经络 肩之上廉属手足少阳经。前廉属手阳明经。后廉属手太阳经。
肩疽 生于肩。肿赤引背。灵枢为 痈。甚连脑胁。治宜汗之。须汗。出至足无害。四五日内逆。KT 之。一
灸会宗穴三七壮。甚者灸肩真穴七壮。
肩痈 生肩外垂骨两接骨处。恐脓深彻骨。虑伤筋脉拘挛。宜缓筋之药饵之。
过肩疽 肿发两肩及两膊连胛骨者。一名干疽。一名丁疽。令人寒战口噤。身热不赤。此手足三阳交
会之所由。风袭热郁所致。十日可刺。无血者死。
太阴疽 生肩胛骨上。一名肩后疽。属手太阴肺经积热所致。即莲子发也。若色黑喘嗽。大渴胸满。脉
微者不治。
蜂窠疽 生于肩前一二寸。先热后寒。皮赤。溃有四十九窍。形如蜂窠。灸三间穴二七壮。
上按症与肿疡溃疡总治例同法。
经络 四肢者。诸阳之本也。阳实则肢肿。阳虚则肢满。又云。脾主四肢。脾实则四肢不举。（湿盛也）脾虚则
四肢不用。（懈惰也）又 臂须别六经。究其痛在何经。加以本经之药行其气血。则症愈矣。别经之法。以两
手伸直。贴身垂下。大指居前。小指居后而定之。则其臂 之前廉者属阳明经。以升麻、白芷、干葛行之。
后廉属太阳经。以 本、羌活行之。外廉属少阳经。以柴胡行之。内廉属厥阴经。以柴胡、青皮行之。内前
廉属太阴经。以升麻、白芷、葱白行之。内后廉属少阴经。以细辛、独活行之。又薄桂味淡。能横行手臂。引
他药直至痛处。白姜黄之性亦同。何则。为非辛不能以达四肢也。治肩膊风寒湿一切疼痛。服蠲痛无
忧散。立止。（见诸痛门）
痈 臂表里俱肿。色赤而坚。惟肘节处差小。故又名藕包毒。灸少海穴七壮。
疽 生肩下连腋。灸会宗穴七壮。
乐疽 生肩内。坚如鹅子。按之痛入骨。恶风。灸腋门穴三七壮。
肩风毒 生臂上节。肿连肩 。
臂痈 生肩外垂骨两接骨处。或从肘引至手接骨处。由荣卫不调所致。如脓深彻骨。虑伤筋脉拳缩。
治宜缓筋之药。
鱼肚发 生于臂内。
按上症。初宜卫生散。或蠲痛无忧散加羌活、独活、桔梗、桂枝。酒水煎服。若漫肿无头。服败毒药不
消者。十全大补汤加桔梗、桂枝托之。托之不应者。由湿痰流注经络也。荣卫返魂汤加南星、酒芩调
之。若臂痛不能举。及左右转痛者。由中脘伏痰也。宜千金指迷丸、九转玉华丹导之。脉细皮寒。泻
利不食者。为五虚。虽盛暑之时。托里温中汤之类温之。甚者脐膜冷痛昏愦。灸左乳下黑肉尽处二
七壮。脉紧细而筋挛者。肝虚而有风寒也。四物汤加丹皮、泽兰、白术。溃深不痛。胃气虚也。脓水清
稀。疮口不合。气血虚也。俱大补之。
石榴疽 生肘上寸余。亦生于各经及臂。初起黄粟小泡。根便开大。色红坚硬。肿如覆碗。破翻如榴。寒
如疟。由少阳相火与外湿相搏所致。初起宜蟾酥丸汗之。外以艾灸九壮。贴蟾酥饼。盖膏。 肿处敷
金黄散。次服消毒无忧散加菊花清之。烦躁热甚者。护心散、金液戊土丹。九日后作稠脓。痛减进食。
表里俱退者。可保无虞。反此者逆。溃后同溃疡调理。一法。破后惟菊花蕊煎汤洗之。最佳。次以菊花
烧灰存性。加轻粉兑匀敷之。诸药不及此。或灸天井穴。
肘痈 生于肘尖。经云。心肺有邪。其气留于两肘。治同臂痈。
白芷升麻汤 治臂肿痛。乃阳明经分野。由八风之变者。然身半以上风受之。治宜却风邪。和经脉。使
无壅滞。亦发表之意也。
黄 （二钱） 酒芩（二钱） 生芩（一钱） 白芷（八分） 连翘（二钱） 升麻（五分） 桔梗（五分）
酒红花（三分） 炙甘草（三分）
酒水各一钟。煎八分。食远热服。
经络：肩部的上外侧缘属于手少阳经和足少阳经。前外侧缘属于手阳明经。后外侧缘属于手太阳经。
肩疽：生于肩部。肿胀发红并牵引至背部。《灵枢》称之为痈。严重时连及脑部和胁部。治疗应当采用发汗法，必须使汗出达到足部才无危险。若四五日内出现逆证（如毒邪内陷），则难以救治。可艾灸会宗穴三七壮。病情严重者，艾灸肩真穴七壮。
肩痈：生于肩外垂骨与两接骨相接之处。担心脓液深透入骨，顾虑损伤筋脉导致拘挛。宜用舒缓筋脉的药物内服治疗。
过肩疽：肿胀发作于双肩及双臂，连及肩胛骨。又名干疽、丁疽。使人寒战、口噤（牙关紧闭）、身热但肤色不红。这是因为手足三阳经交会之处，受风邪侵袭、热邪郁结所致。十日后可刺破排脓。若无脓血排出者死。
