\r莲子蜂窝\p04-a41a164.bmp\r
王肯堂曰∶莲子发即太阴疽，生肩胛内，痛渐至溃烂，属手太阴肺经积热所致。
赤色者可治，青黑者不治，喘嗽大渴，胸满脉微者死。（《准绳》）
又曰∶蜂窝发状如蜂房，十日平塌，寒热痛楚。
《鬼遗方》云∶蜂窝疽发髀背，起心俞及心包络俞，若肩 ，二十日不穴死，十
日可刺。其色赤黑脓清者，可治。
陈实功曰∶莲子蜂窝二发，此言其形似而名之也。多生于背，与心相近，与脊
中平；轻者形长高肿，或偏半背，重则形
斜平塌，两胁俱伤，孔似蜂窝，突如莲子。形虽可畏，常能多险多生，羸弱不堪，反
取常安常稳，大规只怕不纯阳，治法何妨疮势急，治宜护心护膜，谨防毒瓦斯内攻。（《正宗》）
汪省之曰∶蜂窝者，言其头有五七十不止；莲子者，头不过一二十。通背肿者不救。（《理例》）
又曰∶疮头向上发者名曰反，证最凶；疮头向下发者稍顺；如无脓痰发及串流于
肩膊者不治，穿膜者不治。又有两头开发者更凶。（《理例》）
\r两头尖\p04-a41a165.bmp\r
申斗垣曰∶两头尖，又名满天星，乃饮食辛热，蕴酿郁积毒壅所致。气虚相冲，
因虚成毒，故此证形口开而阔，上可至肩，下可至腰，此千无一有之证，治与痈疽同法。（《启玄》）
王肯堂曰∶两头发又名满天星，又名广锦背发。两头小，四边散，因积怒蓄热
所致。肿高红阔者生，低陷黑暗者死。（《准绳》）
【莲子蜂窝发】
王肯堂说：莲子发就是太阴疽，生长在肩胛骨内侧，疼痛逐渐发展到溃烂，属于手太阴肺经积热所致。
颜色赤红的可以治疗，颜色青黑的无法治疗，出现气喘咳嗽、极度口渴、胸部胀满、脉象微弱的会死亡。（《医学准绳六要》）
他又说：蜂窝发的形状像蜂房，十天后变得平塌，伴有寒战发热和剧烈疼痛。
《鬼遗方》记载：蜂窝疽发生在髀部和背部，起始于心俞穴及心包络俞穴，如果波及肩部，二十天不化脓破溃就会死亡，十天时可以针刺排脓。如果颜色赤黑但脓液清澈的，可以治疗。
陈实功说：莲子和蜂窝两种发，是说它们形状相似而得名。多生长在背部，位置靠近心脏，与脊柱中部持平；轻症表现为形体长而高肿，或者偏向背部一侧；重症则形体斜向平塌，两侧胁肋都受伤害，孔洞像蜂窝，突起像莲子。虽然形态看起来可怕，但往往能经历多次危险而存活；身体羸弱的人反而能保持平安稳定，大的规律只怕不是纯阳证，治疗方法不妨碍疮势急迫，治疗应当保护心脏和保护胸膜，谨防毒气内攻入里。（《外科正宗》）
汪省之说：蜂窝发，是说它的疮头有五十到七十多个不止；莲子发，疮头不过一二十个。贯通整个背部的肿胀无法救治。（《疡医理例》）
他又说：疮头向上生长的叫做“反”，证候最凶险；疮头向下生长的稍微顺遂；如果没有脓痰排出且病灶蔓延流窜到肩膀手臂的无法治疗，穿透胸膜的无法治疗。又有两头同时发展的更加凶险。（《疡医理例》）
【两头尖疽】
申斗垣说：两头尖，又名满天星，是由于饮食辛辣燥热，蕴酿郁积毒邪壅滞所致。气虚受到冲击，因虚而成毒，所以这个证候疮口开张而宽阔，上可延伸至肩部，下可延伸至腰部，这是千中无一的证候，治疗方法与痈疽相同。（《疮疡经验全书》）
王肯堂说：两头发又名满天星，又名广锦背发。两头小，四边散开，是因为积怒蓄热所致。肿胀高耸、红色宽阔的预后良好（生），低陷黑暗的死。（《医学准绳六要》）
[Lotus Seed and Honeycomb Carbuncle]
Wang Kentang stated: Lotus seed carbuncle is the same as Taiyin abscess (Taiyin Ju, an abscess affecting the Taiyin meridians), occurring on the medial side of the scapula. The pain gradually progresses to ulceration. It is caused by accumulated heat in the Hand-Taiyin Lung Meridian (Shou Taiyin Fei Jing).
Cases with a red color are treatable; those with a cyan or black color are untreatable. Death occurs if there is wheezing and coughing, extreme thirst, chest fullness, and a faint pulse. (*Yixue Zhunsheng*)
He further stated: Honeycomb carbuncle resembles a honeycomb. After ten days, it becomes flat and sunken, accompanied by alternating chills and fever, and severe pain.
*Guiyi Fang* records: Honeycomb abscess occurs on the thigh and back, originating from Xinshu (BL15) and Xinbaoluo Shu (pericardium shu points). If it spreads to the shoulder, death ensues if no pus forms within twenty days; puncture is feasible within ten days. Cases with a cyan-black color but clear pus are treatable.
Chen Shigong stated: "Lotus seed" and "honeycomb" refer to two types of carbuncles named for their similar shapes. They mostly occur on the back, near the heart and level with the middle of the spine. In mild cases, the shape is elongated and highly swollen, or located on one side of the back. In severe cases, the shape slants and flattens, injuring both hypochondria. The pores resemble a honeycomb, and protrusions look like lotus seeds. Although the appearance is terrifying, patients often survive despite multiple dangers; those who are emaciated and weak may反而 achieve stability and safety. The primary concern is whether it is not a pure Yang syndrome. Treatment methods should not be hindered by the urgency of the lesion. Therapy should focus on protecting the Heart and protecting the membranes, carefully preventing toxic qi from attacking inward. (*Waike Zhengzong*)
Wang Shengzhi stated: Regarding "honeycomb," it refers to having more than fifty to seventy head(s); regarding "lotus seed," there are only ten to twenty heads. Swelling that penetrates the entire back is incurable. (*Yangyi Lili*)
He further stated: Lesions where the head grows upward are called "Fan" (Reversal), which is the most ferocious syndrome; lesions where the head grows downward are slightly more favorable. If there is no pus or phlegm discharge, and the infection spreads to the shoulders and arms, it is incurable. Penetration of the membrane is also incurable. Furthermore, development at both ends simultaneously is even more ferocious. (*Yangyi Lili*)
[Two-Ended Sharp Abscess]
Shen Douyuan stated: Two-ended sharp abscess, also known as "Man Tian Xing" (Stars Filling the Sky), is caused by dietary intake of spicy and hot foods, leading to accumulation, stagnation, and toxin obstruction. Qi deficiency leads to conflict, and toxicity arises from deficiency. Thus, this syndrome presents with an open and wide wound mouth, extending upwards to the shoulder and downwards to the waist. This is a rare condition, occurring once in a thousand times. Its treatment follows the same principles as general carbuncles and sores. (*Chuangyang Jingyan Quanshu*)
Wang Kentang stated: Liangtou Fa (Two-headed hair/abscess) is also known as Man Tian Xing or Guangjin Back Carbuncle. The two ends are small, while the four sides spread out. It is caused by accumulated anger and stored heat. Cases with high swelling, redness, and broadness indicate survival; those with low sinking, darkness, and blackness indicate death. (*Yixue Zhunsheng*)