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Luo Qianfu stated: In the Bingwu year, while residing in Zhending Prefecture, many people suffered from ding sores (malignant skin ulcers). The County Magistrate, Mr. Dong, said to me, "This year, there are extremely many cases of ding sores. Poor people lack the means for treatment. Recently, I obtained several prescriptions from Marquis Shi; those who used them were all effective. The government will provide funds for the medicine. You should treat them free of charge." I agreed. Magistrate Dong posted notices on main thoroughfares, ordering me to distribute medicine. This continued for a year, saving many lives. The prescriptions used included Bao Sheng Ding Zi (Preservation-Protecting Pellets), Tuoli San (Support-the-Interior Powder) from *Qianjin Fang*, Shensheng Gao Yao (Divine Holy Plaster), and Po Guan Dan (Coffin-Breaking Pill), totaling four formulas.

Bao Sheng Ding Zi Formula: Arsenic trioxide variant (Jinjiaoxin) 2 qian, Realgar 3 qian, Calomel 2 qian, Ammonium chloride (Naosha) 3 qian, Musk 1.5 qian, Croton seed 49 grains, Toad venom 1 qian. Grind these medicines into fine powder, melt 5 qian of yellow beeswax, mix the medicine with the melted wax to form pellets. Soak in cold water briefly, take out, and mold into cakes the size of a copper coin's hole. Puncture the sore head, apply one cake each time, then apply Shensheng Gao Yao, followed by internal administration of Tuoli San. If the pathogenic qi of the ding enters the abdomen causing critical illness, administer Po Guan Dan. (Folklore states that ding sores must have a red thread; one can puncture the area where the red thread ends to release toxic blood, then apply medicine.)

Shensheng Gao Yao Formula: Angelica dahurica (Danggui) and Ligusticum wallichii (Gaoben) (each 0.5 liang), Frankincense (Ruxiang) and Myrrh (Moyao) (each 2 qian), Bletilla striata (Baiji) and Amber (Hupo) (each 2.5 qian), Lead monoxide (Huandan) 2 liang, White rosin (Baijiaoxiang) 3 liang, Yellow beeswax 2 liang, Sublimated arsenic trioxide (Fenshuang) 1 qian, Momordica charantia seed (Mubiezi) 50 pieces (peeled), Croton seed 15 grains (oil removed), Clear oil, Sapium sebiferum branches (Huai Zhi) and Salix babylonica branches (Liu Zhi) (each 120 branches), Chalcanthite (Danfan) 1 qian. First, boil Huai and Liu branches in oil until scorched, then remove. Add remaining herbs, boil without scorching, and filter. Once the oil is clear, add Huandan and continue boiling to form the plaster. Spread onto red silk fabric. (This method has immediate miraculous effects.)

Tuoli San Formula: Ginseng root (Renshen) 1.5 liang, Magnolia bark (Houpo), Bupleurum root (Chuanxiong - *Note: Text says Pu Xiong, likely typo for Chuanxiong or Peony, but context implies aromatic/moving herbs, usually Chuanxiong/Fangfeng group*), Saposhnikovia root (Fangfeng) (each 2 liang), Platycodon root (Jiegeng), Angelica dahurica (Baizhi), Forsythia fruit (Lianqiao) (each 2.2 liang), White peony root (Shaoyao), Cinnamon twig (Guizhi), Licorice root (Gancao), Codonopsis/Ginseng (Shen) [Text repeats Shen], Angelica sinensis (Danggui), Aucklandia root (Muxiang), Frankincense (Ruxiang), Myrrh (Moyao) (each 0.5 liang). Grind into fine powder. Take 3 qian per dose, decoct with one large cup of wine for two or three boils, and drink warm including the dregs.

Po Guan Dan Formula: Rhubarb (Dahuang) 2 liang (half raw, half cooked), Licorice root (Gancao), Mirabilite (Mangxiao) (each 1 liang). Grind into powder, make pills the size of mustard seeds using honey. Take half a pill per dose, dissolve in warm wine after meals, or grind with half a cup of child's urine. Avoid cold water.

