麻疯者。古人呼为疠风。又名恶疾。广东呼为大麻疯。又名疙瘩。外省或呼为大皮疯。又曰癞皮疯。染是疾
者。夫妻兄弟子女离散。戚友避之。行道叱之。颠连无告。至此极矣。医者不知受病之源。或言传染。或言风
水。虽非无因。然未必皆此之故也。盖东南地卑近水之处。此疾尤甚。天气较炎。地气卑湿。湿热相搏。乘人
之虚。入于营卫。卫气受之。则上身证多。营血受之。则下体证多。营卫俱受。上下俱多。此其大概也。究之无
论上下。必气虚。邪始乘之而入。血虚。邪始乘之而凝。结于筋络。积于肌肉腠理之间。郁久生热。故此病血
热居多。又或卧于湿地。受其熏蒸。或汗出后浴洗冷水。或湿衣沾身。或房劳后浴冷卧湿。皆能受病。初则
血滞不行。渐生麻痹。日久渐大。不知痛痒。针之不痛。今年发手。明年发足。或如癣形。或如疮癞。或似虫行。
或筋痛肉跳。久则伤形变貌。面生红堆。耳或长大。时如蝉鸣。脸如酒醉。又如油涂。手拳脚跛。口 眼斜。鼻
塌唇翻。不早治。成废疾矣。
疠风古无法治。丹溪止用醉仙散。再造散二方。但服轻粉。多生轻粉毒。恐一疾未愈。又添一疾。又有大黄
皂刺牵牛之类。然惟实者可用。气血虚者。反耗元气。东垣海藏。各有数方。亦兼他病而治之。至耆婆所列
各方。药多难制。外此方书所载。亦殊寥寥。若薜新甫疠疡机要。详于变证类证。而略于正治。要之湿热相
搏。邪气乘虚而入。总以凉血和血为主。驱风驱湿为佐。审元气之虚实。按六经以分治。斯治疠之要道也。
病之轻者。背腰手足之间。形如疥癣。不痛不痒。头面或似虫行。或手足骨节间。撞之如刺痛。或时作热。拭
之又无。病之重者。手足生疮。肉中结核。脸红耳肿。口 眼斜。至年久病深。坏形变貌。鼻塌肉崩。手指脱落。
足底烂穿。则难治矣。又身有麻木。数月即发外。虽重易治。丹溪谓麻木乃疠疾之本是也。又手有痹肉。则
虎口肉珠必焦。左手痹则左虎口肉焦。右手痹则右虎口肉焦。轻则肉珠瘦小。重则肉珠消陷。若两手俱
无痹肉。则虎口肉珠俱全。此法止可看手之轻重。面背腿足之疾。不验之于此。
面带紫色。常如醉人。且如油涂。俱有微浮。或黑而枯瘦。或黄而有浮光。其人身上。必有麻木。或数月即发。
或数年或数十年始大发。近发易愈。远发难治。原于初起不信之故耳。
南人谓药治不过三五年。后必复发。俗云。此病只好治邪。不能除根。皆不通之论也。大凡染病者多贫。药
饵难继。或半痊而囊空。或痊后不戒食物。不守禁忌。或治之未尽。有一二点痹肉未活。或痹肉活而皮色
未撤消。以致复作。此疾最忌房事。盖精乃骨髓。精泄则毒瓦斯乘虚而入。若不断此。必不能治。愈后不再戒。
一年必复发。
轻者脚未吊。手未拳。鼻未塌。肉未崩。证本可治。而服药无效。或气虚未补其气。血虚未补其血。又或兼有
别证。当详审之。
病在外而浮者易愈。在内而沉者难痊。气血盛者易治。衰者难治。在外而浮者。麻木不久尚浅。重扭则痛。
毒发在外。或癣或红堆。即遍身湿烂。亦可速愈。在内而沉者。痹肉沉内。稍稍缘开面上。手足背腿。各处红
紫之色。浸入肉内。不但现于皮肤。重扭不疼。针刺不知。治之必须一二年方可全愈。
死肉红堆。刺浅即觉痛者。不必烂。刺深不知痛。刀割不知疼。鼠咬不觉。宜用药烂去。然后用膏药贴之。用
生肌药敷之。即易平复。未见疾而有臭气逼人。此种一发必甚。亦易传染。虫乃肝经风热所生。肝不受病
则无虫。谓疯病无虫固非。谓疯病有虫亦谬。损筋者。手拳足痿。手拳不硬。以手按之即直。治之得法。手可
复伸。硬者难伸。脚吊痿者。不焦可复旧。焦者难复。手焦亦然。折骨者手足脱落。四肢如冰。骨节挺露。形如
枯树。名为湿坠。
湿闭久而生热。热郁久而生痰。轻则鼻塞。重则声哑。法宜清利肺经。痰自息。塞自通。哑自开。
肺主气。肝藏血。气行则血行。血凝因气滞。肺主皮毛。肝主经络。肝盛而脾胃亦病。故现于面。面属阳明胃
也。发于四肢。四肢脾也。筋弛皮痒。肝之本证。声哑鼻塞。肺之本证。折骨则肾病也。其初必由肝肺而致。又
肝木能自生风生虫。肺失治节。故眉落筋弛。治疯者。当以肝肺二经为主。
