鬓疽属手少阳三焦相火，是经少血多气，尤忌见脓，若妄加针灸，必至不起，余见之
屡矣。薛新甫以为属肝胆二经怒火，或风热血虚所致，若发热作渴者，用柴胡清肝散。肿
痛甚者，用仙方活命饮。若大势已退，余毒未散，用参、 、归、术为主，佐以川芎、
白芷、金银花，以速其脓，脓成仍用参 之类，托而溃之。若欲其生肌收敛，脾虚者，六
味丸。血虚者，四物加参 。或血燥，或水不能生木者，用四物汤、六味地黄丸。气虚
者，用补中益气汤，皆当滋其化源为善。
一老肿痛发热，脓清作渴，脉软而涩，此气血俱虚也，欲补之。彼见作渴发热，乃服
降火之剂，果作呕少食，复求治。投六君子汤四剂，呕止食进，仍用补药月余而愈，（以上
补例。） 一人患此， 痛作肿发热，以小柴胡汤加连翘、金银花、天花粉，四剂而消。
一人因怒后，鬓际肿痛发热，以小柴胡汤加连翘、金银花、天花粉，四剂而消。一人因
怒后，鬓际肿痛发热，以小柴胡汤，加连翘、金银花、天花粉四剂，根畔俱消，惟疮头作
痛，以仙方活命饮二剂，痛止脓熟针之，更以托里消毒药而愈。一人肿痛，寒热拘急，
脉浮数，以荆防败毒散二剂，表证悉退，更以托里消毒散，溃之而安。一人 肿痛甚，
发寒热，服十宣散愈炽，诊之脉数而实，此表里俱有邪也，以荆防败毒散，加芩、连、大
黄二剂少愈，更以荆防败毒散四剂而消。俞黄门，年逾三十，冬患鬓毒肿 ，烦躁便
秘，脉实，此胆经风热壅上也，马氏曰∶疮疡热实不利者，大黄汤下之。一剂便通疮退，
更以荆防败毒散二剂，十宣散去桂，加天花粉、金银花，数剂而愈。 一人头面 肿作
痛，时仲冬，脉弦紧，以托里温经汤，汗之而消。 赵宜人，年逾七十，鬓疽已溃，
肿痛甚，喜冷，脉实便秘，东垣云∶烦躁饮冷，身热脉大，精神昏闷者，脏腑实也，以
清凉饮二剂，肿痛悉退，更以托里药三十剂余而平。
〔汪〕 前疽虽出少阳血少之分，然证与脉，皆属于实，故年壮者，用泻剂之重，老
年者，用泻剂之轻。若拘以年老，或守其经
禁而投补剂，实实之祸难免矣，（以上泻例。）
侍御朱南皋患前证，肿痛发热，日晡尤甚，此肝胆二经血虚火燥也，用四物汤加玄
参、柴胡、桔梗、炙草治之而愈。又因劳役，发热畏寒，作渴自汗，用补中益气汤去柴胡、
升麻，加五味、麦门、炮姜而瘥。 州守胡廷器，年七十患前证，肿 作痛，头目俱胀，
此肾水不足，肝胆火盛而血燥也，用六味丸料四剂，疮头出水而愈。后因调养失宜，仍
肿痛烦热喘渴，脉洪大而虚，此脾胃之气伤也，用补中益气以补脾胃，用六味地黄丸以
补肾肝而痊。（以上补例）
柴胡清肝散 治鬓疽，及肝胆、三焦风热怒火之证，或项胸作痛，或疮毒发热。
柴胡 山栀（炒，各一钱五分） 黄芩（炒） 川芎 人参（各一钱） 连翘 桔梗（各八分） 甘草
（五分）
上水煎服。
Boju (Hairline Carbuncle) belongs to the Ministerial Fire of the Hand-Shaoyang Sanjiao (Triple Burner) meridian. This meridian is characterized by little blood and abundant qi, and it is especially contraindicated to see suppuration. If acupuncture or moxibustion is wrongly applied, death is inevitable; I have witnessed this many times. Xue Xinpu believed that this condition belongs to the angry fire of the Liver and Gallbladder meridians, or is caused by Wind-Heat and Blood Deficiency. If fever and thirst occur, use Chaihu Qinggan San (Bupleurum Decoction to Clear the Liver). If swelling and pain are severe, use Xianfang Huoming Yin (Immortal Formula for Life Preservation Decoction). If the major pathogenic factors have receded but residual toxins remain, take Ren Shen (Ginseng Radix et Rhizoma), [missing character], Dang Gui (Angelicae Sinensis Radix), and Bai Zhu (Atractylodis Macrocephalae Rhizoma) as main herbs, assisted by Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), and Jin Yin Hua (Lonicerae Japonicae Flos) to hasten suppuration. Once pus is formed, continue using Ren Shen (Ginseng Radix et Rhizoma) and [missing character] to support the body and expel the toxin through ulceration. To promote flesh regeneration and contraction, if there is Spleen Deficiency, use Liuwei Wan (Six-Ingredient Pill with Rehmannia). If there is Blood Deficiency, use Siwu Tang (Four Substance Decoction) plus Ren Shen (Ginseng Radix et Rhizoma) and [missing character]. If there is Blood Dryness, or Water fails to generate Wood (Kidney Water failing to nourish Liver Wood), use Siwu Tang (Four Substance Decoction) and Liuhuang Dihuang Wan (Six-Ingredient Rehmannia Pill). If there is Qi Deficiency, use Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi); in all cases, it is best to nourish the source of transformation and generation.
