一夫人性刚多怒。胸前作痛。肉色不变。脉数恶寒。经曰。洪数脉。应发热。反恶寒。
也。今脉洪数则脓已成。但体丰浓。故色不变。似乎无脓。以痛极始肯针。入数寸。脓数碗
。以清肝消毒药治之而愈。设泥其色而不用针。无可救之理。（此凭症脉也。）
一人年逾四十。胸患疮成漏。日出脓碗许。喜饮食如常。用十全大补汤。（十三）加远志
、贝母、白蔹、续断。灸以附子饼。脓渐少。调护岁余而愈。（此凭症也。）
一少妇胸膺间溃一窍。脓血。与口中所咳相应而出。以参、 、当归。加退热排脓等药
而愈。一说此因肺痿所致。
一人胸肿一块。半载不消。令灸百壮方溃。服大补药不敛。灸附子饼而愈。（此凭症也
一百户胸患毒。肿高 赤。发热脉数。大小便涩。饮食如常。齐氏曰。肿起色赤。寒热
。皮肤壮热。头目昏重。气血实也。又曰。大小便涩。饮食如故。肠满膨胀。胸膈痞闷。肢
节疼痛。身热脉大精神昏塞。脏腑实也。进黄连内疏汤（三）二剂。诸症悉退。更以荆防败毒
散。加黄芩、山栀四剂少愈。再以四物加芩连、白芷、桔梗、甘草、金银花数剂而消。（此
凭脉症也。）
机按此项治法。虽因脉症皆实而用泄法。然泄法又有前后次序。先攻里。后发表。最后
又用和解。前贤治病。不肯孟浪如此。学人可不以此为法哉。
A woman with a stern and irritable temperament experienced pain in her chest. The skin color remained unchanged, her pulse was rapid (Shu), and she felt aversion to cold. The medical classics state: A洪 (Hong) and rapid pulse typically corresponds to fever; the fact that she feels aversion to cold instead is consistent with the pathology. Currently, the 洪 (Hong) and rapid pulse indicates that pus has already formed. However, due to her robust and fleshy physique, the surface appearance did not change, seemingly indicating no pus. She only consented to acupuncture when the pain became extreme. Upon insertion of several inches, several bowls of pus were drained. She was treated with herbs for clearing liver heat and detoxification and recovered. (This diagnosis relied on symptoms and pulse.)
Another individual, over forty years old, suffered from a chest abscess that developed into a fistula, discharging approximately one bowl of pus daily. Despite this, his appetite and diet remained normal. He was prescribed Shiquan Dabu Tang (Ten Thousand Benefit Decoction) supplemented with Yuanzhi (Radix Polygalae), Beimu (Bulbus Fritillariae Cirrhosae), Bailian (Radix Anemones Raddeanae), and Xuduan (Radix Dipsaci). He also received moxibustion using Aizi Bing (Moxa cakes prepared with Fuzi). The discharge gradually decreased, and after more than a year of care and recuperation, he recovered. (This diagnosis relied on symptoms.)
A young woman had an ulcerated opening between her chest and diaphragm, discharging pus and blood that corresponded with what she coughed up from her mouth. She was treated with Renshen (Radix Ginseng), [text missing in original, likely Huangqi or similar], Danggui (Radix Angelicae Sinensis), along with herbs for reducing fever and expelling pus, and recovered. Another opinion suggests this condition was caused by Fei Wei (Lung Atrophy).
Another person had a swelling on the chest that persisted for half a year without subsiding. He was instructed to undergo moxibustion for one hundred Zhu (units of moxa cone size/burns) until it suppurated. Taking general tonic herbs failed to heal the wound, but treatment with Aizi Bing moxibustion led to recovery. (This diagnosis relied on symptoms.)
A military officer titled "Baihu" suffered from a toxic swelling in the chest, which was high, red, accompanied by fever and a rapid pulse. His urination and defecation were obstructive, yet his diet remained normal. Qi Shi stated: Swelling that rises and turns red, accompanied by alternating chills and fever, hot skin, and heavy/dizzy head and eyes, indicates an Excess pattern of Qi and Blood. He further stated: Obstructive urination and defecation with normal diet, abdominal fullness and distension, chest and diaphragm stuffiness, pain in limbs and joints, body heat, large pulse, and mental confusion indicate an Excess pattern of the Zang-Fu organs. He administered Lianglian Neishu Tang (Coptis Internal Purging Decoction) for two doses, after which all symptoms receded. Subsequently, Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity) with added Huangqin (Radix Scutellariae) and Shanzhi (Fructus Gardeniae) was given for four doses, resulting in slight improvement. Finally, Siwu Tang (Four Substance Decoction) supplemented with Huangqin, Huanglian (Rhizoma Coptidis), Baizhi (Radix Angelicae Dahuricae), Jiegeng (Radix Platycodonis), Gancao (Radix Glycyrrhizae), and Jinyinhua (Flos Lonicerae Japonicae) was administered for several doses, leading to the resolution of the swelling. (This diagnosis relied on pulse and symptoms.)
Ji's commentary: Although this treatment method employs purgative techniques because both pulse and symptoms indicate excess, there is a specific sequence to purgation: first attacking the interior, then releasing the exterior, and finally using harmonizing methods. Ancient sages did not treat diseases so recklessly. Should learners take this as a standard model?