臂痈之症，当分经络所属受症之因而治之。上廉属手阳明经；下廉属手太阳经；外廉属手少阳经；内廉属手厥阴经；
内之上廉属手太阴经；内之下廉属手少阴经。或经络热郁，风邪外干，气血有乘，即生痈毒。若因心经有热者，导赤散
加黄连。心胞络有热者，柴胡栀子散。肺经有热者，泻白散。大肠经有热者，大连翘饮。 肿作痛者，血气凝结也，用
仙方活命饮。肿痛不消者，欲作脓也，用托里消毒散。脓熟不出者，气血虚也，用托里消毒散。脓出反痛者，气血虚甚
也；肌肉不生者，脾胃气虚也，用五味异功散。不可外敷生肌散，恐反助其邪，而肌肉难长也。
一小儿臂上生痈，肿连肘间，此属手少阴三焦二经，先用仙方活命饮，杀其大势；次用柴胡清肝散，以清心肝之热，
诸症顿退。又用托里消毒散，出脓而愈。
一小儿臂外侧患毒，此属肺经部分，先用神效解毒散加桔梗二剂，肿痛顿减；次用托里消毒散，而脓溃将愈。因母
食炙 之味，患处复肿，兼发热咳嗽，子服泻白散，母服清胃散而痊。
一小儿臂腕漫肿，敷寒凉药，又常以冷水润之，肿热以上至肩，两月余而溃，四月余不敛，脓出清稀，面色痿黄。
余曰∶此气血虚不能充荣于肌肉也。先用异功散、加升麻、柴胡，脾胃渐健，又用托里散而愈。
一小儿臂患痈，久不愈，手足时冷，用异功散加木香，佐以八珍汤。手足温和，乃用托里散，将敛，因饮食停滞伤
脾，患处肿硬，用六君、木香及托里散而愈。
一小儿臀痈，久不愈，溃出碎骨，饮食少思，不时寒热，脓水清稀，此气血俱虚也，用八珍散加肉桂、桔梗渐消，
又用托里散加肉桂及豆豉而愈。
一小儿臂膊赤肿，发热作渴饮冷。症属胃火，先用加味清胃散而愈。后因母食浓味，复肿痛，先用泻黄散二服，再
用清胃散，母子服之并愈。
一女子臂疮，肿 作痛，用仙方活命饮，痛止成脓；用加味八珍汤，而脓溃渐敛；用加味逍遥散与母服而痊。
一小儿因母食膏粱，臂疮溃而作痛，脉洪数有力，用清胃散与母服，子服泻黄散渐愈；又用加味逍遥散，母子俱服
而愈。
一小儿臂疮，服败毒散呕吐腹胀作痛，手足并冷，用六君、姜、桂，诸症渐退，饮食渐进；次用五味异功散而愈。
一小儿臂痈，肿硬色白，寒热倦怠，此血气虚弱而不能溃散，先用五味异功散加干姜，其肿渐退，饮食渐进；又用
托里散、如圣饼，脓溃而愈。
一小儿臂患痈，肿硬不消，食少自汗，此脾肺气虚而不能溃，先用六君子汤而汗止，乃佐以葱熨法而脓成，又用八
珍汤而脓溃，用托里散而疮敛。
一小儿臂患疮，敷寒凉之药，肿硬不消，用补中益气汤加木香、薄、桂、及如圣饼，助其阳气而消。
一小儿臂患疮，肿硬作呕，面色痿黄，饮食少思，此脾气虚也，用六君子汤呕止食进，又用五味异功散、如圣饼而
消。
一小儿臂疮，作痛不止，肌肉不生，先用托里消毒散而痛止，用五味异功散、托里散而肉生。
一小儿臂患疮，久而不敛，肌肉消瘦，日晡体热，此脾
气虚而不能生肌肉也，朝用补中益气汤，夕用五味异功散，诸症渐愈；又用托里散、如圣饼而愈。
一小儿臂疮肿痛 赤，右腮赤色，敷服皆败毒之药，余谓此肺胃二经之症也，当用泻黄、泻白二散主之。不信，恪
用前药泛扰诸经，虚症蜂起而殁。
神效解毒散 治一切疮疡初起，肿者即消，已溃仍肿者即散，已溃毒不解者即愈。
金银花（一两） 甘草节（五钱） 黄 皂角刺（炒） 当归（各三钱） 乳香 没药（各二钱）
上为散，每服二钱，酒煎。温酒调服亦可。婴儿病，乳母亦服。如疮已溃，肿痛已止者，去乳、没、金银花，倍加
黄、甘草。
白芷升麻汤 治手阳明经分臂上生疮。
白芷 升麻 桔梗（各一钱） 黄 （炒） 黄芩（酒炒。各二钱） 生黄芩（五分） 红花 甘草（炙。各五分）
上水酒半钟煎，食后温服。
泻白散 治肺经有热生疮，又化痰止嗽，治气进食。
地骨皮 桑白皮（炒。各一两） 甘草（炙，五钱）
上为末，每服一二钱，入粳米百粒，水煎。
泻心散 治心经实热，生疮作渴，发热饮冷，手足并热者。（详见心脏泻心汤）
导赤散 治小肠实热生疮，作渴发热，小便秘赤。
生地黄 木通 甘草（等分）
上为末，每服一钱，入淡竹叶水煎。
大连翘饮 即大连翘汤，治肺热生疮。
连翘 瞿麦 荆芥 木通 赤芍药 当归 防风 柴胡 滑石 蝉壳 甘草（炒） 山栀子 黄芩（各等分）
上为末，每服二钱，加紫草水煎服之。大便不通，量加大黄。
补中益气汤（方见肌肉不生）
加味逍遥散
六味地黄丸（二方见发热不止）
十全大补汤（方见便痈）
四味肥儿丸（方见贴骨痈）
九味芦荟丸（方见喉痹）
柴胡栀子散（方见腹痈）
东垣清胃散（方见腹痈）
五味异功散（方见败毒之药）
托里消毒散
托里散（二方见热毒疮疡）
