【方歌】初起作痒因风热，溃后脓沤或冒风，将敛作痒生新肉，
痒若虫行气血充。
【注】痒属风，亦各有因。凡肿疡初起，皮肤作痒者，为风热
相搏。溃后作痒者，轻由脓沤，甚由疮口冒风，故突起
疙瘩，形如小米。抓破之后，津水者，是脾湿；津血者
，是脾燥。若将敛作瘩者，缘初肿时肌肉结滞，气血罕
来，及至将敛，气血渐充，助养新肉，故痒也。然必痒
若虫行，方称美疾。他如疥癣作痒，皆属风淫，勿视为
一类也。
【方歌】真晕应知非肿痕，疮旁形状若红筋，藏府蕴受锐毒发，
三晕可愈五伤身。
【注】俗以肿痕为晕，非真晕也。真晕生于疮口之旁，状若红
筋，皆由藏府蕴受锐毒而成，二三晕可治，五晕难医。
【方歌】痈疽疮疡初如粟，麻痒焮痛即大毒。不论阴阳灸最宜，
炙后汤洗膏固护，内用疏解与宣通，外宜敷药四围束。
轻证神灯照三枝，平塌须急补不足，高肿不可过于攻，
内热毒盛须消毒。二便秘结宜通利，脏胕宣通方为福，
十日以后疮尚坚，铍针点破最宜先，半月之后脓若少，
药筒拔提脓要粘。疮已溃烂腐不脱，当腐剪破开其窍，
能令脓管得通流，自然疮头无闭塞。频将汤洗忌风吹，
去腐须当上灵药，生肌散用将敛时，保养须勤毋怠惰。
切忌脓出投寒凉，冬宜温室夏明窗，肌肉长平将疮敛，
谨慎调理更加详，新肉如珠皮不敛，若失保养命多亡。
【注】痈疽疮疡初起如粟，若麻痒焮痛者，即毒甚也。七日以
前，形势未成，不论阴阳，俱先当灸之。轻者使毒气随
火而散，重者拔引郁毒，通彻内外，实良法也。灸完即
用汤洗之法，洗完用太乙膏贴于疮顶上，预防风袭；内
服疏解宣通之剂，如神授卫生汤、内疏黄连汤、蟾酥丸
之类；外围敷药，如冲和膏、玉龙膏之类，四围束之。
轻证以神灯照照之，每用三枝。如形势已成，当因证施
治。平塌者宜投补剂，以益其不足，使毒外出；高肿者
不可过于攻伐，以伤元气，致难溃敛；内热盛者，须佐
消毒之剂，以防毒炽；二便秘结者，急用通利之方，使
脏腑宣通，方为佳兆。如十日之后，疮尚坚硬，必须用
铍针，当头点破；半月之后，脓尚少者，急用药筒拔法
拔之，脓血胶粘者为顺，紫血稀水者为逆；过二十一日
，纵有稀脓，亦难治矣。若已溃之后，腐仍不脱，堵塞
疮口者，用刀剪当头剪开寸余，使脓管通流，自然疮不
闭塞。拔脓剪腐已完，用方盘一个，疮下放定，将猪蹄
汤以软帛淋洗疮上，并入孔内，轻手擦净内脓，庶败腐
宿脓，随汤而出，以净为度。再以软帛叠成七八重，勿
令太干，带汤乘热，覆于疮上，两手轻按片时，帛温再
换。如此洗按四五次，血气疏通，患者自然爽快。每日
如是洗之，谨避风寒。腐肉处以黄灵药掺之，候腐肉脱
尽，已见红肉时，洗后随用抿脚挑玉红膏于手心上，捺
化搽涂疮口内，外用太乙膏盖之。不数日新肉顿生，疮
势将敛，以生肌散或珍珠散撒之，保养谨慎，不可怠缓
。脓出后切忌投以寒凉之药，患者冬宜温室，防其寒也
。夏宜明窗，避风暑也。肌肉长平，疮敛时尤加小心，
谨慎调理。即使新肉如珠，皮口将敛，若调理疏忽，失
于保养，恐致虚脱暴变，命必危亡矣。
【方歌】痈疽初起时出现瘙痒，是因为风热邪气侵袭；溃破流脓后再次发痒，可能是因为伤口接触了风邪；在疮口即将愈合、新肉生长时出现的瘙痒，说明气血已经充盈。如果感觉瘙痒像虫子在皮肤下爬行，这是气血充盛的表现。
【注】瘙痒属于风邪致病，但各有不同的成因。凡是溃疡（肿疡）初起阶段，皮肤出现瘙痒的，是风邪与热邪相互搏结所致。溃破后出现瘙痒的，轻微的是因为脓液浸渍皮肤，严重的则是由于疮口直接受风侵袭，导致突起疙瘩，形状像小米粒一样。抓破之后，流出透明津水的，是脾虚湿盛的表现；流出血液的，是脾阴燥热的表现。如果是疮口即将收敛时出现的瘙痒，是因为起初肿胀时肌肉气血运行阻滞，气血很少到达此处，等到快要愈合时，气血逐渐充盈，滋养新长出的肌肉，所以产生瘙痒。但是，只有那种感觉像虫子爬行的瘙痒，才算是良好的预后征兆。其他的如疥癣引起的瘙痒，都属于风邪过盛所致，不要将它们混为一谈。
