薛立斋治一男子，患鬓疽， 肿作痛，发热，以小柴胡汤加连翘、金银花、桔梗，四剂而消。
一男子因怒后鬓际肿痛发热，以小柴胡汤加连翘、银花、花粉、桔梗，四剂根畔俱消。惟疮头作
痛，以仙方活命饮二剂，痛止。脓成针之，更以托里消毒药而愈。
一男子头面 肿作痛，时仲冬，脉弦紧，以托里温经汤汗之而愈。
一男子患此症，肿痛，寒热拘急，脉浮数，以荆防败毒散二剂，表症悉退。更以托里消毒散溃之
而安。
一男子患此症，脓熟不溃，胀痛，针之而止。更以托里消毒散而愈。凡疮脓熟不溃，属气血虚也。
若不托里，必致难瘥。
一男子患此症，作脓 痛，发呕少食，以仙方活命饮，一剂而止。以六君子汤加当归、桔梗、角
刺，溃而愈。
一男子患此症，脓清不敛，以托里散加乳香、麦冬而敛。
一老人患此症，肿痛发热，脓清作渴，脉软而涩，此血气俱虚也。欲补之，彼见作渴发热，乃服
降火之剂，果作呕少食。复求治，投六君子汤四剂，呕止食进。仍用补药，月余而愈。夫患者脏腑血
气上下，各有虚实，况阴症似阳，阳症似阴，岂可以发热作渴而概用寒凉之剂？常治患者，正气虚，
邪气实，以托里为主，消毒佐之。正气实，邪气虚，以攻毒为主，托里佐之。正气虚，邪气实，而专
用攻毒，则先损胃气。宜先用仙方活命饮，托里消毒散，或用灸法，俟邪气退，正气复，再酌量治之。
大抵正气夺则虚，邪气胜则实。盖邪正不并立，一胜则一负，其虚不待损而自虚矣。若发背脑疽疔毒
及患在四肢，必用灸法，拔引郁毒，以行瘀滞，尤不可专于攻毒。诊其脉而辨之，庶不自误。
一男子患此症，肿 痛甚，发寒热，服十宣散愈炽。诊之，脉数而实，此表里俱有邪也。以荆防
败毒散加芩、连、大黄，二剂少愈。更以荆防败毒散，四剂而消。大抵疮疡之症，肿 痛甚，寒热往
来，或大便秘结，小便淋漓，心神溃闷，恍惚不宁，皆邪热之实也，岂可补哉？东垣云∶疮疽之法，
其受之有内外之别，治之有寒温之异。受之外者，法当托里以温剂，反用寒剂，则是皮毛始受邪，引
入骨髓。受之内者，法当疏利以寒剂，反用温剂托里，则是骨髓之病，上彻皮毛，表里通溃，共为一
疮，助邪为毒，苦楚百倍，轻则危殆，重则死矣。
赵宜人年逾七十，患鬓疽已溃， 肿痛甚，喜冷脉实，大便秘涩。东垣云∶烦躁饮冷，身热脉大，
精神昏闷者，皆脏腑之实也。遂以清凉饮一剂，肿痛悉退。更以托里消毒药，三十余剂而平。若谓年
高溃后，投以补剂，实实之祸不免矣。
维阳俞黄门，年逾三十，冬月鬓患毒肿， 烦躁，便秘脉实，此胆经风热壅上而然也。马氏云∶
疮疡之症，
热壅而不利者，大黄汤下之。遂以一剂，便通疮退。更以荆防散败毒散二剂，再以十宣散去桂，加花
粉、银花，数剂而愈。大宗伯罗公耳后发际患此 痛，脉紧数，以小柴胡汤加桔梗、牛蒡、银花，四
剂而愈。
Dr. Xue Lizhai treated a male patient suffering from temporal carbuncle (Bìn Jū), presenting with swelling, pain, and fever. He prescribed Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Lian Qiao (Forsythiae Fructus), Jin Yin Hua (Lonicerae Japonicae Flos), and Jie Geng (Platycodonis Radix). After four doses, the swelling subsided.
Another male patient developed swelling, pain, and fever at the hairline due to anger. Dr. Xue prescribed Xiao Chai Hu Tang with added Lian Qiao, Yin Hua (Lonicerae Japonicae Flos), Hua Fen (Trichosanthis Radix), and Jie Geng. After four doses, the base of the lesion resolved completely. However, pain persisted at the head of the sore. He then prescribed Xian Fang Huo Ming Yin (Immortal Life-Saving Elixir) for two doses, which stopped the pain. Once pus formed, he punctured it with a needle, followed by Tuo Li Xiao Du Yao (Internal-Strengthening and Toxin-Resolving Medicine) until recovery.
A male patient presented with facial swelling and pain during mid-winter (the eleventh lunar month). His pulse was wiry and tight. Dr. Xue used Tuo Li Wen Jing Tang (Internal-Strengthening and Meridian-Warming Decoction) to induce sweating, resulting in recovery.
A male patient suffered from this condition with swelling, pain, chills, fever, and limb stiffness. His pulse was floating and rapid. He took Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Powder to Resolve Toxicity) for two doses, after which all exterior symptoms disappeared. Subsequently, Tuo Li Xiao Du San (Internal-Strengthening and Toxin-Resolving Powder) was used to promote suppuration and healing.
