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[Danxi] For Lou Chuang (Sinus/Fistula), one must first administer tonic medicines to generate Qi and Blood, with Renshen (Ginseng), Baizhu (Atractylodes Macrocephala), Danggui (Angelica Sinensis), and Chuanxiong (Ligusticum Wallichii) as the main ingredients, taken in large doses. Externally, use Fuzi (Aconite Lateralis Radix Preparata) powder mixed with saliva to form cakes of coin thickness, and apply moxibustion. The size of the moxa cone should correspond to the size of the sinus; moxa until slightly warm, avoiding pain. Replace when dry. Grind the dried material into powder again, mix and moxa again. If the patient feels fatigued, stop and resume the next day. Treatment is effective until the tissue levels out. Alternatively, Fuzi slices can be used for moxibustion, accompanied by the aforementioned Qi- and Blood-tonifying herbs applied as a plaster.

[Lou Quanshan] The *Neijing* states: Large gatherings of muscle are called Gu (Valleys), small gatherings are called Xi (Streams). Between muscle fibers, at the confluence of Xi and Gu, Ying Wei (Nutritive and Defensive Qi) circulates, and Da Qi (Great Qi) converges. When pathogenic factors overflow and Qi becomes stagnant, pulse heat and muscle decay occur. If Ying Wei fails to circulate, pus will inevitably form, consuming bone marrow internally and destroying large muscles externally. If it remains in the joints, degeneration ensues. Accumulated cold lingers, failing to nourish Ying Wei; muscles shrink and tendons contract, elbows cannot extend. Internally this manifests as Gu Bi (Bone Bi/Arthralgia), externally as numbness and insensitivity. This is termed "Great Cold lingering in the Xi and Gu." The rationale for using Fuzi moxibustion lies in this principle.

Physician Shi Kangzu suffered from Xin Lou (Heart Fistula/Sinus) for twenty years, with several orifices on his chest draining blood continuously; physicians could not cure him. Some suggested that since there were many orifices, closing them would cause further damage or create new pathways, so keeping one or two open was the best strategy. Consequently, his body and spirit became exhausted, compounded by chronic lower back pain, stooped posture, aversion to alcohol, and refusal to eat chicken, fish, crab, or shellfish. During the Chunxi era, while serving as Tongpan (Assistant Prefect) of Wenzhou, Han Ziwen, the Junshou (Prefect), saw him with pity. He consulted the *Shenghui Fang*, which listed treatments for lower back pain categorized into cold and hot syndromes, allowing Kangzu to choose. Kangzu said, "I am old and chronically weak; how dare I assume a hot syndrome?" He began treatment for a cold syndrome, taking a formula containing Lurong (Cervus Nippon Cornu Colla). After more than ten days, the pain decreased, and he felt a harmonious flow of Qi. He then exclusively took this formula, discarding all others. After over a month, his waist regained flexibility, the pain ceased, and the heart fistula healed. Physicians were baffled by the mechanism. Nine years later, after completing his term as Tongpan of Zhenjiang and entering the court, Kangzu visited Ziwen and found him full of energy, with no dietary restrictions. He stated that after the fistula healed, his health improved daily. Wu Bi, a clerk under Ziwen, also suffered from this condition and recovered after ten days following the same prescription. This formula originally treated lower back pain: Lurong (de-haired, roasted with butter until slightly yellow) and Fuzi (prepared, de-skinned and de-navel) each 2 liang, Yanhua (Salt Flower) 3 fen ground into powder, formed into pills with jujube flesh, 30 pills per dose, taken with wine on an empty stomach.

