王肯堂曰∶过肩疽，又名筋疽，生肩后夹脊两边，肿硬痛疼，寒热似疟。但初起无头，急用灸法。
《鬼遗方》云∶筋疽发夹脊两边大筋上，其色苍。八日可刺，有痈在肥肠中，九十日死。
《心法》曰∶过肩疽生在肩后廉，左右皆同。总由湿热风邪遏郁而成；亦有负重瘀血凝结而成。
申斗垣曰∶肩井毒，又名气痈，其穴在肩上骨胶动处陷中是也。乃怒气相干，气
血凝滞而成。初起必用铁箍散围住根脚，否则毒流肩脊，不可治矣。（《启玄》）
申斗垣曰∶此乃肩挑负重，压伤肩头，气血凝滞而成；或因枕卧冷处，致令隧道
不通，蓄血而成。破则流脓出血，此外因也。治当早灸，始能消散。（《启玄》）
又有匾担因妇女在上跨过，即害担肩。
验方 剪猫头上毛用，不语唾粘之。
王肯堂曰∶上中下三发背俱在脊中，属
督脉。上发者，伤于肺，发于天柱骨下；中发者，伤于肝，为对心发；下发者，伤于
肾，为对脐发。皆由积热怒气所致。初如粟米，或麻或痒，或拘急，或不痛，或大
痛。初觉便宜隔蒜灸之，或汗、或下、或托，量其虚实施治。（《准绳》）
又曰∶脑发背发在上者，不可用木通，恐导虚下元故也，老弱者尤宜戒。然三发
背总要之地，与他处不同，尤所当谨，微有痛痒，宜速治之。
《鬼遗方》云∶人生最可忧者，发背也。其种有五∶一曰∶阳毒发背，因风而有。或
患热毒消渴，或先患伤寒，余有阳毒未解，蓄积起于背脊膂之间，不问椎数，但从两
夹脊起止，腰上满背 肿，热如炊之状，赤紫或红如焰，脓毒难成，成后不止，止后
痛不除，蓦忽数日之间，复平如旧，将谓肿消，此是内攻肉陷，不可疗矣。二曰∶阴
毒发背，是气冷而作。初如黍米粒起，情绪不快， 而痛，直应前心，心内忪怔，
头目昏重，寒热如疟；五七日后始发引攻肿，开阔难收，内积有脓，深沉迟缓未透。
宜急以补气汤药内托，外以抽脓药贴之。宜急见脓，无脓即平愈无期。三曰∶有人多
服金石烧炼之药，毒恶流滞成发背者。初起如丹疹之状， 渐开如汤火，疮面色
如朱，心膈烦躁，多渴嗜冷，其疮难起，起即惊人，犹胜于阴阳两毒者，缘此有解金
石药毒汤散治其内也，赖有根底分明，亦须急疗方安。四曰∶人有患酒食毒发背者。
此疾非近得之，乃脏腑久积，乘饥乘困，食之便睡，或多食酒肉，冷热粘滞，肥鲜炽
腻，未下胸膈，房室不禁，恣意当风取快，脾脏气虚不能受乘，发毒攻背两夹脊，不
问椎数。初起痈头如小弹子，后大如拳，坚如石，痛遍四肢，加之拘急口苦，舌干腹
急，大小便涩，十数日后头面手足虚肿，及脏腑通泄如利，内急痛者，是其证也。乘
方肿引，急用攻肿发穴溃脓汤药，内实外泄脓水，不可放纵，迟缓则皮肉腐坏，伤
骨烂筋，渐成脓多，因而感邪内败者死矣。五曰∶人有冒山岚瘴气发背，毒瓦斯先在脏
腑，年月浸远，气血虚损衰弱。初起肿色青黑如靴皮，顽痹痛深，附筋骨彻髓，按
之如木石，引手加深，方觉似有痛处，至五七日，毒瓦斯浮浅肿高，色变青白，有如
拳打之状，寒战似疟，及有风候，头动口偏，手足厥逆，眼黑睛小白多而慢。此内
有邪气相搏，急破出清血三五升，有黄脓白汁相和发泄，其皮不宽，不慢亦急，胀
痛亦不住，直至色退，热痛方愈，亦宜急追赶脓与毒瓦斯外出，无害。初患肿三日内
灸者生。八日内脓成针烙导引者生。未瘥慎劳力者生。慎忌食者生。慎喜怒者生。惧
肿猛疗者生。急疗者生，不讳发背者生。待脓自出，不导引者死。未内攻而针烙用药
导引者生。内攻后导引针烙者死。肿 热痛方盛已前疗者生。如过此后已内攻者死。
脓成后不出不导引，但敷药者死。如赤白痢气急者，是已内攻，医疗无益，必死。痈
不救十得五生。疽不疗十全死。轻肿怕痛者必死。不遇良方者死。节候不根据法者必死。愚执恣意用性逸情者死。
王肯堂曰∶有发背痈，有发背疽，如毒瓦斯勇猛而发，如火燎茅，易于败坏。初
起如黍米粒大，两三日渐赤引肿如手掌面大，五七日如碗面大，即易为攻， 热赤
引如火烧之状，浮面渐溃烂阔开，内发肿如炊之状，外烂皮肉如削去，紫瘀脓汁多
而肿不退，疼亦不止，发渴发逆，饮食不下，呕吐气急，浮浅开阔者，尤宜发脓托
毒汤药服之，必愈。（阳证，实也。）其间有只如盏面大者，此非不大，缘为毒瓦斯深沉，内
虚毒瓦斯近膜也。此必内攻，近入脏腑，却外入四肢，先攻头面虚浮，后攻手面，次
攻两足面肿，名曰毒瓦斯散入四肢，其人声嘶气脱，眼睛黑小，十指肿黑干焦不治。（阴
证，虚也。）始发一粒如麻豆大，身体便发热，生疽处肿大热痛，此为发于外，虽大如盆，
治之百可百活。（阳证，实也。）或身体不热，自
觉倦怠，生疽处亦不热，数日后渐大，不肿不痛，低陷而坏烂，此为发于内，虽神仙无如之何。（《准绳》）
陈远公曰∶背心间先发红瘰，后渐红肿，此发背之兆也，最为可畏。古人云∶外
大如豆∶内大如拳，外大如拳，内大如盘，言外小而内实大也。然痈疽大毒，必辨其
阴阳。有先阴变阳者，有先阳变阴者，有前后俱阳者，有前后俱阴者。阳证虽重而
实轻，阴证虽轻而实重，先阴变阳者生，先阳变阴者死，何以知之？阳证形高硕而肿
起，阴证形底平而陷下，阳证色红，阴证色带黑，阳证初起必痛，阴证初起必痒，阳
证溃烂多脓，阴证溃烂多血，阳证收口身必轻爽，阴证收口身必沉重，至于辨阴辨
