诸本无篇字。
黄帝曰 刘涓子鬼遗方作九江黄父问于岐伯。千金翼作九江黄父相痈疽论。黄帝问于岐伯曰。
上焦出气 张云。宗气也。宗气出于喉咙而行呼吸。其以温分肉。养骨节。通腠理者。是卫气化于宗气也。
中焦出气如露 甲乙。露、作雾。是。张云。营气也。其于阴阳已张。因息乃行。是营气化于宗气也。
变化而赤为血 甲乙。作赤而。似是。
皆盈 甲乙。皆上更是络脉二字。千金翼同。
从虚去实（止）补则有余 从虚去虚。甲乙作从实。是。马云。其实者则从虚之之法。以去其
实。所以泻则不足而为虚也。盖疾去其针。则邪气减矣。若久留其针。先后如一。斯则从实之之法。以去其虚。
所以补则有余而为实也。
形气乃持 甲乙作神气。千金翼作形神。张云。持、定也。
草 马本、志本、甲乙、鬼遗方。 、作 。千金翼作芦。史音 。鱼饥切。张云。音宜 。HT 草、
鹿葱也。简案、玉篇。HT 、本作宜男。鹿葱也。然邪客篇。地有草 。此 当 。误。
卫气归之不得复反 志云。归、当也。荣血留泣不行。则卫气亦还转。而不得复反其故道。故痈肿也。
潘氏续焰云。言卫气因以留聚。而不复返于平常流行之故道也。
不当骨空（止）不相荥 千金翼。骨空下更有骨空二字。甲乙作髓消不当骨空。不得泄泻。则筋骨枯空。
枯空则筋骨
肌肉不相亲。志云。骨空者。节之交也。痈肿不当骨空之处。则骨中之邪热。不得泄泻矣。潘氏云。骨空骨中
之细孔如鬃眼者。所以通血液之渗灌。简案、髓充骨空。今髓消而不当骨空。骨空无髓之可泄泻。则筋骨枯矣。
志注恐误。
与忌日名 外台作与期日。无名字。
岐伯曰 鬼遗方、千金翼、外台、引集验。曰字下有略说痈疽之极者八十种一句。
痈发于嗌中名曰猛疽（止）三日已 合、千金翼作含。外台注。一云无冷食。志云。嗌乃肺之上营。呼吸
出入之门。发于嗌中。其势甚猛。故名猛疽。若脓不泻而塞嗌。则呼吸不通。不待半日而死矣。张云。豕膏即
猪脂之炼净者也。观万氏方。有治肺热暴喑者。用猪脂一斤。炼过。入白蜜一斤。再炼少顷。滤净冷定。不时
挑服一匙即愈。若无疾服之。最能润肺润肠。即是豕膏之属。简案、太阴阳明论云。喉主天气。嗌主地气。史
仓公传云。饮食下嗌。说文。嗌、咽也。此嗌为食道。然本文言塞咽半日死。则嗌为气道明矣。王氏准绳云。
结喉痈一名喉痈。灵枢名曰猛疽。以其势毒猛烈可畏也。此以喉外结喉上为嗌也。按卫生宝鉴。有砭刺肿上。出
紫黑血。用桔梗、甘草、连翘、黍粘、黄芩、升麻、防风等药。医治猛疽。按、此乃似指喉内壅肿为猛。当参考。
发于颈名曰夭疽 巢源。夭、作掖。渊腋、作掖渊。千金翼。其痈、作其疽。夭、李本作天。外台注。
太素经曰。项前曰颈。李云。天疽者。在天柱也。俗名对口。潘氏云。外在颈而内则入腋熏肺。以其最上。故
曰天。准绳颈痈乃夭疽。简案、夭疽发于两耳后左右颈上。志云。颈、乃手足少阳阳明。血气循行之分部是也。
盖其毒烈。使人横夭。故名夭疽也。陈氏正宗云。夭疽锐毒。生于耳后一寸三分致命之
处。左为夭疽。夭者妖变之物也。故属于肝木。右为锐毒。锐者利也。锋利之器。属于肺金是也。对口即脑疽。
与此自别。
名曰脑烁 其色不乐 千金翼、留项、作流项、鬼遗方。烁、作漯。千金翼作脑烁疽。注。乐、一作
除。潘云。烁、消烁也。烈火熔金之谓。脑被其热。烁亦加之。烦心者。肾毒传心也。志云。阳气大发者。三
阳之气并发也。三阳者。太阳也。太阳经脉。入于脑。出于项。故阳气大发。留于项。名曰脑烁。张云。色有
不乐。伤乎心也。痛如刺以针毒之锐也。烦心者。邪犯其脏也。简案、准绳以鬼遗方。脑疽、为脑烁。
发于肩及 名曰疵痈（止）逞 之 鬼遗方作雌疽。甲乙作疵疽。甲乙、千金翼、外台。逞、作逆。巢
源。肩、作 。逞、作炖。张云。肩 下软白肉处曰 。此非要害之所。故不及五脏逞疾也。 、艾炷也。谓
宜速灸以除之也。志云。肩 乃肺之部分。故令人汗出至足。此痈生浮浅。如疵之在皮毛。故名疵痈。而不害
五脏。逞、快也。速 治之。则毒随气而散矣。（炖玉篇火盛貌）
名曰米疽（止）勿裹之 千金翼。米、作朱。砭之、作启之。志云。米者言其小也。治之以砭石者。痈
亦浮浅也。毒瓦斯在于皮肤之间。六日则气已周而来复故已。勿裹之者。使毒瓦斯外泄也。张云。砭石欲细者。恐
伤肉也。欲长者。用在深也。故宜疏不宜密。薛氏外科心法云。腋疽一名米疽。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。气凝血滞而成。腋痈又名夹肢痈。李云。豕膏者。即猪油煎当
归。以蜡收者也。
马刀挟缨 千金翼。其痈、作其疽。按上节而为一节。
甲乙。缨、作瘿。外台注太素经曰。颈前曰缨。张云。此即瘰 也。挟缨、经脉篇作侠瘿。欲急治者。恐迟则
伤人也。潘云。马刀蛤蛎之属。痈形似之。挟缨者。发于结缨之处。大迎之下颈侧也。二痈。一在腋。一在颈。
常相联系。故俗名历串。简案、李志并云。缨、当作瘿。非也。婴、瘿从 者。
井疽 李云。井者喻其深而恶也。发于胸者。近犯心王。治之宜早。准绳云。心窝生疽。初起如黄豆。
肉色不变。名曰井疽。又名穿心冷 。申氏启玄云。井疽又名心漏疽。又名穿心毒。最为难治。
甘疽色青 其状如谷实栝蒌 巢源。栝蒌、作瓠瓜。鬼遗方作萎瓜。史音栝蒌。古栝楼字。马云。谷木
名。李云。膺逼近在乳上也。穴名膺窗。足阳明胃之脉也。土味甘。故曰甘疽。薛氏云。此疽生于乳上肉高耸
处。属肺经中腑穴之下。无论左右。皆由忧思气结而成。简案、谷、HT 下从木音构。考本草楮实。亦名谷。实
大如弹丸。青绿色。至六七月。渐深红色。乃成熟。马注为是。张志及潘。俱为米谷之义。殊不知谷谷字自别
也。志云。死后出脓者。谓至将死之候。然后出脓而死。此即乳岩石痈之证也。出脓之解。近是。其为乳岩石
痈者。恐非也。
败疵（止）灸之 巢源、千金翼、外台。败疵、作改訾。巢源又云。痈发女子阴旁。名曰改訾疽。久不
治。其中生息肉。如赤小豆麻黍也。翼外台。灸之、作久之。李云。胁者肝之部也。妇人多郁怒。故患此疮。
潘云。亦乳串之类。
锉 草根（止）至足已 甲乙。根下有及赤松子根五字。外台。 、作连。草下有及字。千金翼。一
升、作一斗。马云。 、今之连翘也。张云。 、芰也。草 、连翘也。二
草之根。俱能解毒。故各用一升。大约古之一升。得今之三合有零。以水一斗六升。煮取三升。俱折数类此。
李云。乘其热而强饮之。复浓衣坐于热汤之釜。薰蒸取汗。汗出至足乃透。已者、愈也。简案、 、说文。芰
也。玉篇。 、 同。故张志以为菱。然据外台马注为是。
发于股胫 名曰股胫疽（止）三十日死矣 巢源。上胫字作阳股。胫疽、作兑疽。甲乙。搏骨、作薄于骨。
鬼遗方、巢源作附骨。张云。股胫、大股也。状不甚变。言外形不显也。痈脓搏骨。言脓着于骨。即今人之所
谓贴骨痈也。毒盛而深。能下蚀三阴阳明之大经。故不为急治则死矣。胡公弼云。贴骨痈。即附骨疽。生大腿
外侧骨上。高不见高。肿不见红。痛深至骨者是也。简案、下文有发于股阴。名曰赤施。知是发于股胫。当是
