肘之内生痈，属三阴经，乃心、肺、胞络郁火。引经，黄连、升麻、柴胡。肘之外
生痈，属三阳经，乃胃、大、小肠积毒。引经 本、升麻、柴胡。并用黄连消毒饮、活
命饮，或乌金散、紫金丹、胜金丹、玉枢丹选用。壮实有里证者，一粒金丹、八阵散下
之。老弱者，黄 木香散、十全大补汤、千金内托散托之。
芙蓉膏 治手臂腕 、肘掌等处结毒， 赤肿痛。
山布瓜（根） 芙蓉叶 紫金皮 凌霄根（皮） 天南星 天布瓜 鸡屎根（取皮） 背子蜈蚣
上砍烂，入些醋，温涂敷患处。
赤葛膏 治病藕节，及臂 腕掌等处结毒。
赤葛根皮 山布瓜根 山苏木 山樟根皮 紫金皮 赤牛膝 赤芎根 赤毛桃根
上用皮砍烂，糟炒。敷涂患处。
敷病肌石 药
山樟子叶
上砍烂，糟炒缚之，又用根，煎酒服之。
臂表里俱肿痛，赤色，惟肘节处差小，故名藕包。以内外分阴阳，俱如上法。
泥油膏 治病藕包。
塘泥（一分） 桐油（三分）
上和匀，以鸭毛扫，时时涂，勿令干。
二瓜散 治病藕包。
山布瓜根 天布瓜根
上砍烂，入米醋少许，和暖涂之。
或问∶手臂阳明经分生 ，初如粟米，渐大如赤豆，痛不可忍，旬日大如胡桃，枯紫
色何如？曰∶此名骨蝼疽。若毒游遍身，拘急发搐，呕哕不食，冷汗自出，滑泄烦躁，脉
乱者死。犯房劳，怒气者死。一人患此证，一月之后，遍身攻串，口吐黄水，秽气满室，既
而呕吐脓血，旬日而亡。其人三四日前，尚进饮食，人与沐浴，扶起皮肉俱烂，患者不
信，医者不识，以致陨身。此由七情不和，积怒、积忧、积热所致，真元虚败，不能胜邪
故也，纵有丸丹，天命而已。惟智者防患于未然，急服黄连消毒散、胜金丹、乌金散、活
命饮加羌活选用。治之稍缓，七恶证多者，必死也。按∶此证发之暴，死之速，乃阴虚极
而火独光之，故前药不滋化源，而扬汤止沸，其能济乎。
肘部内侧发生的痈，归属于三阴经，是由于心、肺、胞络（子宫及相连的脉络）郁结之火所致。引经药选用黄连、升麻、柴胡。
肘部外侧发生的痈，归属于三阳经，是由于胃、大肠、小肠积滞之毒所致。引经药选用本方（注：原文“本”疑为“防风”或特定引经药，此处依原文保留）、升麻、柴胡。
均可选用黄连消毒饮、活命饮，或者乌金散、紫金丹、胜金丹、玉枢丹中的一种进行治疗。体质壮实且有里实证的患者，用一粒金丹、八阵散攻下排毒。年老体弱者，用黄木香散、十全大补汤、千金内托散进行托毒外出。
芙蓉膏：治疗手臂、手腕、肘部、手掌等处结聚之毒，红肿疼痛。
配方：山布瓜（根）、芙蓉叶、紫金皮、凌霄根（皮）、天南星、天布瓜、鸡屎根（取皮）、背子蜈蚣。
制法与用法：将上述药材捣烂，加入少许醋，温热后涂抹敷于患处。
赤葛膏：治疗病藕节（即肘痈），以及手臂、手腕、手掌等处结聚之毒。
配方：赤葛根皮、山布瓜根、山苏木、山樟根皮、紫金皮、赤牛膝、赤芎根、赤毛桃根。
制法与用法：使用上述药材的皮，捣烂后用酒糟炒热，敷涂于患处。
敷病肌石药：
配方：山樟子叶。
制法与用法：将药材捣烂，用酒糟炒热后缚扎患处；另外再用其根部煎酒服用。
臂部表里都出现肿痛，颜色发红，只有肘关节处稍微小一些，所以名叫藕包。根据内外分为阴阳，治疗方法均如上所述。
泥油膏：治疗病藕包（即肘外痈）。
配方：塘泥（一分）、桐油（三分）。
制法与用法：混合均匀，用鸭毛刷涂抹，经常涂抹，不要让它变干。
二瓜散：治疗病藕包。
配方：山布瓜根、天布瓜根。
制法与用法：将药材捣烂，加入少许米醋，调和温暖后涂抹。
有人问：手臂阳明经部位生疮，起初像粟米大小，逐渐增大如赤豆，疼痛难忍，十天之后大如胡桃，干枯紫色，这种情况如何？
回答：这叫做骨蝼疽。如果毒气游走全身，出现肢体拘急抽搐，呕吐呃逆不能进食，冷汗自出，腹泻烦躁，脉象紊乱的，预后不良致死。如果犯房事劳累，或发怒的，也会致死。有一人患此证，一个月后，毒气遍身攻窜，口吐黄水，秽气充满房间，随后呕吐脓血，十天后死亡。该人在死前三四天，还能进食，让人给他洗澡，扶起时皮肉都已溃烂，患者不信，医生不识，导致身亡。这是由于七情不和，长期愤怒、长期忧思、长期积热所致，真元虚败，不能抵御邪气，即使有丸药丹药，也是天命而已。只有智者防患于未然，急忙服用黄连消毒散、胜金丹、乌金散、活命饮加羌活中的一种进行治疗。如果治疗稍慢，出现多种“七恶”症状的，必然死亡。按语：此证发作猛烈，死亡迅速，是阴虚至极而火独旺，所以前面的药物不滋生化之源，只是扬汤止沸，怎么能救得活呢？
The carbuncle occurring on the medial aspect of the elbow belongs to the Three Yin meridians, caused by stagnant fire in the Heart, Lung, and Bao Luo (Pericardium/Uterus). The guiding herbs are Huanglian (Coptis Rhizome), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix).
