汪省之曰∶九疽一生即有九处。当验人之虚实，毒之浅深，脓之稀稠，遗之迟
速，以决死生。如二三处者则轻。（《理例》）
龟背者，多因未满半周，强令坐早，失护背脊，以致客风吹扑，传入于髓，寒则
体痿，故变成斯证。又谓五脏皆系于背，凡五脏受过而成五疳，久则虫蚀脊髓，背骨
似折，高露如龟矣。书曰∶腮肿疳还盛，脊高力已衰，肾无生气，骨无坚长，故为恶候也。
岐天师曰∶如人背脊裂开一缝，出虱千余，此乃肾中有风，得阳气吹之，不觉
破裂而虱出。治以活水止风丹。裂缝生虱尽死。（《秘录》）
活水止风丹（岐天师）
熟地 山萸肉（各三两） 杜仲（一两） 白术（五钱） 防己（一钱） 草（三钱） 白水煎。
脊缝生虱（张仲景）。萆麻子三粒，研成如膏，同红枣三枚，捣成丸如弹子大，火
烧之，熏衣上则虱死而缝合。盖萆麻子能杀虱而去风，风去虱出则脊自合缝矣。
\r肉龟疮\p04-a41a172.bmp\r
汪省之曰∶肉龟疮乃心肾二经受证。生于胸背两胁间，有头有尾，且有四足，皮
色不红，突起二寸。或有头向上者，毒攻心口；或有毒向下者，足如刀割。或左或
右，其痛难忍。急用神针，针住头尾四足，上用艾灸二十八壮，龟疮即死；不可去针，
内服荆防败毒散加天花粉、乳香、没药，然后再泻其针。（《理例》）
汪省之说：九疽病发作时，身体上会出现九个病灶。应当根据患者体质的虚实、毒邪的深浅、脓液的稀稠以及病程遗留时间的迟速，来判断患者的生死预后。如果只有两三个病灶，则病情较轻。（出自《理例》）
龟背证，大多是因为小儿未满周岁，过早强行让其坐立，未能保护好背部脊柱，导致外界风邪侵袭，传入骨髓。若感受寒邪，则身体痿软，从而形成这种病症。又有一种说法认为，五脏都与背部相连，凡是五脏受邪而形成的五种疳积之症，日久便会侵蚀脊髓，使背骨看起来像折断一样，高高隆起如同龟壳。医书说：“腮部肿胀的疳积症依然严重，脊背高突说明体力已经衰退，肾中无生气，骨骼无法坚固生长，所以这是恶候。”
孙思邈在《千金方》中记载：将红药和首乌研成粉末，用龟尿调和后敷贴于脊骨处，逐渐就会平复。
岐天师说：如果有人背部脊柱裂开一道缝，爬出一千多只虱子，这是因为肾中有风邪，得到阳气吹拂，不知不觉破裂而出。治疗可用活水止风丹。裂缝中的虱子全部死亡。（出自《秘录》）
活水止风丹（岐天师方）
熟地黄、山茱萸肉（各三两）、杜仲（一两）、白术（五钱）、防己（一钱）、萆薢（三钱）。用水煎服。
针对脊缝生虱（张仲景方）：取蓖麻子三粒，研磨成膏状，与红枣三枚一起捣烂，制成如弹丸大小的药丸，用火焚烧，烟熏衣物，则虱子死亡且脊缝愈合。因为蓖麻子能杀灭虱子并祛除风邪，风去虱出，脊背自然就会合拢。
[图片：肉龟疮]
汪省之说：肉龟疮是心经和肾经受邪所表现的病症。生于胸背及两胁之间，有头有尾，并且长有四足，皮肤颜色不红，突起约二寸。有的头部向上，毒邪攻冲心口；有的尾部向下，疼痛如刀割一般。无论左右，疼痛难以忍受。急需使用神针，针刺住头、尾及四足部位，然后在上方艾灸二十八壮，肉龟疮即可死亡；不可立即拔针，同时内服荆防败毒散加入天花粉、乳香、没药，然后再拔出针来。（出自《理例》）
Wang Shengzhi stated: In the disease of Nine Abscesses (Jiu Ju), nine lesions appear on the body at once. One must examine the patient's deficiency or excess constitution, the depth of the toxin, the thickness or thinness of the pus, and the delay or speed of the lingering condition to determine life or death prognosis. If there are only two or three lesions, the condition is mild. (From *Li Li*)
The deformity known as "Turtle Back" (Gui Bei) is mostly caused by forcing an infant under one year old to sit too early without proper protection of the spinal column, allowing external wind pathogens to invade and penetrate into the marrow. If cold is contracted, the body becomes flaccid and weak, thus forming this condition. Another theory states that all five Zang organs are connected to the back; any of the five types of Gan malnutrition syndromes resulting from pathogenic invasion of the Zang organs, if prolonged, will cause worms to erode the spinal cord, making the dorsal bones appear fractured and protruding high like a turtle shell. Medical texts state: "Gan syndrome with swollen cheeks remains severe; a high spine indicates declining strength. With no vital energy in the Kidney and bones lacking firm growth, it becomes a malignant condition."
Sun Simiao, in *Qian Jin Fang*, recorded: Grind Hong Yao (Red Herb) and He Shou Wu (Polygonum multiflorum Root) into powder, mix with Turtle Urine, and apply to the spinal bone. It will gradually flatten naturally.
Grand Master Qi stated: If a person has a split in their spinal column from which over a thousand lice emerge, this is due to wind in the Kidneys being blown by Yang Qi, causing unnoticed rupture and emergence of lice. Treat with Huo Shui Zhi Feng Dan (Living Water Wind-Stop Pill). The lice in the crack will die completely. (From *Mi Lu*)
Huo Shui Zhi Feng Dan (Grand Master Qi Formula):
Shu Di Huang (Prepared Rehmannia Root), Shan Yu Rou (Cornus Fruit) (each 3 liang), Du Zhong (Eucommia Bark) (1 liang), Bai Zhu (Atractylodes Macrocephala Rhizome) (5 qian), Fang Ji (Stephania Root) (1 qian), Bi Xie (Dioscorea Hypoglauca Rhizome) (3 qian). Decoct in water and drink.
For Lice in Spinal Fissure (Zhang Zhongjing Formula): Take 3 seeds of Bi Ma Zi (Ricinus Communis Seed), grind into a paste, mash together with 3 Red Dates (Jujube Fruit) to form pills the size of a bullet. Burn them and smoke the clothes; the lice will die and the fissure will close. This is because Bi Ma Zi can kill lice and dispel wind; when wind is expelled and lice leave, the spine naturally closes.
[Image: Rou Gui Chuang]
Wang Shengzhi stated: Rou Gui Chuang (Flesh-Turtle Sore) is a manifestation of pathogenic invasion in the Heart and Kidney meridians. It arises between the chest, back, and lateral hypochondrium, possessing a head, a tail, and four feet. The skin color is not red, and it protrudes about two cun. Some have the head pointing upward, with toxin attacking the heart region; others have the tail pointing downward, with pain feeling like a knife cut. Whether on the left or right, the pain is unbearable. Immediately use Shen Zhen (Divine Needle) therapy: needle the head, tail, and four feet. Apply moxibustion of twenty-eight moxa cones above the area; the Flesh-Turtle Sore will die. Do not remove the needles yet. Internally administer Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Powder to Overcome Toxin) added with Tian Hua Fen (Trichosanthes Root), Ru Xiang (Frankincense), and Mo Yao (Myrrh). Then, withdraw the needles. (From *Li Li*)