阳，以此消息，必不差也。凡红肿高突，乃阳证也。乘其肉肿初发，肉犹未化，急以
散毒之药治之，可随手愈也。发背至横决者，皆因循失治，以至破败而不可救，阳
变阴者多矣。救痈如救火，宜速扑灭，否则延烧屋舍，不尽不止，切勿见为阳证，轻
缓治也。急消汤∶金银花二两，紫花地丁一两，茜草、甘菊花、桔梗、天花粉、生
甘草各三钱，贝母二钱，黄柏一钱。水煎服，三剂全消，不四剂也。（《冰鉴》。此方消阳毒
初起极神，既无迅烈之患，大有和解之妙，人不知法则，谓阳毒易于祛除，浪用虎野狼之味，毒虽消散而真气耗损，
往往变成他证，乃医者成之也，何若王霸并施，有益无损为妙。）
又曰∶背心发瘰痒甚，已而背如山重，隐隐发红晕如盘大。此阴痈初起之形，最
为可畏，非前证可比，乃一生罪孽，鬼祟凭身，必胡言谵语，将平日欺心之事，尽
情宣布，此证本不可救，然人心善恶，成于一念，苟能悔艾而刀圭无术，亦见吾道
之无奇矣。夫阳证有救之条，阴证岂无可生之理，惟在治之得法耳。阴证虽成于鬼
祟之缠，亦必正气大虚，邪得入之也。故治法必用补气血之药，佐以散郁解毒之品，
则正旺邪自散矣。变阳汤∶人参、黄 各
二两，金银花八两，白芍一两，天花粉、生甘草各五钱，荆芥炒黑三钱，柴胡二钱，附
子一钱。水十余碗，煎汁二碗，先服一半，后又服一碗，阴必变阳而作痛，又一剂痛
消，再一剂痊愈。（世人不见皮破血出，断不可信，然先用此方以治发背，无论病患不肯服，即医士亦不肯
用，往往决裂溃烂，疮口至如碗大而不可收，始悔参 之迟用矣。所以论证而多戒辞，劝人早服此方，以免丧
命。盖阳毒可用攻毒，阴毒必须补正，以参 补气，气旺则幽阴之毒不敢入心肺之间，金银花性补，善解阴毒，
得参 而功益大，然非附子不能直入阴毒之中，而又出于阴毒之外，毒深者害深，又加生甘草以解余毒，然毒
结于背者，气血之壅也，壅极者郁之极也，故加柴、荆、粉、芍消痰通滞，开郁引经，自然气宣血活，痰散毒消也。）
又曰∶背痈溃烂，洞见肺腑，疮口黑陷，身不能卧，口渴思饮，人以为阳证败
坏，孰知阴虚不能变阳乎！夫痈虽有阴阳之分，及至溃脓之后，宜补内而不宜消，则
阴阳之证一也。溃烂而见肺腑，足见失补之故，使毒过于延烧，将好肉化为瘀肉耳。
肉瘀必腐，腐则洞见底里，此证九死一生之兆，倘胃气健，能食者，犹可治，若见
食则恶者，必无生理，然能受参 峻补者，尚可生也。转败汤∶人参、熟地各二两，生
黄、当归、山萸各一两，白术、金银花各四两，麦冬二两，远志三钱，肉桂、茯
苓各二钱，北五味一钱。水煎，一服胃气大开者，即可转败为吉，倘服后少能健饭，
亦在可救，若杳无应验者，胃气将绝无救矣。（此方补气血，更补肺肾之阴，盖阴生则阳长，阴阳
生长则有根，易于接续，后以银花解余毒，则毒散而血生，血生而肉长，肉长而皮合，倘以解毒为事，不补气
血之阴阳，则阴毒不能变阳，有死而已矣，不亦悲哉！倘服之而饱闷，少顷渐安者，尚有生机，不可弃置。）
又曰∶背痈将愈，疮口不收，治无一效，人以为余毒未尽也，孰知阴虚不能济
阳乎！夫痈疽初起则毒盛，变脓则毒衰，脓尽则毒化矣。疮口不收，乃阴之虚，非毒
之旺，人不知治法，以败毒攻之，是重虚其虚，欲肌肉之长，得乎，或亦有补而不
效者，必系只用阳分之品以补阳，不用阴
分之品以补阴也。盖独阴不长，独阳不生，今脓血已尽，阴必大虚，只补阳则阳旺阴
虚，阴不能交于阳矣。虽阳有济阴之心，而阴无济阳之力，所以补阳而阴愈虚，疮口
愈难合也。治必大补其阴，使阴精盛满，自能灌注疮口，不必生肌外敷，疮口之肉自
生矣。生肤散∶麦冬、山萸、银花、当归各一两，熟地二两，人参、白术各五钱，肉
桂一钱。水煎二服，肉自内长，又二服外口自平，又二剂痊愈。（此方补阴多于补阳，使阴
胜于阳也。然补阳之药，仍是补阴之助，以其能入阴中交于阳内也，银花非恃以解余毒，取其能领各味至疮口之间也。）
又曰∶背疮长肉，疮口已平，忽开裂流红，人以为疮口肉未坚也，孰知色欲恼
怒不谨乎！夫痈证最忌色欲，次忌恼怒，犯恼怒，新肉有开裂之虞，犯色欲，新肉有
流水之害，然此犹些小疮痈也。其在背痈，犯恼怒者，不过疾病，犯色欲者，多致死
亡，疮口开裂之处，色必变紫黑，流血之处，肉必变败坏矣。此时必急补气血，切
不可仍治其毒，盖前毒未尽，必难收口，复至败坏，实新肉不坚而自决裂也。况发背
新愈，其精神气血空虚，交合泄精，遂变出非常，舍补气血，又安求活乎！然补气
血，必用大剂方能收危乱之功也。定变回生汤∶人参四两，黄 三两，当归、麦冬、
白术、银花各二两，茯苓一两，山萸五钱，肉桂三钱，北五味二钱。水煎，二服肉自
生矣，三剂皮仍合矣，平复如故。再犯禁忌，无不死矣，此方难救。（此方救疮疡坏证仙丹，
不止治发背愈后犯色败腐也，人疑泄精以至决裂，宜熟地大补之，何故不用，因熟地补阴最缓，而证犯甚急，所
以不用熟地，多用气血之药救其垂危，非熟地不可用，轻弃之也，此方数剂之后，正宜减半而多加熟地，以为善后计耳。）
又曰∶夏日生背痈，疮口不起，脉大无力，发热作渴，自汗盗汗，用参 补剂，