大小便不同器。人皆知之。外此。病患吃烟。亦宜避之。不病患吃烟。见病患亦宜避之。病患之尿。不可淋烟
草。淋则吃者必生疯病。此则人所不知。或谓人之气血。各归其经。岂能传染他人。不知疥癣尚有传染。何
况疯乎。父精母血。交媾成形。而所生男女。或染或否。何也。病在内者无不传。病在外者间有不传。未病而
先生子。能禁忌者不传。至云疯病无及子女者。则非也。精血交媾。夫妻岂有不传。男传女者少。女传男者
多。何则。女人因月水下而能泄其毒。故疯病者少。或言妇人卖疯之说。理亦可信。又言地土所产。室女亦
必卖疯。则终身不患此病。而所买之人则生疯。若果有此。当于室女经水初至时。即用药治之。以去血热
为主。以平祛肝经自生之风为佐。但得一次现面则毒出矣。切不可用疯门套药。用之反致成疯。存此以质高明。
气血俱实。脉实而有力。表剂汗之。使从表解。峻剂下之。使从二阴而出。次以清热驱风养血之剂为丸。相
间而服。又重者。用药煎水熏洗。自当速效。若气血俱虚者。以补血和血为主。佐以凉血驱风之品。缓缓治
之。亦无不效。大凡治疯发出者。易治。服药即发亦易愈。
熏洗之法。务要露出头面。凡痹肉无汗者。血死湿闭故无汗。汗即血也。血枯之人。不可大汗。先养其血。血
渐复。则可熏洗。若多服丸药。久久汗出如常。不熏洗亦可。
痹者肉木而不痛。若不针出死血。势必溃烂。脓血淋漓。但针出黑血。不妨再针。若针出鲜血。即止。须一次
针一处。不可连针数处。恐去血过多。血尽而人亡也。大抵烂之则效速。不若针之效虽迟较为稳当也。
灸法。先将痹处以墨点记。然后以生姜一片粘贴。用艾丸灸之。觉痛即止。但痹少则可灸。痹多则不胜其
灸。当以服丸药为主。
死肌痹肉。寒湿永结。久则遍身发泡。烂而为疮。脓水淋漓。名曰风疮。又名疙瘩。须用药撒之。令脓水干。则
结痂。久之痂自脱落。亦有服药得法。泡破而无脓水者。至状若豆疮。硬如牛乳肉豆。结核者。不妨针出恶
血。针而不愈。以药烂之。烂后以膏药贴之。
男人血少。以养血和血为主。驱风行滞为佐。女人血多。以活血行血为主。驱风燥湿为佐。男人忌房事。女
人尤忌。女不禁房事。恐受胎一二月。尚不知其虚实。投以疯药。而胎坠矣。胎坠则血气俱虚。毒更乘虚而
入。而病愈重。况男女交接。毒又必传染乎。又凡女人。必兼一二味调经之品。
疠虽恶疾。治之得法。即常用平和之药。亦无不效。蛇蝎犹可用。至若砒霜、蜈蚣、斑蝥、轻粉之剂。病之极重
者。不得已而用之。不可恃此以为常。川乌、草乌、附子、肉桂。虚寒之人。病愈后以之结功则可。以之治病则
不可。盖辛热之品。能燥血耗血。血亏而病愈加。不可不知。
发毒之物助毒。生冷之物凝血。凝滞之物固毒。煎炒之物助火。皆宜切戒二三年。若自死禽兽之肉。终身
宜戒。母猪肉亦然。
疯疾传染。事故常有。但回避可也。不共享器。不同饮食。各房各床。尽力求治。宽以岁月。无不全愈。否则亦
当调停处置。令衣食不缺。若夫妻离弃之事。切莫劝解。
麻风病，古人称为疠风。又被称为恶疾。广东地区称为大麻疯，又名疙瘩。外省有时称为大皮疯，也叫癞皮疯。感染这种疾病的人，会导致夫妻、兄弟、子女离散，亲戚朋友躲避他们，路人斥责他们，处境艰难无助，到了极点。医生不了解发病的根源，有的说是传染，有的说是风水所致。虽然并非没有原因，但未必都是这个缘故。大概东南地势低洼靠近水的地方，这种病尤为严重。天气炎热，地气卑湿，湿热相互搏结，趁着人体虚弱的时候，侵入营卫之中。卫气受邪，则上身症状多；营血受邪，则下体症状多；营卫都受邪，则上下症状都多。这是大概的情况。究其根本，无论上下，必定是气虚，邪气才能乘虚而入；血虚，邪气才能乘虚而凝滞。邪气结聚于筋络，积聚在肌肉腠理之间，郁积久了产生热邪，所以此病多为血热。又或者睡在潮湿的地方，受到湿气熏蒸；或者出汗后洗冷水澡；或者湿衣服沾身；或者房事后洗冷水澡睡在潮湿处，都能导致生病。起初则是血液停滞不行，逐渐产生麻痹，日子久了逐渐变大，不知道痛痒，针刺也不觉得痛。今年发作在手，明年发作在脚。有的像癣的形状，有的像疮癞，有的像虫子爬行，有的筋痛肉跳。时间久了则损伤形体改变容貌，脸上生出红色的堆状物，耳朵有时变大，时常像蝉鸣一样响，脸像喝醉了一样，又像涂了油一样。手蜷曲成拳，脚跛行，口眼歪斜，鼻子塌陷嘴唇翻卷。如果不早治疗，就会成为废人残疾。