【方歌】真正的晕圈应当知道不是普通的红肿痕迹，疮疡旁边的形状像红色的筋络，这是由于脏腑内部蕴积了剧烈的毒邪而发作，出现两到三个晕圈还可以治愈，出现五个晕圈则难以医治，会损伤身体。
【注】民间常把红肿的痕迹称为“晕”，但这并不是真正的晕圈。真正的晕圈生长在疮口的旁边，形状像红色的筋络，都是由脏腑内部蕴积剧烈毒邪所形成的，出现两三个晕圈可以治疗，出现五个晕圈就很难医治了。
【方歌】痈疽疮疡刚开始时像粟米大小，如果伴有麻木、瘙痒、灼热和疼痛，说明毒性很大。无论属于阴证还是阳证，最适合的治疗方法都是艾灸。施灸后用汤药清洗，再用膏药固定保护，内服疏解宣通的药物，外用敷药包裹四周束缚。轻症用神灯照射三枝，疮形平塌必须急于补益不足，疮形高肿不可过于攻伐，体内热毒旺盛必须使用消毒药物。二便便秘结滞应当通利，脏腑宣通畅达才是福气。十日以后疮面仍然坚硬，最适宜先用铍针点破；半月以后如果脓液很少，用药筒拔法提取脓液要粘稠。疮口已经溃烂腐烂但不脱落，应当剪开腐肉打开孔窍，能让脓液管道通畅流动，自然疮头就不会闭塞。频繁用汤药清洗，忌讳风吹，去除腐肉必须使用灵药，将要收敛时使用生肌散，保养必须勤奋，不可懈怠懒惰。切忌在脓液流出时投用寒凉药物，冬天适宜在温暖的室内，夏天适宜在有明亮窗户的地方，肌肉长平、疮口将敛时，谨慎调理更加详细，如果新肉像珍珠一样长出但皮肤不收敛，若失去保养性命多会死亡。
【注】痈疽疮疡初起时像粟米大小，如果出现麻木、瘙痒、灼热和疼痛的症状，说明毒性很严重。七天以前，病情形势尚未形成，无论属于阴证还是阳证，都应当先进行艾灸。轻症使毒气随着火气消散，重症拔引郁积的毒邪，通达内外，这确实是良法。灸完后立即使用汤药清洗的方法，洗完后用太乙膏贴在疮顶上方，预防风邪侵袭；内服疏解宣通的药剂，如神授卫生汤、内疏黄连汤、蟾酥丸之类的药物；外围敷药，如冲和膏、玉龙膏之类的药物，在四周束缚住。轻症用神灯照射，每次使用三枝。如果病情形势已经形成，应当根据症状施治。疮形平塌的应当投用补剂，以补充其不足，使毒邪外排；疮形高肿的不可过于攻伐，以免损伤元气，导致难以溃破和收敛；体内热盛的，必须辅助使用消毒的药剂，以防毒邪炽盛；二便便秘结的，急用通利的方剂，使脏腑宣通畅达，这才是佳兆。如果十日以后，疮面仍然坚硬，必须使用铍针，从正中间点破；半月以后，脓液还少的，急用药筒拔法拔出，脓血胶粘的是顺证，紫血稀水是逆证；超过二十一天，即使有稀脓，也难以治疗了。如果已经溃破之后，腐肉仍然不脱落，堵塞疮口的，用刀剪从正中间剪开一寸多，使脓管通畅流动，自然疮口不会闭塞。拔脓剪腐完成后，用一个方盘放在疮下方，将猪蹄汤用软布淋洗疮面，并进入孔内，轻轻手擦净内部脓液，这样败腐宿脓就会随着汤水排出，以干净为限度。再用软布叠成七八层厚，不要太干，带着汤水趁热覆盖在疮上，两手轻轻按压片刻，布温后再更换。如此洗按四五次，血气疏通，患者自然感到爽快。每天这样清洗，谨避风寒。腐肉处撒上黄灵药，等候腐肉脱尽，已经见到红肉时，清洗后随即用手心抿化玉红膏涂抹于疮口内，外用太乙膏覆盖。不几天新肉顿时生出，疮势将要收敛，撒上用生肌散或珍珠散，保养谨慎，不可怠慢。脓液流出后切忌投用寒凉药物，患者冬天适宜在温室，防止寒气；夏天适宜在明窗，避开风暑。肌肉长平，疮口收敛时尤其要小心，谨慎调理。即使新肉像珍珠一样长出，皮口将要收敛，如果调理疏忽，失于保养，恐怕导致虚脱暴变，性命必定危亡。
[Prescription Verse] Itching at the initial stage of carbuncle and ulcer is caused by wind-heat; itching after ulceration may be due to pus maceration or exposure to wind; itching during the healing phase indicates the growth of new flesh, signifying sufficient Qi and blood. If the itching feels like insects crawling, it indicates that Qi and blood are abundant.
