上背发生于百劳骨下三、四节之间，由督脉、太阳经所生也。受病在胸身，经生肺肝，乃心经郁热，后因怒
气伤肝，热郁不伸，乃生背发。内经曰∶“营气不从，逆于肉里”，至生痈疽。先宜败毒流气饮一、二剂，次用
护心托里饮。如危甚，用神效忍冬汤，外须用敷药，待脓尽用生肌散。初起如黄豆大时，宜用海马崩毒法，次用
四围灸法，如轻可减半矣。此症大忌房事、秽气、香味等项。
十味败毒流气饮
人参、桔根、枳壳（麸炒）、甘草、防风、荆芥（少许）、柴胡、川芎、白芷、白芍。姜枣引。
空心服。
十味护心托里饮
黄连、栀子、连翘、羌活、桔根、白芷、连子、干葛、升麻、防风。姜引。
空心服。
十四味流气饮
黄连、羌活、柴胡、木香、陈皮、紫苏、当归、生地、川芎、甘草、乌药、槟榔、官桂、连翘。
空心服。
十二味神效忍冬汤
忍冬藤、龙胆草、 本、羌活、炙黄 、柴胡、黄连（酒炒）、甘草节、川芎、荆芥、白芷、防风。溃后加
人参。
水煎温服。
十味敷方
忍冬藤、龙胆草、仙人掌、山龙甲（即松树根上绿衣）、地龙鳞（即地龙皮刺）、雄黄、地骨皮、连翘、白
芷、火炭草。
将酒糟捣碎，敷疮上四围，即止痛，待痛止脓尽上生肌散，可也。
海马崩毒法
以热水从肘后先洗起，至手六经起端处止，日行数十次，内服前方以泻其毒，洗至指甲尖，亦不可住手，看
疮势穣方可住手，
盖手三阳俱系督脉所属，洗手至穣时，势从根本而泄，毒从根本而消，甚勿轻视。此方治发背、搭手、对口俱效，
必要初起时为之。
二味神仙一醉失笑散
蒲公英、忍冬藤各二钱。
以好酒煮热，尽量饮之醉，仍以生葱一根，灌蜜入内要满，以灰火煨热压酒，以被盖睡取汗，汗出而愈。并
治上中下三背发及三手搭，并乳发，立效。
铁箍散亦可用。
Shangbei Fa (a carbuncle occurring on the upper back) arises between the third and fourth vertebral segments below Bailao (B10, Bl-10). It is caused by pathogenic invasion of the Du Mai (Conception Vessel of the Back) and the Foot-Taiyang Bladder Meridian. The pathology involves the chest and back regions, with meridian connections to the Lung and Liver organs. The pathogenesis stems from stagnant heat in the Heart Meridian, exacerbated later by anger injuring the Liver, causing heat stagnation without dispersion, thereby generating a dorsal carbuncle. As stated in the *Neijing* (Inner Canon): "When Ying Qi (Nutritive Qi) fails to flow smoothly and reverses within the muscle layers," it leads to the formation of abscesses and sores. Initially, it is advisable to administer Bai Du Liu Qi Yin (Ten-Ingredient Decoction for Resolving Toxins and Regulating Qi) for one or two doses, followed by Hu Xin Tuo Li Yin (Ten-Ingredient Decoction for Protecting the Heart and Supporting the Interior). If the condition is critical, Shen Xiao Ren Dong Tang (Twelve-Ingredient Divine-Efficacy Honeysuckle Vine Decoction) should be used. Externally, poultices are required; once the pus has completely drained, Sheng Ji San (Flesh-Generating Powder) should be applied. When the lesion first appears the size of a soybean, Hai Ma Beng Du Fa (Sea Horse Method for Bursting Toxins) is appropriate, followed by Si Wei Jiu Fa (Four-Sided Moxibustion); if mild, the dosage/intensity may be halved. This condition strictly forbids sexual intercourse, exposure to foul odors, and fragrant scents.
Shi Wei Bai Du Liu Qi Yin (Ten-Ingredient Decoction for Resolving Toxins and Regulating Qi)
Ren Shen (Ginseng Radix et Rhizoma), Ju Gen (Scrophulariae Radix), Zhi Ke (Aurantii Fructus Prepared with Bran), Gan Cao (Licorice Root), Fang Feng (Saposhnikoviae Radix), Jing Jie (Schizonepetae Spica, small amount), Chai Hu (Bupleuri Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Bai Shao (Paeoniae Radix Alba). Use Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus) as guides. Take on an empty stomach.
