论曰∶夫痈疽初发如微，人多不以为急，此实奇患，唯宜速治之，治之不速，病成难救
，以此致祸能不痛哉。且述所怀以悟后贤，谨按黄父痈疽论，论痈所着缓急之处，死生之期
如下∶
发皮肉浅肿高而赤，贴即消，不治亦愈。
发筋肉深肿下而坚，其色或青黄或白黑，或脱复微热而赤，宜急治之。成消中半发附骨
者，或未觉肉色已殃，已殃者痈疽之甚也。
发背外皮薄为痈，皮浓为疽，如此者多见先兆，宜急治之。皮坚甚大者多致祸也。
夫痈坏后有恶肉者，当以猪蹄汤洗去秽，次敷食肉膏散，恶肉尽，乃敷生肉膏散，及摩
四边，令善肉速生。当绝房室，慎风冷，勿自劳动，须筋脉平复乃可任意耳，不尔，新肉易
伤，伤则重溃，发则祸至，慎之慎之。
痈疽之发，未辨是非饥渴为始，始发之时，或发自疽，或似小疖，或复大痛，或复小痛
，或发米粒大白脓子，皆是微候，宜善察之。欲知是非，重按其处，是即便隐痛，复按四边，
比方得失审实之，是即灸。第一使灸其上二三百壮，又灸四边一二百壮，小者灸四边，中者
灸六处，大者灸八处，壮数不虑多也。亦应即薄贴，令得即消。内须服解毒冷药，令毒瓦斯出
外。外须薄贴热药，法当疮开其口，令泄热气故也。
凡痈按之大坚者未有脓，半坚半软者半有脓，当上薄者都有脓。有脓便可破之，不尔，
侵食筋骨也。
破之法，应在下递上破之，令脓易出，用铍针，脓深难见，肉浓而生者用火针，若不别
有脓者，可当其上数按之，内便隐痛，殃坚者未有脓泄去热气，不尔，长速则不良。
Commentary: When carbuncles and sores (Yongju, 痈疽) first appear, the symptoms are slight, and people often do not consider them urgent. This is actually a grave danger; they should be treated promptly. If treatment is delayed, once the disease is established, it becomes difficult to save [the patient]. How can one not feel pain regarding the disasters caused by this? I hereby state my views to enlighten future scholars. Relying on the *Huangfu Carbuncle and Sore Treatise* (*Huangfu Yongju Lun*, 黄父痈疽论), I discuss the urgency of the onset of carbuncles and sores and the timing of death or survival as follows:
When a carbuncle or sore appears superficially in the skin and flesh, with swelling that is high and red, applying topical medication will cause it to dissipate; even without treatment, it may heal spontaneously.
When it appears deeply in the muscles and sinews, with swelling that is depressed and hard, and the color is either greenish-yellow, white-black, or if the skin sheds and then becomes slightly hot and red, it requires urgent treatment. If it develops into "Xiao Zhong Ban" (a stage where pus formation is partial/incomplete) or attaches to the bone, one might not yet perceive that the muscle color has deteriorated. Once the color deteriorates, it represents the most severe form of carbuncle and sore.
When appearing on the back, if the outer skin is thin, it is a carbuncle (Yong, 痈); if the outer skin is thick, it is a sore (Ju, 疽). Such cases often show prodromal signs and require urgent treatment. If the skin is very hard and the area is large, it often leads to disaster.
After a carbuncle or sore ulcerates and there is foul flesh (E Rou, 恶肉), one should wash away the filth using Pig Trotter Decoction (*Zhuti Tang*, 猪蹄汤), then apply Flesh-Eating Powder San (*Shirou Gao San*, 食肉膏散). Once the foul flesh is completely removed, apply Flesh-Generating Powder San (*Shengrou Gao San*, 生肉膏散) and massage the four sides to promote the rapid growth of healthy tissue. During this period, sexual intercourse must be abstained from, protection against wind and cold is essential, and self-exertion should be avoided. One may resume normal activities only after the sinews and vessels have recovered. Otherwise, the new flesh is easily injured; if injured, it leads to severe ulceration, and upon recurrence, disaster strikes. Be extremely cautious.
The onset of carbuncles and sores often begins with sensations of hunger and thirst before the nature of the condition is clear. At the initial stage, it may arise as a sore, resemble a small boil, cause severe pain, cause mild pain, or produce white pus grains the size of rice grains. These are all subtle signs that require careful observation. To determine the nature of the condition, press heavily on the affected area; if there is dull pain upon pressing, it indicates excess. Press the surrounding areas and compare the differences to verify the diagnosis. If confirmed as excess, apply moxibustion. First, apply two to three hundred moxa cones (Zhuang, 壮) on the top, and one to two hundred moxa cones on the four sides. For small lesions, moxa the four sides; for medium lesions, moxa six points; for large lesions, moxa eight points. Do not worry about the number of moxa cones being too many. Simultaneously, apply a thin plaster immediately to allow it to dissipate at once. Internally, administer cooling detoxifying medicines to expel the toxic qi outward. Externally, apply hot medicinal plasters because the opening of the wound allows the release of heat qi.
Generally, if a carbuncle or sore feels hard when pressed, there is no pus yet. If it is half-hard and half-soft, there is partial pus. If the top part becomes soft, there is full pus. If pus is present, it can be lanced; otherwise, the pus will erode the sinews and bones.
The method of lancing should proceed from the bottom upwards to facilitate the drainage of pus. Use a Pi Needle (Beizhen, 铍针 - a surgical knife-like instrument). If the pus is deep and difficult to see, or if the flesh is thick and dense, use fire needles. If there is no distinct accumulation of pus, one can press repeatedly on the top area; if there is dull pain internally, it indicates hardness without pus, and the heat qi should be vented. Otherwise, if healing occurs too quickly, it may be detrimental.