Library

Yangmei chuang (Keratitis-like sore / Syphilis), originating in the Lingnan region during the Zhengde reign of the Ming Dynasty, is thus named Guang chuang (Broad sore) or Shi chuang (Seasonal sore), also known as Mianhua chuang (Cotton sore). It initially presents with red halos, followed by the eruption of macules, termed Yangmei ban (Bayberry spots). These are red and pruritic, forming rings of varying sizes, sometimes two or three concentrically arranged, called Yangmei quan (Bayberry rings). When the apex ulcerates like an open skylight, and the base becomes necrotic with tissue everted, it is called Fanhuai Yangmei (Everted-flower Bayberry). When shaped like a red bean embedded in flesh and hard as iron, it is called Yangmei dou (Bayberry pustule). This pathology primarily involves the Jueyin (Jueyin meridian) and Yangming (Yangming meridian) channels, while also affecting other meridians, because the Ministerial Fire resides in the Liver, and muscles belong to the Stomach. The pathogenic toxin has two origins: Qi transformation (Qi Hua) and Essence transformation (Jing Hua). Transmission via Qi transformation is mild; transmission via sexual contact with essence is severe. "Qi transformation" refers to contracting the disease from individuals suffering from Yangmei chuang, by inhaling their breath, consuming their leftovers, or being exposed to toxins in latrines. The pathogen enters through the Spleen and Lung, so symptoms first appear on the upper body, manifesting as skin pruritus, bone and tendon pain, with small and dry lesions. "Jing transformation" results from unclean sexual intercourse, where fire-toxin invades internally, so symptoms first appear on the lower body, manifesting as bone and tendon pain, dysuria with dribbling and astringency, with large and firm lesions. For Qi transformation type, the toxin is at the exterior and has not entered the interior. Upon any sign of emergence, immediately administer Tougu Soufeng San (Bone-Penetrating Wind-Searching Powder). For those with robust Yuanqi (Primal Qi), Yangmei Yi Ji San (Bayberry One-Dose Powder) should be taken to induce sweating and resolve toxicity. For Jing transformation type, the toxin has entered the interior and lies deep within the marrow. Jiulong Dan (Nine-Dragon Pill) should be administered to promote urination and drain the toxin from the marrow. In severe cases, two doses are given to expel toxic matter via defecation, thereby suppressing the deep-seated toxin. After purgation, if the constitution is strong, Shengma Jiedu Tang (Cimicifuga Toxin-Resolving Decoction) is indicated; if weak, Guiling Naituo San (Guiling Internal-Supporting Powder) is indicated. Treatment continues until bone and tendon pain cease and lesion color fades to pale white, indicating internal toxin resolution. Subsequently, one course of Jinchan Tuqiao Jiu (Golden Toad Molting Wine) should be taken to sweep away residual toxins and cut off the source. If ulcers suppurate with foul discharge, spreading over large areas and causing pain, Ehuang San (Goose-Yellow Powder) should be sprinkled on the affected area. For Everted-flower Bayberry, add Xionghuang powder (Realgar powder) to Ehuang San and apply mixed with sesame oil. Attendants fearing infection may take Hucong Wan (Attendant-Protection Pill) for prevention. Strictly avoid mistakenly administering Qianfen (Calomel), Shuiyin (Mercury), Baifen Shuang (White Lead Frost) and other harsh, drying, and drastic agents. Although these may force phlegm-saliva out through the mouth and teeth, making sores appear dry and healed, this is a reckless pursuit of rapid effect. Methods such as fumigation, rubbing, or inhalation can drive the toxin deep into the marrow and orifices. Over time, it attacks outward, resulting in Daofa Jiedu (Reverse-Eruption Condensed-Toxin). Initially, there is bone and tendon pain with localized swelling, but normal skin color. As it approaches ulceration, the color turns purple-red, flesh rots, the crown of the head collapses, and the cheeks, lips, and nasal bridge are destroyed, potentially piercing the throat and blinding the eyes, leading to limb contracture and becoming a chronic, incurable disease. At the onset, with hidden bone and tendon pain, Soufeng Jiedu Tang (Wind-Searching Toxin-Resolving Decoction) is suitable. If the whole body is broken, foul-smelling, accompanied by bone and tendon pain, and the patient has strong Qi and abundant toxin, Huadu San (Toxin-Transforming Powder) is appropriate; if Qi is deficient, Zhu Zi Tang (Pig Kidney Decoction - *Note: Text implies a specific formula involving pig parts*) is used. For condensed-toxin masses that persist for years without healing despite various treatments, Xisheng Fujian Wan (Xisheng Re-boiled Pill) is indicated. For condensed-toxin attacking the mouth and nose, Wubao San (Five-Treasure Powder) is used. For long-standing, foul, rotting conditions with nasal collapse, Jiedu Zijin Dan (Condensed-Toxin Purple-Gold Pill) is prescribed. If the toxin attacks the vertex, causing splitting headache, Tianma Bingzi (Gastrodia Cake) is taken internally, and Biyun San (Green Cloud Powder) is insufflated into the nose. For nasal obstruction, Tongbi San (Nasal-Unblocking Powder) should be insufflated. For toxin attacking the throat with rotting and foul erosion, Liuhuang Bu'er San (Sulfur Non-Two Powder) is taken, and Jiedu Lingyao (Condensed-Toxin Spiritual Medicine) mixed with Renzhongbai (Urine Sediment) powder is insufflated. For non-healing, foul condensation, external application of Jiedu Zijin Gao (Condensed-Toxin Purple-Gold Ointment) combined with Jiedu Lingyoy powder is used. For robust constitutions, the focus is on resolving toxin; for weak constitutions, supplementation is added. Treatment follows the sequence of the disease. Severe cases may take one year, mild cases half a year, to expect full recovery. Do not seek rapid effects to avoid self-inflicted delay.