（《灵枢·痈疽篇》全）
黄帝曰∶余闻肠胃受谷，上焦出气，以温分肉，而养骨节，通腠理。（上焦出气，宗气也。宗气出于喉咙而行呼吸，
其以温分肉，养骨节，通腠理者，是卫气化于宗气也。）中焦出气如露，上注溪谷而渗孙脉，津液和调，变化而赤为血，
血和则孙脉先满溢，乃注于络脉，皆盈，乃注于经脉，阴阳已张，因息乃行。（中焦出气如露，营气也。其于阴阳已张，
因息乃行，是荣气化于宗气也。）行有经纪，周有道理，与天协议，不得休止。（行有经纪，周有道理，义详运气类第一。
人有营卫，与天合度，义详经络类二十四、五。）切而调之，从虚去实，泻则不足，（从虚之之法以去实，是泻则不足也。）
疾则气减，留则先后。（凡泻者宜疾，补者宜留，是补之与泻，有疾留先后之异也。）从虚去虚，补则有余，（从治虚之法
以去虚，是补则有余也。）血气已调，形气乃持。余已知血气之平与不平，未知痈疽之所从生，成败之时，死生之期有远
近，何以度之，可得闻乎？（持，定也。度，入声。）岐伯曰∶经脉流行不止，与天同度，与地合纪。故天宿失度，日月
薄蚀，地经失纪，水道流溢，草 不成，五谷不殖，径路不通，民不往来，巷聚邑居，则别离异处，血气犹然，请言其
故。夫血脉营卫，周流不休，上应星宿，下应经数。寒邪客于经络之中则血泣，血泣则不通，不通则卫气归之，不得复
反，故痈肿。（卫气归之，不得复反，言其留聚不散也。蚀音食。 音宜， 草，鹿葱也。殖音植。泣，涩同。）寒气
化为热，热胜则腐肉，肉腐则为脓，脓不泻则烂筋，筋烂则伤骨，骨伤则髓消，不当骨空，不得泄泻，血枯空虚，则筋
骨肌肉不相荣，经脉败漏，熏于五脏，脏伤故死矣。（痈毒由浅至深，伤脏则死。如下文所云，及下编痈疽五逆等候，皆
脏气受伤之证。）
黄帝曰∶愿尽闻痈疽之形，与忌曰名。岐伯曰∶痈发于嗌中，名曰猛疽，猛疽不治，化为脓，脓不泻，塞咽，半日
死。其化为脓者，泻则合豕膏，冷食，三日已。（猛疽，言为害之急也。若脓已泻，当服豕膏，可以愈之，即猪脂之炼净
者也。观《万氏方》有治肺热暴喑者，用猪脂一斤炼过，入白蜜一斤，再炼少顷，滤净冷定，不时挑服一匙即愈。若无
疾服此，最能润肺润肠。即是豕膏之属。）
发于颈，名曰天疽，其痈大以赤黑，不急治，则热气下入渊腋，前伤任脉，内熏肝肺，熏肝肺十余日而死矣。（颈，
前颈也。色赤黑者，其毒必甚。渊液，足少阳经穴。其发在颈，则连于肺系，下入足少阳，则及乎肝脏矣，故至于死。）
阳气大发，消脑留项，名曰脑烁，其色不乐，项痛而如刺以针，烦心者死不可治。（阳气大发，邪热之甚也。色有不
乐，伤乎神也。痛如刺以针，毒之锐也。烦心者，邪犯其脏也，故不可治。烁，式灼切。）
发于肩及 ，名曰疵痈，其状赤黑，急治之，此令人汗出至足，不害五脏，痈发四五日，逞 之。（肩 下软白肉处
曰，此非要害之所，故不及五脏。逞，疾也。 ，艾炷也。谓宜速灸以除之也。 ，儒、软二音，又奴刀、奴到二切。
疵，资、子二音。 ，如瑞切。）
发于腋下赤坚者，名曰米疽，治之以砭石，欲细而长，疏砭之，涂以豕膏，六日已，勿裹之。（砭石欲细者，恐伤肉
也。欲长者，用在深也。故宜疏不宜密。砭，标兼切。）
其痈坚而不溃者，为马刀挟缨，急治之。（此即瘰 也。挟缨，《经脉篇》作侠瘿，详本类前十，足少阳条下。欲急
治者，恐迟则伤人也。）
发于胸，名曰井疽，其状如大豆，三四日起，不早治，下入腹不治，七日死矣。（发于胸者，能熏心肺，若不早治而
使之入腹，毒尤甚矣，故死期之速如此。）
发于膺，名曰甘疽，色青，其状如谷实 KT ，常苦寒热，急治之，去其寒热，十岁死，死后出脓。（膺者，胸旁
之高肉处也。谷实，兼五谷而言，谓痈所结聚，形如谷实之累累也。 KT ，栝蒌也，软而不溃，中有所蓄如子也。此
证延绵难愈，盖即乳痈之属。 KT ，古栝楼字。）
发于胁，名曰败疵，败疵者女子之病也，灸之，其病大痈脓，治之，其中乃有生肉，大如赤小豆，锉 草根各一
升，以水一斗六升煮之竭，为取三升，则强饮浓衣，坐于釜上，令汗出至足已。（ ，芰也。 ，连翘也。二草之根，俱
能解毒，故各用一升。大约古之一升，得今之三合有零。以水一斗六升，煮取三升，俱折数类此。 音陵。 ，翘同。）
发于股胫，名曰股胫疽，其状不甚变，而痈脓搏骨，不急治，三十日死矣。（股胫，大股也。状不甚变，言外形不显
也。痈脓搏骨，言脓着于骨，即今人之所谓贴骨痈也。毒盛而深，能下蚀三阴阳明之大经，故不为急治则死矣。）
