 qian], Tian Hua Fen (Trichosanthis Radix) [2 qian], Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma) [each 1 qian], Bai Guo (Ginkgo Semen) [10 pieces]. Decoct and take orally.

Topical Powder (Qi Tian Shi):
Bing Pian (Borneolum Syntheticum), Zhi Jiang Can (Bombyx Batryticatus) [each 1 fen], Huang Bo (Phellodendri Cortex) [stir-fried 3 qian].
Grind into fine powder and apply topically; the "teeth" will naturally disappear.

Chen Shigong stated: Silkworm cocoon lip (Jian Chun) is caused by overconsumption of fried and roasted foods, combined with anxious and hurried thoughts. Phlegm follows fire and flows, lodging in the lips. This is a syndrome of the Yangming Stomach Meridian. Initially, it forms a nodule like a bean, gradually enlarging to resemble a silkworm cocoon. It protrudes, swells, and becomes hard; in severe cases, it causes pain, hinders eating and drinking, or breaks and bleeds. Over time, it may transform into Xiao Ke (Wasting and Thirsting Syndrome) or Xiao Zhong, becoming a difficult-to-treat condition. (*Zheng Zong*)

Dou Hanqing stated: This condition arises on the lips. The Classics state: Spleen Qi connects to the mouth. Also: The lips are the external manifestation of the Spleen. Also: The flourishing aspect of the Spleen is in the lips. Therefore, dryness leads to chapping, heat leads to cracking, wind leads to twitching, and cold leads to peeling. If swelling occurs with white, wrinkled skin resembling a silkworm cocoon, it is named Jian Chun. It starts as a small tumor the size of a bean, or recurs, gradually swelling and merging into one mass about one cun thick. It may evert like a bayberry, form nodules, resemble lingzhi mushrooms, or look like fungi, with various shapes. All are caused by the interaction of the Six Qi and Seven Emotions. Excessive mental activity or deep worry can cause Heart Fire to become scorching and transmit to the Spleen Meridian. Or, consuming rich wine and heavy flavors can accumulate heat, injuring the Spleen and depleting Kidney Water. One must examine the etiology. Only by tonifying Kidney Water to nourish Spleen Blood can dryness be moistened, fire extinguished, wind calmed, and swelling subsided. This is an unusual condition, rarely seen and poorly understood. If it persists without healing, urgently use a silver or gold cautery iron heated red-hot in moxa fire to cauterize the lesion. Internally administer Gui Pi Yang Rong Tang (Restore the Spleen Nourish the Nutrient Decoction) for easier recovery. Do not use external methods involving corrosive threads to extract toxins, as this will cause further injury. Be cautious! In women, this is due to deficiency of Yin Blood. Si Wu Xiao Yao San (Four Substances Free and Easy Wanderer Powder) should be used as the primary treatment.
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Regardless of whether made of silver or gold, shape the cautery iron. Burn it red-hot with moxa fire each time, and while hot, cauterize the affected area. Repeat burning and cauterizing, but limit to five or six times per day to avoid damaging Yuan Qi. Choose an auspicious day and avoid taboo directions (Kao Shen). After cauterization, rub with medicine to prevent recurrence.

Feng Luzhan stated: After a shock syndrome, if there is teeth grinding, mania, and reversal, with severe white swelling of the lips, it is also named Jian Chun. (*Jin Nang*)

Wang Shengzhi stated: For early-stage Jian Chun without internal symptoms, moxibustion with three cones the size of hemp seeds can be applied, covered with a Toad Venom Cake (Chan Su Bing); over time, it will gradually dissipate. For cases with internal symptoms presenting with thirst, take Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) in the morning and Qing Ling Gan Lu Yin (Clear Cool Sweet Dew Drink) at noon to nourish the source of transformation. If bleeding persists for a long time, accompanied by emaciation, deficiency-heat phlegm generation, dark complexion, malar flush, and extreme dry mouth/thirst, these are all untreatable signs. (*Li Li*)

Kui Guang stated: Jian Chun abscess belongs to the Yangming Stomach Meridian, formed by phlegm-fire flowing and lodging in the lips. It forms a nodule the size of a bean, resembling a silkworm cocoon. It protrudes and is hard; in severe cases, it causes pain, hinders diet, or breaks and bleeds. If prolonged, it is difficult to treat.