疮疡之作，由六淫七情所伤。其痛疏也，因气血凝滞所致。假如热毒在内，便秘而作痛
者，内疏黄连汤导之。热毒炽盛， 肿而作痛者，黄连解毒散治之。不应，仙方活命饮解之。瘀
血凝滞而作痛者，乳香定痛散和之。作脓而痛者，托里消毒散排之。脓胀而痛者，针之。
脓溃而痛者补之。若因气虚而痛，四君加归、 。血虚而痛，四物加参、 。肾虚而痛，六
味地黄丸。口干作渴，小便频数者，加减八味丸。此皆止痛之法也。丹溪先生云∶脓出而反
痛，此为虚也，宜补之。秽气所触者，和解之。风寒所逼者，温散之。若泥用乳、没，斯执
治验
鸿胪苏龙溪，小腹内肿胀作痛，大小便秘结，作渴饮冷，脉洪数而实，用黄连解毒二剂
，肿痛顿止，二便调和，用活命饮而全愈。
一儒者臀患痈，肿 痛甚，用活命饮、隔蒜灸而消。后因饮食劳倦，肿痛恶寒，发热头
疼，用补中益气汤，频用葱熨法，两月余而消。
一妇人胁下作痛，色赤寒热，用小柴胡汤，加山栀、川芎，以清肝火而愈。但经行之后
，患
胆草、芎、归主之。若久而脾胃虚弱，用补中益气为主。若兼气郁伤脾而患，间以归脾汤。
若朝凉暮热，饮食少思，须以逍遥散为主。
夫肌肉者，脾胃之所主。收敛者，气血之所使。但当纯补脾胃，不宜泛敷生肌之剂。夫
疮不生肌而色赤甚者，血热也，四物加山栀、连翘。色白而无神者，气虚也，四君加当归、黄
。晡热内热，阴血虚也，四物加参、术。脓水清稀者，气血虚也，十全大补汤。食少体倦，
脾气虚也，补中益气汤。烦热作渴，饮食如常，胃火也，竹叶黄 汤；不应，竹叶石膏汤。
热渴而小便频数，肾水虚也，用加减八味丸料煎服。若败肉去后，新肉微赤，四沿白膜者
，此胃中生气也，但用四君子汤以培补之，则不日而敛。若妄用生肌之药，余毒未尽，而反
益甚耳。殊不知疮疡之作，由胃气不调；疮疡之溃，由胃气腐化；疮疡之敛，由胃气荣养
。东垣先生云∶胃乃生发之源，为人身之本。丹溪先生亦谓∶治疮疡，当助胃壮气，使根本
坚固。诚哉是言也，可不慎欤。
治验
银台郑敬斋腿患痈，疮口不敛。余考绩到京，请治者，皆用十宣散之类。云旬日收敛，
至今未
脾胃，不数日而疮敛矣。
昆庠王子大背患疽，年余疮口少许不敛。色黯陷下，面色痿黄，形气怯弱，脉浮缓而
涩，此脾肺气虚也，用十全大补汤，加附子少许，数剂而元气渐复；却去附子，又三十余剂全愈，
The occurrence of sores and ulcers is caused by injuries from the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). Mild pain is due to Qi and Blood stagnation. If heat-toxin is internal, causing constipation and pain, Neishu Huanglian Tang (Internal Purging Coptis Decoction) is used to guide out the accumulation. If heat-toxin is vigorous, causing swelling and pain, Huanglian Jiedu San (Coptis Detoxification Powder) is used for treatment. If there is no response, Xianfang Huoming Yin (Immortal Life Elixir) is used to resolve toxicity. If blood stasis stagnates causing pain, Ruxiang Dingtong San (Frankincense Pain-Relieving Powder) is harmonized. If suppuration occurs with pain, Tuoli Xiaodu San (Supporting Interior and Eliminating Toxin Powder) is used to discharge pus. If pus accumulates causing distension and pain, it is punctured with a needle. If pain persists after pus rupture, tonification is applied. If pain is due to Qi deficiency, Sijunzi Tang (Four Gentlemen Decoction) is added with Danggui (Angelica Sinensis) and Huangqi (Astragalus). If pain is due to Blood deficiency, Siwu Tang (Four Substance Decoction) is added with Renshen (Ginseng) and Huangqi (Astragalus). If pain is due to Kidney deficiency, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is used. For dry mouth and thirst with frequent urination, Jiaban Bawei Wan (Modified Eight-Ingredient Pill) is used. These are all methods for relieving pain. Mr. Danxi stated: "If pain returns after pus discharge, this is deficiency, and tonification should be applied." If touched by foul air, harmonization is used. If forced by Wind-Cold, warming dispersion is used. If one rigidly relies only on Ruxiang (Boswellia) and Moyao (Myrrh), this is adhering blindly to empirical treatments.
