王肯堂曰∶特疽发肺俞及肝俞。不穴二十日死，八日可刺，其色红赤，内隐起如椒子者死。（《准绳》）
王肯堂曰∶阴阳二气疽，广阔满背，或大或小，不常肿热胀大。十日可刺，导引
出脓，不拘深浅多少，发渴体倦。十日外不见脓不治。（《准绳》）
王肯堂曰∶黄瓜疽，一名肉龟，生背侧，高二寸，长尺许，状如黄瓜，肉色不
变，疼痛引心，四肢麻木是也。此证多不可治。（《准绳》）
王肯堂曰∶丹毒发疽，背上细瘰无数，浸淫一二尺，如汤火伤，烦躁多渴，因服
丹石刚剂所致。红润者生，紫黯者死，恶证少者，黄连消毒散、国老膏；恶证多，神昏脉躁，膨胀呕哕者死。（《准绳）。）
王肯堂曰∶酒毒发背当心而痛，麻木不常，累累如弹如拳，坚硬如石，痛彻五
内，遍身拘急，由饥饱劳伤，炙 浓味所致。神昏脉乱，大渴狂言，有妨饮食者死。
二便闭结者死。有因寒变而内陷者，用托里温中汤。（《准绳》）
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王肯堂曰∶肩后疽，又名鼠疽，即上搭也。生肩膊后骨上，乃怒气积郁所致。属
太阳兼少阳经，宜灸。（《准绳》）
汪省之曰∶凡辨手搭、腰搭、发背三证，务令患者以手搭肩上，搭着者左为左
搭，右为右搭，头多如蜂窠者易治。向下手搭着者，谓之腰搭。惟两手上下俱搭不着者，谓之发背。（《理例》）
陈实功曰∶肩下脊上痈疽者，乃脾经蕴积膏粱热毒所致。肿形根脚不过两肩者
为顺；如肿平坚硬，渐大渐开，攻注两肩胸项，肿而不定者危。（《正宗》）
《心法》曰∶上搭手生于脊骨第三节旁。中搭手生于脊骨第四节旁开三寸膏肓穴，
名青龙疽。下搭手生脊骨第十四节腰窝内，旁开三寸肓门穴。
王肯堂说：特疽发生在肺俞穴和肝俞穴。如果不进行针刺，二十天会死亡；如果在第八天可以针刺，若疮色红赤，内部隆起像花椒粒一样的，预后不良（主死）。（出自《医学准绳六要》）
王肯堂说：阴阳二气疽，范围广阔布满背部，疮疡大小不一，肿胀热势不恒定。第十天可以进行针刺，通过导引法排出脓液，不论深浅和脓量多少。患者出现口渴、身体疲倦的症状。如果十天之后看不到脓液排出，则难以治愈。（出自《医学准绳六要》）
王肯堂说：黄瓜疽，又名肉龟，生长在背部侧面，高约两寸，长约一尺左右，形状像黄瓜，肤色没有变化，疼痛牵引至心脏部位，伴有四肢麻木。这种病症大多不可治愈。（出自《医学准绳六要》）
王肯堂说：丹毒发疽，背上出现无数细小的结节，蔓延一二尺，如同汤火烫伤一样，伴有烦躁、多渴的症状，这是由于服用丹石类刚烈药物所致。疮面红润的预后良好（主生），紫暗色的预后不良（主死）。邪气较轻的，使用黄连消毒散、国老膏治疗；邪气重重的，出现神志昏迷、脉象躁动、腹部膨胀、呕吐呃逆的，预后不良（主死）。（出自《医学准绳六要》）
王肯堂说：酒毒发背，疼痛位于心口窝处，麻木感不固定，肿块累累如弹丸或拳头大小，坚硬如石头，疼痛深入五脏，全身拘急痉挛，这是由于饥饱失常、劳力损伤以及食用炙烤厚味食物所致。出现神志昏迷、脉象紊乱、极度口渴、胡言乱语、影响饮食的，预后不良（主死）。大小便闭塞不通的，预后不良（主死）。如果有因寒邪变异导致毒邪内陷的情况，使用托里温中汤治疗。（出自《医学准绳六要》）
上搭疽 [图片]
王肯堂说：肩后疽，又名鼠疽，也就是上搭疽。生长在肩胛骨后面的骨骼上，是由怒气积郁所致。病属太阳经兼少阳经，适宜采用艾灸疗法。（出自《医学准绳六要》）
汪省之说：凡是辨别手搭疽、腰搭疽、发背疽这三种病症，务必让患者用手搭在肩上，搭到的位置，左边为左搭疽，右边为右搭疽，头部有多个孔洞如蜂巢状的容易治疗。向下延伸至手部搭到的位置，称为腰搭疽。只有双手上下都搭不到的位置，称为发背疽。（出自《外科理例》）
陈实功说：肩下脊上的痈疽，是脾经蕴积了膏粱厚味的热毒所致。肿胀形态根部不超过双肩范围的属于顺证；如果肿势平坦坚硬，逐渐扩大开放，攻注到双肩胸项部位，肿势不定者危重。（出自《外科正宗》）
《医宗金鉴·外科心法要诀》说：上搭手生于脊柱第三节旁边。中搭手生于脊柱第四节旁开三寸的膏肓穴，名为青龙疽。下搭手生于脊柱第十四节腰窝内，旁开三寸的肓门穴。
Wang Kentang stated: Te ju (Special Carbuncle) occurs at Feishu (BL13, Lung Shu) and Ganshu (BL18, Liver Shu). If not punctured with a needle, death will occur within twenty days; if it can be punctured on the eighth day, but the color is red and dark with internal elevations resembling pepper seeds, death is indicated. (From *Yixue Zhunsheng*)
Wang Kentang stated: Yin-Yang Qi Ju (Carbuncle of Yin and Yang Qi) covers a broad area of the back, varying in size, with fluctuating swelling and heat. It can be punctured on the tenth day to guide out pus, regardless of depth or quantity. The patient presents with thirst and fatigue. If no pus appears after ten days, it is difficult to treat. (From *Yixue Zhunsheng*)
Wang Kentang stated: Huanggua Ju (Cucumber Carbuncle), also known as Rougui (Flesh Turtle), arises on the lateral side of the back. It is approximately two cun high and one chi long, resembling a cucumber, with unchanged skin color. Pain radiates to the heart, accompanied by numbness in the four limbs. This condition is mostly incurable. (From *Yixue Zhunsheng*)