[Note] Itching belongs to wind pathogenic factors, but has various causes. In the initial stage of a swelling ulcer (swollen lesion), skin itching is due to the struggle between wind and heat. Itching after ulceration is mild if caused by pus maceration, but severe if caused by the wound exposed to wind, resulting in raised bumps resembling millet grains. After scratching, clear fluid discharge indicates Spleen dampness, while blood discharge indicates Spleen dryness. Itching when the wound is about to heal occurs because muscle stagnation prevented Qi and blood from reaching the area initially; as healing approaches, Qi and blood gradually fill the area to nourish new flesh, causing itching. However, only itching that feels like insects crawling signifies a favorable prognosis. Other itches caused by scabies and tinea all belong to excessive wind pathogenic factors and should not be confused with this condition.
[Prescription Verse] The true "halo" (erythema) should be distinguished from ordinary redness and swelling; its shape around the wound resembles red veins. This results from sharp toxins accumulating in the Zang-Fu organs. Two or three halos can be cured, but five halos are difficult to treat and damage the body.
[Note] Commonly, redness and swelling are mistaken for halos, but they are not true halos. True halos appear beside the wound, resembling red veins, formed by sharp toxins accumulated within the Zang-Fu organs. Two or three halos are treatable, while five halos are difficult to cure.
