Frostbite of the toes is caused by innate constitutional deficiency and timidity, making it easy for cold pathogens to invade. This leads to stagnation of Qi and blood; if left untreated for a long time, it will ulcerate and form sores. The treatment method must strengthen the Spleen and Stomach and warm the Qi and blood, so that necrotic flesh will naturally slough off and healthy flesh will naturally regenerate. If bones are exposed and tendons remain connected, the necrotic tissue should be promptly excised; otherwise, the toxin will spread to the dorsum of the foot, leading to death. This is because at the extremities of the limbs, Qi and blood have difficulty reaching, and they are blocked by external pathogens, preventing the circulation and operation of Qi and blood. If hot water is used to scald or fire to bake, the flesh there will die and become insensible, and by spring it will inevitably ulcerate, rot, and fall off. If the Yuan Qi (Original Qi) is not depleted, although the disease occurs, it is not harmful. However, if cold medicines are applied externally and detoxifying agents are taken internally, the Yuan Qi will be injured, inevitably resulting in a "bai zheng" (failure syndrome/incurable condition). Whenever frostbite first occurs, frequently rubbing with warm hands is the best approach. In the north, ears affected by frostbite will fall off if mistakenly touched by hand. Extreme cold can indeed split the skin and cause fingers to drop off; this is true.

A girl of several years old traveled north during severe cold. Having lost her support (parents), her feet were chilled. A maid soaked them in hot water. By spring, due to foul air in the room, her father noticed upon removing her socks that all ten toes were rotten, though not yet detached. I used a formula to support the interior and boost Yang Qi, promoting the sloughing of necrotic tissue to preserve life.

A child suffered frostbite on both ears during the severe cold of mid-winter, losing sensation of pain and itch. He was treated by having his ears gently and frequently rubbed with warm hands. Internally, he received herbs to warm and tonify Spleen Qi, and externally Bai Lian San (White Peony Powder) was applied, leading to recovery.

A seven-year-old child experienced frostbite pain in the toes during winter and soaked them in boiling water. By spring, the tissue ulcerated and fell off, but the wounds failed to heal, accompanied by swelling and pain in the ankle. I stated that this was due to weak Yuan Qi, requiring tonification of Stomach Qi to generate muscle tissue. The family did not believe me and instead used cold-natured detoxifying agents. Although the swelling subsided, the area turned black, and they considered themselves cured. I said, "This indicates extreme deficiency of the Spleen and Stomach, where Yuan Qi cannot reach the affected area." Later, the child's legs became emaciated and thin, and he died.

A young boy sustained minor trauma to his foot from a fall, which subsequently developed into frostbite with unceasing pain. Fire baking caused the flesh to die. By spring, the foot detached, with profuse pus discharge, failing to heal, leading to death. If this condition had been managed by regulating the Spleen and Stomach and preserving Yuan Qi, muscle tissue would have regenerated naturally, avoiding death.

Bai Lian San (White Peony Powder)
Bai Lian (Radix Ampelopsis, 1 liang) Huang Bo (Cortex Phellodendri, stir-fried until black, 5 qian)
Grind the above ingredients into powder and apply dryly to the affected area.