KT 病者，由劳役，肢体热盛，自取风冷，而为凉湿所折，入于肌肉筋脉，结聚所成也。其
状，赤脉起，如编绳，急痛壮热。其发于脚者，患从鼠HT 起，至踝；赤如编绳，故谓
KT病也。发于臂者，喜掖下起，至手也。若不即治，其久溃脓，亦令人筋挛缩也。其着
脚，若置不治，不消复不溃，其热歇，气不散，变作 。脉缓涩相搏，肿KT 已成脓
痤疖者，由风湿冷气搏于血，结聚所生也。人运役劳动，则阳气发泄，因而汗出，遇风
冷湿气搏于经络，经络之血，得冷所折，则结涩不通，而生痤疖，肿结如梅李也。
又云∶肿一寸、二寸，疖也。其不消而溃者，即宜熟捻去脓，至清血出。若脓汁未尽，
其疮合者，则更发。其着耳下、颔、颈、掖下，若脓汁不尽，多变成 也。
《养生方》云∶人汗诸食中，食之作痈疖。
又云∶五月，勿食不成核果及桃、枣，发痈疖也。
诸 者，谓 病初发之由不同，至于 成，形状亦异。有以一方而治之者，故名诸 ，
非是诸病共成一 也。而方说九 者，是野狼 、鼠 、蝼蛄 、蜂 、蚍蜉 、蛴螬 、浮
疽、瘰 、转脉 ，此颈之九 也。
野狼 者，年少之时，不自谨慎，或大怒，气上不下之所生也。始发之时，在于颈项，有
根，出缺盆，上转连耳本。其根在肝。
鼠 者，饮食之时有择，虫蛆毒变化所生也。使人寒热。其根在肺。
蝼蛄 者，食果 子，不避有虫，即便啖之，外绝于纲，内绝于肠，有毒不去，
变化所生也。始发之时，在于颈上，状如蜗形，瘾胗而出也。其根在大肠。
蜂 者，食饮劳倦，渴乏多饮流水，即得蜂毒不去，变化所生也。始发之时，其根在颈
，历历三四处，俱肿，以溃生疮，状如痈形，瘥而复移。其根在脾。
蚍蜉 者，因寒，腹中胪胀，所得寒毒不去，变化所生也。始发之时，在其颈项，使人
壮热若伤寒，有似疥癣，娄娄孔出。其根在肺。
蛴螬 者，恐惧、愁忧、思虑，哭泣不止，余毒变化所生也。始发之时，在其颈项，无
头尾，如枣核，或移动皮中，使人寒热心满。其根在心。
浮疽 者，因恚结驰思，往反变化所生也。始发之时，在于颈，亦在掖下，如两指，无
头尾，使人寒热，欲呕吐。其根在胆。
瘰 者，因强力入水，坐湿地，或新沐浴，汗入头中，流在颈上之所生也。始发之时
，在其颈项，恒有脓，使人寒热。其根在肾。
转脉 者，因饮酒大醉，夜卧不安，惊，欲呕，转侧失枕之所生也。始发之时，在其颈
项，濯濯脉转，身如振，使人寒热。其根在小肠。
复有三十六种 ，方不可次第显其名，而有蜣螂、蚯蚓等诸 ，非九 之名，此
即应是三十六种 之数也。但 病之生，或因寒暑不调，故血气壅结所作；或由饮食乖节，
野狼鼠之精，入于腑脏，毒流经脉，变化而生。皆有使血脉结聚，寒热相交，久则成脓而溃漏
也。其生身体皮肉者，亦有始结肿，与石痈相似。所可异者，其肿之中，按之累累有数脉，
喜发于颈边，或两边俱起，便是 证也。亦发两掖下，及两颞 间。初作喜不痛不热，若失
时治，即生寒热也。
所发之处，而有轻重；重者有两种∶一则发口上HT ，有结核，大小无定。或如桃李大，
此虫之窠窟，止在其中。二则发口之下，无有结核，而穿溃成疮。又，虫毒之居，或腑脏无
定，故 发身体，亦有数处，其相应通者多死。其 形状、起发之由，今辩于后章。
《养生方》云∶六月勿食自落地五果，经宿蚍蜉、蝼蛄、蜣螂游上，喜为九 。
又云∶十二月勿食狗、鼠残肉，生疮及 ，出颈项及口里，或生咽内。
【背景信息】
书名：诸病源候论 作者：巢元方 朝代：隋 章节：四十四、瘿病候 / 四十五、痤疖候 / 一、诸瘿候 类别：医论
【待处理原文翻译】
瘿病，是由于过度劳累，肢体发热时，自行感受风冷之气，导致凉湿之邪侵袭，进入肌肉和筋脉，结聚而形成的。其症状表现为皮肤出现红色脉络，像编织的绳索一样，伴有急迫疼痛和高热。如果发病于脚部，患处从足踝处开始，向上蔓延至小腿，红肿如编织的绳索，因此称为瘿病。如果发病于手臂，喜欢从腋下开始，蔓延至手部。如果不立即治疗，日久溃烂流脓，也会导致筋脉挛缩。如果病发于脚部，放置不治疗，既不消散也不溃破，当热势减退但气机仍未散开时，会转变为其他病变。脉象缓涩相搏，肿胀且瘿已成脓。
痤疖，是由于风湿冷气与血液搏结，结聚而生成的。人从事劳动运动时，阳气发泄，因而出汗，遇到风冷湿气侵袭经络，经络中的血液受冷邪遏制，则凝结涩滞不通，从而产生痤疖，肿胀结块像梅子或李子一样。又说：肿大一寸、二寸的，称为疖。对于那些不消散而已经溃破的，应当用熟捻的方法去除脓液，直到流出清血为止。如果脓汁没有排尽，疮口愈合后，就会再次发作。如果病发在耳下、下巴、颈部、腋下，如果脓汁没有排尽，大多会转变为瘿病。