During the Dasheng era, in the household of Gongbu Shangshu (Minister of Works), Lord Zhongsu, an old woman suffered from a sinus for over ten years. A visiting physician said, "This is curable," took one live eel and five to seven bamboo needles, threw the eel on the ground, and upon its coiling, pierced it through the coil. He placed the eel over the wound. After a long time, he removed it and found dozens of white worms, similar to those trapped in the eel. He placed them in a cup of water where they wriggled like threads. He repeated this process five or six times. The physician said, "The worms are not entirely gone, but the rest are small. Apply common medicine." He used Binglang (Areca Seed) and Huanglian (Coptidis Rhizoma) ground into powder and applied it. The next day, he boiled dried mugwort (Ai Ye) with 2–3 qian of Baifan (Alumen) to wash the wound before applying the powder. Since human Qi and Blood are cold, Ai Ye's power is needed to assist Yang, and Ai Ye itself can kill parasites. After two such treatments, granulation tissue grew, and the wound healed within a month. The physician explained: If a wound is untreated for a month, worms may appear. Worms move, causing Qi and Blood to drain; thus, sinuses should not be closed hastily, otherwise toxins accumulate due to the worms. Furthermore, if a disease persists for a month without recovery, deficiency ensues. Women require Spleen and Blood tonification; children need protection from Wind and malnutrition; people in Liangguang regions need treatment for Miasma. Thus, the physician gained fame.

Another case involved a man with a sore on his calf that became a sinus over two years, unresponsive to hundreds of remedies; he believed he would die. A mountain hermit diagnosed it as "Eel Sinus" and prescribed Duanshi (Calcined Iron Ore) 2–3 sheng, soaked and fumigated with boiling water. When itching occurred, it was effective. Following this advice, washing with ash water caused itching, and the wound dried after two or three applications.

A woman developed a swelling under her neck that spread to her breast. Unknown etiology, she accidentally cut it with a knife, releasing a bowl of clear fluid. The wound failed to heal. A Daoist observed, "This is Ant Sinus, caused by accidentally swallowing ants while eating." It was confirmed. The Daoist said, "Easy to treat. Use Qianshanjia (Manis Pentadactyla Scale), burned to retain efficacy, ground to powder, and applied." Qianshanjia repels ants.

Liu Xizu, skilled in divination, had a wife suffering from Shu Liu (Rat Tumor/Lump) for years, near death. He divined and obtained the Yi hexagram, indicating a person surnamed Shi would cure it by catching a rat. Soon, a servant named Shi appeared, capable of treating this disease. He moxaed three points on the head. A rat approached and lay down; they called a cat to bite it. The rat had three moxa marks on its head, and the wife recovered.

Master Mei cited the *Neijing*: "Kidney transmits cold to the Spleen, causing abscesses and shortness of breath. Spleen transmits cold to the Liver, causing abscesses and spasms." Also, "All cold abscesses arise from changes in the Eight Winds." And, "Earthly dampness harms skin, flesh, tendons, and vessels." The *Shengji Zonglu* states, "Overly thick clothing makes the exterior susceptible to cold." The origin is generally like this. Some lesions do not change color initially, some are hard as stone, some are painless to pressure, but later become painful, soft, and purulent, thin like rice water, chronic, non-healing, turning into Gan Lou (Gangrenous Sinus), destroying muscle and bone marrow, leading to Wei Bi (Flaccidity and Obstruction). Treat with Gusuibu Wan.

**Gusuibu Wan**
Gusuibu (Drynariae Rhizoma), Buguzhi (Psoraleae Fructus), Shudihuang (Rehmanniae Radix Preparata), Chuan Danggui (Angelicae Sinensis Radix), Xuduan (Dipsaci Radix), Shinanye (Fatsiae Folium), Huangqi (Astragali Radix), Shihu (Dendrobii Caulis), Niuxi (Achyranthis Bidentatae Radix), Duzhong (Eucommiae Cortex), Bibing (Dioscoreae Hypoglaucae Rhizoma) [each 2 liang]; Fuzi (Prepared, 1 liang); Baishaoyao (Paeoniae Radix Alba), Chuanxiong (Ligustici Chuanxiong Rhizoma), Tusizi (Cuscutae Semen), Shashen (Glehniae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Duhuo (Angelicae Pubescentis Radix), Tianma (Gastrodiae Rhizoma) [each 1.5 liang].
This formula corresponds structurally to the Dalou Wan; it references Guizhi Tang and includes Mugua, Tusizi, and Baizhu.
Grind to powder. Form pills with refined honey. Take with salt water on an empty stomach.

