\r发际疽\p04-a41a155.bmp\r
王肯堂曰∶发际疮，初起如粟米，头白肉赤，热痛如锥刺，妇人患此者多，丈
夫患此者少。始因风湿上攻，或因风热上壅，若如芡实，漫肿寒热，或痛或痒者，是发际疽也。（《准绳》）
《心法》曰∶此疽生项后发际，形如黍豆，痛如锥刺，痒如火燎，破津脓水亦有
浸淫发内者，此由内郁湿热，外兼受风相搏而成。 肿高肿者易治；平塌漫肿，毒
流肩背，未脓先腐者，难治。十四日得脓为吉。
\r后脑发有正有偏\p04-a41a156.bmp\r
申斗垣曰∶玉枕疽即后脑发。乃足太阳兼督脉阳维脉所主，多血少气，在玉枕二穴风府穴端。（《启玄》）
陈实功曰∶玉枕疽生于脑后枕骨，中坚而难溃，痛引肩项，鼻塞气粗，此足太
阳膀胱湿热凝滞而成，痛痒不一。（《正宗》）
申斗垣曰∶蜂窝疽乃热毒结成，形如蜂窝，中多碎孔，多生头后。 痛红肿者
可治；疾发者难治。毒流两肩不可救矣。（《启玄》）
胡公弼曰∶此证与蜂窝发背不同，与对口同治。（《青囊》）
\r锐毒\p04-a41a157.bmp\r
左名夭疽，右名锐毒，生于耳后一寸三分陷中。致命之处。
陈实功曰∶夭疽锐毒，生于耳后一寸
三分致病之处。左为夭疽，夭者，妖也，妖变之物，属于肝木。右为锐毒，锐者，利
也，锋利之器，属于肺金。二者皆起于积想在心，谋虑不决，以致火旺而又郁，郁
而又旺，诚为险恶之候。故形多坚硬，头多隐伏，未溃先黑，未脓先腐，臭秽易生，
元气易败。凡得此者，毒多不得外发，后必内攻而死。初起生于隐微，令人多不知
觉，及其知觉，毒已入内矣。倘红活高肿，易于脓腐者，无妨。（《正宗》）
汪省之曰∶夭疽锐毒，又名痼发，又名耳后发。（《理例》）
胡公弼曰∶耳后锐毒，乃心肾二经受毒。若不急治，恐热气壅心，毒攻喉下，必致伤命。（《青囊》）
王肯堂说：发际疮，初起时像粟米一样大，顶部白色而根部赤红，疼痛剧烈如锥刺，妇女患此病的较多，男子患此病的较少。起初是因为风湿之邪上攻头部，或者因风热之邪上壅所致；如果症状像芡实（一种植物果实）那样，漫肿无头，伴有寒热，或痛或痒的，这就是发际疽。（出自《医学准绳六要》）
《医宗心法》说：这种疽生在项部后面的发际处，形状像黍豆，疼痛如锥刺，瘙痒如火烧，破溃后流出的脓水有时也会浸淫到头发里面。这是由于体内湿热郁结，外部又兼受风邪侵袭，内外相搏而形成的。肿胀高突的容易治疗；平塌漫肿，毒邪流注到肩背部，尚未化脓就先腐烂的，难以治疗。第十四天能出脓为吉兆。
后脑发有正有偏
申斗垣说：玉枕疽即发生在后脑勺的头发部位。它由足太阳膀胱经兼督脉和阳维脉所主管，此处多血少气，位于玉枕穴和风府穴的末端。（出自《外科启玄》）
陈实功说：玉枕疽生于脑后枕骨部位，中间坚实而难以溃破，疼痛牵引至肩部和颈部，鼻塞且呼吸粗重，这是由足太阳膀胱经的湿热凝滞而成的，疼痛和瘙痒的感觉不一。（出自《外科正宗》）
申斗垣说：蜂窝疽是由热毒凝结而成，形状像蜂窝，中间有很多碎孔，多生在后脑勺。红肿疼痛的可以治疗；发病急骤的难以治疗。如果毒邪流注到双肩，就无法救治了。（出自《外科启玄》）
胡公弼说：这个病症与蜂窝发背不同，治疗方法与对口疮相同。（出自《青囊秘传》）
左边的称为夭疽，右边的称为锐毒，生于耳后一寸三分处的凹陷中。这是致命的部位。
陈实功说：夭疽和锐毒，生于耳后一寸三分致病之处。左边为夭疽，“夭”意为妖异，属于肝木系统；右边为锐毒，“锐”意为锋利，属于肺金系统。这两种病都起因于心中积存思虑，谋略决断犹豫不决，导致火气旺盛而又郁结，郁结之后又更加旺盛，确实是险恶的证候。所以患处形态多坚硬，顶端多隐伏不显，未溃破前先变黑，未化脓前先腐烂，气味臭秽，元气容易败坏。凡是得此病的人，毒邪大多不能向外发散，最终必定向内攻伐而死。初起时生于隐蔽细微之处，使人往往不易察觉，等到发觉时，毒邪已经入内了。倘若患处红活高肿，易于化脓腐烂的，则无妨。（出自《外科正宗》）
汪省之说：夭疽和锐毒，又名痼发，又名耳后发。（出自《外科理例》）
胡公弼说：耳后的锐毒，是心和肾两经受毒邪侵袭。如果不紧急治疗，恐怕热气壅塞于心，毒邪攻冲喉下，必然导致丧命。（出自《青囊秘传》）
Faji Ju (Hairline Carbuncle)
Wang Kentang stated: Faji Chuang (Hairline Ulcer) initially appears like a millet grain, with a white head and red flesh, causing pain as sharp as a needle prick. It is more common in women than in men. Initially, it is caused by the upward attack of wind-dampness or the upward congestion of wind-heat. If it presents as a diffuse swelling without a distinct head, resembling a water chestnut (Qianshi), accompanied by chills and fever, or pain and itching, it is termed Faji Ju (Hairline Carbuncle). (From *Yixue Zhunsheng Liuyao*)
*Yizong Xinfa* states: This Ju (Carbuncle) arises at the hairline behind the neck. Its shape resembles a millet seed, with pain like a needle prick and itching like a burning fire. The pus and fluid discharged after rupture may sometimes infiltrate into the hair. This condition results from internal stagnation of damp-heat combined with external invasion of wind, leading to an interaction between the two. Cases with high, swollen protrusions are easy to treat; those that are flat, diffusely swollen, with toxins spreading to the shoulders and back, and rotting before suppuration occurs, are difficult to treat. Suppuration on the fourteenth day is auspicious.
The Hair at the Back of the Head: Central and Lateral