益加手足逆冷，大便不实，喘促呕吐，人以为火毒太盛也，谁知元气大虚，补不足
以济之乎！夫痈分阴阳，疮口不起乃阴证
也，脉大似乎阳证，大而无力，非阴而何！发热作渴，此水不足以济火，故作渴作热
也。即阴证似阳，用参、 助阳，足以祛阴而返阳矣。何以愈补，反作逆冷呕吐，此
阴寒之气甚，而微阳之品力不能胜耳，非加附子之辛热，何能斩关以祛荡阴邪哉！助
阳消毒汤∶人参八两，黄 一斤，当归、白术各四两，陈皮一两，附子五钱。水煎膏，
二次服，诸证退，服数剂疮起，乃减半，又服数剂而愈。（此非治痈之法也。然以治痈之法轻剂
治此，鲜不立亡，可见治痈不可执也。大约阳痈可用消毒化痰，而阴痈切不可用消毒化痰之药，今舍痈从证，乃
治痈变法，医者不可不知也。）
又曰∶背生痈疽，溃脓之后，或发热，或恶寒，或作痛，或脓多，或流清水，自
汗盗汗，脓成不溃，口烂不收，人以为毒瓦斯未尽也，谁知五脏亏损，血气大虚之故
也。凡人气血壮盛，阴阳和平，何能生毒？惟脏腑内损，而毒瓦斯得以内藏，久之外泄，
及至痈疽发出，其毒自不留内，脏腑原虚，又加流脓血则已虚益虚，观其外面疮口未
敛，似乎有余，审其内而气血未生，实为不足，法当全补，不必偏补一脏，致有偏
胜之虞，用十全大补汤为妙，以其兼补气血耳，然有不效者，非方之不佳，乃用之
不得法也。夫背痈何等之证，岂细小之剂所能补哉！必大剂始克有济，余酌一方∶人
参、当归各一两，黄 、熟地各二两，白芍、白术、茯苓各五钱，川芎、生甘草各
三钱，肉桂二钱，水煎服。一剂有一剂之效也。（人以此方绝不败毒，如何毒化肉生，不知痈疽
王肯堂说：过肩疽，又名筋疽，生于肩后脊柱两侧，局部肿胀坚硬、疼痛，伴有寒战高热，症状类似疟疾。但初起时没有脓头，必须紧急使用灸法治疗。
《鬼遗方》记载：筋疽发于脊柱两侧的大筋上，患处颜色发青。发病八天可以刺破排脓，如果痈肿发生在肥肠（指腹腔内深层组织）中，九十日后会死亡。
《心法》指出：过肩疽生于肩后边缘，左右两侧情况相同。总归是由湿热和风邪郁结而成；也有因负重导致瘀血凝结而形成的。
申斗垣说：肩井毒，又名气痈，其穴位位于肩上骨骼连接处活动的凹陷中。这是由于怒气相冲，导致气血凝滞而形成的。初起时必须用铁箍散围住病灶根部，否则毒气流窜至肩脊，就无法治愈了。（出自《启玄》）
申斗垣又说：这是因为肩挑重物，压伤肩头，导致气血凝滞而形成；或者因为睡在寒冷地方，致使经络不通，蓄积瘀血而成。破溃后会流出脓血，这是外因所致。治疗应当尽早施灸，才能消散。（出自《启玄》）还有扁担压伤妇女跨步时压到肩膀的情况。
验方：剪取猫头上的毛，用唾液粘附敷于患处。
王肯堂说：上发背、中发背、下发背都位于脊柱正中，属于督脉。上发背，损伤肺经，发于天柱骨下方；中发背，损伤肝经，称为对心发；下发背，损伤肾经，称为对脐发。这都是由积热和怒气所致。初起时像粟米大小，或者像麻子一样，或者瘙痒，或者拘急，或者不痛，或者剧痛。刚感觉不适时最好隔蒜灸，根据患者虚实情况，采用发汗、攻下或托毒的方法治疗。（出自《准绳》）
王肯堂又说：脑发和上发背，不可使用木通，恐怕会引导虚火下行损伤下元，年老体弱者尤其应该禁忌。然而三发背是总要之地，与其他部位不同，尤其应当谨慎，只要有轻微痛痒，就应迅速治疗。
《鬼遗方》说：人生中最令人担忧的病症，就是发背。其种类有五种：一是阳毒发背，因风邪引发。或者患有热毒消渴症，或者先患伤寒，其余阳毒未解，蓄积在背脊肌肉之间，不论椎骨数量，仅从两夹脊起止，腰部以上背部肿胀，发热如炊煮状，颜色赤紫或红如火焰，脓毒难成，即使形成也不停止，停止后疼痛不除，忽然几天之间，又平复如初，以为消肿了，这其实是内攻肉陷，无法治愈了。二是阴毒发背，是气冷所致。初起如黍米粒大小，情绪不快，疼痛，直应前心，心中悸动怔忡，头目昏重，寒热如疟；五七日后才开始发作并引起肿胀，开阔难以收敛，内部积聚有脓，深沉迟缓未透发。应当紧急用补气汤药内托，外部用抽脓药贴敷。应当尽快见脓，无脓则平愈无期。三是有人长期服用金石烧炼的药物，毒恶流滞形成发背者。初起如丹疹状，逐渐扩大如汤火烫伤，疮面色如朱砂，心膈烦躁，多口渴喜冷饮，其疮难起，一旦起来就惊人，比阴阳两毒更严重，原因在于此病有解毒金石药的汤散在内调理，赖有根基分明，也必须紧急治疗才能安宁。四是有人患酒食毒发背者。此疾不是近期得的，而是脏腑久积毒素，乘饥饿困倦之时，吃了就睡，或多食酒肉，冷热粘腻，肥鲜炽腻，未消化于胸膈，房事不节制，肆意当风取快，脾脏气虚不能承受，发毒攻向背两夹脊，不论椎骨数量。初起痈头如小弹丸，后来大如拳头，坚硬如石，疼痛遍及四肢，加上拘急口苦，舌干腹急，大小便涩滞，十数日后头面手足虚肿，以及脏腑通泄如痢疾，内部急痛，这就是证候。趁肿胀牵引时，紧急用攻肿发穴溃脓汤药，使内实外泄脓水，不可放纵，迟缓则皮肉腐坏，伤骨烂筋，逐渐脓多，因而感邪内败者死。五是有人冒山岚瘴气发背，毒瓦斯先在脏腑，年月浸远，气血虚损衰弱。初起肿色青黑如靴皮，顽痹痛深，附筋骨彻髓，按之如木石，引手加深，才觉得似有痛处，至五七日，毒瓦斯浮浅肿高，色变青白，有如拳打之状，寒战如疟，及有风候，头动口偏，手足厥逆，眼黑睛小白多而慢。这是内有邪气相搏，紧急破出清血三五升，有黄脓白汁相和发泄，其皮不宽，不慢亦急，胀痛亦不住，直至色退，热痛方愈，也应当紧急追赶脓与毒瓦斯外出，无害。初患肿三日内灸者生。八日内脓成针烙导引者生。未痊愈慎劳力者生。慎忌食者生。慎喜怒者生。惧肿猛疗者生。急疗者生，不讳发背者生。待脓自出，不导引者死。未内攻而针烙用药导引者生。内攻后导引针烙者死。肿热痛方盛已前疗者生。如过此后已内攻者死。脓成后不出不导引，但敷药者死。如赤白痢气急者，是已内攻，医疗无益，必死。痈不救十得五生。疽不疗十全死。轻肿怕痛者必死。不遇良方者死。节候不根据法者必死。愚执恣意用性逸情者死。