《养生方》说：人在进食时出汗，食物中混入汗液，食用后会引发痈疖。
又说：五月，不要吃不成熟的核果以及桃、枣，这会引发痈疖。
各种瘿病，是指瘿病初发的原因各不相同，至于形成后的形状也各异。有的可以用一个方剂来治疗，所以称为“诸瘿”，并不是多种疾病共同形成一个瘿病。而方书中提到的九种瘿，是野狼瘿、鼠瘿、蝼蛄瘿、蜂瘿、蚍蜉瘿、蛴螬瘿、浮疽、瘰疬、转脉瘿，这是颈部的九种瘿病。
野狼瘿，是在年少时，自己不谨慎，或者大怒，导致气机上逆不能下行所生成的。刚开始发病时，位于颈项，有根蒂，从缺盆（锁骨上窝）发出，向上转动连及耳根。其病根在肝。
鼠瘿，是因为饮食时有选择性地吃了含有虫蛆毒变化的食物所生成的。使人出现寒热症状。其病根在肺。
蝼蛄瘿，是因为吃果子时，不避开里面有虫子的，就直接吞食，外绝纲维，内绝肠道，有毒之物不去除，变化所生成的。刚开始发病时，位于颈上，形状像蜗牛壳，隐疹而出。其病根在大肠。
蜂瘿，是因为饮食劳倦，口渴缺乏时多喝生水，导致蜂毒滞留不去，变化所生成的。刚开始发病时，病根在颈部，历历可数三四处，都肿胀，溃破生疮，形状像痈，痊愈后又转移。其病根在脾。
蚍蜉瘿，是因为受寒，腹中胀满，所得寒毒不去除，变化所生成的。刚开始发病时，在颈项，使人高热像伤寒，类似疥癣，孔洞中不断渗出液体。其病根在肺。
蛴螬瘿，是因为恐惧、愁忧、思虑，哭泣不止，余毒变化所生成的。刚开始发病时，在颈项，没有头尾，像枣核，有时在皮中移动，使人感到寒热、心满。其病根在心。
浮疽，是因为愤怒郁结、思虑往返变化所生成的。刚开始发病时，在颈部，也在腋下，像两指大小，没有头尾，使人寒热，想呕吐。其病根在胆。
瘰疬，是因为强力入水，坐湿地，或者刚沐浴完，汗水流入头部，流注在颈上所生成的。刚开始发病时，在颈项，常有脓液，使人寒热。其病根在肾。
转脉瘿，是因为饮酒大醉，夜间睡眠不安，惊恐，想呕吐，翻身失枕所生成的。刚开始发病时，在颈项，脉搏跳动明显如水流转动，身体像颤抖一样，使人寒热。其病根在小肠。
另外还有三十六种瘿，方书不能依次列出它们的名称，但有蜣螂瘿、蚯蚓瘿等各种瘿，不是九种瘿的名称，这应该就是三十六种瘿的数量。但是瘿病的生成，有的因为寒暑不调，导致气血壅结所作；有的因为饮食乖节，野狼鼠类的精微物质，进入腑脏，毒物流注经脉，变化而生。都有使血脉结聚，寒热相交，日久则成脓而溃漏。生在身体皮肉间的，也有开始结肿，与石痈相似。所不同的是，其肿之中，按压感觉累累有多个脉动，喜欢发于颈边，或者两边同时起，这就是瘿证的表现。也发于两腋下，以及两颞部之间。初起时喜欢不痛不热，如果错过时机治疗，就会产生寒热。
发病的部位，有轻重之分；重的有两种：一种是发在口上的，有结核，大小不定。有的像桃李那么大，这是虫的窠窟，止在其中。另一种是发在口下的，没有结核，而穿溃成疮。另外，虫毒的居所，或在腑脏无定，所以瘿发于身体，也有多处，其相应相通的多死。瘿的形状、起发的原因，现在在后面章节辨析。
《养生方》说：六月不要食用自己落地的五种果实，经过一夜，蚍蜉、蝼蛄、蜣螂爬在上面，容易变成九种瘿。
又说：十二月不要食用狗、鼠的残肉，会生疮及瘿，出在颈项及口里，或者生在咽内。
Background Information:
Book: *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases)
Author: Chao Yuanfang
Dynasty: Sui
Chapter: 44. Manifestations of Ying Disease / 45. Manifestations of Acne and Furuncle / 1. Manifestations of Various Ying Diseases
Category: Medical Theory
Ying disease (goiter-like swelling in the neck region) is caused by overexertion, where the limbs are hot, and one voluntarily exposes oneself to wind and cold. The cool and damp pathogens invade the muscles and sinews, accumulating and condensing to form the condition. Its manifestations