以槐梅膏涂之，痛息，日涂两次，至愈乃止。内服杜痔丸，每早晚各服五钱。
候登厕翻出肛外，用温水洗净侧卧，其痔尽出，勿使收入。亦有痔自翻出，大如茶杯，
形如
一菌，粪从菌心而出，痛极难忍，上面如盆，四边高，中心陷下，如菌根。粪后用杜枸杞根
捣烂，煎汁热熏温洗，洗净以洞天膏摊如菜碗大，中剪一孔，以一边剪开通孔，烘熔圈于菌
根，贴于四边，围护好肉，诚恐上药药汁漓于好肉耳。每取枯痔药一二分，入杯津调，笔蘸
拂菌之外面四旁，日夜各拂一次。菌之中心，通连肛门，大忌拂药，倘有流入，大痛难当。
拂一两日，毒水流出，菌形渐缩而软。再拂一两日，渐硬而黑，菌边日有脱下。用药一钱，
内再增朱砂一分，仍用津调，日夜照拂。俟菌缩小黑硬，再拂，拂至菌根自落痊愈。
以退管散五钱，黑糖拌，空心陈酒送下，管自退出乃止。或用双鳖丸亦可。
夏秋头面生红疖，初起取洞天膏贴，周时全消。溃者贴之亦愈。用清暑散煎，俟温，服
即无热毒之患。
凡大痈溃后，世人每投炙 、炙草，或用半炙半生，殊不知托里散内用人参者，并非以
参补
虚，不过以参助 ，添其托毒之力，却无补毒之害，而炙 只补气，不能托毒；炙草只补中
，不能解毒。倘毒瓦斯未尽，误投炙 、炙草，或用保元、十全等汤，致毒反得补助，毒攻内
腑。余之治法，凡遇初溃大痈，止其痛，痛息则毒散，其肿亦退。色转红活，即可无须用参
、补托，如须 、草，亦皆用生，不用炙也。惟体虚年老者，投参而 、草则皆炙也。如
体旺家贫者，无参亦易收功。
马曰∶此论极是。何世之疡科，于溃脓以后，每用参、 、炙草以为托里，补住火邪，
致疮难愈，甚则毒攻内腑，危殆不救。能取此为法，必无贻误。
Apply Huaimei Gao (槐梅膏) to the affected area. Once the pain subsides, apply twice daily until healed. Internally administer Duzhi Wan (杜痔丸), taking five qian at morning and evening.
If the hemorrhoid everts outside the anus during defecation, wash it clean with warm water, lie on your side, allow the hemorrhoid to fully protrude, and do not push it back in. In some cases, the hemorrhoid spontaneously everts, large as a teacup, shaped like a mushroom, with feces passing through the center of the mushroom. The pain is extreme and unbearable; the top resembles a basin, high on the four sides and depressed in the center, like the root of a mushroom. After defecation, crush the roots of Du Gouqi (杜枸杞), decoct them, and use the hot juice for fumigation and warm washing. Cleanse thoroughly, then spread Dongtian Gao (洞天膏) to the size of a vegetable bowl. Cut a hole in the center, slit one side open, heat-melt the ring, place it around the mushroom root, and adhere it to the four sides to protect the healthy surrounding skin. This is done out of fear that the medicinal juice might drip onto healthy tissue. Take one or two fen of Zhumi Yao (枯痔药 - Hemorrhoid Cauterizing Medicine), mix with saliva, dip a brush into the mixture, and brush the outer periphery of the mushroom once day and night. The center of the mushroom connects directly to the anus; applying medicine here is strictly forbidden. If any enters, the pain will be intolerable. After brushing for one or two days, toxic fluid will flow out, and the mushroom shape will gradually shrink and soften. Continue brushing for another one or two days; it will gradually become hard and black, with edges shedding daily. Use one qian of medicine, adding one fen of Zhusha (Cinnabar), still mixed with saliva, and brush day and night as before. Wait until the mushroom shrinks, turns black, and becomes hard, then continue brushing until the root falls off naturally and healing occurs.
Take Tuiguan San (退管散) five qian, mixed with Heitang (Black Sugar), taken on an empty stomach with aged wine. Stop when the fistula tract naturally extrudes. Alternatively, Shuangbie Wan (双鳖丸) may be used.
In summer and autumn, if red boils appear on the head and face, apply Dongtian Gao (洞天膏) at the initial stage; they will completely resolve within a week. Apply even if ulcerated, and they will heal. Decoct Qingshu San (清暑散) and drink it when warm to prevent complications from heat-toxin.
After a large carbuncle ulcerates, people often prescribe Zhi Huangqi (Honey-fried Astragali Radix) and Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), or a mix of fried and raw herbs. They fail to realize that in Tuoli San (托里散), Ren Shen (Ginseng Radix) is not used primarily to tonify deficiency, but to assist Huangqi (Astragali Radix) in enhancing its power to expel toxin, without the harm of nourishing the pathogen. Zhi Huangqi only tonifies Qi and cannot expel toxin; Zhi Gancao only tonifies the Middle Jiao and cannot resolve toxin. If the pathogenic qi is not yet exhausted, mistakenly using Zhi Huangqi and Zhi Gancao, or formulas like Baoyuan Tang (保元汤) or Shiquan Dabu Tang (十全大补汤), causes the toxin to be further nourished, attacking the internal organs. My treatment method: for any newly ulcerated large carbuncle, first stop the pain. When pain ceases, the toxin disperses, and swelling recedes. When the color turns red and vibrant, there is no need to use Ren Shen or Huangqi for tonification and expulsion. If Huangqi and Gancao are needed, use the raw forms, not the honey-fried ones. Only for elderly patients with weak constitutions should Ren Shen be administered, along with honey-fried Huangqi and Gancao. For those with strong constitutions who are poor, treatment can succeed easily even without Ginseng.
Ma said: This argument is extremely correct. Why do surgeons of the world, after pus has drained, always use Ren Shen, Huangqi, and Zhi Gancao to support the interior? This retains fire-pathogens, causing sores to be difficult to heal, and in severe cases, toxins attack the internal organs, leading to critical conditions that are incurable. If this method is adopted, errors will certainly be avoided.