人有生痈疽于头顶者，初名脑疽，又名偏正对口，而非真正痈疽也。此症九死一生，然治之得法，亦可救
也。大约生此症者，皆因肾火沸腾也。盖脑为髓海，原通于肾，肾无火则髓不能化精，肾火盛则髓亦不能化精。
不特不能化精，随火之升降，则化为毒而生痈疽矣。盖肾之化精，必得脑中之气以相化，若脑中无肾火，势必
气化为火，火性炎上，不及下降，于是脑中髓海，自化为毒，较之脑气下流而成毒者，其毒更甚，往往更变形
容，改变声音，疮色紫黑，口干烦燥，随饮随渴，甚者脑骨俱腐，片片脱落，其野狼狈之状，莫可形容，将何以
救之耶？此症治法，须问其饮食如何，倘饮食知味，尚可以救，方用五灵汤∶
玄参（三两） 麦冬（三两） 金银花（八两） 黄 （四两） 人参（二两）
水煎服，连服四剂，其痈疽渐愈，改用十全大补汤重四两，服四剂，又改用八味地黄汤，恣其酣饮，可获
痊愈矣。此症十有九死，然而余立一法，实无第二法也。此症得于房劳者居多，兴阳涩精，俱是丹石燥烈之品，
或洗或嚼，或含于口，或纳于脐，霸阻精道，久战不已，日积月累，真阴枯涩，髓竭火发，遂溃顶门，多致不
救。人何苦贪妇人之欢，以千金之命，而轻于夜台也。
秘诀∶
顶上生疽用五灵，三两玄参及麦冬，
银花八两黄 四，人参二两四剂功。
此症用蔓花汤亦效∶
玄参（二两） 山茱萸（二两） 金银花（二两） 川芎（一两） 麦冬（一两） 贝母（三钱）
蔓荆子（二钱）
水煎服，一剂即消，二剂痊愈。
秘诀∶
脑痈蔓花用元参，二两山萸二两金，
川芎一两三钱贝，蔓荆子二效如神。
头顶部长有痈疽的人，起初称为脑疽，又叫做偏正对口疮，但这并非真正的痈疽。这种病症十个人中有九个死亡，只有一人生还，然而如果治疗得当，也是可以救治的。大概患此症的人，都是因为肾火沸腾所致。因为脑为髓海，原本与肾相通，肾中没有火则髓不能转化为精，肾中火气过盛则髓也不能转化为精。
不仅不能化精，随着火的升降，就会化为毒而生出痈疽。肾转化精微物质，必须得到脑中气的配合才能完成转化，如果脑中没有肾火（注：此处原文逻辑似有误或特指某种病理状态，结合上下文“肾无火...肾火盛...”及后文“若脑中无肾火”，实指肾阴不足导致虚火上炎，或肾阳虚衰导致气化无力，但原文表述为“若脑中无肾火...势必气化为火”，意指缺乏真阴制约或气化失常，导致气郁化火），气必然转化为火，火性炎上，来不及下降，于是脑中的髓海自然化为毒。这比脑气下流而成毒的情况，毒性更严重，往往还会改变人的容貌和声音，疮色紫黑，口干烦躁，喝多少水都觉得渴，严重的甚至脑骨全部腐烂，片片脱落，那狼狈不堪的样子，无法用言语形容，该如何救治呢？
这种病症的治疗方法，必须先询问患者的饮食情况，如果饮食还能尝出味道，还可以救治。方剂使用五灵汤：玄参（三两）、麦冬（三两）、金银花（八两）、黄芪（四两）、人参（二两）。用水煎服，连续服用四剂，痈疽逐渐痊愈，然后改用十全大补汤（剂量重至四两），再服用四剂，接着改用八味地黄汤，让其尽情饮用（注：此处“恣其酣饮”可能指药液或配合饮食调养，结合语境多为药后调理），可以获得痊愈。这种病症十个人中有九个死亡，然而我确立了一种方法，确实没有第二种方法了。这种病症大多因房劳过度而得，那些兴阳涩精的药物，都是丹石类燥烈之品，或者清洗，或者咀嚼，或者含在口中，或者纳入肚脐，霸道地阻塞精道，久战不停，日积月累，导致真阴枯涩，髓竭火发，最终溃烂于头顶，大多导致无法救治。人何必贪图妇人的欢愉，以千金之命，轻易地葬送在黄泉之下呢？
秘诀：
顶上生疽用五灵汤，玄参三两及麦冬三两，金银花八两、黄芪四两，人参二两，四剂见效。
此症使用蔓花汤也有效：
玄参（二两）、山茱萸（二两）、金银花（二两）、川芎（一两）、麦冬（一两）、贝母（三钱）、蔓荆子（二钱）。
用水煎服，一剂即可消除，二剂痊愈。
Individuals who develop carbuncles and sores on the vertex of the head are initially diagnosed with Nao Ju (Brain Carbuncle), also known as Pian Zheng Dui Kou (Oblique and Straight Opposite Mouth), though this is not a true carbuncle in the conventional sense. This condition carries a mortality rate of nine out of ten, yet if treated correctly, it can be salvaged. Generally, those suffering from this ailment do so due to the boiling of Kidney Fire (Hyperactive Fire of the Kidney). The brain serves as the Sea of Marrow (Sea of Marrow) and is originally connected to the Kidneys. If the Kidneys lack fire, marrow cannot transform into essence; conversely, if Kidney fire is excessive, marrow also fails to transform into essence.
