【方歌】鬓疽三焦胆二经，证由欲怒火凝成，此经气多而血少、
溃腐惟宜少见脓。
【注】此证发于鬓角，属手少阳三焦、足少阳胆二经，由于相
火妄动，外受风热，更因性情急怒，欲念火生，凝结而
成。此二经俱属气多血少，最难腐溃。更兼鬓角肌肉，
浇薄不宜针灸，候其自溃。溃后不宜多见脓，脓多者过
耗血液难敛。初起宜服柴胡清肝汤解之，脓成者宜托里
消毒散托之，外敷二味拔毒散。已溃内外治法，俱按痈
疽溃疡门。
方剂：柴胡清肝汤
组成：柴胡 生地（各一钱五分）
当归（二钱） 赤芍（一钱五分）
川芎（一钱） 连翘（去心，二钱）
牛蒡子（炒，研，一钱五分）黄芩（一钱）
生栀子（研） 天花粉
甘草节 防风（各一钱）
水二钟，煎八分，食远服。
【方歌】柴胡清肝治怒证，宣血疏通解毒良，四物生用柴翘蒡，
黄芩栀粉草节防。
又方：托里消毒散、二味拔毒散（俱见肿疡门）
【方歌】天疽居左锐毒右，经属胆腑生耳后，谋虑太过郁火成，
此处肉薄当急救。
【注】此二证左为夭疽，右为锐毒，俱生耳后一寸三分高骨之
后。夭者，不尽天年谓之夭；锐者，如锋刃之锐利，言
毒甚也。得此二证，愈者甚少。初起俱如黍粒，渐肿如
瓜，坚硬平塌，紫暗不泽，较诸疮疼痛倍增。名虽各异
，而左右耳后，俱属足少阳胆经，由谋虑不决，郁火凝
结而成。此处皮肉浇薄，气多血少，终属险证，急当治
之。迟则热气下入渊液，前伤任脉，内熏肝肺，恶证悉
添，必致不救。若红肿速溃者顺，坚硬黑陷者逆。如果
投方应证，亦只十全四、五也。初宜服柴胡清肝汤消解
之，脓将成宜服托里消毒散，虚者十全大补汤托补之，
外俱敷乌龙膏，其余内外治法，俱按痈疽肿溃疡门。
（渊液胆经穴名）
方剂：柴胡清肝汤（见前鬓疽）
托里消毒散、乌龙膏（俱见肿疡门）
十全大补汤（见溃疡门）
【方歌】鬓疽发生于手少阳三焦经和足少阳胆经，病症由情欲之火与愤怒之气凝结而成。这两条经脉气多血少，溃烂后只宜见到少量脓液。
【注】此病证发于鬓角部位，归属于手少阳三焦经和足少阳胆经两条经脉。其成因是相火（寄居于肝肾的命门之火）妄动，外受风热侵袭，加之性情急躁易怒，欲念引发内火，导致气血凝结而形成。这两条经脉都属于气多血少的类型，最难腐熟化脓和溃破。再加上鬓角部位的肌肉浅薄，不适合进行针灸治疗，应等待其自然溃破。溃破后不宜流出过多脓液，因为脓液过多会过度消耗血液，导致伤口难以收敛。初起时适宜服用柴胡清肝汤以疏解邪气，脓液已成时适宜用托里消毒散以扶正托毒外出，外部敷贴二味拔毒散。已经溃破后的内外治疗方法，均参照痈疽溃疡门的记载。
方剂：柴胡清肝汤
组成：柴胡、生地黄（各一钱五分），当归（二钱），赤芍（一钱五分），川芎（一钱），连翘（去心，二钱），牛蒡子（炒后研碎，一钱五分），黄芩（一钱），生栀子（研碎），天花粉，甘草节，防风（各一钱）。
煎服法：加水两碗，煎至八分满，在饭后远处服用。
【方歌】柴胡清肝汤治疗因愤怒引起的病症，能宣通血脉、疏通经络并良好地解毒。方中四物汤药物生用，配合柴胡、连翘、牛蒡子，以及黄芩、栀子、天花粉、甘草节和防风。
【方歌】天疽生于左侧，锐毒生于右侧，经络归属胆腑，生于耳后。由于谋虑过多导致郁结之火形成，此处皮肉薄弱，应当紧急救治。
【注】这两个病证，左边称为夭疽，右边称为锐毒，都生长在耳后一寸三分处的高骨之后。“夭”是指未能享尽天年而早亡；“锐”是指像锋刃一样锐利，形容毒邪严重。患上这两种病证，治愈的人很少。初起时都像黍米大小，逐渐肿胀如瓜，质地坚硬且平塌，颜色紫暗无光泽，比一般疮疡疼痛加倍增加。虽然名称各异，但左右耳后部位，都属于足少阳胆经，由谋虑不决、郁结之火凝结而成。此处皮肤肌肉浅薄，气多血少，终究属于险恶证候，必须紧急治疗。如果延误时机，热气会向下进入渊液穴，向前损伤任脉，向内熏蒸肝脏和肺脏，各种恶证全部出现，必然导致无法救治。如果红肿迅速溃破的属顺证，如果坚硬黑陷的属逆证。即使用药对症，也只能有四五成的治愈率。初起时适宜服用柴胡清肝汤以消散化解，脓液将成时适宜服用托里消毒散，体质虚弱者适宜服用十全大补汤以托毒补虚，外部均敷贴乌龙膏，其余内外治疗方法，均参照痈疽肿溃疡门的记载。
（渊液为胆经穴位名）
[Verse] Bristle abscess (Binju) occurs in the Hand Shaoyang Sanjiao Meridian and Foot Shaoyang Gallbladder Meridian. The condition is formed by the condensation of desire-fire and anger. These two meridians have abundant Qi but deficient Blood; after ulceration, only a small amount of pus should be seen.
