阴疽之形，皆阔大平塌，根盘坚硬，皮色不异，或痛或不痛，乃外科最险之证。倘误服
寒凉，其色变如隔宿猪肝，毒攻五内，神昏即死。治之之法，非麻黄不能开其腠理，非肉桂、炮
姜不能解其凝寒；腠理一开，寒凝一解，气血流行，则患随消矣。血气不能化毒者，则宜温
补排脓，虽当溃脓，而毒瓦斯未尽，肿硬未消，亦仍以温气血开腠理为要。大抵初起患轻，未
经误药者，可用加味二陈汤（通用十八。）纳阳和丸（通用六。）同煎数服消之。如曾经误药，
或皮色稍变，须服阳和汤（通用五。）其甚者，与犀黄丸（通用四十八。）早晚轮服。溃后亦然
。如失荣、恶核、石疽等证，初起毒根深固者，须更兼紫元丹（通用五十一。）间服方能全消
。凡详见于各部中，宜同参用。
一、初起兼头痛、发热、恶寒、肢体拘急等表证者，先以保安万灵丹（通用五十四。）汗
之，或人参败毒散（通用三。）去独活加桂枝一钱汗之，待表证退，按前法治之。
一、溃后忽见表证，则以托邪饮（通用十二。）加桂枝一钱煎服。少倾，啜热粥一瓯，暖
卧微汗取效，不可令大汗。如未效，再进。待表势解，须接补元气，用补中益气汤加茯苓、半夏
、熟地最妙。
一、初起或溃后欲呕，而别无表证者，胃气虚也，六君子汤（通用二十一。）加炮干姜主
之。
一、溃后但恶寒而不发热者，阳气虚也，十全大补汤（通用二十六。）加姜、附主之。
一、溃后见晡热、内热证者，阴血虚也，四物汤（通用二十三。）去川芎，倍熟地，加参
、术、地骨皮、甘草主之。
一、大患久溃，或脓血去多，忽见发热恶寒，面赤烦躁，口虽渴而喜热饮者，此血虚发
躁，急以当归补血汤，（通用三十三。）或当归黄 汤（通用三十四。）服之。否则发痉。
一、溃后口干作渴，饮水不歇，小便频数，或淋漓作痛，或舌上燥黄如金色者，乃肾水
枯竭，心火炎炽，此证最恶，急用加减八味丸（通用四十六。）以滋补之，否则不救，迟治亦不救
一、溃后喘促咳嗽，脾肺虚也，补中益气汤，去升麻加茯苓、半夏、五味子主之。或加
熟地，口燥者加麦门冬。
一、溃延日久，病患脾虚气滞者，则先服六君子汤加芎、归数剂，参、术、草宜生，忌
炙。待其饮食复常，再按前法治之。凡经表汗后，亦如是治。
一、好饮之人，每发酒毒，如阴疽状，发无定处。初起漫肿，内似结核，不红或淡红，
重着板痛，多有兼头晕发热汗出呕吐之证。此元气大伤，酒毒熏蒸，结滞经隧。治宜清利湿热，
培补元气。内服加味解酲汤，（见发无定处痼发下。）外以赤小豆为末，滚水或米醋调敷，或
以乌龙膏（通用六十。）敷之。若误投阳和汤，小金丹等甘热之药，轻则呕吐脓血，重则神昏
发狂，成痉不救。此证从前未经发明，余历视颇多，特表揭于此。毫厘千里，生死攸关，业
医者细心审辨焉。
一、凡色白大少阴疽，忌贴洞天、千捶、鲫鱼等膏。盖寒凉不利于阴疽，且内有巴豆、
蓖麻子，未溃者贴则致溃，已溃者贴则致命，有孕者贴则堕胎。故凡阴疽未溃者，宜敷抑阴散，
（通用五十八。）既溃后，宜贴阳和解凝膏。（通用七十七。）
一、犀黄丸、（通用四十八。）小金丹、（通用五十二。）内有麝香，妊妇忌服，当以阳和
汤愈之。愈后再服三、四剂，以代小金丹，永杜后患。
一、小儿不能服煎剂者，以小金丹化服代之。
The morphology of Yin Ju (Yongorous Abscess) is characterized by being broad, large, flat, and depressed, with a hard base and no obvious change in skin color. It may be painful or painless, representing the most dangerous condition in surgery. If cold-natured medicines are mistakenly taken, the color of the lesion will turn like a liver from the previous night; if the toxin attacks the five internal organs, the patient will fall into coma and die immediately. The method of treatment requires Ephedrae Herba (Mahuang, 麻黄) to open the Couli (skin pores and interstices), and Cinnamon Twig Decoction (Rougui Tang, 肉桂) combined with Prepared Ginger Rhizome (Paojiang, 炮姜) to resolve the coagulated cold. Once the Couli are opened and the cold resolved, Qi and Blood circulate freely, and the lesion will subside. If Qi and Blood cannot transform the toxin, warm tonification and pus drainage should be employed. Even when suppuration occurs, if the toxic vapor is not fully exhausted and swelling/hardness persists, the key remains warming Qi and Blood and opening the Couli. Generally, for mild cases at the initial stage that have not been mistreated, Jiawei Erchen Tang (Modified Two-Aged Decoction) can be decocted