肿疡者，以疮疡未溃而言也。经云∶形伤痛，气伤肿。又云∶荣气不从，逆于肉里，乃生痈
肿。皆因禀受胎毒，或乳母膏粱浓味，七情阴火，或儿食炙 甘美积毒，气血不和所致。当
分其经络所属，五脏相胜，与元禀亏损，预为审用攻补调和之剂，速令散溃。尤当审其势之
肿漫，色之赤白，与痛有微甚，毒有表里。若肿高 痛，便利调和，邪在表也，宜表散之。
肿硬痛深，大便秘涩，邪在内也，宜下之。外无拘急，内则便利调和者，邪在经络也，宜调
荣卫。肿 大痛，或麻木不痛，邪气凝滞也，用隔蒜灸或活命饮。若烦躁饮冷，赤痛发热，
二便不通者，火热内炽也，用清凉饮、活命饮，加大黄尤善。若微肿微痛、或不痛，阳气虚
弱也，用参 托里散。微黯微赤或不赤，阳气虚寒也，用加味托里散。若恶寒而不作脓，或
浓熟而不溃者，阳气虚也，用加味托里散。如此则未成者，自能消散，已成者自能溃腐。尤
当别其属阴属阳，或半阴半阳而治之。若泥于肿疡，禁用辛热之说，不分受症之因，兼症之
经，概行败毒，泛扰诸经，诛伐无过，以致不能起发，或不能腐溃收敛，变症莫能枚举。《
痈疽论》云∶肿疡内外皆壅，宜以托里表散为主，但见肿痛，参之脉症虚弱，便与滋补，气
血无亏，可保终吉。婴儿有疾，兼调其母，若肿疡之际，治失其法，必致溃疡之变症。此推
《内经》之微旨，而生平之征验者，尤当触类而长，愚奚庸赘。
肿疡，是指疮疡尚未溃破的阶段。《内经》说：形体受伤则疼痛，气机受伤则肿胀。又说：营气运行不畅，逆乱于肌肉纹理之间，就会发生痈肿。这些情况都是由于先天禀受胎毒，或者乳母食用肥甘厚味，加上七情所伤导致的阴火，或者是婴儿食用炙烤甘甜美味导致积毒，从而引起气血不和所致。应当辨别其所属的经络、五脏之间的相克关系，以及先天禀赋的亏损情况，预先审慎地选用攻邪、补虚或调和的方剂，使病邪迅速消散或溃破。尤其要审察肿胀是漫散还是局限，颜色是红赤还是苍白，疼痛是轻微还是剧烈，病毒是在体表还是在体内。如果肿胀高突且疼痛，大小便调和，说明邪气在表，适宜用解表发散的方法。如果肿胀坚硬且疼痛位置深，大便秘结涩滞，说明邪气在里，适宜用泻下法。如果外部没有拘急感，内部大小便调和，说明邪气在经络，适宜调和营卫。如果肿胀大而疼痛，或者麻木不痛，说明邪气凝滞，可用隔蒜灸或仙方活命饮。如果出现烦躁、想喝冷水、红肿疼痛发热、大小便不通的情况，说明火热之邪在内炽盛，可用清凉饮或仙方活命饮，加大黄效果更好。如果只有轻微肿胀和疼痛，或者不痛，说明阳气虚弱，可用参芪托里散。如果颜色微暗微红或不红，说明阳气虚寒，可用加味托里散。如果出现恶寒但不能化脓，或者脓液成熟但不能溃破，说明阳气虚弱，可用加味托里散。这样处理后，未成形的疮疡自然能消散，已成形的疮疡自然能溃烂排脓。尤其应当辨别其属于阴证还是阳证，或是半阴半阳证而进行治疗。如果拘泥于“肿疡禁用辛热”的说法，不分症状产生的原因、兼症的所属经络，一概使用败毒药物，泛扰各条经络，诛伐无过之脏腑，导致疮疡不能起发，或者不能腐溃收敛，变生诸症无法枚举。《痈疽论》说：肿疡内外都壅滞，应以托里透表和表散为主，只要见到肿痛，结合脉象和症状判断为虚弱，就给予滋补，只要气血没有亏损，就能保证最终吉利。婴儿患病，需同时调理母亲；如果在肿疡阶段治疗失当，必然会导致溃疡阶段的变症。这是推演《内经》的精微旨意，并结合生平验证的经验，尤其应当触类旁通，我哪里还需要多言赘述呢？
Zhongyang (Swollen Ulcer) refers to the stage where a sore or ulcer has not yet ruptured. The Classics state: "Injury to form causes pain, injury to Qi causes swelling." It also states: "When Ying Qi (Nutritive Qi) does not flow smoothly and rebels within the muscle tissue, abscesses and swellings arise." All these conditions are caused by congenital endogenous toxins, or the nursing mother consuming rich and greasy foods, combined with Yin Fire resulting from emotional disturbances, or the infant accumulating toxins from eating roasted, sweet, and delicious foods, leading to disharmony of Qi and Blood. One must differentiate according to the affected meridians, the mutual overcoming relationships among the Five Zang Organs, and deficiencies in innate constitution, pre-emptively and prudently selecting formulas for purging, tonifying, or harmonizing to rapidly cause resolution or rupture. Particular attention must be paid to whether the swelling is diffuse or localized, whether the color is red or pale, whether the pain is slight or severe, and whether the pathogenic toxin is superficial or deep. If the swelling is high and painful, and bowel movements and urination are harmonious, the pathogen is at the exterior; it is appropriate to use exterior-releasing methods. If the swelling is hard and the pain is deep, accompanied by constipation and dryness, the pathogen is at the interior; it