[Commentary] This condition manifests at the hairline, belonging to the Hand Shaoyang Sanjiao Meridian and the Foot Shaoyang Gallbladder Meridian. It arises from the reckless movement of Ministerial Fire (Xianghuo), external invasion of Wind-Heat, and internal fire generated by impatience, anger, and lust, leading to condensation of Qi and Blood. Both meridians are characterized by abundant Qi and deficient Blood, making it difficult for tissue to putrefy and ulcerate. Furthermore, the flesh at the hairline is thin, making acupuncture and moxibustion unsuitable; one should wait for natural ulceration. After ulceration, excessive pus discharge is undesirable, as it excessively depletes Blood and hinders wound healing. In the initial stage, Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) is indicated to resolve the pathogen. When pus has formed, Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) is indicated to support the healthy Qi and expel toxins externally, with Erwei Baidu San (Two-Ingredient Toxin-Extracting Powder) applied topically. For treatment methods after ulceration, refer to the section on Ulcerated Carbuncles and Sores.
Formula: Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction)
Composition: Chai Hu (Radix Bupleuri), Sheng Di Huang (Radix Rehmanniae Preparata) (each 1.5 qian); Dang Gui (Radix Angelicae Sinensis) (2 qian); Chi Shao (Radix Paeoniae Rubra) (1.5 qian); Chuan Xiong (Rhizoma Chuanxiong) (1 qian); Lian Qiao (Fructus Forsythiae) (decored, 2 qian); Niu Bang Zi (Fructus Arctii) (stir-fried and crushed, 1.5 qian); Huang Qin (Radix Scutellariae) (1 qian); Sheng Zhi Zi (Fructus Gardeniae) (crushed); Tian Hua Fen (Radix Trichosanthis); Gan Cao Jie (Ramulus Glycyrrhizae); Fang Feng (Radix Saposhnikoviae) (each 1 qian).
Preparation and Administration: Add two bowls of water, decoct until reduced to eight-tenths, and take far from meals.
[Verse] Chaihu Qinggan Tang treats conditions caused by anger, effectively promoting blood circulation, unblocking collaterals, and detoxifying. The formula uses raw Siwu Tang (Four Substances Decoction) ingredients combined with Chai Hu, Lian Qiao, Niu Bang Zi, Huang Qin, Zhi Zi, Tian Hua Fen, Gan Cao Jie, and Fang Feng.
Another Formula: Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder), Erwei Baidu San (Two-Ingredient Toxin-Extracting Powder) (both see Section on Swollen Sores).
[Verse] Tian Ju (Heaven Abscess) is on the left, Rui Du (Sharp Toxin) is on the right. They belong to the Gallbladder Fu-organ and occur behind the ear. They are formed by郁火 (Stagnant Fire) due to excessive deliberation. The flesh here is thin, requiring urgent treatment.
[Commentary] These two conditions are named Tian Ju (Heaven Abscess) on the left and Rui Du (Sharp Toxin) on the right. Both occur behind the high bone, one inch and three fen behind the ear. "Tian" refers to dying before one's natural lifespan ends; "Rui" means sharp like a blade, indicating severe toxicity. Few patients recover from these conditions. Initially, they appear like millet grains, gradually swelling like a melon, becoming hard, flat, purple-dark, and lusterless, with pain doubling that of other sores. Although named differently, both left and right areas behind the ear belong to the Foot Shaoyang Gallbladder Meridian. They are caused by indecisiveness and condensation of stagnant fire. The skin and flesh here are thin, with abundant Qi and deficient Blood, ultimately constituting a dangerous condition requiring urgent treatment. Delay allows Heat-Qi to descend into Yuan Ye acupoint, damage the Ren Mai (Conception Vessel) anteriorly, and internally熏蒸 (mingle/burn) the Liver and Lungs, causing all malignant symptoms to appear, inevitably leading to death. Rapid swelling, redness, and ulceration indicate a favorable prognosis (Shun); hardness and black depression indicate an unfavorable prognosis (Ni). Even if the prescription matches the syndrome, only four or five out of ten cases may be cured. Initially, Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) is taken to dissipate and resolve. As pus is about to form, Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) is taken. For deficiency patterns, Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) is used to support and tonify. Topically, Wulong Gao (Black Dragon Ointment) is applied. Other internal and external treatments follow the Section on Swollen and Ulcerated Carbuncles and Sores.
(Yuan Ye is an acupoint name of the Gallbladder Meridian.)
Formulas: Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) (see previous section on Bristle Abscess); Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder), Wulong Gao (Black Dragon Ointment) (both see Section on Swollen Sores); Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) (see Section on Ulcerated Sores).