[Yuanrong] stated: The child of Xing Sanlang suffered from Han Ju (Cold Abscess) for a long time without healing. First, use Siwu Chuanjiajia Tang to vent, then Dihuang Danggui Tang to tonify, followed by external Gusuibu Wan.
Yang Qi nourishes the spirit when refined and tendons when soft. If opening and closing fail, cold Qi enters, causing severe curvature (Dalou). Treat with:
**Dalou Wan**
Qianghuo, Fangfeng, Xixin (Asari Radix et Rhizoma), Fuzi, Gancao (Licorice Root), Chuanxiong, Xuduan, Baishaoyao, Baizhu, Danggui, Guixin (Cinnamomi Ramulus), Mahuang (Ephedrae Herba), Huangqi, Shudihuang.
This formula corresponds structurally to the preceding Gusuibu Wan.
When Ying Qi does not follow its course and reverses into the muscle texture, abscesses form. If it sinks into the vessels, it becomes Lou (Mole-like lesion); lingering in the muscle interstices, transforming Qi thins, transmitting fear and惊骇 (startle/fright).
**Guifu Wan** treats Qi Lou and various sores.
Guixin, Fuzi (cracked, soaked in rice vinegar, processed 3-5 times, de-skinned/de-navel), Houpo (Magnolia Bark, ginger-processed), Gancao (roasted), Baizhu [each 1 liang]; Muxiang (Aucklandiae Radix) 2.5 qian; Ruxiang (Olibanum) 2 qian (ground).
Grind to fine powder. Form pills with refined honey, size of Sophora seeds. Take 20-30 pills with rice drink on an empty stomach. Danxi noted: *Jingyao* uses Guifu Wan for cold sinuses. This cold arises because the sore has not healed for a long time, wind-cold invades, and Qi/Blood fail to circulate. Although Houpo is warm, it drains Wei Qi quickly; perhaps Renshen and Huangqi with Chenpi would better suit the condition. For cold sinuses with deficiency-cold, Jiawei Shiquan Tang adjusted by season and meridians is appropriate. For severe deficiency, Shen Zhu Gui Huang Gao is indicated.

**Xianmai San** treats sinuses and goiters lasting 20-30 years, or large as a basin, chronic, leading to leakage and destruction of flesh and bone. Hard, soft, or ulcerated, causing fright, insomnia, twitching pain, recurrence.
Ganjiang (Prepared), Hupo (Amber, ground), Dahuang (Rhei Radix et Rhizoma), Fuzi (Prepared, de-skinned/de-navel, each 1 liang), Danshen (Salviae Miltiorrhizae Radix) 7.5 qian, Shiliuhuang (Sulfur, ground), Bai Shiyin (Quartz, ground), Zhongru Fen (Stalactite Powder, ground), Oubiegu (Sepiae Endoconcha, ground, each 0.5 liang).
Grind to powder. Store in porcelain or leather to prevent gas escape. Apply directly if wet; if dry, mix with rendered pork fat and apply until dry. If dead flesh does not resolve, add 2 liang of Mangxiao (Natrii Sulfas) for better effect. Alternative method: One Hu Yan Ke (Swallow's nest).

[Danxi] Formula for Sinus:
Chuanxiong (0.5 liang), Xixin (2.5 qian), Baizhi Shao (Peucedani Radix tip, 2.5 qian), Gancao (fine powder).
Boil as decoction daily. Upper sores take after meals; lower sores before meals. Depending on pore size, use last year's Huang Ma Gen (Hemp Root), scrape coarse skin, soften, twist into rope, insert into pore until resistance, gradually deepening daily. Cover sore with good plaster.

[Zihe] Xiao Qu and Yuan San, whose legs were injured by bandits, developed sores on their calves that did not heal for years. Pus dripped constantly. Drinking cold water caused cold fluid to seep from the sores, worsening into damp sores. Dai Ren said, "Your Middle Jiao likely holds 2-3 sheng of green water and several mouthfuls of phlegm-saliva." Yuan asked why. Dai Ren said, "When robbed, shock Qi entered the abdomen. Shock injures the Gallbladder, Foot Shaoyang Meridian. Both outer ankles are also Shaoyang areas. The Jia Wood of the Gallbladder is invaded; Jia Wood is green, hence green water. Shaoyang in the Middle Jiao is like fermentation. Shock-phlegm-saliva lurks in the Middle Jiao. Drinking cold water is blocked by this phlegm-saliva; water follows the meridian and leaks into the sore. Hence, drinking water causes fluid to exit the sore." He induced vomiting of cold phlegm and sweating profusely, then purged 2-3 sheng of green fruit/water overnight. The scabs dried. Truly strange.