疠风在古代没有固定的治疗方法。朱丹溪只用醉仙散、再造散两个方子，但是服用轻粉（氯化亚汞），容易产生轻粉中毒。恐怕一种病没治好，又添了一种病。又有大黄、皂角刺、牵牛子之类的药物，然而只有体质壮实的人可以使用，气血虚弱的人，反而会耗损元气。李东垣、张藏各有几个方子，也是兼治其他病症。至于耆婆所列出的各方，药物大多难以制作。除此之外，方书所载的也特别少。如果薛新甫的《疠疡机要》，详细记载了变证和类证，而对于正治之法却简略。总之，湿热相搏，邪气乘虚而入，总以凉血和血为主，驱风驱湿为辅助。审察元气的虚实，按照六经来分别治疗，这才是治疗疠风的要领。
病情轻的，在背腰手足之间，形状像疥癣，不痛不痒。头面部有时像虫子爬行，或者手足骨节间，撞击时像刺痛，或者时而发热，擦拭后又没有感觉。病情重的，手足生疮，肌肉中有结核，脸红耳肿，口眼歪斜。到了年久病深，坏形变貌，鼻子塌陷肌肉崩解，手指脱落，足底烂穿，那就难治了。另外身体有麻木感，几个月就会发作在外，虽然重也容易治。朱丹溪说麻木是疠疾的根本，是对的。另外手上有痹肉（肌肉萎缩或结节），那么虎口处的肉珠（合谷穴附近的肌肉隆起）一定会焦枯。左手有痹肉则左虎口肉焦，右手有痹肉则右虎口肉焦。轻则肉珠瘦小，重则肉珠消陷。如果两手都没有痹肉，那么虎口肉珠就都完好。这种方法只能用来查看手部病情的轻重，面、背、腿、足的疾病，不能用这个方法来验证。
面色带紫色，经常像醉汉，而且像涂了油一样，都有微微浮肿。或者黑而枯瘦，或者黄而有浮光。这个人身上，一定有麻木感，或者几个月就发作，或者几年甚至几十年才大发。近期发作的容易治愈，远期发作的难治。这源于起初不相信会得病的缘故。
南方人说药物治疗不过三五年，后来必定复发。俗语说，这种病只能治邪，不能除根，都是不通之论。大凡染病的人多贫穷，药费难以持续。或者半痊愈时囊中空空，或者痊愈后不忌口食物，不遵守禁忌，或者治疗不彻底，有一两点痹肉没有恢复，或者痹肉恢复了但皮色没有消退，以致复发。这种病最忌讳房事。因为精液乃骨髓所化，精液泄出则毒瓦斯乘虚而入。如果不戒除房事，一定不能治愈。愈后不再戒除，一年必定复发。
病情轻的，脚没有拘挛，手没有蜷曲，鼻子没有塌陷，肌肉没有崩解，证候本来可以治愈，而服药无效。或者气虚没有补气，血虚没有补血，又或者兼有其他证候，应当详细审察。
病位在外且浮浅的容易治愈，在内且深沉的难痊愈。气血旺盛的容易治疗，衰弱的难治疗。病位在外且浮浅的，麻木时间不久尚浅，用力扭转则痛，毒发在外，或者是癣或者是红堆，即使遍身湿烂，也可以迅速愈合。病位在内且深沉的，痹肉沉在内部，稍微蔓延到面上，手足背腿各处红紫之色，浸入肉内，不但现于皮肤，用力扭转不疼，针刺不知痛。治疗必须一两年才可以全愈。
死肉红堆，刺浅即觉痛的，不必让它腐烂。刺深不知痛，刀割不知疼，老鼠咬不觉痛的，宜用药腐蚀去除，然后用膏药贴敷，用生肌药敷上，就容易平复。未见疾病但有臭气逼人的，这种一发必然很严重，也容易传染。虫乃是肝经风热所生，肝不受病就没有虫。说疯病无虫固然不对，说疯病有虫也是谬误。损伤筋脉的，手蜷曲脚痿软，手蜷曲但不僵硬，用手按之即可伸直，治疗得法，手可以重新伸展。僵硬的难伸展。脚拘挛痿软的，不焦枯的可以恢复旧观，焦枯的难恢复。手的焦枯也是如此。折骨者手足脱落，四肢如冰，骨节挺露，形状像枯树，名为湿坠。
湿气闭阻久了而生热，热郁积久了而生痰。轻则鼻塞，重则声音嘶哑。治法宜清利肺经，痰自然平息，塞自然通畅，哑自然开音。
肺主气，肝藏血。气行则血行，血凝因气滞。肺主皮毛，肝主经络。肝盛而脾胃也会生病，所以表现在面部。面属阳明胃经。发于四肢，四肢属脾。筋弛缓皮瘙痒，是肝的本证。声音嘶哑鼻塞，是肺的本证。折骨则是肾病。其初起必由肝肺而导致。另外肝木能自生风生虫，肺失治节，所以眉毛脱落筋弛缓。治疗疯病，应当以肝肺二经为主。
