【方歌】乐疽肩前腋上生，骨缝开合凹陷中，坚如鹅卵痛入骨，
包络血热气郁成。
【注】此证生于肩前腋之上，骨缝开合空凹陷中。初起如椒子
，渐肿坚硬，大如鹅卵，按之疼痛入骨，属包络经，血
热气郁而成。其证届期溃破，出稠脓，肿消者顺；月余
不溃，既溃，出清水，肿硬不退者逆。初宜服神授卫生
汤，若恶风太过，倍加葱白汗之，次服托里透脓汤），
溃迟者十全大补汤。溃后，内外治法俱按痈疽溃疡门。
方剂：神授卫生汤（见肿疡门）
托里透脓汤（见头部侵脑疽）
十全大补汤（见溃疡门）
【方歌】臑痈肩肘周匝肿，色赤焮疼粟〔畾〕僵，藕包毒状鸭
鹅卵，臑内三阴外三阳。
【注】此证由风瘟或风火凝结而成。生于肩下肘上，周匝漫肿
，色赤焮肿。初起状如粟米一攒，亦有起一粒僵疙瘩者
，渐次焮肿红热，〔兴〕脓痛甚。红肿之外无晕者顺，
有二晕者险，三、四晕者逆。肿发臑内或臑外红肿一枚
，如桃如鸭、鹅卵者，名藕包毒。毒者，痈之轻证也。
臑痈、藕包内外治法，俱按痈疽肿疡、溃疡门。此痈毒
发苗之处，若在臑者，属手三阴经，在臑外者，属手三
阳经；随证用引经之药，必然获效。
【方歌】鱼肚发如鱼肚形，青灵穴生心火凝，暴肿红活焮热痛，
痈疽治法即成功。
【注】此证生于臑之后垂肉处，属心经青灵穴，由火毒凝结而
成。暴肿色赤，焮热疼痛，形如鱼肚。肿、溃治法，俱
按痈疽肿疡、溃疡门。其引经之药，惟在临证加之。
[Prescription Verse] Leju (Le Abscess) arises anterior to the shoulder and superior to the axilla, in the depression of the Kaihe (Open and Close) bone fissure. The mass is hard as a goose egg, with pain penetrating to the bone. It is formed by blood-heat and Qi stagnation in the Pericardium Meridian.
[Note] This condition occurs above the anterior shoulder and axilla, in the hollow depression of the Kaihe (Open and Close) bone fissure. Initially, it resembles a peppercorn, gradually swelling and hardening to the size of a goose egg. Palpation causes pain penetrating to the bone. It belongs to the Pericardium Meridian and is caused by blood-heat and Qi stagnation. When the time for suppuration arrives, if it ruptures discharging thick pus and the swelling subsides, it is a favorable prognosis (Shun); if it does not rupture after more than a month, or if it ruptures discharging clear fluid while the swelling and hardness persist, it is an unfavorable prognosis (Ni). In the initial stage, Shen Shou Wei Sheng Tang (Divine Grant Health-Preserving Decoction) should be taken. If aversion to wind is severe, add extra Cong Bai (Scallion White) to induce sweating. Subsequently, Tuo Li Tou Nong Tang (Support Interior and Penetrate Pus Decoction) should be taken; for those with delayed suppuration, Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) is indicated. For post-ulceration internal and external treatments, refer to the Ulcerative Sores section of the Carbuncles and Ulcers chapter.
Formulas: Shen Shou Wei Sheng Tang (see Swollen Ulcer Section); Tuo Li Tou Nong Tang (see Head Invading Brain Carbuncle); Shi Quan Da Bu Tang (see Ulcer Section).
[Prescription Verse] Naoyong (Arm Abscess) presents with circumferential swelling around the shoulder and elbow. The skin is red, hot, and painful, with a rough texture like millet grains or stiff nodules. The swelling resembles a lotus root pouch, duck egg, or goose egg. The interior of the arm (Na) corresponds to the Three Yin Meridians of Hand, and the exterior corresponds to the Three Yang Meridians of Hand.
[Note] This condition is caused by the conglomeration of Wind-Wen (Wind-Epidemic) or Wind-Fire. It arises between the lower shoulder and upper elbow, with diffuse circumferential swelling and red, hot skin. Initially, it appears as a cluster of millet grains, or sometimes a single stiff nodule. Gradually, it becomes red, swollen, hot, and suppurates with severe pain. If there are no halos outside the redness and swelling, it is a favorable prognosis (Shun); if there are two halos, it is dangerous (Xian); if there are three or four halos, it is unfavorable (Ni). A single area of redness and swelling appearing either inside or outside the arm, shaped like a peach, duck egg, or goose egg, is named Ou Bao Du (Lotus Root Pouch Toxin). "Toxin" here refers to a mild form of carbuncle. Internal and external treatments for Naoyong and Ou Bao Du follow the methods in the Swollen Ulcer and Ulcerative Sores sections of the Carbuncles and Ulcers chapter. Regarding the location of this abscess toxin: if it occurs on the inner arm, it belongs to the Three Yin Meridians of Hand; if on the outer arm, it belongs to the Three Yang Meridians of Hand. Using guiding herbs according to the syndrome will surely yield efficacy.
[Prescription Verse] Yudu Fa (Fish Belly Eruption) takes the shape of a fish belly. It arises at Qingling (Green Spirit) acupoint, caused by the conglomeration of Heart Fire. It presents with sudden swelling, vibrant red color, heat, and pain. Applying the treatment methods for carbuncles and ulcers leads to success.
[Note] This condition occurs in the hanging flesh posterior to the arm, belonging to the Qingling (Green Spirit) acupoint of the Heart Meridian. It is caused by the conglomeration of Fire-Toxin. It presents with sudden swelling, red color, burning heat, and pain, resembling a fish belly. Treatment for swelling and ulceration follows the methods in the Swollen Ulcer and Ulcerative Sores sections of the Carbuncles and Ulcers chapter. Guiding herbs should be added clinically as appropriate.