王肯堂说：有发背痈，有发背疽，如毒瓦斯勇猛而发，如火燎茅草，易于败坏。初起如黍米粒大，两三日渐赤引肿如手掌面大，五七日如碗面大，即易为攻，热赤引如火烧之状，浮面渐溃烂阔开，内发肿如炊之状，外烂皮肉如削去，紫瘀脓汁多而肿不退，疼亦不止，发渴发逆，饮食不下，呕吐气急，浮浅开阔者，尤宜发脓托毒汤药服之，必愈。（阳证，实也。）其间有只如盏面大者，此非不大，缘为毒瓦斯深沉，内虚毒瓦斯近膜也。此必内攻，近入脏腑，却外入四肢，先攻头面虚浮，后攻手面，次攻两足面肿，名曰毒瓦斯散入四肢，其人声嘶气脱，眼睛黑小，十指肿黑干焦不治。（阴证，虚也。）始发一粒如麻豆大，身体便发热，生疽处肿大热痛，此为发于外，虽大如盆，治之百可百活。（阳证，实也。）或身体不热，自觉倦怠，生疽处亦不热，数日后渐大，不肿不痛，低陷而坏烂，此为发于内，虽神仙无如之何。（《准绳》）
陈远公说：背心间先发红瘰，后渐红肿，这是发背的征兆，最为可怕。古人说：外大如豆，内大如拳；外大如拳，内大如盘，意思是外表小而内部实际很大。然而痈疽大毒，必须辨别阴阳。有先阴变阳者，有先阳变阴者，有前后俱阳者，有前后俱阴者。阳证虽然严重但实际上较轻，阴证虽然轻微但实际上较重，先阴变阳者生，先阳变阴者死，怎么知道呢？阳证形状高硕而肿起，阴证形状底平而陷下，阳证颜色红，阴证颜色带黑，阳证初起必痛，阴证初起必痒，阳证溃烂多脓，阴证溃烂多血，阳证收口身体必轻爽，阴证收口身体必沉重，至于辨别阴阳，以此斟酌，一定不差。凡红肿高突，乃是阳证。趁着肉肿初发，肉犹未化，紧急用散毒之药治疗，可随手痊愈。发背至横决者，皆因循失治，以至破败而不可救，阳变阴者多了。救痈如救火，宜速扑灭，否则延烧屋舍，不尽不止，切勿见为阳证，轻缓治疗。急消汤：金银花二两，紫花地丁一两，茜草、甘菊花、桔梗、天花粉、生甘草各三钱，贝母二钱，黄柏一钱。水煎服，三剂全消，不超过四剂。（《冰鉴》。此方消除阳毒初起极神效，既无迅烈之患，大有和解之妙，人不知法则，谓阳毒易于祛除，浪用虎野狼之味，毒虽消散而真气耗损，往往变成他证，乃医者成之也，何若王霸并施，有益无损为妙。）
又说：背心发瘰痒甚，已而背如山重，隐隐发红晕如盘大。这是阴痈初起之形，最为可怕，非前证可比，乃一生罪孽，鬼祟凭身，必胡言谵语，将平日欺心之事，尽情宣布，此证本不可救，然人心善恶，成于一念，苟能悔艾而刀圭无术，亦见吾道之无奇矣。夫阳证有救之条，阴证岂无可生之理，惟在治之得法耳。阴证虽成于鬼祟之缠，亦必正气大虚，邪得入之也。故治法必用补气血之药，佐以散郁解毒之品，则正旺邪自散矣。变阳汤：人参、黄芪各二两，金银花八两，白芍一两，天花粉、生甘草各五钱，荆芥炒黑三钱，柴胡二钱，附子一钱。水十余碗，煎汁二碗，先服一半，后又服一碗，阴必变阳而作痛，又一剂痛消，再一剂痊愈。（世人不见皮破血出，断不可信，然先用此方以治发背，无论病患不肯服，即医士亦不肯用，往往决裂溃烂，疮口至如碗大而不可收，始悔参芪之迟用矣。所以论证而多戒辞，劝人早服此方，以免丧命。盖阳毒可用攻毒，阴毒必须补正，以参芪补气，气旺则幽阴之毒不敢入心肺之间，金银花性补，善解阴毒，得参芪而功益大，然非附子不能直入阴毒之中，而又出于阴毒之外，毒深者害深，又加生甘草以解余毒，然毒结于背者，气血之壅也，壅极者郁之极也，故加柴、荆、粉、芍消痰通滞，开郁引经，自然气宣血活，痰散毒消也。）
又说：背痈溃烂，洞见肺腑，疮口黑陷，身不能卧，口渴思饮，人以为阳证败坏，孰知阴虚不能变阳乎！夫痈虽有阴阳之分，及至溃脓之后，宜补内而不宜消，则阴阳之证一也。溃烂而见肺腑，足见失补之故，使毒过于延烧，将好肉化为瘀肉耳。肉瘀必腐，腐则洞见底里，此证九死一生之兆，倘胃气健，能食者，犹可治，若见食则恶者，必无生理，然能受参芪峻补者，尚可生也。转败汤：人参、熟地各二两，生黄、当归、山萸各一两，白术、金银花各四两，麦冬二两，远志三钱，肉桂、茯苓各二钱，北五味一钱。水煎，一服胃气大开者，即可转败为吉，倘服后少能健饭，亦在可救，若杳无应验者，胃气将绝无救矣。（此方补气血，更补肺肾之阴，盖阴生则阳长，阴阳生长则有根，易于接续，后以银花解余毒，则毒散而血生，血生而肉长，肉长而皮合，倘以解毒为事，不补气血之阴阳，则阴毒不能变阳，有死而已矣，不亦悲哉！倘服之而饱闷，少顷渐安者，尚有生机，不可弃置。）