发于尻，名曰锐疽，其状赤坚大，急治之，不治三十日死矣。（尻，尾 骨也，穴名长强，为督脉之络，一名气之阴
，故不治则死。尻，开高切。）
发于股阴，名曰赤施，不急治，六十日死，在两股之内，不治十日而当死。（股阴，大股内侧也。当足太阴箕门、血
海及足厥阴五里、阴包之间，皆阴气所聚之处，故不治则死。若两股俱病，则伤阴之极，其死尤速。）
发于膝，名曰疵痈，其状大痈，色不变，寒热如坚石，勿石，石之者死，须其柔乃石之者生。（膝痈未成而石之者，
伤其筋之府，故致于死。若柔则脓成矣，砭之无害也。疵，慈、子二音。）
诸痈疽之发于节而相应者，不可治也，发于阳者百日死，发于阴者三十日死。（诸节者，神气之所游行出入也，皆不
宜有痈毒之患。若其相应，则发于上而应于下，发于左而应于右，其害尤甚，为不可治。然发于三阳之分者，毒浅在腑，
其死稍缓。发于三阴之分者，毒深在脏，不能出一月也。）
发于胫，名曰兔啮，其状赤至骨，急治之，不治害人也。（胫，足胫也。兔啮，如有所啮伤也。胫，行景、行敬二切。
啮音孽。）
发于内踝，名曰走缓，其状痈也，色不变，数石其输而止其寒热，不死。（数石其输，砭其所肿之处也。踝，胡寡切。）
发于足上下，名曰四淫，其状大痈，急治之，百日死。（阳受气于四末，而大痈淫于其间，阳毒之盛极也。时气移易
则真阴日败，故逾三月而死。）
发于足旁，名曰厉痈，其状不大，初如小指，发急治之，去其黑者，不消辄益，不治百日死。（不消辄益，谓初如小
指而不治，则日以益大也。）
发于足趾，名脱痈，其状赤黑死不治，不赤黑不死，不衰急斩之，不则死矣。（六经原 皆在于足，所以痈发于足者，
多为凶候。至于足趾，又皆六井所出，而痈色赤黑，其毒尤甚。若无衰退之状，则急当斩去其趾，庶得保生，否则毒瓦斯
连脏，必至死矣。）
黄帝曰∶夫子言痈疽，何以别之？岐伯曰∶荣卫稽留于经脉之中，则血泣而不行，不行则卫气从之而不通，壅遏而
不得行，故热。大热不止，热胜则肉腐，腐则为脓。然不能陷骨，髓不为焦枯，五脏不为伤，故命曰痈。（此下辨痈疽之
轻重也。痈毒浮浅在表，不能陷骨，则髓不为枯，五脏不为伤，故病痈者可无虑也。）黄帝曰∶何谓疽？岐伯曰∶热气淳
盛，下陷肌肤，筋髓枯，内连五脏，血气竭，当其痈下，筋骨良肉皆无余，故命曰疽。（痈浅疽深，毒有微甚，故内连五
脏，外败筋骨良肉者，是谓之疽，乃可畏也。）疽者，上之皮夭以坚，上如牛领之皮。痈者，其皮上薄以泽。此其候也。
（夭以色言，黑黯不泽也。此即皮色之状，可以辨其浅深也。）
黄帝说：我听说肠胃受纳水谷，上焦（指胸膈以上部位，主宣发卫气）排出宗气，用以温煦肌肉、滋养骨节、疏通腠理。（上焦排出的气是宗气。宗气出于喉咙而主持呼吸，它之所以能温煦肌肉、滋养骨节、疏通腠理，是因为卫气由宗气化生而来。）中焦（指脾胃，主腐熟水谷）排出的气像露水一样，向上灌注到肌肉间隙并渗入孙脉（最细小的络脉），津液调和，变化而成红色的血液，血液调和则孙脉先充盈，然后注入络脉，络脉都充盈后，再注入经脉，阴阳之气充盛，随着呼吸运行。（中焦排出的气像露水一样，指的是营气。其中“阴阳已张，因息乃行”，是指营气由宗气化生并随呼吸运行。）气血运行有常道，循环有规律，与天地自然相合，不会停止。（气血运行有常道，循环有规律，含义详见运气类第一卷。人体有营卫二气，与天地自然相合，含义详见经络类第二十四、二十五卷。）诊察并调理气血，从虚证角度去除实邪，泻法则使邪气不足，操作要快；留针则调节先后顺序。（凡用泻法应当快速，用补法应当留针，这说明补法与泻法在操作速度和留针时间上有先后差异。）从虚证角度治疗虚损，补法则使正气有余，血气已经调和，形体与正气得以稳固。我已经了解了血气的平衡与不平衡，但还不知道痈疽是如何产生的，其预后成败的时间长短，以及死亡时间的远近，如何判断呢？可以讲给我听吗？（“持”意为稳定。“度”读入声，意为推测。）
岐伯说：经脉中的气血流行不止，与天体的运行度数相同，与大地的纪数相合。所以天上的星宿失去常态，日月就会发生蚀亏；大地的经线失去秩序，水道就会泛滥，草木不能生长，五谷不能种植，道路不通，百姓无法往来，村落城邑分离分散，人体的血气也是这样，请让我讲讲其中的缘故。血脉和营卫之气，周流不息，上应星宿，下应地里的经纬之数。寒邪客居在经络之中，血液就会凝涩，血液凝涩就不通，不通则卫气聚集于此，不能再返回原位，所以形成痈肿。（卫气聚集于此，不能再返回原位，是说它留聚不散。蚀音食。 音宜， 草即鹿葱。殖音植。泣同涩。）寒气转化为热，热邪亢盛则腐蚀肌肉，肌肉腐烂则化为脓，脓液如果不排出则会烂筋，筋烂则伤骨，骨伤则骨髓消减，如果不在骨空处，脓液不得排泄，血液枯竭空虚，则筋骨肌肉失去濡养，经脉败坏渗漏，毒气熏蒸五脏，五脏受损所以死亡。（痈毒由浅入深，损伤五脏就会死亡。如下文所述，以及下编痈疽五逆候等，都是脏气受伤的证候。）
