《灵枢》云∶发于肩及 ，名曰疵痈。其状赤黑，急治之。此令人汗出至足，不害五
脏，痈发四五日，逆 之。 《鬼遗》云∶疔疽发两肩，恶血留结内外，荣卫不通，发成
疔疽。五日肿大，令人口噤寒战，十二日可刺。不治，二十日死。
〔陈〕 干疽肿发，起
两肩及两大臂，连胛骨，二七日痛不息，亦不可动，五十日身热不赤，六十日可刺。刺
之无血者死。 或问∶肩上生疽何如？曰∶此处手足三阳交会之所，名曰肩疽。由风热郁
结所致，或因负重损伤而作。服乌金散、胜金丹、活命饮，加柴胡、桔梗。壮实者，一
粒金丹下之。老弱者，十全大补汤托之。
或问∶肩肿内痛渐至溃烂成疮何如？曰∶此名太阴疽，即莲子发。属手太阴肺经，积
热所致。宜活命饮加桔梗、黄 。夺命丹、胜金丹、黄 木香散选用。壮实者，八阵散、一
粒金丹下之。赤色者可治，青黑者不治。喘嗽大渴胸满，脉微者死。
或问∶左右搭串何如？曰∶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。宜胜金丹、活
命饮加羌活、桔梗。壮实者，八阵散、一粒金丹下之。七恶证少，何虑难痊，元气虚惫，
治之何补哉。
或问∶一人年六十，肩前陷中生疽，寒热大作，饮食少进，肩背拘急，小水不利，胸
腹膨胀何如？曰∶是名缺盆，又名锁骨疽。属足阳明胃经、手少阳三焦经，宜隔蒜灸，先
服紫金丹、夺命丹而恶证退，惟苦小水不利，投以六一散而利，后服十全大补汤而安。若
治之稍缓，必致溃烂，是经少血多气，疮口不合，危笃者多矣。
《灵枢》说：发生在肩膀及腋下部位，名叫疵痈。它的症状表现为局部红肿发黑，必须紧急治疗。这种病会导致患者出汗直至脚部，但不会伤害五脏，痈疽发作四五天后，若出现逆证则预后不良。
《鬼遗集》说：疔疽发生在双肩，是由于恶血滞留结聚于体内内外，导致营卫之气运行不通，从而形成疔疽。发病五天后肿块肿大，导致患者牙关紧闭、寒战，十二天可以施针放血。如果不治疗，二十天后会死亡。
陈氏记载：干疽肿胀发生，起始于双肩及两大臂，连接肩胛骨，如果经过十四天疼痛仍不停止，也不可随意触动，五十天后身体发热但局部不红，六十天可以施针。针刺后不出血的会死亡。
有人问：肩上生疽怎么样？回答说：这里是手三阳经和足三阳经交汇的地方，名叫肩疽。由风热郁结所致，或者是因为负重损伤而引起。服用乌金散、胜金丹、仙方活命饮，并加入柴胡、桔梗。体质壮实的人，用一粒金丹攻下；年老体弱的人，用十全大补汤托毒外出。
有人问：肩部肿胀内部疼痛逐渐溃烂成疮怎么样？回答说：这名叫太阴疽，也就是莲子发。属于手太阴肺经，由积热所致。适宜使用仙方活命饮加入桔梗、黄芪。夺命丹、胜金丹、黄芪木香散可酌情选用。体质壮实的人，用八阵散、一粒金丹攻下。颜色赤红的可以治愈，青黑色的无法治愈。如果出现气喘咳嗽、极度口渴、胸腹胀满、脉象微弱的症状，则预后不良致死。
有人问：左右交叉蔓延的疽怎么样？回答说：左肩骨上生疽，蔓延到右边的，可以治愈；右肩骨上生疽，蔓延到左边的，难以治愈。古代有这样的说法，我认为不对。向左右攻注蔓延的，是气血不调、阴阳交错的结果。适宜使用胜金丹、仙方活命饮加入羌活、桔梗。体质壮实的人，用八阵散、一粒金丹攻下。如果七恶证（危重征象）较少，何必担忧难以痊愈？若是元气虚极疲惫，治疗又有什么用呢？
有人问：一个人六十岁，肩前凹陷处生疽，寒热剧烈发作，饮食减少，肩背拘紧急迫，小便不利，胸腹膨胀，怎么样？回答说：这名叫缺盆疽，又名锁骨疽。属于足阳明胃经、手少阳三焦经，适宜隔蒜灸，先服用紫金丹、夺命丹使恶证消退，只是苦于小便不利，投以六一散通利小便，后来服用十全大补汤而安定。如果治疗稍微迟缓，必然导致溃烂，因为这条经络少血多气，疮口难以愈合，病情危重的很多。
The *Ling Shu* states: When it occurs on the shoulder and axilla, it is called Ci Yong (Cicada Abscess). Its presentation involves redness and blackness of the affected area, requiring urgent treatment. This condition causes sweating extending to the feet but does not harm the Five Zang Organs. If the abscess has been present for four or five days and presents with Ni Zheng (Rebellious Signs), the prognosis is poor.
