Library

Shen Douyuan stated: After a sore and ulcer has ulcerated, it requires even greater protection. If one is not cautious, it may lead to deterioration. If the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright) are internally disturbed, anger injures the Liver. The Liver is referred to as the "General," and it governs anger. Excessive anger overacts upon the Spleen. The Spleen governs flesh; when the Spleen is injured, the interior of the sore swells and protrudes, a condition termed "flesh" (referring to hyperplastic granulation tissue or polyps within the wound). If these fleshy growths fill the wound and cannot resolve spontaneously, if they are not removed, even after the sore heals, the flesh will remain high, hard, and accumulated, eventually causing itching and pain over time. If such growths occur on the face or other prominent areas, the appearance becomes disfigured and ugly, which is due to the failure to remove them. It is advisable to burn *Wumei* (Mume Fruit, *Prunus mume*) to ash, mix with a small amount of *Qingfen* (Calomel, *Hydrargyri Chloridum*), and apply once to flatten the growth; this prevents scarring upon healing. (From *Qixuan*)

Zhou Wencai stated: There are five causes: first, exposure to water; second, exposure to wind; third, emotional anger; fourth, unskilled physicians applying excessive force when squeezing pus nodules by hand; fifth, the reckless use of cold-natured medicines that chill the skin of the sore, thereby generating hyperplastic flesh. (From *Jiyan*)

Gu Shicheng stated: When hyperplastic flesh grows at the sore opening, patients who mistakenly consume ginger, fragrant mushrooms, fungi, or violate sexual abstinence taboos are prone to having healthy tissue proliferate and protrude. Furthermore, hyperplastic flesh on the shoulders and back often results from bearing heavy loads while carrying light ones, straining excessively; those on the elbows, wrists, hands, and fingers result from lifting heavy objects; those on the heels and toes result from running and jumping. In cases where sores have discharged pus, thick paper or lead sheets should be placed over the plaster on the shoulders and back to press down; for elbows, wrists, hands, feet, heels, and fingers, thick paper or silkworm cocoons should be used as padding under the plaster, secured with thin silk. This prevents the proliferation of healthy tissue and facilitates healing.

Zhang Jingyue stated: In cases of large-scale ulceration of a carbuncle on the back, to test whether the inner membrane has been penetrated, one must not use the method of insufflating *Zaojiao San* (Gleditsia Sinensis Powder) into the nose to induce sneezing. Instead, cover the affected area with paper and instruct the patient to control their breathing intentionally. If the paper does not move, the membrane is intact. If the sneeze-inducing method is used to agitate the inner membrane, it may inadvertently cause perforation. Exercise extreme caution. (From *Quan Shu*)

Gu Shicheng stated: For ulcerated carbuncles on the back, roll grass paper into a wick, dip it in sesame oil, ignite it, and hold the flame near the sore. If the flame flickers outwardly, indicating air movement, the inner membrane has already ruptured.