夫疮疡之证候不同，寒热虚实，皆能为痛。止痛之法，殊非一端。世人皆谓乳没可
以止痛，殊不知因病制宜，自有活法。故因热而痛者，以寒凉之剂折其热，则痛自止也。
因寒而痛者，以温热之药熨其寒，则痛自除也。因风而痛者，除其风。因湿而痛者，除
其湿。燥而痛者润之，塞而痛者通之，虚而痛者补之，实而痛者泻之，脓郁而闭者开之，
恶肉浸溃者引之，阴阳不和者调之，经络滞涩者利之，忧愁者远志酒饮之，虚塞而痛者
乳香没药止之。大抵痈疽不可不痛，不可大痛，若大痛闷乱者危。
薛新甫云∶疮疡之作，由六淫七情所伤，其痛也，因气血凝滞所致。假如热毒在内，便
秘而作痛者，内疏黄连汤导之。热毒炽盛， 肿而作痛者黄连解毒散治之，不应，仙方活
命饮解之。瘀血凝滞而作痛者，乳香定痛散和之。作脓而痛者，托里消毒散排之。脓胀
而痛者针之，脓溃而痛者补之，若因气虚而痛，四君加归 。血虚而痛，四物加参 。肾
虚而痛，六味地黄丸。口干作渴，小便频数者，加减八味丸。此皆止痛之法也。
若高肿 痛，热毒也，加黄连。漫肿微痛，气虚也，去金银花、连翘，加参、术。肿
赤作痛，血凝滞也，加乳香、没药，如不应，暂用仙方活命饮。脓出反痛，气血虚也，去
金银花、连翘、白芷，加参、 、归、地。漫肿不痛，或肉死不溃，脾气虚也，去三味，加
人参、白术；如不应，加姜、桂；更不应，急加附子。（《准绳》 三味金银花、连翘、白芷）
寒热虚实，皆能为痛。止痛之法，殊非一端，随症施之，其痛自止。不必拘拘于乳
没也。又疮疡不可不痛，不痛为胃气虚极也，不治。不可大痛，兼烦闷者不治。再麻痒者
更为恶候。（《大成》）
The manifestations of sores and ulcers vary, and pain can be caused by cold, heat, deficiency, or excess. The methods for relieving pain are not limited to a single approach. People generally believe that Ru Xiang (Frankincense) and Mo Yao (Myrrh) can relieve pain, failing to realize that treatment must be tailored to the specific condition, employing flexible methods. Therefore, when pain is caused by heat, cooling agents should be used to subdue the heat, and the pain will cease naturally. When pain is caused by cold, warming agents should be used to dispel the cold, and the pain will be eliminated naturally. When pain is caused by wind, the wind should be expelled; when caused by dampness, the dampness should be removed. If caused by dryness, moisten it; if caused by obstruction, unblock it; if caused by deficiency, tonify it; if caused by excess, purge it. If caused by pus retention and blockage, open the blockage; if caused by foul tissue erosion and ulceration, guide the discharge out; if caused by disharmony of Yin and Yang, harmonize them; if caused by stagnation and涩 (obstruction) in the meridians, promote circulation. If caused by sorrow, administer Yuan Zhi Jiu (Polygala Wine). If caused by Qi and Blood deficiency with stagnation, use Ru Xiang (Frankincense) and Mo Yao (Myrrh) to stop the pain. Generally speaking, carbuncles and sores cannot be completely painless, but they should not cause severe pain. If the pain is so severe as to cause confusion and distress, the condition is critical.
Xue Xinpu stated: Sores and ulcers arise from injuries caused by the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). The pain results from the stagnation of Qi and Blood. For instance, if internal heat-toxin causes constipation and pain, Nei Shu Huang Lian Tang (Internal Draining Coptis Decoction) should be used to guide the expulsion. If heat-toxin is flourishing, causing swelling and pain, Huang Lian Jie Du San (Coptis Detoxification Powder) should be used; if ineffective, Xian Fang Huo Ming Yin (Immortal Formula for Preserving Life) should be used to resolve it. If pain is caused by blood stasis and stagnation, Ru Xiang Ding Tong San (Frankincense Pain-Stopping Powder) should be used to harmonize. If pain occurs during suppuration, Tuo Li Xiao Du San (Supporting Interior and Eliminating Toxin Powder) should be used to drain the pus. If pain is caused by distension of pus, needle drainage should be employed. If pain persists after the pus has drained, tonification should be applied. If pain is due to Qi deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) should be modified with Dang Gui (Angelica Sinensis) and Huang Qi (Astragalus). If pain is due to Blood deficiency, Si Wu Tang (Four Substances Decoction) should be modified with Ren Shen (Ginseng) and Huang Qi (Astragalus). If pain is due to Kidney deficiency, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) should be used. If there is dry mouth with thirst and frequent urination, Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) should be administered. These are all methods for relieving pain.
If there is high swelling with pain, it indicates heat-toxin; add Huang Lian (Coptis). If there is diffuse swelling with slight pain, it indicates Qi deficiency; remove Jin Yin Hua (Honeysuckle), Lian Qiao (Forsythia), and add Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala). If there is red swelling with pain, it indicates blood stagnation; add Ru Xiang (Frankincense) and Mo Yao (Myrrh); if ineffective, temporarily use Xian Fang Huo Ming Yin (Immortal Formula for Preserving Life). If pain increases after pus drainage, it indicates Qi and Blood deficiency; remove Jin Yin Hua (Honeysuckle), Lian Qiao (Forsythia), and Bai Zhi (Angelica Dahurica); add Ren Shen (Ginseng), Huang Qi (Astragalus), Dang Gui (Angelica Sinensis), and Di Huang (Rehmannia). If there is diffuse swelling without pain, or necrotic flesh that does not ulcerate, it indicates Spleen Qi deficiency; remove the aforementioned three herbs, and add Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala); if ineffective, add Gan Jiang (Dried Ginger) and Rou Gui (Cinnamon Bark); if still ineffective, urgently add Fu Zi (Prepared Aconite). (Note from *Zhun Sheng*: The "three herbs" refer to Jin Yin Hua, Lian Qiao, and Bai Zhi.)
Pain can be caused by cold, heat, deficiency, or excess. The methods for relieving pain are not limited to one approach; treat according to symptoms, and the pain will cease naturally. Do not rigidly rely solely on Ru Xiang (Frankincense) and Mo Yao (Myrrh). Furthermore, sores and ulcers cannot be completely painless; if there is no pain, it indicates extreme deficiency of Stomach Qi, which is untreatable. They should not cause severe pain either; if accompanied by irritability and distress, it is also untreatable. Additionally, numbness and itching constitute a more ominous prognosis. (From *Wai Ke Da Cheng*)