下搭手生经膀胱，穴在肓门腰窝旁，房劳过度生毒火，紫陷腐烂透膜肠。
【注】此证发于腰窝旁开三寸，属足太阳膀胱经肓门穴。由房劳过度，有伤肾水，水
竭不能制火，火旺以致荣卫不和，逆于肉里而生也。初发红活 肿，令人寒热往来，口
渴烦躁，百节疼痛，宜服仙方活命饮，宣解毒火；次服内托黄 散，托毒发长。将溃内
外治法，俱按痈疽肿疡、溃疡门。若初肿腰痛如折，不能俯仰者险；若色紫塌陷，腐烂
孔深，透膜透肠者逆。
\r下搭手图\p04-34a76.bmp\r
仙方活命饮（见肿疡门）
内托黄 散（见前中搭手）
莲子发名取象形，胆与膀胱毒化成，形斜平塌侵督重，形长高肿半背轻。
【注】此证一名太阴疽。生于脊背及两胁。属胆与膀胱经，火毒合化凝结而成。若形斜
平塌，头侵督脉，尾站肋骨者，属毒重；若形长高肿，偏于半背，中不过督脉，旁不过
肋骨，属毒轻。遇气实之人，初宜蟾酥丸，或麦灵丹汗之。次宜一粒金丹下之；遇气虚之
人，初宜仙方活命饮宣解之，次宜内托黄 散托补之。其余内外治法，俱宜按痈疽肿疡、溃疡门。
\r莲子发图\p04-34a77.bmp\r
蟾酥丸（见疔疮门）
仙方活命饮（见肿疡门）
一粒金丹 内托黄 散（俱见前中搭手）
麦灵丹（见肿疡门）
下搭手生于足太阳膀胱经，穴位位于肓门穴及腰窝旁侧。因房事过度导致毒火内生，疮形紫暗凹陷，腐烂严重甚至穿透肌肉与肠膜。
【注】此证发生于腰窝旁开三寸处，归属于足太阳膀胱经的肓门穴。由于房劳过度，损伤肾阴（肾水），阴液枯竭无法制约阳气之火，火势旺盛导致营气与卫气不和，逆乱于肌肉纹理之间而生成。初期表现为红肿活润，伴有寒热往来、口渴烦躁、全身关节疼痛等症状，适宜服用仙方活命饮以宣散并解除毒火；随后服用内托黄芪散，以托毒外出并促进疮口愈合。接近溃破时的内外治法，均参照痈疽肿疡、溃疡章节的方法。若初起时腰痛如折断般剧烈，不能俯身或仰身者，预后危险；若疮色紫暗塌陷，腐烂孔洞深重，穿透筋膜与肠膜者，属逆证（难治）。
莲子发名称取象于其形状似莲子。病机涉及胆经与膀胱经的毒火化合而成。若疮形斜向平塌，头部侵犯督脉，尾部抵住肋骨者，属于毒邪深重；若疮形长且高肿，偏于背部一侧，中间不越过督脉，旁边不越过肋骨者，属于毒邪较轻。对于体质壮实之人，初期宜用蟾酥丸，或用麦灵丹通过发汗法治疗；随后宜用一粒金丹通过泻下法治疗；对于体质虚弱之人，初期宜用仙方活命饮宣散解毒，随后宜用内托黄芪散托毒补虚。其余内外治法，均宜参照痈疽肿疡、溃疡章节的方法。
Xia Dashou (Lower Back-Clasping Hand) arises in the Foot-Taiyang Bladder Meridian, located at the Huangmen (BL51) acupoint and beside the lumbar fossa. It is caused by excessive sexual activity leading to the generation of toxic fire; the lesion appears purple, sunken, and rotting, potentially penetrating the fascia and intestines.
[Note] This condition occurs three cun lateral to the lumbar fossa, belonging to the Huangmen (BL51) acupoint of the Foot-Taiyang Bladder Meridian. It results from excessive sexual exertion damaging Kidney Yin (Kidney Water). When Yin fluids are exhausted, they fail to control Yang Fire; the flourishing Fire causes disharmony between Ying (Nutrient) Qi and Wei (Defensive) Qi, which reverses and accumulates within the muscle tissue to form the lesion. Initially, it presents with redness, swelling, and liveliness, accompanied by alternating chills and fever, thirst, irritability, and pain in all joints. It is appropriate to administer Xianfang Huoming Yin (Immortal Life Elixir Decoction) to disperse and resolve the toxic fire; subsequently, Neituo Huangqi San (Internal Support Astragalus Powder) should be taken to support the expulsion of toxins and promote healing. The internal and external treatment methods for the stage approaching suppuration follow the guidelines in the chapters on Carbuncle Swelling and Ulceration. If initial swelling is accompanied by severe lower back pain as if broken, preventing flexion or extension, the prognosis is dangerous (Xian); if the color is purple and sunken, with deep rotting ulcers penetrating the fascia and intestines, it is considered a counter-indication (Ni), indicating a difficult-to-treat case.
Lianzi Fa (Lotus Seed Eruption) derives its name from its resemblance to a lotus seed. Its pathogenesis involves the combination and transformation of toxic heat from the Gallbladder and Bladder meridians. If the shape is oblique, flat, and sunken, with the head invading the Du Mai (Governing Vessel) and the tail resting against the ribs, it indicates heavy toxicity; if the shape is long and highly swollen, located on one side of the back without crossing the Du Mai centrally or the ribs laterally, it indicates mild toxicity. For patients with robust constitution, initially Chan Su Wan (Toad Venom Pill) or Mailing Dan (Mail Spirit Pellet) may be used to induce sweating; subsequently, Yili Jin Dan (One-Pill Golden Pellet) may be used to induce purgation. For patients with deficient constitution, initially Xianfang Huoming Yin (Immortal Life Elixir Decoction) should be used to disperse and resolve toxins, followed by Neituo Huangqi San (Internal Support Astragalus Powder) to support and tonify. All other internal and external treatments should refer to the chapters on Carbuncle Swelling and Ulceration.