Jiulong Wan for Leprosy with Burning Swelling, Itching and Pain in Zhangshi Yitong

Zhang's Comprehensive Medicine in Suits of Clinical Cases (Zhangshi Yitong) records a formula for "leprosy with burning swelling, itching and pain" called "Jiulong Wan" (Nine-Dragon Pill). Its composition is: danggui (Angelicae Sinensis Radix) and kushen (Sophorae Flavescentis Radix), each 2 liang; fangfeng (Saposhnikoviae Radix), jingjie (Schizonepetae Herba), qianghuo (Notopterygii Rhizoma), each 5 qian (15 g); chantui (Cicadae Periostracum) and chuanxiong (Chuanxiong Rhizoma), each 5 qian (15 g); quanxie (Scorpio) 1 qian (3 g); and dafengziren (Chaulmoograe Semen) 8 liang (240 g). This is the amount for one course (yi liao).

Preparation: grind all the herbs into a fine powder, use red rice gruel as a binder, and form pills the size of a parasol-tree seed (about 6–8 mm in diameter). Dry in the shade and seal for storage. Take 3 qian each time, three times daily. A patient whose disease began within the past year takes one course; one ill for more than ten years takes ten or more courses. If the patient's lower body itches more, add niuxi (Achyranthis Bidentatae Radix) 2 liang (60 g) and fangji (Stephaniae Tetrandrae Radix) 1 liang (30 g). This formula expels wind and activates blood, clears heat and drains dampness; it is indicated for "leprosy with burning swelling, itching and pain."

This is a very famous formula for skin diseases; the patent medicine we use today, Danggui Kushen Wan, derives from it. But Danggui Kushen Wan contains only danggui and kushen, with no other herbs. TCM's leprosy disease is the leprosy of modern medicine, caused mainly by infection with Mycobacterium leprae, which can be transmitted through respiration or direct contact. Leprosy is now rare, but this formula remains widely used for other skin diseases. Any skin disease presenting the symptoms of "burning swelling, itching and pain" may be tried with this formula.

According to traditional TCM theory, danggui and kushen in this formula cool the blood, activate blood and drain dampness. Modern research finds kushen inhibits a variety of skin-disease pathogens, and it appears in many contemporary patent medicines for skin disease. The dafengziren in this formula is the kernel of Hydnocarpus anthelmintica, a dedicated Chinese herb for skin disease, commonly used for leprosy, yangmei chuang (syphilis), jie xuan (scabies), jiuzha bi (rosacea) and acne. Quanxie stops spasms and pain and inhibits many pathogens. Jingjie, qianghuo, fangfeng and chantui are wind-expelling herbs in TCM, dispelling wind and reducing fever. Chuanxiong activates blood, moves qi and stops pain, with an action comparable to danggui and quanxie.

Thus such a composition gives good symptomatic treatment for skin diseases presenting "burning swelling, itching and pain." What is relatively rare about this formula is that it specifies a course of treatment; most TCM formulas do not. When a formula does specify a course, it is usually because its originator had practical experience using it and was confident in its efficacy.