大小便不同器，人们都知道。除此之外，病人吸烟，也应该避免。不是病人吸烟，见到病人也应该避免。病人的尿液，不可淋在烟草上，淋了则吸烟的人必定生疯病。这是人们不知道的。有人说人的气血，各归其经，怎么能传染他人。不知道疥癣还有传染，何况疯病呢？父精母血，交媾成形，而生下的男女，有的感染有的不感染，为什么呢？病在内部的无不传播，病在外部的间或有不传播的。未病而先生子，能禁忌的不传播。至于说疯病不及子女的说法，是不对的。精血交媾，夫妻之间岂有不传染的？男传女的少，女传男的多。为什么呢？女人因为月经下行而能泄其毒，所以患疯病的少。有人说妇人卖疯的说法，道理也可信。又说地土所产，处女也必定卖疯，则终身不患此病，而买的人则生疯。如果果真有此情况，应当在处女月经初至时，即用药治疗，以去血热为主，以平祛肝经自生之风为辅助。只要有一次现面则毒就出来了。切不可用疯门套药，用了反而致成疯病。存此以请教高明之士。
气血俱实，脉实而有力，用表剂发汗，使从表解。用峻剂泻下，使从二阴而出。其次用清热驱风养血之剂做成丸药，相间服用。又重的，用药煎水熏洗，自当速效。若气血俱虚的，以补血和血为主，佐以凉血驱风的药物，缓缓治疗，也没有不有效的。大凡治疯病发出者，易治。服药即发亦易愈。
熏洗的方法，务必露出头面。凡是痹肉无汗的，是血死湿闭故无汗。汗即是血。血枯的人，不可大汗。先养其血，血渐渐恢复，则可以熏洗。如果多服丸药，久久汗出如常，不熏洗也可以。
痹症是肉木而不痛。如果不针刺放出死血，势必溃烂，脓血淋漓。但只要针出黑血，不妨再针。如果针出鲜血，即止。须一次针一处，不可连针数处，恐去血过多，血尽而人亡也。大抵腐蚀则见效快，不如针刺见效虽迟较为稳当。
灸法，先将痹处以墨点记，然后用生姜一片粘贴，用艾丸灸之。觉得痛即停止。但痹少则可以灸，痹多则不胜其灸。应当以服丸药为主。
死肌痹肉，寒湿永结，久了则遍身发泡，烂而为疮，脓水淋漓，名叫风疮，又名疙瘩。须用药撒之，令脓水干，则结痂。久之痂自脱落。也有服药得法，泡破而无脓水的。至状若豆疮，硬如牛乳肉豆，结核的，不妨针出恶血。针而不愈，用药腐蚀。烂后用膏药贴之。
男人血少，以养血和血为主，驱风行滞为辅助。女人血多，以活血行血为主，驱风燥湿为辅助。男人忌房事，女人尤其忌。女人不禁房事，恐怕受孕一二月，尚不知其虚实，投以疯药，而胎坠矣。胎坠则血气俱虚，毒更乘虚而入，而病愈重。况且男女交接，毒又必传染乎？另外凡女人，必兼一二味调经之品。
疠风虽是恶疾，治疗得法，即常用平和的药物，也没有不有效的。蛇蝎犹可用，至于砒霜、蜈蚣、斑蝥、轻粉之剂，病极重者，不得已而用之，不可恃此以为常。川乌、草乌、附子、肉桂，虚寒之人，病愈后以之结功则可，以之治病则不可。因为辛热之品，能燥血耗血，血亏而病愈加，不可不知。
发毒之物助毒，生冷之物凝血，凝滞之物固毒，煎炒之物助火，皆宜切戒二三年。若是自死禽兽之肉，终身宜戒。母猪肉亦然。
疯疾传染，事故常有，但回避即可。不共享器具，不同饮食，各房各床，尽力求治，宽以岁月，无不全愈。否则也应当调停处置，令衣食不缺。若夫妻离弃之事，切莫劝解。
Leprosy, referred to as Li Feng (Leprosy) by the ancients, is also known as Evil Disease. In Guangdong, it is called Da Ma Feng (Great Leprosy), or Ge Da (Nodules). In other provinces, it may be called Da Pi Feng (Great Skin Leprosy) or Lai Pi Feng (Scaly Skin Leprosy). Those infected with this disease suffer separation from spouses, siblings, and