经络 肩之上廉属手足少阳经。前廉属手阳明经。后廉属手太阳经。
肩疽 生于肩。肿赤引背。灵枢为 痈。甚连脑胁。治宜汗之。须汗。出至足无害。四五日内逆。KT 之。一
灸会宗穴三七壮。甚者灸肩真穴七壮。
肩痈 生肩外垂骨两接骨处。恐脓深彻骨。虑伤筋脉拘挛。宜缓筋之药饵之。
过肩疽 肿发两肩及两膊连胛骨者。一名干疽。一名丁疽。令人寒战口噤。身热不赤。此手足三阳交
会之所由。风袭热郁所致。十日可刺。无血者死。
太阴疽 生肩胛骨上。一名肩后疽。属手太阴肺经积热所致。即莲子发也。若色黑喘嗽。大渴胸满。脉
微者不治。
蜂窠疽 生于肩前一二寸。先热后寒。皮赤。溃有四十九窍。形如蜂窠。灸三间穴二七壮。
上按症与肿疡溃疡总治例同法。
经络 四肢者。诸阳之本也。阳实则肢肿。阳虚则肢满。又云。脾主四肢。脾实则四肢不举。（湿盛也）脾虚则
四肢不用。（懈惰也）又 臂须别六经。究其痛在何经。加以本经之药行其气血。则症愈矣。别经之法。以两
手伸直。贴身垂下。大指居前。小指居后而定之。则其臂 之前廉者属阳明经。以升麻、白芷、干葛行之。
后廉属太阳经。以 本、羌活行之。外廉属少阳经。以柴胡行之。内廉属厥阴经。以柴胡、青皮行之。内前
廉属太阴经。以升麻、白芷、葱白行之。内后廉属少阴经。以细辛、独活行之。又薄桂味淡。能横行手臂。引
他药直至痛处。白姜黄之性亦同。何则。为非辛不能以达四肢也。治肩膊风寒湿一切疼痛。服蠲痛无
忧散。立止。（见诸痛门）
痈 臂表里俱肿。色赤而坚。惟肘节处差小。故又名藕包毒。灸少海穴七壮。
疽 生肩下连腋。灸会宗穴七壮。
乐疽 生肩内。坚如鹅子。按之痛入骨。恶风。灸腋门穴三七壮。
肩风毒 生臂上节。肿连肩 。
臂痈 生肩外垂骨两接骨处。或从肘引至手接骨处。由荣卫不调所致。如脓深彻骨。虑伤筋脉拳缩。
治宜缓筋之药。
鱼肚发 生于臂内。
按上症。初宜卫生散。或蠲痛无忧散加羌活、独活、桔梗、桂枝。酒水煎服。若漫肿无头。服败毒药不
消者。十全大补汤加桔梗、桂枝托之。托之不应者。由湿痰流注经络也。荣卫返魂汤加南星、酒芩调
之。若臂痛不能举。及左右转痛者。由中脘伏痰也。宜千金指迷丸、九转玉华丹导之。脉细皮寒。泻
利不食者。为五虚。虽盛暑之时。托里温中汤之类温之。甚者脐膜冷痛昏愦。灸左乳下黑肉尽处二
七壮。脉紧细而筋挛者。肝虚而有风寒也。四物汤加丹皮、泽兰、白术。溃深不痛。胃气虚也。脓水清
稀。疮口不合。气血虚也。俱大补之。
石榴疽 生肘上寸余。亦生于各经及臂。初起黄粟小泡。根便开大。色红坚硬。肿如覆碗。破翻如榴。寒
如疟。由少阳相火与外湿相搏所致。初起宜蟾酥丸汗之。外以艾灸九壮。贴蟾酥饼。盖膏。 肿处敷
金黄散。次服消毒无忧散加菊花清之。烦躁热甚者。护心散、金液戊土丹。九日后作稠脓。痛减进食。
表里俱退者。可保无虞。反此者逆。溃后同溃疡调理。一法。破后惟菊花蕊煎汤洗之。最佳。次以菊花
烧灰存性。加轻粉兑匀敷之。诸药不及此。或灸天井穴。
肘痈 生于肘尖。经云。心肺有邪。其气留于两肘。治同臂痈。
白芷升麻汤 治臂肿痛。乃阳明经分野。由八风之变者。然身半以上风受之。治宜却风邪。和经脉。使
无壅滞。亦发表之意也。
黄 （二钱） 酒芩（二钱） 生芩（一钱） 白芷（八分） 连翘（二钱） 升麻（五分） 桔梗（五分）
酒红花（三分） 炙甘草（三分）
酒水各一钟。煎八分。食远热服。
Meridians: The upper lateral margin of the shoulder belongs to the Hand-Shaoyang and Foot-Shaoyang meridians. The anterior lateral margin belongs to the Hand-Yangming meridian. The posterior lateral margin belongs to the Hand-Taiyang meridian.