臂痈这一病症，应当根据经络归属、致病原因来辨证治疗。上廉穴部位属于手阳明经；下廉穴部位属于手太阳经；外侧属于手少阳经；内侧属于手厥阴经；内侧的上部属于手太阴经；内侧的下部属于手少阴经。如果是经络热邪郁结，风邪外袭，气血运行失常，就会发生痈毒。如果是因为心经有热，用导赤散（清心利水方）加黄连。心包络有热者，用柴胡栀子散。肺经有热者，用泻白散。大肠经有热者，用大连翘饮。肿胀且疼痛的，是血气凝结所致，用仙方活命饮。肿痛不消退的，是即将化脓，用托里消毒散。脓已成熟但排不出来的，是气血虚弱，用托里消毒散。脓出后反而疼痛的，是气血极度虚弱；肌肉不生长的，是脾胃气虚，用五味异功散。不可外敷生肌散，恐怕反而会助长邪气，导致肌肉难以生长。
有一个小儿手臂上生痈，肿胀连及肘部，这属于手少阴经和三焦经病变，先用仙方活命饮，消除其大势；接着用柴胡清肝散，以清除心肝之热，各种症状顿时减退。又用托里消毒散，排出脓液而痊愈。
有一个小儿手臂外侧患毒疮，这属于肺经部分病变，先用神效解毒散加桔梗服用两剂，肿痛顿时减轻；接着用托里消毒散，脓溃后将愈。因为母亲吃了烤炙的食物，患处再次肿胀，兼有发热咳嗽，孩子服用泻白散，母亲服用清胃散而痊愈。
有一个小儿手腕处漫肿，敷用寒凉药物，又常用冷水润湿，肿胀热感向上蔓延至肩部，两个多月后溃破，四个多月还不愈合，脓液清稀，面色萎黄。我说：这是气血虚弱，不能充养肌肉所致。先用异功散加升麻、柴胡，脾胃逐渐强健，又用托里散而痊愈。
有一个小儿手臂患痈，久不愈合，手脚时常发冷，用异功散加木香，配合八珍汤。手脚变温暖后，再用托里散，伤口将收敛，因饮食停滞损伤脾脏，患处肿硬，用六君子汤、木香及托里散而痊愈。
有一个小儿臀部生痈，久不愈合，溃烂流出碎骨，饮食减少思食，不时出现寒热交替，脓水清稀，这是气血都虚弱，用八珍散加肉桂、桔梗逐渐消散，又用托里散加肉桂及豆豉而痊愈。
有一个小儿手臂红肿，发热口渴喜饮冷水。症状属胃火，先用加味清胃散而痊愈。后来因母亲吃浓味食物，再次肿痛，先用泻黄散服用两剂，再用清胃散，母子同服并痊愈。
有一个女子手臂生疮，肿胀作痛，用仙方活命饮，痛止成脓；用加味八珍汤，脓溃渐敛；用加味逍遥散与母亲同服而痊愈。
有一个小儿因母亲吃膏粱厚味，手臂疮溃破作痛，脉象洪数有力，用清胃散给母亲服用，孩子服用泻黄散逐渐好转；又用加味逍遥散，母子俱服而痊愈。
有一个小儿手臂疮，服用败毒散后呕吐腹胀作痛，手脚均冷，用六君子汤、生姜、肉桂，各种症状逐渐退去，饮食逐渐增加；接着用五味异功散而痊愈。
有一个小儿手臂痈，肿硬色白，寒热倦怠，这是血气虚弱而不能溃散，先用五味异功散加干姜，其肿逐渐退去，饮食逐渐增加；又用托里散、如圣饼，脓溃而痊愈。
有一个小儿手臂患痈，肿硬不消，食少自汗，这是脾肺气虚而不能溃破，先用六君子汤而汗止，再配合葱熨法使脓成，又用八珍汤使脓溃，用托里散使疮口收敛。
有一个小儿手臂患疮，敷用寒凉药物，肿硬不消，用补中益气汤加木香、薄荷、肉桂及如圣饼，助其阳气而消散。
有一个小儿手臂患疮，肿硬作呕，面色萎黄，饮食减少思食，这是脾气虚，用六君子汤呕止食进，又用五味异功散、如圣饼而消散。
有一个小儿手臂疮，疼痛不止，肌肉不生，先用托里消毒散而痛止，用五味异功散、托里散而肉生。
有一个小儿手臂患疮，久而不收敛，肌肉消瘦，傍晚身体发热，这是脾气虚而不能生肌肉，早晨用补中益气汤，晚上用五味异功散，各种症状逐渐好转；又用托里散、如圣饼而痊愈。
有一个小儿手臂疮肿痛发红，右腮红色，敷药内服皆用败毒类药物，我认为这是肺胃二经的症状，应当用泻黄散、泻白散主治。患者不信，坚持使用前药扰乱各经，虚症蜂拥而起而死亡。
神效解毒散 治疗一切疮疡初起，肿者即消，已溃仍肿者即散，已溃毒不解者即愈。
金银花（一两） 甘草节（五钱） 黄芪 皂角刺（炒） 当归（各三钱） 乳香 没药（各二钱）
以上研为散剂，每次服用二钱，酒煎。温酒调服也可以。婴儿患病，乳母也需服用。如果疮已溃破，肿痛已停止的，去掉乳香、没药、金银花，加倍加入黄芪、甘草。
白芷升麻汤 治疗手阳明经分手臂上生疮。
白芷 升麻 桔梗（各一钱） 黄芪（炒） 黄芩（酒炒。各二钱） 生黄芩（五分） 红花 甘草（炙。各五分）
以上用水和酒半钟煎煮，饭后温服。
泻白散 治疗肺经有热生疮，又能化痰止咳，治气喘进食。
地骨皮 桑白皮（炒。各一两） 甘草（炙，五钱）
以上研为末，每次服用一二钱，加入粳米一百粒，水煎。
泻心散 治疗心经实热，生疮作渴，发热饮冷，手足均热者。（详见心脏泻心汤）
导赤散 治疗小肠实热生疮，作渴发热，小便短赤。
