腋疽初起若核形，肝恚脾忧气血凝，漫肿坚硬宜蒜灸，日久红热溃先疼。
【注】此证一名米疽，又名疚疽，发于 肢窝正中，初起之时，其形如核。由肝、脾
二经，忧思恚怒，气结血滞而成。漫肿坚硬，皮色如常，日久将溃，色红微热疼痛也。初
宜艾壮隔蒜片灸法，内服柴胡清肝汤加乌药消之；虚弱之人，宜服香贝养荣汤，外用乌
龙膏敷之。早治或有全消者，迟则脓成，宜服托里透脓汤；脓胀痛者，针之；脓出痛减，
随患者虚实补之。其余内外治法，俱按痈疽溃疡门。此证初终，内外治法，禁用寒凉。中
年易愈，衰老难痊。
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隔蒜灸法（见首卷灸法）
柴胡清肝汤（见头部鬓疽）
香贝养荣汤（见项部上石疽）
乌龙膏（见肿疡门）
托里透脓汤（见头部侵脑疽）
黯疔藏于腋下生，肝脾火毒痒而疼，寒热拘急色紫黑，急按疔门治即宁。
【注】此证生于腋下，由肝、脾二经火毒而成。坚硬势若钉头，痒而且痛，寒热往来，
四肢拘急，其色紫黑，烦躁作呕，痛引半身，宜服麦灵丹。其次内外急按疔门治之即愈。
\r黯疔图\p04-34a132.bmp\r
麦灵丹（见肿疡门）
肋疽始发属肝经，火毒郁怒结肿形，紫痛梅李甚如碗，急宜针砭免内攻。
【注】此证一名夹荧疽，生于肋条骨间，由肝经火毒郁怒结聚而成。初如梅李，渐大
如碗，色紫 痛，连及肩肘。患在左，痛牵右肋；患在右，痛牵左肋。二十一日之内，脓
溃稠粘者顺；届期不溃，既溃出清水者逆。初肿急宜瓷针砭出紫血，庶免毒瓦斯攻里；砭后
赤肿痛甚，烦躁脉实作呕，为有余之证，宜服双解贵金丸下之；肿硬不溃，宜服透脓散；
脉弱作呕，此胃虚也，宜服香砂六君子汤补之。亦有痛伤胃气而作呕者，即同胃虚治之；
若感受寒邪，及偶触秽气而作呕者，虽肿时尤宜壮胃助气为主。盖肿时作呕，因毒瓦斯内
侵者十有一二，停饮内伤者十有八九，惟医人临证详辨之。脓熟用卧针开之，余按痈疽
溃疡门治法。
\r肋疽图\p04-34a133.bmp\r
双解贵金丸 透脓散 （俱见肿疡门）
香砂六君子汤（见溃疡门）
腋疽初起时形状像核一样，由肝气郁怒、脾土忧思导致气血凝滞而成。表现为漫肿坚硬，适宜用隔蒜灸法；若日久化热，溃破前会先感到疼痛。
【注】此证又名米疽或疚疽，发生于腋下正中位置，初起时形状如核。由于肝、脾二经因忧思恚怒，导致气结血滞而形成。表现为漫肿坚硬，皮色正常，日久将要溃破时，局部色红微热并伴有疼痛。初期适宜采用艾壮隔蒜片灸法，内服柴胡清肝汤加乌药以消散肿块；体质虚弱者，宜服用香贝养荣汤，外用乌龙膏敷贴。早期治疗或许能完全消散，若延误则脓液形成，宜服用托里透脓汤；若脓液胀痛，应进行针刺排脓；脓出后疼痛减轻，随后根据患者的虚实情况进行补益治疗。其余内外治法，均参照痈疽溃疡门的记载。此证在整个病程中，内外治法均禁用寒凉药物。中年患者容易痊愈，年老体弱者难以治愈。
隔蒜灸法（见首卷灸法）
柴胡清肝汤（见头部鬓疽）
香贝养荣汤（见项部上石疽）
乌龙膏（见肿疡门）
托里透脓汤（见头部侵脑疽）
黯疔生于腋下，由肝脾火毒引起，表现为瘙痒且疼痛，伴有寒热往来和肢体拘急，颜色紫黑，需紧急按照疔疮门类的方法治疗即可安宁。
【注】此证生于腋下，由肝、脾二经的火毒所致。患处坚硬势态如钉头，又痒又痛，出现寒热往来，四肢拘急，颜色紫黑，伴有烦躁作呕，疼痛牵引至半身，宜服用麦灵丹。其次内外紧急按照疔门的方法治疗即可痊愈。
肋疽初发属于肝经，由火毒与郁怒结合结成肿块，颜色紫黑疼痛，大小如梅李甚至如碗，急需使用针砭疗法以免毒邪内攻。
【注】此证又名夹荧疽，生于肋骨之间，由肝经火毒与郁怒结聚而成。初起时如梅李，逐渐增大如碗，颜色紫黑且疼痛，牵连肩肘。患处在左侧，疼痛牵引右侧肋部；患处在右侧，疼痛牵引左侧肋部。二十一日之内，脓液溃破且稠粘者为顺证；到期不溃破，或溃破后流出清水者为逆证。初起肿胀时，急需用瓷针砭刺放出紫血，以避免毒瓦斯攻入体内；砭刺后若红肿疼痛加剧，烦躁脉实且作呕，属于有余之证，宜服用双解贵金丸泻下；若肿硬不溃破，宜服用透脓散；若脉弱且作呕，这是胃虚的表现，宜服用香砂六君子汤补益。也有因疼痛损伤胃气而作呕的，即按胃虚治疗；若是感受寒邪，或偶然接触秽气而作呕的，即使在肿胀时期也应以壮胃助气为主。因为肿胀时期作呕，因毒瓦斯内侵的占十分之一二，因停饮内伤的占十分之八九，只有医生临证时详细辨别。脓熟时用卧针切开，其余按照痈疽溃疡门的治法处理。
Axillary carbuncle (Yè Jū) initially presents as a nodule-like swelling, caused by Qi stagnation and Blood congealment due to Liver anger and Spleen worry. It manifests as diffuse swelling and hardness; garlic-moxibustion is indicated. If the condition persists for a long time, redness and heat develop, and pain precedes ulceration.
