Library

Wang Kentang stated: There are five types of scabies (Jie): The first is called Da Jie (Large Scabies), characterized by redness, itching, and pain, with pus exuding upon scratching. The second is Ma Jie (Horse Scabies), presenting as隐起的 lesions with roots, (where scratching does not cause pain). The third is Shui Jie (Water Scabies), (containing serous fluid that flows out when broken). The fourth is Gan Jie (Dry Scabies), (characterized by itching where scratching causes the skin to flake and form dry crusts). The fifth is Shi Jie (Damp Scabies), (thin-skinned small sores that frequently ooze fluid). These should be treated separately. (From *Yixue Zhunsheng*)

Chen Shigong stated: Scabies arises from damp-heat in the Spleen Meridian and wind-toxin in the Lung Meridian, lodging in the skin and muscles. When the toxin is superficial, it manifests as scabies; when deep, it becomes tinea (Xuan). If the Spleen is affected by damp-heat, it may develop into pustular ulcers or scabies/tinea. All these conditions involve tiny insects and are highly contagious. One must strictly avoid soaking in hot water for washing; although this may provide temporary relief, it inadvertently drives heat-toxin inward, causing the insects to burrow deeper. Even with excellent prescriptions, how can quick results be expected? Patients must beware. Additionally, one must avoid all "fa wu" (stimulating foods) and seafood. (From *Waike Zhengzong*)

When suffering from scabies, one should not bathe in public bathhouses but must use medicinal decoctions to bathe at home. Methods such as wrapping medicine in paper and placing it near a stove, or fumigating under blankets, should never be followed, as this risks driving the toxin into the zang-fu organs and harming the body. Be extremely cautious, most cautious. (From *Shishi Milu*)

Jiang Shiji stated: Scabies is referred to as Gan Jie (Dry Scabies), Shi Jie (Damp Scabies), Chong Jie (Insect Scabies), Sha Jie (Sand Scabies), and Zi Jie (Purple Scabies). They appear like small rashes, are dry, and itchy. This is caused by wind-heat insects. Internal administration of Jie Ling Dan (Scabies Spirit Pill) and external application of San Huang Dan (Three Yellows Powder) will lead to self-healing. (From *Yizong Shuyue*)

*Yizong Xinfa* stated: Scabies has five types: Dry, Damp, Insect, Sand, and Pustular. If Lung Meridian dry-heat is excessive, Dry Scabies occurs, characterized by itching, dry skin, and white scales. If Spleen Meridian dampness is excessive, Damp Scabies occurs, characterized by swelling, pain, yellow fluid upon rupture, and potentially black fluid in severe cases. If Liver Meridian wind is excessive, Insect Scabies occurs, characterized by intense itching penetrating to the bone and insensitivity to scratching. If Heart Blood stagnates, Sand Scabies occurs, resembling fine sand grains, with redness, itching, pain, and fluid upon scratching. If Kidney Meridian damp-heat exists, Pustular Scabies occurs, resembling bean-sized lesions, with itching during bowel movements/urination and clear, pale pus. Alternatively, if Spleen Meridian dampness is excessive, Pustular Scabies also occurs, but the top contains thick pus, with combined itching and pain being the distinguishing feature. Weak individuals may also suffer from this; constipation indicates excess syndrome, while loose stools indicate deficiency syndrome. However, some deficient patients have dry stools; for instance, Qi stagnation leads to dry stools, and dryness of the Blood aspect leads to difficult passage. Differentiation should also be made based on the color and shape of the sores and the strength or weakness of the pulse.