李氏云∶大抵疽口紧小而硬者，盖因风毒所胜，合用蚣蝎散掺疮口，以神异膏贴之。
蚣蝎散
赤足蜈蚣（一条去头足） 全蝎（三个去足生用）
上为末，用猪蹄汤净洗，搽之。
愚按∶前症乃风寒滞于疮口，而未传于内也。凡伤损之症，尤多此患。经云∶风症善行
而数变，入脏甚速，死生在乎反掌，当急分表里虚实而治之。其邪在表者，善伸数欠，筋脉
拘急，恶寒惕搦，脉浮而弦，宜羌活防风汤和解之。传于里者，舌强口噤，项背反张，筋惕
搐搦，痰涎壅盛，胸腹满闷，或便溺闭赤，时或汗出，脉洪数而弦，宜大芎黄汤 导之。其
汗初出者，由风热郁于里，亦宜大芎黄汤之类下之。若热既退，脏腑已和，而汗仍出者，表
虚也，宜白术防风汤以实其表。然解散、和解、 导三法，此治暴患之症，气血未损者。若
脓瘀内 ，而见前症者，宜针之，急投十全大补。或口噤遗尿，乃气血虚极，亦用十全大补
加炮附子。大抵此症，若因脓血去多，宜以补中益气加羌活主之。或人素多痰，因伤损而见
风症，宜二陈、白术、芎、归、栀子、芩、连。气虚加四君，血虚加四物，血气俱虚内热甚
而生风者，宜四物、参、术、柴、芩、栀子。若因怒伤而见前症，宜小柴胡汤倍加川芎、山
栀、天麻、钩藤钩。若患破伤风，至三五年忽然复发，或跌扑而患者，皆气虚有痰所致也，
用二陈加参、术、芎、归主之（治验见正体部）。
Li stated: Generally, when the opening of a carbuncle or ulcer is tight, small, and hard, it is due to the predominance of wind-toxin. One should apply Gongxie San (Centipede and Scorpion Powder) to the wound surface and cover it with Shenyi Gao (Miraculous Ointment).
Gongxie San (Centipede and Scorpion Powder)
Gecko Centipede (Scolopendra subspinipes mutilans) (one strip, remove head and feet)
Whole Scorpion (Buthus martensii) (three, keep feet, use raw)
Grind the above into powder. Clean the wound thoroughly with pig trotter soup, then apply the powder.
My commentary: The aforementioned symptoms are caused by wind-cold stagnating at the wound site without having transmitted inward. This condition is particularly common in trauma cases. The Classics state: "Wind diseases move freely and change frequently; once entering the zang organs, the progression is very rapid, and life or death depends on a moment's notice." Therefore, one must urgently differentiate between exterior and interior, excess and deficiency, and treat accordingly. If the pathogen is in the exterior, manifesting as frequent stretching and yawning, tendon and vessel spasm, aversion to cold, and tremors or convulsions, with a floating and wiry pulse, Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) should be used to harmonize the exterior. If the pathogen has transmitted to the interior, manifesting as a stiff tongue, trismus, opisthotonos, muscle twitching and convulsions, profuse phlegm-saliva, chest and abdominal fullness and oppression, or constipation and dark urine, accompanied by occasional sweating and a surging, rapid, and wiry pulse, Daxiong Huang Tang (Large Cyperi and Rhubarb Decoction) should be used to guide out the heat via purgation. If sweating occurs initially, it is due to wind-heat郁结 (stagnating) in the interior, and purgatives such as Daxiong Huang Tang are also appropriate. If the heat has subsided, the internal organs have harmonized, but sweating persists, this indicates exterior deficiency; Baizhu Fangfeng Tang (Atractylodes Macrocephala and Saposhnikovia Decoction) should be used to consolidate the exterior. However, the methods of dispersing, harmonizing, and guiding/purging are applicable only to acute conditions where qi and blood have not yet been depleted. If pus and blood are stagnant internally presenting with these symptoms, acupuncture should be employed to drain them, followed immediately by Shiquan Dabu Tang (Complete Ten Tonics Decoction). If trismus and urinary incontinence occur, indicating extreme deficiency of qi and blood, Shiquan Dabu Tang combined with Pao Fuzi (Prepared Aconite Root) should be used. Generally, if this condition arises from excessive loss of pus and blood, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Qianghuo (Notopterygium Rhizome) should be the primary treatment. Or, if a patient who is constitutionally prone to phlegm develops wind symptoms after trauma, Erchen Tang (Two-Cured Decoction), Baizhu (Atractylodes Macrocephala Rhizome), Xiong (Cyperi Rhizoma), Gui (Angelicae Sinensis Radix), Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), and Lian (Coptidis Rhizoma) should be used. For qi deficiency, add Sijunzi Tang (Four Gentlemen Decoction); for blood deficiency, add Siwu Tang (Four Substances Decoction); for simultaneous qi and blood deficiency with severe internal heat generating wind, Siwu Tang, Renshen (Ginseng Radix), Baizhu, Chaihu (Bupleuri Radix), Huangqin, and Zhizi should be used. If the symptoms arise from anger injuring the liver, Xiaochaihu Tang (Minor Bupleurum Decoction) with increased doses of Chuanxiong (Ligusticum Chuanxiong Rhizome), Zhizi, Tianma (Gastrodiae Rhizoma), and Goutenggou (Uncariae Ramulus cum Uncis) should be used. If traumatic tetanus recurs suddenly after three to five years, or results from falls and blows, it is caused by qi deficiency with phlegm; Erchen Tang added with Renshen, Baizhu, Chuanxiong, and Danggui (Angelicae Sinensis Radix) should be the main treatment (clinical cases see Zhengti Bu [Standard Treatment for Traumatology]).