The ulceration of the supraclavicular fossa refers to the condition of ulceration in the depression above the clavicle.

This condition is recorded in ancient medical texts as "Quepen Gan," "Suogu Ju," "Du Ju," and "Madao scrofula." Due to the abundance of qi and scarcity of blood in the supraclavicular fossa, the sores are persistent and difficult to heal. For the treatment of Madao scrofula, refer to the section on subcutaneous nodes on the side of the neck.

bubble_chart Pattern Analysis

1. Dampness-heat︰The ulcer appears bright red and festering, with an irregular base. The pus is initially thick but gradually becomes thin. If the necrotic tissue is slow to detach, the wound heals more slowly. Systemic symptoms may include fever, chills, restlessness, poor appetite, abdominal distension and fullness, chest tightness, scanty and difficult urination, a yellow tongue coating, and a rapid pulse. This condition is often caused by heat accumulation in the stomach and triple energizer, leading to dampness retention, disharmony between nutrient and defensive qi, meridian obstruction, and stagnation of qi and blood. Treatment should focus on clearing heat and removing toxins, promoting blood circulation to resolve stasis, draining dampness, and reducing swelling. The Immortal Formula Life-Saving Decoction can be used with Plantain Seed and Six-to-One Powder. If pus drainage is poor, add Pus-Draining Powder. If excessive pus discharge occurs, tonify and replenish qi and blood with Eight Precious Ingredients Decoction. For external treatment: - For abundant pus, use Five-Five Powder. - For scanty pus, use Nine-One Powder. - After pus is fully drained, apply Granulation-Promoting Powder and cover with Granulation-Promoting Jade and Red Paste.
2. Deficiency of Both Qi and Blood︰The wound only discharges bloody fluid with a foul odor, and the surrounding area remains hard and unrelieved, becoming increasingly swollen and firm. The wound gradually enlarges, appearing uneven and rock-like, accompanied by excruciating pain that radiates to the heart and head. Occasionally, blood spurts from the wound. The patient suffers from sleepless nights, chest tightness, dysphoria, a dull complexion, and emaciation. The tongue is pale with a thin coating, and the pulse is thin and weak, eventually leading to exhaustion of qi and a fatal outcome. This condition is often caused by severe abdominal mass disease, which depletes qi and blood, resulting in deficiency. Treatment should focus on tonifying and nourishing qi and blood, using prescriptions such as Returning to Spleen Decoction or Xiangbei Nourishing Camp Decoction, combined with Minor Golden Pill and Wake-Up Subsiding Pill. For external treatment: apply Haifu Powder to the wound and cover it with Granulation-Promoting Jade and Red Paste.

bubble_chart Documentation

1. Waike Dacheng．Chest: "Supraclavicular gangrene, occurring in the depression of the supraclavicular fossa, also known as clavicular carbuncle... If this condition is not treated, it will ulcerate and become difficult to heal, also known as moth carbuncle."