【方歌】逆证黍米不知疼，漫肿不热顶塌平，未老白头坚且硬，
舌干烦躁不生脓。肉肿疮陷猪肝紫，遗尿直视并撮空，
眼神透露精神短，身缩循衣唇吻青，面若涂脂皮枯槁，
唇白腹胀定难生。已溃内坚皮破烂，腐后心烦脓水清，
新肉不生多臭秽，头低项软憔悴容。阳病指甲青必绝，
阴病颧红命必终。鼻生烟煤谵妄语，新肉板片泻直倾，
面色土黄耳枯黑，人中抽缩沟坦平。口张气出无回返，
鼻孔相扇随息行，汗出如珠不易散，血水如腩痰胶凝。
肉绽烂斑神离乱，满面黑气惨天庭，绵溃内似葡萄签，
眼眶迷漫黑气浓。以上无论肿与溃，但逢此证悉属凶。
【注】痈疽初起，形如黍米，不知疼痛，漫肿不热，顶见平塌
，未溃白头，按之坚硬，舌干烦躁，此等逆证，决不化
脓。肉肿疮不肿而陷，其色如猪肝之紫者，是毒邪已深
也。若更见遗尿直视，神露神短，撮空循衣，唇吻青，
面若涂脂，皮肤枯槁，唇白腹胀，种种恶候，断无生理
。已溃后，内坚皮烂，腐后心烦，脓水清稀，新肉不生
，臭秽难近，头低项软，形容憔悴，阳病指甲青色，阴
病两颧红赤，以至眼眶迷漫黑气浓等证，无论毒之肿溃
，但逢此数者，皆为凶证难治也。
【方歌】虚漫实高火焮红，寒肿木硬紫黯青，湿深肉绵浅起疱，
风肿宣浮微热疼，痰肿硬绵不红热，郁结更硬若岩棱，
气肿皮紧而内软，喜消怒长无热红。疼血跌扑暴肿热，
产后闪挫久瘀经，木硬不热微红色，将溃色紫已成脓。
【注】人之气血，周流不息，稍有壅滞，即作肿矣。然肿有虚
肿、实肿、寒肿、湿肿、风肿、痰肿，有郁结伤肝作肿
，有气肿，有跌扑瘀血作肿，有产后与闪挫瘀血作肿，
诸肿形势各异。如虚者漫肿；实者高肿；火肿者色红皮
光，焮热僵硬；寒肿者其势木硬，色紫黯青；湿肿者，
皮肉重坠，深则按之如烂绵，浅则起光水疱，破流黄水
；风肿者，皮肤拘皱不红，其势宣浮微热微疼；痰肿者
，软如绵，硬如馒，不红不热；郁结伤肝作肿者，不红
不热，坚硬如石棱角，状如岩凸；气肿者，以手按之，
皮紧而内软，遇喜则消，遇怒则长，无红无热，皮色如
常；跌仆瘀血作肿者，暴肿大热，胖胀不红；产后与闪
挫瘀血作肿者，瘀血久滞于经络，忽发则木硬不热微红
，若脓已成而将溃者，其色必紫。诸肿形状如此，不可
一概而论也。
【方歌】逆证表现为疮疡初起如黍米大小却不知疼痛，肿胀弥漫且局部不发热，疮顶塌陷平坦；未成熟时疮头坚硬发白；舌体干燥，心中烦躁，无法化脓。肌肉肿胀但疮口凹陷，颜色像猪肝一样紫暗，伴有遗尿、直视眼球不动、手在空中抓握（撮空理线），眼神外露、精神短少，身体蜷缩、手指循摸衣被、嘴唇和口角发青，面色红艳如同涂了脂粉、皮肤干枯憔悴，嘴唇苍白、腹部胀满，这些情况必定难以生存。已经溃破后，内部依然坚硬、表皮破烂，腐肉脱落后心烦意乱，脓水清稀，新肉不生且气味恶臭难闻，低头颈软、面容憔悴。阳证患者指甲发青必死，阴证患者颧骨发红命必终。鼻部出现如烟煤般的黑气、胡言乱语，新肉生长呈板片状、腹泻如水直下，面色土黄、耳朵干枯发黑，人中穴部位抽缩、沟纹平坦消失。口张气出不能回返，鼻孔随呼吸扇动，汗出如珠不易消散，血水像肥肉汁液、痰液胶结凝固。肌肉绽裂、烂斑遍布、神志离乱，满面黑气笼罩天庭，慢性溃烂内部似葡萄串，眼眶周围迷漫浓重的黑气。以上无论肿胀还是溃破，只要遇到这些证候，都属于凶险之证。
【注】痈疽初起时，形状像黍米，不知道疼痛，肿胀弥漫且不发热，疮顶平塌，没有溃破的白头，按压感觉坚硬，舌干烦躁，这些属于逆证，绝对不会化脓。如果肌肉肿胀而疮口凹陷，颜色像猪肝那样紫暗，说明毒邪已经深入体内。如果再见到遗尿、直视、眼神外露、精神短少、手在空中抓握、循摸衣被、嘴唇口角发青、面色像涂了脂粉、皮肤干枯憔悴、嘴唇苍白、腹部胀满等种种恶候，断定没有生机。已经溃破之后，内部坚硬、表皮破烂，腐肉脱落后心烦，脓水清稀，新肉不生，气味恶臭难以靠近，低头颈软，形容憔悴，阳证指甲青色，阴证两颧红赤，直到眼眶周围迷漫浓重黑气等证候，无论毒邪是处于肿胀阶段还是溃破阶段，只要遇到上述几种情况，都是凶险难治的证候。
【方歌】虚证肿胀弥漫，实证肿胀高突，火毒炽盛则红肿焮热；寒邪凝滞则肿胀木硬，颜色紫暗青黑；湿邪深重则肌肉松软，浅表起疱；风邪所致则肿胀宣浮，微热微痛；痰浊凝结则肿势硬绵，不红不热；气机郁结则更加坚硬，如岩石棱角；气滞所致则皮肤紧绷而内部柔软，情绪好时消退，愤怒时增大，无红热；跌打损伤或暴发性肿胀热痛，产后或闪挫导致的瘀血久留经络，肿胀木硬不热微红，若脓已成即将溃破，颜色必为紫色。
【注】人体的气血周流不息，稍有壅滞停滞，就会发生肿胀。然而肿胀有虚肿、实肿、寒肿、湿肿、风肿、痰肿之分，还有因郁结伤肝引起的肿胀，有气肿，有跌打损伤瘀血引起的肿胀，有产后与闪挫瘀血引起的肿胀，各种肿胀的形势各不相同。例如：虚肿表现为肿胀弥漫；实肿表现为肿胀高突；火肿表现为颜色红、皮肤光亮、焮热僵硬；寒肿表现为肿势木硬，颜色紫暗青黑；湿肿表现为皮肉沉重下坠，病位深者按之如烂棉，病位浅者起光亮的疱疹，破溃后流出黄水；风肿表现为皮肤拘挛皱褶、不红，肿势宣浮、微热微痛；痰肿表现为软如棉、硬如馒头，不红不热；郁结伤肝引起的肿胀表现为不红不热，坚硬如石且有棱角，形状像岩石凸起；气肿表现为用手按压，皮肤紧绷而内部柔软，高兴时消退，生气时增大，无红无热，皮色正常；跌仆瘀血引起的肿胀表现为突然肿大热痛，肿胀但不红；产后与闪挫瘀血引起的肿胀表现为瘀血久滞于经络，忽然发作时木硬不热微红，若脓已成即将溃破，其颜色必定是紫色。各种肿胀的形状如此，不可一概而论。