Xue Lizhai treated Chen Jinghan from Shanglin, who had a ding sore on his face. His pulse was surging, rapid, and forceful, indicating pathogenic qi accumulation. He took Er Ji doses of Qingre Xiaodu San (Clear Heat and Detoxify Powder) without effect. Someone else administered Huangqi (Astragalus) and Rougui (Cinnamon Bark) for two doses, which exacerbated the condition, causing swelling and closure of the ears, eyes, lips, and mouth, making the head and face swollen as large as a beanbag. This was due to external pathogenic excess. The previous pulse felt weak upon pressure, indicating internal deficiency of Yuan Qi (Original Qi). Consequently, he continuously administered Tuoli Xiaodu medicines and underwent multiple phlebotomy treatments (Bianshi) at the lesion site, releasing approximately one bowl of dark blood. Pus and necrotic tissue subsequently drained. Re-administration of interior-supporting medicines gradually improved the sore. Seven days later, due to improper nursing, he developed irritability, thirst, and anorexia. Both Chi pulses became thread-like and nearly imperceptible. Emergency administration of Siwei Wan (Eight-Treasure Pill) decoction restored the pulse immediately, and his hands and feet warmed naturally. Had it not been for phlebotomy to drain exterior pathogens, Tuoli San to tonify the interior, and Siwei Wan to restore Yang, improper treatment would surely have led to death. Caution is essential.

Su Zizhong, a scholar from Changzhou, had a ding sore on his nasal bridge. The syndrome belonged to exterior pathogens, but both Qi and Blood were deficient, making him intolerant to dispersing therapies. Treatment focused on Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), supplemented with Fangfeng (Saposhnikovia) and Baizhi (Angelica dahurica), resulting in recovery.

Zhang Suowang treated a monk at Li'an Temple suffering from Shui Ding (Water Ding) with Zouhuang (spreading toxin). The patient had abstained from food and water for three days, and other physicians could not treat him. Upon examination, Zhang said, "The toxin has entered the interior. What can be done? A needle insertion is necessary." He inserted a needle more than one cun into the top of the sore. Only then did the patient cry out in pain. Zhang said, "There is life." He applied plaster and administered several pills of Danyao, extracting a ding root about one cun long, which was hard and black like iron. The patient recovered. (From *Qiantang County Annals*)

Xue Lizhai treated a man with a ding sore on his foot, accompanied by itching, nausea, vomiting, and occasional confusion. The pulse was floating and rapid. After moxibustion (ming jiu) for over twenty moxa cones, pain began. One dose of Duoming Dan (Life-Restoring Pill) reduced swelling, and Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder) cured him.

A man with a ding sore presented with fever, irritability, and a full pulse. He was cured by administering Qingliang Yin (Cooling Drink) to purge heat.

A man with a chest ding sore experienced whole-body numbness and a rapid, full pulse. Emergency phlebotomy released bad blood, followed by moxibustion until pain was felt. He took Fangfeng Tongsheng San (Schizonepeta and Sage Universal Victory Powder) and recovered after having a bowel movement.

A man with a ding sore on the back of his left hand experienced arm numbness on the first day and hemibody numbness the next, with mental confusion. Moxibustion continued for over twenty cones without pain sensation, another thirty cones stopped the numbness, and only after one hundred cones was pain felt. One dose of Duoming Dan raised the swelling, and Shenyi Gao (Miraculous Unique Plaster) combined with Jingfang Baidu San cured him.

An elderly woman had a painful ding sore on her big toe. She refused moxibustion and exclusively took Baidu medicines (detoxifying purgatives), leading to deficiency of True Qi and excess of pathogenic qi, resulting in death. Although Baidu San can disperse surface toxins, one must consider the location (exterior/interior), severity, body region (upper/lower), and constitution (deficiency/excess). Can they be used uniformly? Moreover, the lower limbs are the most Yin part of the body, where medicinal power rarely reaches. Relying solely on medicine is too slow; moxibustion is superior. Therefore, sores on the lower body should be treated with Garlic-Separated Moxibustion. For painful sores, moxa until pain ceases; for non-painful sores, moxa until pain appears. If still painless after moxibustion, use bright moxibustion and needle the four sides of the ding to release bad blood. Insert one grain of Duoming Dan into the sore opening and cover with plaster. If needling yields no pain or blood, use a red-hot needle to frequently cauterize the site until pain is achieved. If there is no pain and vision darkens as if seeing firelight, the toxin has entered the Zang-Fu organs; this is untreatable. If the sore is on the extremities and red threads attack the heart and abdomen, puncture the end of the thread to release bad blood and take Jingfang Baidu San. If the thread is near the heart/abdomen, puncture the sore head to release bad water and apply plaster. If numbness occurs, take Duoming Dan. If trismus or throat involvement occurs, hold one or two pills in the mouth. Sudden death is often caused by ding toxin; illuminate the body with a lamp to find small sores and moxa urgently. After regaining consciousness, take Baidu medicine or Duoming Dan. Consuming meat contaminated with human sweat can cause ding sores; caution is required.

