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I have loved studying the art of medicine since childhood. I believe that although medicine is a minor skill, it benefits both others and oneself, and thus should be studied by scholars. However, I do not visit patients' homes to practice nor do I demand payment; instead, I treat according to the methods of the Six Channels (Six Meridians).

As more and more people sought prescriptions, later on, fearing it would interfere with my preparation for the imperial examinations, I firmly declined and set it aside. Yet, when treating Leprosy (Leprosy disease), I was particularly eager and hurried, often fearing that I might not encounter such cases. Leprosy causes fathers and sons to be separated, husbands and wives to live apart; relatives and friends avoid those afflicted, and passersby scold them. Unlike other diseases that harm only one person, leprosy is indeed contagious and often affects many. It may harm neighbors and friends, or an entire family, leading to situations where marriage is impossible and lineage ends. Zhang Zi said, "Those who are paralyzed, suffering from strangury, or physically disabled are our brothers in distress without anyone to appeal to." Is this not true? However, ancient and modern texts rarely have dedicated books on treating this disease, and prescriptions are scarce. Quack doctors occasionally obtain one or two prescriptions, keep them as secret manuscripts, and use them to extort heavy fees. When asked about the disease etiology and drug properties, they are clueless. Skilled physicians, on the other hand, may shun the filth and neglect it, or attribute it to karmic retribution and fate, leaving sufferers with no medicine, leading to suicides by hanging or drowning, which happens frequently. I deeply pity this situation. After years of devoted study, having treated hundreds of patients, I compiled this book, outlining its principles and details, clarifying each point meticulously. It took three winters and summers and considerable effort. Readers of this book will not only learn to treat leprosy but also gain a general understanding of treating diseases according to channel differentiation. If those with sincere intentions widely promote and apply these methods, it will be one way we benefit people according to local conditions.

Written by the Master Xiaoting on the 9th day of the first month of early summer, in the first year of the Jiaqing reign.

The *Suwen: Treatise on the Essence and Subtleties of Pulse Diagnosis* states: "When the pulse is affected by wind, it becomes Li Feng (Leprosy)." In the *Treatise on Wind*, it says: "When wind-cold pathogens lodge in the vessels and do not depart, it is called Li Feng." Patients with Li Feng have heat in their Ying (Nutrient) and Wei (Defensive) levels, and their qi is impure, causing the nasal bridge to collapse, complexion to deteriorate, and skin to ulcerate.

The *Changci Chapter* states: "Severe wind disease presents with heavy joints and loss of eyebrows and beard, named Da Feng (Great Wind)."

The *Lingshu* states: "To treat Li Feng, puncture the swollen areas multiple times. After puncturing, use a sharp needle at the site, press to expel evil qi, and stop when the swelling subsides. Eat regular food, avoid other foods."

The *Qianjin Yifang* cites Qipo's treatment of severe diseases: "Wind diseases number four hundred types, but generally fall into five categories, governed by the Five Winds. What are the Five Winds? First, Yellow Wind; second, Green Wind; third, White Wind; fourth, Red Wind; fifth, Black Wind. These winds correspond to the Zang organs, hence the name Five Winds. The Five Winds generate five types of worms: Yellow Wind generates yellow worms, Green Wind generates green worms, White Wind generates white worms, Red Wind generates red worms, Black Wind generates black worms. These five worms consume the Zang organs. If they consume the Spleen, speech becomes altered and voice scattered; if they consume the Liver, eyebrows and eyelashes fall out; if they consume the Heart, sores appear all over the body; if they consume the Lungs, the nasal bridge collapses and polyps grow in the nose; if they consume the Kidneys, tinnitus occurs like the sound of thunder drums or moving carts; if they consume the Skin, the skin becomes numb and insensible; if they consume the Tendons, limbs and joints drop off. The Five Winds combine with the Zang organs, worms multiply excessively, enter the bone marrow, move freely, and damage the human body, named Ji Feng (Rapid Wind). Ji Feng is the root cause of Leprosy. At the onset of the disease, some feel like being pricked by needles, named Ci Feng (Pricking Wind); some feel like insects crawling, named You Feng (Wandering Wind); whole-body twitching, named Che Feng (Twitching Wind); no sensation of pain or itch, named Wan Feng (Stupid/Insensible Wind); flesh raised like small peach or jujube pits, starting from the head and face, named Shun Feng (Smooth Wind); starting from both feet, named Ni Feng (Reverse Wind); resembling linked coins or round shapes, with mottled red, white, green, black patterns, named KT Feng; or sores all over the body, resembling eczema or psoriasis, fish scales, elm seeds, or coin holes; itching or painful, flowing with yellow fluid, limbs and joints rotting into pus and blood; or neither itchy nor painful, appearing and disappearing, colors changing unpredictably among green, yellow, red, white, and black. The cause of onset is due to the interaction of cold and heat entering the Zang organs, penetrating the bone marrow, excessive physical exertion, improper diet, irregular sexual activity, deficiency and extreme fatigue, profuse sweating throughout the body. This leads to accumulated heat, allowing wind-heat to penetrate the Zang organs. Impure and mixed diet causes worms to multiply, consuming the Zang organs, bone marrow, skin, flesh, tendons, and joints. Over time, destruction occurs, named Li Feng."