股阳。楼引刘涓子作股阳。今本作股阳明。准绳以此为伏兔发。
锐疽 张云。尻尾、骨 也。穴名长强。为督脉之络。一名气之阴 。故不治则死。潘云。尾骨尽处
而尖锐。故名。简案、顾氏疡医大全。以此为鹳口疽。（正宗云鹳口疽发在尾闾之穴高骨头尖初起形似鱼胞久
则突如鹳嘴）
赤施 甲乙、巢源、千金翼、外台。施、作弛。鬼遗方作赤旋疽。张云。股阴、大股内侧也。当足
太阴箕门、血海。及足厥阴五里、阴包之间。皆阴气所聚之处。故不治则死。若两股俱病。则伤阴之极。其死
尤速。志云。股阴者。足三阴之部分也。以火毒而施于阴部。故名曰赤施。潘氏云。股阴。足太阴厥阴二经所
过之处。火毒伤阴之甚则发此。曰赤施者。谓赤火之施发耳。准绳以此为股阴疽。
疵痈 鬼遗方作雌疽。甲乙、巢源、千金翼作疵疽。甲乙、千金翼。如坚石、作而坚者。其柔、作其
色异柔。鬼
遗方作须以手缓柔之乃破。外台作其柔色异。志云。膝者筋之会。足少阳之分也。色不变者。色与皮肤相同而
不赤也。其状如大痈而色不变者。毒在外内之间也。如坚石者。石之则死。毒瓦斯入于内也。须其柔软而石之者
生。毒瓦斯出于外也。余伯荣曰。坚石者。毒瓦斯尚未透发。柔则发于外矣。故有外内死生之分焉。薛氏心法云。
膝痈生膝盖。色红 肿疼痛。属气血实。疵疽亦生在膝盖。肿大如痈。其色不变。寒热往来。属气血虚。和软
为顺。坚硬如石者逆。两膝俱生属败证。不可治也。简案、准绳一名鹤膝风。一名鼓槌风。恐误。
诸痈疽之发于节（止）三十日死 甲乙。三十、作四十。马云。节者关节也。其节之外廉为阳。内廉为
阴。张云。诸节者。神气之所游行出入也。皆不宜有痈毒之患。若其相应。则发于上而应于下。发于左而应于
右。其害尤甚。为不可治。然发于三阳之分者。毒浅在腑。其死稍缓。发于三阴之分者。毒深在脏。不能出一
月也。志云。百日死者。日之终也。三十日者。月之终也。简案、外台注云。丈夫阳器曰阳。妇人阴器曰阴。
楼氏云。阳谓诸节之背。阴谓诸节之 间。刘涓子云。应者内发透外也。数说未稳。张注得其旨矣。
兔啮其状赤至骨 巢源作兔啮疽。甲乙、千金翼作其状如赤豆。志云。啮、音业。噬也。准绳云。足
跟疽。又名兔啮。其状如兔啮故名。简案、此生于胫而为足跟疽之名误也。顾氏大全胫疽门。引本篇为是。
走缓（止）数石其输而止 鬼遗方。缓、作 。千金翼、外台作数灸而止。千金翼无内踝之内字。志云。
痈疽之变。有病因于内而毒瓦斯走于外者。有肿见于外而毒瓦斯走于内者。此邪留于脉而不行。故名曰走缓。张云。
数石其输。砭其所肿之处也。准绳云。足内踝生疽。名曰鞋带痈。简案、作数
灸而止。近是。
寒热不死 志云。盖足少阴秉先天之水火。故能为寒为热也。简案、为寒热而不死者。其义可疑。志
注欠详。马张无解。
四淫其状大痈 鬼遗方。大、作如。张云。阳受气于四末。而大痈淫于其间。阳毒之极盛也。时气移
易。则真阴日败。故逾三月而死。简案、顾氏大全。于足发背门列此证。觉不稳焉。
厉痈（止）不消辄益 千金翼。厉、作疠。如字甲乙、千金翼、外台作从。巢源、鬼遗方无。志云。此
寒邪客于足阳明之脉而为痈也。足阳明之脉。起于足大趾次趾之厉兑。故发于足旁。名曰厉痈。闵士先云。初
如小趾。其状肿而长。乃邪在经络之形也。卫气归之。则圆而坟起矣。李云。去其黑者。而犹不消。反益大焉。
则百日必死矣。简案、志。厉字之解。始为傅会焉。其言发于足旁。则初从小趾发可知耳。如字必误。当根据甲
乙等作从。
脱痈（止）斩之 甲乙、鬼遗方。痈、作疽。斩下有去字。张云。六经原 。皆在于足。所以痈发于足
者。多为凶候。至于足趾。又皆六井所出。而痈色赤黑。其毒尤甚。若无衰退之状。则急当斩去其趾。庶得保
生。否则毒瓦斯连脏。必至死矣。陈氏正宗云。脱疽者。外腐而内坏也。凡患此者。多生手足。初生如粟。一点
黄泡。其皮犹如煮熟红枣。黑色侵漫相传。五趾传遍。上至脚面。疼如汤泼火燃。其形骨枯筋纵。其秽异香难
解。其命仙方难活。孙真人曰。在肉则割。在趾则切。即此病也。
不则死矣 马云。不、否同。
腐则为脓 甲乙。腐上有肉字。
不能陷骨髓 甲乙。重骨髓二字。
淳盛 甲乙、千金翼。淳、作纯。
陷肌肤筋髓枯 志本。肤、作肉。甲乙。枯、作骨肉二字。是。
上之皮夭以坚（止）此其候也 甲乙。夭下有瘀字。张云。夭以色言。黑暗不泽也。此即皮色之状。可
以辨其浅深矣。李云。夭者、色枯暗也。牛皮、喻其浓也。泽者、光亮也。痈字从壅。疽字从沮。总是气血稽
留。营卫不通之症。大而浅者为痈。六腑受伤。可无大患。深而恶者为疽。五脏受伤。大可忧畏。治之者顾可
缓乎。顾可忽乎。简案痈疽二证。以阴阳深浅轻重分之耳。而考上文诸篇。痈疽互称。亦似无大分别。后世精
要诸书。二寸至五寸为痈。五寸至一尺为疽之类。皆谬说也。
各版本中均无“篇”字。
黄帝问岐伯说：刘涓子《鬼遗方》中作“九江黄父问于岐伯”。《千金翼方》中作“九江黄父相痈疽论”。黄帝向岐伯问道：
上焦发出的气，张景岳认为是宗气（积聚于胸中的大气）。宗气出于喉咙而主持呼吸。它用来温煦肌肉、滋养骨节、疏通腠理（皮肤纹理和汗孔），这是卫气（行于脉外，具有防御作用的气）由宗气化生而来的表现。
中焦发出的气像露水一样，甲乙经中，“露”字作“雾”，这是对的。张景岳认为是营气（行于脉中，具有营养作用的气）。它在阴阳之气充盛时，随着呼吸的运行，这是营气由宗气化生而来的表现。
经过变化变成红色就成为血，甲乙经中作“赤而”，似乎更合理。
气血都充盈在络脉中，甲乙经中，“皆盈”二字后更有“络脉”二字，《千金翼方》相同。
从虚证转为实证（停止针刺则补法会导致有余），如果用补法治疗实证就会造成有余；如果是从虚证去治疗虚证，甲乙经中作“从实”，这是对的。马莳认为，对于实证，应当采用从虚处入手的方法，以去除其实邪。所以泻法如果操作不当导致不足，就会变成虚证。大概疾速出针，邪气就减退了。如果长时间留针，无论先后都一样，这就是从实处入手的方法，以去除其虚损。所以补法如果操作不当造成有余，就会变成实证。
形体与正气相持，甲乙经中作“神气”，《千金翼方》作“形神”。张景岳认为，“持”是定的意思。
草（音yí，鹿葱），马本、志本、甲乙经、《鬼遗方》中作“HT”（音宜），《千金翼方》作“芦”。史崧注音为鱼饥切。张景岳注音为音宜。“HT草”即鹿葱。简案：《玉篇》中，“HT”本作“宜男”，即鹿葱。然而《邪客篇》中有“地有草HT”，这里的“HT”应当是“苻”（或类似字），此处误写。
卫气归附于此而不能返回原路，张志聪认为，“归”当解释为“止”。营血留滞不行，卫气也就回转，不能恢复原来的运行道路，所以发生痈肿。潘氏《续焰》说：意思是卫气因此留聚，不再返回平常流行的原有道路。
不应当在骨空处（停止针刺则不相荥穴），《千金翼方》中，“骨空”下还有两个“骨空”字。甲乙经中作“髓消，不当骨空，不得泄泻”，如果不泄泻，筋骨就会枯空。枯空则筋骨肌肉不相亲附。张志聪认为，“骨空”指关节交会之处。痈肿如果不发生在骨空之处，那么骨中的邪热就不能泄泻了。潘氏说：骨空是骨中细小的孔窍如鬃眼者，是用来通行血液渗灌的。简案：骨髓充满骨空，现在骨髓消减而不当骨空，骨空没有骨髓可以泄泻，那么筋骨就会枯槁。张志聪的注释恐怕有误。
