【方歌】兑疽生腕动脉间，坚硬漫肿兑骨边，痛彻手膊为险证，
本属肺经穴太渊。
【注】此证生于手腕里面，横纹前稍动脉之间，兑骨里侧，属
肺经太渊穴，由忧思气滞风火结成。坚硬漫肿，疼痛彻
骨，手膊不能转动。此动脉处，乃肺经门户，若发此疽
，或溃深大泄肺气，最为险候。内外治法，俱按痈疽肿
疡、溃疡门。
【方歌】穿骨疽生间使穴，掌后三寸包络经，坚硬漫肿因蕴热，
毒盛溃深穿骨疼。
【注】此证生于间使穴，处在掌后横纹上三寸两筋陷中，属包
络经，蕴热凝结而成。初起如粟，渐增坚硬，漫肿微红
，〔兴〕热疼痛，应期速溃者顺；若溃破迟缓，脓毒溃
穿骨缝，从臂外侧出脓者险。内外治法，俱按痈疽肿疡
、溃疡门。
【方歌】骨蝼疽生臂外廉，经属阳明忧怒缠，疮疼根束多善顺，
紫晕腐串七恶难。
【注】此证生于臂外侧前廉，大骨之后，属手阳明大肠，由忧
郁暴怒凝结而成。初如粟豆，旬日大如桃李，肿硬疼痛
，疮根收束，多见五善之证者顺；若紫晕开大，腐烂斑
点，串通肌肉，抽搐拘急，多见七恶之证者逆。始终内
外治法，俱按痈疽肿疡、溃疡门。
【方歌】蝼蛄串生臂内中，患伤脾气包络凝，筋骨如中流矢痛，
内溃串孔似漏形。
【注】此证生于臂内中廉，属包络经。由思虑伤脾，脾伤则运
化迟，故生浊液，流于肌肉，脾气滞郁不舒，凝结而成
。此患初起，筋骨如中流矢，疼痛渐增，漫肿坚硬，不
红不热，连肿数块，臂膊不能转动，日久其肿块渐次溃
破，孔孔时流白浆，内溃串通诸孔，外势肿硬不消，脓
水淋沥如漏，虚证悉添，如面黄、食少、削瘦，甚则午
后寒热交作，而成败证也。初起宜服逍遥散，外敷太乙
紫金锭；次服人参养荣汤，调和气血，扶助脾胃，十中
可保二三。溃，按痈疽溃疡治法，若投药不效者属逆。
方剂：逍遥散（见背部上搭手）
太乙紫金锭（见胸部脾发疽）
人参养荣汤（见溃疡门）
【方歌】兑疽生于手腕动脉之间，坚硬且漫肿于兑骨边缘，疼痛放射至手膊属于险证，本病归属于肺经的太渊穴。
【注】此证生于手腕内侧，横纹前方稍偏动脉之间，兑骨的内侧，归属于肺经的太渊穴，由忧思导致气机阻滞，风火邪气凝结而成。表现为坚硬漫肿，疼痛彻骨，手膊不能转动。此动脉处是肺经的门户，若发生此疽，或者溃破后深大导致肺气大量泄失，最为危险。内治和外治的方法，均按照痈疽肿疡、溃疡门的法则处理。
【方歌】穿骨疽生于间使穴，位于掌后三寸处的包络经，因蕴热导致坚硬漫肿，毒势旺盛、溃破深入则穿透骨骼引起疼痛。
【注】此证生于间使穴，位于掌后横纹上三寸的两筋凹陷中，归属于心包络经，由蕴热凝结而成。初起如粟米大小，逐渐增加硬度，漫肿微红，发热疼痛，如期迅速溃破者为顺证；若溃破迟缓，脓毒溃穿骨缝，从手臂外侧流出脓液者属险证。内治和外治的方法，均按照痈疽肿疡、溃疡门的法则处理。
【方歌】骨蝼疽生于臂外侧前缘，经络归属阳明经，由忧郁和暴怒纠缠所致，疮口疼痛、疮根收束多属顺证，若出现紫晕扩大、腐烂斑点、串通肌肉及七恶症状则难治。
【注】此证生于臂外侧前缘，大骨之后，归属于手阳明大肠经，由忧郁和暴怒凝结而成。初起如粟豆大小，十日左右大如桃李，肿胀坚硬疼痛，疮根收束，多见五善症状者属顺证；若紫晕开大，腐烂斑点，串通肌肉，抽搐拘急，多见七恶症状者属逆证。始终的内治和外治方法，均按照痈疽肿疡、溃疡门的法则处理。
【方歌】蝼蛄串生于臂内侧中间，患伤脾气并涉及包络经凝结，筋骨疼痛如同被流矢射中，内部溃破串通孔洞似漏管形状。
【注】此证生于臂内侧中间，归属于心包络经。由思虑损伤脾气，脾伤则运化迟缓，因此产生浊液，流注于肌肉，脾气滞郁不舒，凝结而成。此患初起时，筋骨疼痛如同被流矢射中，疼痛逐渐加重，漫肿坚硬，不红不热，连成数块肿块，臂膊不能转动，日久肿块逐渐溃破，孔孔时常流出白色浆液，内部溃破串通各个孔洞，外部肿胀坚硬不消，脓水淋漓如漏管，虚证全部显现，如面色黄、食欲少、消瘦，甚至午后寒热交替发作，从而形成败证。初起宜服用逍遥散（Xiaoyao San, Free and Easy Wanderer Powder），外敷太乙紫金锭（Taiyi Zijin Ding, Taiyi Purple Gold Plaster）；随后服用人参养荣汤（Renshen Yangrong Tang, Ginseng Decoction for Nourishing the Vigor），调和气血，扶助脾胃，十例中可保全二三。溃破后，按照痈疽溃疡的治法处理，若投药无效者属逆证。
方剂：逍遥散（见背部上搭手章节）
太乙紫金锭（见胸部脾发疽章节）
人参养荣汤（见溃疡门章节）
[Verse] Dui Ju (Dui Carbuncle) arises between the arterial pulse of the wrist, presenting with hardness and diffuse swelling along the edge of the Duigong bone. Pain radiating to the arm is a critical sign; this condition belongs to the Taiyuan (LU9) acupoint of the Lung Meridian.