together with Yanghe Wan (Yanghe Pill) for several doses to eliminate the condition. If there has been prior medication error or slight changes in skin color, Yanghe Tang (Yanghe Decoction) must be taken. For severe cases, Xihuang Wan (Xihuang Pill) should be administered alternately morning and evening. This approach applies equally after suppuration. For conditions such as Shiyun (Loss of Prosperity), Ehe (Malignant Nodule), and Shiju (Stone Abscess), where the toxin root is deep-seated at onset, Ziyuan Dan (Ziyuan Pill) should be taken intermittently along with other treatments to ensure complete resolution. Refer to detailed descriptions in respective sections for combined use.
1. If initial symptoms include headache, fever, aversion to cold, and limb stiffness (Exterior Syndrome), first administer Bao'an Wanling Dan (Bao'an Ten-Thousand Spirit Pill) to induce sweating, or Ren Shen Baidu San (Ginseng Detoxifying Powder) minus Achyranthis Bidentatae Radix (Duhuo, 独活) plus one qian of Cinnamon Twig (Guizhi, 桂枝) to induce sweating. After exterior symptoms resolve, treat according to the aforementioned methods.
2. If exterior symptoms suddenly appear after suppuration, administer Tuoxie Yin (Toxin-Expelling Infusion) plus one qian of Cinnamon Twig (Guizhi, 桂枝). Shortly after, drink a bowl of hot porridge, keep warm, and aim for slight sweating. Profuse sweating must be avoided. If ineffective, repeat the dose. Once exterior symptoms resolve, proceed to tonify Yuan Qi (Original Qi) using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Poria (Fuling, 茯苓), Pinellia (Banxia, 半夏), and Prepared Rehmannia Root (Shudi, 熟地) for best results.
3. If nausea occurs at onset or after suppuration without other exterior symptoms, it indicates Stomach Qi deficiency. Treat with Liujunzi Tang (Six Gentlemen Decoction) added with Prepared Dried Ginger (Paoganjiang, 炮干姜).
4. If only aversion to cold without fever occurs after suppuration, it indicates Yang Qi deficiency. Treat with Shiquan Dabu Tang (Ten Complete Tonifying Decoction) added with Fresh Ginger (Shengjiang, 生姜) and Aconite Root (Fuzi, 附子).
5. If afternoon fever and internal heat occur after suppuration, it indicates Yin Blood deficiency. Treat with Siwu Tang (Four Substances Decoction) minus Ligusticum Chuanxiong Rhizome (Chuanxiong, 川芎), double the amount of Prepared Rehmannia Root (Shudi, 熟地), and add Ginseng (Renshen, 人参), Atractylodes Macrocephala Rhizome (Baizhu, 白术), Groundcherry Root (Digupi, 地骨皮), and Licorice Root (Gancao, 甘草).