给予禁忌日的名称，《外台秘要》中作“与期日”，没有“名字”二字。
岐伯回答说：《鬼遗方》、《千金翼方》、《外台秘要》引用《集验方》，在“曰”字下有“略说痈疽之极者八十种”一句。
痈发于咽喉中间，名叫猛疽（停止针刺则三日已愈），合本、《千金翼方》中“含”字作“含”。《外台秘要》注：一说不要吃冷食。张志聪认为：嗌是肺的上部营卫所在，是呼吸出入的门。发于嗌中，其势非常猛烈，所以叫猛疽。如果脓液不排出而堵塞嗌，就会呼吸不通，不到半天就会死亡。张景岳认为：豕膏就是精炼干净的猪脂。看万全的方子，有治疗肺热突发失音的，用猪脂一斤，炼过后，加入白蜜一斤，再炼片刻，过滤干净冷却定型，不时挑服一匙就能痊愈。如果没有病服用，最能润肺润肠，这属于豕膏一类。简案：《太阴阳明论》说：喉主天气，嗌主地气。史迁《仓公传》说：饮食下嗌。《说文解字》：嗌，咽也。这里的嗌是指食道。然而本文中说塞咽半日死，那么嗌作为气道是很明显的。王肯堂《准绳》说：结喉上的痈一名喉痈，《灵枢》名叫猛疽。因为它的气势毒烈猛烈可畏。这是指喉外结喉上方为嗌。按《卫生宝鉴》，有用砭刺肿上，放出紫黑血，用桔梗、甘草、连翘、黍粘、黄芩、升麻、防风等药医治猛疽。按：这大概是似指喉内壅肿为猛，应当参考。
发于颈部，名叫夭疽，《巢源》中“夭”作“掖”，“渊腋”作“掖渊”。《千金翼方》中“其痈”作“其疽”，“夭”李本作“天”。《外台秘要》注：《太素经》说：项前曰颈。李云：天疽者，在天柱穴部位。俗名对口。潘氏说：外在颈部而内则入腋熏肺。因为它位置最上，所以叫天。《准绳》认为颈痈就是夭疽。简案：夭疽发于两耳后左右颈上。张志聪认为：颈，是手足少阳阳明经血气循行的分部区域。大概它的毒性猛烈，使人横死早夭，所以叫夭疽。陈氏《正宗》说：夭疽锐毒，生于耳后一寸三分致命之处。左为夭疽，夭者是妖变之物，所以属于肝木。右为锐毒，锐者是锋利之意，属于肺金。对口即脑疽，与此自不同。
名叫脑烁，其面色不乐，《千金翼方》、《留项》作“流项”，《鬼遗方》中“烁”作“漯”。《千金翼方》作“脑烁疽”。注：乐，一作“除”。潘氏说：烁，消烁的意思。烈火熔金的称谓。脑被热邪灼烧，烁也施加其上。烦心，是肾毒传心。张志聪认为：阳气大发，是三阳之气并发。三阳，指太阳经。太阳经脉，入于脑，出于项。所以阳气大发，留于项，名叫脑烁。张景岳认为：色有不乐，伤及心。痛如针刺，是用毒针刺痛。烦心，是邪气侵犯内脏。简案：《准绳》以《鬼遗方》中的脑疽为脑烁。
发于肩部及腋下，名叫疵痈（停止针刺则逞逆），《鬼遗方》作“雌疽”。甲乙经作“疵疽”。甲乙经、《千金翼方》、《外台秘要》中“逞”作“逆”。《巢源》中“肩”作“肩髃”，“逞”作“炖”。张景岳说：肩髃下软白肉处曰髃。这不是要害所在，所以不及五脏那样急速致病。髃，即艾炷。谓应当迅速艾灸以除去它。张志聪说：肩髃是肺的部分，所以令人汗出至足。此痈生得浮浅，如疵在皮毛，所以名叫疵痈，而不伤害五脏。逞，快也。迅速治疗它，则毒随气而散。（炖，玉篇解释为火盛貌）
名叫米疽（停止针刺则勿裹之），《千金翼方》中“米”作“朱”。砭之，作“启之”。张志聪说：米是说它小。用砭石治疗，是因为痈也浮浅。毒瓦斯在皮肤之间，六天则气已周遍而来复故常，所以痊愈。勿裹之，是让毒瓦斯向外排泄。张景岳说：砭石想要细的，是怕损伤肌肉。想要长的，是用在深处。所以宜疏不宜密。薛己《外科心法》说：腋疽一名米疽，又名疚疽。发于腋肢窝正中。初起之时，其形如核。由肝脾二经，忧思恚怒，气凝血滞而成。腋痈又名夹肢痈。李云：豕膏者，即猪油煎当归，以蜡收束而成的。
马刀挟缨，《千金翼方》中“其痈”作“其疽”。按上一节合并为一节。甲乙经中“缨”作“瘿”。《外台秘要》注：《太素经》说：颈前曰缨。张景岳说：这就是瘰疬。挟缨，在《经脉篇》作“侠瘿”。想要急切治疗，是怕迟缓则伤人。潘氏说：马刀蛤蛎之类，痈形似之。挟缨者，发于结缨之处，大迎穴之下颈侧。这两种痈，一种在腋，一种在颈，常相联系，所以俗名历串。简案：李志并说：缨，当作瘿，不对。婴、瘿从贝者。
井疽，李云：井比喻其深而恶。发于胸部的，近犯心王。治疗应当早。《准绳》说：心窝生疽，初起如黄豆，肉色不变，名叫井疽。又名穿心冷。申氏《启玄》说：井疽又名心漏疽，又名穿心毒，最为难治。
甘疽色青，其状如谷实栝蒌，《巢源》中“栝蒌”作“瓠瓜”。《鬼遗方》作“萎瓜”。史崧注音栝蒌，古栝楼字。马云：谷木名。李云：膺逼近在乳上也。穴名膺窗，是足阳明胃经的脉。土味甘，所以叫甘疽。薛己说：此疽生于乳上肉高耸处，属肺经中腑穴之下，无论左右，皆由忧思气结而成。简案：谷，HT下从木音构。考《本草》楮实，亦名谷。实大如弹丸，青绿色，到六七月，渐深红色，乃成熟。马注是正确的。张志及潘，俱为米谷之义，殊不知谷谷字自别也。张志聪说：死后出脓的，谓到将死的时候，然后出脓而死。这就是乳岩石痈的证候。出脓的解释，接近是对的。说是乳岩石痈，恐怕不对。
败疵（停止针刺则灸之），《巢源》、《千金翼方》、《外台秘要》中“败疵”作“改訾”。《巢源》又说：痈发女子阴旁，名叫改訾疽。久不治，其中生息肉，如赤小豆麻黍。《千金翼方》、《外台秘要》中“灸之”作“久之”。李云：胁是肝的部位。妇人大多郁怒，所以患此疮。潘氏说：也是乳串之类。
锉草根（停止针刺则至足已），甲乙经中，根下有“及赤松子根”五字。《外台秘要》中“ ”作“连”。草下有“及”字。《千金翼方》中“一升”作“一斗”。马云： ，今之连翘也。张景岳说： ，芰也。草 ，连翘也。两种草的根，都能解毒，所以各用一升。大约古之一升，得今之三合有零。以水一斗六升，煮取三升，都折数类此。李云：乘其热而强饮之，复浓衣坐于热汤之釜，薰蒸取汗，汗出至足乃透。已者，愈也。简案： ，《说文》：芰也。《玉篇》： 、 同。所以张志以为菱。然而据《外台秘要》马注是正确的。
发于大腿和小腿，名叫股胫疽（停止针刺则三十日死矣），《巢源》中上胫字作“阳股”。胫疽，作“兑疽”。甲乙经中“搏骨”作“薄于骨”。《鬼遗方》、《巢源》作“附骨”。张景岳说：股胫，是大腿。形状不太变化，言外形不显。痈脓搏骨，言脓着于骨，即今人之所谓贴骨痈。毒盛而深，能下蚀三阴阳明之大经，所以不紧急治疗就会死亡。胡公弼说：贴骨痈，即附骨疽。生在大腿外侧骨上，高不见高，肿不见红，痛深至骨的是。简案：下文有发于股阴，名叫赤施。知是发于股胫，应当是股阳。楼氏引刘涓子作股阳。今本作股阳明。《准绳》以此为伏兔发。
锐疽，张景岳说：尻尾，骨 也。穴名长强，为督脉之络。一名气之阴 。所以不治则死。潘氏说：尾骨尽处而尖锐，所以命名。简案：顾氏《疡医大全》，以此为鹳口疽。（《正宗》说鹳口疽发在尾闾之穴高骨头尖，初起形似鱼胞，久则突如鹳嘴）
