夫痈疽之症，本由心经而发，何以发自心经，因实火动而成痈疽，虽有各症，亦当分内因、外因、不内外因。内因
者，乃心、肝、脾、肺、肾及心包络等处，或因寒热而血凝气滞，或膏粱浓味而遗诸毒；外因者，乃肩挑背负，劳苦奔
趋，而迎暑湿风邪，扰动气血不和，此外因也；不内外因者，乃五脏受伤而邪毒透入也。痈疽之发，分筋、骨、韧、皮、
肤五类。痈发于血脉之间，属阳，为顺症；疽发于筋骨之内，属阴，为逆症。发于皮内者为疡，发于肤上者为疖。凡症
宜视阴阳，详察善恶，若见三善，纵然沉重，亦无大害；如见四恶，虽然微小，亦必丧亡。凡业医者，不可徒从表里、
寒热而辨阴阳，以贻害于人也。
痈疽原是火毒生，经络阻隔气血凝，外因六淫八风感，内因六欲并七情，饮食起居多失慎，肩挑背负损其身，膏粱
之变营卫过，藜藿之躯气血贫，疽由筋骨阴分发，痈从阳分肉脉生，疡起皮里肉之外，疮发皮肤为失荣，阳盛 肿赤痛
易，阴盛色暗陷不疼，半阴半阳不高肿，微痛微热红亦轻，五善为顺七恶逆，见三见四可分明，临症色脉须详察，温凉
补汗攻应分，善治伤寒杂症易，能察痈疽肿毒精。
经云∶“诸痛痒疮，皆属心火。故曰痈疽原是火毒生也。痈疽皆因营卫不和，气血凝结，经络阻隔而生，故曰经络
阻隔气血凝也。其因有三，内因、外因、不内外因是也。外因者，由于春之风，夏之暑湿，秋之燥，冬之寒也，当其时
而至，则为正气，非其时而至，或过盛，则为淫邪。凡此六淫为病，皆属外因。亦有因八风相感，如冬至日正北大刚风，
春分日正东婴儿风，秋分日正西罡风，立夏日东南弱风，立冬日西北折风，应时而至，则生养万物，不应时而至，则杀
害生灵万物，若人感受，则内生重病，外发痈疽。凡此八风为病，皆属于外，故亦曰外因六淫、八风感也。内因者，耳
听淫声，目视邪色，鼻闻过臭，舌食滋味，心思过度，意念妄生，皆损人神，凡此六淫为病，皆属内因，故曰内因六欲
并七情也。不内外因者，饮食不节，起居不慎，过饮醇酒则生火，消烁阴液，过饮茶水则生湿，过食五辛则损气血，过
饥过饱则伤脾胃，凡此种种，皆饮食之致病；昼夜过劳，担轻负重，跌扑损坠等类，损其身形，夜不静息，强力入房，
劳伤精气，此起居之病也。其起于膏粱浓味者，多令人营卫不和，火毒内结，起于藜藿薄食者，多令人胃气不充，气血
亏少，凡此种种，皆不内外因也。人之身体，计有五层，皮、脉、肉、筋、骨也。发于筋骨间者曰疽，属阴；发于血脉
间者曰痈，属阳；发于皮里肉外者曰疡毒，只发于皮肤上者名曰疮疖。凡痈疽阳盛者，初起 肿，色赤，疼痛，则易溃
易敛，顺而易治，以其为阳症也。阴盛者，初起色黯，不红，塌陷，不肿，木硬不疼，则难溃难敛，逆而难治，以其为
阴症也。半阴半阳者，漫肿不高，微痛不甚，色不甚红，此症属险，若能随症施治，不失其时，则亦可转险为顺，否则
逆矣。五善者，五善之症也，诸疮见之则为顺，则易治；七恶者，七恶之症也，诸疮见之则为逆，则难治。凡患痈疽者，
五善为顺，七恶为逆，如见三善者必生，见四恶者必死矣。尔后学业医者，当于临症之际详察其色，宜温者则温之，宜
凉者则凉之，宜补则补，宜汗则汗，宜攻则攻，果能如是，庶有济而不误也。然而外症痈疽，犹如内症伤寒，能善治伤
寒者，则杂症无不易治，能善疗痈疽者，则诸疮无不精妙，盖以其能辨表里、阴阳、虚实、寒热也。
The disease of carbuncle and furuncle (Yongju) originates from the Heart Meridian. Why does it originate from the Heart Meridian? Because excessive fire moves and generates carbuncle and furuncle. Although there are various symptoms, one must distinguish between internal causes, external causes, and causes neither internal nor external.
