Guo Moumou, male, 53 years old, was first diagnosed on October 14, 2008. Complaint: Redness and ulceration of the left foot for more than 2 months. Six months ago, the patient developed callus growth on the bottom of his left foot, which was painful to walk on, and often trimmed himself. The swelling further increased, and three ulcers appeared on the dorsum of the foot, and the pus increased. The patient refused to undergo amputation, so he came to our outpatient clinic for treatment. Since the onset of the disease, the patient denied symptoms such as chills and high fever, polyphagia and polyuria. The patient’s body is hot and flat, the left foot is dark red and swollen, pus is dripping, mild pain, walking is unfavorable, sleep is acceptable, and stool is regulated. The tongue is dark red with thick and greasy coating, and the pulse is stringent. Special examination: the left foot was dark red and swollen, and two ulcers of about 12.5px×12.5px were seen in the middle part of the 2nd and 3rd metatarsal bones on the dorsal side of the foot, with yellow necrotic fascial-like material accumulating inside and yellow thick pus oozing out after squeezing, and the toe bone could be reached by forceps probing; a 12.5px×12.5px ulcer was seen at the Yongquan point on the sole of the foot, with thickened skin keratinization at the edge of the sore and a small amount of blood and water oozing out from the sore, and a 12.5px×12.5px ulcer was seen on the medial side of the arch of the foot. A 12.5px×12.5px ulcer was seen on the medial side of the arch, and a 75px×75px red swelling was seen next to the ulcer, which was soft when pressed. The four examinations together showed that this was a case of “gangrene” and “damp-heat and toxic evidence” in Chinese medicine. The left foot was treated with diabetic gangrene debridement and dragline surgery, and postoperative treatment was combined with external treatment such as herbal irrigation, topical doping and patching. The second consultation (October 24) showed that the patient’s body heat was calm, his sleep was acceptable, his bowel movements were regulated, the swelling of the left foot was gradually reduced, and the local pus decay was reduced. The tongue and pulse are the same as before. Since then, the patient’s condition gradually improved, the swelling of the left foot gradually reduced, and the local pus decay gradually removed. On December 12, 2008, the patient’s general symptoms were significantly improved, and he was able to eat and sleep, regulate his bowel movements, and the swelling of the left foot had subsided, the local pus decay was removed, the granules were dark red, and white epithelial growth was seen around the sore. On review, the patient’s tongue was light red and slightly dark, with a thin white coating and a thin string pulse. The prescription was adjusted to “benefit Qi and strengthen the spleen, invigorate blood and promote muscle”, with the following formula: 30g of raw Astragalus, 15g of Radix Codonopsis, 9g of Atractylodes Macrocephala, 12g of Poria, 9g of Radix Panax Ginger, 6g of Pericarpium Citri Reticulata, 15g of Radix Paeoniae Alba, 30g of Salviae Miltiorrhizae, 12g of Radix Angelicae Sinensis, 12g of Radix Aconiti, 15g of Radix Bupleuri, 9g of Semen Spleen, 9g of Roasted Licorice. After 3 weeks, the patient’s local sore surface healed. No recurrence at 12 months follow-up. The case is considered as a gangrene. The patient’s initial localized redness and swelling, pus and water dripping, the four diagnoses together, the evidence belongs to “damp-heat and toxic evidence”, “urgent treatment of its symptoms”, “to eliminate the evil first to control the disease”, so the treatment is proposed The treatment was to “clear heat and dampness, cool the blood and detoxify the toxin”, and was based on “Si Miao Wan” combined with “Rhizoma Rhizoma Dihuang Tang”. The patient was also treated with the herbal remedies such as snake’s tongue herb, deer’s head herb, lonicera vine and red vine to clear heat and detoxify the toxin; because of the bone damage, the patient was treated with bone crushing tonic to tonify the kidney and strengthen the bone. At the same time, surgery and other external treatments were used to give an outlet for the evil. Later, the local redness and swelling subsided, and the pus and decay were gradually removed, so the prescription was reduced with the products to dispel the evil and added with the products to support the righteousness and invigorate the blood, so as to “support the righteousness to improve the future”. The proposed treatment was to “benefit the qi and strengthen the spleen, invigorate the blood and promote the growth of muscle”, and “Si Jun Zi Tang” combined with “Tonic Yang Returning Five Soup” was added and reduced. At the same time, according to the theory of “prolonged illness affects the kidney”, we added products to warm the yang and tonify the kidney to warm the yang energy to help the blood flow and promote the healing of the sore surface.