属性：凡遇生内痈之人，与生黄豆五粒，嚼之口中无豆味者，
是其候也。
【方歌】肩疽痈发正肩中，疽硬黑陷痈肿红，干疽肩前过肩后，
风湿积热血瘀凝。
【注】此疽生于肩中廉，属三焦、胆二经，红活高肿，一名疵
痈，坚硬平塌，为肩中疽。肩之前廉，属大肠经，名干
疽，一名疔疽。肩之后廉属小肠经，名过肩疽。疮势无
论大小，惟在发源之处命名。总由湿热风邪郁成，亦有
负重瘀血凝结而成。高肿红活，焮热速溃者顺；若平塌
坚硬，无红无热，溃迟者险；甚则肿痛连及臂胛，口噤
寒战，大痛不食，或兼绵溃便泻者逆。治法：初起有表
证者，俱宜荆防败毒散汗之；有里证者，内疏黄连汤下
之；汗下之后，肿痛不退，脓势将成，宜用托里透脓汤
，脓熟开之。至于引经之药，惟在临证时因经加之。溃
后，内外治法俱按痈疽溃疡门。
方剂：荆防败毒散（见项部脑疽）
内疏黄连汤（见肿疡门）
托里透脓汤（见头部侵脑疽）
【方歌】〔骨翏〕疽肩后腋外生，小肠肩贞风火凝，肩风毒生肿
臑端上，大肠肩〔骨禺〕风湿成。
【注】〔月翏〕疽，生于肩之后下，腋之后外微上，岐骨缝之
间，经属小肠肩贞穴，由风火凝结而成。初起如粟，坚
硬肿痛，肩臑拘急，不能举扬。初服荆防败毒散，便燥
实者，服双解贵金丸双解之。肩风毒生于肩梢臑上骨尖
处，经属大肠肩〔骨禺〕穴，由邪风深袭骨缝，与湿稽
留，化热而成。初起宣肿色赤，大者如桃，小者如杏，
痛连肩臑，更兼拘急。初服蠲痛无忧散汗之即消，若肿
痛日深，不能尽消者，脓势将成也，宜服托里透脓汤。
二证溃后，内外治法俱按痈疽溃疡门。
方剂：蠲痛无忧散
组成：番木鳖（香油炸浮） 当归（酒洗）
甘草（生，各二两） 麻黄（三两）
穿山甲（陈土炒） 川乌（黑豆酒煮，去皮、尖）
草乌（姜汁煮） 苍术（米泔水浸炒）
半夏（制，各二两） 威灵仙（一两）
各制为末，共和，匀每服五、七分至一钱，无灰酒
调服，再饮酒以醉为度，盖卧出汗避风。此方加闹羊化
四两，亦治头风痛。
【方歌】蠲痛无忧肩风毒，风袭骨缝与湿凝，番鳖归草麻黄甲，
川芎乌苍半威灵。
又方：荆防败毒散（见项部脑疽）
双解贵金丸（见肿疡门）
托里透脓汤（见头部侵脑疽）
属性：凡是遇到患有内痈的人，给他五粒生黄豆，如果在口中咀嚼没有豆腥味，就是这种病的征候。
【方歌】肩疽痈发生在肩膀正中，疽表现为坚硬黑陷，痈表现为红肿，干疽位于肩前和过肩后，由风湿积热、血瘀凝滞引起。
【注】这种疽生于肩膀内侧边缘，归属于三焦经和胆经。如果疮面红活高肿，名叫疵痈；如果疮面坚硬平塌，称为肩中疽。肩膀的前侧边缘，归属于大肠经，名叫干疽，也叫疔疽。肩膀的后侧边缘归属于小肠经，名叫过肩疽。疮势无论大小，只在发病源头处命名。总归是由湿热风邪郁结而成，也有因负重导致瘀血凝结而形成的。如果疮面高肿红活，焮热且迅速溃破的，为顺证；如果疮面平塌坚硬，无红无热，溃破迟缓的，为险证；甚至肿痛牵连手臂和肩胛，牙关紧闭、寒战，剧烈疼痛不能进食，或者兼有绵软溃烂、腹泻的，为逆证。治疗方法：初起有表证的，都适宜用荆防败毒散发汗治疗；有里证的，用内疏黄连汤泻下治疗；汗法或下法之后，肿痛不退，脓势将要形成时，宜用托里透脓汤；脓成熟后切开排脓。至于引经药，只在临证时根据所属经络添加。溃破后，内外治法都按照痈疽溃疡门的规范进行。
方剂：荆防败毒散（见项部脑疽）
内疏黄连汤（见肿疡门）
托里透脓汤（见头部侵脑疽）
【方歌】骨骱疽生于肩后腋外，小肠经肩贞穴受风火凝滞，肩风毒生于肿大的上臂端，大肠经肩髃穴受风湿影响而成。
【注】骨骱疽，生于肩膀后下方，腋窝后外侧稍上方，岐骨缝隙之间，经脉归属小肠经肩贞穴，由风火凝结而成。初起像粟米一样，坚硬肿痛，肩膀和上臂拘急，不能抬举。初起服用荆防败毒散，大便燥实者，服用双解贵金丸以双解之。肩风毒生于肩梢上臂骨尖处，经脉归属大肠经肩髃穴，由邪风深入侵袭骨缝，与湿邪稽留，化热而成。初起宣肿色赤，大的如桃子，小的如杏子，疼痛牵连肩膀和上臂，更兼拘急。初起服用蠲痛无忧散发汗即可消除，如果肿痛日益加深，不能完全消除的，说明脓势将要形成，宜服用托里透脓汤。这两种病证溃破后，内外治法都按照痈疽溃疡门的规范进行。
方剂：蠲痛无忧散
组成：番木鳖（香油炸至浮起） 当归（酒洗）
甘草（生用，各二两） 麻黄（三两）
穿山甲（陈土炒） 川乌（黑豆酒煮，去皮、尖）
草乌（姜汁煮） 苍术（米泔水浸炒）
半夏（制，各二两） 威灵仙（一两）
各制成粉末，混合均匀，每次服用五分至一钱，用无灰酒调服，再饮酒直到醉为止，盖被睡觉出汗并避风。此方加闹羊花四两，也能治疗头风痛。
【方歌】蠲痛无忧散治疗肩风毒，风邪侵袭骨缝与湿邪凝滞，番木鳖、当归、甘草、麻黄、穿山甲，川芎、川乌、苍术、半夏、威灵仙。
又方：荆防败毒散（见项部脑疽）
双解贵金丸（见肿疡门）
托里透脓汤（见头部侵脑疽）
Attribute: Whenever encountering a person suffering from internal carbuncle (internal abscess), give them five raw soybeans. If there is no bean flavor when chewed in the mouth, this is the sign of the disease.