Internal causes refer to the Zang-Fu organs such as the Heart, Liver, Spleen, Lung, Kidney, and Pericardium. Due to cold-heat imbalance, blood may coagulate and Qi stagnate; or due to a diet rich in fatty and sweet foods, various toxins may remain.
External causes refer to carrying heavy loads on shoulders or backs, laboring and rushing, thereby being exposed to summer heat, dampness, and wind pathogens, which disturb Qi and Blood causing disharmony. This is the external cause.
Causes neither internal nor external refer to injuries to the Five Zang organs allowing pathogenic toxins to penetrate inward.
The onset of carbuncle and furuncle is categorized into five types: tendon, bone, ligament, skin, and flesh. Carbuncle (Yong) arises between blood vessels and meridians, belongs to Yang, and is a favorable prognosis (Shun syndrome). Furuncle (Ju) arises within bones and sinews, belongs to Yin, and is an unfavorable prognosis (Ni syndrome). Those arising within the skin are called ulcers (Yang), and those arising on the surface of the skin are called boils (Jie).
In all cases, one should observe Yin and Yang, and carefully examine for good or bad omens. If three "good" signs are seen, even if the condition is severe, there will be no major harm. If four "bad" signs are seen, even if the lesion is small, death is inevitable.
Practitioners must not rely solely on exterior-interior or cold-heat differentiation to determine Yin and Yang, lest they cause harm.
Carbuncle and furuncle originally arise from fire-toxin. Obstruction of meridians leads to coagulation of Qi and Blood. External causes include invasion by the Six Excesses (Liu Yin) and Eight Winds. Internal causes include the Six Desires and Seven Emotions. Diet and daily life are often imprudent. Carrying heavy burdens damages the body. Rich diets cause excess in Ying and Wei (Nutritive and Defensive Qi); coarse diets lead to deficiency of Qi and Blood. Furuncles arise from the Yin aspect of bones and sinews; carbuncles arise from the Yang aspect of muscles and vessels. Ulcers arise outside the flesh but inside the skin; sores arising on the skin are termed "Shi Rong" (Loss of Glory/Nourishment). Yang excess presents with swelling, redness, and pain, which are easy to treat; Yin excess presents with dark color, depression, and lack of pain, which are difficult to treat. Half-Yin half-Yang presents with diffuse swelling without elevation, slight pain and heat, and mild redness. The Five Goods indicate favorable outcomes; the Seven Evils indicate unfavorable outcomes. Observing three or four can clarify the prognosis. In clinical practice, colors and pulses must be examined in detail; warming, cooling, tonifying, sweating, and purging methods should be distinguished appropriately. It is easy to treat Shaoyang diseases and miscellaneous disorders if one is skilled; one becomes precise in treating carbuncles and furuncles by observing them well.
The Classic states: "All pain, itching, and sores belong to Heart Fire." Thus, it is said that carbuncle and furuncle originally arise from fire-toxin. Carbuncle and furuncle are generated because Ying and Wei are disharmonious, Qi and Blood coagulate, and meridians are obstructed. Hence, it is said that obstruction of meridians leads to coagulation of Qi and Blood. There are three causes: internal, external, and neither internal nor external.
