凡疮虽因营气不从。逆于肉理所生。各形不同者。因逆之微甚。邪之轻重可知也。痈
者壅也塞也。壅塞之甚。故形大而浮也。纵广尺许者是也。疽者阻也。不通也。深而恶也。
其形有头粒是也。疔者丁也。定也。其形虽小。一起即有顶如泡丁之形。痒痛不一者是也。
疖者节也。乃时之邪热感受而成。故形小。至大不过二三寸者是也。瘤者留也。畜也。赤
肿如榴之形是也。丹者赤也。火也。标红势浅大而浮也。疡者阳也。乃有头之小疮是也。
痘者豆也。形有豆。是胎毒所生也。故世人未免也。疹者隐也。隐而现。现而隐。有头粒
而更手。俗称痧子是也。亦胎毒畜于肝脏之所生也。结核者在皮肤中。如果之核坚硬。初
则推之可动无根是也。久则推之不动。亦有作脓而未得其治也。
夫疮疡者阳也。火也。经云。诸痛痒疮疡皆属心火。火为阳。宜于春夏。旺于巳午。
乃万物蕃秀之时。故为顺。忌秋冬者为阴。乃万物收藏之时。故为逆也。此四时之逆顺也。
然五脏六腑亦有生克。四时所宜之逆顺。疮医不可不知也。假令肺疽肺痿之症。肺为五脏
之华盖。生于皮毛。行于气。气为卫。乃卫护于一身。使荣血润养。周流无所不至是也。
今肺病则右寸口脉数而虚者。肺萎也。数而实者。肺疽也。其候则口干喘满。烦躁而渴。
甚则四肢微肿。咳吐脓血腥臭。胸中隐隐微痛是也。甚症现于秋冬可救何也。则肺旺于秋
是也。冬寒水旺。子能救母。母子相生。故云可救为顺是也。春夏木旺火胜之时。肺金病
再遇火旺之时。三伏之天。流金烁石之时。金受火克。此为逆。故难治也。叔和云夏得肺
而难瘥是也。余脏仿此则可知也。
All sores and ulcers, although generated because Ying Qi (Nutritive Energy) fails to flow smoothly and reverses within the muscle tissues, vary in form. The severity of this reversal and the lightness or heaviness of the pathogenic factors can be known from these differences.
"Yong" (Carbuncle) means obstruction. Due to severe obstruction, the shape is large and floating (swollen). Those spanning approximately one chi in length and width belong to this category.
"Ju" (Deep-seated abscess) means blockage and non-patency. It is deep and malignant. Its shape presents with granular protrusions.
"Ding" (Tetanus-like nodule/Plague boil) takes its name from "Ding" (nail) and "Ding" (fixed/stable). Although small in size, once it arises, the top resembles a blister or a nail. It presents with varying degrees of itching and pain.
"Jie" (Boil/Furuncle) takes its name from "Jie" (node/joint). It is formed by contracting seasonal pathogenic heat. Therefore, its shape is small, not exceeding two or three cun even at its largest.
"Liu" (Tumor) takes its name from "Liu" (retention) and "Xu" (accumulation). It appears red and swollen, resembling the shape of a pomegranate.
"Dan" (Erysipelas) takes its name from "Chi" (red) and "Huo" (fire). It is bright red, superficial in nature but extensive and swollen.
"Yang" (Ulcer/Sore) takes its name from "Yang" (Yang energy). It refers to small sores that have a head.
"Dou" (Smallpox) takes its name from "Dou" (bean). Its shape resembles beans; it is generated by fetal toxicity. Thus, people cannot avoid it.
"Zhen" (Measles/Rash) takes its name from "Yin" (hidden). It appears and disappears intermittently. It has granular protrusions and is more palpable to the touch. Commonly known as "Sha Zi". It is also generated by fetal toxicity accumulated in the Liver.
"Tie He" (Scrofula/Knots) are located within the skin, hard like the pits of fruits. Initially, they can be pushed and move without a root; after a long time, they become immobile. Some may suppurate if not treated correctly.
Sores and ulcers belong to Yang and Fire. The Classics state: "All pain, itching, sores, and ulcers belong to Heart Fire." Fire is Yang, favorable in Spring and Summer, and prosperous during the Si and Wu hours. This is the time when all things flourish and appear beautiful, hence it is considered a "Shun" (Favorable/Smooth) condition. Autumn and Winter are avoided because they belong to Yin, the time when all things are stored and collected, hence it is considered a "Ni" (Unfavorable/Opposing) condition. This constitutes the favorable and unfavorable conditions of the four seasons.
However, the Five Zang and Six Fu organs also have generating and overcoming relationships. Physicians treating sores and ulcers must understand the favorable and unfavorable conditions relative to the seasons.
For example, consider symptoms of Lung Ju (Lung Abscess) and Lung Fei Wei (Lung Atrophy/Withering). The Lung is the canopy of the five Zang organs, originating in the skin and hair, and functioning through Qi. Qi acts as Wei Qi (Defensive Energy), protecting the entire body, allowing Ying Blood to nourish and circulate throughout without omission.
If there is lung disease, a rapid and deficient pulse at the right Cun Kou position indicates Lung Fei Wei (Atrophy); a rapid and excess pulse indicates Lung Ju (Abscess). The manifestations include dry mouth, panting, chest fullness, irritability, thirst, and in severe cases, slight swelling of the four limbs, coughing up purulent bloody sputum with a foul odor, and dull, slight pain in the chest.
Severe symptoms appearing in Autumn and Winter can be cured. Why? Because the Lung prospers in Autumn. In Winter, Cold Water Qi is prosperous; the Child organ (Kidney/Water) can rescue the Mother organ (Lung/Metal). Since Mother and Child generate each other, it is said to be curable and thus favorable (Shun).
In contrast, during Spring and Summer when Wood is prosperous and Fire prevails, if Lung Metal is diseased and encounters a time of excessive Fire, such as during the Sanfu days (the hottest period of summer) when metal flows and stones melt, Metal is overcome by Fire. This is considered Ni (Unfavorable/Opposing), making it difficult to treat. Shuhe (Wang Shuhe) stated that obtaining Lung disease in Summer is difficult to heal. The situations of other organs can be understood by analogy.