He once treated a sinus from knee to ankle, with the affected foot twice the size of the healthy one, limping. He used Wulong Wan to purge heavily six times, each time 5-7 bowel movements. Afterwards, he regulated with Huangbai (Phellodendri Cortex), Cangzhu (Atractylodis Rhizoma), Chi Shao (Paeoniae Radix Rubra), Dihuang, Gancao, Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Radix), Nanxing (Arisaematis Rhizoma), Banxia (Pinelliae Rhizoma), Niuxi, Huashi (Talcum), and Rougui (Cinnamomi Cortex). He stabilized after 3-4 months.

[Materia Medica] For Lou Fu (Mole-like lesion) with head and continuous pus, burn one woodpecker to ash. Mix with wine and take 1 qian bi; immediate cure. Dongyuan recorded: Surgeons must document experiences. For Gan Shi (Gangrenous erosion) and malignant sores unresponsive to drugs, take Qicao (Ground Beetle Larva), cut off both ends, place on the sore, and moxa. Change every 7 moxa cones, no more than 7 larvae; always effective. Another method: Use Qihuo Po Chonger (likely a specific insect/larva) for moxibustion, same method, repeatedly effective. People keep this secret, often not passing it from father to son.

Take Rotting Bone: Found in chronic ulcers and hemorrhoidal sinuses.
Take black-bone chicken tibias, fill with high-grade Pishuang (Arsenic Trioxide). Seal with salt mud, calcine red-hot. Remove from fire to eliminate toxicity, remove mud, grind bone fine. Form pills like millet grains with rice paste. Insert into orifice with paper twist, cover with plaster.

*Xianshi Fang* records realgar treating sores. *Zhou Li* states surgeons use "Five Toxins" to attack sores. Zheng Chengcheng notes: Modern formulas use "Five Toxic Medicines": Huang Ci Ji (Yellow Hen? Text says Huang Ci, likely referring to the vessel or ingredient context, usually associated with calcination vessels or specific minerals in this context, often interpreted as the container or a specific mineral preparation involving arsenic compounds), Shidan (Cinnabar), Xionghuang (Realgar), Fanshi (Alum), Cishi (Magnetite). Calcine for 3 days/nights. Smoke deposits on chicken feathers, apply to wound. Bad flesh and broken bones emerge completely. Yang Daniang recorded: Relative Yang Ou had a cheek ulcer extending to teeth/jaw, swollen like an inverted bowl, flesh rotting with pus/blood, painful to spit. Hundred remedies failed. Following Zheng's method, prepared medicine injected into wound. Soon, rotten bone and two teeth emerged, cured. Confirms speed of ancient formulas. "Huang Ci" refers to a clay pot/vessel.

**Zhugu Gao** treats sores with cold sensation, non-healing.
Pork marrowbone (2, extract marrow), Songzhi (Pine Resin, 2 qian, transparent, ground), Ruxiang (Frankincense, ground separately), Huanglian (Coptidis Rhizoma, de-filament, powder), Baiji (Bletillae Rhizoma, powder, each 2.5 qian), Qiandan (Lead Tetroxide, ground separately), Huangla (Yellow Beeswax, each 0.5 liang).
Pound and grind, melt wax to make ointment. Apply anytime.

**Fuzi San** treats cold sores, painful intermittently day and night.
Fuzi (0.5 liang, prepared, de-skinned/de-navel), Chuanjiao (Sichuan Pepper, de-seeds), Xionghuang (Realgar, fine powder, each 2.5 qian), Baifan (Alum, calcined, ground, 7.5 qian), Nifen (Calomel, ground, 2 qian).
Grind uniformly. Mix with pure hemp oil and apply to sore.

**Xionghuang San** treats cold sores, warms sore mouth.
Xionghuang (ground), Baihe (Lilii Bulbus), Ruxiang, Huangbai (Phellodendri Cortex, roasted, de-bark), Qiangshang Lan Baixianke (Rotten white clam shells on wall, small clams, each 1 fen).
Grind uniformly. First wash with Jiangshui (fermented grain water) decocted with Gancao and Willow branch, wipe dry, then apply.