Wang Kentang stated: Dandu Fabai (Carbuncle caused by Dan Du/Red Toxicity) presents with countless small nodules on the back, spreading over one or two chi, resembling burns from boiling water or fire. Symptoms include irritability and excessive thirst, caused by taking rigid/mineral drugs (Dan Shi). If the lesion is red and lustrous, survival is indicated; if purple and dark, death is indicated. For mild cases, Huanglian Xiaodu San (Coptis Decoction for Disinfecting Toxins) and Guolao Gao (Honeydew Melon Paste) are used; for severe cases with coma, restless pulse, abdominal distension, vomiting, and hiccupping, death is indicated. (From *Yixue Zhunsheng*)
Wang Kentang stated: Jiudu Fabai (Back Carbuncle caused by Alcohol Toxicity) causes pain in the epigastric region, with intermittent numbness. Lumps accumulate like bullets or fists, hard as stone, with pain penetrating the five zang organs, and general stiffness/spasms of the body. This results from irregular eating/drinking, labor injury, and consumption of roasted rich foods. If coma, chaotic pulse, extreme thirst, delirious speech, and inability to eat occur, death is indicated. If urination and defecation are blocked, death is indicated. If cold transformation leads to internal sinking of toxicity, Tuoli Wenzhong Tang (Decoction for Supporting Interior and Warming the Middle) should be used. (From *Yixue Zhunsheng*)
Shangda Ju (Upper Reaching Carbuncle) [Image]
Wang Kentang stated: Jianhou Ju (Carbuncle behind the Shoulder), also known as Shuju (Mouse Carbuncle), is also called Shangda Ju. It arises on the bone behind the shoulder blade, caused by accumulated anger and depression. It belongs to the Taiyang (Greater Yang) channel combined with Shaoyang (Lesser Yang) channel, and moxibustion is appropriate. (From *Yixue Zhunsheng*)
Wang Shengzhi stated: When distinguishing between Shou Da Ju (Hand-Reaching Carbuncle), Yao Da Ju (Waist-Reaching Carbuncle), and Fabai Ju (Back-Opening Carbuncle), the patient must place their hand on their shoulder. If it touches the left side, it is Left Shou Da Ju; if the right, Right Shou Da Ju. Those with multiple openings like a bee hive are easy to treat. If it extends downward to where the hand reaches, it is called Yao Da Ju. If neither hand can reach when placed up or down, it is called Fabai Ju. (From *Waike Lili*)
Chen Shigong stated: Carbuncles and sores below the shoulders and on the spine are caused by heat-toxin accumulation in the Spleen channel due to rich food. If the swelling's base does not exceed both shoulders, it is a favorable sign (Shun); if the swelling is flat and hard, gradually expanding and attacking both shoulders, chest, and neck, with unstable swelling, it is critical. (From *Waike Zhengzong*)
*Xinfa* (Essentials of Medical Methods) states: Shangdashou (Upper Hand-Reaching Carbuncle) arises beside the third thoracic vertebra. Zhongdashou (Middle Hand-Reaching Carbuncle) arises three cun lateral to the fourth thoracic vertebra at the Gaohuang (BL43, Bladder 43) acupoint, named Qinglong Ju (Azure Dragon Carbuncle). Xiashashou (Lower Hand-Reaching Carbuncle) arises in the waist hollow at the fourteenth thoracic vertebra, three cun lateral at the Mangmen (BL52, Bladder 52) acupoint.