又说：背痈将愈，疮口不收，治无一效，人以为余毒未尽也，孰知阴虚不能济阳乎！夫痈疽初起则毒盛，变脓则毒衰，脓尽则毒化矣。疮口不收，乃阴之虚，非毒之旺，人不知治法，以败毒攻之，是重虚其虚，欲肌肉之长，得乎，或亦有补而不效者，必系只用阳分之品以补阳，不用阴分之品以补阴也。盖独阴不长，独阳不生，今脓血已尽，阴必大虚，只补阳则阳旺阴虚，阴不能交于阳矣。虽阳有济阴之心，而阴无济阳之力，所以补阳而阴愈虚，疮口愈难合也。治必大补其阴，使阴精盛满，自能灌注疮口，不必生肌外敷，疮口之肉自生矣。生肤散：麦冬、山萸、银花、当归各一两，熟地二两，人参、白术各五钱，肉桂一钱。水煎二服，肉自内长，又二服外口自平，又二剂痊愈。（此方补阴多于补阳，使阴胜于阳也。然补阳之药，仍是补阴之助，以其能入阴中交于阳内也，银花非恃以解余毒，取其能领各味至疮口之间也。）
又说：背疮长肉，疮口已平，忽开裂流红，人以为疮口肉未坚也，孰知色欲恼怒不谨乎！夫痈证最忌色欲，次忌恼怒，犯恼怒，新肉有开裂之虞，犯色欲，新肉有流水之害，然此犹些小疮痈也。其在背痈，犯恼怒者，不过疾病，犯色欲者，多致死亡，疮口开裂之处，色必变紫黑，流血之处，肉必变败坏矣。此时必急补气血，切不可仍治其毒，盖前毒未尽，必难收口，复至败坏，实新肉不坚而自决裂也。况发背新愈，其精神气血空虚，交合泄精，遂变出非常，舍补气血，又安求活乎！然补气血，必用大剂方能收危乱之功也。定变回生汤：人参四两，黄芪三两，当归、麦冬、白术、银花各二两，茯苓一两，山萸五钱，肉桂三钱，北五味二钱。水煎，二服肉自生矣，三剂皮仍合矣，平复如故。再犯禁忌，无不死矣，此方难救。（此方救疮疡坏证仙丹，不止治发背愈后犯色败腐也，人疑泄精以至决裂，宜熟地大补之，何故不用，因熟地补阴最缓，而证犯甚急，所以不用熟地，多用气血之药救其垂危，非熟地不可用，轻弃之也，此方数剂之后，正宜减半而多加熟地，以为善后计耳。）
又说：夏日生背痈，疮口不起，脉大无力，发热作渴，自汗盗汗，用参芪补剂，益加手足逆冷，大便不实，喘促呕吐，人以为火毒太盛也，谁知元气大虚，补不足以济之乎！夫痈分阴阳，疮口不起乃阴证也，脉大似乎阳证，大而无力，非阴而何！发热作渴，此水不足以济火，故作渴作热也。即阴证似阳，用参、芪助阳，足以祛阴而返阳矣。何以愈补，反作逆冷呕吐，此阴寒之气甚，而微阳之品力不能胜耳，非加附子之辛热，何能斩关以祛荡阴邪哉！助阳消毒汤：人参八两，黄芪一斤，当归、白术各四两，陈皮一两，附子五钱。水煎膏，二次服，诸证退，服数剂疮起，乃减半，又服数剂而愈。（此非治痈之法也。然以治痈之法轻剂治此，鲜不立亡，可见治痈不可执也。大约阳痈可用消毒化痰，而阴痈切不可用消毒化痰之药，今舍痈从证，乃治痈变法，医者不可不知也。）
又说：背生痈疽，溃脓之后，或发热，或恶寒，或作痛，或脓多，或流清水，自汗盗汗，脓成不溃，口烂不收，人以为毒瓦斯未尽也，谁知五脏亏损，血气大虚之故也。凡人气血壮盛，阴阳和平，何能生毒？惟脏腑内损，而毒瓦斯得以内藏，久之外泄，及至痈疽发出，其毒自不留内，脏腑原虚，又加流脓血则已虚益虚，观其外面疮口未敛，似乎有余，审其内而气血未生，实为不足，法当全补，不必偏补一脏，致有偏胜之虞，用十全大补汤为妙，以其兼补气血耳，然有不效者，非方之不佳，乃用之不得法也。夫背痈何等之证，岂细小之剂所能补哉！必大剂始克有济，余酌一方：人参、当归各一两，黄芪、熟地各二两，白芍、白术、茯苓各五钱，川芎、生甘草各三钱，肉桂二钱，水煎服。一剂有一剂之效也。（人以此方绝不败毒，如何毒化肉生，不知痈疽
Wang Kentang stated: Guoshen ju (Over-shoulder carbuncle), also known as Jinju (Sinew carbuncle), arises on both sides of the spine behind the shoulder. The area is swollen, hard, and painful, accompanied by chills and high fever resembling malaria. However, initially there is no head (pustule), so moxibustion should be urgently applied.
The *Guiyi Fang* states: Jinju arises on the large sinews on both sides of the spine, and the color is bluish-green. It can be punctured after eight days; if the abscess occurs in the deep fatty tissue (fat intestine), death will occur within ninety days.
