疖者。初生突起。浮赤。无根脚。肿见于皮肤。止阔一二寸。有少疼痛。数日后微软。
剥起。始出青水。后自破脓出。如不破。用簪针丸。○痈者。初生红肿。突起阔三四寸。
热恶寒。烦渴。或不热。抽掣疼痛。四五日后按之微软。此证毒瓦斯浮浅。春夏宜防风败毒散
。加葱姜枣煎。秋冬去葱姜枣。加木香。身半以上。加栝蒌。身半以下。加射干。又有皮色
不变。但肌肉内微痛。甚发热恶寒。烦渴。此证热毒深沉。日久按之。中心微软。脓成。用
火烙烙开。以决大脓。宜服托里之药。○疽者。初生白粒如粟米。便觉痒痛。触着其痛应心
。此疽始发之兆。或误触者。便觉微赤肿痛。三四日后。根脚赤晕展开。浑身壮热微渴。疮
上亦热。此疽也。疽上或渐生白粒如黍米。逐个用银篦挑去。勿令见血。或有少血亦不妨。
不见血尤妙。却用老皮散敷之。五七日。疮头无数如蜂房。脓不肯出。冬用五香连翘汤。夏
用黄连羌活散。夏初用防风败毒散。加葱枣。秋去之。加木香。若形气实。脉洪滑有力。痛
肿开。壮热便闭。宜五利大黄汤。复元通。气散。选用通利。又有初生白粒。误触后。便
觉情思不畅。背重如石。身体烦疼。胸膈痞闷。怕闻食气。此谓外如麻。里如瓜。疽毒深恶
。内连腑脏。疽顶白粒如椒者数十。间有大如连子蜂房者。指HT 有脓不流。时有清水微肿不
突。根脚红晕。渐渐展开。或痒痛。或不痛。疽不甚热。疮反陷下。如领之皮。渐变黑色。
恍惚沉重。脉若虚弱。便用大料参 归术。浓煎调理。
Jie (Furuncle) initially presents as a protruding elevation, with a floating red color and no distinct root. The swelling is confined to the skin surface, spanning only one or two cun, accompanied by slight pain. After several days, it becomes soft, the epidermis peels up, and clear green fluid exudes, followed by spontaneous rupture and pus discharge. If it does not rupture spontaneously, Zanzhen Wan (Pin Needle Pill) may be used to puncture it.
Yong (Carbuncle) initially presents with redness and swelling, protruding over an area three to four cun wide. Symptoms include fever, aversion to cold, irritability, and thirst, or absence of fever with pulling-type pain. After four to five days, palpation reveals softness in the center. This condition involves superficial pathogenic heat-toxin. In spring and summer, Fangfeng Baidu San (Saposhnikovia Decoction for Resolving Toxins) is indicated, decocted with scallion, ginger, and jujube; in autumn and winter, remove scallion, ginger, and jujube, and add Muxiang (Aucklandiae Radix). For lesions on the upper half of the body, add Gualou (Trichosanthis Fructus); for the lower half, add Shegan (Belamcandae Rhizoma). Alternatively, the skin color may remain unchanged, with only slight pain within the muscle tissue, potentially accompanied by severe fever, aversion to cold, irritability, and thirst. This indicates deep-seated heat-toxin. After prolonged duration, the center becomes soft upon palpation, indicating pus formation. Huoluo (Fire Cauterization) should be used to open the abscess and drain large amounts of pus. It is appropriate to administer Tuoli medications (medicines for supporting the healthy qi and expelling toxins).
Ju (Deep Abscess/Gangrene) initially presents as white granules like millet seeds, causing itching and pain. Touching them causes pain that resonates deeply ("should heart"), which is a sign of initial Ju onset. If accidentally touched, local redness, swelling, and pain occur. After three to four days, the red halo at the root expands, accompanied by systemic high fever, slight thirst, and heat on the ulcer surface. This is Ju. White granules resembling foxtail millet seeds gradually appear on the ulcer. Each should be picked off using a silver comb without causing bleeding; slight bleeding is acceptable, but no bleeding is preferable. Then, Laopi San (Old Skin Powder) should be applied externally. After five to seven days, numerous ulcer heads resembling a honeycomb may form, refusing to discharge pus. In winter, Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction) is used; in summer, Huanglian Qianghuo San (Coptis and Notopterygium Powder); in early summer, Fangfeng Baidu San with scallion and jujube; in autumn, remove scallion and jujube, adding Muxiang. If the patient's constitution is robust and the pulse is surging, slippery, and forceful, with opened swelling, high fever, and constipation, Wuli Dahuang Tang (Five-Advantage Rhubarb Decoction) is indicated to restore Yuanqi (Primary Qi) and unblock circulation, after which purgative methods are selected. Another presentation involves initial white granules; after accidental contact, mental distress, heaviness in the back like stone, bodily aching, chest and diaphragm stuffiness, and aversion to food odors occur. This is termed "externally like hemp, internally like melon," indicating deep and malignant Ju toxin connecting to the zang-fu organs. Dozens of white granules like peppercorns may appear on the top of the Ju, interspersed with larger ones resembling lotus seeds or honeycombs. In the fingers, pus exists but does not flow; sometimes clear fluid appears with slight swelling but no protrusion. The root red halo gradually expands. There may be itching or pain, or neither. The Ju is not very hot, but the ulcer sinks inward, resembling the leather of a collar, gradually turning black. The patient feels恍惚 (trance-like) and heavy. If the pulse is weak, large doses of Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma) should be decocted thickly for regulation.