\r骨蝼疽\p04-a41a107.bmp\r
王肯堂曰∶骨蝼疽生手臂阳明经分，生瘰初如粟米，渐大如赤豆，痛不可忍，旬
日大如胡桃，枯紫色。若毒游遍身，拘急发搐，呕哕不食，冷汗自出，滑泄烦躁，脉
乱者死。犯房劳怒气者死。此证乃七情不和，积怒积忧积热所致。真元虚败，不能
胜邪，发之暴死之速，乃阴虚极而火独亢之故。治当滋化源，勿以扬汤止沸之法误之。（《准绳》）
薛立斋曰∶骨蝼疽生臂外前 大骨之后，属手阳明大肠经，由忧郁暴怒凝结而
成。初如粟豆，旬日大如桃李，肿硬疼痛。若紫晕开大，腐烂斑点串通肌肉，搐搦拘
急，多见七恶者逆。
\r垂臂发\p04-a41a108.bmp\r
《鬼遗方》云∶垂臂发生于垂臂两处发接骨下，臂鹅上起如鸡鸭卵大，皆由荣卫
不调所致也。喜患实处而不透内，亦宜急消或发穴早疗。
窦汉卿曰∶生于臂撑上者，名 痈。红肿作痛，初起宜灸。若溃之，必损命，不可轻忽。
\r 痈\p04-a41a109.bmp\r
陈实功曰∶石榴疽生在肘尖上一寸是也。此乃少阳相火与湿热并搏而成。初起
一点黄粟小泡，根便开大，色红坚硬，肿
如覆碗，皮破泛出，叠如榴子，令人寒战，俨同疟疾。初起即灸九壮，内服蟾酥丸发
汗，顶上以蟾酥饼贴之，膏盖，肿处以金黄散敷之。九日后，得脓为吉，反此为凶。
均如痈疽调治。（《正宗》）
又曰∶此乃少阳相火与外湿煎搏而成也。
薛立斋曰∶石榴疽生肘尖上一寸余，属三焦天井穴。初起黄粟小泡，根脚便觉开
大，色红 肿，坚硬疼痛，肿如覆碗，破翻如榴，寒热如疟，由三焦相火与外湿相
搏而成。破后用菊花蕊煎汤洗之，次以菊花烧灰存性，加轻粉少许，兑匀敷之，神效。
\r石榴疽\p04-a41a110.bmp\r
王肯堂说：骨蝼疽生于手臂阳明经部位，初起时像瘰疬（颈部淋巴结结核），开始如粟米大小，逐渐增大如赤豆，疼痛难以忍受，十天后大如胡桃，颜色枯暗发紫。如果毒邪游走遍全身，出现肢体拘挛抽搐、呕吐呃逆不能进食、冷汗自出、腹泻滑脱、烦躁不安、脉象紊乱的，预后不良致死。犯房事过度或暴怒的也会致死。此证是由于七情（喜、怒、忧、思、悲、恐、惊）不和，长期积怒、积忧、积热所致。真元虚衰败坏，不能抵御邪气，发病迅猛导致速死，这是阴虚至极而火独亢的缘故。治疗应当滋生化之源，不要用扬汤止沸（治标不治本）的方法误事。（出自《医学准绳六要》）
薛立斋说：骨蝼疽生于手臂外侧前方大骨之后，属于手阳明大肠经，由忧郁和暴怒凝结而成。初起如粟豆大小，十天后大如桃李，肿胀坚硬疼痛。如果出现紫色晕圈扩大，腐烂斑点串通肌肉，抽搐拘挛，多见“七恶”（中医外科判断预后的七种危重症状）的，属于逆证（预后不良）。
《鬼遗方》说：垂臂发发生于垂臂两处发际接骨之下，臂臑穴上方，肿起如鸡鸭蛋大小，这都是由于营卫不调所致。喜欢发生在实处而不向内部透发，也应当急消或尽早切开排脓治疗。
窦汉卿说：生于臂撑（腋后纹头）上的，名叫痈。红肿疼痛，初起宜用灸法。如果溃破，必定损伤性命，不可轻视忽略。
陈实功说：石榴疽生在肘尖上一寸处。这是由于少阳相火与湿热搏结而成。初起时有一个黄色粟米小泡，根部随即扩大，颜色红且坚硬，肿胀如倒扣的碗，皮肤破裂后翻出，层层叠叠如同石榴籽，令人寒战，症状类似疟疾。初起即灸九壮，内服蟾酥丸以发汗，头顶部位用蟾酥饼贴敷，膏药覆盖，肿胀处以金黄散外敷。九日后，若出脓为吉兆，反之则为凶兆。均按照痈疽常规调治。（出自《外科正宗》）
薛立斋说：石榴疽生在肘尖上一寸余处，属于三焦经的天井穴。初起为黄粟米小泡，根部便觉扩大，色红肿痛，肿胀如倒扣的碗，破溃后翻出如石榴状，寒热往来如疟疾，由三焦相火与外湿相搏结而成。破溃后用菊花蕊煎汤清洗，随后将菊花烧灰存性，加入少许轻粉，调和均匀后外敷，效果神奇。
Gu Lou Ju (Bone Ant-Furuncle)
Wang Kentang stated: Gu Lou Ju arises in the region of the Yangming meridian of the arm. Initially resembling Luo Li (scrofula), it starts as small as millet grains, gradually enlarges to the size of a red bean, and is unbearably painful. After ten days, it becomes as large as a walnut, withering to a purple color. If the pathogenic toxin wanders throughout the body, accompanied by limb stiffness and convulsions, vomiting and hiccups with inability to eat, spontaneous cold sweat, diarrheal incontinence, restlessness, and chaotic pulse, death ensues. Violating sexual abstinence or experiencing violent anger also leads to death. This condition is caused by disharmony of the Seven Emotions (joy, anger, worry, thought, sadness, fear, fright), resulting from accumulated anger, worry, and heat. The True Yuan (original qi) is deficient and failing, unable to overcome the pathogen; the rapid onset and death are due to extreme Yin deficiency with solitary hyperactivity of Fire. Treatment should nourish the source of transformation (Spleen and Stomach); do not err by using methods that merely suppress symptoms without addressing the root (like stirring boiling water to stop it from boiling). (From *Yixue Zhunsheng*)