[Note] This syndrome, also known as Rice Carbuncle (Mǐ Jū) or Ji Carbuncle (Jiù Jū), occurs in the center of the axilla. Initially, it resembles a nodule. It arises from Qi knotting and Blood stasis in the Liver and Spleen meridians due to worry, thought, anger, and resentment. The presentation includes diffuse swelling and hardness with normal skin color. As it approaches ulceration, the area becomes red, slightly hot, and painful. Initially, moxibustion with mugwort cones separated by garlic slices is appropriate, combined internally with Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) plus Wuyao (Lindera Root) to dissipate the swelling. For patients with deficiency, Xiangbei Yangrong Tang (Aucklandia and Tangerine Peel Nourishing Harmony Decoction) should be taken, with Wulong Gao (Black Dragon Plaster) applied externally. Early treatment may lead to complete resolution; if delayed, pus forms, requiring Tuoli Toung Tang (Interior-Supporting Pus-Permeating Decoction). If there is distending pain from pus, needle drainage is indicated. After pus discharge, pain decreases, followed by tonification based on the patient's excess or deficiency patterns. Other internal and external treatments follow the protocols for Carbuncles and Ulcers. Throughout the course of this syndrome, cold and cooling agents are strictly contraindicated in both internal and external treatments. It heals easily in middle-aged individuals but is difficult to cure in the elderly.
Garlic-Moxibustion Method (see Moxibustion Methods in Volume 1)
Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) (see Temporal Carbuncle in Head Section)
Xiangbei Yangrong Tang (Aucklandia and Tangerine Peel Nourishing Harmony Decoction) (see Upper Stone Carbuncle in Neck Section)
Wulong Gao (Black Dragon Plaster) (see Swollen Ulcer Section)
Tuoli Toung Tang (Interior-Supporting Pus-Permeating Decoction) (see Brain-Infiltrating Carbuncle in Head Section)
Dark Carbuncle (Àn Dīng) arises in the axilla, caused by Fire-Toxin in the Liver and Spleen, presenting with itching and pain, alternating chills and fever, limb stiffness, and purple-black discoloration. Urgent treatment according to the Carbuncle category brings peace.
[Note] This syndrome occurs in the axilla, resulting from Fire-Toxin in the Liver and Spleen meridians. The lesion is hard, resembling a nail head, accompanied by itching and pain, alternating chills and fever, limb stiffness, purple-black color, irritability, vomiting, and pain radiating to half the body. Mai Ling Dan (Wheat Spirit Pill) is indicated. Subsequently, urgent internal and external treatment according to the Carbuncle category leads to recovery.
Dark Carbuncle Diagram
Mai Ling Dan (Wheat Spirit Pill) (see Swollen Ulcer Section)
Costal Carbuncle (Lèi Jū) originates in the Liver Meridian, where Fire-Toxin and pent-up anger condense into a swelling. It appears purple, painful, and ranges in size from a plum or apricot to a bowl. Needle scarification is urgently required to prevent internal invasion of toxins.
[Note] Also known as Clinging Fluorescent Carbuncle (Jiā Yíng Jū), this syndrome occurs between the ribs, caused by the condensation of Liver Meridian Fire-Toxin and pent-up anger. Initially small like a plum or apricot, it gradually enlarges to the size of a bowl, appearing purple and painful, extending to the shoulder and elbow. If on the left, pain radiates to the right costal region; if on the right, pain radiates to the left costal region. Within twenty-one days, if pus breaks out thickly and viscously, it is a favorable sign (Shun); if it does not break out by the deadline, or if clear fluid is discharged after breaking out, it is an unfavorable sign (Ni). For initial swelling, urgent scarification with a porcelain needle to release purple blood is necessary to prevent toxin invasion into the interior. After scarification, if redness, swelling, and pain worsen, accompanied by irritability, full pulse, and vomiting, it indicates an Excess pattern, treated with Shuangjie Guijin Wan (Double-Resolving Precious Metal Pill) to purge. If the swelling is hard and does not suppurate, Toung San (Pus-Permeating Powder) is indicated. If the pulse is weak and vomiting occurs, this indicates Stomach Deficiency, treated with Xiangsha Liujunzi Tang (Atractylodes and Amomum Six-Gentlemen Decoction) to tonify. Vomiting may also result from pain damaging Stomach Qi, treated similarly to Stomach Deficiency. If vomiting is caused by Cold pathogen invasion or accidental exposure to foul odors, strengthening the Stomach and assisting Qi is the primary approach even during the swelling phase. Only one or two cases of vomiting during swelling are due to internal toxin invasion, while eight or nine cases are due to retained fluids and internal injury. Physicians must distinguish these carefully clinically. When pus is ripe, use a horizontal needle to incise. Other treatments follow the protocols for Carbuncles and Ulcers.
Costal Carbuncle Diagram
Shuangjie Guijin Wan (Double-Resolving Precious Metal Pill) & Toung San (Pus-Permeating Powder) (both see Swollen Ulcer Section)
Xiangsha Liujunzi Tang (Atractylodes and Amomum Six-Gentlemen Decoction) (see Ulcer Section)