赤施，甲乙经、《巢源》、《千金翼方》、《外台秘要》中“施”作“弛”。《鬼遗方》作“赤旋疽”。张景岳说：股阴，是大腿内侧。当足太阴箕门、血海，及足厥阴五里、阴包之间，都是阴气聚集之处。所以不治则死。如果两股都病，则伤阴之极，其死尤其快。张志聪说：股阴，是足三阴的部分。以火毒而施于阴部，所以名叫赤施。潘氏说：股阴，足太阴厥阴二经所过之处。火毒伤阴之甚则发此。曰赤施者，谓赤火之施发耳。《准绳》以此为股阴疽。
疵痈，《鬼遗方》作“雌疽”。甲乙经、《巢源》、《千金翼方》作“疵疽”。甲乙经、《千金翼方》中“如坚石”作“而坚者”。其柔，作“其色异柔”。《鬼遗方》作“须以手缓柔之乃破”。《外台秘要》作“其柔色异”。张志聪说：膝是筋的会合，足少阳的分部。色不变者，色与皮肤相同而不赤。其状如大痈而色不变者，毒在外内之间。如坚石者，石之则死，毒瓦斯入于内。须其柔软而石之者生，毒瓦斯出于外。余伯荣说：坚石者，毒瓦斯尚未透发。柔则发于外。故有外内死生之分。薛己《心法》说：膝痈生膝盖，色红肿疼痛，属气血实。疵疽亦生在膝盖，肿大如痈，其色不变，寒热往来，属气血虚。和软为顺，坚硬如石者逆。两膝俱生属败证，不可治。简案：《准绳》一名鹤膝风，一名鼓槌风，恐怕错误。
诸痈疽之发于节（停止针刺则三十日死），甲乙经中“三十”作“四十”。马云：节是关节。其节之外廉为阳，内廉为阴。张景岳说：诸节，是神气游行出入的地方。都不应该有痈毒之患。如果相应，则发于上而应于下，发于左而应于右，其害尤其严重，为不可治。然而发于三阳分部的，毒浅在腑，其死稍缓。发于三阴分部的，毒深在脏，不能出一月。张志聪说：百日死者，日之终。三十日者，月之终。简案：《外台秘要》注说：丈夫阳器曰阳，妇人阴器曰阴。楼氏说：阳谓诸节之背，阴谓诸节之 间。刘涓子说：应者内发透外。数说未稳。张注得其旨矣。
兔啮其状赤至骨，《巢源》作“兔啮疽”。甲乙经、《千金翼方》作“其状如赤豆”。张志聪说：啮，音业。噬也。《准绳》说：脚跟疽，又名兔啮。其状如兔啮故名。简案：此生于胫而为足跟疽之名误。顾氏《大全》胫疽门，引本篇为是。
走缓（停止针刺则数石其输而止），《鬼遗方》中“缓”作“ ”。《千金翼方》、《外台秘要》作“数灸而止”。《千金翼方》无“内踝之内”四字。张志聪说：痈疽之变，有病因于内而毒瓦斯走于外的，有肿见于外而毒瓦斯走于内的。此邪留于脉而不行，所以名叫走缓。张景岳说：数石其输，砭其所肿之处。《准绳》说：足内踝生疽，名叫鞋带痈。简案：作“数灸而止”，接近是对的。
寒热不死，张志聪说：盖足少阴秉先天之水火，所以能为寒为热。简案：为寒热而不死的，其义可疑。志注欠详。马张无解。
四淫其状大痈，《鬼遗方》中“大”作“如”。张景岳说：阳受气于四末，而大痈淫于其间，阳毒之极盛。时气移易，则真阴日败，所以逾三月而死。简案：顾氏《大全》，于足发背门列此证，觉不稳焉。
厉痈（停止针刺则不消辄益），《千金翼方》中“厉”作“疠”。如字甲乙经、《千金翼方》、《外台秘要》作“从”。《巢源》、《鬼遗方》无。张志聪说：此寒邪客于足阳明之脉而为痈。足阳明之脉，起于足大趾次趾之厉兑，所以发于足旁，名叫厉痈。闵士先说：初如小趾，其状肿而长，乃邪在经络之形。卫气归之，则圆而坟起。李云：去其黑者，而犹不消，反益大，则百日必死。简案：志，厉字之解，始为傅会。其言发于足旁，则初从小趾发可知耳。如字必误，当根据甲乙等作“从”。
脱痈（停止针刺则斩之），甲乙经、《鬼遗方》中“痈”作“疽”。斩下有“去”字。张景岳说：六经原 ，皆在于足。所以痈发于足者，多为凶候。至于足趾，又皆六井所出，而痈色赤黑，其毒尤其甚。若无衰退之状，则急当斩去其趾，庶得保生。否则毒瓦斯连脏，必至死。陈氏《正宗》说：脱疽者，外腐而内坏。凡患此者，多生手足。初生如粟，一点黄泡，其皮犹如煮熟红枣，黑色侵漫相传，五趾传遍，上至脚面，疼如汤泼火燃，其形骨枯筋纵，其秽异香难解，其命仙方难活。孙真人说：在肉则割，在趾则切，即此病。
腐则为脓，甲乙经中，腐上有“肉”字。
不能陷骨髓，甲乙经中，重“骨髓”二字。
淳盛，甲乙经、《千金翼方》中“淳”作“纯”。
陷肌肤筋髓枯，志本中“肤”作“肉”。甲乙经中“枯”作“骨肉”二字，是。
上之皮夭以坚（停止针刺则此其候也），甲乙经中，夭下有“瘀”字。张景岳说：夭以色言，黑暗不泽。此即皮色之状，可以辨其浅深。李云：夭者，色枯暗。牛皮，喻其浓。泽者，光亮。痈字从壅，疽字从沮，总是气血稽留，营卫不通之症。大而浅者为痈，六腑受伤，可无大患。深而恶者为疽，五脏受伤，大可忧畏。治之者顾可缓乎？顾可忽乎？简案：痈疽二证，以阴阳深浅轻重分之耳。而考上文诸篇，痈疽互称，亦似无大分别。后世精要诸书，二寸至五寸为痈，五寸至一尺为疽之类，皆谬说。
There is no character "Pian" (Chapter) in various editions.
The Yellow Emperor asked Qibo: Liu Juanzi's *Gui Yi Fang* reads "Jiujiang Huangfu asked Qibo." *Qianjin Yifang* reads "Jiujiang Huangfu discussed carbuncles and sores." The Yellow Emperor asked Qibo:
The Qi emitted from the Upper Jiao, Zhang Jingyue considers it to be Zong Qi (Grand Qi accumulating in the chest). Zong Qi emerges from the throat and governs respiration. It warms the muscles, nourishes the joints, and unblocks the Cou Li (skin texture and pores); this indicates that Wei Qi (Defensive Qi circulating outside the vessels with defensive functions) is transformed by Zong Qi.
The Qi emitted from the Middle Jiao is like dew or mist (as corrected in *Jia Yi Jing*), which is correct. Zhang Jingyue identifies it as Ying Qi (Nutritive Qi circulating within the vessels with nourishing functions). When Yin and Yang are full, it moves with respiration; this indicates that Ying Qi is transformed by Zong Qi.
