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Yukou Biandu (Fish Mouth and Common Swelling), located between the lower abdomen and the inner seam of the thighs, is called Yukou on the left and Biandu on the right. It belongs to the Jueyin Liver Meridian (Jueyin Gan Jing). This condition is rarely caused by strenuous labor and damp-heat sinking downward; it is most commonly contracted through unclean sexual intercourse and exposure to venereal toxins. Often, chancre (Xiagan) appears first, and if not healed, Biandu follows, which is a manifestation of damp-heat and foul toxins. In other cases, it results from excessive sexual activity, retaining semen without ejaculation, or unfulfilled desires, causing stale essence and blood to bind together, stagnate in the meridians, and form due to obstruction. Clinical differentiation must be meticulous. The treatment principle should focus on resolving depression, dispersing qi, and clearing damp-heat. For toxin-related conditions, sweating (Fa Han) should be induced first, followed by promoting urination, allowing toxins to exit via the skin pores or urine. If these methods fail, formulas that break toxins, invigorate blood, and regulate qi should be used to attack the pathogen. Once the toxic qi is unblocked, tonifying agents should be employed to support the body and expel toxins; this is a fixed protocol. In women, this disease often presents with swelling and pain in both groin areas, abdominal masses, lower abdominal distension, pain radiating to the hypochondrium, dysuria, aversion to cold with high fever. These are mostly due to damp-heat sinking in the Jueyin Liver Meridian or liver-spleen damage from depression and anger. Formulas such as Longdan Xiegan Tang (Gentian Liver-Draining Decoction) and Jiawei Xiaoyao San (Modified Free Wanderer Powder) are appropriate. One should not indiscriminately use blood-dispersing and toxin-attacking agents. Children may also suffer from this condition, generally due to heat-toxin in the Liver Meridian. Treatment should involve draining the Liver, adjusting based on the toxin status in the Blood level.

"Dou" (Smallpox/Varicella-like eruption) originates from congenital toxins. "Doudou" (Smallpox Toxin) refers to residual toxins that have not fully expressed themselves and subsequently condense into abscesses. Human life receives Qi from the father and forms shape from the mother. At the time of conception, relying on a spark of true Yuan Fire, the initial formation of the fetal origin inherently harbors fetal toxins, hence termed "Fetal Toxin." This toxin lies dormant in the Mingmen (Gate of Life). After birth, it erupts upon contact with triggers; without triggers, it remains latent. Thus, its onset varies: some erupt within months, others after years, and even after ten-plus years. Before eruption, its signs are indistinguishable, like an unlit fire—where to find it? How to explain it? Once triggered, it erupts violently and cannot be restrained. The toxin moves from the Mingmen, emanates from the Five Zang Organs, and actually disturbs the True Qi of the Five Zang. At this stage, success relies entirely on Qi and Blood sending the toxin outward, transforming it into pus, and consolidating it into scabs. Only then is the toxin exhausted, and the Zang-Fu organs restored. If Qi and Blood are weak, and pus fluid insufficient, the toxin cannot be fully expelled. Even if the eruptions heal, residual toxins remain, condensing into sores and ulcers, thus generating Doudou. However, Doudou arising after natural smallpox is mild, while that after inoculation is severe. Why? Natural smallpox is caused by seasonal epidemic pathogens triggering fetal toxins; although the syndrome is severe, the toxin is fully vented. Any subsequent sores are merely ordinary smallpox, carbuncles, furuncles, or boils. In contrast, inoculation lacks external epidemic pathogens, relying only on the slight Qi of the vaccine material to draw out fetal toxins. Thus, the smallpox syndrome is mild, but residual toxins remain unvented, developing into Doudou, purely formed by congenital Fire Evil. Hence, suppuration and rotting occur, and healing is slow. Moreover, residual toxins inevitably manifest at joints. Because the scabs have not formed and Fire-Toxin has not been vented, it enters the collaterals. Thus, it may appear at elbows and wrists, or knees and shins. Onset features diffuse swelling, alternating chills and fever, tidal fever, irritability, dry mouth, and eventual suppuration. After ulceration, if the child has strong congenital endowment and robust Qi, recovery occurs in days. If Zheng (Upright Qi) is deficient and residual toxins attack collaterals, it is called Qi Deficiency with Stagnant Toxin; post-ulceration wounds are difficult to close. Generally, strong Stomach and prosperous Spleen, with abundant Qi and Blood, ensure no complications. If the body is frail with poor appetite, or Spleen deficiency with diarrhea, or persistent tidal fever, it develops into consumptive weakness. Note that when this sore begins, if it is red, diffusely swollen, with alternating chills and fever, treat as Excess Syndrome using Heat-clearing and Toxin-resolving methods. If it begins white, diffusely swollen, with slow suppuration, treat as Deficiency Syndrome using Tonification and Support methods. If it fails to heal after ulceration, treat as Deficient Phlegm. Using only Heat-clearing and Toxin-resolving agents damages the Spleen and Stomach, leading to loss of appetite, persistent low-grade fever, and often death from consumptive weakness. This distinction is crucial.