正背发生于当心中，不上不下，不左不右，正对心脾，比诸毒尤甚，与对口相同，乃通身经络所属也。不宜
勾割，治与诸发
背同。
上搭手生于匙骨之下，去背沟一指是也，乃手足太阴太阳之所属也。去肺膈不远，不可勾割。由下元枯竭，
上焦积热，宜滋阴降火。三香内托饮（方见前），加黄柏、知母、连翘、二花。定痛拔毒饮（方见前），加黄柏、
知母、栀子、二花、牛子、连翘、花粉、黄芩、湘莲而服，排脓定痛而愈。
八味白芷散
连翘、白芷、乳香、黄柏、升麻、没药、羌活、二花。竹叶引。
空心服。
九味敷方
生地、牛膝、二花、仙人掌、半边莲、龙胆草、清凉膏、雄黄、连须子。
以酒糟共捣，敷患处。
中搭手生于背中心，离三指之间，亦手足三阴三阳之所属也。离脏腑亦近，不可用刀针。因肾不足而心有郁
热，故生斯毒。宜顺气开郁，清热追毒。先服三香连翘汤，次服定痛清气汤，然后排脓生肌。
九味三香连翘汤
香附（酒炒）、木香、乳香、羌活、连翘、牛子、二花、当归、白芍。
空心服。
十六味定痛清气汤
人参、黄 、白术（土炒）、连翘、生地、当归、木香、乳香、没药、桔根、白芷、川芎、麦冬、羌活、二
花、皂角刺。
空心服。
生肌妙方
猪骨髓、轻粉（一分）。
用青布 定，捶膏贴之，神效。
五味敷方
生地、忍冬、胆草、黄柏、雄黄。
以酒糟捣烂，敷之。
Zhengbei Fa (Central Back Carbuncle) occurs at the exact center of the back, neither high nor low, neither left nor right, directly opposite the Heart and Spleen. Its severity exceeds that of other toxic sores; it is identical to Duikou Chuang (Opposite Mouth Carbuncle), as this area belongs to the meridians of the entire body. It should not be treated with hooking or cutting incisions; the treatment method is the same as for other back carbuncles.
Shangdashou (Upper Back-joining Hand) arises below the clavicle (scapula bone), one finger-breadth away from the midline of the back. It is governed by the Hand-Taiyin Lung Meridian, Hand-Shaoyin Heart Meridian, Foot-Taiyin Spleen Meridian, Foot-Shaoyin Kidney Meridian, Hand-Taiyang Small Intestine Meridian, and Foot-Taiyang Bladder Meridian. This area is close to the Lungs and Diaphragm and must not be subjected to hooking or cutting incisions. The etiology involves depletion of the Lower Yuan (Kidney Essence) and accumulation of heat in the Upper Jiao. Treatment should focus on nourishing Yin and descending Fire. Administer Sanxiang Neituo Yin (Three-Fragrance Internal Support Decoction, see previous section) with added Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Lianqiao (Forsythiae Fructus), and Erhua (Lonicerae Japonicae Flos). Alternatively, administer Dingtong Badu Yin (Pain-Calming and Toxin-Expelling Decoction, see previous section) with added Huangbai, Zhimu, Zhizi (Gardeniae Fructus), Erhua, Niuzi (Arctii Fructus), Lianqiao, Huafen (Trichosanthis Radix), Huangqin (Scutellariae Radix), and Xianglian (Nelumbinis Semen). This will expel pus, relieve pain, and lead to recovery.
Bawei Baizhi San (Eight-Ingredient Angelica Dahurica Powder): Consists of Lianqiao, Baizhi (Angelicae Dahuricae Radix), Ruxiang (Olibanum), Huangbai, Shengma (Cimicifugae Rhizoma), Moyao (Myrrha), Qianghuo (Notopterygii Rhizoma et Radix), and Erhua. Take with a decoction of Zhuye (Bamboo Leaf) on an empty stomach.
Jiuwei Fu Fang (Nine-Ingredient Topical Application Formula): Consists of Shengdi (Rehmanniae Radix), Niuxi (Achyranthis Bidentatae Radix), Erhua, Xianrenzhang (Opuntiae Dillenii Caulis), Banbianlian (Lysimachiae Herba), Longdancao (Gentianae Radix), Qingliang Gao (Cooling Ointment), Xionghuang (Realgar), and Lianxuzi (Allii Macrostemonis Bulbus). Mash together with Jiuzao (Wine Lees) and apply topically to the affected area.
Zhongdashou (Middle Back-joining Hand) arises at the center of the back, three finger-breadths away from the spine. It is also governed by the Three Yin and Three Yang meridians of the hands and feet. This area is close to the Zang-Fu organs and must not be treated with knives or needles. The pathology stems from Kidney Deficiency combined with Stagnant Heat in the Heart, resulting in this toxic sore. Treatment should aim to regulate Qi, resolve stagnation, clear heat, and drive out toxins. First, administer Sanxiang Lianqiao Tang (Three-Fragrance Forsythia Decoction); subsequently, administer Dingtong Qingqi Tang (Pain-Calming and Qi-Clearing Decoction); finally, promote pus expulsion and tissue regeneration.
Jiuwei Sanxiang Lianqiao Tang (Nine-Ingredient Three-Fragrance Forsythia Decoction): Consists of Xiangfu (Cyperi Rhizoma, wine-fried), Muxiang (Aucklandiae Radix), Ruxiang, Qianghuo, Lianqiao, Niuzi, Erhua, Danggui (Angelicae Sinensis Radix), and Baishao (Paeoniae Radix Alba). Take on an empty stomach.
Shiliuwei Dingtong Qingqi Tang (Sixteen-Ingredient Pain-Calming and Qi-Clearing Decoction): Consists of Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Lianqiao, Shengdi, Danggui, Muxiang, Ruxiang, Moyao, Jiegen (Scrophulariae Radix), Baizhi, Chuanxiong (Chuanxiong Rhizoma), Maidong (Ophiopogonis Tuber), Qianghuo, Erhua, and Zaocispina (Gleditsiae Sinensis Spina). Take on an empty stomach.
Shengji Miaofang (Miraculous Formula for Tissue Regeneration): Consists of Zhu Guisui (Porcine Marrow) and Qingfen (Calomelas, 1 fen). Wrap in green cloth, pound into an ointment, and apply topically for miraculous efficacy.
Wuwei Fu Fang (Five-Ingredient Topical Application Formula): Consists of Shengdi, Rendong (Lonicerae Japonicae Caulis), Danshen (Note: Text says "Dancao" likely Gentianae Radix given context of cooling heat, but literal is Gallbladder Grass/Longdancao), Huangbai, and Xionghuang. Mash with wine lees and apply topically.