生地黄 木通 甘草（等分）
以上研为末，每次服用一钱，加入淡竹叶水煎。
大连翘饮 即大连翘汤，治疗肺热生疮。
连翘 瞿麦 荆芥 木通 赤芍药 当归 防风 柴胡 滑石 蝉壳 甘草（炒） 山栀子 黄芩（各等分）
以上研为末，每次服用二钱，加紫草水煎服之。大便不通，酌情加大黄。
补中益气汤（方见肌肉不生）
加味逍遥散
六味地黄丸（二方见发热不止）
十全大补汤（方见便痈）
四味肥儿丸（方见贴骨痈）
九味芦荟丸（方见喉痹）
柴胡栀子散（方见腹痈）
东垣清胃散（方见腹痈）
五味异功散（方见败毒之药）
托里消毒散
托里散（二方见热毒疮疡）
The syndrome of arm carbuncle (Bi Yong) should be treated by differentiating the meridian involvement and the cause of the disease. The upper Lian acupoint belongs to the Hand-Yangming Meridian; the lower Lian acupoint belongs to the Hand-Taiyang Meridian; the lateral aspect belongs to the Hand-Shaoyang Meridian; the medial aspect belongs to the Hand-Jueyin Meridian; the upper part of the medial aspect belongs to the Hand-Taiyin Meridian; the lower part of the medial aspect belongs to the Hand-Shaoyin Meridian. If there is heat stagnation in the meridians, external invasion by wind pathogen, or disorder of Qi and Blood, a carbuncle or toxic swelling will arise. If the heat is in the Heart Meridian, Dao Chi San (Carpesium Powder for Guiding Out Heat) with Huanglian (Rhizoma Coptidis) is used. If the heat is in the Pericardium Collateral, Chaihu Zhizi San (Bupleurum and Gardenia Powder) is used. If the heat is in the Lung Meridian, Xie Bai San (Powder for Draining White/Lung) is used. If the heat is in the Large Intestine Meridian, Da Lianqiao Yin (Large Forsythia Decoction) is used. For swelling accompanied by pain, which indicates stagnation of Qi and Blood, Xian Fang Huo Ming Yin (Immortal Formula for Reviving Life) is used. For persistent swelling and pain indicating impending suppuration, Tuo Li Xiao Du San (Powder for Supporting the Right and Eliminating Toxin) is used. For mature pus that fails to discharge due to deficiency of Qi and Blood, Tuo Li Xiao Du San is also used. If pain persists after pus discharge, it indicates severe deficiency of Qi and Blood; if muscle tissue fails to regenerate, it