Shen Douyuan stated: Yuzhen Ju (Jade Pillow Carbuncle) occurs at the hair on the back of the head. It is governed by the Foot-Taiyang Bladder Meridian, along with the Du Mai (Governing Vessel) and Yangwei Mai (Yang Linking Vessel). This area has abundant blood but scarce qi, located at the ends of the Yuzhen (GB12) and Fengfu (GV16) acupoints. (From *Waike Xuanyuan*)
Chen Shigong stated: Yuzhen Ju arises at the occipital bone at the back of the head. It is firm in the center and difficult to ulcerate, with pain radiating to the shoulders and neck, nasal congestion, and coarse breathing. This is caused by the stagnation of damp-heat in the Foot-Taiyang Bladder Meridian, presenting with varying degrees of pain and itching. (From *Waike Zhengzong*)
Shen Douyuan stated: Fengwo Ju (Honeycomb Carbuncle) is formed by the condensation of heat-toxins. Its shape resembles a honeycomb with many small holes, often occurring at the back of the head. Cases with redness, swelling, and pain are treatable; those with rapid onset are difficult to treat. If the toxin spreads to both shoulders, it is incurable. (From *Waike Xuanyuan*)
Hu Gongbi stated: This condition differs from Fengwo Fabei (Honeycomb Back Carbuncle) and is treated similarly to Duikou Chuang (Opposite Mouth Carbuncle). (From *Qinang Michuan*)
Ruidu (Sharp Toxin)
The one on the left is called Yaoju (Premature Death Carbuncle), and the one on the right is called Ruidu (Sharp Toxin). They arise in the depression 1.3 cun behind the ear. This is a fatal location.
Chen Shigong stated: Yaoju and Ruidu arise at the pathological site 1.3 cun behind the ear. The left side is Yaoju; "Yao" means demon/abnormal, belonging to the Liver Wood system. The right side is Ruidu; "Rui" means sharp, belonging to the Lung Metal system. Both conditions originate from persistent thoughts and indecision in the mind, leading to excessive fire that becomes stagnant, and then becomes excessive again. This is indeed a perilous syndrome. Consequently, the lesion is often hard, with the head hidden or indistinct, turning black before ulceration, and rotting before suppuration. It produces foul odors easily, and the Yuanqi (Original Qi) is prone to failure. Patients with this condition usually cannot expel the toxin outwardly, and it will inevitably attack inwardly, leading to death. Initially arising in obscure and subtle places, it often goes unnoticed. By the time it is perceived, the toxin has already entered the interior. However, if the lesion is red, vibrant, highly swollen, and easily suppurates and rots, there is no cause for concern. (From *Waike Zhengzong*)
Wang Shengzhi stated: Yaoju and Ruidu are also known as Gufa (Stubborn Hair Carbuncle) or Erhou Fa (Post-Auricular Hair Carbuncle). (From *Waike Lili*)
Hu Gongbi stated: Ruidu behind the ear involves toxins affecting the Heart and Kidney meridians. If not treated urgently, the pathogenic heat may congest the Heart, and the toxin may attack the throat and lower regions, inevitably resulting in death. (From *Qinang Michuan*)