Zhu Danxi stated: "Leprosy must be differentiated into upper and lower parts. For those in the upper part, use Zuixian San (Immortal Drunken Powder) to extract foul blood from between the teeth. For those in the lower part, use Tongtian Zaizai San (Sky-Penetrating Rebirth Powder) to expel foul matter and roundworms from the anus. Although the exit paths differ, both relate to the Yangming Channel. Observe where symptoms appear first: if mostly on the upper body, the disease is above; if mostly on the lower body, the disease is below; if both, the disease is in both. Why? The Yangming Channel governs the Stomach and Large Intestine, accepting everything, and is rich in Qi and Blood. When evil wind attacks, Qi involvement manifests more in the upper body, Blood involvement more in the lower body. If both Qi and Blood are involved, affecting both upper and lower, unless the physician is skilled and the patient resolute, few will succeed. Qi is Yang and Wei, Blood is Yin and Ying. Above the mid-body, Yang is affected first; below the mid-body, Yin is affected first. Thus, Zaizai San treats diseases in the Yin aspect, using Gelsemium spinosum thorns (Zaojiao Ci) to drive out wind toxins from the Ying-Blood. The Liver stores Blood; stagnant foul blood cannot move, generating worms. Treatment must focus on regulating Zang Qi and killing worms, using Rhubarb (Dahuang) to guide toxins into the intestines and bowels for expulsion. Zuixian San treats diseases in the Yang aspect, using Arctium fruit (Niubangzi) to drive wind toxins and sores from the body, Sesame (Huma) to dispel wind and tonify the Lungs, moistening the skin, Tribulus (Jili) to remove foul blood, relieve wind-itch, and open nasal passages, Saposhnikovia (Fangfeng) to treat various winds, Trichosanthes root (Gualougen) to resolve blood stasis and reduce heat-swelling, Goji berry (Gouqi) to clear wind-heat and detoxify sores, Vitex (Manjingzi) to drive away thief-wind, and Sophora root (Kushen) to clear heat-toxins. Crucially, Calomel (Qingfen) is used as a guiding agent to expel foul and toxic substances from the stomach, kill generated worms, travel up the channels to the soft gums, and discharge foul saliva. If teeth are damaged after taking the medicine, wipe them with Coptis powder (Huanglian), or add it initially to the formula to neutralize Calomel's toxicity. Calomel in Zuixian San has the power of capturing flags and slaying generals, creating the unique efficacy of this prescription, unmatched by others."

Xue Xinpu stated: "Leprosy ulcers affect not just one Zang organ, but Qi and Blood are invariably injured, and symptoms are invariably mixed. Since manifestations appear externally after accumulation, one must differentiate the upper and lower channels and examine the deficiency and excess of Qi and Blood. One should not indiscriminately use toxic-resolving drugs. Instead, one should first strengthen the Stomach and boost Qi to solidify the root, then treat the ulcers."

One must understand that Leprosy ulcers have different variations and similar presentations, requiring diverse treatments such as diaphoresis, purgation, scarification, acupuncture, moxibustion, and tonification. Similar presentations require assessing severity; variable presentations require distinguishing truth from falsehood. Treatment must weigh the patient's deficiency or excess and investigate the disease's origin before applying therapy. Deficiency refers to weak Zheng Qi (Upright Qi); Excess refers to strong Xie Qi (Evil Qi).

Zhang Hezi, skilled in acupuncture and scarification for Leprosy ulcers, claimed that one session of diaphoresis is worth a thousand gold pieces, because bleeding via acupuncture is less comprehensive than inducing sweat. Diaphoresis and bloodletting share the same principle. If foul blood stagnates in the muscles and channels, acupuncture or diaphoresis is suitable; bleeding from Weizhong (BL40) is effective. If toxic heat accumulates in the Zang organs, internal purgation is necessary for cure. If toxins are external, one must puncture all affected areas, including arms, legs, wrists, hands, feet, and finger webs, to disperse the toxin. If both exterior and interior are affected, external needling and internal purging are required to fully expel the toxin. If lesions are predominantly on the upper body, use Zuixian San to expel internal foul blood through the gums, and prick the fingernails and wrists to remove surface toxic blood. If lesions are predominantly on the lower body, use Zaizai San to expel foul blood and worms via the anus, and prick the toe webs and leg wrists. Repeat every one or two days until the blood turns bright red. If symptoms like chills, fever, or headache occur, treat according to the specific presentation.