〔《灵》〕五脏，身有五部，伏兔一；腓二，腓者， 也；背三；五脏之 四；项五。此五部有痈
疽者死。（寒热病篇王海藏云∶脑须鬓颐四处亦为痈疽必死之处。）
〔涓〕不可患痈疽者七处∶眼后虚处，颐接骨处，阴根根上毛间胯与尻骨接处，耳门前后车骨
接处，诸因小腹风水所成痈疽，颔骨下近耳后虚处，鼻骨中，并能害人。但以诸法疗之，或有得
瘥，唯眼后虚处最险。正脑上一处起，为脑痈及脑疽、脑铄，并在大椎骨上。入发际生脑痈，皮
起易得破穴，急破急出脓，不害。脑疽皮浓难得破穴，须急发内毒，使破穴方可。
脑铄一处，初起如横木掘，上起顶门，下止大椎。发肿如火烧，其色青黑如靴皮，大硬不见
脓，即损外皮，如犬咬去肉之迹，难愈。（铄，式约切。）
左右鬓两处痈疽疖，初起如虫咬，瘾疹痛肿，不赤红，难见脓汁，是为鬓发，此亦危笃之患，
既损破多为漏疮。
左右发际起如粟米，头白肉赤，热痛如锥刺，此疾妇人患多，丈夫患少，始因风湿上攻
发际，亦宜出脓无伤。
左额右额发赤疽，不拘大小，状如桃李，急宜药贴破，见脓无害。右额角一处，发毒疽
及恶疖，为近太阳穴，如肿满太阳，即成虚损，为近穴而难消，不可破。如破后，伤外风水，即
能害人，亦宜用药溃脓，后速敛合疮口。如经冬月，即成冷疮，缘此处近太阳穴，上至额角，
都为险处。
左右太阳穴或发疽疖及痈，五七日不溃，毒瓦斯流入眼眶攻眼，眼舍不开，用药贴破。
破后慎外风水，所入
即损其睛，疰损眼睑而成大疾。
左右眉棱两处发为发眉，不拘在头尾，宜虑未穴已前攻击。在眉头，即攻入眼损睛。在眉后，即攻
入太阳。并宜戒慎。
鼻下一处，人中两处，为发髭。此多因摘髭外入风而结，攻作不常，寒热相并，此亦害人。
下颐一处，发为发颐，肥人多有，此疾恐手搔伤而发肿。
左右牙叉骨接处，发痈疽处肿胀，攻骨及牙关，张口不得，因诸风热上攻，或多食烧炙之物
所为，或因患牙痈，即从牙缝中破出脓血，切忌外风水触犯。
垂臂两处发接骨下，臂肘上，起如鸡鸭卵大，皆由荣卫不调所为也。喜患实处而不透内，亦
宜急消，或发穴早疗。
两臂肘起，在接骨下引手至小骨之上，发痈疖。此处虽实，奈连大小筋骨，举动不便，垂手
多堕疼，如脓深沉彻骨，即伤筋脉，拳缩不舒，搐撮宜急，以缓慢筋脉药饵治之。
两手背发痈疽，初生如水刺无头脑，顽然满手背肿满，后聚毒成疮，深入至骨，而为发手背，
此属五种，皆发毒之类也。
两肋起疽，名为发肋。初肿盛，至十数日不穴攻，即肿大如杯碗，高如 背，痛彻内肠绞刺，
左边患应右边痛，右边患应左边痛。唯有此处多是内毒，却入攻而死者多。人有斯患，急以针刺
出脓血，则免内攻伤内矣。
三里两处起痈疽，初发如牛眼睛青黑，便五七日破穴出黑血汁脓，肿攻膀肚连腿里，拘急冷
疼，此因伤筋气劳力所成，宜用汤药注射，去其外毒，自平息矣。
两脚接骨近上膀肚下一处，起丹疽如胡桃大，硬如物打 之状，不苦疼，但肿急胀。虑其损
筋，亦须早出脓毒，可保平安矣。
两脚心发彻骨者，不治。如脚心微皮破，不至深发，脓不多者，可治。痈发虽重，不至损人，
但世人不晓医治，自至危殆耳。
上焦发痈为阳，是壅塞实候，宜解利温凉汤药，去其积热上攻，外即贴消毒逼肿药。如已
结定，即用发穴药，候穴破出其脓毒，肿平方贴生肉等药，然后敛合疮口。亦虑外伤风水，勿
食发风热酱面毒物等，忌房事。
中焦发痈，至腰上一节前后心不定所在，皆是涩滞候，亦乘虚而作。不拘大小，前起心鸠
尾者，最要紧，近两腋是虚处，两胁肋下至脐上及脐下两傍一二寸发痈，填气伏硬难溃脓，为此
等处偏难发穴，穴后难合疮口，并须先用暖内药服后用热药贴令软和，慢慢破穴，不得急破，
急破即朝夕出脓不住，缓慢破穴即一顿出脓，易为将息。后心者，唯有十一椎脾俞下，十四椎
上为肾俞，肾俞下为腰俞，两处起痈者，防毒瓦斯内攻，为此处皆是至虚处，凡有痈起，先须补内
气令实，方可放破。内气实，则不内攻，且易得溃。唯腰俞两处，多成漏疾，预防节欲，则免矣。
下焦发为流注虚损候。前阴股两处起如鸡卵大，长横折内，初起肿核结块，后四畔浮肿，
相并伏硬，色青黑。先用和平内药，服三五日，后用发穴散，及罨药令软即穴。穴后其疮口即
随折子内作长疮，疮口破，宜急用抽毒膏出脓，脓尽，便贴合疮口药。为此处无肉可坏，更不
须长肉也。
腿 两处起为便毒。胯下两臀尖下，大道前（谷道）小道后（水道）成悬痈，皆是虚极人患此。痈
近谷道左右亦名痔痈。宜急补脾脏，及发处贴药，即用发穴散，破后用抽脓膏，脓尽用合疮口散合
之，慎勿过冬，即成冷漏难治。
垂珠左右两处起痈，为骗马坠。初起大小不定，此处微实，皮肉薄，纹紧，口亦难合。
疮初起宜以消散药，贴令内消。此处亦易成漏疮，唯宜消散之，硬即恐缓慢难为功矣。又云∶交
HT一处，近棱在线，亦为骗马坠，防漏。（骗，匹扇切，俗名跨马痈是也。）
两曲 膀肚下，内外两踝前有廉刃，两边为里外廉，上结痈肿。此处近骨，难瘥。宜用
收毒散外贴四畔，中心即用活血肉药贴，无害。
下至两脚心发痈疖，沉深不治。如微似皮薄易破者，犹可也。凡有痈肿，皆属六腑有疾。
〔《灵》〕痈发于嗌中，名曰猛疽。猛疽不治，化为脓，脓不泻塞咽，半日死。其化为脓者，
泻则合豕膏，冷食，三日而已。发于颈者，名曰夭疽。其痈大而赤黑，不急治，则热气下入渊腋，
前伤任脉，内熏肝肺，熏肝肺十余日而死矣。（俱出痈疽篇，下同。）
〔涓〕百脉疽，肿起环颈项疼痛，身体大热，不敢动止， 不能食。此有大畏恐骇，上气咳
嗽，其发引耳，不可以肿。十五日可刺导引，不刺导引见血八十日必死。土龙疽发背，起胃俞
及肾俞，大发寒热十数日，大汗展颈，引身尽热如沸。不穴，二十日死。九日可刺，不刺其上下
亦黑，若脓青黑者死，血脓者不死。
〔《灵》〕阳气大发，消脑留项，名曰脑烁。其色不乐，项痛而如刺以针。烦心者，死不可治。
〔涓〕赤色疽，发头额以脑前并手掌中，十日不穴者死。七日可刺，出赤血。七日未有脓不可
治。（不穴者，不作穴而东攻西击也。）杼疽发鬓须及两耳，不穴十五日死。可刺。其脓色黑如
豆豉，或见血者死。黑疽发大椎骨上，连两夹脊上。七日可刺导引，为痈疽出脓，不可止吐碎骨。
身痒后痛者，此故伤寒气入脏腑，发为食疽也。九日可刺导引之。不刺不导引，十一日死。
〔《灵》〕发于肩及 ，名曰疵痈。其状赤黑，急治之，此令人汗出至足，不害五脏，痈发
四五日，逆。 之。（痈疽篇此当入痈。）
〔涓〕丁疽发两肩，恶血留结内外，荣卫不通，发成疔疽。五日肿大，令人口噤寒战，十二日
可刺，不治，二十日死。陈干疽，肿发起两肩及两大臂连胛骨，二七日痛不息，亦不可动，五十
日身热不赤，六十日可刺，刺之无血者死。
〔《灵》〕发于腋下赤坚者，名曰米疽，治之以砭石，欲细而长，疏砭之，涂以豕膏。六日已，
勿裹之。其痈坚而不溃者，为马刀挟瘿，急治之。
〔涓〕内疚疽发两腋下及臂，并两手掌中，振寒热而嗌干，饮多即呕，烦心 ，脉盛。六七
八日诊如此，可汗，不汗死。
〔《灵》〕发于胸名曰井疽，其状如大豆，三四日起，不早治，下入腹，不治，七日死矣。
发于膺，名曰甘疽，色青，其状如谷实栝蒌，常苦寒热，急治之，去其寒热，不急治，十岁死，死
后出脓。发于胁，名曰败疵，败疵者，女子之病也，灸之，其病大痈脓。治之，其中乃有生肉，
大如赤小豆。锉菱翘草根各一升，以水一斗六升煮之，竭为取三升，则强饮浓衣，坐于釜上，
令汗出至足已。（疵，疾HT 盗切。《甲乙经》于赤少豆下作治之锉菱草、赤松根各一升。）
〔涓〕使荧疽肿起，发肋及两肩肘头，二十日不穴死。九日可刺，发赤白相间，脓多可治，全无
赤白者不治。蜂疽发髀背，起心俞及心包络俞。若肩髁二十日，不穴死。十日可刺，其色赤黑，脓清
者不治。特疽发肺俞及肝俞，不穴，二十日死。八日可刺，其色红赤，内隐起如椒子者死。阴阳
二气疽，广阔满背，或大或小不常，肿热胀大。十日，可刺导引出脓，不拘深浅多少，发渴体倦。
十日外不见脓，不治。筋疽发夹脊两边大筋上，其色苍。八日，可刺。有痈在肥肠中，九十日死。
冲疽发小腹疼痛而振寒热，四日 ，五日变色，可刺。不刺即导引出脓毒。不治，五十余日死。
〔《灵》〕发于尻，名曰锐疽。其状赤坚大，急治之。不治，三十日死矣。（治见经虚条。）
〔涓〕涌泉疽，肿起发太阴，如伏鼠。二十日不穴死。十日，可刺，发清脓，赤黑者死，白
者可治。（太阴，尻尾前是也。）
〔《灵》〕发于股胫，名曰股胫疽。其状不甚变色，痈肿内薄于骨。不急治，三十日死矣。
（股胫，刘涓子作股阳。）发于股阴，名曰赤施。不急治，六十日死。在两股之内不治，十日死。
〔涓〕阴疽，发腿髀及阴股。始发腰强，数饮不能多，七日发坚肿胀恶疼，心烦躁，死不治。
〔《灵》〕发于膝，名曰疵疽。其状大，痈色不变，寒热而坚。勿石，石之者死。须其柔，乃
石之者生。（坚如石者，用生樟陆根擦之则效。）诸痈疽之发于节而相应者，不可治也。发于阳者，
百日死。发于阴者，三十日死。（阳谓诸节之背，阴谓诸节之 间。刘涓子云∶应者，内发
透外也。）发于胫，名曰兔啮。其状如赤豆，至骨，急治之，不急治，害人也。
发于内踝，名曰走缓。其状痈色不变。数石其输而止其寒热，不死。发于足上下，名曰四淫。
其状大痈，不急治之，百日死。发于足傍，名曰厉痈。其状不大，初从小指发，急治去之。其状
黑者不可消，辄益。不治，百日死。发于足指，名曰脱痈。其状赤黑者，死不治。不赤黑者不死。
治之不衰，急斩之，否则死矣。
〔涓〕 敦疽发两足指，五日不穴，死。四日可刺，其色发黑痈者不堪，未过节者可治。阳
疽起足跗及足下，二十日不穴死。十日可刺，发赤白脓血不多，其疮上痒及赤黑者死。禽疽，始
发者如疹数十处，如拳打之状，发寒齿噤。如此者，十四日死。十日可刺，导引脓出即愈。衡
疽发如肿，或时复往来，可要其所刺之，导引脓出即愈。
〔丹〕琥珀膏
归须 川芎 黄 梢 蜂房 细辛 皂角 升麻 甘草梢 蓖麻子 木鳖子 芍药 白蔹
独活 川椒 本 防风梢 枸杞子 菖蒲 降真香 官桂 栝蒌 苏木 白芷 杏仁 黄连
槐枝（以上各一两） 琥珀 沉香 木香 丁香 藿香 零陵香 云母石 乳香 雄黄 朱砂
安息香 甘松（以上各二钱半） 轻粉 麝香（各一钱） 发灰（五钱） 白矾（枯，一两，以上十六味
为极细末） 羊肾脂（四两） 蟾酥（二两） 香油（四斤） 黄丹
上先以前二十六味锉，槌碎，用水五升，文武火熬至二升半，去渣。再用水五升，又熬至
二升半，去渣，与前汁一处慢火煎，用槐枝不住手搅成膏，用瓷器盛，顿起。将后琥珀等十六味
研为极细末，用纸包起，于前膏内，下净羊脂四两，真酥二两，同膏入香油内搅令匀，以文武
火熬膏内水尽，用纸捻点油烧不爆为度渐入黄丹，以二两五钱重为一次，仍用槐枝不住手搅，滴
水中不散，软硬得所。如软添黄丹，如硬添油，再上火熬。却入前药细末五两，微煎数沸，用
瓷器盛贮。如用，于纸上摊之，量疮口大小。专治五发恶疮、疔肿、瘰 ，远年冷疳、痔漏、
一切无名恶疮、蛇伤、蝎啮、犬咬，并皆治之。
【《灵枢》】五脏在体表有五个对应部位：伏兔穴所在处为一；小腿肚腓肠肌处为二，腓肠肌即腓部；背部为三；五脏背俞穴处为四；颈部为五。这五个部位如果发生痈疽，会导致死亡。（《寒热病篇》王海藏说：脑、须、鬓、颐四处也是发生痈疽必死的地方。）
【刘涓子】有七个部位不可患痈疽：眼睛后面的虚软处，下巴与下颌骨连接处，阴根上方毛发之间的胯部与尾骶骨连接处，耳门前后颧骨与下颌骨连接处，所有因小腹风水邪气所成的痈疽，下颌骨下方靠近耳朵后的虚软处，鼻骨中间，这些部位都能致人于死地。虽然用各种方法治疗，有的可能痊愈，但唯独眼睛后面的虚软处最为危险。正对头顶中央一处发起的，称为脑痈、脑疽、脑铄，都在大椎骨上方。发际线内生出脑痈，皮肤隆起容易破溃出脓，应紧急刺破排脓，不会造成危害。脑疽皮厚难以破溃，必须紧急发散内部毒邪，使其破溃出脓才行。
脑铄这一处，初起时像横木掘地一样，上起头顶百会穴，下止大椎穴。肿胀如火烧般，颜色青黑像靴皮，坚硬不见脓头，随即损伤外皮，像被狗咬去肉留下的痕迹，难以治愈。（“铄”读音同“朔”。）
左右鬓角两处发生的痈疽疖，初起时像虫咬，出现瘾疹样痛肿，不红赤，难见脓汁，这叫鬓发疽，这也是危重的病患，一旦破损多变成漏疮。
左右发际线处起如粟米大小，头白肉红，热痛如锥刺，这种病妇女患得多，男子患得少，起初是因为风湿之邪上攻发际所致，也应当让脓液排出而无伤害。
左额右额发红疽，不论大小，形状像桃李，应紧急用药贴敷使其破溃，见到脓液便无大碍。右额角一处，发生毒疽及恶疖，因为靠近太阳穴，如果肿胀充满太阳穴区域，就会形成虚损，因为靠近穴位而难以消散，不可强行刺破。如果刺破后，受到外界风水的侵袭，就能害人，也宜用药促使化脓，随后迅速收敛愈合疮口。如果经过冬天，就会变成冷疮，因为此处靠近太阳穴，上至额角，都是险要之处。
左右太阳穴或发生疽疖及痈，五到七天不溃破，毒气流入眼眶攻击眼睛，眼睑无法睁开，需用药贴敷使其破溃。破溃后要谨慎防止外界风水入侵，否则进入眼中会损伤睛明，导致眼睑病变而成大病。
左右眉棱骨两处发生的是发眉疽，不论在眉头还是眉尾，都应忧虑未穴（指眼部穴位）之前受攻击。如果在眉头，就会攻入眼睛损伤视力。如果在眉后，就会攻入太阳穴。都应当戒慎小心。
鼻子下一处，人中穴两处，称为发髭疽。这多是因为拔除胡须时外风侵入而结聚，发作无常，寒热交作，这也伤人。
下巴一处，发生的是发颐，肥胖人多有此病，此病恐怕用手抓挠受伤而引发肿胀。
左右牙叉骨连接处，发生痈疽时肿胀，攻及骨骼和牙关，张口困难，这是因为各种风热上攻，或多食烧烤炙烤之物所致，或因患有牙痈，就从牙缝中破出脓血，切忌外界风水触犯。
垂臂两处，接骨下方，手臂肘部上方，起如鸡鸭卵大小，都是由营卫不调所致。喜欢发生在实处而不向内透发，也宜急消，或者尽早刺破治疗。
两臂肘部发起，在接骨下方引手至小骨之上，发生痈疖。此处虽然坚实，但连着大小筋骨，举动不便，垂手时多坠痛，如果脓液深沉彻骨，就会损伤筋脉，导致拳头收缩不能舒展，抽搐拘挛，宜紧急使用缓慢舒缓筋脉的药物进行治疗。
两手背发生痈疽，初生时如水刺无头，顽固地满布手背肿胀，后来聚毒成疮，深入至骨，称为发手背，这属于五种发毒之类。
两肋发起疽，名为发肋。初起肿胀严重，到了十几天不刺破攻毒，就肿大如杯碗，高如脊背，疼痛彻入内脏绞刺，左边患病右边痛，右边患病左边痛。只有此处多是内毒，反而攻入体内致死的多。人有此患，急用针刺出脓血，就能避免内攻伤及内脏。
