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This condition initially presents with scrofula (tuberculosis of cervical lymph nodes) and five-colored urticaria-like rashes. Itching occurs upon exposure to heat, while pain arises upon exposure to cold; scratching leads to ulceration. Over time, alternating chills and fever occur, parasites develop within the body, gnawing at the muscles.

If the body form resembles flea-bite scars that are hidden, and cold-dampness is contracted internally, it results in skin erosion, paralysis, spasms, and convulsions, which are difficult to treat. If it erupts on the dorsum of the foot, toes, and heels, forming contiguous patches of purple and white, causing the disappearance of the large bones of the foot dorsum (tarsal bones), it is named "Shoe Strap Sore" (Xiedai Chuang), also known as "Straw Sandal Wind" (Caoxie Feng). This is caused by cold-damp-wind pathogens lodging in the skin, gradually entering the Ying and Wei (nutritive and defensive) systems. Lung Metal is constrained, Spleen-Stomach deficiency leads to weak Earth and rebellious Water attacking, and exposure to frost and dew triggers the onset. Chao Yuanfang stated: Initially, macules and leprosy-like lesions appear faintly like tinea, varying in color from red or purple to black or white. They gradually enlarge and deform, swelling or collapsing, itching or hurting, eventually becoming ulcers. Bones and sinews ache, with cold-heat spasms, foul-smelling pus and saliva, leading to tissue decay and death. This results from excessive indulgence in alcohol and lust, or from arrogance harboring Yin toxins and suppressed Qi injuring the Liver, fatigue and mental strain depleting Kidney Water, combined with wind-dampness damaging Stomach collaterals and spreading to the Zang-Fu organs, causing severe disease. Treat with Liushen Fusheng Dan, Kushen Wan, and Shenxiao Zhuifeng Wan. If white dry tinea sores start from the hands and feet, named "Four Extremities Wind" (Simi Feng), they are the most difficult to treat.

This condition manifests as spontaneous shaking and trembling of the hands and feet with weakness, inability to hold objects, difficulty in movement, traction and spasms, sudden stiffness, or numbness and severe pain in the joints, and calf cramps. This is due to excessive injury from turbid toxins. The Liver and Stomach are too thin with extreme damp-heat, blood is exhausted, bones are withered, and Lung and Liver are damaged. There are also cases caused by geographical yin-yang imbalance. Treat with Dama Tang, Zhenfang Duoming Dan, and Da Xiaofeng San, supplemented by tonifying Qi and Blood, clearing Yang, and nourishing Yuan as the superior approach.

This condition gradually forms lump-like scrofula, linked in strings of three to five, penetrating each other in size. Cases appearing first at elbows and knees are mild; those appearing first at the neck, ribs, and flanks are severe. They gradually enlarge into strings, elongating like a ground beetle burrowing into a hole. The bodily symptoms may present as excess heat, pain, or itching. Quack doctors mistake it for "chestnut" (a type of skin lesion), and their treatment accelerates disaster. Over time, the whole body rots and dies. This is caused by encountering foul, toxic, and impure Qi, violently injuring the Stomach Fu, with major toxins attacking the Spleen, leaving the Five Viscera empty. The pathogen spreads through the skin collaterals, Qi and Blood are deficient, evil pathogens bulge outward, and the toxins of the Nine Transmission Parasites infest the muscle surface. Treat with Banlong Bashuai Dan, Kushen Wan, Zhenfang Duoming Dan, and Yushu Dan, plus fumigation and washing for cure. Another variant presents with whole-body blisters resembling sweet pear fruits; when ruptured, fluid drains out, containing a stone piece the size of a fingernail. Healing occurs only when the stone exits, but blisters recur endlessly until muscles are depleted and death ensues. Treat with Ezhu and Sanleng, five taels each, powdered, divided into three doses, taken with warm wine for cure.