[Prescription Verse] Shoulder carbuncle and abscess occur exactly in the center of the shoulder; the carbuncle is hard with black depression, while the abscess is red and swollen. Dry carbuncle is located before and after the shoulder, caused by accumulation of wind-dampness and heat, with blood stasis coagulation.
[Note] This carbuncle arises on the medial margin of the shoulder, belonging to the Sanjiao (Triple Burner) and Gallbladder meridians. If the lesion is red, vibrant, and high-swollen, it is named Ci Carbuncle; if it is hard and flat, it is called Shoulder Middle Carbuncle. The anterior margin of the shoulder belongs to the Large Intestine meridian, named Dry Carbuncle, also known as Ding Carbuncle. The posterior margin of the shoulder belongs to the Small Intestine meridian, named Over-shoulder Carbuncle. Regardless of the size of the lesion, it is named based on its origin. Generally, it is formed by the stagnation of damp-heat and wind-pathogens, or sometimes by the coagulation of blood stasis due to carrying heavy loads. If the swelling is high, red, and vibrant, with rapid suppuration and ulceration, it is a favorable prognosis (Shun); if it is flat, hard, without redness or heat, and suppurates slowly, it is dangerous; if pain and swelling extend to the arm and scapula, accompanied by trismus, chills, severe pain preventing eating, or soft ulceration with diarrhea, it is an unfavorable prognosis (Ni). Treatment methods: In the initial stage with exterior syndrome, Jingfang Baidu San (Jingjie, Fangfeng, and other herbs to expel pathogens) should be used to induce sweating; with interior syndrome, Neishu Huanglian Tang (Internal Draining Coptis Decoction) should be used to purge. After sweating or purging, if pain and swelling persist and pus is about to form, Tuoli Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction) is suitable; once the pus matures, incision and drainage are performed. As for guiding herbs, they are added according to the specific meridian during clinical practice. After ulceration, both internal and external treatments follow the regulations in the "Carbuncle and Ulcer" section.