6. In severe chronic ulcers with excessive loss of pus and blood, sudden onset of fever, aversion to cold, red face, irritability, thirst but preference for hot drinks indicates Blood deficiency causing restlessness. Immediately administer Danggui Buxue Tang (Angelica Tonifying Blood Decoction) or Danggui Huangqi Tang (Angelica and Astragalus Decoction). Otherwise, spasms may develop.
7. If dry mouth and thirst persist after suppuration, frequent urination, dysuria, or a dry yellow tongue resembling gold, this indicates exhaustion of Kidney Water and blazing Heart Fire. This is a dire prognosis requiring immediate administration of Jiajian Bawei Wan (Modified Eight-Ingredient Pill) for nourishment. Delayed treatment is also fatal.
8. If panting and coughing occur after suppuration, it indicates Spleen and Lung deficiency. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) minus Cyathulae Radix (Shengma, 升麻), added with Poria (Fuling, 茯苓), Pinellia (Banxia, 半夏), and Schisandra Fruit (Wuweizi, 五味子). Alternatively, add Prepared Rehmannia Root (Shudi, 熟地); if dry mouth exists, add Ophiopogon Tuber (Maidong, 麦门冬).
9. For prolonged ulcers with Spleen deficiency and Qi stagnation, first administer Liujunzi Tang (Six Gentlemen Decoction) added with Ligusticum Chuanxiong Rhizome (Chuanxiong, 川芎) and Angelica Sinensis Radix (Danggui, 当归) for several doses. Use raw Ginseng (Renshen, 人参), Atractylodes Macrocephala Rhizome (Baizhu, 白术), and Licorice Root (Gancao, 甘草); avoid honey-fried versions. Once diet normalizes, resume previous treatments. This applies similarly after diaphoresis.
10. Individuals fond of alcohol often suffer from Wine Toxin manifesting like Yin Ju, with unpredictable locations. Initial presentation involves diffuse swelling, internal nodules, non-red or pale-red skin, heaviness, board-like hardness, and pain, often accompanied by dizziness, fever, sweating, and vomiting. This indicates severe damage to Yuan Qi (Original Qi), steaming by wine toxin, and stagnation in meridians. Treatment should clear damp-heat and tonify Yuan Qi (Original Qi). Internally, take Jiawei Jiecheng Tang (Modified Sobering Decoction). Externally, apply powdered Adzuki Bean (Chixiaodou, 赤小豆) mixed with boiling water or rice vinegar, or apply Wulong Gao (Black Dragon Ointment). Mistakenly using Yanghe Tang (Yanghe Decoction) or Xiaojin Dan (Small Gold Pill), which are sweet and hot, can cause vomiting of pus and blood, coma, mania, spasms, and death. This condition was previously unclarified; I have treated many cases and reveal them here. A slight error leads to great consequences, affecting life and death; practitioners must examine carefully.
11. For large, pale-colored Shaoyin Yin Ju (Yongorous Abscess), avoid Dongtian Gao (Cave Heaven Ointment), Qianchui Gao (Thousand Hammer Ointment), and Crucian Carp Ointment. Cold-natured medicines are detrimental to Yin Ju. These ointments contain Croton Seed (Badou, 巴豆) and Castor Seed (Bimazi, 蓖麻子). Application on intact skin causes ulceration; on open wounds, it is fatal; in pregnancy, it causes abortion. Therefore, for un-ulcerated Yin Ju, apply Yiyin San (Suppress Yin Powder). For ulcerated Yin Ju, apply Yanghe Jiening Gao (Yanghe Resolving Hardness Ointment).
12. Xihuang Wan (Xihuang Pill) and Xiaojin Dan (Small Gold Pill) contain Musk (Shexiang, 麝香) and are contraindicated in pregnancy. Use Yanghe Tang (Yanghe Decoction) instead. After recovery, take three to four additional doses to substitute for Xiaojin Dan (Small Gold Pill) and prevent recurrence.
13. For children unable to take decoctions, dissolve Xiaojin Dan (Small Gold Pill) in water for administration as a substitute.