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The manifestation of thigh carbuncle (Thigh Carbuncle) occurring on the medial side belongs to the Liver Meridian and Spleen Meridian; that occurring on the lateral side belongs to the Gallbladder Meridian and Stomach Meridian. It may arise from damp-heat failing to transform, stagnating in the meridians, and obstructing the flow of Qi and Blood; or it may result from external pathogens such as wind-cold-damp invading, causing congestion and failure to circulate, leading to knotting. One must distinguish whether the color is red or white, and examine whether the syndrome is Yin or Yang, before administering treatment. Cases with prominent swelling and pain belong to damp-heat and are suitable for clearing heat, promoting diuresis, and resolving toxicity; cases that are flat, depressed, hard, and unchanged in color indicate condensation of Yin pathogens and are suitable for dispersing and warming to induce resolution; after pus has ulcerated, supplementation and expulsion methods should be applied to both.

Yinbao Toxicity arises at the Yinbao acupoint on the medial aspect of the thigh. It is caused by wind-heat toxicity of the Foot-Jueyin Liver Meridian, complicated by turbid dampness. The area swells high and becomes hard, also known as Zhun Ju (Abdominal Carbuncle). Folklore often claims this carbuncle is hard without pus, not realizing that internal pus has already formed but cannot temporarily penetrate the skin. Internal support formulas should be used to promote pus rupture; in urgent cases, needle drainage is required. Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction for Overcoming Toxins) is suitable, or Huangqin Chaihu Tang (Scutellaria and Bupleurum Decoction). This decoction is highly effective for treating carbuncles and sores near the thigh on the inner leg.

Crane’s Knee Wind (Crane’s Knee Deformity) gets its name because the knee is swollen while the lower leg is emaciated and thin, resembling the knee of a crane. This condition has two types: those that develop abruptly are called Water Crane’s Knee, and those that develop slowly are called Dry Crane’s Knee. When a person suddenly contracts wind, cold, summer-heat, or dampness, pain is immediately felt in the knee. After three to five days, the legs and feet cannot flex or extend, alternating chills and fever occur, and both the inside and outside of the knee swell with a slight redness, shining heat, and the thigh gradually appears thinner. This is due to excess pathogens and is considered a mild case. If the meridians are unblocked, damp-heat is dispelled, and wind-cold is scattered, recovery is easily achieved. In cases developing slowly, it is due to deficiency of the Three Yin Meridians of the Foot, allowing wind-cold-damp pathogens to enter through the deficiency. Blood vessels become obstructed and fail to circulate normally, accumulating in the knee to cause disease. In the upper thigh, blood vessels have outflow but no return, leading to increasing emaciation, coldness, and tendon contraction; in the lower leg, blood vessels have accumulation but no dispersion, leading to increasing swelling, heat, and muscle wasting. This condition, along with Gu Ben Ju (Bone-Adhering Carbuncle), is caused by Kidney deficiency. The Kidney governs the bones, and the area below the buttocks belongs to the Kidney. When true Qi is weak, pathogens can invade deeply. If unresolved over time, extreme Yin generates Yang, transforming cold into heat, leading to eventual ulceration. Misuse of cold-natured drugs will inevitably lead to disability, such as contracture and hemiplegia, flaccidity and inability to rise, hardness like stone becoming Shi Ju (Stone Carbuncle), or late ulceration with rotting of skin and flesh becoming Huan Ju (Slow Carbuncle). Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root) must be used. Because the lower body pathways are distant, these herbs are necessary to reach the site and enter the Kidney Meridian to distribute their effects. Additionally, for pediatric Crane’s Knee Wind, if there is redness and swelling, worsening in the evening compared to morning, with alternating chills and fever, Lingyang Jiao San (Antelope Horn Powder) added with Huangbai (Phellodendron Bark) and Cangzhu (Atractylodes Rhizome), or Duhuo Jisheng Tang (Angelica Pubescens and Poria Decoction), should be used first to clear damp-fire, followed by warming tonification. If the swelling is hard, white in color, and does not form pus, it is due to congenital Kidney deficiency and insufficient Qi and Blood. Liuwei Wan (Six-Ingredient Rehmannia Pill) added with Lurong (Deer Antler Velvet) or Huqian Wan (Tiger Crouching Pill) should be used to tonify essence and blood; furthermore, the Spleen and Stomach must be regulated and tonified to aid the source of production and transformation.

Renmian Chuang (Human-Face Sore) is formed from the ulceration and breakdown of Crane’s Knee Wind. The patella resembles a forehead, the openings on either side resemble eyes, and the central bony prominence resembles a nose. Ulceration and decay make it look remarkably like a human face, hence the name. It is not truly a sore shaped like a human face. Did predecessors claim that feeding it meat causes it to eat? Is there any truth to this? In summary, this condition involves cold toxin entering the bone marrow. Only white serous fluid flows out, vital energy is depleted, muscles are necrotic, and new tissue cannot regenerate. Even with immortal techniques, no therapeutic success can be achieved.