Another male patient had mature pus that failed to rupture, causing distending pain. Puncture relieved the pain, and Tuo Li Xiao Du San led to recovery. Generally, when pus matures but does not rupture, it indicates deficiency of Qi and Blood. Without internal-strengthening methods, recovery will be difficult.
A male patient experienced pain during pus formation, accompanied by vomiting and poor appetite. One dose of Xian Fang Huo Ming Yin stopped these symptoms. Then, Liu Jun Zi Tang (Six Gentlemen Decoction) with added Dang Gui (Angelicae Sinensis Radix), Jie Geng, and Jiao Ci (Gleditsiae Spina) promoted suppuration and recovery.
A male patient had clear, thin pus that failed to heal. Tuo Li San (Internal-Strengthening Powder) with added Ru Xiang (Olibanum) and Mai Dong (Ophiopogonis Tuber) promoted healing.
An elderly patient presented with swelling, pain, fever, clear thin pus, thirst, and a soft, choppy pulse, indicating dual deficiency of Blood and Qi. Although the patient desired tonification, he mistakenly took heat-clearing drugs due to thirst and fever, leading to vomiting and anorexia. Upon re-treatment, Liu Jun Zi Tang for four doses stopped vomiting and improved appetite. Continued tonic treatment resulted in recovery after more than a month. The viscera and Qi-Blood have varying excesses and deficiencies above and below. Moreover, Yin syndromes may resemble Yang, and Yang syndromes may resemble Yin. How can one indiscriminately use cold-natured drugs simply because of fever and thirst? Typically, if Zheng Qi (Upright Qi) is deficient and Xie Qi (Pathogenic Qi) is excessive, the primary method is Tuo Li (Supporting the Interior), assisted by Xiao Du (Resolving Toxicity). If Zheng Qi is sufficient and Xie Qi is deficient, the primary method is Gong Du (Attacking Toxicity), assisted by Tuo Li. If Zheng Qi is deficient and Xie Qi is excessive, using only attacking methods damages Stomach Qi first. One should initially use Xian Fang Huo Ming Yin or Tuo Li Xiao Du San, or apply moxibustion. Wait for pathogenic factors to recede and upright Qi to recover before adjusting treatment. Generally, loss of Zheng Qi leads to deficiency; victory of Xie Qi leads to excess. Pathogen and upright Qi cannot coexist; when one wins, the other loses. Deficiency manifests naturally without needing further depletion. For conditions like back carbuncles, brain carbuncles, carbuncles on limbs, moxibustion is essential to draw out stagnant toxins and move blood stasis. One must not rely solely on attacking methods. Differentiate via pulse diagnosis to avoid self-mistreatment.
A male patient suffered severe swelling and pain with chills and fever. After taking Shi Xuan San (Ten Vitality Powder), his condition worsened. His pulse was rapid and forceful, indicating pathogenic factors in both interior and exterior. Jing Fang Bai Du San with added Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Da Huang (Rhei Radix et Rhizoma) for two doses brought slight improvement. Four doses of Jing Fang Bai Du San resolved the condition. Generally, severe swelling and pain, alternating chills and fever, constipation, scanty urination, mental restlessness, and agitation indicate excess Heat-Toxin. Tonification is contraindicated. Dong Yuan stated: For carbuncles and sores, etiology differs between interior and exterior, requiring warm or cold treatments accordingly. Exterior pathogens should be treated with warm decoctions to support the interior; using cold decoctions draws pathogens from the skin into the marrow. Interior pathogens should be treated with cold decoctions to unblock; using warm decoctions to support the interior causes marrow pathology to penetrate the skin, leading to systemic ulceration and exacerbating toxicity. This brings immense suffering, danger, or death.
Zhao Yi Ren, over seventy years old, had an ulcerated temporal carbuncle with severe swelling and pain, preference for cold drinks, forceful pulse, and constipation. Citing Dong Yuan: Irritability, desire for cold drinks, body heat, large pulse, and mental confusion indicate visceral excess. Qing Liang Yin (Cooling Drink) for one dose resolved swelling and pain. Tuo Li Xiao Du Yao for over thirty doses restored health. Prescribing tonics for an elderly patient post-ulceration would constitute the error of "reinforcing excess."
Yu Huang Men from Weiyang, over thirty years old, developed toxic swelling in winter with irritability, constipation, and a forceful pulse. This was due to Wind-Heat stagnation in the Gallbladder meridian ascending upward. According to Ma Shi: For sores with heat stagnation and obstruction, Da Huang Tang (Rhubarb Decoction) should be used to purge. One dose cleared bowels and reduced the sore. Two doses of Jing Fang Bai Du San followed, then Shi Xuan San minus Gui Zhi (Cinnamomi Ramulus), plus Hua Fen and Yin Hua, cured the patient after several doses. Luo Gong, Grand Secretary, suffered pain behind the ear and at the hairline. His pulse was tight and rapid. Xiao Chai Hu Tang with added Jie Geng, Niu Bang Zi (Arctii Fructus), and Yin Hua cured him in four doses.