百会疽者,一名玉顶疽。起于前顶后一寸五分,顶中央旋毛中,督脉、足太阳之交会处
。初起寒热大作,形如粟米,根盘坚硬,疼痛彻脑,头如顶石,色赤者,可治。此由阳经亢
极,热气不散,气血凝滞,结聚巅顶而成;或由六阳经受风邪,风火相煽,脏腑热毒上攻所
致,其证为阳。治以真人活命饮、泻心汤或犀角地黄汤。至七日成脓,脓泄毒化,调理可愈
。若因心事劳攘,或真阴耗竭,虚阳浮泛而发,其色紫黑,三、五日后,闷乱而神不定,则
不可治矣。证虽发于阳,实由阴精之消涸也。
玉枕疽,即后脑发,生于脑后枕骨中。由足太阳膀胱经湿热凝滞而成。 赤高肿者,易
治;平塌漫肿,未脓先腐,但流血水者,难治。治与脑疽同。
夫夭疽锐毒者,发于耳后一寸三分,属少阳胆络,左名夭疽,右名锐毒,俗谓之耳后发
。此证有虚有实,初起根盘散漫,顶不高突,平塌色白,形神俱静,微恶寒,微身热,渐减
谷食。此由肝邪久郁,微感温邪,触动而发。如正旺者,气血亦能化脓,溃后肿消郁散,月
余收功。治法用疏肝流气饮,或羚羊角散加石决明、牡蛎、刺蒺,或真人活命饮。如阴亏肝
旺,化风逆络,半边头痛彻脑者,正气不能引血成脓,毒必内攻,或手足逆冷,或气喘呃逆
,或痉或厥,或七日,或两候而毙,此为真阴证也。
又有温邪阻络,耳后发肿,根松顶高,初起虽色白,成脓却 红,憎寒壮热,痛则朝轻
暮重;溃后即热退肿消,脓尽收口。是即风热轻证,名火痰毒也。治以疏散凉解为主,如万
灵丹、荆防败毒散、羚羊角散之类。
Baihui Ju (Abscess at Baihui Point), also known as Yuding Ju, arises 1.5 cun posterior to the Qianding point, in the center of the scalp hair whorl, which is the intersection of the Du Meridian and the Foot-Taiyang Bladder Meridian. Initially, there are severe chills and high fever; the lesion resembles a millet grain, with a hard base and pain radiating to the brain, giving a sensation of the head being weighed down by a stone. If the color is red, it is treatable. This condition results from extreme hyperactivity of Yang meridians, where heat fails to dissipate, causing Qi and Blood stagnation and accumulation at the vertex. It may also be caused by Wind pathogens invading the Six Yang meridians, where Wind and Fire mutually exacerbate each other, and internal organ Heat-Toxins attack upward. The syndrome is classified as Yang. Treatment involves Zhenren Huoming Yin (True Man's Life-Saving Decoction), Xiexin Tang (Drain the Heart Decoction), or Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). By the seventh day, pus forms; once the pus drains and toxins resolve, recovery can be achieved through regulation. However, if it arises due to mental distress and overwork, or exhaustion of True Yin leading to floating of deficient Yang, the lesion appears purple-black. After three to five days, if the patient experiences confusion and unsettled spirit, it is untreatable. Although manifesting in a Yang region, the root cause is actually the depletion of Yin essence.
Yuzhen Ju (Abscess at Yuzhen Point), also known as Hou Nao Fa (Back-of-Head Hair Abscess), occurs in the occipital bone region at the back of the head. It is formed by Damp-Heat stagnation in the Foot-Taiyang Bladder Meridian. If the swelling is high and red, it is easy to treat; if flat and diffuse, with putrefaction preceding pus formation and only bloody fluid oozing out, it is difficult to treat. The treatment is the same as for Brain Ju.
Tao Ju and Ruidu refer to lesions occurring 1.3 cun behind the ear, belonging to the Luo-connecting vessels of the Shaoyang Gallbladder Meridian. Lesions on the left are called Tao Ju, while those on the right are called Ruidu; commonly known as "Ear-Posterior Hair Abscess." This condition presents as either Deficiency or Excess. Initially, the base is diffuse, the top is not prominent, appearing flat and white, with the patient showing calm demeanor, slight aversion to cold, slight fever, and gradually decreasing appetite. This arises from long-term Liver Qi stagnation triggered by mild exposure to Warm pathogens. If the healthy Qi is strong, Blood and Qi can transform into pus; after ulceration, swelling subsides and stagnation disperses, healing occurs within about a month. Treatment uses Shugan Liuqi Yin (Soothe Liver and Circulate Qi Decoction), Lingyangjiao San (Antelope Horn Powder) added with Shijueming (Haliotidis Concha), Muli (Ostreae Concha), and Ciji (Tribuli Fructus), or Zhenren Huoming Yin. If there is Yin deficiency with Liver hyperactivity, generating Wind that rebels against the collaterals, causing unilateral headache radiating to the brain, the healthy Qi cannot guide Blood to form pus, and Toxins will invade internally. Symptoms may include cold extremities, asthma and hiccups, spasms, or coma, leading to death on the seventh day or after two ten-day periods. This is a True Yin Deficiency syndrome.
Another type involves Warm pathogens blocking the collaterals, causing swelling behind the ear. The base is loose but the top is high. Although initially white, it turns red upon pus formation. There is severe aversion to cold and high fever, with pain that is lighter in the morning and heavier in the evening. After ulceration, fever subsides and swelling decreases; the wound heals once pus is exhausted. This is a mild Wind-Heat syndrome, named Huotan Du (Fire-Phlegm Toxin). Treatment focuses on dispersing and cooling, such as Wanling Dan (Myriad Spirits Pill), Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction to Overcome Pathogens), or Lingyangjiao San.