足三里两处发起痈疽，初发如牛眼睛般青黑，五到七天破溃流出黑血汁脓，肿胀攻及膀胱腹部连及腿里，拘急冷疼，这是因伤筋气、劳力所致，宜用汤药注射，去除外部毒邪，自然平息。
两脚接骨近上，膀胱腹部下一处，起丹疽如胡桃大，硬如被打过状，不苦痛，只是肿胀急胀。担心损伤筋脉，也必须早日排出脓毒，可保平安。
两脚心发起并彻骨的，不治。如果脚心微破皮，不至深发，脓不多的，可治。痈发虽重，不至死人，只是世人不懂医治，自己走向危殆罢了。
上焦发起痈为阳证，是壅塞实候，宜解利温凉汤药，去除积热上攻，外用贴消毒逼肿药。如果已经结定，就用发穴药，等候破溃排出脓毒，肿平后贴生肌肉等药，然后收敛愈合疮口。也要忧虑外伤风水，勿食发风热酱面毒物等，忌房事。
中焦发起痈，在腰上一节前后心不定所在，皆是涩滞候，也是乘虚而作。不论大小，前起于心鸠尾者，最要紧，靠近两腋是虚处，两胁肋下至脐上及脐下两旁一二寸发起痈，填气伏硬难溃脓，为此等处偏难发穴，破穴后难合疮口，并须先用暖内药服用，后用热药贴令软和，慢慢破穴，不得急破，急破则早晚出脓不止，缓慢破穴则一顿出脓，易于调养。后心处，唯有第十一椎脾俞下，第十四椎上是肾俞，肾俞下是腰俞，这两处发起痈的，要防毒气内攻，因为此处皆是至虚处，凡有痈起，先须补内气令其实，方可放破。内气实，则不内攻，且容易溃破。唯腰俞两处，多成漏疾，预防节制欲望，则可免除。
下焦发起为流注虚损候。前阴股两处起如鸡卵大，长横折向内，初起肿核结块，后四周浮肿，相并伏硬，色青黑。先用和平内药，服三五日，后用发穴散，及罨药令软即刺破。破后其疮口即随折子内作长疮，疮口破，宜急用抽毒膏出脓，脓尽，便贴合疮口药。因为此处无肉可坏，更不需要长肉了。
腿弯两处发起为便毒。胯下两臀尖下，大道前（谷道/肛门）、小道后（水道/尿道）成悬痈，都是极虚之人患此。痈近谷道左右也称痔痈。宜急补脾脏，及发处贴药，即用发穴散，破后用抽脓膏，脓尽用合疮口散合之，慎勿过冬，即成冷漏难治。
垂珠左右两处发起痈，为骗马坠（跨马痈）。初起大小不定，此处微实，皮肉薄，纹紧，口亦难合。疮初起宜以消散药，贴令内消。此处也易成漏疮，唯宜消散之，硬即恐缓慢难为功矣。又说：交骨一处，近棱在线，也为骗马坠，防漏。（“骗”音匹扇切，俗名跨马痈。）
两曲池膀肚下，内外两踝前有廉刃，两边为里外廉，上结痈肿。此处近骨，难愈。宜用收毒散外贴四畔，中心即用活血肉药贴，无害。
下至两脚心发起痈疖，沉深不治。如微似皮薄易破者，犹可也。凡有痈肿，皆属六腑有疾。
【《灵枢》】痈发于咽喉中间，名叫猛疽。猛疽不治疗，化为脓，脓不泻出堵塞咽喉，半天就死。如果已化为脓，泻出后配合猪脂膏，冷食，三天就好。发于颈部的，名叫夭疽。其痈大而赤黑，不紧急治疗，则热气下入渊腋，前伤任脉，内熏肝肺，熏灼肝肺十余日就死了。（均出自《痈疽篇》，下同。）
【刘涓子】百脉疽，肿胀起于环颈项疼痛，身体大热，不敢动止，不能进食。此症有大畏恐惊骇，上气咳嗽，其发作牵引耳朵，不可以肿胀。十五日可刺破导引，不刺破导引见血，八十日必死。土龙疽发背，起于胃俞及肾俞，大发寒热十数日，大汗展颈，引身尽热如沸。不刺破，二十日死。九日可刺，不刺其上下亦变黑，若脓青黑者死，血脓者不死。
【《灵枢》】阳气大发，消脑留项，名叫脑烁。其面色不乐，项痛而如针刺。心烦者，死不可治。
【刘涓子】赤色疽，发于头额以及脑前并手掌中，十日不刺破者死。七日可刺，出赤血。七日未有脓不可治。（不刺破，是指不作刺破而向东向西乱攻。）杼疽发于鬓须及两耳，不刺破十五日死。可刺。其脓色黑如豆豉，或见血者死。黑疽发于大椎骨上，连两夹脊上。七日可刺导引，为痈疽出脓，不可止吐碎骨。身痒后痛者，这是故伤寒气入脏腑，发为食疽也。九日可刺导引之。不刺不导引，十一日死。
【《灵枢》】发于肩及臑，名叫疵痈。其状赤黑，急治之，此令人汗出至足，不害五脏，痈发四五日，逆。刺之。（《痈疽篇》此当入痈。）
【刘涓子】丁疽发两肩，恶血留结内外，营卫不通，发成疔疽。五日肿大，令人口噤寒战，十二日可刺，不治，二十日死。陈干疽，肿发起两肩及两大臂连胛骨，二七日痛不息，亦不可动，五十日身热不赤，六十日可刺，刺之无血者死。
【《灵枢》】发于腋下赤坚者，名叫米疽，治之以砭石，欲细而长，疏砭之，涂以豕膏。六日已，勿裹之。其痈坚而不溃者，为马刀挟瘿，急治之。
【刘涓子】内疚疽发两腋下及臂，并两手掌中，振寒热而咽干，饮多即呕，烦心，脉盛。六七八日诊如此，可汗，不汗死。
【《灵枢》】发于胸名叫井疽，其状如大豆，三四日起，不早治，下入腹，不治，七日死矣。发于膺，名叫甘疽，色青，其状如谷实栝蒌，常苦寒热，急治之，去其寒热，不急治，十岁死，死后出脓。发于胁，名叫败疵，败疵者，女子之病也，灸之，其病大痈脓。治之，其中乃有生肉，大如赤小豆。锉菱翘草根各一升，以水一斗六升煮之，竭为取三升，则强饮浓衣，坐于釜上，令汗出至足已。（“疵”，疾盗切。《甲乙经》于赤小豆下作治之锉菱草、赤松根各一升。）