The *Xinfa* says: Guoshen ju arises at the edge behind the shoulder, with identical conditions on both left and right sides. It is generally caused by the entrapment and stagnation of damp-heat and wind-pathogens; it can also be formed by the coagulation of blood stasis due to carrying heavy loads.
Shen Douyuan said: Jianjing du (Toxicity at Jianjing point), also known as Qi Yong (Qi abscess), is located in the depression where the bones connect above the shoulder. It is formed by the interference of anger, leading to the stagnation of Qi and Blood. At the onset, Tiegu San (Iron Hoof Powder) must be used to encircle the root of the lesion; otherwise, the toxicity will flow to the shoulder and spine, becoming incurable. (*Qixuan*)
Shen Douyuan also said: This is caused by carrying heavy loads on the shoulders, injuring the shoulder head, leading to Qi and Blood stagnation; or by sleeping in cold places, causing blockage of the collaterals and accumulation of blood stasis. Upon rupture, pus and blood flow out; this is an external cause. Treatment should involve early moxibustion to achieve resolution. (*Qixuan*) There are also cases of shoulder injury from a pole when a woman steps over it.
Empirical Prescription: Use hair cut from a cat's head, stick it with saliva, and apply to the affected area.
Wang Kentang said: Shangfabei (Upper Back Carbuncle), Zhongfabei (Middle Back Carbuncle), and Xiafabei (Lower Back Carbuncle) all occur along the midline of the spine, belonging to the Du Meridian (Governing Vessel). Shangfa (Upper) injures the Lung, arising below the Tianzhu bone; Zhongfa (Middle) injures the Liver, called Duixin Fa (Opposite Heart Eruption); Xiafa (Lower) injures the Kidney, called Duiqi Fa (Opposite Umbilicus Eruption). All are caused by accumulated heat and anger. Initially, it resembles millet grains or hemp seeds, may be itchy, tight, painless, or severely painful. As soon as discomfort is felt, garlic-separated moxibustion is advisable. Treatment should be based on deficiency or excess, employing sweating, purging, or supporting methods to expel toxicity. (*Zhunsheng*)
He further stated: Naofabei (Brain Back Carbuncle) and upper Fabei should not use Mutong (Akebiae Caulis), as it may guide deficiency downward and damage the lower Yuan (Primordial Qi), especially for the elderly and weak. However, the three Fabei locations are critical and differ from other areas; one must be particularly cautious. Any slight pain or itch requires immediate treatment.
The *Guiyi Fang* states: Among human diseases, Fabei (Back Carbuncle) is the most worrying. There are five types: First, Yangdu Fabei (Yang Toxicity Back Carbuncle), caused by wind. It may arise from heat-toxic diabetes or unresolved residual yang toxicity from prior typhoid. Accumulation occurs between the back muscles, regardless of vertebral count, starting from both sides of the spine. Swelling extends from the waist up the back, feeling hot like cooking, with red-purple or flame-red color. Pus and toxicity are difficult to form; if formed, they do not stop. Pain persists even after stopping. Suddenly, within a few days, it flattens as if resolved, but this is actually internal attack and flesh sinking, which is incurable. Second, Yindu Fabei (Yin Toxicity Back Carbuncle), caused by cold qi. It starts like a millet grain, with low mood, pain radiating to the front heart, palpitations, heavy head and eyes, and chills/fever like malaria. After five to seven days, swelling develops, spreading widely and difficult to contain, with deep, slow, unpenetrated pus inside. Urgent internal support with Qi-tonifying decoctions and external application of pus-drawing medicines are needed. Pus must appear quickly; without it, recovery is indefinite. Third, some people take long-term mineral/alchemical pills, leading to toxic stagnation forming Fabei. It starts like erysipelas, spreading like scalds, with crimson ulcer color, restlessness, thirst for cold drinks. The sore is hard to rise; if it rises, it is alarming, worse than Yin/Yang toxicity types. Internal detoxification for minerals is required. Although rooted clearly, urgent treatment is necessary for peace. Fourth, Jiushi Du Fabei (Alcohol/Food Toxicity Back Carbuncle). This is not recent but accumulates in organs over time. Triggered by hunger/fatigue, eating then sleeping, excessive alcohol/meat, cold/hot sticky/greasy foods undigested, unrestrained sexual activity, and exposure to wind. Spleen Qi deficiency fails to handle this, causing toxicity to attack the back spine. Starts like a small bean, grows to fist size, hard as stone, pain throughout limbs, tightness, bitter taste, dry tongue, abdominal urgency, constipation/dysuria. After ten+ days, puffiness of head/face/limbs, diarrhea-like organ leakage, internal acute pain. While swelling spreads, urgently use Gongzhong Faxue Kuinong Tang (Attack Swelling, Open Acupoints, Drain Pus Decoction) to solidify internally and drain pus externally. Do not delay, or flesh rots, bones injure, tendons rot, pus increases, pathogen enters internally causing death. Fifth, Shanlan Zhangqi Fabei (Mountain Miasma Back Carbuncle). Toxic qi resides in organs for years, depleting Qi/Blood. Starts with blue-black swelling like boot leather, deep numb pain attaching to bones/marrow, hard as wood/stone. Pain felt only when pressing deeply. After 5-7 days, toxicity floats superficially, swelling rises, color turns blue-white, bruise-like, chills like malaria, wind symptoms, head turning, mouth deviation, cold extremities, slow eye movement with white dominating black. Internal evil struggle requires urgent lancing to release 3-5 sheng of clear blood, mixed with yellow/white pus. Skin tension, throbbing pain persist until color fades and heat/pain cease. Urgently chase pus/toxicity outward. Survival if moxibusted within 3 days of swelling onset. Survival if lanced/drained within 8 days of pus formation. Survival if avoiding labor before cure. Survival if observing dietary taboos. Survival if controlling emotions. Survival if fearing severe swelling and treating urgently. Survival if treating early and not denying Fabei. Death if waiting for spontaneous pus without drainage. Survival if lanced/drained before internal attack. Death if lanced/drained after internal attack. Survival if treated before peak swelling/heat/pain. Death if treated after internal attack. Death if pus forms but not drained, only medicated. Death if bloody dysentery with rapid breathing (internal attack, medical futility). For carbuncles, 5 in 10 survive if untreated; for ulcers, 10 in 10 die if untreated. Death if afraid of pain in mild swelling. Death if lacking good prescription. Death if ignoring seasonal laws. Death if foolishly indulging temper/emotions.