Shoulder Carbuncle (Jian Ju): Arises in the shoulder. Swelling is red and radiates to the back. *Ling Shu* calls it a carbuncle (Yong). In severe cases, it extends to the brain and hypochondrium. Treatment should employ diaphoresis (sweating method); sweat must reach the feet to avoid danger. If adverse conditions arise within four to five days, it is difficult to treat. Moxibustion can be applied to Huizong (SJ4) acupoint for 21-37 moxa cones. In severe cases, apply moxibustion to Jianzhen acupoint for 7 cones.
Shoulder Abscess (Jian Yong): Arises at the junction of the hanging bone of the shoulder and the adjacent bones. There is concern that pus may penetrate deeply into the bone, damaging tendons and vessels leading to contracture. It is advisable to administer herbs that relax the tendons orally.
Over-the-Shoulder Carbuncle (Guo Jian Ju): Swelling occurs on both shoulders and arms, extending to the scapula. Also known as Gan Ju or Ding Ju. It causes chills, trismus (lockjaw), fever without facial redness. This occurs because it is the intersection of the three Yang meridians of the hand and foot, caused by wind invasion and heat stagnation. Puncture for drainage can be performed after ten days. Death ensues if no blood or pus is discharged.
Taiyin Carbuncle (Taiyin Ju): Arises above the scapula. Also known as Shoulder Posterior Carbuncle. It is caused by accumulated heat in the Hand-Taiyin Lung Meridian. Also called Lianzi Fa. If the color is black, accompanied by asthma/cough, extreme thirst, chest fullness, and a faint pulse, it is incurable.
Honeycomb Carbuncle (Feng Ke Ju): Arises one to two cun anterior to the shoulder. Initially fever followed by chills, skin is red. Upon ulceration, there are forty-nine orifices, resembling a honeycomb. Apply moxibustion to Sanjian (LI3) acupoint for 14 moxa cones.
The treatment for the above conditions follows the general principles for swelling ulcers and ulcerated sores.
Meridians: The four limbs are the root of all Yang meridians. When Yang is excess, limbs swell; when Yang is deficient, limbs feel distended. It is also said that the Spleen governs the four limbs. When Spleen is excess, limbs cannot be lifted (due to dampness abundance). When Spleen is deficient, limbs cannot function (due to lassitude). Furthermore, the arm must be differentiated by the six meridians to determine which meridian is affected by pain, and herbs belonging to that meridian should be added to promote Qi and Blood circulation, thereby curing the disease. The method to differentiate meridians is as follows: extend both hands straight down along the body, with the thumb forward and the little finger backward. Then, the anterior lateral margin of the arm belongs to the Yangming meridian, treated with Shengma (Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Gange (Puerariae Lobatae Radix). The posterior lateral margin belongs to the Taiyang meridian, treated with Qianghuo (Notopterygii Rhizoma et Radix). The lateral margin belongs to the Shaoyang meridian, treated with Chaihu (Bupleuri Radix). The medial margin belongs to the Jueyin meridian, treated with Chaihu and Qingpi (Citri Reticulatae Pericarpium Viride). The anterior medial margin belongs to the Taiyin meridian, treated with Shengma, Baizhi, and Congbai (Allii Fistulosi Bulbus). The posterior medial margin belongs to the Shaoyin meridian, treated with Xixin (Asari Radix et Rhizoma) and Duhuo (Angelicae Pubescentis Radix). Additionally, Hougui (thin Cinnamomi Cortex) has a light flavor and can travel horizontally through the arms, guiding other herbs directly to the painful area. Bai Jianghuang (Curcumae Longae Rhizoma) has similar properties. Why? Because only pungent herbs can reach the four limbs. For all pains in the shoulder and arm caused by wind-cold-dampness, take Juan Tong Wu You San to stop pain immediately. (See Section on Various Pains).
Arm Abscess (Bi Yong): Both superficial and deep layers of the arm are swollen, red and hard, except slightly smaller at the elbow joint, hence also called Ou Bao Du (Lotus Root Bag Toxin). Apply moxibustion to Shaohai (HT3) acupoint for 7 cones.