【刘涓子】使荧疽肿起，发肋及两肩肘头，二十日不刺破死。九日可刺，发赤白相间，脓多可治，全无赤白者不治。蜂疽发髀背，起心俞及心包络俞。若肩髁二十日，不刺破死。十日可刺，其色赤黑，脓清者不治。特疽发肺俞及肝俞，不刺破，二十日死。八日可刺，其色红赤，内隐起如椒子者死。阴阳二气疽，广阔满背，或大或小不常，肿热胀大。十日，可刺导引出脓，不拘深浅多少，发渴体倦。十日外不见脓，不治。筋疽发夹脊两边大筋上，其色苍。八日，可刺。有痈在肥肠中，九十日死。冲疽发小腹疼痛而振寒热，四日变色，五日变色，可刺。不刺即导引出脓毒。不治，五十余日死。
【《灵枢》】发于尻，名叫锐疽。其状赤坚大，急治之。不治，三十日死矣。（治法见经虚条。）
【刘涓子】涌泉疽，肿起发太阴，如伏鼠。二十日不刺破死。十日，可刺，发清脓，赤黑者死，白者可治。（太阴，尻尾前是也。）
【《灵枢》】发于股胫，名叫股胫疽。其状不甚变色，痈肿内薄于骨。不急治，三十日死矣。（股胫，刘涓子作股阳。）发于股阴，名叫赤施。不急治，六十日死。在两股之内不治，十日死。
【刘涓子】阴疽，发腿髀及阴股。始发腰强，数饮不能多，七日发坚肿胀恶疼，心烦躁，死不治。
【《灵枢》】发于膝，名叫疵疽。其状大，痈色不变，寒热而坚。勿石，石之者死。须其柔，乃石之者生。（坚如石者，用生樟陆根擦之则效。）诸痈疽之发于节而相应者，不可治也。发于阳者，百日死。发于阴者，三十日死。（阳谓诸节之背，阴谓诸节之间。刘涓子云：应者，内发透外也。）发于胫，名叫兔啮。其状如赤豆，至骨，急治之，不急治，害人也。发于内踝，名叫走缓。其状痈色不变。数石其输而止其寒热，不死。发于足上下，名叫四淫。其状大痈，不急治之，百日死。发于足傍，名叫厉痈。其状不大，初从小指发，急治去之。其状黑者不可消，辄益。不治，百日死。发于足指，名叫脱痈。其状赤黑者，死不治。不赤黑者不死。治之不衰，急斩之，否则死矣。
【刘涓子】敦疽发两足指，五日不刺破，死。四日可刺，其色发黑痈者不堪，未过节者可治。阳疽起足跗及足下，二十日不刺破死。十日可刺，发赤白脓血不多，其疮上痒及赤黑者死。禽疽，始发者如疹数十处，如拳打之状，发寒齿噤。如此者，十四日死。十日可刺，导引脓出即愈。衡疽发如肿，或时复往来，可要其所刺之，导引脓出即愈。
【丹溪】琥珀膏配方：
当归须、川芎、黄柏梢、蜂房、细辛、皂角、升麻、甘草梢、蓖麻子、木鳖子、芍药、白蔹、独活、川椒、本、防风梢、枸杞子、菖蒲、降真香、官桂、栝蒌、苏木、白芷、杏仁、黄连、槐枝（以上各一两）；琥珀、沉香、木香、丁香、藿香、零陵香、云母石、乳香、雄黄、朱砂、安息香、甘松（以上各二钱半）；轻粉、麝香（各一钱）；发灰（五钱）；白矾（枯，一两，以上十六味为极细末）；羊肾脂（四两）；蟾酥（二两）；香油（四斤）；黄丹。
制作法：先将以上二十六味切碎，捣碎，用水五升，文武火熬至二升半，去渣。再用水五升，又熬至二升半，去渣，与前汁一处慢火煎，用槐枝不住手搅成膏，用瓷器盛，顿起。将后琥珀等十六味研为极细末，用纸包起，于前膏内，下净羊脂四两，真酥二两，同膏入香油内搅令匀，以文武火熬膏内水尽，用纸捻点油烧不爆为度渐入黄丹，以二两五钱重为一次，仍用槐枝不住手搅，滴水中不散，软硬得所。如软添黄丹，如硬添油，再上火熬。却入前药细末五两，微煎数沸，用瓷器盛贮。如用，于纸上摊之，量疮口大小。专治五发恶疮、疔肿、瘰疬，远年冷疳、痔漏、一切无名恶疮、蛇伤、蝎啮、犬咬，并皆治之。
[Ling Shu] The five Zang organs correspond to five regions on the body: the region of Futu (ST32) is one; the calf (Fei) is two, where "Fei" refers to the gastrocnemius muscle; the back is three; the Back-Shu points of the five Zang organs are four; and the neck is five. If carbuncles or sores (Yong Ju) occur in these five regions, death ensues. (Wang Haicang in the chapter "Cold-Heat Disease" states: The brain, beard, temples, and chin are also regions where carbuncles or sores invariably lead to death.)
