痈疽二毒，由于心生。盖心主血而行气，气血凝而发毒。毒借部位而名，治论循经则误
。症
之根盘，逾径寸而红肿者谓痈，痈发六腑；若形止数分，乃为小疖。按之陷而不即高，虽温
而顶不甚热者，脓尚未成；按之随指而起，既软而顶热甚者，脓已满足。无脓宜消散，有脓
勿久留。醒消一品，立能消肿止疼，为疗痈之圣药。白陷者谓疽，疽发五脏，故疽根深而痈
毒浅。根红散漫者，气虚不能拘血紧附也；红活光润者，气血拘毒出外也；外红里黑者，毒
滞于内也；紫黯不明者，气血不充，不能化毒成脓也。脓色浓浓者，气血旺也；脓色清淡者
，气血衰也。未出脓前，腠理之间，痈有火毒之滞，疽有寒痰之凝；既出脓后，痈有热毒未
尽宜托，疽有寒凝未解宜温。既患寒疽，酷暑仍宜温暖，如生热毒，严冬尤喜寒凉。然阴虚
阳实之治迥别，阅古方书，总觉未详，因畅其旨备览焉。诸疽白陷者，乃气血虚寒凝滞所致
，其初起毒陷阴分，非阳和通腠，何能解其寒凝？已溃而阴血干枯，非滋阴温畅，何能浓其
脓浆？盖气以成形，血以华色，故诸疽平塌，不能逐毒者，阳和一转，则阴分凝结之毒，自
能化解；血虚不能化毒者，尤宜温补排脓，故当溃脓毒瓦斯未尽之时，通其腠理之功，仍不可
缓。一容一纵，毒即逗留；一解一逐，毒即消散。开腠而不兼温补，气血虚寒，何以成脓？
犹无米之炊也。滋补而不兼开腠，仅可补其虚弱，则寒凝之毒，何能觅路行消？且毒盛者反
受其助，犹车粟以助盗粮矣。滋补而不兼温暖，则血凝气滞，孰作酿脓之具？犹之造酒不暖
，何以成浆？造饭无火，何以得熟？世人但知一概清火而解毒，殊不知毒即是寒，解寒而毒自
化，清火而毒愈凝。然毒之化必由脓，脓之来必由气血，气血之化，必由温也，岂可凉乎？
况清凉之剂，仅可施于红肿痈疖，若遇阴寒险穴之疽，温补尚虞不及，安可妄行清解，反伤
胃气？甚至阳和不振，难溃难消，毒攻内腑，可不畏欤？盖脾胃有生死，故首贵止痛，次宜
健脾。痛止则恶气自化，脾健则肌肉自生。阳和转盛，红润肌生，惟仗调和补养气血之剂，
若夫性寒之药，始终咸当禁服。
马曰∶数分之疖，亦须看生在何处。若在险要穴上，亦不可小视，谁谓数分之疖无害耶
！
又曰∶白陷者乃是痰症发于肉里，由于气滞而成。若坚凝附于筋骨者，乃血分受病，必
初起红硬有头，方谓之疽。然亦须辨阴阳。
又曰∶有阴虚阳旺之辈，毒火结于荣分，疮坚平色紫，按之烙手者，必泄其火毒，阴充
血和
，方能起发，岂可谓之寒疽，治以温暖乎？投之则阴愈干，则火愈炽，诊视之时，全在察脉
观色观形，切宜填之。
又曰∶毒概指为寒，左矣。须知阳中有阴，阴中有阳，有真寒假热，有真热假寒，如执
色白
之说，则有色白按之烙手，脉洪数者，将其作疽治欤。泥色红之说，其有色红按之不热，脉
不洪数者，其将作痈治欤。若不谙脉理，何能无误耶？
陶曰∶中国之疮毒，西国则称之为发炎。有内炎外炎之名，外炎即痈疽，内炎即肺痈肠
痈等类。用蜞数条，放在肿处，吮去其毒。
又曰∶如疖生在险要穴上，用广东所产金壳栉，水研搽，可移于不致命一二寸。但此药
有毒
，不可入口。又，《验方新编·痈毒杂治门》内有移山过海散、赶毒散，皆能移开疮于不致
命处。
又曰∶徐灵胎亦云∶红亦有非痈，白亦有非疽者。
痈和疽这两种毒证，根源在于心脏。因为心主司血液运行并推动气机，气血凝滞就会引发毒邪。毒邪根据发病部位不同而命名，如果治疗时只遵循经络理论而不辨阴阳寒热，就会出错。
症状表现为：根盘直径超过一寸且红肿的称为“痈”，痈发于六腑；如果形状只有几分大小，则称为小疖。按压患处凹陷、不能立即回弹隆起，虽然局部温热但顶部不是很热的，说明脓液尚未形成；按压后手指抬起即随指而起，质地变软且顶部灼热严重的，说明脓液已经成熟。没有脓液时适宜用消散法，已有脓液时不宜久留体内。醒消丸（一种方剂）能迅速消肿止痛，是治疗痈的圣药。颜色苍白下陷的称为“疽”，疽发于五脏，所以疽的病根深而痈的毒邪浅。
根部红色散漫的，是气虚不能固摄血液紧密附着所致；根部红活光润的，是气血充足能将毒邪向外托出；外部发红内部发黑的，是毒邪停滞在体内；颜色紫暗不明亮的，是气血不充盈，无法化解毒邪生成脓液。脓液浓稠的，说明气血旺盛；脓液清淡稀薄的，说明气血衰弱。