children; relatives and friends shun them, and passersby curse them. Their plight is helpless and extreme. Physicians who do not understand the origin of the disease attribute it to contagion or wind-water factors. While there may be some basis for these views, they are not necessarily the sole cause. Generally, in the southeast where the terrain is low and near water, this disease is particularly severe. The weather is hot, and the earthy qi is damp and low. Damp-heat contends and combines, taking advantage of human deficiency to enter the Ying (Nutritive) and Wei (Defensive) levels. If the Wei Qi is affected, symptoms appear mostly on the upper body; if the Ying Blood is affected, symptoms appear mostly on the lower body; if both are affected, symptoms appear throughout. This is the general pattern. Fundamentally, regardless of location, Qi deficiency allows pathogenic factors to enter, and Blood deficiency allows pathogens to coagulate. Pathogens accumulate in the sinews and collaterals, gathering between muscles and interstices. Prolonged stagnation generates heat, so this disease is predominantly characterized by Blood Heat. Alternatively, sleeping on damp ground exposes one to steamy dampness; bathing in cold water after sweating; wearing wet clothes; or bathing in cold water and lying on damp surfaces after sexual intercourse can all lead to illness. Initially, blood stasis occurs, gradually leading to numbness. Over time, lesions enlarge, losing sensation to pain and itching, such that needle pricks are not felt. Lesions may appear on the hands one year and feet the next. They may resemble tinea, ulcers, or leprosy nodules; feel