[Liu Juanzi] There are seven regions where carbuncles or sores must not occur: the hollow area behind the eyes, the junction of the chin and mandible, the groin between the root of the genitals and the upper pubic hair, the junction of the zygomatic bone and mandible before and after the ear gate, all carbuncles or sores caused by wind-water pathogens in the lower abdomen, the hollow area below the mandible near the ear, and the middle of the nasal bone. These regions can be fatal. Although various treatments may cure some cases, the hollow area behind the eye is the most dangerous. A lesion arising directly above the vertex is called Brain Carbuncle, Brain Sore, or Brain Melt (Nao Shuo), located above the Dazhui (GV14) vertebra. A Brain Carbuncle arising within the hairline presents with raised skin that ruptures easily; urgent incision and drainage are required, which causes no harm. A Brain Sore has thick skin that is difficult to rupture; internal toxins must be urgently dispersed to induce rupture and drainage.
Brain Melt begins like a transverse log being dug up, rising from the Baihui (GV20) point on the vertex down to the Dazhui (GV14) vertebra. The swelling feels like burning fire, with a color resembling boot leather (dark green/black), hard without visible pus, followed by external skin damage resembling dog bites, making it difficult to heal. ("Shuo" is pronounced "shuo".)
Carbuncles, sores, or boils at the left and right temples begin like insect bites, presenting as urticaria-like painful swelling, not red, with difficulty in forming pus. This is called Temple Hair Carbuncle, a critical condition that often becomes a fistula upon rupture.
Lesions at the left and right hairlines appear like millet grains, white-headed with red flesh, hot and painful like needle pricks. This disease is more common in women than men. It initially arises from wind-dampness attacking the hairline. Pus discharge is beneficial and harmless.
Red sores on the left and right forehead, regardless of size, resemble plums or peaches. Urgent topical application to induce rupture is recommended; once pus appears, there is no danger. A toxic sore or malignant boil at the right temple angle is dangerous because it is near the Taiyang (GB14) acupoint. If swelling fills the Taiyang region, it leads to deficiency. Due to its proximity to the acupoint, it is difficult to resolve and should not be forcibly lanced. If lanced and exposed to external wind-water pathogens, it can be harmful. Medication should be used to promote suppuration, followed by rapid wound closure. If it persists through winter, it becomes a cold sore due to the location near Taiyang up to the forehead angle, which are hazardous areas.
Carbuncles, sores, or boils at the left and right Taiyang (GB14) acupoints that do not ulcerate within 5-7 days allow toxic qi to flow into the eye socket, causing inability to open the eyelids. Topical application should induce rupture. After rupture, guard against external wind-water invasion; entry into the eye damages vision and causes severe eyelid disease.
Lesions on the left and right eyebrow ridges are called Eyebrow Hair Carbuncles. Whether at the head or tail of the brow, care must be taken regarding attacks on the eye acupoints. At the brow head, it attacks the eye and damages vision. At the brow tail, it attacks the Taiyang (GB14) region. Caution is essential.
The area under the nose and the Renzhong (GV26) acupoint are sites for Beard Carbuncles. These often result from wind invasion after plucking beard hairs, presenting with alternating chills and fever, and are harmful.
The chin area presents as Jaw Carbuncle (Fa Yi), common in obese individuals. Scratching can cause injury and swelling.
Swelling at the junction of the left and right jawbones (mandibular condyle) involves pain in the bones and jaw joint, causing trismus. This is caused by wind-heat attacking upward or excessive consumption of roasted/fried foods. If associated with dental abscesses, pus and blood may drain from the teeth. External wind-water contact must be strictly avoided.
Lesions on the hanging arms, below the elbow joints, appearing like chicken or duck eggs, are caused by disharmony of Ying and Wei Qi. They tend to remain superficial without penetrating inward. Prompt resolution or early incision is advised.
Boils at both elbows, extending from below the humeroulnar joint to the small bones of the hand, involve solid tissue connected to tendons and bones, causing limited movement and drooping pain. Deep pus reaching the bone damages tendons and vessels, leading to clenched fists and spasms. Slow-acting tendon-relaxing medications should be used urgently.
Carbuncles on the dorsum of both hands begin like water blisters without heads, causing stubborn fullness and swelling. Later, toxins gather into ulcers penetrating deep to the bone, known as Hand Dorsum Carbuncle, belonging to the category of five types of toxic eruptions.
Sores on both ribs are called Rib Carbuncles. Initial swelling is severe; if not drained after ten days, they swell like cups, high as the back, with pain piercing the intestines. Pain may radiate contralaterally. Internal toxicity is common here, often leading to death from internal attack. Urgent needle drainage of pus and blood prevents internal organ damage.
Lesions at both Zusanli (ST36) acupoints begin like dark green-black cow eyes. Rupture occurs within 5-7 days, draining black bloody pus. Swelling attacks the bladder and abdomen, extending into the legs, causing stiffness and cold pain. This results from tendon/qi injury and labor. Decoctions should be used to expel external toxins, leading to resolution.
A Dan Carbuncle on both feet, near the ankle above the calf, resembles a walnut, hard as if beaten, not painful but swollen and tense. Concern for tendon damage requires early drainage of pus and toxins to ensure safety.
Bone-penetrating sores on both foot soles are incurable. If the skin is slightly broken, penetration is shallow, and pus is scant, it is treatable. Severe sores are not necessarily fatal, but ignorance of treatment leads to danger.
Upper Jiao carbuncles are Yang syndromes, characterized by obstruction and excess. Warm-cooling decoctions should clear accumulated heat attacking upward; externally, detoxifying and anti-swelling pastes are applied. Once formed, eruptive medicines are used until rupture and drainage occur. After swelling subsides, flesh-regenerating pastes are applied to close the wound. Guard against external wind-water; avoid wind-heating foods (fermented bean paste, noodles); abstain from sexual activity.
Middle Jiao carbuncles, occurring anywhere on the torso above the waist, indicate stagnation and deficiency. Lesions starting at the Xijiewei (CV12) are critical. Areas near the axillae are deficient. Sores between the costal margins and umbilicus are difficult to erupt due to qi stagnation and hardness. Post-rupture healing is slow. Internal warming medicines should be taken first, followed by hot topical applications to soften tissues for gradual eruption. Rapid eruption causes continuous drainage; gradual eruption allows single-batch drainage, facilitating care. Posterior lesions at Shenshu (BL23) and Yaoshu (BL23/L4) are highly deficient. Tonify internal Qi before lancing to prevent internal attack. Yaoshu lesions often become fistulas; abstinence prevents this.