include red vascular patterns appearing on the skin, resembling woven ropes, accompanied by urgent pain and high fever. If it occurs on the legs, the lesion starts from the ankle and extends upward; it is red like a woven rope, hence termed "Ying disease." If it occurs on the arms, it tends to start from the axilla and extend to the hand. If not treated promptly, prolonged ulceration with pus discharge can lead to sinew contraction. If occurring on the legs and left untreated, it may neither resolve nor suppurate; when the heat subsides but the pathogenic qi remains unresolved, it transforms into other lesions. The pulse is slow and choppy, indicating that swelling and Ying have formed pus.
Acne and furuncles (small skin infections) arise from the combat between wind-damp-cold qi and blood, leading to accumulation and condensation. When humans engage in physical labor, yang qi dissipates, causing sweating. Exposure to wind, cold, and dampness then attacks the meridians. The blood within the meridians is constrained by the cold, becoming stagnant and obstructed, thereby generating acne and furuncles, presenting as swollen nodules resembling plums or apricots. It is also stated that swellings measuring one or two cun in diameter are called furuncles. For those that do not resolve but have already ulcerated, one should use warm manipulation to remove the pus until clear blood flows. If the pus is not fully drained and the wound closes, it will recur. If occurring under the ear, chin, neck, or axilla, incomplete drainage of pus often leads to transformation into Ying disease.
The *Yangsheng Fang* (Prescriptions for Nourishing Life) states: Sweat mixing with food during eating, if consumed, induces carbuncles and furuncles.
It further states: In the fifth month, avoid consuming unripe drupes such as peaches and jujubes, as this induces carbuncles and furuncles.
Various Ying diseases refer to conditions where the initial causes differ, and the resulting shapes vary. Some can be treated with a single formula, thus named "Various Ying," rather than multiple diseases combining to form one Ying. The formulas mention nine types of Ying: Wild Wolf Ying, Rat Ying, Mole Cricket Ying, Bee Ying, Ant Ying, White Worm Ying, Floating Carbuncle, Scrofula (Luo Li), and Turning Pulse Ying. These are the nine types of Ying affecting the neck.
Wild Wolf Ying arises from imprudence in youth, or extreme anger causing qi to ascend without descending. Initially, it appears at the neck, having a root, emerging from the Clavicular Fossa (Quepen), and turning upward to connect with the base of the ear. Its root lies in the Liver.
Rat Ying is generated from dietary choices involving food contaminated with insect larvae toxins. It causes alternating chills and fever. Its root lies in the Lungs.
Mole Cricket Ying results from eating fruits containing insects without avoidance, swallowing them directly. This blocks external connective tissues and internal intestines; retained toxins undergo transformation. Initially, it appears above the neck, shaped like a snail shell, emerging as hidden rashes. Its root lies in the Large Intestine.
Bee Ying is caused by fatigue from diet and work, combined with excessive drinking of raw water when thirsty, retaining bee toxin which undergoes transformation. Initially, the root is in the neck, manifesting as three or four distinct swollen areas that ulcerate, resembling carbuncles, healing only to recur elsewhere. Its root lies in the Spleen.
Ant Ying arises from cold exposure causing abdominal distension; retained cold toxin undergoes transformation. Initially, it appears at the neck, causing high fever similar to Cold Damage, resembling scabies or tinea, with fluid oozing from pores. Its root lies in the Lungs.
White Worm Ying is generated from fear, sorrow, overthinking, and incessant crying, where residual toxins undergo transformation. Initially, it appears at the neck, lacking head or tail, resembling a date pit, sometimes moving within the skin, causing chills, fever, and chest fullness. Its root lies in the Heart.
Floating Carbuncle arises from anger, stagnation, and obsessive thinking. Initially, it appears at the neck or axilla, sized like two fingers, lacking head or tail, causing chills, fever, and nausea. Its root lies in the Gallbladder.
Scrofula (Luo Li) is generated by strenuous entry into water, sitting on wet ground, or bathing while sweat enters the head and flows down the neck. Initially, it appears at the neck, constantly producing pus, causing chills and fever. Its root lies in the Kidneys.
Turning Pulse Ying is caused by heavy alcohol intoxication, restless night sleep, fright, nausea, and improper pillow positioning during turning. Initially, it appears at the neck, with pulses throbbing like flowing water, body trembling, causing chills and fever. Its root lies in the Small Intestine.
There are additionally thirty-six types of Ying. Formulas cannot list all names sequentially, but include Vulture Beetle Ying, Earthworm Ying, etc., which are not among the nine types, totaling thirty-six. However, Ying diseases arise either from imbalance of cold and heat causing Qi and Blood congestion, or from irregular diet allowing essences of wild animals/rats to enter the Zang-Fu organs, with toxins flowing through meridians and transforming. All cause blood vessel congestion, interaction of cold and heat, eventually forming pus and leaking. Those arising in skin and flesh may initially resemble Stone Carbuncles. The difference is that pressing the swelling reveals multiple pulsating nodes. They tend to appear on the sides of the neck or bilaterally, constituting Ying syndromes. They may also appear in both axillae and temporal regions. Initially, they are painless and non-febrile; if treatment is delayed, chills and fever develop.
Lesions vary in severity. Severe cases include two types: First, lesions above the mouth with tubercles of variable size, sometimes plum-sized, serving as nests for parasites contained therein. Second, lesions below the mouth without tubercles, penetrating and ulcerating. Furthermore, parasite toxins may reside unpredictably in Zang-Fu organs, causing Ying to appear in multiple body sites; corresponding connections often lead to death. The morphology and etiology of Ying are discussed in subsequent chapters.
The *Yangsheng Fang* states: In the sixth month, do not eat fruits that have fallen naturally; after overnight exposure, ants, mole crickets, and vulture beetles crawl on them, easily inducing the nine types of Ying.
It also states: In the twelfth month, do not consume leftover meat of dogs or rats, as this generates sores and Ying, appearing on the neck, in the mouth, or inside the pharynx.