Shank sore

Also trouser-bottom sore; trouser-bottom toxin sore; skirt-hem sore. A sore on the shin, characterized by redness, swelling, and itching. The local skin and flesh turns gray and dark. When scratched open, it suppurates. Shank sores can persist for a long time without healing. It arises mostly when damp-heat pours downward and causes blood stasis and qì stagnation. Accordingly, it is accompanied by a thin slimy yellow tongue fur, and a slippery rapid pulse. If the sore persists without healing, it becomes grayish-white in color, and exudes thin dirty gray or green pus, and tends to swell in the evening. Such conditions indicate center qì fall, which often attended by bright-white facial complexion, thin sloppy stool, pale tongue with thin fur, and a fine pulse.

Biomedical correspondence: ulceration of the lower leg.

Medicinal therapy: Oral: Clear heat and disinhibit dampness; harmonize provisioning and resolve toxin. Take Fish Poison Yam Toxin-Transforming Decoction (萆薢化毒汤 bì xiè huà dú tāng) or Mysterious Three Pill (三妙丸 sān miào wán) combined with Fish Poison Yam Dampness-Percolating Decoction (萆薢渗湿汤 bì xiè shèn shī tāng). Apply Golden Yellow Paste (金黄膏 jīn huáng gāo) with Nine-to-One Elixir (九一丹 jiǔ yī dān). For those who are allergic to Nine-to-One Elixir, use Black Tiger Elixir (黑虎丹 hēi hǔ dān) topically. Center qì fall is treated by nourishing the blood and harmonizing provisioning, and by freeing the network vessels and relieving pain. Use variations of Cinnamon Twig Decoction Plus Chinese Angelica (桂枝加当归汤 guì zhī jiā dāng guī tāng). For liver-kidney yīn vacuity, use Six-Ingredient Rehmannia Pill (六味地黄丸 liù wèi dì huáng wán), Left-Restoring [Kidney Yin] Pill (左归丸 zuǒ guī wán), or Double Supreme Pill (二至丸 èr zhì wán). For spleen-kidney vacuity cold with a sore that is black and painless, add Perfect Major Supplementation Decoction (十全大补汤 shí quán dà bǔ tāng). Topical: Dab on Flesh-Engendering Powder (生肌散 shēng jī sǎn) and cover with White Jade Plaster (白玉膏 bái yù gāo).

NB: Some older literature makes a distinction between inner shank sores (on the medial face of the shin) and outer shank sore (on the lateral face). It attributes inner shank sores to dampness in the three yīn channels of the foot, with vacuity heat in the blood aspect, and attributes outer shank sores to damp-heat gathering in the three yáng channels of the foot. The Great Compendium of External Medicine (外科大成 wài kē dà chéng) states inner shank sores are hard to cure, whereas outer shank sores are easy to cure.