凡胸膈赤肿疼痛，头疼身痛，发热恶寒，此名赤膈伤寒。宜荆防败毒散加栝蒌
子、黄连、黄芩、紫荆皮、元参、赤芍、升麻、白芷。如证有表复有里，胸膈赤肿疼
痛者，防风通圣散加黄连、栝蒌子、紫荆皮；如表证已退，大便燥实，胸膈肿痛者，
凉膈解毒，如栝蒌子、枳壳、桔梗、紫荆皮、赤芍，又宜棱针刺肿毒出血；如半表
半里，胸膈肿痛者，柴胡枳桔汤加栝蒌子、紫荆皮、赤芍。
龟胸者，胸高胀满，形如复掌，多因乳母酒面五辛无度所伤，或夏月烦躁，热
乳、宿乳与儿。盖肺气最清，为诸脏华盖，水气泛溢，肺为之浮，日久痰滞，则生风
热，一触诸辛，肺气昏乱，是以唇红面赤，咳嗽喘促，溏泻蒸热，由此而成疳，由疳
而成龟背矣。如药后而复作传变，目睛直视，痰涎壅上，或发搐者难治。
王肯堂曰∶脾发疽生心窝下两旁，属脾经食窦穴，无论左右皆生。由多食煎 ，
醉饱入房，以致毒聚脾经而成。稍迟则溃伤脾膜，脓如蟹沫者死。服药而呕，饮食
不进者死。（《准绳》）
《心法》曰∶此疽因过饮辛热药酒，积火成毒亦生。
\r脾发疽\p04-a41a134.bmp\r
\r胸前蜂窠发\p04-a41a135.bmp\r
申斗垣曰∶蜂窠发在胸乳间，或左或右，或双发，在 中、（穴在俞府下一寸六分陷中。）
神藏、（穴在 中下一寸六分。）灵墟（穴在神藏下一寸七分。）三穴。乃足少阴肾经所立。心热甚，急
宜内托疏心火。其证心悬若饥，饥不能食，舌干咽肿，归心则死。（《启玄》）
凡是胸膈部位出现红肿疼痛，伴有头痛、全身疼痛，发热且怕冷，这种情况称为赤膈伤寒。适宜使用荆防败毒散（Jingfang Baidu San, Jingfang Decoction for Overcoming Toxins）加入栝蒌子（Trichosanthis Semen）、黄连（Coptidis Rhizoma）、黄芩（Scutellariae Radix）、紫荆皮（Broussonetiae Cortex）、元参（Scrophulariae Radix）、赤芍（Paeoniae Radix Rubra）、升麻（Cimicifugae Rhizoma）、白芷（Angelicae Dahuricae Radix）。如果病症既有表证又有里证，表现为胸膈红肿疼痛的，使用防风通圣散（Fangfeng Tongsheng San, Fangfeng Detoxification Powder）加入黄连、栝蒌子、紫荆皮；如果表证已经消退，大便干燥结实，胸膈肿痛，应当采用凉膈解毒的方法，方药如栝蒌子、枳壳（Aurantii Fructus）、桔梗（Platycodonis Radix）、紫荆皮、赤芍，同时也适宜用棱针点刺肿毒部位使其出血；如果病在半表半里之间，胸膈肿痛，使用柴胡枳桔汤（Chaihu Zhijie Tang, Bupleurum and Magnolia Bud Decoction）加入栝蒌子、紫荆皮、赤芍。
所谓龟胸，是指胸部高耸胀满，形状像倒扣的手掌，多因乳母过量食用酒类、面食及五种辛辣刺激性食物所致，或者是夏季烦躁时，让婴儿饮用热奶或隔夜奶。因为肺气最为清肃，是五脏六腑的华盖（保护脏器的屏障），水气泛溢会导致肺脏上浮，日久痰液停滞，则产生风热，一旦接触各种辛味食物，肺气就会昏乱，从而出现嘴唇红、面色赤、咳嗽气喘急促、腹泻伴蒸蒸发热等症状，由此形成疳积（Nutritional Disturbance in Children），由疳积进而发展为龟背（Kyphosis resembling a turtle's back）。如果用药后病情再次传变，出现两眼直视、痰涎壅盛上涌，或者发生抽搐的，属于难治之症。
王肯堂说：脾发疽生于心窝下方两侧，归属于脾经的食窦穴（Shidou, ST18），无论左侧还是右侧都会发生。这是由于多吃煎炸食物，醉酒后行房事，导致毒素聚集在脾经而成。如果治疗稍晚，疮疡溃破伤及脾膜，脓液像蟹沫一样的会死亡。服药后呕吐，饮食无法进服的也会死亡。（出自《医学准绳六要》）
《医宗金鉴·心法要诀》说：这种疽是因为过量饮用辛辣热性的药酒，积火成毒而生成的。
申斗垣说：蜂窠发生于胸乳之间，或在左或在右，或双侧同时发生，位置在中府穴（Zhongfu, LU1，穴位在俞府穴下一寸六分的凹陷处）、神藏穴（Shencang, BL17，穴位在中府穴下一寸六分）、灵墟穴（Lingxu, BL18，穴位在神藏穴下一寸七分）这三个穴位附近。这些穴位属于足少阴肾经所立（注：此处原文可能有误，中府属肺经，神藏、灵墟属膀胱经，但依原文翻译）。其病因是心火极盛，急需使用内托法疏泄心火。其症状表现为心中悬空感似饥饿，但饥饿时又不能进食，舌头干燥咽喉肿痛，如果邪气归于心经则会导致死亡。（出自《外科启玄》）
Whenever the chest and diaphragm area presents with redness, swelling, and pain, accompanied by headache, body ache, fever, and aversion to cold, this condition is named Chige Shanghan (Red Diaphragm Cold Damage). It is appropriate to use Jingfang Baidu San (Jingfang Decoction for Overcoming Toxins) added with Trichosanthis Semen (Gualouzi), Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Broussonetiae Cortex (Zijingpi), Scrophulariae Radix (Yuanshen), Paeoniae Radix Rubra (Chishao), Cimicifugae Rhizoma (Shengma), and Angelicae Dahuricae Radix (Baizhi). If the syndrome presents both exterior and interior signs, characterized by redness, swelling, and pain in the chest and diaphragm, Fangfeng Tongsheng San (Fangfeng Detoxification Powder) should be used, added with Huanglian, Gualouzi, and Zijingpi. If the exterior syndrome has subsided, yet the stool is dry and solid, and there is pain and swelling in the chest and diaphragm, one should employ the method of cooling the diaphragm and detoxifying, using herbs such as Gualouzi, Aurantii Fructus (Zhike), Platycodonis Radix (Jiegeng), Zijingpi, and Chishao; additionally, it is suitable to puncture the swollen toxic area with a triangular needle to induce bleeding. If the disease is at the half-exterior half-interior level, with pain and swelling in the chest and diaphragm, Chaihu Zhijie Tang (Bupleurum and Magnolia Bud Decoction) should be used, added with Gualouzi, Zijingpi, and Chishao.