Not only does it fail to transform into essence, but following the ascent and descent of fire, it transforms into toxicity, giving rise to carbuncles and sores. The transformation of essence by the Kidneys requires the qi of the brain to assist in this process. If there is an absence of proper Kidney fire regulation in the brain (implying a pathological state where qi transforms into fire due to lack of yin or improper qi transformation), qi inevitably transforms into fire. Since fire has a nature of flaming upward and fails to descend, the marrow sea within the brain naturally transforms into toxicity. This toxicity is more severe than that caused by brain qi flowing downward. It often alters one's appearance and voice; the sore color becomes purple-black; the mouth is dry with irritability; thirst persists despite drinking; in severe cases, the skull bones rot completely and fall off in pieces. The wretched state is indescribable. How can it be saved?
The treatment for this condition requires first inquiring about the patient's diet. If the food still tastes good, there is hope for salvation. The prescribed formula is Wu Ling Tang (Five Spirit Decoction): Xuan Shen (Scrophulariae Radix, 3 liang), Mai Dong (Ophiopogonis Tuber, 3 liang), Yin Hua (Honeysuckle Flower, 8 liang), Huang Qi (Astragali Radix, 4 liang), Ren Shen (Ginseng Radix et Rhizoma, 2 liang). Decoct in water and take orally. After taking four doses consecutively, the carbuncle and sore will gradually heal. Then switch to Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction, heavy dose of 4 liang), take for four doses. Subsequently, switch to Ba Wei Di Huang Wan (Eight-Ingredient Pill with Rehmannia), allowing liberal consumption, which can lead to complete recovery. Ninety percent of such cases result in death, yet I have established one method, truly without a second option. Most cases of this disease arise from sexual exhaustion. Herbs used to stimulate yang and astringe essence are typically caustic and hot mineral drugs (Dan Shi). Whether applied externally for washing, chewed, held in the mouth, or inserted into the navel, they aggressively block the essence pathway. Prolonged intercourse without release accumulates over time, causing True Yin to become withered and dry, marrow to exhaust, and fire to erupt, leading to ulceration at the vertex. Most cases prove untreatable. Why should one indulge in the pleasure of women and lightly sacrifice a life worth a thousand gold to the underworld?
Secret Formula:
For sores on the vertex, use Wu Ling Tang; Xuan Shen and Mai Dong each three liang; Yin Hua eight liang, Huang Qi four liang, Ren Shen two liang; effective in four doses.
This condition is also effectively treated with Man Hua Tang (Vitex Decoction):
Xuan Shen (Scrophulariae Radix, 2 liang), Shan Zhu Yu (Corni Fructus, 2 liang), Yin Hua (Honeysuckle Flower, 2 liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1 liang), Mai Dong (Ophiopogonis Tuber, 1 liang), Bei Mu (Fritillariae Bulbus, 3 qian), Man Jing Zi (Viticis Fructus, 2 qian).
Decoct in water and take orally. One dose eliminates the swelling; two doses ensure recovery.
Secret Formula:
For Brain Carbuncle using Man Hua Tang, use Xuan Shen; Shan Yu (Shan Zhu Yu) two liang, Jin Yin (Yin Hua) two liang; Chuan Xiong one liang, Bei Mu three qian, Man Jing Zi two qian; efficacy is miraculous.