岐伯说：痈发于咽喉中间，名叫猛疽，猛疽不治疗，会化为脓，脓液不排出，堵塞咽喉，半天就会死亡。如果已经化为脓，排出脓液后服用猪脂膏，冷服，三天即可痊愈。（猛疽，是说危害急迫。如果脓已排出，应当服用猪脂膏，可以治愈，即精炼干净的猪油。看《万氏方》中有治疗肺热突发失音者，用一斤猪油炼过，加入一斤白蜜，再炼片刻，过滤干净冷却定形，不时挑服一匙即愈。如果没有病服用此物，最能润肺润肠。这也属于猪脂膏一类。）
痈发于颈部，名叫天疽，它的痈肿块大且颜色赤黑，如果不及时治疗，热气就会向下进入渊腋穴（足少阳胆经穴位），向前损伤任脉，向内熏蒸肝肺，熏蒸肝肺十余天后就会死亡。（颈，指前颈。颜色赤黑的，毒性一定很严重。渊液即渊腋穴，属足少阳经。痈发在颈部，就连接肺系，向下进入足少阳经，就波及肝脏了，所以导致死亡。）
阳气大发，消耗脑髓留在项部，名叫脑烁，患者面色不乐，项痛如针刺，心烦意乱的，属于死证，不可治疗。（阳气大发，是邪热极盛。面色不乐，是伤了神志。痛如针刺，是毒性锐利。心烦意乱，是邪气侵犯内脏，所以不可治疗。烁，读音为式灼切。）
痈发于肩部及腋下软肉处，名叫疵痈，形状赤黑，必须紧急治疗，这会导致患者出汗直到脚底，但不伤害五脏，痈发四五天，应当迅速施灸以消除它。（肩下软白肉处曰 ，这不是要害部位，所以不及五脏。逞，意为疾速。 ，指艾炷。意思是应该迅速艾灸来祛除它。 ，读音为儒、软二音，又作奴刀、奴到二切。疵，读音为资、子二音。 ，读音为如瑞切。）
痈发于腋下，颜色赤硬，名叫米疽，用砭石治疗，砭石要求细而长，稀疏地刺破，涂上猪脂膏，六天痊愈，不要包扎。（砭石要求细，是怕损伤肌肉。要求长，是用在深处。所以适宜稀疏而不宜密集。砭，读音为标兼切。）
那些痈坚硬而不溃破的，叫做马刀挟缨，必须紧急治疗。（这就是瘰疬。挟缨，《经脉篇》写作侠瘿，详见本类前十卷，足少阳条下。想要紧急治疗，是担心拖延伤人。）
痈发于胸部，名叫井疽，形状像大豆，三四天起病，如果不早治疗，毒气下行进入腹部就无法治疗，七天就会死亡。（发于胸部的，能熏蒸心肺，如果不早治疗让它进入腹部，毒性就更严重了，所以死亡期如此迅速。）
痈发于胸前，名叫甘疽，颜色青，形状像谷物果实，常常苦于寒热，必须紧急治疗，去除寒热症状，十天后死亡，死后流出脓液。（膺，是胸旁高起的肉处。谷实，泛指五谷，是说痈结聚的形状像累累的谷物果实。 KT ，即栝蒌，质地软而不溃，中间蓄积的东西像种子一样。这个病症延绵难愈，大概属于乳痈一类。 KT ，是古“栝楼”字。）
痈发于胁部，名叫败疵，败疵是女子的病，用灸法治疗，会变成大痈化脓，治疗时，里面会长出像赤小豆大小的新肉，锉碎芰草根和连翘根各一升，用水一斗六升煮至干竭，取三升药汁，让病人强饮，穿厚衣服，坐在锅上熏蒸，令汗出直到脚底即可痊愈。（ ，即芰。 ，即连翘。这两种草的根都能解毒，所以各用一升。大约古代的一升，相当于现在的三合多。用水一斗六升，煮取三升，都是折算后的数量。 音陵。 ，同翘。）
痈发于大腿和小腿，名叫股胫疽，外形变化不明显，但脓液附着在骨头上，如果不及时治疗，三十天就会死亡。（股胫，指大腿。状不甚变，是说外形不明显。痈脓搏骨，是说脓着在骨上，就是现在人所说的贴骨痈。毒性旺盛且深重，能向下侵蚀三阴三阳的大经脉，所以不紧急治疗就会死亡。）
痈发于臀部，名叫锐疽，形状赤黑坚硬肿大，必须紧急治疗，不治疗三十天就会死亡。（尻，尾骨，穴位名长强，是督脉的络穴，又名气之阴，所以不治疗就会死亡。尻，读音为开高切。）
痈发于大腿内侧，名叫赤施，如果不及时治疗，六十天死亡，如果在两腿内侧，不治疗十天就会死亡。（股阴，是大腿内侧。位于足太阴箕门、血海及足厥阴五里、阴包之间，都是阴气聚集的地方，所以不治疗就会死亡。如果两腿都患病，则是阴气极度受伤，死亡尤其迅速。）
痈发于膝盖，名叫疵痈，形状是大痈，颜色不变，感觉寒冷坚硬如石头，不要用砭石刺破，刺破的会死亡，等到它变柔软再用砭石刺破的才会生还。（膝痈未成脓时用砭石刺破，会损伤筋的汇聚处，所以导致死亡。如果变软说明脓已成，刺破就没有害处了。疵，读音为慈、子二音。）