indicates deficiency of Spleen and Stomach Qi, in which case Wu Wei Yi Gong San (Five-Ingredient Powder for Enhancing Function) is used. External application of Sheng Ji San (Powder for Generating Flesh) is contraindicated, as it may exacerbate the pathogen and hinder flesh regeneration.
A child developed a carbuncle on the arm, with swelling extending to the elbow, involving the Hand-Shaoyin and Sanjiao meridians. First, Xian Fang Huo Ming Yin was administered to subdue the major pathogenic force; subsequently, Chaihu Qing Gan San (Bupleurum Liver-Clearing Powder) was used to clear heat from the Heart and Liver, resulting in immediate relief of symptoms. Finally, Tuo Li Xiao Du San was used to drain the pus, leading to recovery.
A child suffered from a toxic sore on the lateral aspect of the arm, belonging to the Lung Meridian. Initially, Shen Xiao Jie Du San (Miraculous Efficacy Antidote Powder) with Jiegeng (Platycodon Root) was given for two doses, significantly reducing swelling and pain. Then, Tuo Li Xiao Du San was used, leading to suppuration and healing. However, because the mother consumed roasted foods, the lesion swelled again, accompanied by fever and cough. The child took Xie Bai San, and the mother took Qing Wei San (Stomach-Clearing Powder), both recovering.
A child presented with diffuse swelling at the wrist. After applying cold-natured medicines and frequently rinsing with cold water, the swelling and heat spread up to the shoulder. It ulcerated after more than two months but failed to close after four months, discharging thin pus, with a sallow complexion. I stated: This is due to deficiency of Qi and Blood failing to nourish the muscles. First, Yi Gong San (Efficacy-Enhancing Powder) with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) was used to strengthen the Spleen and Stomach; subsequently, Tuo Li San was used for recovery.
