消上搭方（《单方集验》）
全蝎（三个） 核桃肉（三个）
共研细，热酒冲服，一二次自消。
\r中搭\p04-a41a169.bmp\r
王肯堂曰∶中搭即龙疽，生第九椎两旁，忽肿痛而无头，寒热大作，属太阳经。
由七情不和，愤怒积热所致。色赤起发润泽者可治；色黑低陷，恶心眩晕，大便滑泄，小便如淋，谵语者死。（《准绳》）
\r左右搭\p04-a41a170.bmp\r
王肯堂曰∶左右搭串者，左肩骨上生疽串于右者可治；右肩骨上生疽串于左者
难治。古有此说，愚谓不然，攻注左右者，气血不调，阴阳交错也，七恶证少，何虑
难痊？元气虚惫，治之何补哉。（《准绳》）
陈实功曰∶左搭属肝，右搭属肺，俱生于左右肩骨移动之处，为可治。如左搭
串右，右搭串左，俱为难治（《正宗》）
申斗垣曰∶两肩左右齐发，名双串肩搭疽。（《启玄》）
\r瘭疽发\p04-a41a171.bmp\r
申斗垣曰∶瘭疽发，发于背之两旁，属足太阳膀胱经，多血少气。发于脊中，属
督脉经。初起如豆如梅李，黑白色不定，惨
痛应心，四畔如牛唇，四十岁以前可治。已衰弱者难痊。（《启玄》）
《鬼遗方》云∶禽疽始发者如疹数十处，如拳打之状，发寒齿噤。如此者十四日死；十日可刺，导引脓出即愈。
王肯堂曰∶禽疽，背忽麻木拘急不痛，十数处肉紫色如拳触状。七日内寒热口噤
者死；得汗可治，无汗不治。神昏脉躁，或微或代者死。漫肿不溃，宜服台阁紫微丸。（《准绳》）
消上搭方（出自《单方集验》）
全蝎（三枚） 核桃仁（三个）
共同研磨成细粉，用热酒冲服，服用一两次后肿块自然消散。
中搭
王肯堂说：中搭就是龙疽，生长在第九胸椎两旁，突然肿痛但没有脓头，寒战和高热剧烈发作，属于太阳经病变。
这是由于七情失调，愤怒导致积热所引起。如果患处颜色红赤、肿胀隆起且润泽的可以治疗；如果颜色黑陷、伴有恶心眩晕、大便滑泄、小便像淋证一样涩痛、胡言乱语的是死证。（出自《医学准绳六要》）
左右搭
王肯堂说：左右搭串症，如果在左肩骨上生疽并串连到右侧的可以治疗；在右肩骨上生疽并串连到左侧的难以治疗。古代有这样的说法，我认为不对。如果是攻注于左右两侧的，是气血不调、阴阳交错所致，如果出现“七恶”证候很少，何必担心难以痊愈？如果是元气虚弱疲惫，又该如何补益呢？（出自《医学准绳六要》）
陈实功说：左搭属于肝，右搭属于肺，都生长在左右肩骨活动之处，是可以治疗的。如果是左搭串连到右边，右搭串连到左边，都属于难治。（出自《外科正宗》）
申斗垣说：两肩左右同时发作，名叫双串肩搭疽。（出自《外科启玄》）
瘭疽发
申斗垣说：瘭疽发，生长在背部两旁，属于足太阳膀胱经，多血少气。如果生长在脊柱正中，属于督脉经。初起时像豆子或梅子李子大小，颜色黑白不定，疼痛剧烈令人心惊，四周肿势如牛唇状，四十岁以下的人可以治疗。已经身体衰弱的人难以痊愈。（出自《外科启玄》）
《鬼遗方》说：禽疽刚开始发作时有数十处皮疹，像被拳头打过的样子，出现发冷、牙齿打颤的症状。像这样的情况十四天会死亡；如果在十天内可以针刺，引导脓液流出就会痊愈。
王肯堂说：禽疽，背部突然麻木拘急但不痛，十几处皮肤呈紫色，像被拳头撞击过的形状。七日内出现寒战、高热、口噤不开的是死证；能够出汗的可以治疗，不能出汗的无法治疗。神志昏迷、脉搏躁动，或者脉象微弱或代脉的是死证。漫肿不溃破的，适宜服用台阁紫微丸。（出自《医学准绳六要》）
Xiao Shangda Formula (from *Danfang Jiyuan*)
Scorpio (three pieces) Walnut kernel (three pieces)
Grind together into a fine powder, take with hot wine. The swelling will naturally subside after one or two doses.