在未出脓之前，腠理之间，痈有火毒停滞，疽有寒痰凝结；在出脓之后，痈有余热毒邪未尽，宜用托毒法；疽有寒凝未解，宜用温法。既然患的是寒性疽，即使在酷暑季节仍宜采用温暖疗法；如果是产生热毒，即使在严冬时节尤其喜欢寒凉疗法。然而阴虚与阳实的治疗原则截然不同，阅读古代方书，总觉得不够详尽，因此我畅述其旨意以供参考。
各种白色下陷的疽，是由于气血虚寒凝滞导致的。初起时毒邪陷入阴分，如果不是用阳和汤（方剂名）通调腠理，怎么能解除寒凝？溃破后阴血干枯，如果不是滋阴并温和通畅，怎么能使脓浆浓稠？气用来形成形体，血用来荣华色泽，所以各种平塌下陷、不能驱逐毒邪的疽症，只要阳气调和转动，阴分凝结的毒邪自然能化解；血虚不能化解毒邪的，尤其适宜温补排脓，所以在溃脓毒气未尽之时，开通腠理的功效，仍然不可迟缓。一旦容许放纵，毒邪就会逗留；一旦解开阻滞并驱逐，毒邪就会消散。只开通腠理而不兼用温补，面对气血虚寒，凭什么生成脓液？这就像无米之炊。只滋补而不兼开通腠理，只能补充虚弱，那么寒凝的毒邪，怎么能找到路径消散？而且毒盛的时候反而会受到滋补药的助长，这就像用车载粮食去帮助盗贼一样。只滋补而不兼用温暖，会导致血凝气滞，谁来做酿脓的工具？这就像酿酒不加热，怎么能成酒浆？做饭没有火，怎么能煮熟？世人只知道一概清热泻火来解毒，却不知道毒即是寒，解除寒邪则毒自然化解，清热泻火反而使毒更加凝结。然而毒邪的化解必然通过脓液，脓液的生成必然依靠气血，气血的转化，必然依靠温煦，怎么可以用凉药呢？况且清凉的药物，仅适用于红肿的痈疖，如果遇到阴寒险恶部位的疽症，温补还担心力度不够，怎么可以妄行清解之法，反而损伤胃气？甚至导致阳气不和，难以溃破或消散，毒邪攻入内脏，能不害怕吗？脾胃关乎生死，所以首先贵在止痛，其次宜健脾。疼痛停止则恶气自然化解，脾健运则肌肉自然生长。阳气调和转盛，红润肌肤生长，全赖调和补养气血的药剂。至于性质寒凉的药物，始终应当禁止服用。
马曰：几分的疖子，也必须看生长在何处。如果在危险要害穴位上，也不可轻视，谁说几分的疖子没有危害呢！
又说：白色下陷的乃是痰症发于肉里，由于气滞而成。如果坚硬凝结附着在筋骨上的，是血分受病，必须初起时红硬且有头，才称之为疽。但也必须辨别阴阳。
又说：有阴虚阳旺的人，毒火结聚在荣分，疮疡坚硬平塌颜色紫暗，按压时感觉烫手，必须泄其火毒，待阴充气和，才能起发，怎么能说是寒疽，用温暖法治呢？投用温药则阴更干，火更炽，诊视之时，全在于察脉、观色、观形，切切记住这一点。
又说：将毒概指为寒，是错误的。须知阳中有阴，阴中有阳，有真寒假热，有真热假寒。如果执着于“色白”的说法，那么有色白但按压烫手、脉象洪数的，难道将其作为疽来治吗？拘泥于“色红”的说法，那么有色红但按压不热、脉象不洪数的，难道将其作为痈来治吗？如果不精通脉理，怎么能不出错呢？
陶曰：中国的疮毒，西方国家则称之为发炎。有内炎外炎之名，外炎即痈疽，内炎即肺痈、肠痈等类别。用几条水蛭（蜞），放在肿胀处，吸吮去除其毒邪。
又说：如疖子生在危险要害穴位上，用广东所产的金壳栉（药材/物品），用水研磨涂抹，可以将毒邪转移到不致命的一两寸处。但这种药有毒，不可入口。另外，《验方新编·痈毒杂治门》内有移山过海散、赶毒散，都能将疮毒移开至不致死的地方。
Carbuncles and deep abscesses (Yong Ju, 痈疽) are two types of toxic conditions originating from the Heart. The Heart governs blood circulation and promotes Qi movement; when Qi and Blood stagnate, toxins arise. These toxins are named according to their location. Treatment based solely on meridian theory without distinguishing Yin-Yang and Cold-Heat leads to errors.
