脑疽属膀胱经积热，或湿热上涌，或阴虚火炽，或肾水亏损，阴精消涸。初起肿赤痛甚
，烦渴饮冷，脉洪数而有力，乃湿热上涌，当用黄连消毒散，并隔蒜灸以除湿热。漫肿微痛，渴
不饮冷，脉洪数而无力，乃阴虚火炽，当用六味丸，及补中益气汤，以滋化源。若口舌干燥
，小便频数，或淋漓作痛，及肾水亏损，急用加减八味丸，及前汤，以固根本，引火归经。
若不成脓，不腐溃，阳气虚也，四君加归、 。不生肌，不收敛，脾气虚也，十全大补汤。
若色黯不溃，或溃而不敛，乃阴精消涸，名曰“脑烁”，为不治。若攻补得宜，亦有可愈。
治者审焉！
治验
一妇人患前症，口干舌燥，内服清暑，外敷寒凉，色黯不 ，胸中气噎，此因内寒而外
假热也。彼疑素有痰火，不欲温补。余以参、 各五钱，姜、桂各二钱，一剂顿然溃，又用大补
一妇人冬间患此，肿痛热渴，余用清热消毒药，溃之而愈。次年三月，其舌肿大，遍身
发疔如葡萄，不计其数，手足尤多，乃脾胃受毒也。先各刺出黑血，随服夺命丹七粒，出臭汗，
疮热益甚，便秘二日，与大黄、芩、连，各三钱，升麻、白芷、山栀、薄荷、连翘，各二钱
，生甘草一钱，水煎三五沸，服之。大小便出臭血甚多，下体稍退，乃磨入犀角汁再服，舌
本及齿缝出臭血，诸毒乃消，更以犀角地黄汤而愈。
Naoju (Brain Carbuncle) belongs to the Bladder Meridian, caused by accumulated heat in this meridian; or it may result from damp-heat surging upward; or it may be due to Yin deficiency with blazing fire; or it may stem from Kidney Water depletion and exhaustion of Yin essence. In the initial stage, the lesion presents with swelling, redness, and severe pain, accompanied by irritability, thirst with a desire for cold drinks, and a pulse that is flooding, rapid, and forceful. This indicates damp-heat surging upward, and one should use Huanglian Xiaodu San (Coptis Decoction for Detoxification) combined with garlic-partitioned moxibustion to dispel damp-heat. If the swelling is diffuse with slight pain, thirst without a desire for cold drinks, and a pulse that is flooding and rapid but weak, this indicates blazing fire due to Yin deficiency. One should use Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to nourish the source of transformation (the Spleen and Stomach). If there is dryness of the mouth and tongue, frequent urination, or painful dribbling, this indicates Kidney Water depletion. Urgently use Jiaban Bawei Wan (Modified Eight-Ingredient Pill) and the aforementioned decoction to consolidate the root and guide the fire back to its origin. If pus does not form and the sore does not ulcerate, this indicates Yang Qi deficiency; use Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix) and Huangqi (Astragali Radix). If flesh does not regenerate and the wound does not close, this indicates Spleen Qi deficiency; use Shiquan Dabu Tang (Decoction for Tenfold Great Tonification). If the color is dark and does not ulcerate, or if it ulcerates but does not heal, this indicates exhaustion of Yin essence, named "Naoshuo" (Brain Burning), which is considered incurable. However, if the methods of attacking pathogens and tonifying deficiency are appropriate, cure is possible. Practitioners must exercise caution!
Clinical Case:
A woman suffered from this condition, presenting with dry mouth and tongue. She had taken internal cooling summer-resolving herbs and applied external cooling agents externally, resulting in a dark-colored lesion that failed to ulcerate and chest qi obstruction. This was due to internal cold manifesting as external false heat. Suspecting she had chronic phlegm-fire, she refused warm tonification. I prescribed Renshen (Ginseng Radix) and Huangqi (Astragali Radix) each at 5 qian, Ganjiang (Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex) each at 2 qian. After one dose, the abscess suddenly ulcerated. Subsequently, I used Da Bu Tang (Great Tonification Decoction).
Another woman contracted this disease in winter, presenting with swelling, pain, heat, and thirst. I used heat-clearing and detoxifying medicines, leading to ulceration and recovery. In March of the following year, her tongue became swollen, and she developed numerous carbuncles resembling grapes all over her body, particularly on the hands and feet. This indicated toxin invasion of the Spleen and Stomach. I first pricked acupoints to release black blood, then administered Duoming Dan (Life-Snatching Pill) seven pills. She sweated foul-smelling sweat, and the heat of the sores intensified. With constipation lasting two days, I prescribed Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), and Huanglian (Coptidis Rhizoma) each at 3 qian, Shengma ( Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Shanzhi (Gardeniae Fructus), Bohe (Menthae Haplocalycis Herba), and Lianqiao (Forsythiae Fructus) each at 2 qian, and Sheng Gancao (Glycyrrhizae Radix et Rhizoma) at 1 qian. Decocted in water and boiled for three to five minutes, after administration, large amounts of foul-smelling blood were discharged through stool and urine. Symptoms in the lower body subsided slightly. Then, Xijiao (Rhinocerotis Cornu) juice was ground and mixed for further administration. Foul-smelling blood was discharged from the base of the tongue and tooth gaps, and various toxins were eliminated. Finally, she recovered after taking Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction).