Chronic osteomyelitis belongs to the category of “epiphyseal gangrene” in Chinese medicine, with a high incidence and the most common causative organism being Staphylococcus aureus. Due to its complex pathological changes, as well as the increasing production and detection rate of methicillin-resistant Staphylococcus aureus (MRSA), chronic osteomyelitis is difficult to treat. Modern medical treatment mainly relies on the combined application of high-dose antibiotics for internal or local treatment, together with surgical debridement and drainage and repair of bone defects to promote recovery. However, the disease is often prone to recurrence and is difficult to heal. Chinese medicine has accumulated a lot of valuable experience on this disease, which has enabled some stubborn cases to be cured. Through the study of Chinese medicine for this disease, it is confirmed that the application of Chinese medicine for internal use has the advantages of adjusting the functions of the internal organs of the body, enhancing immunity, improving nutrition, reducing bacterial resistance, reducing the toxic side effects of western drugs, and improving the efficacy of treatment. Following the theory of traditional Chinese medicine and combined with years of clinical practice, we systematically observed the efficacy of herbal gavage in the treatment of chronic osteomyelitis through animal experiments, so as to further guide the treatment of chronic osteomyelitis in clinical practice. At present, the treatment of chronic osteomyelitis in Chinese medicine mainly relies on drugs, and most of them are clinical reports, especially the experimental prescriptions, whose results need to be further verified. Among them, Liu Xianxiang et al. reported the experimental observation of using the bone marrow formula (strychnine, saponaria, dandelion, asteranthus, forsythia, honeysuckle, raw groundnut, sizzling scorpion, panax quinquefolium, red peony, raw astragalus, angelica, licorice) for irrigation and internal administration in rats with good results. The exact efficacy of Chinese medicine in the treatment of chronic osteomyelitis has yet to be confirmed by large-scale animal experiments. The understanding of chronic osteomyelitis (epiphyseal gangrene) in Chinese medicine over the ages 1. The understanding of the etiological mechanism of the disease in Chinese medicine Chronic osteomyelitis has been recorded in the Yellow Emperor’s Classic of Internal Medicine as early as the name and cause of the disease, and was called “epiphyseal carbuncle” and “epiphyseal gangrene” in the Treatise on the Origin of Diseases in the Sui Dynasty. It is still used today. The causes of the disease are many, but there are four main causes: the patient is weak or weak after the disease, the residual toxin remains, combined with dampness and heat, the evil toxin scurries the tendons and bones, resulting in congestion of qi and blood, the meridians are closed and blocked, and the depression eats the bones; or the internal heat is strong, the fire toxin runs deep into the bones, the congestion does not work, the heat wins, the flesh rots, the flesh rots, the flesh becomes pus, and the pus rots the bones; or the kidney is deficient in essence, the evil of yin and cold attacks deeply, the stagnation of the internal depression, the heat defeats the bones; or the cold and damp evil attacks the bones. Or the evil of cold and dampness because of the person’s deficiency, deep attack volatile knot, depression for a long time into heat, the evil of dampness and heat stagnation of the meridians and blood, pus into decay and injury to the bone. 2, the understanding of Chinese medicine on the treatment of this disease 2.1 clear heat and detoxification Chinese medicine believes that fire and poison is always the main conflict of the disease. The pathogenesis of the disease is to feel the evil toxin, which will suppress the tendons and bones and turn into pus, so the treatment should be based on clearing the heat and detoxifying the toxin, removing the rot and creating muscle. Clinical symptoms include pain in the affected limbs, restricted movement, persistent fever, dry mouth, constipation, red tongue, slippery coating, and smooth pulse. Shi’s [1] and others treated with Dihuang Shuang Hua Tang with addition and subtraction, in which Sheng Dihuang, Jin Yin Hua, and Lian Qiao were used to clear heat and detoxify the toxin, supplemented by Angelica sinensis, Red Paeoniae, and Turbinate to invigorate blood and relieve pain, and complemented by Chen Pi to regulate Qi and disperse knots, so as to clear heat without stagnation. Zhang’s [2] treatment is based on the principle of detoxification to dispel wind and clear heat to disperse nodules, using the addition and subtraction of detoxification and clearing of bones. In the formula, honeysuckle, zhebei mum, dandelion and fleabane are used to clear heat and detoxify and dispel canker sores and knots, while ginseng and angelica tonify qi and blood to support the righteousness and dispel evil. Li’s [3] used Bone Gangrene Ling San, in which raw Nanxing and raw rhubarb are used to remove fire and detoxify, invigorate blood and subdue swelling, and Xuanming powder is added to enhance the power of clearing heat, subduing swelling and relieving pain; ice chips are pungent and aromatic, helping the drugs to penetrate the skin and reach the bones, and the combined effect of the drugs is to remove fire and detoxify, subdue swelling and relieve pain. 2.2 benefit Qi and blood famous Ming dynasty doctor Chen Shigong in the “Surgery Zhengzong” pointed out that: “the attached bone gangrene, is the disease of Yin cold into the bone, but people’s Qi and blood is born strong, although the cold evil does not enter the bone”. It is stated that the positive qi is weak, the clear evil attack, the positive does not overcome the evil, the evil toxin can not be dispersed outside but the body flee into the bone, so the treatment principle of tonifying the qi and blood, supporting the positive qi, to take the toxin out. Qing’s [4] used the basic formula of Plus and Minus Tori Disinfection San to treat this disease, in which Huang Qi and Dang Ginseng were used to tonify Qi, and Chuan Xiong, Angelica and Bai Shao to tonify Blood. In Zhao [5], for those who showed general weakness at the end of the disease, the treatment was based on tonifying Qi and nourishing Blood, supplemented by eliminating putrefaction, and internal administration of Bajhen Tang combined with Siwusan. 2.3 Invigorate blood circulation and remove blood stasis Chronic osteomyelitis that does not heal over a long period of time will result in stagnation of qi and blood, making it difficult for the affected area to heal because it is not moistened. Tang’s [6] and others, based on the former’s formula of removing decay and creating new blood stasis, used drugs to invigorate blood circulation and resolve stasis, such as angelica, Chuanxiong, red peony, peach kernel, etc., and achieved good results. Zhang [7] used Xianghu Bone Inflammation Tablets No. 2 with the effect of invigorating blood circulation and removing blood stasis, clearing heat and detoxifying the toxin mainly, and supporting the righteousness and supporting the toxin, which also achieved satisfactory results. 2.4 Tonifying the kidney and filling the essence According to Chinese medicine, “the kidney is the master of bone and marrow” and “long-standing disease affects the kidney”. The development of this disease to the late stage, the inevitable depletion of qi and injury to the essence, essence deficiency is kidney deficiency, kidney deficiency is not solid bone. Tang’s [6] advocated the method of tonifying the kidney and filling the essence and strengthening the bones, mostly using medicines such as Du Zhong, dog’s spine, Cistanches, and Cuscuta to tonify the kidney, and using blood and flesh sentient products such as deer antler and tortoise plate to fill the essence and strengthen the bones, with remarkable results. Li [7] often used Epimedium and Bonesetter in the selected prescriptions, so that the spleen and kidneys are healthy, the qi and blood flow smoothly, and the sick bones recover day by day. 3. Analysis of the evidence, legislation, prescriptions, and combinations The recurrent attacks of gangrene with bones that do not heal over the years have depleted the organism and caused deficiency of qi and blood and deficiency of the spleen and kidneys. Because of the residual evil and toxicity inside, there are real deficiencies in the deficiency, so although the local symptoms are prominent, the treatment should be combined with the whole to support the righteousness and eliminate the evil, so the treatment should be to replenish the qi and blood, warm the kidneys and strengthen the spleen, and detoxify the toxicity. In this formula, Astragalus and Radix et Rhizoma are used to tonify the middle and benefit the qi and raise the yang, to produce fluid and nourish the blood, to support the righteousness and eliminate the evil, and to support the toxicity and the muscle, together as the monarch. Radix Angelicae Sinensis, Radix Paeoniae Alba, Rhizoma Atractylodis Macrocephalae, Radix Rehmanniae Sinensis, Radix Rehmanniae Sinensis, Radix Deer Antler Gum, Poria Cocos nourishes the kidneys and strengthens the spleen, generates blood and essence, nourishes the yin and produces muscle and astringent sores. Accompanied by Dandelion and Phellodendron, it clears heat and dampness, removes fire and detoxifies, and clears residual evil toxins. Glycyrrhiza glabra produces fluid, nourishes Yin and nourishes Blood, and harmonizes all the medicines as an ambassador. The whole formula has both tonifying and diaphoretic effects, treating both the symptoms and the root cause, nourishing Qi and Blood, nourishing the spleen and kidney, supporting the righteousness and eliminating the evil and generating muscle. Modern pharmacological research shows that this formula has antibacterial and antibacterial effects, enhances the immunity of the body and improves vascular microcirculation. The clinical treatment of chronic osteomyelitis with this formula has shown significant efficacy.