Formulas: Jingfang Baidu San (See Occipital Brain Carbuncle)
Neishu Huanglian Tang (See Swelling and Ulcer Section)
Tuoli Tou Nong Tang (See Head Invasion Brain Carbuncle)
[Prescription Verse] Gu Liao Carbuncle arises behind the shoulder and outside the armpit, where the Small Intestine meridian's Jianzhen acupoint is affected by wind-fire coagulation. Shoulder Wind-Toxicity causes swelling at the upper end of the arm, formed by wind-dampness affecting the Large Intestine meridian's Jianyu acupoint.
[Note] Gu Liao Carbuncle arises below the posterior shoulder, slightly above the posterior-lateral aspect of the armpit, between the bone gaps. It belongs to the Small Intestine meridian's Jianzhen acupoint and is formed by wind-fire coagulation. Initially, it resembles millet grains, hard, painful, and swollen, with stiffness in the shoulder and arm, unable to lift. Initially, take Jingfang Baidu San; for those with dry and solid stool, take Shuangjie Guijin Wan (Double Resolution Golden Pill) for double resolution. Shoulder Wind-Toxicity arises at the tip of the shoulder and the bony prominence of the upper arm, belonging to the Large Intestine meridian's Jianyu acupoint. It is caused by pathogenic wind deeply invading the bone gaps, lingering with dampness, and transforming into heat. Initially, there is diffuse swelling and redness; large lesions are like peaches, small ones like apricots. Pain extends to the shoulder and arm, accompanied by stiffness. Initially, take Juantong Wuyou San (Pain-Relieving Worries-Free Powder) to induce sweating, which will eliminate the condition immediately. If swelling and pain deepen daily and cannot be completely eliminated, pus is about to form, and Tuoli Tou Nong Tang should be taken. For both conditions after ulceration, internal and external treatments follow the "Carbuncle and Ulcer" section.
Formula: Juantong Wuyou San
Composition: Strychnos nux-vomica (Fanned in sesame oil until floating) Angelica sinensis (Washed with wine)
Glycyrrhiza uralensis (Raw, two taels each) Ephedrae Herba (three taels)
Manis squama (Stir-fried with old soil) Aconiti Radix lateralis preparata (Boiled with black soybean wine, skin and tip removed)
Aconiti Kusnezoffii Radix (Boiled with ginger juice) Atractylodis Rhizoma (Soaked in rice water and stir-fried)
Pinelliae Tuber (Prepared, two taels each) Salvia miltiorrhiza (one tael)
Each processed into powder, mixed uniformly. Take 0.5 to 1 qian per dose, mixed with clear wine. Drink more alcohol until drunk, then cover with blankets to sweat and avoid wind. Adding four liang of Datura metel (Nao Yang Hua) to this formula also treats headache due to wind.
[Prescription Verse] Juantong Wuyou San treats Shoulder Wind-Toxicity, where wind invades bone gaps and coagulates with dampness; Strychnos nux-vomica, Angelica sinensis, Glycyrrhiza uralensis, Ephedrae Herba, Manis squama, Chuanxiong Rhizome, Aconiti Radix lateralis preparata, Atractylodis Rhizoma, Pinelliae Tuber, and Salvia miltiorrhiza.
Another Formula: Jingfang Baidu San (See Occipital Brain Carbuncle)
Shuangjie Guijin Wan (See Swelling and Ulcer Section)
Tuoli Tou Nong Tang (See Head Invasion Brain Carbuncle)