Lower Jiao eruptions present as flowing injections and deficiency syndromes. Lesions in the anterior genital thighs resemble chicken eggs, lying horizontally. Initial nodules swell, becoming firm and dark green/black. Peaceful internal medicines are taken for 3-5 days, followed by eruptive powders and compresses to soften tissues for lancing. Post-rupture, the wound extends internally; toxic ointments extract pus, followed by wound-closing agents. Tissue regeneration is not expected here.
Sores in the popliteal fossa are called Ben Du (Soft Chancre). Perineal sores between the anus and urethra are called Xuan Yong, occurring in extremely deficient individuals. Sores near the anus are also called Hemorrhoidal Carbuncles. Spleen tonification and topical eruptive powders are used. After rupture, pus-extracting ointments and wound-closing powders are applied. Avoid winter exposure to prevent chronic cold fistulas.
Sores on the scrotum are called Pian Ma Zhui (Straddle Sore). Size varies; the area is slightly solid, thin-skinned, tight, and difficult to close. Dissolving pastes are used initially. Fistulas are common; dissolution is preferred over hardening, which is slow to respond. The pubic symphysis area is also prone to this; fistula prevention is key. ("Pian" is pronounced "pian", commonly known as Straddle Sore.)
Swelling at the popliteal fossa and medial/lateral malleoli involves the inner and outer edges. Proximity to bone makes healing difficult. Toxic-absorbing powder is applied peripherally, while blood-invigorating flesh-regenerating paste is applied centrally.
Deep sores on the foot soles are incurable. Superficial, thin-skinned lesions are treatable. All sores belong to disorders of the Six Fu organs.
[Ling Shu] Carbuncle in the throat is called Meng Ju (Fierce Sore). Untreated, it suppurates; if pus blocks the pharynx, death occurs in half a day. If suppurated, draining pus and consuming cold pig fat (Su Gao) cures it in three days. Carbuncle on the neck is called Yao Ju (Premature Death Sore). Large, red-black lesions, if not treated urgently, allow heat to descend to Yuanye (SI10), damaging the Ren Mai and steaming the Liver and Lungs, causing death in ten-plus days. (From "Carbuncle and Sore Chapter".)
[Liu Juanzi] Bai Mai Ju (Hundred Vessel Sore) presents with neck swelling, pain, high fever, immobility, and anorexia. Accompanied by fear, cough, and ear traction. Acupuncture and Dao Yin at 15 days are curative; failure leads to death in 80 days. Tu Long Ju (Earth Dragon Back Sore) arises at Weishu (BL21) and Shenshu (BL23), with severe chills, fever, sweating, and whole-body heat. No lancing leads to death in 20 days. Lancing at 9 days is effective; black pus indicates death, bloody pus indicates survival.
[Ling Shu] Excessive Yang qi dissipating the brain and remaining in the neck is called Nao Shuo (Brain Melt). Unhappy demeanor, neck pain like needle pricks, and irritability indicate incurable death.
[Liu Juanzi] Red Sore on the forehead and palms, un-lanced for 10 days, is fatal. Lancing at 7 days to release red blood is effective. Lack of pus at 7 days is untreatable. (Non-lancing means chaotic spreading.) Zhu Ju (Spindle Sore) at temples/beard/ears, un-lanced for 15 days, is fatal. Lancing is indicated. Black bean-like pus or bleeding indicates death. Black Sore on Dazhui (GV14) and paraspinal muscles. Lancing at 7 days is effective. Do not force out bone fragments. Itching then pain indicates Cold-Qi entering Zang-Fu, causing Food Sore. Lancing at 9 days is curative; failure leads to death in 11 days.
[Ling Shu] Carbuncle on shoulder and arm is called Ci Yong. Red-black, urgent treatment induces sweating to feet, sparing Zang organs. Delay beyond 4-5 days is adverse. Puncture is indicated. (Liu Juanzi: "Corresponding" means internal eruption.)
[Liu Juanzi] Ding Ju (Tack Sore) on shoulders involves stagnant evil blood, blocking Ying-Wei. Swelling at 5 days causes lockjaw and chills. Lancing at 12 days is effective; untreated death in 20 days. Chen Gan Ju (Old Dry Sore) on shoulders/arms/scapulae, pain persisting 14 days, immobility. Fever without redness at 50 days; lancing at 60 days without blood indicates death.
[Ling Shu] Red-hard carbuncle in axilla is Mi Ju (Rice Sore). Treat with fine, long bi-shi (stone needles), sparse puncturing, and apply pig fat. Cured in 6 days; do not bandage. Hard, non-ulcerating lesions are Ma Dao Jia Ying (Horse Knife Goiter); treat urgently.
[Liu Juanzi] Nei Jiu Ju (Internal Guilt Sore) in axillae/arms/palms presents with chills, dry throat, vomiting after drinking, irritability, and surging pulse. Sweating at 6-8 days is curative; lack of sweating is fatal.
[Ling Shu] Chest carbuncle is Jing Ju (Well Sore), soybean-sized, appearing in 3-4 days. Spreading to abdomen untreated causes death in 7 days. Chest-front carbuncle is Gan Ju (Sweet Sore), green, like melon seeds, with chills/fever. Untreated death in 10 years, post-mortem suppuration. Costal carbuncle is Bai Zi, a female disease. Moxibustion causes large abscess. Treatment involves removing fleshy growths like adzuki beans. Decoct rhizome of Polygonatum and root of Pseudolarix (1 sheng each) in 16 sheng water to 3 sheng. Drink strongly, wrap warmly, sit over pot to sweat to feet. ("Zi" pronounced "ji dao".)
[Liu Juanzi] Shi Ying Ju swelling ribs/shoulders/elbows, un-lanced 20 days is fatal. Lancing at 9 days with mixed red-white pus is curative; pure non-red-white is untreatable. Feng Ju (Bee Sore) on thigh/back at Xinshu (BL15) and Xinbaoluo Shu (BL17). Shoulder acromion un-lanced 20 days is fatal. Lancing at 10 days; red-black color or clear pus is untreatable. Te Ju (Special Sore) at Feishu (BL13) and Ganshu (BL18), un-lanced 20 days is fatal. Lancing at 8 days; red color with internal peppercorn-like bumps is fatal. Yin-Yang Two Qi Sore covers back broadly, variable size, hot/swollen. Lancing at 10 days to drain pus; thirst/fatigue occur. No pus after 10 days is untreatable. Jin Ju (Tendon Sore) on paraspinal tendons, pale color. Lancing at 8 days is effective. Abscess in fatty intestine is fatal in 90 days. Chong Ju (Charging Sore) lower abdominal pain/chills. Color change at 4-5 days; lancing/draining is effective. Untreated death in 50+ days.
