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Sores and ulcers are commonly seen in localized areas due to various diseases such as furuncles, carbuncles, abscesses, ulcers, and pressure sores, presenting symptoms of redness, swelling, heat, and pain, and may even become purulent or ulcerated. Patients may suffer from external pathogenic factors or special epidemic toxins, or due to irregular diet. Below, we will discuss the common causes of sores and ulcers in TCM, diagnostic patterns, and treatment, along with examples of commonly used Chinese patent medicines.
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Common Causes and Diagnostic Treatment
Furuncles: These commonly occur on the superficial skin, are relatively small (usually less than 3 cm), and are characterized by a single pus-filled lesion. Generally, there are no systemic symptoms or only mild ones. They are prone to pus formation, ulceration, and healing, presenting with redness, burning, and pain, possibly accompanied by fever, dry mouth, constipation, yellow tongue coating, and rapid pulse. Common patterns include Heat Toxin Accumulation, Damp Toxin Stagnation, and Yin Deficiency with Internal Heat, with treatment focusing on clearing heat and detoxifying, while also supporting the body’s righteousness.
Carbuncles: These often occur on the face and extremities, with the sore being small and swollen, approximately 3-6 cm in size, with a hard root resembling a nail, and severe swelling and pain. The condition develops rapidly, and the toxic pathogen can easily spread, with severe cases presenting chills and fever. Carbuncles on the extremities include snake-eye carbuncles, snake-head carbuncles, snake-belly carbuncles, and foot-bottom carbuncles.
Abscesses: These are acute purulent diseases occurring between the skin and flesh, commonly found on the back and neck. They present as firm, dark red swellings, approximately 6-9 cm in size, with a rapid onset, easy swelling, pus formation, ulceration, and healing, often accompanied by severe pain or tenderness. Generally, they take 1-2 weeks to become purulent, and most patients experience chills and fever. They typically do not damage tendons or bones or cause deep-seated conditions. Common patterns include Fire Toxin Congestion, Excess Heat Causing Flesh Necrosis, and Qi and Blood Deficiency, with treatment focusing on clearing heat and detoxifying, promoting drainage, and ensuring thorough pus expulsion, with integrated TCM and Western medicine treatment for those with purulent blood conditions.
Head Abscess: Characterized by millet-sized pus heads, larger than abscesses, with diameters exceeding 10 cm and potentially reaching 30 cm, easily spreading to deeper tissues and surrounding areas, with multiple pus-filled lesions. Upon ulceration, they resemble a honeycomb, with local skin showing redness, swelling, heat, and pain, and are prone to inward sinking, commonly seen in middle-aged and diabetic patients. Common patterns include Qi Stagnation with Heat Congestion, Excess Heat Toxin, Yin Deficiency with Excess Fire, and Damp-Heat Stagnation, with treatment focusing on clearing heat, draining fire, and transforming dampness, nourishing Yin, generating fluids, and harmonizing the blood to expel toxins.
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Seven Commonly Used Chinese Patent Medicines for Sores and Ulcers:
Lianqiao Baidu Wan (Forsythia Detoxifying Pill), Function: Clears heat and detoxifies, reduces swelling and alleviates pain; Indications: Sores and ulcers, erysipelas, purulent discharge, burning fever, scabies, and itching. Ingredients: Lianqiao (Forsythia), Jinyinhua (Honeysuckle), Huanglian (Coptis), Huangbai (Phellodendron), Tianhuafen (Trichosanthes), Huangqin (Scutellaria), Fangfeng (Siler), Baizhi (Angelica dahurica), Qianghuo (Notopterygium), Kudiqing (Bitter Herb), Dahuang (Rhubarb), Chaihu (Bupleurum), Danggui (Angelica sinensis), Chishaoyao (Red Peony), Kushen (Sophora), Jingjiesui (Schizonepeta), Mahuang (Ephedra), Bohe (Mint), and Gancao (Licorice).
Niu Huang Xing Xiao Wan (Bovine Gallbladder Detoxifying Pill), Function: Clears heat and detoxifies, reduces swelling and alleviates pain; Indications: Unnamed swellings, scrofula, abscesses, and mastitis. Ingredients: Ruxiang (Frankincense, processed), Moyi (Myrrh, processed), Artificial Niu Huang (Bovine Gallbladder), Shexiang (Musk), and Xionghuang (Realgar).