[Song] Adverse manifestations present as sores initially the size of a millet seed yet painless, with diffuse swelling lacking local heat and a flattened, collapsed apex. Before maturation, the head is hard and white; the tongue is dry, restlessness prevails, and suppuration fails to occur. Muscle swelling accompanies a sunken sore aperture, colored purple like pig liver, accompanied by urinary incontinence, fixed gaze, and grasping at empty air (cuo kong). The eyes reveal protrusion and spirit is deficient; the body curls up, fingers trace clothes, lips and corners of the mouth turn cyanotic, the face appears red as if coated with rouge, skin is dry and emaciated, lips are pale, abdomen is distended—these conditions are invariably fatal. After ulceration, the interior remains hard while the epidermis is broken; post-necrosis, there is mental restlessness, thin pus, failure of new flesh to grow, and foul odor difficult to bear; the head droops, the neck is soft, and the countenance is haggard. In Yang syndromes, cyanotic nails indicate certain death; in Yin syndromes, malar flush indicates inevitable demise. Black smoke-like discoloration on the nose, delirious speech, new flesh growing in plate-like sheets, diarrhea flowing straight down, sallow complexion, dry black ears, contraction of the philtrum, and flattening of the nasal groove are observed. Mouth open with exhaled breath not returning, nostrils flapping with respiration, sweat beading like pearls and difficult to dissipate, bloody fluid resembling suet juice, and coagulated phlegm. Muscle splitting, widespread ulcers, chaotic spirit, dark qi covering the face and Tian Ting area, chronic ulceration resembling grape clusters inside, and dense dark qi surrounding the eye sockets. Regardless of whether swelling or ulceration is present, encountering these signs all belongs to ominous prognoses.
