以槐梅膏涂之，痛息，日涂两次，至愈乃止。内服杜痔丸，每早晚各服五钱。
候登厕翻出肛外，用温水洗净侧卧，其痔尽出，勿使收入。亦有痔自翻出，大如茶杯，
形如
一菌，粪从菌心而出，痛极难忍，上面如盆，四边高，中心陷下，如菌根。粪后用杜枸杞根
捣烂，煎汁热熏温洗，洗净以洞天膏摊如菜碗大，中剪一孔，以一边剪开通孔，烘熔圈于菌
根，贴于四边，围护好肉，诚恐上药药汁漓于好肉耳。每取枯痔药一二分，入杯津调，笔蘸
拂菌之外面四旁，日夜各拂一次。菌之中心，通连肛门，大忌拂药，倘有流入，大痛难当。
拂一两日，毒水流出，菌形渐缩而软。再拂一两日，渐硬而黑，菌边日有脱下。用药一钱，
内再增朱砂一分，仍用津调，日夜照拂。俟菌缩小黑硬，再拂，拂至菌根自落痊愈。
以退管散五钱，黑糖拌，空心陈酒送下，管自退出乃止。或用双鳖丸亦可。
夏秋头面生红疖，初起取洞天膏贴，周时全消。溃者贴之亦愈。用清暑散煎，俟温，服
即无热毒之患。
凡大痈溃后，世人每投炙 、炙草，或用半炙半生，殊不知托里散内用人参者，并非以
参补
虚，不过以参助 ，添其托毒之力，却无补毒之害，而炙 只补气，不能托毒；炙草只补中
，不能解毒。倘毒瓦斯未尽，误投炙 、炙草，或用保元、十全等汤，致毒反得补助，毒攻内
腑。余之治法，凡遇初溃大痈，止其痛，痛息则毒散，其肿亦退。色转红活，即可无须用参
、补托，如须 、草，亦皆用生，不用炙也。惟体虚年老者，投参而 、草则皆炙也。如
体旺家贫者，无参亦易收功。
马曰∶此论极是。何世之疡科，于溃脓以后，每用参、 、炙草以为托里，补住火邪，
致疮难愈，甚则毒攻内腑，危殆不救。能取此为法，必无贻误。
用槐梅膏涂抹患处，疼痛停止后，每天涂抹两次，直到痊愈才停止。内服杜痔丸，早晚各服用五钱。
如果排便时痔疮翻出肛门外，用温水洗净后侧卧，让痔疮完全脱出，不要让它缩回去。也有痔疮自行翻出，大如茶杯，形状像一朵菌菇，粪便从菌菇中心排出，疼痛剧烈难以忍受，上面像盆一样，四边高起，中心凹陷，像菌菇的根部。便后用杜枸杞根捣烂，煎汁趁热熏蒸并温洗，洗净后取洞天膏摊开如菜碗大小，中间剪一个孔，将一边剪开通孔，烘烤熔化后套在菌菇根部，贴在四边，围护好周围的正常皮肤，这是担心上面的药液流到好肉上。每次取枯痔药一二分，加入唾液调和，用笔蘸取涂抹在菌菇外面的四周，日夜各涂抹一次。菌菇的中心连通肛门，绝对禁止涂抹药物，如果有药液流入，会剧痛难忍。涂抹一两天后，毒水流出，菌菇形状逐渐缩小变软。再涂抹一两天，逐渐变硬发黑，菌菇边缘每天都有脱落。用药一钱，里面增加朱砂一分，仍然用唾液调和，日夜照样涂抹。等到菌菇缩小、变黑、变硬，继续涂抹，直到菌菇根部自然脱落而痊愈。
用退管散五钱，与黑糖拌合，空腹用陈年酒送服，直到瘘管自行退出才停止。或者使用双鳖丸也可以。
夏秋季节头面部生红色疖子，初起时取洞天膏贴敷，一周即可全消。已经溃破的贴敷也能治愈。用清暑散煎煮，待温度适宜后服用，就不会有热毒的祸患。
凡是大的痈肿溃破后，世人往往投用炙黄芪、炙甘草，或者半炙半生，却不知道托里散中用人参，并不是为了人参补虚，不过是用人参辅助黄芪，增加其托毒外出的力量，却没有补益毒邪的危害，而炙黄芪只补气，不能托毒；炙甘草只补中气，不能解毒。如果毒气未尽，误投炙黄芪、炙甘草，或者使用保元汤、十全大补汤等，导致毒邪反而得到补助，毒邪攻入内脏。我的治疗方法，凡是遇到初溃的大痈，先止住疼痛，疼痛停止则毒气消散，肿胀也会消退。颜色转为红润鲜活，就可以不需要用人参、黄芪进行补托，如果需要黄芪、甘草，也都用生品，不用炙品。只有身体虚弱的高龄老人，才投用人参，此时黄芪和甘草都用炙品。如果身体强壮且家境贫寒的人，没有参药也很容易收功。
马曰：这个观点非常正确。为什么世上的外科医生，在溃脓之后，每用参、芪、炙草来托里，补住了火邪，导致疮疡难以愈合，甚至毒邪攻入内脏，危险得无法救治。如果能采用这种方法，必定不会贻误病情。
Apply Huaimei Gao (槐梅膏) to the affected area. Once the pain subsides, apply twice daily until healed. Internally administer Duzhi Wan (杜痔丸), taking five qian at morning and evening.
