（谓痈生于胁之前肤之傍白者五下皆是也）
腋痈属足少阳、手少阴、手厥阴三经。小儿患之，多禀赋肝火所致，初起先用活命饮，次用柴胡栀子散，五七日间
作脓， 肿作痛者，亦用活命饮杀其大势，虽溃亦轻而易敛。若脓已成，用托里消毒散。已出，用托里散。如有变症，
当随症治之。
一小儿患前症，肿痛，用仙方活命饮而痛止，用托里消毒散而溃。因母饮酒，后加肿痛，母服清胃散，儿服活命饮、
托里散而愈。
一小儿患之，因乳母恚怒所致，子用仙方活命饮，母用柴胡栀子散、加味逍遥散并愈。后复患，令母仍服前药，子
服托里消毒散而脓溃，用托里散而敛。
一小儿腋下常患一枚，此禀肝胆怒火也，用牛黄解毒丸，母服柴胡栀子散、逍遥散而愈。后每发即服前药而愈，或
用荆防败毒散，外敷铁箍散，以杜后患，几至不救。
一小儿十四岁患之，内外皆用寒凉败毒之药，肿硬作痛，上连肩胛，脓成不溃，或用针之，脓仍不出。余曰∶此气
血虚甚，当峻补之。不信，半载后，肩骨溃解，惟皮相连，沥尽气血而殁。
一小儿患之，恪服败毒之药，久不溃，色不变，肿硬如石，余用葱熨之法，及托里散二十余剂，患处微赤作痛，又
数剂，肿起，针出秽脓，气息奄奄，用人参一两、干姜一钱、枣子十枚四剂，仍用前散寻愈。
一小儿患之，脓内溃，久不出，色不变，亦不痛，余谓气血虚甚，当先大补而用火针。不信，或用冷针，脓果不出；
更气喘自汗，余用独参汤二剂，喘汗少止，脓仍未出，又二剂，脓出甚多，喘汗大作，又用前汤四剂，诸症悉退，乃用
八珍汤渐愈。后因伤风咳嗽，误用表散之药，烦躁自汗，面目赤色，脉洪大无伦，按之如无，此血脱发躁也，先用当归
补血汤，诸症顿愈，再用八珍汤而安。又饮食过多发厥，手足并冷，用五味异功散加升麻、柴胡、生姜，一剂而愈。
一小儿患之，色黯不敛，三年不愈，用十全大补汤及豆豉饼，三月余将愈；后劳倦怒气，腋下肿痛，以加味逍遥散、
十全大补汤，相间服之，月余而愈。
豆豉饼 治疮疡肿痛，硬而不溃，及溃而不敛，并一切顽疮恶疮。用江西豆豉为末，唾津和成饼，大如铜钱，
浓如三四钱，置患处，以艾壮于饼上灸之，灸干则再易。如疮大，作大饼覆患处，以艾铺饼上灸之。疮未成者即消，已
成者祛毒。间有不效者，乃气血虚败之症也，参疔疮类灸法用之。（方见腋痈）
四物汤 治疮疡血虚，发热，日晡益甚，或烦躁不寐。
当归 熟地黄（各二钱） 芍药（炒） 川芎（各一钱）
上水煎服。
参术柴苓汤 治疮疡脾气虚弱，肝气内动，肢体抽动者。
人参 白术 茯苓 陈皮（各一钱） 山栀（炒） 钩藤钩子（各七分） 甘草（炒五分） 柴胡 升麻（各三分）
上每服一二钱，姜、枣水煎，婴儿用，大剂与母服，子少服之。
黄连安神丸 治心经血热发热，惊悸不安。
黄连（五分） 生甘草（二钱五分） 生地黄（五钱） 当归 朱砂（三钱）
上为末，饭糊丸，小豆大。每服十五丸，滚汤下。如二三服不应，当服归脾汤，婴儿乳母并服。
柴胡栀子散（方见胁痈，一名柴胡清肝散）
托里消毒散
托里散（二方见热毒疮疡）
清胃散（方见腹痈）
加味逍遥散（方见发热不止）
牛黄解毒散（方见胎毒疮疥）
十全大补汤（方见便痈）
（注：此处指痈发生在胁部前方皮肤旁边，即腋下部位。）
腋痈归属于足少阳胆经、手少阴心经和手厥阴心包经。小儿患此病，多因先天禀赋导致肝火旺盛所致。初起时先用仙方活命饮，随后用柴胡栀子散。在五到七天内化脓，若肿胀疼痛，也使用仙方活命饮以消除其猛烈之势，即使溃破也较轻且容易愈合。如果脓液已经形成，则使用托里消毒散。脓液已排出后，使用托里散。如果出现变证，应当根据具体症状进行治疗。