[Note] At the onset of carbuncles and sores, the shape resembles a millet seed, pain is absent, swelling is diffuse without heat, the apex is flat, there is no white head prior to ulceration, and palpation reveals hardness. Dry tongue and restlessness characterize these adverse syndromes, which absolutely fail to suppurate. If muscle swells but the sore aperture sinks, and the color is purple like pig liver, it indicates that toxic pathogens have penetrated deeply. If additionally urinary incontinence, fixed gaze, protruding eyes, deficient spirit, grasping at empty air, tracing clothes, cyanotic lips and mouth corners, face appearing rouged, dry and withered skin, pale lips, and abdominal distension are seen among these various malignant signs, life is undoubtedly lost. After ulceration, internal hardness with broken skin, mental restlessness post-necrosis, thin pus, failure of new flesh growth, unbearable foul odor, drooping head, soft neck, emaciated appearance, cyanotic nails in Yang syndromes, red malar bones in Yin syndromes, and dense dark qi surrounding the eye sockets—all these signs, regardless of whether the toxin is in the swelling or ulcerated stage, constitute ominous and difficult-to-treat syndromes.
[Song] Deficiency-type swelling is diffuse; excess-type swelling is elevated; fire toxicity causes redness, inflammation, and heat; cold stagnation causes wooden hardness with purple-dark cyanotic color; deep dampness causes soft flesh with superficial blisters; wind-induced swelling is floating and slightly hot/painful; phlegm-induced swelling is hard yet soft, non-red/non-hot; Qi stagnation causes further hardness like rock edges; Qi swelling features tight skin but soft interior, subsiding with joy and expanding with anger, without redness or heat; traumatic swelling presents as sudden large swelling with heat; postpartum or sprain-induced blood stasis results in wooden hardness without heat but slight redness; if pus has formed and is about to ulcerate, the color must be purple.
[Note] Human Qi and Blood flow continuously; any slight stagnation leads to swelling. However, swelling includes deficiency, excess, cold, damp, wind, and phlegm types, as well as those caused by Qi stagnation injuring the Liver, Qi swelling, traumatic blood stasis, and postpartum/sprain-induced blood stasis. The forms of these swellings vary greatly. For instance: deficiency swelling is diffuse; excess swelling is elevated; fire swelling is red, shiny-skin, inflamed, hot, and stiff; cold swelling is wooden-hard, purple-dark cyanotic; damp swelling features heavy, sagging flesh—deep ones feel like rotten cotton upon pressure, shallow ones form shiny blisters leaking yellow fluid; wind swelling shows wrinkled, non-red skin, floating swelling with slight heat/pain; phlegm swelling is soft as cotton, hard as a steamed bun, non-red/non-hot; Liver-injuring Qi stagnation swelling is non-red/non-hot, hard as stone with angular edges, resembling rock protrusions; Qi swelling feels tight on skin but soft internally, subsides with joy, expands with anger, lacks redness/heat, and maintains normal skin color; traumatic blood stasis swelling is suddenly large, hot, swollen but non-red; postpartum/sprain blood stasis swelling involves long-standing stasis in meridians, suddenly manifesting as wooden-hard, non-heat, slightly red; if pus has formed and is about to ulcerate, the color is inevitably purple. Thus, the shapes of various swellings differ, and one cannot generalize.