A child had a chronic arm carbuncle with cold extremities. Yi Gong San with Muxiang (Aucklandiae Radix) was combined with Ba Zhen Tang (Eight-Treasure Decoction). Once the extremities warmed, Tuo Li San was used. Due to food stagnation damaging the Spleen, the lesion became swollen and hard; Liu Jun Zi Tang (Six-Gentleman Decoction), Muxiang, and Tuo Li San were then used for cure.
A child had a chronic buttock carbuncle discharging fragmented bone, with poor appetite, alternating chills and fever, and thin pus, indicating dual deficiency of Qi and Blood. Ba Zhen San was used with Rougui (Cinnamomi Cortex) and Jiegeng to gradually resolve the condition; finally, Tuo Li San with Rougui and Douchi (Fermented Soybean) led to recovery.
A child presented with red, swollen arms, fever, thirst, and preference for cold drinks, indicating Stomach Fire. Jia Wei Qing Wei San (Modified Stomach-Clearing Powder) cured the condition. Later, due to the mother’s consumption of rich foods, swelling and pain recurred. Xie Huang San (Powder for Draining Yellow/Spleen-Fire) was taken twice, followed by Qing Wei San, curing both mother and child.
A woman had an arm sore with painful swelling. Xian Fang Huo Ming Yin stopped the pain and promoted suppuration; Jia Wei Ba Zhen Tang (Modified Eight-Treasures Decoction) promoted drainage and contraction; Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) taken by both mother and daughter led to recovery.
A child’s arm sore ulcerated and pained after the mother consumed rich foods. The pulse was surging, rapid, and forceful. Qing Wei San was given to the mother, and Xie Huang San to the child, leading to gradual improvement. Jia Wei Xiao Yao San was then taken by both for full recovery.
A child taking Bai Du San (Anti-Toxin Powder) for an arm sore developed vomiting, abdominal distension, pain, and cold extremities. Liu Jun Zi Tang with Shengjiang (Zingiberis Rhizoma Recens) and Rongui (Cinnamomi Cortex) alleviated symptoms and improved appetite; Wu Wei Yi Gong San completed the cure.
A child had a white, hard, swollen arm carbuncle with chills, fever, and fatigue, indicating Qi and Blood deficiency preventing suppuration. Wu Wei Yi Gong San with Ganjiang (Zingiberis Rhizoma) reduced swelling and improved diet; Tuo Li San and Ru Sheng Bing (Like-Sage Cake) led to suppuration and recovery.
A child had a non-resolving, hard arm carbuncle with poor appetite and spontaneous sweating, indicating Spleen and Lung Qi deficiency. Liu Jun Zi Tang stopped the sweating; Cong Yun Fa (Scallion-Moxibustion Method) promoted suppuration; Ba Zhen Tang promoted drainage; Tuo Li San closed the wound.
A child with an arm sore applied cold medicines, resulting in hardness without resolution. Bu Zhong Yi Qi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) with Muxiang, Bohe (Menthae Haplocalycis Herba), and Rougui, plus Ru Sheng Bing, supported Yang Qi to resolve the swelling.
A child had a hard, vomiting-inducing arm sore with sallow complexion and poor appetite, indicating Spleen Qi deficiency. Liu Jun Zi Tang stopped vomiting and improved intake; Wu Wei Yi Gong San and Ru Sheng Bing resolved the condition.
A child had persistent pain and lack of flesh regeneration in an arm sore. Tuo Li Xiao Du San stopped the pain; Wu Wei Yi Gong San and Tuo Li San promoted flesh growth.
A child had a chronic, non-healing arm sore with emaciation and afternoon fever, indicating Spleen Qi deficiency failing to generate flesh. Bu Zhong Yi Qi Tang was taken in the morning, and Wu Wei Yi Gong San in the evening, gradually improving symptoms; Tuo Li San and Ru Sheng Bing completed the cure.