一个小孩患有上述病症，出现肿痛，服用仙方活命饮后疼痛停止，服用托里消毒散后溃破。因为母亲饮酒，后来病情加重出现肿痛，母亲服用清胃散，孩子服用仙方活命饮和托里散而痊愈。
另一个小孩患病，是因为乳母愤怒所致，孩子服用仙方活命饮，母亲服用柴胡栀子散和加味逍遥散，母子均痊愈。后来再次患病，让母亲继续服用之前的药物，孩子服用托里消毒散使脓液排出，再用托里散促进伤口愈合。
还有一个小孩腋下经常长一个疖肿，这是禀受肝胆怒火所致，服用牛黄解毒丸，母亲服用柴胡栀子散和逍遥散而痊愈。后来每次发作就服用之前的药物而痊愈，或者使用荆防败毒散，外敷铁箍散，以防止后患，几乎到了无法救治的地步。
一个十四岁的小孩患病，内外都使用寒凉败毒的药物，导致肿块坚硬疼痛，向上连及肩胛，脓成但不溃破，有人用针刺，但脓仍不出来。我说：这是气血非常虚弱，应当峻补。患者不信，半年后，肩骨溃烂分解，只有皮肤相连，气血耗尽而死。
另一个小孩患病，严格服用败毒药物，久不溃破，颜色不变，肿块坚硬如石，我采用葱熨法，以及服用托里散二十多剂，患处微微发红并疼痛，又服几剂，肿块隆起，针刺出秽浊脓液，气息微弱，用人参一两、干姜一钱、枣子十枚，四剂药后，仍用前面的方剂寻回健康。
一个小孩患病，脓液在内溃破，久久不出，颜色不变，也不疼痛，我说这是气血非常虚弱，应当先大补并使用火针。患者不信，改用冷针，脓果然出不来；更出现气喘自汗，我用独参汤两剂，喘汗稍止，脓仍未出，又服两剂，脓出很多，喘汗大作，又用前面的汤药四剂，所有症状全部消退，于是用八珍汤逐渐痊愈。后来因伤风咳嗽，误用发散表邪的药物，出现烦躁自汗，面目赤红，脉象洪大无比，按之空虚，这是血脱导致的烦躁，先用当归补血汤，所有症状顿时痊愈，再用八珍汤而安定。又因饮食过多导致昏厥，手足冰冷，用五味异功散加升麻、柴胡、生姜，一剂药而愈。
一个小孩患病，颜色暗紫不愈合，三年不愈，使用十全大补汤及豆豉饼，三月多将愈；后因劳累疲倦和怒气，腋下肿痛，以加味逍遥散、十全大补汤，交替服用，月余而愈。
豆豉饼 治疗疮疡肿痛，硬而不溃，以及溃破后不愈合，以及一切顽固恶疮。用江西豆豉研为粉末，用唾液调和成饼状，大小如铜钱，厚度约三四分，放置在患处，在饼上灸艾壮，灸干了再更换。如果疮口大，做大饼覆盖患处，铺艾绒在饼上灸治。疮未形成的即可消散，已形成的可祛除毒邪。间或有无效的，是气血虚败的症状，参照疔疮类的灸法使用。（方剂见腋痈）
四物汤 治疗疮疡血虚，发热，傍晚时分加重，或烦躁失眠。
当归 熟地黄（各二钱） 芍药（炒） 川芎（各一钱）
以上用水煎服。
参术柴苓汤 治疗疮疡脾气虚弱，肝气内动，肢体抽动者。
人参 白术 茯苓 陈皮（各一钱） 山栀（炒） 钩藤钩子（各七分） 甘草（炒五分） 柴胡 升麻（各三分）
以上每服一二钱，姜、枣水煎，婴儿服用，大人剂量给母亲服用，孩子少量服用。
黄连安神丸 治疗心经血热发热，惊悸不安。
黄连（五分） 生甘草（二钱五分） 生地黄（五钱） 当归 朱砂（三钱）
以上研为粉末，饭糊做丸，如小豆大小。每次服用十五丸，滚开水送下。如果二三服无效，应当服用归脾汤，婴儿及其乳母同时服用。
柴胡栀子散（方剂见胁痈，又名柴胡清肝散）
托里消毒散
托里散（两个方剂见热毒疮疡）
清胃散（方剂见腹痈）
加味逍遥散（方剂见发热不止）
牛黄解毒散（方剂见胎毒疮疥）
十全大补汤（方剂见便痈）
(Note: This refers to a carbuncle occurring on the skin beside the anterior aspect of the hypochondrium, i.e., the axilla.)