各种痈疽发于关节且上下左右相应的，不可治疗，发于阳分的百日死亡，发于阴分的三十日死亡。（各个关节，是神气游行出入的地方，都不应该有痈毒的祸患。如果相应，就是发在上面而对应在下面，发在左边而对应在右边，危害尤其严重，属于不可治疗。然而发在三阳分位的，毒浅在腑，死亡稍慢。发在三阴分位的，毒深在脏，不出一个月就会死亡。）
痈发于小腿，名叫兔啮，形状红色直达骨头，必须紧急治疗，不治疗会害人。（胫，是小腿。兔啮，像被咬伤一样。胫，读音为行景、行敬二切。啮音孽。）
痈发在内踝，名叫走缓，形状是痈，颜色不变，多次用砭石刺其输穴以制止寒热，不会死亡。（数石其输，是砭刺其肿胀的部位。踝，读音为胡寡切。）
痈发于足上下，名叫四淫，形状是大痈，必须紧急治疗，一百天死亡。（阳气受气于四肢末端，而大痈淫溢在其中，是阳毒极盛。时令气候变迁则真阴日渐败坏，所以超过三个月死亡。）
痈发于足旁，名叫厉痈，形状不大，起初像小指，发病紧急治疗，去掉黑色的部分，如果不消退反而增大，不治疗一百天死亡。（不消辄益，是说起初像小指如果不治疗，就会每天增大。）
痈发于足趾，名叫脱痈，形状赤黑死亡不可治疗，不赤黑不死，如果不衰退必须紧急截肢，否则就会死亡。（六经的原穴都在足部，所以痈发于足部，多为凶兆。至于足趾，又是六井穴所出，而痈色赤黑，毒性尤其严重。如果没有衰退的迹象，就应当紧急斩去脚趾，才能保全生命，否则毒气连及内脏，必然死亡。）
岐伯说：营气滞留于经脉之中，血液凝涩不行，不行则卫气随之也不通，壅塞阻碍而不能运行，所以发热。大热不止，热胜则肌肉腐烂，腐烂则化为脓。但是不能陷没到骨头，骨髓不为焦枯，五脏不为损伤，所以命名为痈。（这部分辨别痈疽的轻重。痈毒浮浅在表，不能陷骨，则骨髓不为枯，五脏不为伤，所以患痈的人不必担忧。）
岐伯说：热气淳厚盛大，向下陷入肌肤，筋髓枯槁，内连五脏，血气耗尽，在其痈下，筋骨良肉全部坏死无余，所以命名为疽。（痈浅疽深，毒有轻微严重之分，所以内连五脏，外败筋骨良肉的，称为疽，这是可怕的。）
疽的病证，上部皮肤枯暗坚硬，表面像牛颈皮一样。痈的病证，上部皮肤薄而有光泽。这就是它们的征候。（夭指颜色，黑黯无光泽。这是皮肤的色泽状态，可以用来辨别病位的浅深。）
The full text of the *Ling Shu: Yong Ju Chapter* (Spiritual Pivot: Carbuncles and Ulcers)
Huang Di said: I have heard that the intestines and stomach receive grain, the Upper Jiao (the upper burner, located above the diaphragm, responsible for dispersing Wei Qi) releases Zong Qi (Gathering Qi), which warms the muscles, nourishes the joints, and unblocks the interstices. (The Qi released by the Upper Jiao is Zong Qi. Zong Qi emerges from the throat to govern respiration; its ability to warm the muscles, nourish the joints, and unblock the interstices stems from Wei Qi (Defensive Qi) being transformed from Zong Qi.) The Middle Jiao (the middle burner, involving the spleen and stomach, responsible for rotting and ripening food) releases Qi like dew, which flows upward into the muscle clefts and渗ates into the Sun Mai (finest collateral vessels). When the body fluids are harmonized, they transform and turn