like insects crawling; or involve tendon pain and muscle twitching. Long-term damage alters physical appearance: red mounds appear on the face, ears may enlarge and ring like cicadas, the face resembles drunkenness or oil coating, hands curl into fists, legs become lame, mouth and eyes deviate, the nose collapses, and lips evert. Without early treatment, it leads to disability.
In ancient times, there was no fixed treatment for Leprosy. Zhu Danxi used only two formulas: Zui Xian San (Intoxicating Immortal Powder) and Zai Zao San (Reconstruction Powder). However, the use of Qing Fen (Calomel/Mercurous Chloride) often caused mercury poisoning, risking a new disease before the old one healed. Other prescriptions included Da Huang (Rhubarb Rhizome), Zao Ci (Gleditsia Sinensis Thorn), and Qian Niu Zi (Pharbitis Seed), which are suitable only for robust constitutions; using them in those with Qi and Blood deficiency would further deplete Yuan Qi. Li Dongyuan and Zhang Congzheng each had several formulas, often treating concurrent conditions. The formulas listed by Aryadeva (Qipo) involved difficult-to-process ingredients. Other medical texts contain few records. Xue Xinpu's "Li Yang Ji Yao" (Essentials of Leprosy Treatment) details variant and similar syndromes but omits primary treatments. Essentially, since damp-heat contends and pathogens enter via deficiency, the main strategy should be Cooling Blood and Harmonizing Blood, assisted by Expelling Wind and Dampness. One must assess the deficiency or excess of Yuan Qi and treat according to the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin). This is the key to treating Leprosy.
