紫桐散（李常山。） 专敷手足发背，止痛消肿。梧桐叶鲜的捣烂，或初秋采取阴
干，紫花地丁各等分，研细，砂糖调敷。
手发背。（吕氏秘方。）
生甘草 炙甘草 大贝母（各五钱） 皂角刺（土炒） 穿山甲（炒黑） 知母（各二钱五分） 半
夏（一钱五分）
姜引，酒水同煎，二剂全愈。
自胸膺起至乳房、脐腹、胁肋止，凡一切痈疽疔毒，皆汇于此部中，以便检阅参治。
《灵枢》云∶甘疽发于膺，（膺，胸两旁高起，亦谓之臆。）色青，其状如谷实瓜薮，常苦寒热。
急治之，去其寒热；不急治，十日死。死后出脓。
\r甘疽\p04-a41a128.bmp\r
《心法》曰∶此疽生于乳上肉高耸处，属肺经中府穴之下，无论左右，皆由忧思气结而成。
申斗垣曰∶胸发，发于玉堂、（穴在紫宫下一寸六分，又名玉英。）膻中、（一名元儿穴，在玉堂下
一寸六分，两乳间。）中庭、（穴有膻中下一寸六分。）鸠尾（穴在蔽骨之端，言其骨垂下如鸠形，故名臆，
前蔽骨下五分，人无蔽骨者，从岐骨之际下行一寸是也。）等穴，皆任脉之络，名阴脉之海，乃人身之
子午也。急早内托，防毒归心，伤膜者死。（《启玄》）
\r胸发\p04-a41a129.bmp\r
汪省之曰∶中庭疽，在乳之中央，任
脉之经。（《理例》）
薛立斋曰∶胸发生于正胸堂，去结喉三寸，与心窝不远，乃手足六经交会之所，
其患最凶，丧人性命，宜速治。若三四日失治，则皮开肉裂，甚可畏也。若使长大，
百不救一。宜用牛黄熊胆研细，香油调涂四边弦上，以免开花。如痛用乳香、没药
为末，铺粗纸内外，以青布片卷好，蘸清油点着，在疮四围照之，痛自止矣。内服
清热护心，祛毒镇心汤剂；若开花穿穴，神仙莫救。
紫桐散（李常山方。）专门外敷治疗手足发背，具有止痛消肿的功效。取新鲜的梧桐叶捣烂，或者在初秋时节采集后阴干，与紫花地丁按等比例混合，研成细末，用砂糖调匀后外敷。
手发背。（吕氏秘方。）
生甘草 炙甘草 大贝母（各五钱） 皂角刺（土炒） 穿山甲（炒黑） 知母（各二钱五分） 半夏（一钱五分）
以生姜为引，酒水同煎，服用两剂即可痊愈。
从胸膺部起，延伸至乳房、脐腹部及胁肋部为止，凡是这一部位发生的一切痈疽疔毒，都汇总在此部分中，以便于查阅和参考治疗。
《灵枢》说：甘疽发生在膺部，（膺，指胸廓两侧高起之处，也称为臆。）颜色发青，形状像谷粒或瓜蒂，患者常常感到恶寒发热。必须紧急治疗，以去除寒热症状；如果不及时治疗，十天内会死亡。死后脓液流出。
[图片：甘疽]
《医宗金鉴·心法要诀》说：这种疽生在乳上肉高耸的地方，属于肺经中府穴下方，无论左侧还是右侧，都是由忧思导致气机郁结而形成的。
申斗垣说：胸发，发生在玉堂穴、（穴位在紫宫穴下一寸六分，又名玉英穴。）膻中穴、（又名元儿穴，在玉堂穴下一寸六分，两乳之间。）中庭穴、（穴位在膻中穴下一寸六分。）鸠尾穴（穴位在蔽骨即剑突的末端，因其骨下垂如鸠鸟形状而得名臆，前蔽骨下五分处，如果人没有明显的蔽骨，则从歧骨交界处向下行一寸的位置。）等穴位，这些都是任脉的络脉，被称为“阴脉之海”，是人身子午经气的关键所在。应当尽早使用内托法，防止毒邪归于心经，损伤心包膜者会死亡。（出自《启玄》）
[图片：胸发]
汪省之说：中庭疽，位于乳房的中央，属于任脉的经脉。（出自《理例》）
薛立斋说：胸发发生在正胸堂位置，距离结喉三寸，离心窝不远，这里是手足六条经脉交会的地方，病情最为凶险，能丧人性命，应当迅速治疗。如果三四天失治，就会皮开肉裂，非常可怕。如果让疮疡长大，百人中救不活一个。适宜用牛黄、熊胆研成细末，用香油调匀涂抹在疮疡四周的边缘，以避免疮口溃烂开花。如果疼痛，可用乳香、没药研成粉末，铺在粗纸上，内外包裹，用青布片卷好，蘸取清油点燃，在疮疡四周照射，疼痛自然停止。内服清热护心、祛毒镇心的汤剂；如果疮疡溃烂穿孔，神仙也救不了。
Zitong San (Formula by Li Changshan.) is specifically applied externally to treat "Hand and Foot Back Carbuncle" (a severe infection on the back of hands or feet), with the effects of relieving pain and reducing swelling. Take fresh Foliium Firmianae (Wutong Ye) and mash it, or collect it in early autumn and dry it in the shade. Mix it with equal parts of Radix Violae (Zihua Diding), grind into a fine powder, and apply externally mixed with granulated sugar.