太阴疽：生于肩胛骨上方。又名肩后疽。属手太阴肺经积热所致。即莲子发。若颜色发黑、气喘咳嗽、大渴、胸满、脉微细者，属不治之症。
蜂窠疽：生于肩前一二寸处。先发热后恶寒，皮肤发红。溃烂后有四十九个孔窍，形状像蜂巢。艾灸三间穴二七壮。
以上病症与肿疡、溃疡的总治法相同。
经络：四肢是诸阳经的根本。阳气实盛则肢体肿胀，阳气虚弱则肢体胀满。又说，脾主四肢。脾实则四肢不能抬举（因湿邪盛也）。脾虚则四肢不能使用（因懈怠懒惰也）。另外，手臂必须辨别六经，探究疼痛在哪一经，加入本经的药物以通行气血，则病症痊愈。辨别经脉的方法：将双手伸直，贴身下垂，大拇指在前，小指在后，以此定之。则手臂的前外侧缘属于阳明经，用升麻、白芷、干葛引药上行；后外侧缘属于太阳经，用羌活引药上行；外侧缘属于少阳经，用柴胡引药上行；内侧缘属于厥阴经，用柴胡、青皮引药上行；内侧前缘属于太阴经，用升麻、白芷、葱白引药上行；内侧后缘属于少阴经，用细辛、独活引药上行。另外，薄桂（肉桂的一种）味道淡，能横行于手臂，引导其他药物直达痛处。白姜黄的药性也是如此。为什么呢？因为非辛味药不能到达四肢。治疗肩膊风寒湿引起的各种疼痛，服用蠲痛无忧散，立即止痛。（见诸痛门）
臂痈：手臂表里俱肿，颜色红且坚硬，只有肘关节处稍小，所以又名藕包毒。艾灸少海穴七壮。
乐疽：生于肩内部，坚硬如鹅卵，按压时疼痛深入骨髓，怕风。艾灸腋门穴三七壮。
肩风毒：生于臂上节，肿胀连及肩部。
臂痈：生于肩外垂骨与两接骨相接之处。或从肘部牵引至手部接骨处。由营卫不调所致。如果脓液深透入骨，顾虑损伤筋脉导致拳缩。治疗宜用舒缓筋脉的药物。
鱼肚发：生于手臂内侧。
按上述病症，初期宜用卫生散，或蠲痛无忧散加羌活、独活、桔梗、桂枝，酒水各半煎服。若漫肿无头，服用败毒药不消退者，用十全大补汤加桔梗、桂枝托毒外出。托毒无效者，是由于湿痰流注经络所致。用荣卫返魂汤加南星、酒黄芩调理。若臂痛不能举起，及左右转动时疼痛者，是由于中脘伏痰所致。宜用千金指迷丸、九转玉华丹导痰下行。脉细、皮寒、腹泻、不能进食者，为五虚证。即使在盛夏之时，也用托里温中汤之类温补。严重者脐膜冷痛、昏愦，艾灸左乳下黑肉尽处二七壮。脉紧细且筋脉拘挛者，是肝虚而有风寒。用四物汤加牡丹皮、泽兰、白术。溃烂深而不痛者，是胃气虚。脓水清稀、疮口不合者，是气血虚。均宜大补。
石榴疽：生于肘上一寸多，也生于各经及手臂。初起为黄色粟米状小泡，根部随即扩大，颜色红硬，肿胀如倒扣的碗，破溃后翻花如石榴籽。寒战如疟疾，由少阳相火与外湿相搏所致。初起宜用蟾酥丸发汗，外用艾灸九壮，贴蟾酥饼，覆盖膏药。肿胀处敷金黄散，其次服用消毒无忧散加菊花清热解毒。烦躁热甚者，用护心散、金液戊土丹。九日后化为稠脓，疼痛减轻，食欲恢复，表里症状皆退者，可保无虞。反之则为逆证。溃后同溃疡调理。另一种方法：破溃后惟有用菊花蕊煎汤清洗最佳，其次将菊花烧灰存性，加轻粉调匀外敷。诸药不及此法。也可艾灸天井穴。
白芷升麻汤：治疗手臂肿痛。乃阳明经分野，由八风之变所致。然而身半以上受风邪，治疗宜祛除风邪，调和经脉，使无壅滞，也有发表的意思。
黄芩（二钱） 酒黄芩（二钱） 生黄芩（一钱） 白芷（八分） 连翘（二钱） 升麻（五分） 桔梗（五分） 酒红花（三分） 炙甘草（三分）
酒水各一钟，煎至八分，饭后热服。
Meridians: The upper lateral margin of the shoulder belongs to the Hand-Shaoyang and Foot-Shaoyang meridians. The anterior lateral margin belongs to the Hand-Yangming meridian. The posterior lateral margin belongs to the Hand-Taiyang meridian.