Mild cases present as scabies-like lesions on the back, waist, hands, and feet, without pain or itch. The head and face may feel like insects crawling, or joints may sting when struck, or fever may arise intermittently but vanish upon wiping. Severe cases involve ulcers on hands and feet, subcutaneous nodules, facial redness, ear swelling, and deviation of the mouth and eyes. In long-standing, deep-seated disease, deformity worsens: the nose collapses, flesh disintegrates, fingers fall off, and soles ulcerate through, making it difficult to treat. However, systemic numbness that manifests externally within months, even if severe, is easier to treat. Zhu Danxi stated that numbness is the root of Leprosy, which is correct. Additionally, the presence of Bi Rou (numb/atrophy tissue) in the hand indicates changes in the He Gu area (muscle mound at the thumb-web). Left-hand Bi Ru implies left He Gu atrophy; right-hand implies right. Mild cases show thinning; severe cases show depression. If neither hand has Bi Ru, the He Gu areas remain intact. This method only assesses hand severity, not facial, dorsal, leg, or foot conditions.
A purple complexion resembling drunkenness or an oily sheen, with slight edema, or black and emaciated, or yellow with a glossy sheen, always accompanies numbness. Symptoms may flare after months or decades. Recent onset is easier to cure; distant onset is harder, due to initial denial.
Southerners claim medication works for only 3-5 years before relapse, saying the disease can only suppress pathogens, not eradicate them. This is incorrect. Most patients are poor, unable to sustain medication costs. Relapses occur due to empty purses during partial recovery, dietary indiscretion post-recovery, incomplete treatment leaving residual numbness, or persistent skin discoloration. Sexual abstinence is strictly forbidden, as essence (Jing) transforms into marrow; ejaculation allows toxins to enter via deficiency. Without abstinence, cure is impossible. Post-cure failure to abstain guarantees relapse within a year.
Mild cases (no claw-hand, no collapsed nose, no flesh loss) are curable. If medication fails, check for unaddressed Qi/Blood deficiency or concurrent syndromes.
External/superficial diseases are easier to cure than internal/deep ones. Robust Qi/Blood responds better than deficient states. Superficial numbness is painful to pressure; toxins manifest externally as tinea or red mounds. Even widespread weeping ulcers can heal quickly. Deep/internal numbness involves sinking tissues, spreading redness/purple hues into muscles beyond the skin, lacking pain to pressure or needles. Cure requires 1-2 years.
Dead flesh/red mounds painful to shallow needling do not require cauterization. Deeply insensitive tissue (painful to deep needling, cutting, or rat bites) requires chemical cauterization, followed by plasters and tissue-regenerating herbs for easy recovery. Foul odor preceding visible disease indicates severe, contagious cases. Parasites arise from Liver Wind-Heat; absence of Liver pathology means no parasites. Denying parasites in Leprosy is wrong, as is affirming them indiscriminately. Tendon damage causes claw-hand and foot flaccidity; soft clonus is reversible with proper treatment, while rigid clonus is difficult. Foot flaccidity without atrophy recovers; atrophy does not. Bone fracture/destruction presents with ice-cold limbs, protruding joints, and withered appearance, termed Shi Zhui (Damp Drooping).
Prolonged Damp obstruction generates Heat; prolonged Heat stagnation generates Phlegm. Mild cases have nasal congestion; severe cases have hoarseness. Treatment clears and benefits the Lung Meridian, resolving Phlegm, congestion, and hoarseness.
The Lung governs Qi; the Liver stores Blood. Qi movement drives Blood flow; Blood coagulation stems from Qi stagnation. The Lung governs skin/hair; the Liver governs sinews/collaterals. Liver excess affects Spleen/Stomach, manifesting on the face (Yangming Stomach meridian). Limbs belong to the Spleen. Flaccid sinews and itchy skin are Liver signs; hoarseness and nasal congestion are Lung signs; bone destruction is Kidney pathology. Initial pathology originates in Liver and Lung. The Liver Wood generates internal Wind and parasites; Lung loses regulatory function, causing eyebrow loss and tendon flaccidity. Treatment focuses on the Liver and Lung meridians.
