【方歌】天柱疽生天柱骨，上焦郁热蓄督经，灸之有疱方为顺，
色黑形陷逆而凶。
【注】此疽生于项后高骨，名天柱骨，即大椎骨也。疽之初起
，形如卧蚕，由上焦郁热，蓄于督脉，以致肩背拘急，
极痒入骨。宜于疽上以艾灸之，若灸之有疱者顺，无疱
者逆。甚至色黑形陷，血出不止，溃烂神昏，呕哕恶心
等证，是为大凶。其内外治法同脑疽。
【方歌】鱼尾毒生后发角，在左在右浅而轻，膀胱湿热七日溃，
脓出肿消痛自宁。
【注】此毒生于项后发际两旁角处，由足太阳膀胱经湿热凝结
而发。其毒或在左，或在右，皆属轻浅。初起宜荆防败
毒散；脓将成，宜服托里排脓汤。其外治之法，同痈疽
肿疡、溃疡诸证。
方剂：托里排脓汤
组成：当归 白芍（酒炒）
人参 白术（土炒）
茯苓 连翘（去心）
金银花 浙贝母（去心，各一钱）
生黄耆（二钱） 陈皮（八分）
肉桂（六分） 桔梗（胸之上加一钱）
牛膝（下部加八分） 白芷（顶之上加五分）
甘草（四分）
姜一片，水三钟，煎一钟，食远温服。
【方歌】托里排脓治溃疮，排脓消肿实称强，归芍四君翘桂芷，
银耆贝桔膝陈良。
又方：荆防败毒散（见脑疽）
【方歌】百脉疽生肿色形，引耳绕颈色紫红，痛热不食气逆嗽，
刺出脓吉血出凶。
【注】此疽初发，漫肿大小数块，环绕颈项，其色紫红，痛热
不食，气逆欬嗽，其发引耳。十五日可刺，迟则毒攻咽
喉。刺见脓者顺，见血者逆。余治法，按痈疽肿疡、溃
疡门。
[Prescription Verse] Tianzhu Ju (Tianzhu Carbuncle) arises at the Tianzhu bone, caused by stagnant heat in the Upper Jiao accumulating in the Du Meridian. The appearance of blisters after moxibustion indicates a favorable prognosis; black coloration and sunken morphology indicate an unfavorable and ominous prognosis.
[Annotation] This carbuncle arises at the prominent bone at the back of the neck, named Tianzhu bone, which is also known as Dazhui (GV14). At the initial stage, the lesion resembles a lying silkworm. It is caused by stagnant heat in the Upper Jiao accumulating in the Du Meridian, leading to stiffness and spasm of the shoulders and back, with intense itching penetrating to the bone. Moxibustion should be applied directly on the carbuncle. The appearance of blisters after moxibustion indicates a favorable course, while the absence of blisters indicates an unfavorable course. In severe cases, symptoms such as black discoloration, sunken morphology, unceasing bleeding, ulceration, coma, vomiting, hiccups, and nausea may occur, representing a highly ominous condition. Its internal and external treatment methods are the same as those for Nao Ju (Brain Carbuncle).
[Prescription Verse] Yutui Du (Yutui Toxicity) arises at the angle of the posterior hairline. Whether on the left or right side, it is superficial and mild. Damp-heat in the Bladder Meridian condenses, and after seven days, it may ulcerate. Once pus is discharged, the swelling subsides, and pain naturally ceases.
[Annotation] This toxicity arises at the angles on both sides of the posterior hairline at the back of the neck, caused by the condensation of damp-heat in the Foot-Taiyang Bladder Meridian. The toxicity may be on the left or the right, both being considered mild and superficial. At the initial stage, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction to Expel Toxins) is suitable. When pus is about to form, Tuoli Paimeng Tang (Decoction to Support the Interior and Drain Pus) is suitable. Its external treatment methods are the same as those for various conditions of Yong Ju (Carbuncles and Ulcers), including Swellyang (Swelling Stage) and Ku yang (Ulceration Stage).
Prescription: Tuoli Paimeng Tang (Decoction to Support the Interior and Drain Pus)
Composition: Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba, stir-fried with wine), Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae, stir-fried with soil), Fuling (Poria), Lianqiao (Forsythiae Fructus, heart removed), Jinyinhua (Lonicerae Japonicae Flos), Zhebeimu (Fritillariae Thunbergii Bulbus, heart removed, each 1 qian), Sheng Huangqi (Astragali Radix, raw, 2 qian), Chenpi (Citri Reticulatae Pericarpium, 8 fen), Rougui (Cinnamomi Cortex, 6 fen), Jiegeng (Platycodonis Radix, add 1 qian if located in the upper chest), Niuxi (Achyranthis Bidentatae Radix, add 8 fen if located in the lower body), Baizhi (Angelicae Dahuricae Radix, add 5 fen if located at the vertex), Gancao (Glycyrrhizae Radix et Rhizoma, 4 fen).
One slice of Shengjiang (Zingiberis Rhizoma Recens), three zhong of water, decocted to one zhong. Take warm after meals.
[Prescription Verse] Tuoli Paimeng Tang treats ulcerated sores; its ability to drain pus and reduce swelling is truly powerful. It contains Danggui, Baishao, Si Jun Zi Tang components, Qiao (Lianqiao), Gui (Rougui), Zhi (Baizhi); Yin (Jinyinhua), Qi (Huangqi), Bei (Zhebeimu), Jie (Jiegeng), Xi (Niuxi), and Chen (Chenpi) are excellent herbs.
Another Prescription: Jingfang Baidu San (See Nao Ju section).
[Prescription Verse] Baimai Ju (Baimai Carbuncle) presents with swelling, specific color, and morphology. It radiates to the ear and wraps around the neck with purple-red coloration. Symptoms include pain, heat, loss of appetite, qi rebellion, and cough. Pricking to release pus is auspicious; pricking to release blood is ominous.
[Annotation] At the initial onset of this carbuncle, there are several blocks of diffuse swelling of varying sizes, wrapping around the neck. The color is purple-red, accompanied by pain, heat, inability to eat, qi rebellion, and cough. The eruption radiates to the ear. It can be pricked after fifteen days; delay will allow the toxin to attack the throat. The appearance of pus upon pricking indicates a favorable course, while the appearance of blood indicates an unfavorable course. For other treatment methods, refer to the sections on Yong Ju Swellyang and Ku yang.