Ruyi Jinhuang San (Auspicious Golden Yellow Powder), Function: Clears heat and detoxifies, reduces swelling and alleviates pain; Indications: Symptoms of skin redness, swelling, heat, and pain due to heat toxin stagnation, can also be used for trauma. Ingredients: Jianghuang (Turmeric), Dahuang (Rhubarb), Huangbai (Phellodendron), Cangzhu (Atractylodes), Houpo (Magnolia Bark), Chenpi (Dried Tangerine Peel), Gancao (Licorice), Shengtian Nansheng (Fresh Arisaema), Baizhi (Angelica dahurica), and Tianhuafen (Trichosanthes).
Pifubing Xuedu Wan (Blood Detoxifying Pill for Skin Diseases), Function: Clears blood and detoxifies, reduces swelling and alleviates itching; Indications: Sores and swellings caused by disharmony of meridians, warm heat rashes, athlete’s foot, skin itching, freckles, facial redness, wind rash, and dizziness. Ingredients: Qincao (Madder), Taoren (Peach Kernel), Chishaoyao (Red Peony), Danggui (Angelica sinensis), Dihuang (Rehmannia), Lianqiao (Forsythia), Jinyinhua (Honeysuckle), Kudiqing (Bitter Herb), Tufuling (Smilax), Huangbai (Phellodendron), Yimucao (Motherwort), Fangfeng (Siler), Baishao (White Peony), Shudihuang (Cooked Rehmannia), Zicao (Lithospermum), Chuanxiong (Ligusticum), Gancao (Licorice), Baizhi (Angelica dahurica), Zijingpi (Cercis), Jixueteng (Spatholobus), and Honghua (Safflower).
Dasima Baowan (Dasima Detoxifying Pill), Function: Clears heat and detoxifies, reduces inflammation and kills pathogens; Indications: Meningitis, influenza, sores and ulcers, pneumonia, pharyngitis, and various epidemic diseases. Ingredients: Tieban (Iron Hammer), Zicao (Lithospermum), Hezi (Myrobalan), Muxiang (Aucklandia), Tuercao (Rabbit Ear Grass), Tanggu Te Wutou (Tangut Aconite), Zhizhaimu (Stop Diarrhea Wood), Zangqincao (Tibetan Madder), Jizidou (Jujube), Duolac (Dandelion), and Anxi Xiang (Benzoin).
Zicao Gao (Lithospermum Ointment), Function: Transforms necrotic tissue and promotes skin regeneration; Indications: Sores and ulcers, and abscesses that have already ulcerated. Ingredients: Zicao (Lithospermum), Danggui (Angelica sinensis), Dihuang (Rehmannia), Ruxiang (Frankincense), Baizhi (Angelica dahurica), and Fangfeng (Siler).
Badou Shengji San (Detoxifying and Regenerating Powder), Function: Detoxifies and promotes skin regeneration; Indications: Sores and ulcers with Yang syndrome that have ulcerated, with pus and necrosis not yet cleared, and slow healing. Ingredients: Bingpian (Borneol), Luganshi (Calamine, calcined), Longgu (Dragon Bone, calcined), Hongfen (Red Powder), Huangdan (Yellow Lead), Qingfen (Light Powder), Chongbaili (White Wax), and Shigao (Gypsum, calcined).
Clinical Experience with Medications:
1. Tang Tian conducted clinical research on Badou Shengji San for treating non-lactating mastitis with pus and necrosis, concluding that the external application of Badou Shengji San effectively reduces lumps, promotes pus expulsion, and alleviates pain; its use over 4 weeks falls within a safe range and has clinical promotion value.
2. Fu Liyuan and others observed the clinical efficacy of Badou Shengji San for postoperative dressing changes in anal and rectal diseases, concluding that it is effective and safe for difficult-to-heal and infected wounds, warranting further research.
3. Guo Xingrui and others observed the clinical efficacy of Badou Shengji San for treating diabetic foot ulcers, concluding that its application can alleviate patient suffering, shorten treatment cycles, act quickly, show significant efficacy, have few adverse reactions, and be convenient for direct observation and timely monitoring; it has clear advantages in treating diabetic foot ulcers.
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