[Prescription Verse] Carbuncles, ulcers, and sores initially resemble millet grains; numbness, itching, burning, and pain indicate severe toxicity. Regardless of Yin or Yang syndrome, moxibustion is most suitable. After moxibustion, wash with decoction and protect with plaster. Internally use herbs to disperse and unblock; externally apply poultices to bind the surroundings. For mild cases, use Shen Deng (Divine Lamp) irradiation with three branches. For flat lesions, urgently tonify deficiency; for high swellings, avoid excessive purgation. If internal heat and toxin are abundant, use detoxifying agents. For constipation of both bowels and bladder, promote unblocking; smooth flow of Zang-Fu organs is auspicious. If the sore remains hard after ten days, puncture first with a Pi needle (scalpel). If pus is scant after half a month, use the medicinal cylinder suction method. If pus is viscous, it is a favorable sign; if purple blood or thin water, it is unfavorable. After twenty-one days, even with thin pus, it is difficult to treat. If ulcerated sores have necrotic tissue that does not shed, cut open the aperture to allow pus drainage. Wash frequently, avoid wind. Remove necrosis with spiritual medicines; use flesh-regenerating powder when nearing healing. Maintain diligence, do not be lazy. Avoid cold-cold herbs when pus is discharging. Winter: warm room; Summer: bright window. When muscles level out and wounds close, manage carefully. If new flesh grows like pearls but skin does not close, neglect leads to death.
[Note] Carbuncles and ulcers start like millet grains; numbness, itching, burning, and pain indicate severe toxicity. Before seven days, when the condition is not yet fully formed, regardless of Yin or Yang syndrome, moxibustion should be applied first. For mild cases, toxins dissipate with fire; for severe cases, moxibustion draws out stagnant toxins and connects interior and exterior, which is an excellent method. After moxibustion, wash with decoction, then apply Taiyi Plaster to the top of the wound to prevent wind invasion. Internally administer dispersing and unblocking agents such as Shenshou Weisheng Decoction, Neishu Huanglian Decoction, or Chansu Pill. Externally apply poultices like Chonghe Ointment or Yulong Ointment to bind the perimeter. For mild cases, irradiate with Shen Deng using three branches. Once the condition is established, treat according to symptoms. Flat lesions require tonics to supplement deficiency and expel toxins outward. High swellings should not be aggressively purged to avoid damaging Yuan Qi and hindering ulceration and healing. Internal heat requires adjunctive detoxification to prevent toxin proliferation. Constipation requires urgent unblocking agents to ensure smooth Zang-Fu function, which is a good omen. If the sore remains hard after ten days, puncture with a Pi needle. If pus is scant after fifteen days, urgently use the medicinal cylinder suction method. Viscous pus and blood indicate a favorable course; thin purple blood or watery discharge indicates an unfavorable course. Beyond twenty-one days, even with thin pus, treatment is difficult. If necrotic tissue persists after ulceration, cut open one inch at the center to unblock pus drainage. After removing pus and necrosis, place a square plate under the wound. Pour pig trotter decoction over soft cloth to wash the wound surface and enter the cavity, gently wiping clean internal pus so that decayed matter and old pus exit with the liquid, until clean. Fold soft cloth seven or eight layers thick, not too dry, keep warm with the liquid, cover the wound, press gently for a moment, and replace when cool. Repeat washing and pressing four or five times to unblock Qi and blood, making the patient feel refreshed. Wash daily, avoiding wind and cold. Apply Huang Ling Yao (Yellow Spiritual Medicine) to necrotic areas. When necrosis sheds and red flesh appears, melt Yuhong Gao (Jade Red Ointment) on the palm and apply inside the wound after washing, covering externally with Taiyi Plaster. New flesh will grow rapidly within a few days, and the wound will begin to close. Sprinkle Shengji San (Flesh-Generating Powder) or Zhenzhu San (Pearl Powder). Maintain careful care without delay. Avoid cold-cold herbs after pus discharge. Winter: stay in warm rooms to prevent cold. Summer: stay in bright windows to avoid wind and summer heat. When muscles level and wounds close, exercise extra caution. Even if new flesh grows like pearls and skin closes, negligence in care may lead to collapse and sudden changes, endangering life.