肘痈发于肘围绕，高肿 热赤红疼，心肺稽留风邪火，势小为疖势大痈。
【注】此证生于肘之围绕，暴发高肿， 热，色红，疼痛，由心、肺风火之邪，稽留
凝滞而成。情势小者为疖毒，情势大者为痈。初服荆防败毒散汗之，次服白芷升麻汤清托
之，外敷二味拔毒散。将溃治法，俱按痈疽肿疡、溃疡门。
\r肘痈图\p04-34a149.bmp\r
白芷升麻汤
黄芩（半生、半酒炒，二钱） 连翘（去心，二钱） 黄 （三钱） 白芷（八分）
升麻 桔梗（各五分） 红花（酒洗） 甘草（炙，各三分）
酒、水各一盅，煎八分，食远热服。
【方歌】白芷升麻医肿痛，解热除烦托肘痈，芩翅桔梗红花草，黄 酒水各一盅。
荆防败毒散（见项部脑疽）
二味拔毒散（见肿疡门）
（自肘至腕曰臂）
（附∶疽）
臂痈臂疽绕臂生，平紫硬疽红肿痈，荣卫风邪逆肉理，甚则拳缩彻骨疼。
【注】此证生臂外侧，属三阳经；臂里侧，属三阳经。高肿红活， 痛溃速者为痈；平
陷紫暗，坚硬木痛，溃迟者为疽。俱由荣卫不周，感受风邪，逆于肉理而成。初起形如
粟粒，憎寒壮热，宜服荆防败毒散汗之； 痛烦热，宜服白芷升麻汤消之；脓势将成，宜
服托里透脓汤，脓熟针之。若疽证木痛，无红无热，此属气血两虚，无论已溃、未溃，宜
服十全大补汤托之。溃后，内外治法俱按痈疽肿疡、溃疡门。若拳缩筋不能舒，疼痛彻
骨者，系溃深伤脉也，属逆。
\r臂痈图\p04-34a150.bmp\r
荆防败毒散（见项部脑疽）
白芷升麻汤（见 部肘痈）
托里透脓汤（见头部侵脑疽）
十全大补汤（见溃疡门）
Elbow carbuncle occurs around the elbow, presenting with high swelling, heat, redness, and pain. This is caused by the retention of wind pathogenic factors and fire pathogenic factors in the Heart and Lung meridians. When the condition is mild, it is called a furuncle (boil); when severe, it is called a carbuncle.
[Note] This condition arises around the elbow, appearing suddenly with high swelling, accompanied by heat, redness, and pain. It is formed by the stagnation and coagulation of wind-fire pathogenic factors from the Heart and Lungs. When the severity is slight, it is termed a toxic furuncle; when severe, it is termed a carbuncle. In the initial stage, administer Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction) to induce sweating. Subsequently, administer Baizhi Shengma Tang (Angelica Dahurica and Cimicifuga Decoction) to clear heat and expel toxicity externally. Apply Erwei Baidu San (Two-Ingredient Toxicity-Expelling Powder) topically. The treatment methods for the stage approaching suppuration follow the guidelines in the sections on Carbuncles and Ulcers (Swelling/Ulceration).
[Image: Elbow Carbuncle]
Baizhi Shengma Tang (Angelica Dahurica and Cimicifuga Decoction)
Huangqin (Scutellariae Radix, half raw, half wine-fried, 2 qian)
Lianqiao (Forsythiae Fructus, heart removed, 2 qian)
Huangqi (Astragali Radix, 3 qian)
Baizhi (Angelicae Dahuricae Radix, 8 fen)
Shengma (Cimicifugae Rhizoma)
Jiegeng (Platycodonis Radix, each 5 fen)
Honghua (Carthami Flos, wine-washed)
Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 3 fen)
Decoct with one cup of wine and one cup of water until reduced to 0.8 cups. Take hot after meals.
[Prescription Verse] Baizhi and Shengma treat swelling and pain, clearing heat and relieving irritability while supporting the elbow carbuncle; Huangqin, Lianqiao, Jiegeng, Honghua, Gancao, and Huangqi are decocted with one cup each of wine and water.
Jingfang Baidu San (See section on Nuchal Brain Carbuncle)
Erwei Baidu San (See section on Swelling/Ulceration)
(The area from the elbow to the wrist is called the arm.)
[Appendix: Chancre/Gangrene]
Arm carbuncle and arm chancre both arise along the arm. Those that are flat, purple, and hard are chancre (gangrenous sore); those that are red, swollen, and protruding are carbuncle. This results from the disharmony of Ying and Wei (Nutritive and Defensive Qi), where wind pathogenic factors invade the muscle tissue. In severe cases, it leads to clenched fists and pain penetrating to the bone.
[Note] This condition occurring on the lateral aspect of the arm belongs to the Yangming, Taiyang, and Shaoyang meridians; the medial aspect also belongs to these meridians. High swelling with vibrant red color, painful, and rupturing quickly characterizes a carbuncle. Flat depression with dark purple color, hardness, numbness, and pain, with slow rupture, characterizes a chancre. Both result from the failure of Ying and Wei Qi to circulate uniformly, contracting wind pathogenic factors that reverse into the muscle tissue. Initially, the lesion resembles a millet grain, accompanied by aversion to cold and high fever; administer Jingfang Baidu San to induce sweating. If irritability and heat occur, administer Baizhi Shengma Tang to dissipate the pathogen. When pus formation is imminent, administer Tuoli Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction); once the pus matures, puncture with a needle. If the chancre presents with numbness and pain without redness or heat, this indicates deficiency of both Qi and Blood. Regardless of whether it has ruptured or not, administer Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) to support the interior and expel toxicity. After rupture, internal and external treatments follow the guidelines in the sections on Carbuncles and Ulcers. If the hand becomes clenched and cannot extend, with pain penetrating to the bone, this indicates deep ulceration damaging the vessels, which is considered an adverse prognosis (Ni syndrome).
[Image: Arm Carbuncle]
Jingfang Baidu San (See section on Nuchal Brain Carbuncle)
Baizhi Shengma Tang (See section on Elbow Carbuncle)
Tuoli Tou Nong Tang (See section on Head Invading Brain Carbuncle)
Shiquan Dabu Tang (See section on Ulceration)