Through transformation, it becomes red and turns into blood. In *Jia Yi Jing*, it is written as "Chi Er" (becomes red), which seems more plausible.
All fill the Luo Mai (Collateral Vessels). In *Jia Yi Jing*, two characters "Luo Mai" follow "Jie Ying". *Qianjin Yifang* agrees.
From deficiency transforming into excess (stopping needle retention leads to excess if tonified): If one treats an excess condition with tonification, it results in surplus; if one treats a deficiency condition, *Jia Yi Jing* writes "from excess," which is correct. Ma Shi argues that for excess conditions, one should adopt methods from deficient areas to remove the excess pathogen. Thus, if purging causes insufficiency, it becomes deficiency. Generally, rapid needle withdrawal reduces pathogenic Qi. If needles are retained for a long time regardless of sequence, this is a method addressing excess to remove deficiency. Therefore, improper tonification causing surplus leads to excess.
Form and Zheng Qi remain stable. *Jia Yi Jing* writes "Shen Qi" (Spirit Qi); *Qianjin Yifang* writes "Xing Shen" (Form and Spirit). Zhang Jingyue states "Chi" means stability.
Grass (Yi, Deer Onion): Ma Ben, Zhi Ben, *Jia Yi Jing*, and *Gui Yi Fang* use the character "HT" (pronounced Yi). *Qianjin Yifang* uses "Lu". Shi Song annotates pronunciation as Yu Ji Qie. Zhang Jingyue annotates as sound Yi. "HT Cao" is Deer Onion. Commentary: In *Yu Pian*, "HT" was originally "Yi Nan", i.e., Deer Onion. However, in *Xie Ke Pian*, "Di You Cao HT", here "HT" should likely be another character; this is an error.
Wei Qi returns but cannot reverse its course: Zhang Zhicong explains "Gui" as stopping. When Ying Blood stagnates and does not flow, Wei Qi also turns back and cannot return to its original path, resulting in carbuncle and swelling. Pan's *Xu Yan* states: This means Wei Qi stays aggregated and does not return to its normal circulation path.
Not at the Gu Kong (Bone Cavity) (stop needle retention then Bu Xing Ying): *Qianjin Yifang* adds two "Gu Kong" after "Gu Kong". *Jia Yi Jing* reads "Sui Xiao, Bu Dang Gu Kong, Bu De Xie Xie" (Marrow depletion, not at bone cavity, cannot drain). If not drained, the sinews and bones become withered and empty. Withered and empty means sinews, bones, muscles do not adhere closely. Zhang Zhicong says "Gu Kong" refers to joint intersections. If a carbuncle does not occur at a Gu Kong site, the heat pathogen in the bone cannot be drained. Pan states: Gu Kong are fine pores in the bone like sieve holes, allowing blood seepage. Commentary: Marrow fills the Gu Kong. Now marrow depletes and is not at the Gu Kong; since there is no marrow to drain, sinews and bones wither. Zhang Zhicong's annotation is likely incorrect.