**Heiling San** treats sinuses.
Muli Fen (Oyster Shell Powder), Guo Dan (Vermilion/Cinnabar?), Liuhuang (Sulfur, ground, each 1 fen), Lubofang (Vespa Nest, chopped, 2 fen).
Stir-fry together until smoke ceases. Grind fine. Add 1 fen hair ash and a little Shexiang (Musk). Mix and apply.

**Machixian Gao** treats all types of fistulas.
Machixian (Portulaca Oleracea, shade-dried), Layue Zhu Jin (December candle dregs, equal parts. Alternative: December mouse ash).
Grind fine. Mix with December pork fat. First wash with warm rice-washing water, dry, then apply. Three times daily.

For sinus under rib like ox-eye with continuous pus:
Place a little salt in a white bull's ear, collect the dirt/mucus inside, apply to sore. Cured. Without salt, ear doesn't itch, hard to collect.

For chronic non-healing sores:
Use prepared Fuzi, de-skinned/de-pointed, fine powder. Mix with saliva, form cake according to sore size. Place on site, moxa on cake. Also take major Qi-Blood tonics. Form cakes with Jiangxi Douchi (Fermented Soybean), moxa frequently; also effective.

**Shenying Gao**: Song Dynasty Defense Officer Chu used this for Emperor Lizong's chronic sinus when other formulas failed. It cured him. For Intestinal/Stomach toxins, taken as pills, miraculous.
Danggui (1.1 liang), Chishaoyao (Red Peony Root), Dahuang (Rhubarb, each 1.5 liang), Xiang Baizhi (Angelica Dahurica), Guanchun (Cinnamon Twig, each 1 liang), Xuanshen (Scrophulariae Radix) 1.3 liang, Chuan Xuduan (Dipsacus) 1.2 liang, Ezhu (Curcumae Rhizoma) 1 liang, Sheng Dihuang (Rehmannia) 1.2 liang.
Nine herbs, finely cut. Soak in 2 jin true sesame oil: Spring 5 days, Summer 3 days, Autumn 7 days, Winter 10 days. Boil in pot with gentle/fire alternating until black. Filter dregs. In hot weather use 20 liang Huangdan (Lead Tetroxide), cold months 15 liang. Add lead oxide slowly while stirring constantly. Test by dropping in water; sink when ready. Avoid women/chickens/dogs seeing it. For sinuses with holes, inject paste inside; spread externally.

**Binglang San**: Treats carbuncles/sores after pus discharge, exposed to wind-cold, swelling/stiffness, thin pus, continuous drainage, empty muscle interstices, foul odor, dry sore edges, no healthy flesh growth. Also treats gangrenous erosions. (Formula seen in Ulcer Healing section: Muxiang, Binglang, Huanglian equal parts, ground).

**External Plugging Medicine for Sinus**:
Luganshi (Calaminite, quenched in child's urine), Muli Fen (Oyster Shell Powder).
Grind extremely fine. Apply.

**Wujin San**: Paste for malignant sores/gangrene.
Two Oak Acorns: one filled with Huangdan, one with Baifan powder. Bind together. Wrap in black hemp skin, burn in fire, grind fine. Add little water. Wash sore, apply.

**Dongyuan Jiegan San**: Treats chronic gangrenous sores.
Huanglian, Shexiang (Musk, ground separately), Longnao (Borneol, each 0.5 liang), Mituoseng (Litharge), Huangdan, Baiji, Bailian (Smilacis Glabrae Rhizoma, each 1 liang), Qingfen (Calomel, 1 qian).
Grind fine, mix. Dry sprinkle on erosion, cover with plaster.

**Yingxiao San** (also Tuoli San): Treats Qi Fistula/Gangrenous erosion, chronic failure.
Digupi (Lycii Cortex, any amount, winter harvest, bark only, shade-dried).
Grind fine. Dip paper twist in erosion, promotes natural flesh growth. Also take 2 qian mixed with rice drink, anytime, 3 times daily.

For sinus, plug with Wubeizi (Chinese Gall) powder mixed with Xuejie (Dragon's Blood).

**Jiu Lou Chuang** (Chronic Sinus):
Acupoint: 1 cun above medial malleolus (Moxa 3-6 cones). If upper, Jianjing (GB21), Jiutui (CV15).
Lung pulse slightly slow indicates Wei Lou (Flaccid Fistula); slow pulse indicates much heat.