Xue Lizhai stated: Gu Lou Ju arises behind the large bone on the anterior-lateral aspect of the arm, belonging to the Hand-Yangming Large Intestine Meridian. It forms due to condensation from depression and violent anger. Initially the size of millet or beans, after ten days it grows as large as plums or peaches, becoming swollen, hard, and painful. If a purple halo expands, with rotting spots connecting through muscles, convulsions, and stiffness, often presenting the "Seven Evils" (seven critical prognostic signs in surgery), it indicates a adverse prognosis (Ni Zheng).
Chui Bi Fa (Drooping Arm Carbuncle)
*Gui Yi Fang* states: Chui Bi Fa occurs below the junction of the hairline at the two sites of the drooping arm, arising above the Binao acupoint, swelling to the size of a chicken or duck egg. This is caused by disharmony of Ying (Nutritive) and Wei (Defensive) Qi. It tends to occur in solid areas without penetrating inward; it should be urgently resolved or incised early for drainage.
Dou Hanqing stated: When occurring on the Bisong (posterior axillary fold), it is named Yong (Carbuncle). It presents with redness, swelling, and pain; moxibustion is suitable at the initial stage. If it ulcerates, it will inevitably damage life; it must not be neglected.
Chen Shigong stated: Shi Liu Ju (Pomegranate Furuncle) occurs one cun above the tip of the elbow. This results from the combined struggle of Shaoyang Ministerial Fire and Damp-Heat. Initially, there is a single yellow millet-sized blister; the base quickly expands, appearing red and hard, with swelling like an inverted bowl. Upon skin rupture, the tissue everts in layers resembling pomegranate seeds, causing chills, similar to malaria. At the onset, apply nine moxa cones. Internally administer Chansu Wan (Toad Venom Pill) to induce sweating. Apply Chansu Bing (Toad Venom Cake) to the vertex of the head, covered with plaster. Apply Jinhuang San (Golden Yellow Powder) to the swollen area. After nine days, suppuration indicates a favorable outcome; otherwise, it is ominous. Manage according to standard protocols for Yong and Ju. (From *Waike Zhengzong*)
He further stated: This results from the scorching struggle between Shaoyang Ministerial Fire and external Dampness.
Xue Lizhai stated: Shi Liu Ju occurs slightly more than one cun above the tip of the elbow, belonging to Tianjing (TE16) of the Sanjiao (Triple Burner) Meridian. Initially, it presents as a yellow millet-sized blister; the base feels expanded, with redness, swelling, hardness, and pain. The swelling resembles an inverted bowl; upon rupture, it everts like a pomegranate. There are alternating chills and fever resembling malaria. It is caused by the interaction of Sanjiao Ministerial Fire and external Dampness. After rupture, wash with decoction of Chrysanthemum stamens. Then, burn Chrysanthemum flowers to ash while preserving their nature, mix with a small amount of Qingfen (Calomel), blend evenly, and apply externally. This yields miraculous effects.