A child had a red, swollen, painful arm sore with redness on the right cheek. Using only anti-toxin herbs externally and internally, I diagnosed this as a Lung and Stomach Meridian issue, prescribing Xie Huang San and Xie Bai San. The family refused, persisting with previous herbs, causing widespread deficiency syndromes and death.
Shen Xiao Jie Du San treats all initial sores and ulcers; it reduces swelling immediately, disperses residual swelling after ulceration, and resolves unresolved toxins after ulceration.
Jinyinhua (Lonicerae Japonicae Flos, 1 liang), Gancao Jie (Glycyrrhizae Radix et Rhizoma Node, 5 qian), Huangqi (Astragali Radix), Zaogelaci (Gleditsiae Sinensis Spina, stir-fried), Danggui (Angelicae Sinensis Radix, each 3 qian), Xuxiang (Olibanum, Myrrha, each 2 qian).
Grind into powder. Take 2 qian per dose, decocted in wine. Alternatively, mix with warm wine. For infants, the nursing mother should also take it. If the sore has ulcerated and pain/swelling have ceased, remove Xuxiang, Moyao, and Jinyinhua, and double the dosage of Huangqi and Gancao.
Baizhi Shengma Tang treats sores on the arm in the Hand-Yangming Meridian distribution.
Baizhi (Angelicae Dahuricae Radix), Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodonis Radix, each 1 qian), Huangqi (stir-fried), Huangqin (Scutellariae Radix, wine-fried, each 2 qian), Sheng Huangqin (raw Scutellariae Radix, 5 fen), Honghua (Carthami Flos), Gancao (honey-fried, each 5 fen).
Decoct with half a zhong of water and wine. Take warm after meals.
Xie Bai San treats sores caused by Lung heat, resolves phlegm, stops cough, and regulates Qi/appetite.
Digupi (Lycii Cortex), Sangbaipi (Mori Cortex, stir-fried, each 1 liang), Gancao (honey-fried, 5 qian).
Grind into powder. Take 1-2 qian per dose with 100 grains of Jingmi (Oryza Sativa Germen), decocted in water.
Xie Xin San treats excess heat in the Heart Meridian, causing sores, thirst, fever with preference for cold drinks, and hot extremities. (See detailed formula: Heart-Xie Xin Tang).
Dao Chi San treats sores caused by excess heat in the Small Intestine, causing thirst, fever, and dark, scanty urine.
Sheng Dihuang (Rehmanniae Radix Preparata), Mutong (Akebiae Caulis), Gancao (equal parts).
Grind into powder. Take 1 qian per dose with Danzhuyez (Liriopes Folium) water, decocted.
Da Lianqiao Yin (also known as Da Lianqiao Tang) treats sores caused by Lung heat.
Lianqiao (Forsythiae Fructus), Qumai (Diantherae Herba), Jingjie (Schizonepetae Spica), Mutong, Chi Shaoyao (Paeoniae Radix Rubra), Danggui, Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Huashi (Talcum), Chanqiao (Cicadae Periostracum), Gancao (stir-fried), Shanzhizi (Gardeniae Fructus), Huangqin (each equal parts).
Grind into powder. Take 2 qian per dose, decocted with Zicao (Arnebiae Radix et Rhizoma). If constipation exists, add Dahuang (Rhei Radix et Rhizoma) according to need.
Bu Zhong Yi Qi Tang (See formula under "Muscle Not Regenerating")
Jia Wei Xiao Yao San
Liu Wei Di Huang Wan (Two formulas see "Unremitting Fever")
Shi Quan Da Bu Tang (See formula under "Perineal Carbuncle")
Si Wei Fei Er Wan (See formula under "Deep Bone Carbuncle")
Jiu Wei Lu Hui Wan (See formula under "Throat Bi")
Chaihu Zhizi San (See formula under "Abdominal Carbuncle")
Dong Yuan Qing Wei San (See formula under "Abdominal Carbuncle")
Wu Wei Yi Gong San (See formula under "Anti-Toxin Drugs")
Tuo Li Xiao Du San
Tuo Li San (Two formulas see "Heat-Toxic Sores and Ulcers")