An elderly man suffered from swelling, pain, and fever, with thin pus and thirst, and a soft and choppy pulse. This indicates both Qi and Blood Deficiency, so treatment aimed at tonification was desired. However, seeing his thirst and fever, he took heat-clearing and fire-draining agents, which indeed caused vomiting and reduced appetite, leading him to seek treatment again. He was administered Liu Junzi Tang (Six-Gentlemen Decoction) for four doses; vomiting stopped and appetite returned. He continued using tonic medicines for over a month and recovered. (Above: Case of Tonification.)
Another person suffered from this condition, experiencing [missing character] pain, swelling, and fever. He was treated with Xiaochaihu Tang (Minor Bupleurum Decoction) plus Lianqiao (Forsythiae Fructus), Jin Yin Hua (Lonicerae Japonicae Flos), and Tianhua Fen (Trichosanthis Radix), and resolved after four doses.
Another person experienced swelling, pain, and fever at the hairline after anger. He was treated with Xiaochaihu Tang (Minor Bupleurum Decoction) plus Lianqiao (Forsythiae Fructus), Jin Yin Hua (Lonicerae Japonicae Flos), and Tianhua Fen (Trichosanthis Radix), and resolved after four doses.
Another person experienced swelling, pain, and fever at the hairline after anger. He was treated with Xiaochaihu Tang (Minor Bupleurum Decoction) plus Lianqiao (Forsythiae Fructus), Jin Yin Hua (Lonicerae Japonicae Flos), and Tianhua Fen (Trichosanthis Radix) for four doses. The area around the root cleared, but only the head of the sore remained painful. He was given Xianfang Huoming Yin (Immortal Formula for Life Preservation Decoction) for two doses; pain ceased, and upon maturation of pus, it was pricked. He then recovered using Tuoli Xiaodu Yao (Medicines to Support the Interior and Dispel Toxicity).
Another person had swelling and pain, accompanied by chills, fever, and limb stiffness, with a floating and rapid pulse. He was treated with Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Pathogens) for two doses; exterior symptoms completely receded. He was then treated with Tuoli Xiaodu San (Powder to Support the Interior and Dispel Toxicity), causing ulceration, and he became stable.
Another person had severe [missing character] swelling and pain, with chills and fever. After taking Shixuan San (Ten-Vitality Powder), the condition worsened. His pulse was rapid and excess, indicating pathogens in both the interior and exterior. He was treated with Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Pathogens) plus Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Da Huang (Rhei Radix et Rhizoma) for two doses, showing slight improvement. He was then treated with Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Pathogens) for four doses, and it resolved.