Shoulder Carbuncle (Jian Ju): Arises in the shoulder. Swelling is red and radiates to the back. *Ling Shu* calls it a carbuncle (Yong). In severe cases, it extends to the brain and hypochondrium. Treatment should employ diaphoresis (sweating method); sweat must reach the feet to avoid danger. If adverse conditions arise within four to five days, it is difficult to treat. Moxibustion can be applied to Huizong (SJ4) acupoint for 21-37 moxa cones. In severe cases, apply moxibustion to Jianzhen acupoint for 7 cones.
Shoulder Abscess (Jian Yong): Arises at the junction of the hanging bone of the shoulder and the adjacent bones. There is concern that pus may penetrate deeply into the bone, damaging tendons and vessels leading to contracture. It is advisable to administer herbs that relax the tendons orally.
Over-the-Shoulder Carbuncle (Guo Jian Ju): Swelling occurs on both shoulders and arms, extending to the scapula. Also known as Gan Ju or Ding Ju. It causes chills, trismus (lockjaw), fever without facial redness. This occurs because it is the intersection of the three Yang meridians of the hand and foot, caused by wind invasion and heat stagnation. Puncture for drainage can be performed after ten days. Death ensues if no blood or pus is discharged.
Taiyin Carbuncle (Taiyin Ju): Arises above the scapula. Also known as Shoulder Posterior Carbuncle. It is caused by accumulated heat in the Hand-Taiyin Lung Meridian. Also called Lianzi Fa. If the color is black, accompanied by asthma/cough, extreme thirst, chest fullness, and a faint pulse, it is incurable.
Honeycomb Carbuncle (Feng Ke Ju): Arises one to two cun anterior to the shoulder. Initially fever followed by chills, skin is red. Upon ulceration, there are forty-nine orifices, resembling a honeycomb. Apply moxibustion to Sanjian (LI3) acupoint for 14 moxa cones.
The treatment for the above conditions follows the general principles for swelling ulcers and ulcerated sores.
Meridians: The four limbs are the root of all Yang meridians. When Yang is excess, limbs swell; when Yang is deficient, limbs feel distended. It is also said that the Spleen governs the four limbs. When Spleen is excess, limbs cannot be lifted (due to dampness abundance). When Spleen is deficient, limbs cannot function (due to lassitude). Furthermore, the arm must be differentiated by the six meridians to determine which meridian is affected by pain, and herbs belonging to that meridian should be added to promote Qi and Blood circulation, thereby curing the disease. The method to differentiate meridians is as follows: extend both hands straight down along the body, with the thumb forward and the little finger backward. Then, the anterior lateral margin of the arm belongs to the Yangming meridian, treated with Shengma (Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Gange (Puerariae Lobatae Radix). The posterior lateral margin belongs to the Taiyang meridian, treated with Qianghuo (Notopterygii Rhizoma et Radix). The lateral margin belongs to the Shaoyang meridian, treated with Chaihu (Bupleuri Radix). The medial margin belongs to the Jueyin meridian, treated with Chaihu and Qingpi (Citri Reticulatae Pericarpium Viride). The anterior medial margin belongs to the Taiyin meridian, treated with Shengma, Baizhi, and Congbai (Allii Fistulosi Bulbus). The posterior medial margin belongs to the Shaoyin meridian, treated with Xixin (Asari Radix et Rhizoma) and Duhuo (Angelicae Pubescentis Radix). Additionally, Hougui (thin Cinnamomi Cortex) has a light flavor and can travel horizontally through the arms, guiding other herbs directly to the painful area. Bai Jianghuang (Curcumae Longae Rhizoma) has similar properties. Why? Because only pungent herbs can reach the four limbs. For all pains in the shoulder and arm caused by wind-cold-dampness, take Juan Tong Wu You San to stop pain immediately. (See Section on Various Pains).