red to become Blood. When Blood is harmonized, the Sun Mai first fill up, then pour into the Luo Mai (collateral vessels); when the Luo Mai are all full, they pour into the Jing Mai (main meridians). Yin and Yang are fully distended, and movement proceeds with the breath. (The Qi released by the Middle Jiao like dew refers to Ying Qi (Nutritive Qi). The phrase "Yin and Yang are fully distended, and movement proceeds with the breath" indicates that Ying Qi is transformed from Zong Qi and moves in accordance with respiration.) Movement has its order, circulation has its principles, conforming to the agreement of Heaven, never ceasing. (Movement has its order, circulation has its principles; the meaning is detailed in Volume 1 of the Yun Qi category. Humans possess Ying and Wei Qi, conforming to the measure of Heaven; the meaning is detailed in Volumes 24 and 25 of the Jing Luo category.) Palpate and regulate them, removing excess from deficiency; the reducing method makes excess insufficient. (Removing excess by treating from the perspective of deficiency means the reducing method renders excess insufficient.) Rapid action reduces Qi; retention adjusts the sequence. (Reducing methods should be rapid, while tonifying methods should involve retention; this shows a difference in speed and retention time between tonification and reduction.) Treating deficiency from a deficient perspective makes sufficiency abundant; when Blood and Qi are regulated, form and Zheng Qi (Upright Qi) are stabilized. I already understand the balance and imbalance of Blood and Qi, but I do not yet know how carbuncles and ulcers arise, their timing for success or failure, and the proximity or distance of their death periods. How can we estimate this? May I hear it? ("Chi" means stable. "Du" is pronounced with an entering tone, meaning to estimate.)