Wang Kentang said: There are Fabei Yong (Carbuncle) and Fabei Ju (Ulcer). If toxicity erupts fiercely like fire burning thatch, it easily deteriorates. Starts like millet, grows to palm size in 2-3 days, bowl size in 5-7 days. Easy to treat then. Heat/redness like burning, surface ulcerates widely, internal swelling like cooking, external flesh sloughs off. Purple stasis, abundant pus, swelling/pain persist, thirst, vomiting, shortness of breath, inability to eat. Floating/shallow/wide lesions especially need Fannong Tuodu Tang (Expel Pus, Support Toxicity Decoction) for certain cure. (Yang Syndrome, Excess). Some are only cup-sized; this is not small, but because toxicity is deep, internal deficiency allows toxicity near membranes. This will definitely attack internally, entering organs, then limbs. First attacks head/face puffiness, then hands, then feet. Called "Toxicity Scattering into Limbs." Voice hoarse, Qi depleted, eyes dark/small, ten fingers black/dry/crispy – incurable. (Yin Syndrome, Deficiency). Starts like sesame/bean, body fevers, site swells/hot/painful. External eruption, even if basin-sized, 100% curable. (Yang Syndrome, Excess). Or body not hot, fatigue, site not hot, grows slowly, painless, sunken/rotten. Internal eruption, incurable even by immortals. (*Zhunsheng*)
Chen Yuangong said: Red nodules appearing first on the back, gradually becoming red/swollen, is a sign of Fabei, most terrifying. Ancients said: Outside like bean, inside like fist; outside like fist, inside like plate. Meaning external small but internal large. Must distinguish Yin/Yang. Can change Yin to Yang, Yang to Yin, both Yang, or both Yin. Yang seems severe but is light; Yin seems light but is heavy. Yin-to-Yang change survives; Yang-to-Yin change dies. How to know? Yang: high/swollen shape; Yin: flat/sunken shape. Yang: red color; Yin: blackish color. Yang: painful onset; Yin: itchy onset. Yang: suppurates with much pus; Yin: bleeds much. Yang: healing feels light/refreshing; Yin: healing feels heavy. Distinguish by these signs. Red/swollen/high protrusion is Yang. Treat early with dispersing toxins while flesh not yet liquefied; quick cure. Fabei spreading horizontally results from delayed treatment, breaking down irreparably, many changing Yang to Yin. Saving carbuncle is like saving from fire; extinguish quickly, or house burns down. Do not treat Yang lightly. Jixiao Tang: Jin Yin Hua (Honeysuckle Flower) 2 liang, Zi Hua Di Ding (Viola Yedoensis Herb) 1 liang, Qian Cao (Madder Root), Gan Ju Hua (Chrysanthemum Flower), Jie Geng (Platycodon Root), Tian Hua Fen (Trichosanthes Root), Sheng Gan Cao (Raw Licorice Root) each 3 qian, Bei Mu (Fritillaria Bulb) 2 qian, Huang Bo (Phellodendron Bark) 1 qian. Water decoction, 3 doses resolve completely, not exceeding 4. (*Bingjian*). This formula is miraculous for early Yang toxicity, gentle yet harmonizing. Ignorance leads to using harsh drugs, damaging true Qi, causing other syndromes. Better to combine King/Hegemon methods, beneficial without harm.
Also said: Back nodule very itchy, then back feels heavy, faint red halo plate-sized. Form of early Yin Yong (Abscess), most terrifying, unlike previous. Karmic retribution, spirit possession, delirium confessing sins. Incurable, but if repentant, our Dao has wonders. Yang has rescue paths; why not Yin? Only depends on correct method. Yin caused by spirit attachment implies massive Zheng Qi (Upright Qi) deficiency allowing evil entry. Treat with Qi/Blood tonics plus dispersing/decocting agents. Strong Zheng disperses Evil. Bianyang Tang: Ren Shen (Ginseng Root), Huang Qi (Astragalus Root) each 2 liang, Jin Yin Hua 8 liang, Bai Shao (White Peony Root) 1 liang, Tian Hua Fen, Sheng Gan Cao each 5 qian, Jing Jie (Schizonepeta Spike, charred) 3 qian, Chai Hu (Bupleurum Root) 2 qian, Fu Zi (Aconite Lateral Root) 1 qian. 10+ bowls water, boil to 2 bowls. Drink half, then remaining bowl. Yin changes to Yang with pain. One dose pain subsides, next dose cures. (People doubt without skin break/blood, but use this first for Fabei. Patients/doctors refuse, leading to rupture/wide wounds regretting late use of Ginseng/Astragalus. Argument and warnings urge early use to save life. Yang toxicity uses attacking toxins; Yin toxicity must tonify Zheng. Ginseng/Astragalus boost Qi, preventing Yin toxicity from entering Heart/Lungs. Honeysuckle tonifies, resolves Yin toxicity, enhanced by Ginseng/Astragalus. But Aconitus is needed to enter/exit Yin toxicity. Deep toxicity needs Raw Licorice to resolve residue. Toxicity knot on back is Qi/Blood congestion/extreme depression. Add Chai/Jing/Fen/Shao to resolve phlegm/stagnation, open depression, guide meridians. Qi circulates, blood activates, phlegm disperses, toxicity消.)
Also said: Back carbuncle ulcerated, exposing viscera, black sunken wound, unable to lie, thirsty. People think Yang syndrome ruined, but who knows Yin deficiency cannot transform to Yang! Carbuncles have Yin/Yang, but after suppuration, tonify interior, do not eliminate. Yin/Yang become one. Ulceration exposing viscera shows lack of tonification, allowing toxicity to burn good flesh into stasis. Stasis rots, revealing depth. Nine deaths, one life sign. If Stomach Qi strong, able to eat, still treatable. If aversion to food, no hope. But if tolerating strong Ginseng/Astragalus tonification, survival possible. Zhuansai Tang: Ren Shen, Shu Di (Prepared Rehmannia Root) each 2 liang, Sheng Huang (Raw Astragalus), Dang Gui (Angelica Sinensis Root), Shan Yu (Cornus Fruit) each 1 liang, Bai Zhu (Atractylodes Rhizome), Jin Yin Hua each 4 liang, Mai Dong (Ophiopogon Tuber) 2 liang, Yuan Zhi (Polygala Root) 3 qian, Rou Gui (Cinnamon Bark), Fu Ling (Poria) each 2 qian, Bei Wu Wei Zi (Schisandra Berry) 1 qian. Water decoction. One dose opens Stomach Qi, turning bad to auspicious. If slightly better appetite, salvageable. If no response, Stomach Qi extinct, hopeless. (This tonifies Qi/Blood, plus Lung/Kidney Yin. Yin generates Yang, roots allow connection. Later Honeysuckle resolves residue, toxicity disperses, blood generates, flesh grows, skin closes. If only resolving toxicity without tonifying Qi/Blood Yin/Yang, Yin toxicity cannot change to Yang, only death. Sad! If fullness/nausea then relief, still vital, do not abandon.)