Arm Abscess (Bi Yong): Both superficial and deep layers of the arm are swollen, red and hard, except slightly smaller at the elbow joint, hence also called Ou Bao Du (Lotus Root Bag Toxin). Apply moxibustion to Shaohai (HT3) acupoint for 7 cones.
Axillary Carbuncle (Ye Ju): Arises below the shoulder connecting to the axilla. Apply moxibustion to Huizong (SJ4) acupoint for 7 cones.
Le Ju: Arises inside the shoulder, hard like a goose egg, painful upon pressure penetrating to the bone, aversion to wind. Apply moxibustion to Yimen (EX-HN15) acupoint for 21-37 moxa cones.
Shoulder Wind Toxin (Jian Feng Du): Arises in the upper segment of the arm, swelling connects to the shoulder.
Arm Abscess (Bi Yong): Arises at the junction of the hanging bone of the shoulder and the adjacent bones. Or radiates from the elbow to the wrist joint. Caused by disharmony of Ying and Wei. If pus penetrates deeply into the bone, there is concern of damaging tendons and vessels leading to flexion contracture. Treatment should use herbs that relax the tendons.
Fish Belly Fa (Yu Du Fa): Arises on the inner aspect of the arm.
Regarding the above conditions, initially use Wei Sheng San, or Juan Tong Wu You San plus Qianghuo, Duhuo, Jiegeng, and Guizhi, decocted in water and wine. If there is diffuse swelling without a head, and Baidu Yao fails to resolve it, use Shiquan Dabu Tang plus Jiegeng and Guizhi to expel toxins outward. If expulsion fails, it is due to damp-phlegm flowing into the meridians. Use Yingwei Fanhun Tang plus Nanxing and Jiuhuangqin to regulate. If arm pain prevents lifting, and pain occurs during left/right rotation, it is due to latent phlegm in Zhongwan. Use Qianjin Zhi Mi Wan or Jiuzhuan Yuhua Dan to guide phlegm downward. If the pulse is fine, skin is cold, with diarrhea and anorexia, it is Wuxu (Five Deficiencies). Even in midsummer, use Tuoli Wenzhong Tang to warm and tonify. In severe cases with cold pain of the umbilical membrane and confusion, apply moxibustion to the end of the black hair under the left nipple for 14 cones. If the pulse is tight and fine with tendon spasm, it is Liver deficiency with wind-cold. Use Siwu Tang plus Mudanpi, Zelan, and Baizhu. If the ulcer is deep but painless, it is Stomach Qi deficiency. If pus is clear and thin, and the wound does not close, it is Qi and Blood deficiency. All should be strongly tonified.
Pomegranate Carbuncle (Shiliu Ju): Arises about one cun above the elbow, also occurring in various meridians and arms. Initially presents as small yellow millet-like blisters, the base expands rapidly, color is red and hard, swelling resembles an inverted bowl, upon rupture it looks like pomegranate seeds. Chills resemble malaria, caused by interaction between Shaoyang Ministerial Fire and external dampness. Initially, use Chansu Wan to induce sweating. Externally, apply 9 moxa cones, paste Chansu Bing, and cover with plaster. Apply Jinhuang San to the swollen area. Subsequently, take Xiaodu Wu You San plus Juhua to clear heat and detoxify. For restlessness and high fever, use Huxin San or Jin Ye Wu Tu Dan. After nine days, thick pus forms, pain decreases, and appetite returns; if exterior and interior symptoms recede, safety is assured. The opposite indicates adverse prognosis. Post-ulceration, manage according to ulcer protocols. Another method: after rupture, wash best with decoction of Juhua (Chrysanthemi Flos). Alternatively, burn Juhua to ash retaining its nature, mix with Qingfen (Calomelas), and apply externally. This surpasses other medicines. Moxibustion can also be applied to Tianjing (TE10) acupoint.
Elbow Abscess (Zhou Yong): Arises at the tip of the elbow. The classics state: "When Heart and Lung have pathogenic factors, their Qi remains in the two elbows." Treatment is the same as Arm Abscess.
Baizhi Shengma Decoction (Baizhi Shengma Tang): Treats arm swelling and pain. It affects the Yangming meridian territory, caused by variations of the Eight Winds. Since the upper half of the body is affected by wind, treatment should dispel wind pathogens and harmonize meridians to prevent stagnation, also serving as a releasing-the-exterior method.
Huang Qin (2 qian), Jiu Huang Qin (2 qian), Sheng Huang Qin (1 qian), Baizhi (8 fen), Lianqiao (2 qian), Shengma (5 fen), Jiegeng (5 fen), Jiu Hong Hua (3 fen), Zhi Gancao (3 fen).
Decoct with one cup of water and one cup of wine until reduced to 0.8 cups. Take hot after meals.