The so-called "Tortoise Chest" refers to a condition where the chest is elevated and distended, shaped like an inverted palm. It is mostly caused by the nursing mother consuming excessive amounts of alcohol, wheat products, and the five pungent spices, or by allowing the infant to drink hot milk or leftover milk during summer irritability. Since Lung Qi is the purest and serves as the Huagai (Canopy protecting the organs) for all viscera, when water qi overflows, the lung floats upward. Over time, phlegm stagnates, generating wind-heat. Upon contact with various pungent foods, Lung Qi becomes chaotic, resulting in red lips, flushed face, coughing, wheezing, loose stools with steaming heat sensations. This leads to the formation of Ganji (Nutritional Disturbance in Children), which further develops into Guibei (Kyphosis resembling a turtle's back). If after medication the condition relapses and transforms, presenting with fixed staring eyes, copious phlegm and saliva surging upwards, or convulsions, it is difficult to treat.
Wang Kentang stated: Pi Fa Ju (Sple Carbuncle) arises on both sides below the heart pit, belonging to the Shidou acupoint (ST18, SP15 contextually often associated with spleen channel but text says ST/SP area, strictly translating location) of the Spleen Meridian, occurring regardless of left or right side. It is caused by excessive consumption of fried foods and sexual intercourse while drunk, leading to toxin accumulation in the Spleen Meridian. If treatment is delayed, the ulcer may rupture and damage the spleen membrane; if the pus resembles crab foam, death ensues. Death also occurs if vomiting happens after taking medicine and food intake is impossible. (From *Yixue Zhunsheng*)
*Yizong Jinjian: Xinfa Yaojue* states: This type of ju (carbuncle/abscess) arises from excessive drinking of spicy and hot medicinal wines, where accumulated fire turns into toxicity.
Shen Douyuan stated: Fengke Fa (Honeycomb Eruption) occurs between the chest and breasts, either on the left, right, or bilaterally. Its locations are near the Zhongfu acupoint (LU1, located 1.6 cun below Yufo in the depression), Shencang acupoint (BL17, located 1.6 cun below Zhongfu), and Lingxu acupoint (BL18, located 1.7 cun below Shencang). These points are established by the Foot-Shaoyin Kidney Meridian (Note: Text attribution may vary in standard texts, but translated as per source). The etiology is extreme Heart Heat, requiring immediate internal support and venting of Heart Fire. The symptoms include a sensation of emptiness in the heart akin to hunger, yet inability to eat when hungry, dry tongue, and swollen throat. If the pathogen returns to the Heart, death will result. (From *Waike Qixuan*)