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(Those sores with flesh protruding are...)
[Xue Ji] Fan Hua Chuang (Reversed Flower Sore) is caused by liver fire and dry blood generating wind after the ulceration of a sore. In some cases, flesh grows out from the wound opening, varying in size like mushrooms; in others, it protrudes like snake heads of different lengths. The treatment method: One should nourish the liver and tonify primordial qi, and apply Li Lu Gao (Veratrum Ointment) externally, which will cause the protruding flesh to retract naturally. This must be done only after the primordial qi has gradually recovered and the pus and toxins are about to be exhausted; otherwise, even if it retracts, it will ulcerate again. If mistakenly treated with knives, needles, cauterizing medicines, or moxibustion/fire, the condition will worsen, potentially leading to uncontrollable bleeding, and inevitably causing symptoms such as alternating chills and fever, and vomiting. At this point, greatly tonifying the spleen and stomach is the best approach. Zhang Cheng'en, a judge, had an abscess on his inner thigh that was nearly healed when a mushroom-like piece of flesh protruded. I said: "This belongs to wind-heat and dry blood in the liver meridian; one should clear liver heat and nourish liver blood." He disagreed, using internal fire-descending medicines and external cauterizing agents. After cauterization, the flesh protruded again; after protrusion, it was cauterized again. The flesh grew larger, and the primordial qi became more deficient, until he finally believed my words. He then took Zhi Zi Qing Gan San (Gardenia Decoction to Clear the Liver) internally and applied Li Lu Gao externally, resulting in recovery. A student of the Imperial Academy, who habitually consumed rich foods and was prone to anger, developed a nodule under his ear. After it ulcerated, the wound opened and the flesh protruded like a mushroom, associated with headache, occasional chest and hypochondriac distension, and internal heat or alternating chills and fever. Having used heat-clearing and detoxifying medicines for over a year without cure, I used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) to achieve a quick recovery. A man with a back sore had it constrict to the size of a bean, yet fleshy growths protruding over an inch appeared. Repeated attempts to eliminate them using escharotic and cutting methods failed as they kept growing back; this was due to liver blood deficiency and wind-heat. I prescribed Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) for over thirty doses and applied Li Lu Gao, leading to resolution; subsequently, Ba Zhen San (Eight Treasure Powder) with increased amounts of Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Dang Gui (Angelica Sinensis Root), and Fu Ling (Poria) was used to promote healing. A woman, prone to anger, developed an abscess on her arm with two inches of flesh protruding from the wound. This was attributed to liver-spleen depression and anger causing qi and blood deficiency with internal wind movement. She was treated with Jia Wei Xiao Yao San and topical Li Lu Gao, resulting in cure. Later, due to anger, she experienced swelling and stifling sensation at the lesion site, with profuse sweating all over the body like rain. This was due to liver meridian wind-heat, as wind scatters qi. She recovered using the previous powder combined with Ba Zhen Tang (Eight Treasure Decoction). A man with neck swelling produced excessive phlegm and saliva. Treatment with hard-resolving and qi-moving agents exacerbated the hardness and swelling. He suffered from panting, fever, spontaneous sweating, night sweats, fatigue, and poor appetite. I stated: "This belongs to deficiency of the three yin meridians of the foot; one should nourish the source of transformation." Disbelieving this, he subjected the lesion to cauterization, causing the wound to evert to about six cun. The color was red, and fresh blood flowed daily for over three months. The liver pulse was wiry, surging, tight, and solid. I administered Da Bu Tang (Great Tonifying Decoction) plus Mai Men Dong (Ophiopogon Tuber) and Wu Wei Zi (Schisandra Fruit) for over fifty doses. Various symptoms gradually improved, and bleeding stopped for three to four intervals. Later, due to anger and sudden decrease in food intake, blood gushed forth. This indicated liver injury failing to store blood and spleen injury failing to control blood. Using Bu Zhong Yi Qi Tang as the main formula, added with Wu Wei Zi and Mai Men Dong, the bleeding stopped immediately. Subsequently, Liu Wei Wan (Six-Ingredient Pill) with added Wu Wei Zi was taken regularly. The wound contracted to about one cun. Medication was then discontinued. However, he died because he did not observe dietary and lifestyle restrictions.

Li Lu Gao (Veratrum Ointment): Treats all types of carbuncles and sores with protruding flesh, regardless of size or length. Use Veratrum (Li Lu) alone, grind into powder, mix with raw lard, and grind into an ointment. Apply to the affected area and change once a week.

Yan Zhi San (Rouge Powder): Treats Fan Hua Chuang (Reversed Flower Sore).
Ingredients: Yan Zhi (Vermilion/Rouge), Bei Mu (Fritillaria Bulb), Hu Fen (Lead Carbonate/White Lead), Peng Sha (Borax), Mo Yao (Myrrh).
Dosage: Each ingredient one fen (except Peng Sha and Mo Yao, which are half a fen).
Preparation: Grind finely. First wash and wipe the area with warm rice water, then apply the medicine.

Gan Cao Tu Fu Fang (Licorice Topical Application Formula): Treats Fan Hua Chuang (Reversed Flower Sore).
Ingredients: Gan Cao (Licorice Root, half raw, half stir-fried), Fan Duan Shi (Calcined Alum Stone), Ren Zhong Bai (Human Placenta Ash), Mi Duo Seng (Litharge).
Dosage: Each half liang.
Preparation: Grind into fine powder. Take half a cup of urine from an uncircumcised boy, boil gently without strong fire, stir with a bamboo spatula until it forms an ointment. Apply to the sore five times a day.

E Shi Gen Tu Fu Fang (Arctium Root Topical Application Formula): Treats Fan Hua Chuang (Reversed Flower Sore) and various sores that have not healed for years.
Ingredients: E Shi Gen (Arctium Root, ground into powder, four liang), Zhu Zhi (Pork Lard, two liang).
Preparation: Mix well to form a paste. Apply to the sore three to four times a day.

For sores where flesh protrudes like a snake head for several inches, applying sulfur powder causes immediate retraction. (From *Sheng Hui Fang*). For sores with protruding flesh, burning Chinese plum (Wu Mei) to ash and applying the powder causes immediate disappearance. (From *Gui Yi Ji*). Also, pounding white plum flesh finely, mixing with honey, forming cakes the size of coins, and applying them is excellent. (From *Sheng Hui Fang*).
[Mei]: To treat Fan Hua Chuang (Reversed Flower Sore), use one jin of Purslane (Ma Chi Xian), burn to ash, grind finely, and mix with pork lard for application.
[Shi]: For sores protruding about one cun, with roots the size of a small bean or large as a plum, wrap the root with silk from a spotted-legged spider. It will gradually dry and fall off naturally.