Zhongda (Middle Shoulder Carbuncle)
Wang Kentang stated: Zhongda is also known as Longju (Dragon Carbuncle). It arises on both sides of the ninth thoracic vertebra. It presents with sudden swelling and pain without a head, accompanied by severe chills and high fever. It belongs to the Taiyang meridian.
It is caused by disharmony of the Seven Emotions, specifically anger leading to accumulated heat. If the lesion is red, raised, and moist/lustrous, it is treatable; if it is black and depressed, accompanied by nausea, dizziness, loose stools, dysuria resembling strangury, and delirium, it is fatal. (From *Yixue Zhunsheng*)
Zuoyou Da (Left and Right Shoulder Carbuncle)
Wang Kentang stated: In cases of Zuoyou Da where the carbuncle spreads from left to right, arising on the left shoulder bone and spreading to the right, it is treatable; if it arises on the right shoulder bone and spreads to the left, it is difficult to treat. This was an ancient saying, but I disagree. If the pathogen attacks both left and right, it indicates disharmony of Qi and Blood and intermingling of Yin and Yang. If few of the "Seven Evil" syndromes are present, why worry about non-recovery? However, if the Yuan Qi is deficient and exhausted, what benefit can treatment bring? (From *Yixue Zhunsheng*)
Chen Shigong stated: Left Da belongs to the Liver, and Right Da belongs to the Lung. Both arise at the movable joints of the left and right shoulder bones and are treatable. However, if Left Da spreads to the right or Right Da spreads to the left, they are considered difficult to treat. (From *Waike Zhengzong*)
Shen Douyuan stated: When carbuncles erupt simultaneously on both shoulders, left and right, it is called Shuangchuan Jianda Ju (Double-Stringing Shoulder Carbuncle). (From *Waike Qixuan*)
Baoju Fa (Acute Ulcerative Carbuncle Eruption)
Shen Douyuan stated: Baoju Fa arises on both sides of the back and belongs to the Foot-Taiyang Bladder Meridian, which is characterized by abundant blood and scarce Qi. If it arises in the center of the spine, it belongs to the Du Mai (Governing Vessel). Initially, it resembles a bean or a plum/prune in size. The color is indeterminate between black and white. The pain is severe and distressing to the heart. The surrounding swelling resembles an ox's lip. Patients under forty years old are treatable. Those who are already debilitated are difficult to cure. (From *Waike Qixuan*)
*Guiyi Fang* states: At the onset of Qinju (Bird Carbuncle), there are dozens of rash-like lesions, resembling the appearance of being struck by a fist, accompanied by chills and trismus (lockjaw). Such cases result in death within fourteen days; if punctured within ten days to drain pus, recovery ensues.
Wang Kentang stated: Qinju presents with sudden numbness and stiffness in the back without pain. Several patches of skin turn purple, resembling contusions from a fist blow. Cases presenting with chills, high fever, and trismus within seven days are fatal. Recovery is possible if sweating occurs; if no sweat occurs, it is untreatable. Coma with a restless pulse, or a faint or intermittent pulse, indicates death. For diffuse swelling that does not ulcerate, Taige Ziwei Wan should be administered. (From *Yixue Zhunsheng*)