疮疡及诸病面赤。虽伏大热。禁不得攻里。为阳气怫郁。邪气在经。宜发表以去之。故
郁则发之。虽大便数日不去。宜多攻其表以发散阳气。少加润燥之药。若见风脉风证。只可
用发表风药。便可以通利也。若只干燥秘涩。只宜润之不可。（注∶“可”下疑有脱。）
疮疡发寒热。多汗。或先寒后热。或先热后寒。或连日作。又有或间日作。必先呕痰。
寒热。寒热解。大汗出。精要言以上之证。不可专以为热。亦有气虚而得。亦有因怒而得。
或先感寒邪。脾气不正而然者。
丹溪曰。因气虚者。当以补气药补之。因怒者当以顺气药和之。脾气不正者。当以脾药
之。今用不换金正气散。悉是温散泄卫之药。欲以一两人参。收拾十四两之泄卫可乎。若用
于肿疡时感寒邪者。犹或庶几。彼气虚者。因怒者。脾气不正者。此方能兼治乎。抑不知其
用于肿疡耶。溃疡耶。
凡疽疾咽喉口舌生疮。精要归罪不得内托。以致热毒冲心。
一贵人病此。与琥珀犀角膏。一日而安。
丹溪曰。肿疡用之。尚为近理。若溃疡后用之。彼犀角之升散。宁不助邪致虚以速其死
后有犀角散以大黄佐黄 。用黄 则知为虚矣。用大黄又似疑其有实热。夫疮脓体虚。纵有
旧热。将自渐因脓血而消。何必以峻冷利动脏腑。若在秋冬。何异刀剑。
Chan Chuang (Skin sores and ulcers) and other diseases presenting with facial redness. Although there is latent severe heat inside, purgation (attacking the interior) is strictly prohibited. This is because Yang Qi is constrained and depressed, and pathogenic factors are in the meridians. It is appropriate to release the exterior to dispel them. Therefore, for depression/constraint, one should disperse it. Even if bowel movements have not occurred for several days, one should use more exterior-releasing herbs to disperse Yang Qi, adding a small amount of herbs that moisten dryness. If wind pulse and wind symptoms are seen, only exterior-releasing wind-dispelling herbs can be used, which will facilitate bowel movement. If it is merely dryness and constipation, only moistening methods should be applied; purgation is contraindicated. (Note: There may be missing text after "ke" [can].)
Chan Chuang (Skin sores and ulcers) presenting with aversion to cold and fever, profuse sweating, or alternating chills and fever (either chills first then fever, or fever first then chills), occurring daily or every other day. These episodes must be preceded by vomiting phlegm. After the chills and fever resolve, profuse sweating occurs. *Jing Yao* (Essentials) states that the above syndromes should not be exclusively attributed to heat. They may also result from Qi deficiency, anger, or initial exposure to cold pathogens leading to spleen Qi disharmony.
Zhu Danxi said: For those caused by Qi deficiency, tonifying Qi herbs should be used. For those caused by anger, herbs that regulate Qi should be used to harmonize. For those due to spleen Qi disharmony, splein-regulating herbs should be used. Now, using Bu Huan Jin Zheng Qi San (Unchanging Metal Upright Qi Decoction), which consists entirely of warming, dispersing, and Wei Qi-draining herbs, how can one expect one or two qian of Ren Shen (Ginseng Root) to rectify the Wei Qi depletion caused by fourteen liang of these draining herbs? If used for Chan Chuang (sores/ulcers) where cold pathogens were contracted during the swelling stage, it might be acceptable. But can this formula simultaneously treat those with Qi deficiency, those affected by anger, and those with spleen Qi disharmony? Moreover, is it unknown whether it is intended for the swelling stage or the ulcerative stage?
Whenever Ju (Deep abscesses) causes sores in the throat, pharynx, mouth, and tongue, *Jing Yao* (Essentials) blames the failure to use internal support (Nei Tuo) methods, allowing heat toxins to rush to the heart.
A noble person suffered from this condition and was given Hu Po Xi Jiao Gao (Amber and Rhinoceros Horn Paste), recovering in one day.
Zhu Danxi said: Using it during the swelling stage is still somewhat reasonable. However, if used after the ulcerative stage, the ascending and dispersing nature of Xi Jiao (Rhinoceros Horn) would surely exacerbate pathogens and deplete healthy Qi, hastening death. Later, there was a case of Xi Jiao San (Rhinoceros Horn Powder) assisted by Da Huang (Rhubarb Root) and Huang Qi (Astragalus Root). The use of Huang Qi indicates an awareness of deficiency. The use of Da Huang seems to suspect excess heat. In the pus-forming stage of Chan Chuang (sores/ulcers), the body is deficient. Even if old heat exists, it will gradually dissipate as pus and blood are discharged. Why use harsh, cold, purgative herbs to disturb the Zang-Fu organs? If used in autumn or winter, what difference is there from swords and knives?