薛立斋曰∶脑疽属太阳膀胱经积热，或湿热上壅，或风温外感，或阴虚火炽，或肾水亏
损、阴精消涸所致。其源之浅深不同，而证之轻重亦异。初起一粒形如麻豆；至一二日微寒
身热，渐渐加大；至七日成形，根盘红肿，顶突宽松，是为顺证。斯时憎寒壮热，朝轻暮重
，舌白苔腻，胸痞哕恶，脉细弦数，此湿热上壅，即用黄连泻心汤，或温胆法；若面油红，
舌干绛赤，烦躁干哕，口渴喜饮，大便坚实，是火热伤液，如犀角地黄汤，或羚羊角、银花
、地丁、石斛、芦根、鲜首乌、黄芩、枳壳、山栀、丹皮、灯心、竹叶、夏枯草等类，清其
火毒、解其营热。至十四日后脓透，根盘焦紫，热退身凉，脓水淋漓，倘有不能透彻，清营
方内加甲末、制蚕、角针，以攻其毒。至二候半，瘀腐渐脱，新肉渐生，身热渐退，脾胃醒
复。过二十八日后，腐全脱，新肉满，饮食嘉，调养好，四十日收功。
又有一种阴证，初起形色俱不正，寒热不加重，身虽发热，面色形寒，疡不高肿，根盘
平塌，散漫不收，过候不透，脓稀不腐，正气内亏，不能使毒外泄，而显陷里之象。此由平
日肾水亏损，阴精消涸，阴火炽甚而成，其危险不能过三候矣。其中犹有三陷变局，谓火陷
、干陷、虚陷也。火陷者，气不能引血外腐成脓，火毒反陷入营，渐致神迷，发痉发厥；干
陷者，脓腐未透，营卫已伤，根盘紫滞，头顶干枯，渐致神识不爽，有内闭外脱之象；虚陷
者，脓腐虽脱，新肉不生，状如镜面，光白板亮，脾气不复，恶谷日减，形神俱削，渐有腹
痛便泄寒热，宛似损怯变象，皆不治之证也。大凡此证以小者为对口，大者为脑疽，俗即云
落头疽也。由感于六淫之邪而发者，为顺为阳；伤于七情而发者，为逆为阴。余疽仿此。（
对疽发背，必以候数为期，七日成形，二候成脓，三候脱腐，四候生肌）
以上论中，自阴证起，及三陷变局，不录方药者，以其变化多端，各宜随证治之。
薛立斋说：脑疽属于足太阳膀胱经的积热，或者是由湿热上壅、风温外感、阴虚火旺、肾水亏损导致阴精枯竭所引起。其病源的深浅不同，病症的轻重也各异。初起时像一粒麻豆大小的肿块；到一两天后出现轻微恶寒和身体发热，肿块逐渐增大；到第七天成形，根部红肿，顶部突起且松软，这是顺证。此时如果憎寒壮热，早晨轻晚上重，舌苔白腻，胸闷恶心，脉象细弦数，这是湿热上壅，应立即使用黄连泻心汤，或采用温胆法治疗；如果面色油红，舌干绛赤，烦躁干呕，口渴喜饮，大便坚实，这是火热伤及津液，可用犀角地黄汤，或用羚羊角、金银花、地丁、石斛、芦根、鲜首乌、黄芩、枳壳、山栀、丹皮、灯心草、竹叶、夏枯草等药物，以清解火毒和营分的热邪。到了十四天后脓液透出，根部焦紫，热退身凉，脓水淋漓，如果有不能透彻排出的情况，在清营方中加入穿山甲末、制僵蚕、皂角刺，以攻解毒邪。到了第二候半（约15-20天），瘀腐逐渐脱落，新肉逐渐生长，身热逐渐消退，脾胃功能恢复。超过二十八天后，腐肉完全脱落，新肉填满，饮食正常，调养得当，四十天左右痊愈。
又有一种阴证，初起时形色都不正，寒热症状不加重，虽然身体发热，但面色和形体畏寒，疮疡不高肿，根部平塌，散漫不收束，过了时限也不透脓，脓液稀薄且不腐溃，正气内亏，不能使毒邪向外排泄，而显现出毒邪内陷的迹象。这是由于平日肾水亏损，阴精枯竭，阴火炽盛所致，其危险性很大，不能超过三个候期了。其中还有三种内陷变局，称为火陷、干陷、虚陷。火陷者，气不能引血外出化腐成脓，火毒反而陷入营分，逐渐导致神志昏迷，抽搐厥逆；干陷者，脓腐未透，营卫已受伤，根部紫暗滞涩，顶部干枯，逐渐导致神志不清，有内闭外脱的迹象；虚陷者，脓腐虽已脱落，但新肉不生，状如镜面，光白板亮，脾气不复，厌恶谷物，日渐减少，形体和精神都消瘦，逐渐出现腹痛腹泻、寒热往来，宛似虚损劳怯的变化，都是不治之证。大凡这种病，小的是对口疽，大的是脑疽，俗称落头疽。由感受六淫邪气而发发的，为顺证、阳证；由七情内伤而发的，为逆证、阴证。其他疽症可参照此理。（对于对口疽和发背疽，必须以候数为期限，七天成形，两候成脓，三候脱腐，四候生肌）
以上论述中，从阴证开始，以及三种内陷变局，没有记录方药的原因，是因为病情变化多端，应当根据具体证候进行治疗。
Xue Lizhai stated: Naoju (Brain Carbuncle) belongs to the accumulation of heat in the Foot-Taiyang Bladder Meridian, or is caused by the upward congestion of damp-heat, external contraction of wind-warmth, hyperactivity of fire due to Yin deficiency, or depletion of Kidney Water leading to the exhaustion of Yin essence. The depth of the pathogenic source varies, resulting in different severities of symptoms. Initially, it appears as a small lump resembling a hemp seed; after one or two days, slight aversion to cold and fever occur, with the lump gradually enlarging; by the seventh day, it takes shape with redness and swelling at the base, and a protruding, loose top, which constitutes a favorable syndrome (Shun Zheng). At this stage, if there is severe aversion to cold and high fever, lighter in the morning and heavier in the evening, white greasy tongue coating, chest fullness, hiccups, and nausea, with a fine, wiry, and rapid pulse, this indicates upward congestion of damp-heat. One should immediately use Huanglian Xiexin Tang (Coptis Decoction to Drain the Heart) or employ the Wendan method. If the face is oily and red, the tongue is dry, crimson, and red, accompanied by irritability, dry hiccups, thirst with desire to drink, and firm stools, this indicates fire damaging body fluids. In such cases, Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) may be used, or herbs such as Lingyangjiao (Antelope Horn), Yinhua (Honeysuckle Flower), Diding (Viola Herba), Shihu (Dendrobium Stem), Lugeng (Reed Rhizome), Xian Shouwu (Fresh Polygonum Multiflorum Stem), Huangqin (Scutellaria Root), Zhike (Aurantium Fructus), Shanzhi (Gardeniae Fructus), Danpi (Moutan Cortex), Dengxincao (Juncus Effusus), Zhuye (Bamboo Leaf), and Xiakucao (Prunella Spica) can be utilized to clear fire toxins and resolve Ying-level heat. After fourteen days, when pus penetrates, the base turns scorched purple, fever subsides, the body becomes cool, and pus flows profusely, if penetration is incomplete, add powder of Jiashan Jia (Pangolin Scales), Zhi Jiangcan (Silkworm), and Jiaozhen (Gleditsia Sinensis Spine) to the Qingying formula to attack the toxin. By the middle of the second period (approximately 15-20 days), necrotic tissue gradually detaches, new flesh begins to grow, fever recedes, and the Spleen and Stomach function recover. After twenty-eight days, if all necrotic tissue has detached, new flesh fills the wound, appetite is good, and care is adequate, recovery is achieved around forty days.
There is another type, the Yin Syndrome, where the initial appearance and color are abnormal, chills and fever do not intensify, although the body may feel hot, the complexion and form show signs of cold. The lesion does not swell prominently, the base is flat and collapsed, spreading without confinement, failing to penetrate even after the appropriate time, producing thin pus that does not slough, indicating internal deficiency of healthy Qi unable to expel toxins outward, manifesting as inward sinking of pathogens. This results from chronic depletion of Kidney Water and exhaustion of Yin essence, leading to intense Yin fire. It is dangerous and cannot survive beyond three periods. Among these, there are three types of sinking transformations: Huoxian (Fire Sinking), Ganxian (Dry Sinking), and Xuxian (Deficiency Sinking). Huoxian occurs when Qi fails to guide Blood outward to form pus, causing fire toxins to sink into the Ying level, gradually leading to coma, convulsions, and syncope. Ganxian occurs when pus and necrosis have not penetrated, Ying and Wei levels are damaged, the base is purplish and stagnant, the top is dry and withered, gradually leading to clouded consciousness and signs of internal closure and external collapse. Xuxian occurs when pus and necrosis have detached, but no new flesh grows, the surface is smooth like a mirror, pale and shiny, Spleen Qi fails to recover, aversion to grain increases daily, physical and mental strength decline, gradually presenting with abdominal pain, diarrhea, and alternating chills and fever, resembling consumptive diseases; these are all incurable conditions. Generally, this condition is called Duikou Ju (Opposite Neck Carbuncle) if small, and Naoju (Brain Carbuncle) if large, commonly known as Luotou Ju (Head-Dropping Carbuncle). Those caused by the six excesses (pathogenic factors) are favorable and Yang-type; those caused by the seven emotions are adverse and Yin-type. Other carbuncles follow this principle. (For Duikou Ju and Fabei [Back Eruption], the timeline is strict: formation in 7 days, pus formation in two periods, necrosis detachment in three periods, and muscle regeneration in four periods.)
In the above discussion, regarding Yin syndromes and the three sinking transformations, formulas and drugs are not recorded because the changes are manifold, and treatment should be adapted to each specific syndrome.