Axillary carbuncle (Yi Yong) belongs to the Foot Shaoyang Gallbladder Channel, Hand Shaoyin Heart Channel, and Hand Jueyin Pericardium Channel. In children, it is mostly caused by innate Liver Fire (Gan Huo). At the initial stage, Xian Fang Huo Ming Yin (Immortal Life Elixir) is used first, followed by Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder). Pus forms within five to seven days; if swelling and pain occur, Xian Fang Huo Ming Yin is also used to suppress the severe condition. Even if ulcerated, the condition is mild and heals easily. If pus has already formed, Tuo Li Xiao Du San (Supporting Interior and Detoxifying Powder) is used. After discharge, Tuo Li San (Supporting Interior Powder) is used. If complications arise, treatment should be adjusted according to symptoms.
A child suffered from the aforementioned condition with swelling and pain. After taking Xian Fang Huo Ming Yin, the pain ceased. After taking Tuo Li Xiao Du San, it ulcerated. Because the mother drank alcohol, the condition worsened with swelling and pain later. The mother took Qing Wei San (Stomach-Clearing Powder), and the child took Xian Fang Huo Ming Yin and Tuo Li San, resulting in recovery.
Another child suffered from it due to the wet nurse's anger. The child took Xian Fang Huo Ming Yin, and the mother took Chai Hu Zhi Zi San and Jia Wei Xiao Yao San (Modified Free Wanderer Powder), leading to recovery for both. Later, the child relapsed. The mother was instructed to continue taking the previous medicines, while the child took Tuo Li Xiao Du San to promote pus discharge, followed by Tuo Li San to promote healing.
Yet another child frequently developed a boil in the axilla, attributed to inherited Liver and Gallbladder Fire. He took Niu Huang Jie Du Wan (Calculus Bovis Detoxification Pills), and his mother took Chai Hu Zhi Zi San and Xiao Yao San, resulting in recovery. Subsequent recurrences were cured by taking the previous medicines. Alternatively, Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxins) was used, with Tie Gu San (Iron Hoop Powder) applied externally to prevent future occurrences, nearly reaching a critical state.
A fourteen-year-old child suffered from it. Both internal and external treatments used cold-natured detoxifying herbs, causing hard, painful swelling extending to the scapula. Although pus formed, it did not ulcerate. Someone attempted puncture with a needle, but no pus came out. I stated: "This is severe deficiency of Qi and Blood; vigorous tonification is required." The patient did not believe this. Half a year later, the shoulder bone ulcerated and disintegrated, connected only by skin, and the child died after exhausting Qi and Blood.
Another child suffered from it, strictly taking detoxifying herbs, which failed to ulcerate for a long time. The color remained unchanged, and the swelling was hard as stone. I employed the Cong Yun method (scallion moxibustion) and administered Tuo Li San for over twenty doses. The affected area became slightly red and painful. After a few more doses, swelling rose, and puncture discharged foul pus. The child's breath was faint. I prescribed Ren Shen (Ginseng Root) 1 liang, Gan Jiang (Dried Ginger) 1 qian, and dates 10 pieces for four doses. Still using the previous powder, health was restored.
A child suffered from it with internal ulceration of pus that failed to discharge for a long time. The color was unchanged, and there was no pain. I stated: "This is severe deficiency of Qi and Blood; major tonification is needed first, combined with fire needle therapy." The patient did not believe this and used a cold needle instead. Pus indeed failed to discharge. The child developed wheezing and spontaneous sweating. I administered Du Shen Tang (Single Ginseng Decoction) for two doses, which slightly stopped the wheezing and sweating, but pus still had not discharged. After two more doses, a large amount of pus discharged, accompanied by severe wheezing and sweating. I used the previous decoction for four doses, after which all symptoms subsided. Then, Ba Zhen Tang (Eight Treasures Decoction) was used for gradual recovery. Later, due to wind-cold invasion causing cough, dispersing exterior herbs were mistakenly used, leading to irritability, spontaneous sweating, red face, and a flooding pulse that was empty upon pressure. This indicated irritability due to blood loss. Dang Gui Bu Xue Tang (Angelica Sinensis and Astragalus Decoction for Tonifying Blood) was used first, instantly resolving all symptoms. Ba Zhen Tang was then used to stabilize the condition. Later, syncope occurred due to excessive food intake, with cold hands and feet. Wu Wei Yi Gong San (Five-Ingredient Decoction to Support the Function) plus Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), and Sheng Jiang (Zingiberis Rhizoma Recens) was used, curing the condition in one dose.