Give the name of forbidden days: *Wai Tai Mi Yao* reads "Yu Qi Ri" (Give date), omitting "Zi Ming" (Name).
Qibo answered: *Gui Yi Fang*, *Qianjin Yifang*, and *Wai Tai Mi Yao* cite *Ji Yan Fang*, adding after "Yue" (said): "Briefly discussing eighty extreme types of carbuncles and sores."
A carbuncle appearing in the middle of the Yi (throat/pharynx) is called Meng Ju (Fierce Carbuncle) (stop needle retention then three days to heal): He Ben and *Qianjin Yifang* write "Han" for "Han". *Wai Tai Mi Yao* note: One version says avoid cold food. Zhang Zhicong notes: Yi is the upper part of the Lung where Ying-Wei circulate, the gate for breathing. Appearing in the Yi, its momentum is fierce, hence "Meng Ju". If pus does not discharge and blocks the Yi, respiration stops, leading to death within half a day. Zhang Jingyue states: Shi Gao is refined lard. Wan Quan's formula for treating sudden hoarseness due to Lung Heat uses one jin of lard, refined, mixed with one jin of white honey, refined briefly, filtered, cooled, and taken by spoonfuls until cured. For healthy individuals, it moistens lungs and intestines, belonging to Shi Gao category. Commentary: *Tai Yin Yang Ming Lun* says: Throat governs Heaven Qi, Yi governs Earth Qi. Sima Qian's *Cang Gong Zhuan* says: Food goes down the Yi. *Shuo Wen*: Yi is the pharynx. Here Yi refers to the esophagus. However, the text says blocking the Yi leads to death in half a day, indicating Yi is the airway. Wang Ken-tang's *Zhun Sheng* states: A carbuncle on the Adam's apple is called Hou Yong (Throat Carbuncle); *Ling Shu* calls it Meng Ju because its toxicity is fierce and terrifying. This refers to the area above the external Adam's apple as Yi. According to *Wei Sheng Bao Jian*, treating Meng Ju involves pricking the swelling to release purple-black blood, using herbs like Jie Geng, Gan Cao, Lian Qiao, Shu Nian, Huang Qin, Sheng Ma, Fang Feng, etc. Note: This likely refers to internal throat swelling; reference is advised.
A carbuncle appearing on the neck is called Yao Ju (Premature Death Carbuncle): *Chao Yuan* writes "Yao" as "Ye" (Axilla), "Yuan Ye" as "Ye Yuan". *Qianjin Yifang* writes "Qi Ju" for "Qi Yong", "Yao" as "Tian" in Li's edition. *Wai Tai Mi Yao* note: *Tai Su Jing* says: Front of the neck is Jing. Li Yun: Tian Ju is at Tian Zhu point. Commonly known as "Dui Kou" (Opposite Mouth). Pan states: Externally on the neck, internally entering the axilla to smolder the Lung. Because it is highest, it is called Tian. *Zhun Sheng* equates Neck Carbuncle with Yao Ju. Commentary: Yao Ju appears on the neck behind both ears. Zhang Zhicong states: The neck is the distribution area for blood and Qi of the Hand and Foot Shaoyang and Yangming meridians. Its toxicity is fierce, causing premature death, hence "Yao Ju". Chen's *Zheng Zong* states: Yao Ju Rui Du arises at a fatal spot one inch three fen behind the ear. Left is Yao Ju (Yao implies demonic change, associated with Liver Wood); Right is Rui Du (Rui implies sharpness, associated with Lung Metal). Dui Kou is Nao Ju (Brain Carbuncle), distinct from this.
Named Nao Shuo (Brain Scorched), with an unhappy complexion: *Qianjin Yifang* and *Liu Xiang* write "Liu Xiang"; *Gui Yi Fang* writes "Mo" for "Shuo". *Qianjin Yifang* writes "Nao Shuo Ju". Note: Le, alternatively "Chu". Pan states: Shuo means scorching/consuming, like fire melting metal. The brain is scorched by heat. Irritability indicates Kidney toxin transmitting to the Heart. Zhang Zhicong states: Vigorous Yang expansion is the concurrent emission of Three Yang Qi. Three Yang refers to Taiyang. The Taiyang meridian enters the brain and emerges from the nape. Thus, vigorous Yang Qi remains in the nape, named Nao Shuo. Zhang Jingyue states: Unhappy complexion indicates Heart injury. Pain like needle pricks suggests toxic needle stimulation. Irritability indicates pathogen invading organs. Commentary: *Zhun Sheng* equates Brain Carbuncle in *Gui Yi Fang* with Nao Shuo.
Appearing on the shoulder and armpit, named Ci Yong (Flaw Carbuncle) (stop needle retention then Ni/Reverse): *Gui Yi Fang* writes "Ci Ju". *Jia Yi Jing* writes "Ci Ju". *Jia Yi Jing*, *Qianjin Yifang*, *Wai Tai Mi Yao* write "Ni" for "Cheng". *Chao Yuan* writes "Jian Yu" for "Jian", "Dun" for "Cheng". Zhang Jingyue states: The soft white flesh below Jian Yu is called Yu. This is not a critical area, so it does not cause rapid disease affecting the Five Zang. Yu refers to moxa cones. It implies urgent moxibustion to remove it. Zhang Zhicong states: Jian Yu is the domain of the Lung, causing sweating down to the feet. This carbuncle is superficial, like a flaw on the skin/hair, hence named Ci Yong, without harming the Zang. Cheng means fast. Treating it quickly disperses the toxin with Qi. (Dun, *Yu Pian*: appearance of intense fire).
Named Mi Ju (Rice Carbuncle) (stop needle retention then Do Not Bandage): *Qianjin Yifang* writes "Zhu" for "Mi". Bian Zhi (prick with stone) is written as "Qi Zhi" (Open it). Zhang Zhicong states: Mi implies smallness. Using bian stone indicates the carbuncle is superficial. Toxin is between skin and flesh; after six days, Qi cycles and recovers, so it heals. Do not bandage allows toxin to vent externally. Zhang Jingyue states: Fine bian stones prevent muscle damage; long ones reach deep depths. Hence, sparse application is better than dense. Xue Ji's *Wai Ke Xin Fa* states: Axillary abscess is named Mi Ju or Jiu Ju. Appears in the center of the axilla pit. Initially kernel-sized. Caused by worry, anger, Qi stagnation, and blood stasis in Liver and Spleen meridians. Axillary carbuncle is also called Jia Zhi Yong. Li Yun: Shi Gao is pig fat fried with Dang Gui, collected with beeswax.
Ma Dao Jia Ying (Horse Knife Clinging Ribbon): *Qianjin Yifang* writes "Qi Ju" for "Qi Yong". Merged with the previous section. *Jia Yi Jing* writes "Ying" as "Ying" (Goiter). *Wai Tai Mi Yao* note: *Tai Su Jing* says: Front of neck is Ying. Zhang Jingyue states: This is Luoli (Scrofula). Jia Ying, in *Jing Mai Pian*, is written as "Xia Ying". Urgent treatment is needed to prevent harm from delay. Pan states: Similar to Ma Dao and Ge Li. Jia Ying appears where the ribbon ties, below Da Ying point on the neck side. These two carbuncles, one in axilla, one in neck, often connect, commonly known as "Li Chuan" (String of Pearls). Commentary: Li Zhi claims Ying should be Ying (Goiter), which is incorrect. Ying and Ying derive from different radicals.