Shi Wei Hu Xin Tuo Li Yin (Ten-Ingredient Decoction for Protecting the Heart and Supporting the Interior)
Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), Lian Qiao (Forsythiae Fructus), Qiang Huo (Notopterygii Rhizoma et Radix), Ju Gen (Scrophulariae Radix), Bai Zhi (Angelicae Dahuricae Radix), Lian Zi (Nelumbinis Semen), Gan Ge (Puerariae Lobatae Radix), Sheng Ma (Cimicifugae Rhizoma), Fang Feng (Saposhnikoviae Radix). Use Sheng Jiang (Zingiberis Rhizoma Recens) as a guide. Take on an empty stomach.
Shi Si Wei Liu Qi Yin (Fourteen-Ingredient Decoction for Regulating Qi)
Huang Lian (Coptidis Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Chai Hu (Bupleuri Radix), Mu Xiang (Aucklandiae Radix), Chen Pi (Citri Reticulatae Pericarpium), Zi Su (Perillae Folium), Dang Gui (Angelicae Sinensis Radix), Sheng Di Huang (Rehmanniae Radix Praeparata), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gan Cao (Licorice Root), Wu Yao (Linderae Radix), Bing Lang (Arecae Semen), Guan Gui (Cinnamomi Cortex), Lian Qiao (Forsythiae Fructus). Take on an empty stomach.
Shi Er Wei Shen Xiao Ren Dong Tang (Twelve-Ingredient Divine-Efficacy Honeysuckle Vine Decoction)
Ren Dong Teng (Lonicerae Japonicae Caulis), Long Dan Cao (Gentianae Radix), Gao Ben (Ligustici Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Zhi Huang Qi (Astragali Radix Preparata), Chai Hu (Bupleuri Radix), Huang Lian (Coptidis Rhizoma, stir-fried with wine), Gan Cao Jie (Licorice Joint), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Jing Jie (Schizonepetae Spica), Bai Zhi (Angelicae Dahuricae Radix), Fang Feng (Saposhnikoviae Radix). Add Ren Shen (Ginseng Radix et Rhizoma) after ulceration. Decoct in water and take warm.
Shi Wei Fu Fang (Ten-Ingredient External Poultice Formula)
Ren Dong Teng (Lonicerae Japonicae Caulis), Long Dan Cao (Gentianae Radix), Xian Ren Zhang (Opuntiae Dillenii Caulis), Shan Long Jia (Green moss on pine roots), Di Long Lin (Spicules of earthworm skin), Xiong Huang (Realgar), Di Gu Pi (Lycii Cortex), Lian Qiao (Forsythiae Fructus), Bai Zhi (Angelicae Dahuricae Radix), Huo Tan Cao (Euphorbiae Humifusae Herba).
Mash jiu zao (distiller's grains) and apply around the wound perimeter to relieve pain. Once pain subsides and pus is exhausted, apply Sheng Ji San (Flesh-Generating Powder).
Hai Ma Beng Du Fa (Sea Horse Method for Bursting Toxins)
Wash with hot water starting from behind the elbow up to the origin points of the six hand meridians, performing dozens of times daily. Internally, take the aforementioned formulas to drain toxins. Wash up to the fingernail tips without stopping; cease only when the swelling of the lesion subsides. Since the Three Hand-Yang Meridians belong to the jurisdiction of the Du Mai (Conception Vessel of the Back), washing until the swelling subsides allows the pathological trend to drain from the root and the toxin to dissipate from the source. Do not underestimate this method. This technique is effective for treating Bei Fa (Dorsal Carbuncle), Da Shou (Hand-Hanging Carbuncle), and Dui Kou Chuang (Opposite-Mouth Sore), but must be applied during the initial stage.
Er Wei Shen Xian Yi Zui Shi Xiao San (Two-Ingredient Divine Immortal One-Drunken-Laugh-Away Powder)
Pu Gong Ying (Taraxaci Herba) and Ren Dong Teng (Lonicerae Japonicae Caulis), each 2 qian.
Boil in good wine until hot, drink to intoxication. Then, insert honey-filled fresh green onion into the anus, press the wine bowl with the heated onion using ash-fire heat, cover with a blanket, sleep, and induce sweating. Recovery occurs upon sweating. This also treats Bei Fa (Dorsal Carbuncles) of the upper, middle, and lower back, Da Shou (Hand-Hanging Carbuncles) of all three hands, and Ru Fa (Breast Carbuncle), with immediate effect.
Tie Gu San (Iron-Hoop Powder) may also be used.