If the hemorrhoid everts outside the anus during defecation, wash it clean with warm water, lie on your side, allow the hemorrhoid to fully protrude, and do not push it back in. In some cases, the hemorrhoid spontaneously everts, large as a teacup, shaped like a mushroom, with feces passing through the center of the mushroom. The pain is extreme and unbearable; the top resembles a basin, high on the four sides and depressed in the center, like the root of a mushroom. After defecation, crush the roots of Du Gouqi (杜枸杞), decoct them, and use the hot juice for fumigation and warm washing. Cleanse thoroughly, then spread Dongtian Gao (洞天膏) to the size of a vegetable bowl. Cut a hole in the center, slit one side open, heat-melt the ring, place it around the mushroom root, and adhere it to the four sides to protect the healthy surrounding skin. This is done out of fear that the medicinal juice might drip onto healthy tissue. Take one or two fen of Zhumi Yao (枯痔药 - Hemorrhoid Cauterizing Medicine), mix with saliva, dip a brush into the mixture, and brush the outer periphery of the mushroom once day and night. The center of the mushroom connects directly to the anus; applying medicine here is strictly forbidden. If any enters, the pain will be intolerable. After brushing for one or two days, toxic fluid will flow out, and the mushroom shape will gradually shrink and soften. Continue brushing for another one or two days; it will gradually become hard and black, with edges shedding daily. Use one qian of medicine, adding one fen of Zhusha (Cinnabar), still mixed with saliva, and brush day and night as before. Wait until the mushroom shrinks, turns black, and becomes hard, then continue brushing until the root falls off naturally and healing occurs.
Take Tuiguan San (退管散) five qian, mixed with Heitang (Black Sugar), taken on an empty stomach with aged wine. Stop when the fistula tract naturally extrudes. Alternatively, Shuangbie Wan (双鳖丸) may be used.
In summer and autumn, if red boils appear on the head and face, apply Dongtian Gao (洞天膏) at the initial stage; they will completely resolve within a week. Apply even if ulcerated, and they will heal. Decoct Qingshu San (清暑散) and drink it when warm to prevent complications from heat-toxin.
After a large carbuncle ulcerates, people often prescribe Zhi Huangqi (Honey-fried Astragali Radix) and Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), or a mix of fried and raw herbs. They fail to realize that in Tuoli San (托里散), Ren Shen (Ginseng Radix) is not used primarily to tonify deficiency, but to assist Huangqi (Astragali Radix) in enhancing its power to expel toxin, without the harm of nourishing the pathogen. Zhi Huangqi only tonifies Qi and cannot expel toxin; Zhi Gancao only tonifies the Middle Jiao and cannot resolve toxin. If the pathogenic qi is not yet exhausted, mistakenly using Zhi Huangqi and Zhi Gancao, or formulas like Baoyuan Tang (保元汤) or Shiquan Dabu Tang (十全大补汤), causes the toxin to be further nourished, attacking the internal organs. My treatment method: for any newly ulcerated large carbuncle, first stop the pain. When pain ceases, the toxin disperses, and swelling recedes. When the color turns red and vibrant, there is no need to use Ren Shen or Huangqi for tonification and expulsion. If Huangqi and Gancao are needed, use the raw forms, not the honey-fried ones. Only for elderly patients with weak constitutions should Ren Shen be administered, along with honey-fried Huangqi and Gancao. For those with strong constitutions who are poor, treatment can succeed easily even without Ginseng.
Ma said: This argument is extremely correct. Why do surgeons of the world, after pus has drained, always use Ren Shen, Huangqi, and Zhi Gancao to support the interior? This retains fire-pathogens, causing sores to be difficult to heal, and in severe cases, toxins attack the internal organs, leading to critical conditions that are incurable. If this method is adopted, errors will certainly be avoided.