Yu Huangmen, over thirty years old, suffered from hairline carbuncle swelling in winter, with irritability and constipation, and an excess pulse. This was Wind-Heat stagnating upward in the Gallbladder Meridian. Ma Shi said: For sores and ulcers with Heat-Excess and difficulty in discharge, use Dahuang Tang (Rhubarb Decoction) to purge. After one dose, bowel movement was unblocked and the sore subsided. He was then treated with Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Pathogens) for two doses, and Shixuan San (Ten-Vitality Powder) minus Guizhi (Cinnamomi Ramulus), plus Tianhua Fen (Trichosanthis Radix) and Jin Yin Hua (Lonicerae Japonicae Flos), resolving after several doses.
Another person had [missing character] swelling and pain on the head and face during mid-winter, with a wiry and tight pulse. He was treated with Tuoli Wenjing Tang (Decoction to Support the Interior and Warm the Meridians), inducing sweating, and it resolved.
Zhao Yi-ren, over seventy years old, had an ulcerated hairline carbuncle with severe swelling and pain, preference for cold drinks, an excess pulse, and constipation. Dong Yuan stated: Irritability, desire for cold drinks, body heat, large pulse, and mental confusion indicate Excess in the Zang-Fu organs. He was treated with Qingliang Yin (Cooling Drink) for two doses; swelling and pain completely receded. He was then treated with Tuoli medicines (Interior-Supporting Medicines) for over thirty doses and recovered.
[Wang] Although the previous carbuncles originated in the Shaoyang region where blood is scant, the syndrome and pulse both indicated Excess. Therefore, for young and strong individuals, heavy purgative agents were used; for the elderly, light purgative agents were used. If one rigidly adheres to age considerations or observes the meridian's contraindications by administering tonics, the disaster of "treating Excess with Excess" (aggravating an Excess condition) cannot be avoided. (Above: Cases of Purging/Draining.)
Shiyu Zhu Nangao suffered from the previous syndrome, with swelling, pain, and fever, worse in the late afternoon. This was Blood Deficiency and Fire Dryness in the Liver and Gallbladder meridians. He was treated with Siwu Tang (Four Substance Decoction) plus Xuanshen (Scrophulariae Radix), Chaihu (Bupleuri Radix), Jiegeng (Platycodonis Radix), and Zhigancao (Prepared Licorice Root), and recovered. Later, due to labor and fatigue, he experienced fever, aversion to cold, thirst, and spontaneous sweating. He was treated with Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi), minus Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma), plus Wuweizi (Schisandrae Chinensis Fructus), Maimendong (Ophiopogonis Radix), and Paojiang (Prepared Ginger), and recovered.
Zhoushou Hu Tingqi, aged seventy, suffered from the previous syndrome, with [missing character] swelling and pain, and distension in the head and eyes. This was insufficient Kidney Water, excessive Liver and Gallbladder Fire, and Blood Dryness. He was treated with Liuwei Wan formula for four doses; water exuded from the sore head, and he recovered. Later, due to improper recuperation, he still suffered from swelling, pain, irritability, heat, panting, and thirst, with a flooding and empty pulse. This indicated injury to Spleen and Stomach Qi. He was treated with Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) to tonify the Spleen and Stomach, and Liuhuang Dihuang Wan (Six-Ingredient Rehmannia Pill) to tonify the Kidneys and Liver, and recovered. (Above: Cases of Tonification.)
Chaihu Qinggan San (Bupleurum Decoction to Clear the Liver) treats hairline carbuncles, and syndromes of Wind-Heat and Angry Fire in the Liver, Gallbladder, and Sanjiao meridians, or pain in the neck and chest, or fever from sore toxins.
Chaihu (Bupleuri Radix) 1.5 qian (fried)
Shanzhi (Gardeniae Fructus, fried) 1.5 qian
Huangqin (Scutellariae Radix, fried)
Chuanxiong (Ligustici Chuanxiong Rhizoma)
Renshen (Ginseng Radix et Rhizoma) 1 qian
Lianqiao (Forsythiae Fructus)
Jiegeng (Platycodonis Radix) 0.8 qian
Gancao (Licorice Root) 0.5 qian
Decoct with water and take orally.