Qi Bo said: The flow of Qi and Blood in the meridians never stops, matching the degrees of Heaven and the records of Earth. Thus, if celestial bodies lose their proper degree, solar and lunar eclipses occur; if earthly meridians lose their order, waterways overflow, grass fails to grow, grains fail to multiply, paths become blocked, people cease to travel, and villages and towns become separated and isolated. Human Blood and Qi are similarly affected; let me explain the reason. Blood vessels, Ying Qi, and Wei Qi circulate without rest, corresponding above to the stars and below to the measures of the earth. When Cold Evil lodges in the meridians, Blood becomes stagnant and does not flow. When Blood does not flow, Wei Qi gathers there and cannot return, thus forming a carbuncle (Yong). (Wei Qi gathering there and unable to return means it stays and accumulates without dispersing. Shi is pronounced shi. Yi is pronounced yi; Cao is Lu Cong [deer leek]. Zhi is pronounced zhi. Qi is synonymous with Se.) Cold Qi transforms into Heat. When Heat prevails, flesh rots; when flesh rots, pus forms. If pus is not drained, tendons rot; when tendons rot, bones are injured; when bones are injured, marrow diminishes. If not at bone apertures, pus cannot drain; Blood becomes depleted and empty, so tendons, bones, muscles, and flesh lose mutual nourishment. Meridians fail and leak, fumes熏 (smoke/percolate) into the Five Zang Organs. Injury to the Zang Organs leads to death. (Carbuncle toxins progress from shallow to deep; injury to the Zang Organs leads to death. As mentioned below, and in the Five Reversal signs of carbuncles and ulcers in the lower compilation, these are all syndromes of Zang Qi injury.)
Huang Di said: I wish to hear completely about the forms of carbuncles and ulcers, and their taboo days and names.
Qi Bo said: A carbuncle arising in the middle of the throat is called Meng Ju (Fierce Carbuncle). If Meng Ju is not treated, it turns to pus. If pus is not drained, it blocks the throat, leading to death within half a day. If it has turned to pus, after draining, administer Shi Gao (Pig Fat Ointment), take it cold, and it will heal in three days. (Meng Ju implies urgent harm. If pus is already drained, taking Shi Gao can cure it; this is refined, clean pig fat. In *Wan's Formulas*, there is a treatment for sudden aphonia due to Lung Heat using one jin of refined pig fat mixed with one jin of white honey, refined briefly, filtered, cooled, and taken by the spoonful as needed, which cures immediately. Taking this without illness best moistens the Lungs and Intestines. This belongs to the category of Shi Gao.)
A carbuncle arising on the neck is called Tian Ju (Heavenly Carbuncle). Its swelling is large and red-black. If not treated urgently, Heat Qi descends into Yuan Ye (Yuan-ye Acupoint, Foot Shaoyang Gallbladder Meridian), damages the Ren Mai (Conception Vessel) anteriorly, and internally fumigates the Liver and Lungs. Fumigation of the Liver and Lungs leads to death after more than ten days. (Neck refers to the anterior neck. Red-black color indicates severe toxicity. Yuan Ye is the Foot Shaoyang point. Arising on the neck connects to the Lung system; descending into Foot Shaoyang affects the Liver, hence death.)
Excessive expansion of Yang Qi consumes brain marrow and remains in the nape, called Nao Shuo (Brain Melting). The complexion is unhappy, neck pain feels like needle pricking, and irritability indicate a fatal, untreatable condition. (Excessive Yang Qi expansion is extreme pathogenic heat. Unhappy complexion indicates Spirit injury. Pain like needle pricking indicates sharp toxicity. Irritability indicates Evil invading the Zang Organs, hence untreatable. Shuo is pronounced shi zhuo qie.)
A carbuncle arising on the shoulder and the soft flesh below the armpit is called Ci Yong (Flaw Carbuncle). It appears red-black. Treat it urgently; this causes sweating down to the feet but does not harm the Five Zang Organs. Four to five days after onset, apply moxibustion swiftly to eliminate it. (The soft white flesh below the shoulder is called . This is not a vital area, so it does not affect the Zang Organs. Cheng means swift. refers to moxa cones. It means rapid moxibustion should be applied. is pronounced ru or ruan, also nu dao or nu dao. Ci is pronounced zi or zi. is pronounced ru rui qie.)
A carbuncle arising in the axilla that is red and hard is called Mi Ju (Rice Carbuncle). Treat with bi stone (lithic stone). The stone should be fine and long, puncture sparsely, apply Shi Gao (Pig Fat Ointment), and it will heal in six days. Do not bandage it. (Fine stones avoid damaging flesh; long stones reach deep areas. Hence, sparse rather than dense puncture is suitable. Bian is pronounced biao jian qie.)
Those carbuncles that are hard and do not ulcerate are called Ma Dao Xia Ying (Horse Knife with Pendant). Treat urgently. (This is Scrofula. Xia Ying is written as Xia Ying in the *Jing Mai Chapter*; see Volume 10 of this category, under Foot Shaoyang. Urgent treatment is feared to delay harm to the person.)
A carbuncle arising in the chest is called Jing Ju (Well Carbuncle). It resembles a soybean. It arises in three to four days. If not treated early, it descends into the abdomen and becomes untreatable, leading to death in seven days. (Arising in the chest fumigates the Heart and Lungs. If not treated early and allowed to enter the abdomen, the toxin is even more severe, hence such rapid death.)
A carbuncle arising in the anterior chest is called Gan Ju (Sweet Carbuncle). It is green, resembling grain fruits, often accompanied by aversion to cold and fever. Treat urgently to remove cold and fever; death occurs in ten days, with pus discharging after death. (Ying refers to the raised flesh on the side of the chest. Grain fruit refers to various grains, indicating the lump resembles clustered grains. KT refers to Trichosanthes fruit, soft and non-ulcerated, containing seeds inside. This condition is lingering and difficult to cure, belonging to breast carbuncles. KT is the ancient character for Gua Lou.)
A carbuncle arising in the hypochondrium is called Bai Ci (Ruined Flaw). Bai Ci is a disease of women. Moxibustion causes it to become a large carbuncle with pus. Treatment reveals new flesh growing inside, the size of a red bean. Decoct one sheng each of Ji Gen (Water Caltrop Root) and Qiao Gen (Forsythia Root) in one dou six sheng of water until reduced to three sheng. Drink strongly, wear thick clothes, sit over a pot to steam, and induce sweating down to the feet to cure. ( is Water Caltrop. is Forsythia. Both roots detoxify, hence one sheng each. Ancient one sheng equals roughly modern three he plus. One dou six sheng boiled to three sheng involves numerical conversion. Ling is pronounced ling. Qiao is same as qiao.)
A carbuncle arising in the thigh and shin is called Gu Ting Ju (Thigh-Shin Carbuncle). External changes are slight, but pus adheres to the bone. If not treated urgently, death occurs in thirty days. (Gu Ting refers to the thigh. Slight change means external appearance is not obvious. Pus adhering to bone refers to what is now called osteomyelitis/carbuncle adhering to bone. Toxin is intense and deep, eroding the great meridians of Three Yin and Three Yang; hence, lack of urgent treatment leads to death.)
A carbuncle arising in the buttocks is called Rui Ju (Sharp Carbuncle). It is red, black, hard, and large. Treat urgently; without treatment, death occurs in thirty days. (Kao is the coccyx, acupoint Chang Qiang, a collateral of the Du Mai, also named Qi Yin. Untreated, it leads to death. Kao is pronounced kai gao qie.)
