小儿疮疡用针法，比之大人，尤宜慎重。当审经络表里之虚实，部分肌肉之浓薄而施之。夫肿高而软者，发于血脉
也；肿硬而坚者，发于肌肉也，肉色不变者，发于骨也。疮未成者，解散以消其毒。已成者托里以速其脓。脓已成者，
当验其生熟浅深而后针之。以指轻按便痛者，脓浅也。重按方痛者，脓深也。按之不起者，脓未成也。按之即起者，脓
已成也。若脓初生而即针，则泄其气血而脓反难成。若脓已熟而不针，则腐溃益深，而不能收敛。若疮深而针浅，则内
溃不出，外血反伤。若疮浅而针深，则其脓虽出，良肉亦伤。盖疮疡之症，气血已伤，肌肉已坏，当随决其毒不可拘泥
人神部分，其脓一出，诸症自退。若脓出反痛，或烦躁呕逆者，皆由胃气亏损，急宜托里调补。凡脓已成者，宜急刺去
以纸捻蘸由 疮内，以膏药贴之，儿安不必服药。如疮反复未痊，多是乳母食浓味，或七情火动而然，当审所因而调治
其母，俱药中加漏芦，令母服之，乳中药过，而疮自愈。
一小儿患疮肿硬，或用针出血，寒热呕吐，乃胃气虚而复伤也，用异功散而呕止，用八珍汤而血止，用托里散而疮
愈。
一小儿项间患毒，脓成未溃，欲急刺之，不从，至胀痛始针出脓，用托里散而安。若及时用针不用药亦可也。
一小儿项间患毒，脓内溃胀痛，此脾肺气虚，而不能外
溃也，用大补汤四剂，针之，清脓滴沥，发热恶寒，用独参汤四剂，脓涌泄，乃用大补汤、托里散而愈。东垣先生云∶
气血壮实，脓自涌出。信矣。
一小儿臂痈，用针过深出血不止，恶寒口噤，脉微细，尚可救，乃用独参汤灌之，良久咽下，半晌而苏，再剂而能
言，四剂而脓出；又用托里散、异功散而愈。
一小儿项疮脓成不出，两腮皆白，余曰∶此肝胆经之症，腮白乃肺经之色，金能克木。当急用针，并补脾气。不信，
竟殁。
五味异功散（方见用败毒之药）
八珍汤（方见发热不止）
托里散（方见热毒疮疡）
十全大补汤（方见便痈）
The method of using needles for treating sores and ulcers in children is even more cautious than that for adults. One must examine the deficiency and excess of the exterior and interior of the meridians, as well as the thickness of the flesh at the affected part, before applying treatment. Swelling that is high and soft originates from the blood vessels; swelling that is hard and firm originates from the muscles; skin color that remains unchanged originates from the bones. For sores not yet formed into pus, use dispersing methods to eliminate the toxin; for those already formed (early stage), use internal-supporting methods to hasten suppuration. When pus has formed, one must verify its ripeness, shallowness, or depth before puncturing with a needle. If light pressure causes pain, the pus is shallow; if heavy pressure causes pain, the pus is deep; if pressing leaves an indentation that does not rise immediately, the pus has not yet formed; if pressing causes immediate rebound, the pus has formed. If punctured when pus is just beginning to form, it will drain Qi and Blood, making it difficult for pus to form. If not punctured when ripe, the rot and ulceration will deepen, preventing healing. If the sore is deep but the puncture is shallow, internal decay will not be discharged, and external blood vessels will be damaged. If the sore is shallow but the puncture is deep, although pus may be discharged, healthy flesh will also be injured. Generally, in sores and ulcers, Qi and Blood are already damaged, and muscles are necrotic; one should promptly decide to discharge the toxin without being constrained by taboos regarding "Ren Shen" (vital spirit) locations. Once pus is discharged, all symptoms will naturally recede. If pain persists after discharge, or if restlessness and vomiting occur, these are due to Spleen-Stomach Qi deficiency, requiring urgent internal-supporting and tonifying treatment. For formed pus, urgent puncture is needed, followed by inserting paper wicks dipped in medicated oil into the sore and applying plaster. The child will stabilize without needing oral medication. If the sore recurs and fails to heal, it is often due to the nursing mother consuming rich flavors or emotional disturbances generating fire. One should investigate the cause and treat the mother, adding Radix Agrimoniae (Lulu) to her medicine. Through medicated breast milk, the sore will heal spontaneously.
A child suffered from a hard, swollen sore. After someone punctured it causing bleeding, the child developed chills, fever, and vomiting, indicating Spleen-Stomach Qi deficiency compounded by injury. Vomiting stopped after administering Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder); bleeding stopped after Bazen Tang (Eight-Treasure Decoction); the sore healed after Tuoli San (Internal-Supporting Powder).
A child had a toxic sore on the neck. Pus had formed but not ruptured. Urgent puncture was desired, but the child resisted. Puncture occurred only after severe distending pain, discharging pus. Condition stabilized after Tuoli San. Timely puncture without medication would also have sufficed.
A child had a toxic sore on the neck with internal rupture causing distending pain, indicating Spleen-Lung Qi deficiency preventing external rupture. After four doses of Dabu Tang (Great Tonifying Decoction), puncture was performed, discharging dripping pus accompanied by fever and chills. After four doses of Dushen Tang (Single Ginseng Decoction), pus gushed out. Subsequently, Dabu Tang and Tuoli San were used for recovery. Mr. Dongyuan stated: "When Qi and Blood are robust, pus will surge forth spontaneously." This is true.
A child had an abscess on the arm. Over-deep puncturing caused uncontrollable bleeding, chills, trismus (lockjaw), and a faint, fine pulse. It was still salvageable. Du Shen Tang was administered via灌 (pouring/feeding). After some time, it was swallowed, and consciousness returned after half an hour. After two more doses, speech resumed; after four doses, pus discharged. Finally, Tuoli San and Yigong San were used for full recovery.
A child had a neck sore with formed pus unable to discharge, and both cheeks appeared white. I stated: "This is a Liver-Gallbladder meridian issue; whiteness of the cheeks reflects Lung meridian color, where Metal overcomes Wood." Urgent puncture and Spleen Qi tonification were advised. The family did not believe this, and the child died.
Wuwei Yigong San (Formula see "Using Antitoxic Drugs")
Bazen Tang (Formula see "Unceasing Fever")
Tuoli San (Formula see "Heat-Toxic Sores and Ulcers")
Shiquan Dabu Tang (Formula see "Perianal Abscess")