Also said: Back carbuncle nearly healed, wound not closing, treatments fail. People think residual toxicity remains, but who knows Yin deficiency cannot nourish Yang! Carbuncle start: toxicity strong; turning pus: toxicity weak; pus gone: toxicity transformed. Wound not closing is Yin deficiency, not strong toxicity. People don't know treatment, attacking with敗毒 (defeating toxicity) doubly harms deficiency. Wanting flesh growth impossible? Or tonification fails because only Yang tonics used, no Yin tonics. Independent Yin doesn't grow, independent Yang doesn't generate. Pus/blood gone, Yin greatly deficient. Tonifying Yang makes Yang strong/Yin weak, Yin cannot interact with Yang. Yang wants to help Yin, but Yin lacks power to help Yang. Tonifying Yang makes Yin weaker, wound harder to close. Must strongly tonify Yin, filling Yin Essence to irrigate wound. No need for external flesh-generating meds; flesh grows naturally. Shengfu San: Mai Dong, Shan Yu, Yin Hua, Dang Gui each 1 liang, Shu Di 2 liang, Ren Shen, Bai Zhu each 5 qian, Rou Gui 1 qian. Water decoction, 2 doses. Flesh grows internally, 2 more doses flatten exterior, 2 more doses cure. (Tonifies Yin more than Yang, making Yin superior. Yang tonics aid Yin by entering Yin to interact with Yang. Honeysuckle not just for residue, but to lead ingredients to wound.)
Also said: Back sore growing flesh, wound flat, suddenly cracks bleeding. People think flesh not firm, but who knows indiscretion in lust/anger! Carbuncles forbid lust, then anger. Anger risks cracking new flesh; lust risks weeping new flesh. Minor sores okay. Back carbuncle: anger causes disease, lust causes death. Crack site turns purple/black; bleeding site flesh rots. Urgently tonify Qi/Blood, do not treat toxicity. Residual toxicity prevents closure, leading to ruin. Actually new flesh not firm, self-rupturing. Newly healed Fabei has empty Spirit/Qi/Blood. Intercourse/ejaculation causes extraordinary changes. Without Qi/Blood tonification, how to survive? Must use large doses for critical success. Dingbian Huisheng Tang: Ren Shen 4 liang, Huang Qi 3 liang, Dang Gui, Mai Dong, Bai Zhu, Yin Hua each 2 liang, Fu Ling 1 liang, Shan Yu 5 qian, Rou Gui 3 qian, Bei Wu Wei Zi 2 qian. Water decoction. 2 doses flesh grows, 3 doses skin closes, returns to normal. Repeating taboos ensures death, this formula hard to save. (Immortal pill for ruined sores, not just post-Fabei lust-ruin. People suspect semen loss needs Shu Di, why not use? Shu Di tonifies Yin slowly, condition urgent. So use Qi/Blood drugs to save crisis, not abandoning Shu Di lightly. After several doses, halve and add Shu Di for aftermath.)
Also said: Summer back carbuncle, wound not rising, pulse large/powerless, fever/thirst, spontaneous/night sweats. Using Ginseng/Astragalus tonics worsens cold extremities, loose stools, panting/vomiting. People think Fire-Toxicity too strong, but who knows Yuan Qi (Primal Qi) greatly deficient, insufficient tonification to assist! Carbuncles divide Yin/Yang. Wound not rising is Yin syndrome. Pulse large looks Yang, but large/powerless is Yin! Fever/thirst is Water insufficient to control Fire. Yin syndrome resembling Yang. Using Ginseng/Astragalus assists Yang, dispelling Yin returning Yang. Why does tonification cause cold/vomiting? Yin-Cold Qi strong, mild Yang drugs insufficient. Without Aconite's acrid-hot nature, how to break barriers and sweep Yin Evil? Zhuyang Xiaodu Tang: Ren Shen 8 liang, Huang Qi 1 jin, Dang Gui, Bai Zhu each 4 liang, Chen Pi (Tangerine Peel) 1 liang, Fu Zi 5 qian. Water decoction to paste, take twice. Symptoms retreat, take several doses for wound rising, then halve, continue to cure. (Not standard carbuncle method. Light doses for carbuncle here lead to instant death. Shows carbuncle treatment cannot be rigid. Generally Yang carbuncles use detoxification/phlegm-resolving; Yin carbuncles strictly avoid them. Now abandoning carbuncle for syndrome is variable treatment, doctors must know.)
Also said: Back carbuncle/ulcer, after suppuration, fever/chills/pain, much pus/clear fluid, sweats, pus formed not ruptured, mouth rotten not closing. People think toxicity remains, but who knows Five Zang depletion, Qi/Blood great deficiency! Healthy Qi/Blood, balanced Yin/Yang, how generate toxicity? Only internal organ damage allows toxicity storage, later leaking out. When carbuncle emerges, toxicity stays not internal. Organs originally deficient, plus pus/blood loss makes deficiency worse. Exterior wound not closed seems surplus; interior Qi/Blood not generated is actual deficit. Method: Full tonification, not biasing one Zang to avoid imbalance. Shiquan Dabu Tang (Ten Significant Tonifying Decoction) is excellent for dual Qi/Blood tonification. If ineffective, not bad formula, but improper use. Back carbuncle is serious; small doses cannot tonify. Must use large doses. I propose: Ren Shen, Dang Gui each 1 liang, Huang Qi, Shu Di each 2 liang, Bai Shao, Bai Zhu, Fu Ling each 5 qian, Chuan Xiong (Szechwan Lovage Rhizome), Sheng Gan Cao each 3 qian, Rou Gui 2 qian. Water decoction. One dose brings effect. (People think this never defeats toxicity, how does toxicity transform/flesh grow? Not knowing carbuncle...)