is appropriate to use purgative methods. If there is no external tension but internal bowel and urinary functions are harmonious, the pathogen is in the meridians; it is appropriate to harmonize Ying and Wei (Nutritive and Defensive Qi). If the swelling is large and painful, or numb and painless, indicating stagnation of pathogenic factors, Garlic-partitioned moxibustion or Xianfang Huoming Yin (Immortal Life Elixir Decoction) should be used. If restlessness, desire for cold drinks, redness, pain, fever, and obstruction of both bowels and urine occur, indicating intense internal Heat-Fire, Qingliang Yin (Cooling Drink Decoction) or Xianfang Huoming Yin (Immortal Life Elixir Decoction) should be used, adding Da Huang (Rhubarb Rhizome) is especially beneficial. If there is only slight swelling and pain, or no pain, indicating deficiency of Yang Qi, Shenqi Tuoli San (Ginseng and Astragalus Interior-Tonifying Powder) should be used. If the color is slightly dark or slightly red, or not red at all, indicating deficiency and cold of Yang Qi, Jiawei Tuoli San (Modified Interior-Tonifying Powder) should be used. If aversion to cold occurs without pus formation, or if pus matures but fails to rupture, indicating deficiency of Yang Qi, Jiawei Tuoli San (Modified Interior-Tonifying Powder) should be used. In this manner, unformed lesions will naturally dissipate, and formed lesions will naturally suppurate and rot. It is crucial to distinguish whether the condition belongs to Yin, Yang, or half-Yin half-Yang, and treat accordingly. If one rigidly adheres to the saying that "acrid and hot substances are contraindicated for swollen ulcers," without differentiating the etiology of symptoms or the meridian involvement of accompanying symptoms, and indiscriminately uses detoxifying herbs, disturbing various meridians, and attacking non-pathogenic areas, it may result in failure of the lesion to rise or suppurate and heal, leading to unpredictable complications. The *Tongju Lun* (Treatise on Carbuncles and Sores) states: "When both interior and exterior of a swollen ulcer are obstructed, the primary treatment should be interior-tonifying and exterior-releasing. Whenever swelling and pain are observed, if pulse and symptoms indicate weakness, tonification should be administered immediately. As long as Qi and Blood are not depleted, auspicious outcomes can be ensured." When infants are ill, their mothers should also be regulated simultaneously. If treatment during the swollen ulcer stage is improper, it will inevitably lead to complications in the ulcerated stage. This deduces the subtle principles of the *Neijing* (Inner Canon) and reflects personal clinical verification; one should particularly extend understanding through analogy. What need is there for me to add further words?