托者起也上也。痈毒之发外之内者。邪必攻内。自然之理。当用托里汤液。内加升麻金银花。使荣卫
通行。血脉调和。疮毒消散。故云疮家无一日不托里也。
言补者治虚之法也。经云。虚者补之。如气虚四君子汤。乃人参黄 白术甘草。血虚当归川芎芍
药地黄四物汤合而为八物汤。或为八珍丸内详寒热加黄连附子随症活法加减。无出此二方之妙。自然
肌生肉长气血和而体自强矣。
夫痈疽疔毒。瘰 瘤疖其名甚多。故余总谓疮疡是也。然各有形。其形不同。其苦不一。十四经
络部位之高下。血气之多少。症之善恶。疮之大小浅深。腑脏之源。感之轻重所发也。故有阴有阳。
有表有里。有标有本之异也。经云。诸痛痒疮疡皆属心火。又云。营气不从。逆于肉理。乃生痈肿是
也。然形大而浮者。痈也。乃六腑积毒之所生。初起有头。一如 。白色焦枯。触之痛应心者。疽
也。肿浮根小。至大不过二三寸者。疖也。至于疔者。形有二十三种。余今分为三十四种。其形小顶
如钉 。故名之。如有红丝直皈于心。当刺其头。泻去毒血。 入蟾酥等药。不刺则皈心必死矣。然
痈疖初则宜灸。谓其气本浮。令其气血通达畅快矣。痈则易疗。而将息难瘥迟。疽则难医。易得痊。
宜烙不宜灸。诸疮之中。惟有疔疮发背最凶。须明五善七恶之理。当察其前论。篇篇有味。卷卷出奇。
虽云疮科。古之未竭其奥。未尽其传。余虽不敏。详之至微其理。大至痈疽。小至于痤痱。无不选其精秘。然方法无
不择其良验。故云之外科启玄。又图之形症。鸣之经络。施之治法。后学人可一览而即为上志矣。
The method of "Tuo" (Supporting/Promoting) means to lift and support. When carbuncles and toxins manifest from the exterior to the interior or from the interior to the exterior, pathogenic factors inevitably attack the interior; this is a natural principle. In such cases, one should employ *Tuoli Tangye* (Decoction for Supporting the Interior), adding *Shengma* (Cimicifugae Rhizoma) and *Yinhuahua* (Lonicerae Japonicae Flos) to facilitate the circulation of Ying and Wei (Nutritive and Defensive Qi), harmonize the blood vessels, and dissipate the toxin. Hence it is said that in treating sores and ulcers, there is not a single day when supporting the interior is omitted.
The term "Bu" (Tonifying/Supplementing) refers to the method of treating deficiency syndromes. The Classics state: "Deficiency should be tonified." For example, for Qi deficiency, use *Sijunzi Tang* (Four Gentlemen Decoction), composed of *Renshen* (Ginseng Radix), *Huangqi* (Astragali Radix), *Baizhu* (Atractylodis Macrocephalae Rhizoma), and *Gancao* (Glycyrrhizae Radix et Rhizoma). For Blood deficiency, use *Siwu Tang* (Four Substances Decoction), composed of *Danggui* (Angelicae Sinensis Radix), *Chuanxiong* (Chuanxiong Rhizoma), *Shaoyao* (Paeoniae Radix), and *Dihuang* (Rehmanniae Radix). Combining these two formulas yields *Bawu Tang* (Eight Substances Decoction), or they can be processed into *Bazhen Wan* (Eight Treasures Pill). Depending on cold or heat symptoms, *Huanglian* (Coptidis Rhizoma) or *Fuzi* (Aconiti Lateralis Radix Praeparata) may be added, with flexible modifications based on specific conditions. The efficacy lies essentially within these two formulas. Naturally, muscles will grow, flesh will regenerate, Qi and Blood will harmonize, and the body will become strong.
Regarding carbuncles (*Yong*), deep abscesses (*Ju*), hard boils (*Ding*), toxins, scrofula (*Luoli*), tumors (*Liu*), and furuncles (*Jie*), the names are numerous. Therefore, I generally refer to them collectively as "Chuanyang" (Sores and Ulcers). However, each has its own morphology; their shapes differ, and the suffering varies. This depends on the location along the fourteen meridians, the abundance or scarcity of Qi and Blood, the severity of the syndrome, the size and depth of the sore, the source organ involved, and the degree of pathogenic invasion. Thus, there are differences between Yin and Yang, Exterior and Interior, Biao (Branch/Symptom) and Ben (Root/Etiology). The Classics state: "All pain, itching, sores, and ulcers belong to Heart Fire." It also states: "When Ying Qi does not flow smoothly and reverses into the muscle tissue, carbuncles and swellings arise." A large, floating swelling is a *Yong* (Carbuncle), generated by accumulated toxins in the Six Fu Organs. Initially presenting with a head, resembling a millet grain, white and scorched, where touching causes pain piercing the heart, is a *Ju* (Deep Abscess). A swelling that is superficial, with a small root, reaching no more than two or three cun in diameter, is a *Jie* (Furuncle). As for *Ding* (Hard Boils), there are twenty-three forms; I currently classify them into thirty-four types. They are named so because their shape is small with a pointed top like a nail. If red threads extend directly to the heart, the head should be pricked to drain toxic blood, and substances like *Chansu* (Bufonis Venenum) should be applied. If not pricked, the toxin returning to the heart will certainly cause death. However, for initial *Yong* and *Jie*, moxibustion is suitable because their pathogenic Qi is superficial; moxibustion allows Qi and Blood to circulate freely. *Yong* is easy to treat but difficult to heal completely, often lingering; *Ju* is difficult to treat but easier to cure. *Ju* is suitable for cauterization rather than moxibustion. Among all sores, only *Dingchuang* (Hard Boil Sores) and *Fabei* (Back Carbuncle) are the most fierce. One must understand the principles of "Five Auspicious Signs" and "Seven Ominous Signs," referring to the previous discussions. Every chapter contains profound meaning, every volume reveals unique insights. Although this concerns surgery, the ancients had not exhausted its mysteries nor fully transmitted its teachings. Though I am not talented, I have detailed the subtle principles extensively, from major carbuncles and abscesses down to minor acne and miliaria, selecting only the most refined and secret methods. All prescriptions are chosen for their proven efficacy. Hence the book is titled *Waike Qixuan* (Enlightenment on External Medicine). Furthermore, diagrams of morphologies and symptoms are provided, meridian pathways are explained, and treatment methods are applied, so that future students may grasp the essentials at a glance and establish high aspirations.