天柱疽生天柱骨，上焦郁热蓄督经，灸之有 方为顺，色黑形陷逆而凶。
【注】此疽生于项后高骨，名天柱骨，即大椎骨也。疽之初起，形如卧蚕，由上焦郁
热，蓄于督脉，以致肩背拘急，极痒入骨。宜于疽上以艾灸之，若灸之有 者顺，无 者
逆。甚至色黑形陷，血出不止，溃烂神昏，呕哕恶心等证，是为大凶。其内、外治法同脑疽。
\r天柱疽图\p04-34a60.bmp\r
鱼尾毒生后发角，在左在右浅而轻，膀胱湿热七日溃，脓出肿消痛自宁。
【注】此毒生于项后发际两旁角处，由足太阳膀胱经湿热凝结而发。其毒或在左，或
在右，皆属轻浅。初起宜荆防败毒散；脓将成，宜服托里排脓汤。其外治之法，同痈疽
肿疡、溃疡诸证。
\r鱼尾毒图\p04-34a61.bmp\r
托里排脓汤
当归 白芍（酒炒） 人参 白术（土炒） 茯苓 连翘（去心） 金银花 浙贝母（去心，各一钱）
生黄 （二钱） 陈皮（八钱） 肉桂（六分） 桔梗（胸之上加一钱） 牛膝（下部加八分）
白芷（顶之上加五分） 甘草（四分）
姜一片，水三盅，煎一盅，食远温服。
【方歌】托里排脓治溃疮，排脓消肿实称强，归芍四君翘桂芷，银 贝桔膝陈良。
荆防败毒散（见脑疽）
天柱疽发生在大椎骨部位，是由于上焦郁热蓄积在督脉所致。施灸后若出现“焮”（红肿热痛）的现象为顺证，若颜色发黑、形态下陷则为逆证且凶险。
【注】此疽生于项后高骨处，名为天柱骨，即大椎骨。疽初起时，形状像卧着的蚕，由上焦郁热蓄积于督脉引起，导致肩背拘急僵硬，极度瘙痒深入骨髓。适宜在疽上使用艾灸治疗，如果施灸后出现“焮”的反应则是顺证，若无此反应则为逆证。甚至出现颜色发黑、形态下陷、出血不止、溃烂、神志昏迷、呕吐呃逆恶心等症状，属于大凶之兆。其内治和外治方法同脑疽。
鱼尾毒生于后发际角处，无论位于左侧还是右侧，病情都较浅表轻微。因膀胱湿热凝结而成，通常在七日后溃破，脓液排出后肿胀消退，疼痛自然平息。
【注】此毒生于项后发际两旁角处，由足太阳膀胱经的湿热凝结而引发。此毒或在左侧，或在右侧，都属于轻浅之症。初起时适宜服用荆防败毒散；脓液即将形成时，适宜服用托里排脓汤。其外治方法，同痈疽肿疡、溃疡等各类病症。
托里排脓汤
当归 白芍（酒炒） 人参 白术（土炒） 茯苓 连翘（去心） 金银花 浙贝母（去心，各一钱）
生黄芪（二钱） 陈皮（八钱） 肉桂（六分） 桔梗（胸部上方加一钱） 牛膝（下部加八分）
白芷（头顶上方加五分） 甘草（四分）
生姜一片，水三盅，煎至一盅，饭后温服。
【方歌】托里排脓治疗溃疮，排脓消肿确实功效强大，当归白芍配合四君子汤及翘桂芷，金银花、贝母、桔梗、牛膝、陈皮均为良药。
荆防败毒散（见脑疽章节）
Tian Zhu Ju (Heavenly Pillar Carbuncle) occurs at the Dazhui point (Great Vertebra), caused by stagnant heat in the Upper Jiao accumulating in the Du Meridian. If "Xin" (redness, swelling, heat, and pain) appears after moxibustion, it is a favorable sign; if the color turns black and the shape sinks, it is an unfavorable and ominous sign.
[Note] This carbuncle arises on the high bone at the back of the neck, named Tian Zhu Gu (Heavenly Pillar Bone), which is the Dazhui point. At the initial stage, the lesion resembles a lying silkworm. It is caused by stagnant heat in the Upper Jiao accumulating in the Du Meridian, leading to stiffness and spasm of the shoulders and back, with extreme itching penetrating into the bones. Moxibustion should be applied directly on the carbuncle. If "Xin" appears after moxibustion, it indicates a favorable course; if not, it indicates an unfavorable course. In severe cases, symptoms such as blackening of the skin, sinking of the lesion, unceasing bleeding, ulceration, coma, vomiting, hiccups, and nausea may occur, representing a highly ominous prognosis. The internal and external treatment methods are the same as those for Nao Ju (Brain Carbuncle).
Yu Wei Du (Fish Tail Toxin) arises at the corners of the posterior hairline. Whether located on the left or right, the condition is superficial and mild. Caused by damp-heat condensation in the Bladder Meridian, it typically suppurates after seven days. Once pus is discharged, the swelling subsides, and the pain naturally ceases.
[Note] This toxin arises at the corners on both sides of the posterior hairline, triggered by the condensation of damp-heat in the Foot-Taiyang Bladder Meridian. Whether the toxin is on the left or the right, it belongs to the category of superficial and mild conditions. At the initial stage, Jing Fang Bai Du San (Scutellaria and Saposhnikovia Decoction to Eliminate Toxicity) is suitable; when pus is about to form, Tuo Li Pai Nong Tang (Decoction to Support the Interior and Expel Pus) is suitable. The external treatment methods are the same as those for various conditions of Yong Ju (Carbuncles and Ulcers), including swollen ulcers and open ulcers.
Tuo Li Pai Nong Tang (Decoction to Support the Interior and Expel Pus)
Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba, stir-fried with wine), Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Fu Ling (Poria), Lian Qiao (Forsythiae Fructus, heart removed), Jin Yin Hua (Lonicerae Japonicae Flos), Zhe Bei Mu (Fritillariae Thunbergii Bulbus, heart removed, each 1 qian);
Sheng Huang Qi (Astragali Radix, raw, 2 qian), Chen Pi (Citri Reticulatae Pericarpium, 8 qian), Rou Gui (Cinnamomi Cortex, 6 fen), Jie Geng (Platycodonis Radix, add 1 qian for upper chest), Niu Xi (Achyranthis Bidentatae Radix, add 8 fen for lower body), Bai Zhi (Angelicae Dahuricae Radix, add 5 fen for top of head), Gan Cao (Glycyrrhizae Radix et Rhizoma, 4 fen).
One slice of fresh ginger, three cups of water, decocted to one cup, taken warm well after meals.
[Prescription Song] Tuo Li Pai Nong treats open ulcers, its ability to expel pus and reduce swelling is truly powerful; Dang Gui and Bai Shao combined with Si Jun Zi Tang plus Lian Qiao, Rou Gui, and Bai Zhi, while Jin Yin Hua, Bei Mu, Jie Geng, Niu Xi, and Chen Pi are excellent herbs.
Jing Fang Bai Du San (See section on Brain Carbuncle)