External Use of Xuejie (Dragon's Blood) and Pengsha (Borax) to Remove Necrotic Tissue and Promote Granulation

In Waike Chuanxin Ji (A Handed-Down Collection of External Medicine), written by Ma Peizhi, a distinguished Qing-dynasty surgeon, there is a very small, simple formula named Chidan Ling Dan (Cinnabar Elixir). Its composition is: Shangxuejie (high-quality Sanguis Draconis, dragon's blood resin) 1 qian (3 g), Pengsha (Borax, borax) 1 liang (30 g). Grind the two herbs into a powder, apply to the affected area, and change the dressing once daily. Ma Peizhi believed that this formula clears heat and detoxifies, removes necrotic tissue and promotes granulation, and used it for purulent tissue that fails to detach after a ding (deep-rooted boil).

Xuejie (dragon's blood) is a resin—the dried resin exuded from the fruit and trunk of Daemonorops draco (a Palmae plant), named for its blood-red color. Taken internally, Xuejie activates blood and resolves stasis, reduces swelling and stops pain; applied externally, it stops bleeding and promotes tissue regeneration, and astringes and closes sores. Xuejie contains dracorubin, dracorhodin, nordracorhodin, nordracorubin, and pimaric acid. Modern pharmacological research has confirmed that Xuejie has anti-inflammatory, antibacterial, and antithrombotic effects. Although externally applied Xuejie can astringe and close sores, an excessive dose can increase bleeding; therefore, when using Xuejie to stop bleeding and astringe sores, the dose should be small. Genuine Xuejie is expensive, and the herb should not be wasted.

Pengsha (borax) is a refined crystalline product of the borate mineral borax, belonging to the mineral class of Chinese materia medica. TCM holds that borax clears heat and detoxifies, and clears the lung and resolves phlegm; it treats mouth and tongue ulcers, sore throat, sores and swellings, and red eyes with nebulae. The well-known Chinese patent medicine Bingpeng San is a famous treatment for oral ulcers. Applied externally, borax clears heat, detoxifies, reduces swelling and stops pain; it is a common herb for treating sores with swelling and pain. Modern pharmacological studies show that borax can combat urinary tract infection, has antibacterial and mucosal-protective effects, and also has anticonvulsant action. The amount of borax used in this formula is relatively large, making full use of its heat-clearing, detoxifying action.

A ding-induced sore that fails to heal for a long time is often due to infection of the surrounding tissue. Borax and Xuejie both fight infection and promote the growth of new tissue, so this is a well-chosen formula. If the ulcer discharges a large amount of exudate, an appropriate amount of Duan Shigao (gypsum Ustum, calcined gypsum) or Luganshi (Calamina, calamine) may be added for better effect.