【方歌】下搭手生经膀胱，穴在门肓腰窝旁，房劳过度生毒火，
紫陷腐烂透膜肠。
【注】此证发于腰窝旁开三寸，属足太阳膀胱经肓门穴。由房
劳过度，有伤肾水，水竭不能制火，火旺以致荣卫不和
，逆于肉里而生也。初发红活焮肿，令人寒热往来，口
渴烦躁，百节疼痛，宜服仙方活命之，宣解毒火；次服
内托黄耆散，托毒发长。将溃内外治法，俱按痈疽肿疡
、溃疡门。若初肿腰痛如折，不能俯仰者险；若色紫塌
陷，腐烂孔深，透膜透肠者逆。
方剂：仙方活命饮（见肿疡门）
内托黄耆散（见前中搭手）
【方歌】莲子发名取象形，胆与膀胱毒化成，形斜平塌侵督重，
形长高肿半背轻。
【注】此证一名太阴疽。生于脊背及两胁，属胆与膀胱经，火
毒合化凝结而成。若形斜平塌，头侵督脉，尾站肋骨者
，属毒重；若形长高肿，偏于半背，中不过督脉，旁不
过肋骨，属毒轻。遇气实之人，初宜蟾酥丸，或麦灵丹
汗之，次宜一粒金丹下之；遇气虚之人，初宜仙方活命
饮宣解之，次宜内托黄耆散托补之。其余内外治法，俱
宜按痈疽肿疡、溃疡门。
方剂：蟾酥丸（见疔疮门）
仙方活命饮（见肿疡门）
一粒金丹、内托黄耆散（俱见前中搭手）
麦灵丹（见肿疡门）
【方歌】下搭手病发于足太阳膀胱经，穴位位于肓门穴及腰部凹陷处旁侧。因房事过度产生毒火，导致患处紫黑凹陷、腐烂并穿透肌肉深层。
【注】此证发生于腰窝旁开三寸处，归属于足太阳膀胱经的肓门穴。由于房劳过度，损伤肾水，肾水枯竭无法制约心火，导致火势旺盛，进而使营气与卫气不和，逆乱于肌肉纹理之间而生成此病。初期表现为红肿焮热，令人出现寒热往来、口渴烦躁、全身关节疼痛等症状，适宜服用仙方活命饮（Xianfang Huoming Yin），以宣散解毒之火；随后服用内托黄芪散（Neituo Huangqi San），以托毒外出并促进疮口愈合。在即将溃破前后的内外治法，均参照“痈疽肿疡”和“溃疡”章节的方法。如果初起时腰痛如折断般剧烈，不能俯身或仰身，则病情险恶；如果患处颜色紫暗塌陷，腐烂孔洞深重，甚至穿透筋膜和肠道，则预后不良（属逆证）。
方剂：仙方活命饮（参见肿疡门）
内托黄芪散（参见前文的中搭手章节）
【方歌】莲子发之名取自其形状像莲子，由胆经与膀胱经的毒火化合而成。若形状斜向平塌且侵犯督脉，则病情沉重；若形状长而高肿且仅占据背部一半，则病情较轻。
【注】此证又名太阴疽（Taiyin Ju）。生于脊背及两侧胁肋部，归属于胆经与膀胱经，由火毒合化凝结而成。如果形状斜向平塌，头部侵犯督脉，尾部抵住肋骨，属于毒邪深重；如果形状长而高肿，偏于背部一侧，中间不越过督脉，旁边不越过肋骨，属于毒邪较轻。对于体质壮实之人，初期适宜服用蟾酥丸（Chansu Wan）或麦灵丹（Mailing Dan）以发汗解表，随后适宜服用一粒金丹（Yili Jinwan）以泻下攻毒；对于体质虚弱之人，初期适宜服用仙方活命饮以宣散解毒，随后适宜服用内托黄芪散以托毒补虚。其余内外治法，均适宜参照“痈疽肿疡”和“溃疡”章节的方法。
[Prescription Verse] The "Lower Dashi Hand" (Lower Back Carbuncle) arises in the Foot-Taiyang Bladder Meridian, located beside the Humen (BL59) acupoint and the lumbar fossa. Excessive sexual activity generates toxic fire, leading to purple depression, rotting, and penetration into deep muscle layers.
[Annotation] This condition occurs three cun lateral to the lumbar fossa and belongs to the Humen (BL59) acupoint of the Foot-Taiyang Bladder Meridian. It is caused by excessive sexual exertion, which damages Kidney Water. When Kidney Water is exhausted, it cannot control Fire, causing Fire to flourish. This leads to disharmony between Ying (Nutritive Qi) and Wei (Defensive Qi), which counterflow and accumulate within the muscle tissue, resulting in this disease. Initially, it presents with redness, swelling, heat, and inflammation, accompanied by alternating chills and fever, thirst, irritability, and pain in all joints. It is appropriate to administer Xianfang Huoming Yin (Precious Formula for Saving Life), to disperse and resolve toxic fire; subsequently, Neituo Huangqi San (Internal Support Astragalus Powder) should be taken to support the body's resistance, expel toxins, and promote healing. For internal and external treatments before and after ulceration, refer to the sections on "Carbuncles, Ulcers, and Swellings" and "Ulcerated Sores." If lower back pain is severe as if broken, preventing flexion or extension, the prognosis is dangerous. If the color is purple and depressed, with deep rotting holes penetrating fascia and intestines, the prognosis is adverse (Ni syndrome).
Formulas: Xianfang Huoming Yin (See Section on Swellings and Ulcers); Neituo Huangqi San (See preceding section on Middle Dashi Hand).
[Prescription Verse] The "Lotus Seed Eruption" (Lianzi Fa) is named for its shape resembling a lotus seed, formed by the combination of toxic fire from the Gallbladder and Bladder meridians. A slanting, flat, and collapsed shape invading the Du Meridian indicates heavy toxicity; a long, high, and swollen shape occupying half the back indicates light toxicity.
[Annotation] This condition is also known as Taiyin Ju (Taiyin Abscess). It arises on the spine and bilateral hypochondriac regions, belonging to the Gallbladder and Bladder meridians, formed by the coagulation of combined fire and toxin. If the shape is slanting, flat, and collapsed, with the head invading the Du Meridian and the tail pressing against the ribs, it indicates heavy toxicity. If the shape is long, high, and swollen, confined to one side of the back, not crossing the Du Meridian centrally nor the ribs laterally, it indicates light toxicity. For patients with robust constitution, initially administer Chansu Wan (Toad Venom Pill) or Mailing Dan to induce sweating and release the exterior, followed by Yili Jinwan (One-Pill Golden Pellet) to purge and attack toxins. For patients with deficient constitution, initially administer Xianfang Huoming Yin to disperse and resolve toxins, followed by Neituo Huangqi San to support the interior and tonify deficiency. For other internal and external treatments, refer to the sections on "Carbuncles, Ulcers, and Swellings" and "Ulcerated Sores."
Formulas: Chansu Wan (See Section on Ding Sores); Xianfang Huoming Yin (See Section on Swellings and Ulcers); Yili Jinwan and Neituo Huangqi San (See preceding section on Middle Dashi Hand); Mailing Dan (See Section on Swellings and Ulcers).