Regarding external causes, they stem from Spring wind, Summer heat-dampness, Autumn dryness, and Winter cold. When these arrive in their proper seasons, they are righteous Qi; when they arrive out of season or are excessive, they become Excess Pathogens (Yin Xie). All diseases caused by the Six Excesses belong to external causes. Also, there are invasions by the Eight Winds, such as the Great Rigid Wind from the North on the Winter Solstice, the Infant Wind from the East on the Spring Equinox, the Gang Wind from the West on the Autumn Equinox, the Weak Wind from the Southeast on the Start of Summer, and the Breaking Wind from the Northwest on the Start of Winter. When arriving in season, they nourish all things; when out of season, they kill living beings. If humans contract these winds, severe internal diseases arise, and carbuncles/furuncles manifest externally. These Eight Winds causing disease belong to external causes; thus, it is also said that external causes include the Six Excesses and Eight Winds.
Regarding internal causes, listening to licentious sounds, viewing lewd sights, smelling foul odors, eating flavorful foods, mental overexertion, and delusional thoughts all damage the Spirit. These sensory desires constitute internal causes; thus, it is said that internal causes include the Six Desires and Seven Emotions.
Regarding causes neither internal nor external: immoderate diet and imprudent lifestyle. Drinking too much fine wine generates fire, consuming Yin fluids; drinking too much tea generates dampness; eating too much of the Five Pungents (Garlic, Scallion, Chives, Leek, Asafoetida) damages Qi and Blood; hunger or overeating injures the Spleen and Stomach. These are diseases caused by diet. Overwork day and night, bearing light or heavy loads, falls and injuries damage the body structure. Lack of quiet rest at night and forced sexual activity injure Essence and Qi. These are diseases caused by lifestyle. Conditions arising from rich diets often cause Ying-Wei disharmony and internal binding of fire-toxin. Conditions arising from coarse diets often cause insufficient Stomach Qi and deficiency of Qi and Blood. All these are causes neither internal nor external.
The human body has five layers: Skin, Vessels, Flesh, Tendons, and Bones. Arising between bones and tendons is Ju (Furuncle/Deep Abscess), belonging to Yin. Arising between blood vessels is Yong (Carbuncle/Superficial Abscess), belonging to Yang. Arising outside the flesh but inside the skin is Yang Du (Ulcer Toxin). Arising only on the skin is Chuang Jie (Sore/Boil).
In Yang-excess carbuncles/furuncles, initial presentation includes swelling, red color, and pain; they easily suppurate and heal, representing a favorable course because they are Yang syndromes. In Yin-excess cases, initial presentation includes dark color, lack of redness, depression, no swelling, woody hardness, and no pain; they are difficult to suppurate and heal, representing an unfavorable course because they are Yin syndromes. Half-Yin half-Yang cases present with diffuse swelling without elevation, slight pain, and mild redness. This condition is dangerous. If treated according to symptoms without delay, danger can turn to favorability; otherwise, it becomes unfavorable.
The Five Goods refer to five favorable signs; seeing them in sores indicates favorability and ease of treatment. The Seven Evils refer to seven unfavorable signs; seeing them indicates unfavorability and difficulty of treatment. For patients with carbuncles/furuncles, Five Goods are favorable, Seven Evils are unfavorable. Seeing three Goods implies survival; seeing four Evils implies death.
Future practitioners must carefully observe the patient's complexion during clinical examination. Apply warming methods where appropriate, cooling methods where appropriate, tonification where appropriate, diaphoresis where appropriate, and purgation where appropriate. If done correctly, treatment will be effective and error-free. However, external diseases like carbuncles and furuncles are analogous to internal diseases like Cold Damage (Shang Han). One who is skilled in treating Cold Damage can easily treat miscellaneous disorders; one who is skilled in treating carbuncles and furuncles will master all sores. This is because they can differentiate Exterior-Interior, Yin-Yang, Deficiency-Excess, and Cold-Heat.