Hand Back Carbuncle (Secret Formula by Mr. Lv.)
Raw Radix Glycyrrhizae (Sheng Gancao), Roasted Radix Glycyrrhizae (Zhi Gancao), Bulbus Fritillariae Cirrhosae (Dabei Mu) (each 5 qian), Spina Gleditsiae Sinensis (Zaojiaoci) (stir-fried with soil), Squama Manis (Chuanshanjia) (stir-fried until black), Rhizoma Anemarrhenae (Zhimu) (each 2.5 qian), Rhizoma Pinelliae (Banxia) (1.5 qian).
Use Zingiberis Rhizoma (Ginger) as a guide, decoct together with wine and water. Take two doses for complete recovery.
Starting from the chest and hypochondrium, extending to the breasts, umbilical abdomen, and lateral costal region, all carbuncles, ulcers, and toxin sores occurring in this area are compiled here for easy reference and treatment consultation.
The *Ling Shu* states: Gan Ju (Sweet Ulcer) occurs on the Ying (chest sides), (Ying refers to the raised areas on both sides of the chest, also called Yi.) The color is bluish-green, and its shape resembles a grain seed or melon stalk. Patients often suffer from aversion to cold and fever. It must be treated urgently to eliminate the cold and heat symptoms; if not treated promptly, death will occur within ten days. Pus will discharge after death.
[Image: Gan Ju]
The *Xin Fa* states: This ulcer arises at the high fleshy part above the breast, located below the Zhongfu acupoint of the Lung Meridian. Regardless of whether it is on the left or right, it is caused by emotional sorrow and worry leading to Qi stagnation.
Shen Douyuan stated: Chest Fa (Chest Eruption) occurs at the Yutang acupoint, (located 1.6 cun below the Ziping acupoint, also known as the Yuying acupoint.), Danzhong acupoint, (also known as the Yuan'er acupoint, located 1.6 cun below the Yutang acupoint, between the two breasts.), Zhongting acupoint, (located 1.6 cun below the Danzhong acupoint.), and Jiwei acupoint (located at the tip of the xiphoid process, named Yi because the bone hangs down like a turtledove's shape; 0.5 cun below the anterior xiphoid process; if no distinct xiphoid process exists, measure 1 cun downward from the junction of the cartilaginous ribs.). These are all collaterals of the Ren Mai (Conception Vessel), known as the "Sea of Yin Meridians," representing the Zi-Wu axis of the human body. Early internal support therapy should be employed urgently to prevent toxic pathogens from entering the Heart, which damages the pericardium and leads to death. (From *Qi Xuan*)
[Image: Chest Fa]
Wang Shengzhi stated: Zhongting Ju (Zhongting Ulcer) is located in the center of the breast and belongs to the meridian of the Ren Mai. (From *Li Li*)
Xue Lizhai stated: Chest Fa occurs at the Zheng Xintang position, three cun away from the Laryngeal Prominence (Jiehou), close to the heart pit. This is where the six meridians of the hands and feet intersect. The condition is extremely fierce and can cause death; it requires rapid treatment. If treatment is delayed for three to four days, the skin will split and flesh will crack, which is very frightening. If allowed to grow larger, fewer than one in a hundred will survive. It is advisable to use powdered Niuhuang (Calculus Bovis) and Xiongdan (Ursi Bile) mixed with sesame oil, applied to the margins of the sore to prevent it from bursting open. For pain, use powdered Ruxiang (Olibanum) and Moyao (Myrrha), spread on coarse paper, wrapped inside and out, rolled in a piece of green cloth, dipped in clear oil, lit, and used to irradiate the surroundings of the wound, which will stop the pain. Internally, take decoctions that clear heat, protect the Heart, dispel toxins, and calm the spirit. If the sore bursts and perforates, even immortals cannot save the patient.