Liu Yuxi compiled the Liuzhou Three-Deaths Rescue Prescription: In the 11th year of Yuanhe, he suffered from a ding sore that worsened over fourteen days. Unknown remedies failed. Jia Fangbo of Changle taught him to use dung beetle (Qiángláng) flesh. Overnight, all suffering ceased. In January of the following year, eating mutton caused a severe recurrence; using the beetle again was miraculous. The method is to apply the single herb to the sore, changing every half hour until blood stops and the root emerges, curing the disease. Take the flesh from under the heart and abdomen of the beetle, which is slightly white. Eating mutton exacerbates the condition because beetles eat mutton. Mutton should be avoided during treatment. This method originates from Ge Hong's *Zhouhou Beiji Fang*. (Cited in *Bencao*)

Han Guang treated ding swellings. In the early Zhenguan era, Xu Shijun of Weizhou obtained this prescription: Burn one dan (a unit of weight) of mugwort to ash, place in a bamboo tube, and leach with water to obtain 1-2 he of juice. Mix with vitriol (Duanshi) to the consistency of flour paste. Prick the sore with a needle until pain, then apply the paste. Applying three times causes the root to fall off spontaneously. It is very effective. Used to cure over thirty people in the Zhenguan era. (From *Qianjin Fang*: Xiupo Gong stated: Ding sores depend entirely on location. If the location is unfavorable, it is difficult to treat. Observe signs of spreading toxin. Prick the four sides with a needle, insert pulling-toxin medicine, and prick swollen areas to release bad blood. This method is excellent.)

Miao Zhongchun treated the wife of Dr. Gu Boqin, who had a ding sore on her left ear while pregnant. He instructed applying Baiyaizi (Stemona tubera) powder mixed with egg white to the abdomen to protect the fetus, followed by a large dose of internal decoction containing Xiakucao (Prunella), Ganju (Chrysanthemum), Beimu (Fritillaria), Rendong (Honeysuckle), and Dideng (Viola). Pain stopped after one dose, the ding was expelled, and the fetus remained safe. Baiyaizi is typically used for equine diseases. (From *Guang Biji*)

Ma Mingju treated the younger brother of Gu Shengfu, who had a Zhi Ding (beard ding). The physician initially used fire needles around the swelling, which spread to obscure the eyes and nose, accompanied by trismus. Ma used the patient's earwax and tooth tartar, mixed with fingernail clippings to the size of a bean. This mixture was lightly moxaed on a tea spoon over a lamp flame. Formed into a pill, the surrounding medicine was washed off, the ding head opened with a silver hairpin, and the pill inserted. Covered with moistened cotton paper, pain stopped immediately. Swelling halved in half a day, eyes opened. The next day, Xianfang Huoming Yin (Immortal Recipe Life-Saving Decoction) was taken for two doses, resulting in recovery. This method also treats Red Thread Ding. Hua Chengxi from Changzhou cured his finger joint ding with this method. It is also said to treat White Face Ding, though untested. This formula was passed down from a Daoist priest. (From *Guang Biji*)

*Guang Biji* records: Use aged iron rust exposed to rain, ground to fine powder. Puncture the toxic area with a gold hairpin, insert the rust powder, and cover the skin. Soon, black fluid drains, revealing white threads like fine lines. Slowly extract these threads, which are the ding root. Removal leads to immediate cure. Another method: Crush fresh Chrysanthemum flowers, roots, and leaves, extract juice, and take with wine for immediate resolution. (Both methods are miraculous and verified.)

Xue Lizhai treated Liu Guanqing, who had a ding sore on the dorsum of his foot. Though small like millet, the toxin was severe, requiring strong purgative medicine. Due to his frailty, Garlic-Separated Moxibustion was applied for over fifty cones, stopping the itch. After further moxibustion, pain was felt. Plaster was applied, followed by Ren Shen Bai Du San (Ginseng and Detoxifying Powder), resulting in gradual improvement. The lower limbs are the most Yin region, distant and remote. For frail individuals, strong medicines may damage Stomach Qi before reaching the site, leading to collapse. Moxibustion is preferable.