While everyone knows urine and feces exit through different orifices, smokers should avoid patients, and patients should avoid smokers. Patient urine contaminating tobacco causes Leprosy in smokers—a hidden transmission route. Some argue Qi and Blood stay in their meridians and cannot transmit, ignoring that Scabies/Tinea are contagious. Parental Essence and Blood form the fetus; offspring may or may not inherit the disease. Internal diseases transmit fully; external diseases transmit intermittently. Pre-conception abstinence prevents transmission. Claiming Leprosy does not affect children is false. Spouses transmit to each other; male-to-female transmission is less common than female-to-male because menstruation expels toxins, reducing female prevalence. The theory of "virgin prostitution" (buying virgins to avoid infection) suggests buying virgins prevents disease in the buyer but causes it in the seller. If true, treating virgins at menarche with Blood-Cooling and Liver-Wind-Expelling herbs could prevent manifestation. Avoid standard Leprosy remedies, which may induce the disease.
For Excess patterns (robust pulse), use diaphoretics to release from the exterior or purgatives to drain from the yin orifices, followed by alternating pills for Clearing Heat, Expelling Wind, and Nourishing Blood. Severe cases benefit from fumigation and washing. For Deficiency patterns, prioritize Nourishing and Harmonizing Blood, assisted by Cooling Blood and Expelling Wind herbs, treating slowly for efficacy. Eruptive forms are easier to treat; drug-induced eruptions also heal well.
Fumigation/washing must expose the head/face. Absence of sweat in numb areas indicates dead Blood and Damp closure. Sweating equals Blood loss; Blood-deficient patients should not sweat heavily. Nourish Blood first; then fumigate once Blood recovers. Long-term pill use inducing normal sweating makes fumigation optional.
Bi syndrome (numbness without pain) requires needling to release dead Blood, preventing ulceration and pus discharge. Black blood can be repeatedly needled; stop when bright red blood appears. Needling one area per session to avoid fatal blood loss. Cauterization acts faster but is less stable than needling.
Moxibustion: Mark numb areas with ink, apply ginger slice, and moxa cone. Stop when pain is felt. Suitable for mild numbness; extensive numbness requires pills instead.
Dead muscle/tissue with chronic Cold-Damp leads to blistering, ulceration, and pus (Wind Ulcer/Nodules). Apply medicaments to dry pus and form scabs. Some cases resolve without pus. Hard nodules resembling bean curd may be needled to release foul blood; if ineffective, use cauterization followed by plasters.
Men (Blood deficiency): Prioritize Nourishing/Harmonizing Blood, assisting with Wind-Expelling and Stagnation-Resolving herbs. Women (Blood abundance): Prioritize Invigorating/Moving Blood, assisting with Wind-Expelling and Damp-Drying herbs. Men must abstain from sex; women especially so. Pregnancy risks miscarriage if toxic drugs are given unknowingly, worsening deficiency and toxin invasion. Intercourse transmits toxins. Women’s prescriptions should include Menses-Regulating herbs.
Though Leprosy is malignant, proper treatment with mild herbs is effective. Snake/scorpion preparations are usable. Arsenic (Pi Shuang), Centipede (Wu Gong), Blister Beetle (Ban Mao), and Calomel (Qing Fen) are reserved for extreme cases only. Aconite (Chuan Wu, Cao Wu), Cinnamon Bark (Rou Gui) are for post-cure Yang deficiency consolidation, not active treatment, as acrid-hot herbs dry and consume Blood, worsening deficiency.
Toxin-aggravating foods, raw/cold foods (coagulate Blood), stagnant foods (fix toxins), and fried/spicy foods (generate Fire) must be avoided for 2-3 years. Dead meat and sow meat are lifelong prohibitions.
Contagion occurs; avoidance is key. Do not share utensils/diet; separate rooms/beds. Seek treatment diligently over time for full recovery. Provide social support (food/clothing). Do not mediate spousal abandonment.