Su Longxi, a Honglu (Court Herald), suffered from internal swelling and pain in the lower abdomen, with constipation of both large and small intestines, thirst for cold drinks, and a pulse that was surging, rapid, and full. Two doses of Huanglian Jiedu San were administered, immediately stopping the swelling and pain and regulating bowel movements. Subsequently, Xianfang Huoming Yin was used, resulting in complete recovery.
A scholar developed an abscess on his buttock with severe swelling and pain. It was resolved using Xianfang Huoming Yin combined with Garlic-Separated Moxibustion. Later, due to dietary irregularities and overexertion, he experienced swelling, pain, aversion to cold, fever, and headache. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used, along with frequent application of Scallion-Ironing therapy, leading to resolution after more than two months.
A woman suffered from pain under her ribs, with redness, chills, and fever. Xiao Chaihu Tang (Minor Bupleurum Decoction) was used, supplemented with Zhizi (Gardenia) and Chuanxiong (Ligusticum), clearing Liver Fire to achieve cure. However, after menstruation, [the text is incomplete here, likely referring to recurrence or related symptoms], treated primarily with Longdancao (Gentiana), Chuanxiong (Ligusticum), and Danggui (Angelica). If the condition persists leading to Spleen-Stomach weakness, Bu Zhong Yi Qi Tang is the primary treatment. If accompanied by Qi stagnation injuring the Spleen, Guipi Tang (Restore the Spleen Decoction) is used intermittently. If there is morning chill and evening fever with poor appetite and lack of desire to eat, Xiaoyao San (Free and Easy Wanderer Powder) must be the primary treatment.
Muscle is governed by the Spleen and Stomach. Convergence and healing are driven by Qi and Blood. Therefore, one should purely tonify the Spleen and Stomach and avoid indiscriminately applying flesh-generating agents. If the sore does not generate flesh and appears intensely red, it is Blood Heat; Siwu Tang is added with Zhizi (Gardenia) and Lianqiao (Forsythia). If the color is pale and lacks spirit, it is Qi deficiency; Sijunzi Tang is added with Danggui (Angelica) and Huangqi (Astragalus). Afternoon fever and internal heat indicate Yin-Blood deficiency; Siwu Tang is added with Renshen (Ginseng) and Baizhu (Atractylodes). Clear and thin pus indicates Qi and Blood deficiency; Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) is used. Poor appetite and body fatigue indicate Spleen-Qi deficiency; Bu Zhong Yi Qi Tang is used. Irritability, fever, and thirst with normal diet indicate Stomach Fire; Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used. If ineffective, Zhuye Shigao Tang is continued [Note: Text implies switching or continuing similar formula]. Thirst and frequent urination indicate Kidney Water deficiency; Jiaban Bawei Wan (Modified Eight-Ingredient Pill) decoction is taken. After necrotic tissue is removed, if new flesh is slightly red with white membranes around the edges, this is the generating Qi of the Stomach. Simply using Sijunzi Tang (Four Gentlemen Decoction) to cultivate and tonify will lead to convergence in a few days. If flesh-generating drugs are misused while residual toxins remain, the condition will worsen. One must not fail to realize that the occurrence of sores is due to disharmony of Stomach Qi; ulceration is due to the putrefying action of Stomach Qi; and convergence is due to the nourishing action of Stomach Qi. Mr. Dongyuan stated: "The Stomach is the source of generation and the root of the human body." Mr. Danxi also said: "In treating sores and ulcers, one must assist the Stomach and strengthen Qi to make the foundation solid." These words are indeed true; how can one not be cautious?
Treatment Cases:
Zheng Jingzhai, a Yintai (Silver Tablet Official), developed an abscess on his leg with non-converging wound. When I went to the capital for performance review, doctors treating him all used Shixuan San (Ten-Vitality Powder), claiming convergence within ten days, but [text is incomplete, implying failure]. [Xu Ji's intervention implied]: Tonifying the Spleen and Stomach led to wound convergence in a few days.
Wang Zida, a student at the Imperial Academy, developed a carbuncle on his back. The wound had not fully converged for over a year. The color was dark and depressed, complexion sallow, physique and Qi weak, and pulse floating, slow, and choppy. This indicated Lung and Spleen Qi deficiency. Shiquan Dabu Tang was used with a small amount of Fuzi (Aconite). After several doses, Yuan Qi gradually recovered. Fuzi was then removed, and after another thirty-plus doses, complete recovery was achieved.