A carbuncle arising in the medial thigh is called Chi Shi (Red Spread). If not treated urgently, death occurs in sixty days. If in both inner thighs, death occurs in ten days without treatment. (Medial thigh is the inner aspect of the thigh. Located between Ji Men, Xue Hai of Foot Taiyin Spleen Meridian, and Wu Li, Yin Bao of Foot Jueyin Liver Meridian, these are places where Yin Qi gathers. Untreated, it leads to death. If both thighs are diseased, Yin is extremely injured, leading to faster death.)
A carbuncle arising in the knee is called Ci Yong (Flaw Carbuncle). It is a large carbuncle, color unchanged, feeling cold and hard like stone. Do not pierce with bi stone; piercing leads to death. Wait until it softens before piercing; survival follows. (Piercing a pre-suppurative knee carbuncle damages the府 of tendons, causing death. Softness indicates pus formation; piercing is harmless then. Ci is pronounced ci or zi.)
All carbuncles and ulcers arising in joints with corresponding symptoms elsewhere are untreatable. Those arising in Yang aspects die in one hundred days; those in Yin aspects die in thirty days. (Joints are places where Shen Qi (Spirit Qi) travels and enters/exits; they should not suffer carbuncle toxins. Correspondence means upper corresponds to lower, left to right, causing greater harm, hence untreatable. However, those in Three Yang aspects have shallow toxin in Fu Organs, dying slightly slower. Those in Three Yin aspects have deep toxin in Zang Organs, dying within one month.)
A carbuncle arising in the shin is called Tu Nie (Rabbit Bite). It is red reaching the bone. Treat urgently; untreated, it harms the person. (Ting is the shin. Rabbit bite implies biting injury. Ting is pronounced xing jing or xing jing. Nie is pronounced nie.)
A carbuncle arising in the medial malleolus is called Zou Huan (Slow Walker). It presents as a carbuncle, color unchanged. Frequent bi stone puncture of the Shu points stops cold and fever; death does not occur. (Shu Shi Qi Shu means bi-stoning the swollen area. Huai is pronounced hu gua qie.)
A carbuncle arising on the top and bottom of the foot is called Si Yin (Four Excesses). It is a large carbuncle. Treat urgently; death occurs in one hundred days. (Yang Qi receives Qi from the four extremities; large carbuncles overflowing there indicate extreme Yang toxin. Seasonal changes cause daily decline of True Yin, hence death beyond three months.)
A carbuncle arising beside the foot is called Li Yong (Fierce Carbuncle). It is not large, initially like a small finger. Treat urgently. Remove black parts. If it does not subside but grows, untreated death occurs in one hundred days. (No subsidence but growth means starting small like a finger, untreated it grows daily.)
A carbuncle arising in the toes is called Tuo Yong (Peeling Carbuncle). Red-black indicates death and untreatability; non-red-black indicates survival. If no regression, amputation is urgent; otherwise, death ensues. (Yuan sources of the Six Meridians are in the feet; thus, foot carbuncles are often ominous. Toes are where the Six Jing Wells emerge; red-black color indicates severe toxin. Without regression, urgent toe amputation preserves life; otherwise, toxin connects to Zang Organs, leading to death.)
Huang Di said: You speak of carbuncles and ulcers; how do we distinguish them?
Qi Bo said: When Ying Qi stagnates in the meridians, Blood stagnates and does not flow. When Blood does not flow, Wei Qi follows but cannot pass, obstructing and failing to move, thus generating Heat. Unchecked high Heat causes flesh to rot and turn to pus. However, it does not sink into bones, marrow does not scorch, and the Five Zang Organs are not injured; thus it is named Yong (Carbuncle). (This section distinguishes severity. Yong toxin is superficial, cannot sink into bones, so marrow is not dried and Zang Organs are uninjured; thus, Yong patients need not worry.)
Huang Di said: What is Ju (Ulcer)?
Qi Bo said: When Heat Qi is pure and excessive, sinking into skin and muscle, drying sinews and marrow, connecting internally to the Five Zang Organs, exhausting Blood and Qi, the area beneath the carbuncle sees bones, sinews, and good flesh entirely destroyed; thus it is named Ju. (Yong is shallow, Ju is deep; toxin varies in severity. Internal connection to Zang Organs and external destruction of bones, sinews, and flesh defines Ju, which is fearsome.)
In Ju, the upper skin is dull and hard, resembling ox neck skin. In Yong, the upper skin is thin and lustrous. These are the signs. (Tao refers to color, dark and dull. This skin condition distinguishes depth/shallowness.)