[Ling Shu] Sacral carbuncle is Rui Ju (Sharp Sore). Red-hard-large, urgent treatment prevents death in 30 days. (See Jing Xu section.)
[Liu Juanzi] Yong Quan Ju (Yongquan Sore) arises at Taiyin (sacrum/coccyx), like a hidden rat. Un-lanced 20 days is fatal. Lancing at 10 days; clear pus is curative, red-black is fatal.
[Ling Shu] Thigh-shank carbuncle is Gu Ting Ju. Little color change, swelling pressing on bone. Untreated death in 30 days. (Liu Juanzi calls it Gu Yang.) Thigh-yin carbuncle is Chi Shi. Untreated death in 60 days. Internal thigh lesions untreated die in 10 days.
[Liu Juanzi] Yin Ju on thighs/genitals starts with stiff waist, frequent sips, then hard painful swelling, irritability; fatal and untreatable.
[Ling Shu] Knee carbuncle is Ci Ju. Large, unchanged color, cold/hard. Do not lance; lancing kills. Wait for softness to lance for survival. (Rub with fresh Litsea cubeba root for hardness.) Joint-associated carbuncles are incurable. Yang joint lesions die in 100 days; Yin joint lesions die in 30 days. (Yang = dorsal joints; Yin = ventral joints. Liu Juanzi: Corresponding means internal eruption.) Shank carbuncle is Tu Nie (Rabbit Bite). Red-bean sized, reaching bone; urgent treatment prevents harm. Ankle carbuncle is Zou Huan. Unchanged color; frequent puncturing of Shu points stops chills/fever; survival. Foot-top/bottom carbuncle is Si Yin. Large abscess; untreated death in 100 days. Foot-side carbuncle is Li Yong. Small, starting from little toe; urgent removal prevents spread. Black lesions cannot dissolve; untreated death in 100 days. Toe carbuncle is Tuo Yong. Red-black is fatal/untreatable; non-red-black is survivable. Failure to improve requires amputation; otherwise death.
[Liu Juanzi] Dun Ju on toes, un-lanced 5 days is fatal. Lancing at 4 days; black color is unfavorable, pre-joint lesions are treatable. Yang Ju on dorsum/sole, un-lanced 20 days is fatal. Lancing at 10 days; scant red-white pus, itching, or red-black color indicates death. Qin Ju (Bird Sore) starts as dozens of rashes, bruise-like, chills/jaw clenching. Fatal in 14 days. Lancing at 10 days drains pus for cure. Heng Ju (Balance Sore) swelling/wandering; puncture site directs drainage for cure.
[Danxi] Hu Po Gao (Amber Ointment) Formula:
Danggui Xu (Angelica Sinensis Root Tip), Chuanxiong (Ligusticum Chuanxiong Rhizome), Huangbai Shao (Phellodendron Bark Tip), Fengfang (Apis Nest), Xixin (Asarum Root), Zaojiao (Gleditsia Sinensis Fruit), Shengma (Cimicifuga Rhizome), Gancao Shao (Licorice Root Tip), Bimazi (Ricinus Seed), Miebiezi (Momordica Seed), Shaoyao (Paeonia Root), Bailian (Belamcanda Rhizome), Duhuo (Angelica Pubescens Root), Chuanjiao (Sichuan Pepper), Ben Cao (Ligusticum Wallichii Rhizome), Fangfeng Shao (Saposhnikovia Root Tip), Gouqizi (Lycium Fruit), Changpu (Acorus Rhizome), Jiangzhenxiang (Daemonorops Resin), Guanzi Gui (Cinnamon Twig), Gualou (Trichosanthes Fruit), Sumu (Sappan Wood), Baizhi (Angelica Dahurica Root), Xingren (Apricot Seed), Huanglian (Coptis Rhizome), Huaizhi (Salix Branch) [1 liang each]; Hupo (Amber), Chenxiang (Aquilaria Wood), Muxiang (Vladimiria Root), Dingxiang (Clove), Huoxiang (Pogostemon Herb), Linglingxiang (Lysimachia Herb), Yunmushi (Mica Stone), Ruxiang (Frankincense), Xionghuang (Realgar), Zhusha (Cinnabar), Anshixiang (Styrax), Gangsong (Nardostachys Root) [2.5 qian each]; Qingfen (Calomel), Shexiang (Musk) [1 qian each]; Fahui (Hair Ash) [5 qian]; Baifan Ku (Calcined Alum) [1 liang] [These 16 ingredients ground to fine powder]; Yangshenzhi (Sheep Kidney Fat) [4 liang]; Chansu (Toad Venom) [2 liang]; Xiangyou (Sesame Oil) [4 jin]; Huangdan (Lead Monoxide).
Preparation: Chop and crush the first 26 ingredients. Decoct in 5 sheng water to 2.5 sheng, strain. Repeat with 5 sheng water to 2.5 sheng, strain. Combine filtrates, simmer slowly, stirring constantly with willow branch until ointment forms. Store in porcelain. Grind the 16 powdered ingredients finely, wrap in paper. Add 4 liang sheep fat and 2 liang true toad venom to the ointment and sesame oil, mix well. Simmer until water evaporates (test by dropping oil on paper without popping). Gradually add Huangdan in 2.5 liang increments, stirring constantly with willow branch until drops do not disperse in water. Adjust consistency with more Huangdan (if soft) or oil (if hard). Reheat. Add 5 liang of the fine powder mixture, boil briefly. Store in porcelain. Apply thinly on paper according to wound size. Treats all malignant sores, carbuncles, scrofula, chronic cold ulcers, hemorrhoids/fistulas, unknown malignant sores, snake/scorpion/dog bites.