Axillary Carbuncle (Ye Ju): Arises below the shoulder connecting to the axilla. Apply moxibustion to Huizong (SJ4) acupoint for 7 cones.
Le Ju: Arises inside the shoulder, hard like a goose egg, painful upon pressure penetrating to the bone, aversion to wind. Apply moxibustion to Yimen (EX-HN15) acupoint for 21-37 moxa cones.
Shoulder Wind Toxin (Jian Feng Du): Arises in the upper segment of the arm, swelling connects to the shoulder.
Arm Abscess (Bi Yong): Arises at the junction of the hanging bone of the shoulder and the adjacent bones. Or radiates from the elbow to the wrist joint. Caused by disharmony of Ying and Wei. If pus penetrates deeply into the bone, there is concern of damaging tendons and vessels leading to flexion contracture. Treatment should use herbs that relax the tendons.
Fish Belly Fa (Yu Du Fa): Arises on the inner aspect of the arm.
Regarding the above conditions, initially use Wei Sheng San, or Juan Tong Wu You San plus Qianghuo, Duhuo, Jiegeng, and Guizhi, decocted in water and wine. If there is diffuse swelling without a head, and Baidu Yao fails to resolve it, use Shiquan Dabu Tang plus Jiegeng and Guizhi to expel toxins outward. If expulsion fails, it is due to damp-phlegm flowing into the meridians. Use Yingwei Fanhun Tang plus Nanxing and Jiuhuangqin to regulate. If arm pain prevents lifting, and pain occurs during left/right rotation, it is due to latent phlegm in Zhongwan. Use Qianjin Zhi Mi Wan or Jiuzhuan Yuhua Dan to guide phlegm downward. If the pulse is fine, skin is cold, with diarrhea and anorexia, it is Wuxu (Five Deficiencies). Even in midsummer, use Tuoli Wenzhong Tang to warm and tonify. In severe cases with cold pain of the umbilical membrane and confusion, apply moxibustion to the end of the black hair under the left nipple for 14 cones. If the pulse is tight and fine with tendon spasm, it is Liver deficiency with wind-cold. Use Siwu Tang plus Mudanpi, Zelan, and Baizhu. If the ulcer is deep but painless, it is Stomach Qi deficiency. If pus is clear and thin, and the wound does not close, it is Qi and Blood deficiency. All should be strongly tonified.
Pomegranate Carbuncle (Shiliu Ju): Arises about one cun above the elbow, also occurring in various meridians and arms. Initially presents as small yellow millet-like blisters, the base expands rapidly, color is red and hard, swelling resembles an inverted bowl, upon rupture it looks like pomegranate seeds. Chills resemble malaria, caused by interaction between Shaoyang Ministerial Fire and external dampness. Initially, use Chansu Wan to induce sweating. Externally, apply 9 moxa cones, paste Chansu Bing, and cover with plaster. Apply Jinhuang San to the swollen area. Subsequently, take Xiaodu Wu You San plus Juhua to clear heat and detoxify. For restlessness and high fever, use Huxin San or Jin Ye Wu Tu Dan. After nine days, thick pus forms, pain decreases, and appetite returns; if exterior and interior symptoms recede, safety is assured. The opposite indicates adverse prognosis. Post-ulceration, manage according to ulcer protocols. Another method: after rupture, wash best with decoction of Juhua (Chrysanthemi Flos). Alternatively, burn Juhua to ash retaining its nature, mix with Qingfen (Calomelas), and apply externally. This surpasses other medicines. Moxibustion can also be applied to Tianjing (TE10) acupoint.
Elbow Abscess (Zhou Yong): Arises at the tip of the elbow. The classics state: "When Heart and Lung have pathogenic factors, their Qi remains in the two elbows." Treatment is the same as Arm Abscess.
Baizhi Shengma Decoction (Baizhi Shengma Tang): Treats arm swelling and pain. It affects the Yangming meridian territory, caused by variations of the Eight Winds. Since the upper half of the body is affected by wind, treatment should dispel wind pathogens and harmonize meridians to prevent stagnation, also serving as a releasing-the-exterior method.
Huang Qin (2 qian), Jiu Huang Qin (2 qian), Sheng Huang Qin (1 qian), Baizhi (8 fen), Lianqiao (2 qian), Shengma (5 fen), Jiegeng (5 fen), Jiu Hong Hua (3 fen), Zhi Gancao (3 fen).
Decoct with one cup of water and one cup of wine until reduced to 0.8 cups. Take hot after meals.