[Note] This lesion occurs on the medial aspect of the wrist, in the space slightly anterior to the transverse crease near the arterial pulse, on the medial side of the Duigong bone, belonging to the Taiyuan (LU9) acupoint of the Lung Meridian. It is formed by Qi stagnation due to worry and thought, combined with the condensation of Wind-Fire pathogens. The presentation includes hardness and diffuse swelling, pain penetrating to the bone, and immobility of the arm. This arterial area serves as the gateway of the Lung Meridian. If this carbuncle develops, or if it ulcerates deeply causing severe depletion of Lung Qi, it is extremely dangerous. Both internal and external treatment methods follow the protocols for Sores and Ulcers (Yong Ju Zhongyang and Kuilang Men).
[Verse] Chuangu Ju (Bone-Penetrating Carbuncle) arises at the Jianshi (PC5) acupoint, located three cun posterior to the palm crease on the Pericardium Meridian. Hardness and diffuse swelling result from accumulated Heat; when the Toxin is excessive and ulceration penetrates deeply, it causes pain by piercing the bone.
[Note] This lesion arises at the Jianshi (PC5) acupoint, situated in the depression between two tendons three cun proximal to the distal palmar crease, belonging to the Pericardium Meridian. It is formed by the condensation of accumulated Heat. Initially resembling a millet grain, it gradually becomes hard with diffuse, slightly red swelling, accompanied by heat and pain. Rapid ulceration according to the expected timeline indicates a favorable prognosis (Shun); delayed ulceration where pus and toxin penetrate the bone gaps and discharge from the lateral aspect of the arm indicates a dangerous prognosis (Xian). Both internal and external treatment methods follow the protocols for Sores and Ulcers (Yong Ju Zhongyang and Kuilang Men).
[Verse] Gulu Ju (Bone-Locust Carbuncle) arises on the anterior border of the lateral aspect of the arm, belonging to the Yangming Meridian, entangled by depression and sudden anger. Painful sores with gathered roots are mostly favorable; purple halos expanding, rotting spots, muscle involvement, and Seven Evils indicate difficulty.
[Note] This lesion arises on the anterior border of the lateral aspect of the arm, posterior to the major bone, belonging to the Hand-Yangming Large Intestine Meridian. It is formed by the condensation of depression and sudden anger. Initially resembling a millet bean, it grows to the size of a plum or peach within ten days, becoming swollen, hard, and painful. If the sore root gathers tightly and presents mostly with Five Favorable signs, it is favorable; if the purple halo expands, rotting spots appear, muscles become involved, convulsions and spasms occur, and mostly Seven Evil signs are present, it is unfavorable. Internal and external treatments throughout follow the protocols for Sores and Ulcers (Yong Ju Zhongyang and Kuilang Men).
[Verse] Lougu Chuan (Mole-Cricket String) arises in the middle of the medial aspect of the arm, injuring Spleen Qi and condensing in the Pericardium Meridian. Bone and tendon pain feels like being struck by an arrow; internal ulceration connects holes resembling a fistula.
[Note] This lesion arises in the middle of the medial aspect of the arm, belonging to the Pericardium Meridian. It results from excessive thought damaging Spleen Qi; damage to the Spleen slows transformation and transportation, generating turbid fluids that flow into the muscles. Stagnant and depressed Spleen Qi condenses to form the lesion. Initially, bone and tendon pain feels like being struck by an arrow, with gradually increasing pain, diffuse hard swelling without redness or heat, forming several connected lumps, and immobility of the arm. Over time, the masses gradually ulcerate, with each hole discharging white serous fluid. Internal ulceration connects various holes, while external swelling remains hard and unsubsided, with dripping pus resembling a fistula. Deficiency syndromes fully manifest, such as sallow complexion, poor appetite, and emaciation; even alternating chills and fever in the afternoon may occur, leading to a failure syndrome (Bai Zheng). Initially, Xiaoyao San (Free and Easy Wanderer Powder) should be taken internally, and Taiyi Zijin Ding (Taiyi Purple Gold Plaster) applied externally. Subsequently, Renshen Yangrong Tang (Ginseng Decoction for Nourishing the Vigor) should be taken to harmonize Qi and Blood and support the Spleen and Stomach; only two or three out of ten cases may be saved. After ulceration, treat according to the protocols for Carbuncle Ulcers; if medication is ineffective, it is considered unfavorable (Ni).
Formulas: Xiaoyao San (See Upper Back Da Shou section); Taiyi Zijin Ding (See Chest Pi Fa Ju section); Renshen Yangrong Tang (See Ulcer Men section).