Zhu Dayin of Songjiang had a ding on his lip for five days, swollen and hard, with a rapid pulse, irritability, and preference for cold. This was caused by accumulated heat in the Stomach Meridian. One dose of Liangge San (Cool the Chest Powder) reduced heat by 50-60%. Two pills of Duoming Dan reduced swelling by 20-30%. Four doses of Jingfang Baidu San cured him.

Yang Jinyi had a ding below the lip. With full pulse and symptoms, he should have been purged but was instead given interior-supporting medicine, leading to pus discharge from mouth and nose and death. This is the disaster of "reinforcing excess" (Shi Shi).

Madam Ma suddenly experienced chills, vomiting, shoulder/arm numbness, palm itching, and fainting. There was a blister on her hand, indicating ding toxin. Urgent moxibustion (50+ cones) induced pain, and Jingfang Baidu San cured her. Ancients say sudden death is often due to ding toxin; illuminate the body to find small sores and moxa urgently. If the chest and abdomen are warm, moxibustion is suitable. My father said: Someone fainted after slaughtering a dead cow. Inspection revealed purple blisters all over. Urgent moxibustion revived him, and Baidu medicine cured him.

Madam of Grand Secretary Zhang had a facial ding, severely swollen and painful, not ulcerating after several days. Pulse and symptoms were full. Treated with Jingfang Baidu San plus Huangqin (Scutellaria) and Lianqiao (Forsythia), improving slightly. Believing the effect was slow, she took one dose of interior-supporting medicine, worsening the condition. Pain intensified before she realized her error. Two doses of Liangge San reduced pain and promoted ulceration. Ten-plus doses of Liaoqiao Xiaodu San cured her.

The Zheng family had limb ding sores caused by eating dead beef. Phlebotomy released black blood, and Zijin Dan (Purple Gold Pill) cured them.

Wang Jian'tao Ruhe contracted smallpox toxin, developing over ten facial ding sores with swelling, pain, and rapid pulse. Jingfang Baidu San provided slight relief but fear remained. Duoming Dan cured him in one dose.

Lu Xuanzi, a famous physician from Shandong, recounted that Li Gongzi of Beijing had a fleshy tube growing from his fingernail, red in color, growing three chi in an instant, touching the ground and moving, causing blood loss and near-death. Physicians were helpless. Li drank heavily, cut the tube, lost much blood, and it regenerated. He accepted death. A beggar claimed he could cure it, bringing a large snake. The beggar scolded the doctors, saying, "This is Snake Head Ding. The tube connects to all limbs and bones; cutting it regenerates. What can you do?" The beggar had once suffered this, bankrupting himself seeking a cure. A mendicant taught him to swallow a large snake, pierce its head, and press it against the fleshy tube. The snake absorbed the toxin via Qi, dissolving the growth while the snake died with red threads. Li recovered and gave the beggar half his wealth. (Recorded by Jiang Xiangfan)

Ding Sore Treatment Formula: Pine resin (Songxiang) 20 liang, White beeswax (Baila) 2 liang, Frankincense (Ruxiang) 3 liang (de-oiled, finely ground), Yellow beeswax (Huangla) 10 liang, Verdigris (Tonglv) 5 liang (finely ground), Sesame oil (Mayou) 6 liang, Myrrh (Moyao) 3 liang (de-oiled, finely ground), Hundred Grass Frost (Baicaoshuang) 5 liang (best from clean burning of grass in mountain villages). Boil sesame oil, add pine resin, then white beeswax, yellow beeswax, frankincense, myrrh, verdigris, and finally Baicaoshuang. Boil several times, pour onto brick ground or cool in the pot, roll into strips. Form pills the size of longan seeds, soften with breath, flatten, and apply to the sore. If it is a ding, it sticks; otherwise, it does not. If it sticks for a moment, pain stops. Swelling subsides the next day, slight yellow discharge indicates cure. Avoid meat, raw/cold foods, and spicy foods. Each pill weighs approx. 4 fen.

Another Method: White Chrysanthemum 4 liang, Licorice 4 qian. Decoct in water and take. Resolution within two doses. All other ding-resolving medicines cannot compare. Chrysanthemum treats the whole body and is the sacred medicine for ding sores.