The carbuncle occurring on the lateral aspect of the elbow belongs to the Three Yang meridians, caused by accumulated toxicity in the Stomach, Large Intestine, and Small Intestine. The guiding herbs are Ben (likely Fengfang or specific local herb, retained as text), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix).
One may select from Huanglian Xiaodu Yin (Coptis Detoxification Decoction), Huoming Yin (Life-Saving Decoction), or alternatively Wujin San (Black Gold Powder), Zijin Dan (Purple Gold Pill), Shengjin Dan (Victory Gold Pill), or Yushu Dan (Jade Pivot Pill). For patients with robust constitution and excess syndrome in the interior, Yili Jin Dan (One-Pill Golden Pill) or Bazhen San (Eight-Array Powder) should be used to purge the accumulation. For elderly or weak patients, Huangmuxiang San (Costus Powder) or Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction), Qianjin Neituo San (Thousand-Gold Internal Support Powder) should be used to support and expel the toxin.
Furong Gao (Hibiscus Ointment): Treats toxic accumulations in the arms, wrists, elbows, and palms, characterized by redness, swelling, and pain.
Ingredients: Shanbugua root (Root of *Passiflora foetida* or similar local species), Furongye (Hibiscus Leaf), Zijinpi (Purple Skin/Bark), Lingxiaogen bark (Bark of *Campsis grandiflora* root), Tiannanxing (Arisaema Rhizome), Tianbugua root (Root of *Benincasa hispida* or similar), Jishigen bark (Bark of *Paederia scandens* root), Beizi Wugong (Centipede).
Preparation and Administration: Pound the ingredients into a paste, add some vinegar, warm it, and apply topically to the affected area.
Chige Gao (Red Kudzu Ointment): Treats "Bing'oujie" (Elbow Carbuncle) and toxic accumulations in the arms, wrists, and palms.
Ingredients: Chigegenpi (Bark of *Pueraria lobata* root), Shanbugua root, Shansumu (Mountain Sappan Wood), Shanzhanggenpi (Bark of *Cinnamomum camphora* root), Zijinpi (Purple Skin/Bark), Chiniuxi (Achyranthes Root), Chixionggen (Root of *Ligusticum chuanxiong*), Chimao tao gen (Root of *Prunus persica*).
Preparation and Administration: Use the barks of the above ingredients, pound them, stir-fry with wine lees until warm, and apply to the affected area.
Medicine for Applying to Muscle Ulcers:
Ingredients: Shanzhangziye (Leaf of *Cinnamomum camphora* fruit).
Preparation and Administration: Pound the leaves, stir-fry with wine lees, bind to the affected area. Additionally, decoct the roots in wine for oral administration.
When both the exterior and interior of the arm are swollen and painful, with redness, but slightly smaller at the elbow joint, it is named "Oubao" (Lotus Seed Pod). Differentiating by interior/exterior corresponds to Yin/Yang; the treatment methods are as described above.
Niyou Gao (Mud and Oil Ointment): Treats "Oubao".
Ingredients: Tangni (Pond Mud, 1 part), Tongyou (Tung Oil, 3 parts).
Preparation and Administration: Mix evenly, apply frequently with a duck feather brush, keeping it moist and not allowing it to dry.
Er Gua San (Two Melons Powder): Treats "Oubao".
Ingredients: Shanbugua root, Tianbugua root.
Preparation and Administration: Pound the roots, add a small amount of rice vinegar, mix well, warm it, and apply.
Question: A sore appears on the Yangming meridian of the arm, initially like millet grains, gradually enlarging to the size of a red bean, unbearable pain, and after ten days becomes as large as a walnut with a dry purple color. What is this?
Answer: This is called Gulou Ju (Bone Ant Tubercle). If the toxin spreads throughout the body, causing stiffness, convulsions, vomiting, hiccups, inability to eat, spontaneous cold sweat, diarrhea, irritability, and chaotic pulse, death ensues. Engaging in sexual activity or anger also leads to death. One patient suffered from this condition; after one month, the toxin spread all over the body, he vomited yellow fluid, and a foul odor filled the room. Subsequently, he vomited pus and blood, dying ten days later. Three or four days before his death, he could still eat and was bathed by others; when lifted, his skin and flesh were rotting. The patient did not believe it, and the doctor failed to recognize it, leading to his demise. This is caused by disharmony of the Seven Emotions, accumulated anger, accumulated sorrow, and accumulated heat, resulting in deficiency and collapse of the True Yuan, unable to resist the pathogenic factor. Even with pills and elixirs, it is a matter of fate. Only the wise prevent disaster before it happens, urgently administering Huanglian Xiaodu San (Coptis Detoxification Powder), Shengjin Dan (Victory Gold Pill), Wujin San (Black Gold Powder), or Huoming Yin (Life-Saving Decoction) with Qianghuo (Notopterygii Rhizoma et Radix). If treatment is delayed and multiple "Seven Evils" symptoms appear, death is certain. Commentary: This condition erupts violently and kills rapidly, due to extreme Yin deficiency with solitary blazing Fire. Therefore, the aforementioned medicines do not nourish the source of transformation, acting merely as stirring the boiling water to stop the boil; how can they save the patient?