A child suffered from it with dark discoloration and failure to heal, lasting three years. Shi Quan Da Bu Tang (Great Tonifying Decoction of Ten Ingredients) and Dou Chi Bing (Fermented Soybean Cake) were used, nearing recovery after three months. Later, due to fatigue and anger, swelling and pain occurred in the axilla. Jia Wei Xiao Yao San and Shi Quan Da Bu Tang were taken alternately, resulting in recovery after one month.
Dou Chi Bing (Fermented Soybean Cake): Treats carbuncles and sores with swelling and pain, hardness without ulceration, and ulcers that fail to heal, as well as all stubborn malignant sores. Use Jiangxi fermented soybeans (Jiang Xi Dou Chi) ground into powder, mixed with saliva to form a cake, size of a copper coin, thickness of about 3-4 fen. Place on the affected area. Apply moxa cones on the cake. Replace when dry. If the sore is large, make a large cake to cover the area, place moxa on top, and moxa-burn. For unformed sores, it dissipates them; for formed ones, it expels toxins. Occasionally ineffective cases indicate severe deficiency of Qi and Blood; refer to the moxibustion methods for Ding Chuang (Furuncle/Carbuncle) category. (Formula see Axillary Carbuncle).
Si Wu Tang (Four Substance Decoction): Treats carbuncles and sores due to Blood deficiency, fever worsening in the late afternoon, or irritability and insomnia.
Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Praeparata) (2 qian each), Shao Yao (Paeoniae Radix Alba, stir-fried), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (1 qian each).
Decoct in water and take orally.
Shen Zhu Chai Ling Tang (Ginseng, Atractylodes, Bupleurum, and Poria Decoction): Treats carbuncles and sores due to Spleen Qi deficiency with internal stirring of Liver Qi, causing limb twitching.
Ren Shen (Ginseng Root), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Chen Pi (Citri Reticulatae Pericarpium) (1 qian each), Shan Zhi (Gardeniae Fructus, stir-fried), Gou Teng (Uncariae Ramulus cum Uncis) (7 fen each), Gan Cao (Licorice Root, stir-fried) (5 fen), Chai Hu (Bupleuri Radix), Sheng Ma (Cimicifugae Rhizoma) (3 fen each).
Take 1-2 qian per dose, decoct with ginger and jujube. For infants, administer to the nursing mother in a larger dose, and give a small dose to the child.
Huang Lian An Shen Wan (Coptis Calming Spirit Pill): Treats fever due to Heat in the Heart channel with Blood, palpitations, and restlessness.
Huang Lian (Coptidis Rhizoma) (5 fen), Sheng Gan Cao (Raw Licorice Root) (2.5 qian), Sheng Di Huang (Rehmanniae Radix) (5 qian), Dang Gui (Angelicae Sinensis Radix), Zhu Sha (Cinnabar) (3 qian).
Grind into powder, mix with rice paste to form pills the size of adzuki beans. Take 15 pills per dose with boiling water. If ineffective after two or three doses, Gui Pi Tang (Restore the Spleen Decoction) should be taken, administered to both infant and nursing mother.
Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder) (See Hypochondriac Carbuncle formula, also known as Chai Hu Qing Gan San).
Tuo Li Xiao Du San (Supporting Interior and Detoxifying Powder).
Tuo Li San (Supporting Interior Powder) (Both formulas see Heat-Toxin Carbuncles and Sores).
Qing Wei San (Stomach-Clearing Powder) (See Abdominal Carbuncle formula).
Jia Wei Xiao Yao San (Modified Free Wanderer Powder) (See Formula for Persistent Fever).
Niu Huang Jie Du San (Calculus Bovis Detoxification Powder) (See Formula for Fetal Toxin Sores and Scabies).
Shi Quan Da Bu Tang (Great Tonifying Decoction of Ten Ingredients) (See Anal Carbuncle formula).