The *Gui Yi Ji* states: Ding Ju (Ding Carbuncle) occurring on both shoulders is caused by evil blood stagnating and knotting internally and externally, leading to obstruction of Ying Wei (Defensive and Nutritive Qi), resulting in the formation of Ding Ju. After five days, swelling increases, causing trismus (lockjaw) and chills. Acupuncture may be performed on the twelfth day. Without treatment, death will occur within twenty days.
Chen records: Gan Ju (Dry Carbuncle) presenting with swelling originates on both shoulders and upper arms, connecting to the scapula. If pain persists without cessation after fourteen days, it must not be manipulated. After fifty days, if there is body heat but local redness is absent, acupuncture may be performed on the sixtieth day. Death ensues if no blood flows upon puncture.
A question was raised: "What about carbuncles arising on the shoulder?" The answer is: This location is where the Hand and Foot Yang Meridians intersect, known as Jian Ju (Shoulder Carbuncle). It is caused by the stagnation and knotting of Wind-Heat, or by injury from carrying heavy loads. Treat with Wu Jin San (Black Gold Powder), Sheng Jin Dan (Victory Golden Pill), or Xian Fang Huo Ming Yin (Immortal Life Decoction), adding Chai Hu (Bupleurum Root) and Jie Geng (Platycodon Root). For those with robust constitution, use Yi Li Jin Dan (One-Pill Golden Pill) to purge; for the elderly or weak, use Shi Quan Da Bu Tang (Decoction for Ten Complete Tonifications) to support and expel toxins.
A question was raised: "What about swelling inside the shoulder with pain gradually progressing to ulceration and sore formation?" The answer is: This is named Tai Yin Ju (Tai Yin Carbuncle), also known as Lian Zi Fa (Lotus Seed Eruption). It belongs to the Hand Tai Yin Lung Meridian and is caused by accumulated Heat. Suitable treatments include Xian Fang Huo Ming Yin (Immortal Life Decoction) added with Jie Geng (Platycodon Root) and Huang Qi (Astragalus Root). Duo Ming Dan (Life-Taking Pill), Sheng Jin Dan (Victory Golden Pill), or Huang Qi Mu Xiang San (Astragalus and Costus Powder) may be selected according to circumstances. For those with robust constitution, Ba Zhen San (Eight-Trigram Powder) or Yi Li Jin Dan (One-Pill Golden Pill) may be used to purge. Cases with red coloration are treatable; those with blue-black discoloration are untreatable. Death occurs if symptoms include panting and coughing, extreme thirst, chest fullness, and a faint pulse.
A question was raised: "What about carbuncles spreading across left and right sides?" The answer is: A carbuncle arising on the left shoulder bone and spreading to the right is treatable; one arising on the right shoulder bone and spreading to the left is difficult to treat. Although this view exists in ancient texts, I disagree. Spreading to both left and right indicates disharmony of Qi and Blood, and disorder of Yin and Yang. Suitable treatments include Sheng Jin Dan (Victory Golden Pill) or Xian Fang Huo Ming Yin (Immortal Life Decoction) added with Qiang Huo (Notopterygium Root) and Jie Geng (Platycodon Root). For those with robust constitution, Ba Zhen San (Eight-Trigram Powder) or Yi Li Jin Dan (One-Pill Golden Pill) may be used to purge. If the Seven Evil Signs (critical manifestations) are few, why worry about failure to recover? However, if Yuan Qi (Original Qi) is exhausted and depleted, what benefit can treatment bring?
A question was raised: "A sixty-year-old person has a carbuncle in the depression anterior to the shoulder, with severe alternating chills and fever, reduced food intake, stiffness and tension in the shoulder and back, difficulty urinating, and abdominal distension. What should be done?" The answer is: This is named Que Pen Ju (Clavicle Carbuncle), also known as Suo Gu Ju (Collarbone Carbuncle). It belongs to the Foot Yang Ming Stomach Meridian and the Hand Shao Yang San Jiao Meridian. Garlic-partitioned moxibustion is suitable. Initially administer Zi Jin Dan (Purple Gold Pill) and Duo Ming Dan (Life-Taking Pill) to resolve the critical signs. Since the patient suffers from difficulty urinating, Liu Yi San (Six-to-One Powder) should be given to promote urination. Subsequently, administer Shi Quan Da Bu Tang (Decoction for Ten Complete Tonifications) to stabilize the condition. If treatment is delayed even slightly, ulceration will inevitably occur. Because this meridian has abundant Qi but scarce Blood, the wound will fail to heal, leading to many critical cases.