Jing Ju (Well Carbuncle): Li Yun: Jing metaphorically implies depth and malignancy. Appearing in the chest, it nears the Heart King. Early treatment is suitable. *Zhun Sheng* states: Carbuncle arising in the heart pit, initially like a soybean, flesh color unchanged, named Jing Ju. Also called Chuan Xin Leng (Penetrating Heart Cold). Shen's *Qi Xuan* states: Jing Ju is also called Xin Lou Ju (Heart Fistula Carbuncle) or Chuan Xin Du (Penetrating Heart Poison), most difficult to treat.
Gan Ju (Sweet Carbuncle) has green color, shape like grain fruit Trichosanthes: *Chao Yuan* writes "Hu Gua" for "Gua Lou". *Gui Yi Fang* writes "Wa Gua". Shi Song annotates Gua Lou, ancient character for Gua Lou. Ma Yun: Gu is a tree name. Li Yun: Ying is close to the breast. Acupoint Ying Chuang belongs to Foot Yangming Stomach Meridian. Earth flavor is sweet, hence Gan Ju. Xue Ji states: This carbuncle arises on the elevated flesh above the breast, below the Lung Meridian acupoints, regardless of left or right, caused by emotional constraint. Commentary: Gu, HT radical under Wood, pronounced Gou. *Ben Cao*褚实 (Euodia Fruit) is also named Gu. Fruit size like a pellet, green turning dark red in June-July when ripe. Ma's annotation is correct. Zhang Zhicong and Pan interpret it as rice/grain, failing to distinguish the characters. Zhang Zhicong states: Pus discharge before death occurs only at the dying moment. This resembles Breast Rock Carbuncle. The explanation of pus discharge is close, but identifying it as Breast Rock Carbuncle is doubtful.
Bai Ci (Decayed Flaw) (stop needle retention then Moxibustion): *Chao Yuan*, *Qianjin Yifang*, *Wai Tai Mi Yao* write "Gai Zi" for "Bai Ci". *Chao Yuan* adds: Carbuncle appearing beside female genitals named Gai Zi Ju. Untreated long-term, polyps grow inside like red beans or hemp seeds. *Qianjin Yifang*, *Wai Tai Mi Yao* write "Jiu Zhi" (Moxa for long time) for "Jiu Zhi". Li Yun: Hypochondrium is Liver domain. Women often have depression/anger, thus suffering this sore. Pan states: Also a type of breast chain carbuncle.
Cut Grass Roots (stop needle retention then Sweat reaches feet): *Jia Yi Jing* adds "Ji Chi Song Zi Gen" (and Red Pine Root) five characters after "Gen". *Wai Tai Mi Yao* writes "Lian" for " ". Grass has "Ji" (and). *Qianjin Yifang* writes "One Dou" for "One Sheng". Ma Yun: , modern Lian Qiao (Forsythia). Zhang Jingyue states: , Jizi (Water Caltrop). Grass , Lian Qiao. Roots of both grasses detoxify, hence each used one sheng. Ancient one sheng equals roughly modern three he. Boil in sixteen dou water to obtain three sheng, similar reductions apply. Li Yun: Drink while hot, wrap warmly, sit over hot water cauldron, fumigate to induce sweat. Sweat reaching feet indicates cure. Yi means healed. Commentary: , *Shuo Wen*: Jizi. *Yu Pian*: same as . Thus Zhang Zhicong thinks it is Water Caltrop. However, based on *Wai Tai Mi Yao* Ma annotation, it is correct.
Appearing on thigh and shin, named Gu Ting Ju (Thigh-Shin Carbuncle) (stop needle retention then thirty days to die): *Chao Yuan* writes "Yang Gu" for upper "Ting". Ting Ju, writes "Dui Ju". *Jia Yi Jing* writes "Bo Yu Gu" (Thin on bone) for "Bo Gu". *Gui Yi Fang*, *Chao Yuan* write "Fu Gu" (Attached Bone). Zhang Jingyue states: Gu Ting refers to large thigh. Shape changes little, meaning external appearance is not obvious. Pus adhering to bone means pus attaches to bone, known today as Tie Gu Yong (Bone-Adherent Carbuncle). Toxicity is severe and deep, eroding major channels of Three Yin/Yang and Yangming. Without urgent treatment, death ensues. Hu Gongbi states: Tie Gu Yong is Fu Gu Ju. Arises on outer thigh bone, high but not visibly high, swollen but not red, pain deep to bone. Commentary: Later text mentions Fa Yu Gu Yin named Chi Shi. Knowing it arises from Gu Ting, it should be Gu Yang. Lou cites Liu Juanzi as Gu Yang. Current text has Gu Yang Ming. *Zhun Sheng* identifies this as Fu Tu emergence.
Rui Ju (Sharp Carbuncle): Zhang Jingyue states: Kao Wei is bone . Acupoint Chang Qiang, collateral of Du Meridian. Also named Qi Yin . Untreated leads to death. Pan states: Tip of tailbone is sharp, hence named. Commentary: Gu's *Yang Yi Da Quan* identifies this as Guan Kou Ju. (*Zheng Zong* says Guan Kou Ju arises at Wei Lv point, high bone tip, initial shape like fish bladder, later protrudes like stork beak).
Chi Shi (Red Spread): *Jia Yi Jing*, *Chao Yuan*, *Qianjin Yifang*, *Wai Tai Mi Yao* write "Chi" (Relax) for "Shi". *Gui Yi Fang* writes "Chi Xuan Ju". Zhang Jingyue states: Gu Yin is inner thigh. Located between Taiyang Jimen, Xuehai, and Jueyin Wuli, Yinbao, areas of Yin Qi accumulation. Untreated leads to death. If both thighs affected, extreme Yin injury, death is faster. Zhang Zhicong states: Gu Yin is domain of Three Foot Yin meridians. Fire toxin applied to Yin area, hence Chi Shi. Pan states: Gu Yin is passage of Foot Taiyang and Jueyin. Severe Yin injury by fire toxin causes this. Chi Shi means spreading of red fire. *Zhun Sheng* identifies this as Gu Yin Ju.
Ci Yong (Flaw Carbuncle): *Gui Yi Fang* writes "Ci Ju". *Jia Yi Jing*, *Chao Yuan*, *Qianjin Yifang* write "Ci Ju". *Jia Yi Jing*, *Qianjin Yifang* write "Er Jian Zhe" (And hard) for "Ru Jian Shi" (Like hard stone). Qi Rou, writes "Qi Se Yi Rou" (Its color differs in softness). *Gui Yi Fang* writes "Xu Yi Shou Huan Rou Zhi Nai Po" (Must soften by hand then break). *Wai Tai Mi Yao* writes "Qi Rou Se Yi". Zhang Zhicong states: Knee is convergence of sinews, domain of Shaoyang. Color unchanged means same as skin, not red. Shape like large carbuncle but color unchanged, toxin is between exterior and interior. Like hard stone, pricking leads to death, toxin enters interior. Must wait for softness to prick, life ensues, toxin exits exterior. Yu Borong states: Hard stone means toxin not yet erupted. Softness means erupting outward. Hence distinction of death/life based on interior/exterior. Xue Ji's *Xin Fa* states: Knee carbuncle arises on kneecap, red/swollen/painful, belongs to Qi/Blood excess. Ci Ju also on kneecap, swollen like carbuncle, color unchanged, alternating chills/fever, belongs to Qi/Blood deficiency. Soft is favorable, hard as stone is adverse. Bilateral knee involvement is failure syndrome, untreatable. Commentary: *Zhun Sheng* names it He Xi Feng (Crane Knee Wind) or Gu Chui Feng (Drumstick Wind), likely erroneous.
