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From the Zusanli (ST36) acupoint down to the fibula region, all carbuncles, ulcers, sores, and toxic eruptions occurring in this area are compiled here for easy reference and treatment consultation.

The *Guiyi Fang* states: Carbuncles and ulcers arising at both Zusanli points are named "Sanli Fa" (Eruption of Sanli). Initially, they resemble a cow's eye, appearing blue-black. After five to seven days, they rupture, discharging black blood, serum, and pus. The swelling attacks the bladder and abdominal regions, extending into the legs, accompanied by stiffness, coldness, and pain. This condition is caused by injury to the sinews and qi due to labor and exertion. It is appropriate to use decoctions administered orally or injected; the external toxicity will naturally subside.

The *Xinfa* states: "Sanli Fa" occurs three cun below the knee on the lateral anterior edge, between the two tendons. Initially, the swelling resembles a cow's eye, with stiffness, coldness, and pain. It results from injury to sinews and bones due to physical labor, leading to the condensation of stagnant heat. The swelling and pain gradually increase, the color turns blue-black, and upon ulceration, purple blood is discharged, followed by thin pus. The treatment is the same as for general carbuncles and ulcers. (From *Yizong Jinjian*)

Wang Shengzhi stated: Heyang Ju (Abscess of Heyang) is caused by damp-heat toxin in the Foot-Taiyang Bladder Meridian, located on the lateral side of the leg below the knee. (From *Lili*)

The *Xinfa* states: Hongxiangjiao Chuang (Hongxiangjiao Sore) arises below the knee and above the foot, on the tibia. Symptoms include swelling, obesity, itching, and pain in the lower leg. Upon rupture, yellow fluid oozes out and forms a yellow crust. These conditions arise from internal stagnation and binding of damp-heat, obstructing the skin and interstices, compounded by external wind invasion, preventing free circulation. The morphology resembles Huangshui Chuang (Yellow Water Sore), but differs in that the patient suffers from high fever, mental restlessness, and a chronic course difficult to cure. (From *Yizong Jinjian*)

Chen Shigong stated: Lian Chuang (Shin Ulcer) is formed by the gathering of wind-heat and damp-toxin. For cases with predominant external symptoms, Sibao Wan (Four Generations Pill) should be taken frequently; for cases with predominant internal symptoms, Shenqi Wan (Kidney Qi Pill) should be taken frequently. (From *Zhengzong*)

Feng Luzhan stated: Women developing sores on both lower legs may do so due to improper regulation after childbirth or pregnancy, damaging the Spleen and Stomach; or due to worry, thought, depression, and anger, injuring the Liver and Spleen, causing damp-heat to sink downward. Sores on the outer leg belong to the Foot-Yangming and Foot-Taiyang meridians (part of the Three Yang meridians) and are easier to treat; sores on the inner leg belong to the Foot-Yin meridians (Three Yin meridians) and are harder to cure. If the sore initially presents with redness, swelling, and pain, it is caused by damp-toxin; Ren Shen Bai Du San (Ginseng Decoction for Resisting Toxicity) is indicated. If there is diffuse swelling and pain, or no swelling and no pain, it is due to Spleen deficiency with sinking damp-heat; Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) or Bazhen Tang (Eight Treasures Decoction) added with Biba (Dioscorea Hypoglauca) and Yinhua (Honeysuckle Flower) is indicated. If pus and water drip continuously, accompanied by fatigue, poor appetite, internal heat, and dry mouth, it indicates Spleen Qi deficiency; Buzhong Yiqi Tang added with Baifuling (Poria with White Ginseng) and Jiuchaobaishao (White Peony Root stir-fried with wine) is indicated. If there is afternoon fever and fatigue, it indicates Blood deficiency; add Chuanxiong (Szechwan Lovage Rhizome) and Shudi (Prepared Rehmannia Root) to the previous formula, or use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). If there is aversion to cold in the limbs and poor desire for food, it indicates Spleen and Kidney deficiency-cold; Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) or Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) is indicated. Red color indicates heat-toxin and is easy to treat; dark color indicates deficiency-cold and is hard to treat. (From *Jinnang*)

Zhou Wencai stated: Lian Chuang (Shin Ulcer) is all caused by Kidney deficiency-cold, where wind-pathogen and toxic vapors attack externally near Zusanli, pouring into the side of Yinjiao. Wind-heat toxic vapors flow into both feet, causing sores, swelling, rotting, pain, and foul odor, making walking difficult. This type of sore occurring on the tibia bone is considered severe because there is little muscle and thin skin above the bone, making it difficult to heal. (From *Jiyan*)

Shen Douyuan stated: The inner aspect of the lower leg is governed by the Foot-Jueyin Liver Meridian, while the outer aspect is governed by the Foot-Yangming Stomach Meridian. (From *Qixuan*)

He further stated: Qunbian Chuang (Skirt-Hem Sore) is caused by wind from the skirt hem. If sexual intercourse is not abstained from, it persists for a long time without healing.

He further stated: Leg sores strictly forbid sexual intercourse. Violating this leads to gradual opening of the wound, rotting, and foul odor, hence the name "Shangshou Chuang" (Injured Guard Sore), implying a failure to observe taboos. Some people today, seeing the itching, suspect the sore was scratched by fingernails and call it "Shangshou Chuang," which is incorrect.

He further stated: Qunbian Chuang is the same as Kukou Fengchuang (Pantleg Wind Sore).

He further stated: Kukou Du (Pantleg Toxin) refers to sores arising above the malleolus.

*Mingyi Ji* records: A woman suffered from Lian Chuang (Shin Ulcer) with no effect from various medicines. Each month, new flesh would grow over the wound, but suddenly blood would flow from the sore, stopping after three days with no other discomfort. Many doctors could not identify the condition. One doctor asked, "Does your menstruation come on schedule?" The woman replied, "It has been absent for one year." The doctor then administered herbs to guide blood back to its normal pathway for over a month, and applied external Jisheng Gao Dan (Flesh-Generating Paste and Pills) to close the wound, resulting in a cure. This was a syndrome of Liver and Spleen injury due to depression, causing abnormal uterine bleeding (misdirected menstruation). By guiding the blood back to its proper channel, the sore healed spontaneously.

The *Xinfa* states: Sores on the outer leg belong to the Foot-Yangming and Foot-Taiyang meridians, formed by the accumulation of damp-heat; early treatment yields quick results. Sores on the inner leg belong to the Foot-Yin meridians, formed by dampness combined with Blood deficiency-heat. Moreover, the skin and flesh over the tibia are thin, making it difficult to see results, and the course is extremely lingering. (From *Yizong Jinjian*)

Jiang Shiji stated: Red Lian Chuang indicates Heat; swollen ones indicate Dampness; itchy ones indicate Wind; painful ones indicate Excess. Those that improve in the morning and swell in the evening indicate Qi deficiency with sinking. Early stages are mostly due to wind-heat-damp-toxin; long-standing stages are dominated by sinking damp-heat. (From *Shuoyue*)