All carbuncles/sores arising at joints (stop needle retention then thirty days to die): *Jia Yi Jing* writes "Forty" for "Thirty". Ma Yun: Joint is Guan Jie. Outer edge is Yang, inner edge is Yin. Zhang Jingyue states: All joints are pathways for Shen Qi circulation. Carbuncle pathology is unsuitable. If corresponding, upper affects lower, left affects right, harm is severe, untreatable. Eruption in Three Yang domains, toxin shallow in Fu organs, death slower. Eruption in Three Yin domains, toxin deep in Zang organs, death within one month. Zhang Zhicong states: Hundred days death is end of day cycle. Thirty days death is end of month cycle. Commentary: *Wai Tai Mi Yao* note: Male organ is Yang, female organ is Yin. Lou states: Yang refers to backs of joints, Yin refers to spaces between joints. Liu Juanzi states: Correspondence means internal eruption to exterior. These explanations are unstable. Zhang's annotation captures the essence.
Tu Nie (Rabbit Bite), shape red to bone: *Chao Yuan* writes "Tu Nie Ju". *Jia Yi Jing*, *Qianjin Yifang* write "Qi Zhuang Ru Chi Dou" (Shape like red bean). Zhang Zhicong states: Nie, sound Ye. Bite. *Zhun Sheng* states: Heel carbuncle, also named Tu Nie. Shape like rabbit bite, hence name. Commentary: This arises in tibia but named heel carbuncle is erroneous. Gu's *Da Quan* Tibia Carbuncle section cites this chapter correctly.
Zou Huan (Walking Slow) (stop needle retention then repeatedly pierce Shu points to stop): *Gui Yi Fang* writes " " for "Huan". *Qianjin Yifang*, *Wai Tai Mi Yao* write "Shu Jiu Er Zhi" (Repeated moxa to stop). *Qianjin Yifang* omits "Nei Huai Zhi Nei" (Inside medial malleolus). Zhang Zhicong states: Carbuncle variations include internal cause/toxin moving external, or external swelling/toxin moving internal. Pathogen stays in vessels not moving, hence Zou Huan. Zhang Jingyue states: Shu Shi Qi Shu, prick the swollen area. *Zhun Sheng* states: Carbuncle on medial malleolus named Xie Dai Yong (Shoe Strap Carbuncle). Commentary: Writing "Repeated moxa to stop" is closer to truth.
Han Re Bu Si (Chills/Fever not dead): Zhang Zhicong states: Foot Shaoying embodies primordial Water/Fire, hence capable of chills/fever. Commentary: Meaning of surviving chills/fever is questionable. Zhicong's note lacks detail. Ma/Zhang have no explanation.
Si Yin (Four Extremities Indulgence), shape large carbuncle: *Gui Yi Fang* writes "Ru" (Like) for "Da" (Large). Zhang Jingyue states: Yang receives Qi from four extremities, large carbuncle indulges among them, extreme Yang toxicity. Seasonal Qi shifts, True Yin declines daily, hence death after three months. Commentary: Gu's *Da Quan* lists this in Foot Back Carbuncle section, feels unstable.
Li Yong (Plague Carbuncle) (stop needle retention then若不消辄益 - if not resolved, increases): *Qianjin Yifang* writes "Li" (Plague) for "Li". As written *Jia Yi Jing*, *Qianjin Yifang*, *Wai Tai Mi Yao* write "Cong" (From). *Chao Yuan*, *Gui Yi Fang* omit. Zhang Zhicong states: Cold pathogen lodges in Foot Yangming meridian causing carbuncle. Foot Yangming originates at Lidui on second toe. Hence appearing on foot side, named Li Yong. Min Shixian states: Initially like small toe, swollen and long, shape of pathogen in collaterals. Wei Qi returns, becomes round and raised. Li Yun: Remove black parts, if still not resolved, increases, death in hundred days. Commentary: Zhicong's interpretation of Li character is forced. Saying it arises on foot side implies starting from small toe. "As written" must be wrong; follow *Jia Yi Jing* as "Cong".
Tuo Yong (Fallen Carbuncle) (stop needle retention then Amputate): *Jia Yi Jing*, *Gui Yi Fang* write "Ju" for "Yong". Under "Zhan" (Amputate) add "Qu" (Remove). Zhang Jingyue states: Six Meridian Yuan Source points are all in feet. Hence carbuncles on feet are often ominous. Toe tips are origins of Six Jing points, carbuncle color red/black, toxicity severe. If no signs of decline, urgently amputate toe to preserve life. Otherwise toxin connects to Zang, certain death. Chen's *Zheng Zong* states: Tuo Ju is external rot and internal decay. Often on hands/feet. Initially like millet, one yellow blister, skin like cooked red date, black spreads, passes through five toes up to foot surface, pain like boiling water/fire, bones wither, sinews relax, foul odor hard to resolve, immortal prescriptions fail. Sun Simiao said: Cut flesh, amputate toes, this is the disease.
Bu Ze Si Yi (Otherwise Die): Ma Yun: Bu same as Fou (No).
Fu Ze Wei Nong (Rotting becomes pus): *Jia Yi Jing* adds "Rou" (Flesh) before "Fu".
Bu Neng Xian Su Sui (Cannot sink into marrow/bone): *Jia Yi Jing* repeats "Su Sui" (Marrow/Bone).
Chun Sheng (Purely Flourishing): *Jia Yi Jing*, *Qianjin Yifang* write "Chun" (Pure) for "Chun" (Thick).
Xian Ji Fu Jin Sui Ku (Sink into muscle/flesh, sinew/marrow wither): Zhi Ben writes "Rou" (Flesh) for "Fu". *Jia Yi Jing* writes "Gu Rou" (Bone Flesh) for "Ku" (Wither), which is correct.
Upper skin is Tian (Withered/Dark) and Jian (Hard) (stop needle retention then this is the sign): *Jia Yi Jing* adds "Yu" (Stasis) after "Tian". Zhang Jingyue states: Tian refers to color, dark and dull. This is skin color state, distinguishing depth. Li Yun: Tian means withered/dark color. Niu Pi (Cowhide) implies thickness. Ze means glossy. Yong (Carbuncle) derives from Yong (Obstruct), Ju (Sore) derives from Ju (Depress). Both are symptoms of Qi/Blood stagnation and Ying/Wei blockage. Large and shallow is Yong, Six Fu injured, no major harm. Deep and malignant is Ju, Five Zang injured, highly concerning. Can treatment be delayed? Can it be ignored? Commentary: Yong and Ju distinguished by Yin/Yang, depth, severity. Examining previous chapters, Yong and Ju are used interchangeably, seemingly no major difference. Later essential books claiming 2-5 cun is Yong, 5-10 cun is Ju are erroneous theories.