Clinical manifestations: A lesion with a base diameter exceeding one cun that is red and swollen is called "Yong" (Carbuncle/Superficial Abscess), which arises in the Six Fu Organs. If the shape is only a few fen in size, it is termed a small boil (Jie, 疖). Pressing the area leaves an indentation that does not immediately rebound; although warm, if the apex is not very hot, pus has not yet formed. If pressing causes the tissue to rise with the finger, becoming soft with significant heat at the apex, pus is mature. When there is no pus, dispersal methods are suitable; when pus exists, it should not be retained for long. Xingxiao Wan (Wake-Up Pill) can rapidly reduce swelling and relieve pain, serving as a holy medicine for treating Yong. White lesions that sink inward are called "Ju" (Deep Abscess/Gangrene), which arise in the Five Zang Organs; thus, Ju has a deep root while Yong's toxin is shallow.
A red base that spreads diffusely indicates Qi deficiency failing to hold blood tightly. A red, vibrant, and lustrous base indicates sufficient Qi and Blood pushing the toxin outward. Red externally but black internally indicates toxin stagnation within. Purple-dark and unclear coloration indicates insufficient Qi and Blood, unable to transform toxin into pus. Thick pus indicates robust Qi and Blood; thin, clear pus indicates deficient Qi and Blood.
Before pus formation, between the interstices (Cou Li, 腠理), Yong involves stagnation of Fire-Toxin, while Ju involves condensation of Cold-Phlegm. After pus discharge, Yong requires supportive expulsion (Tuo, 托) due to residual Heat-Toxin, while Ju requires warming methods due to unresolved Cold-Condensation. For Cold-Ju, even in intense summer heat, warming therapies are appropriate. For Heat-Toxin, even in severe winter cold, cooling therapies are preferred. However, treatments for Yin Deficiency and Yang Excess differ significantly. Reading ancient formularies, I found them insufficiently detailed, so I elaborate their principles for reference.
Various white, sinking Ju are caused by Qi and Blood deficiency with Cold-Stagnation. In the early stage, when toxin sinks into the Yin aspect, unless Yang-Harmonizing methods (such as using Yanghe Tang, 阳和汤) open the interstices, how can Cold-Condensation be resolved? After ulceration, if Yin-Blood is dry, unless nourishing Yin and gently promoting circulation, how can thick pus be generated? Qi forms the structure, Blood provides luster. Therefore, for flat, sinking Ju that cannot expel toxin, once Yang energy harmonizes and rotates, the condensed toxin in the Yin aspect naturally dissolves. For Blood deficiency failing to transform toxin, warming and tonifying to promote pus discharge is especially suitable. Thus, during the phase of pus discharge with incomplete toxin elimination, the function of opening interstices must not be delayed. Laxity allows toxin to linger; resolution and expulsion allow toxin to dissipate. Opening interstices without concurrent warming and tonification—how can pus form amidst Qi and Blood deficiency and Cold? This is like cooking without rice. Tonifying without opening interstices merely supplements weakness; how can Cold-Condensed toxin find a path to dissipate? Moreover, in cases of abundant toxin, tonics may inadvertently aid the pathogen, like providing grain to thieves. Tonifying without warmth leads to Blood stasis and Qi stagnation; who will act as the vessel for pus formation? This is like brewing wine without heat—how can liquid form? Cooking rice without fire—how can it cook? People generally know only to clear Heat and drain Fire to detoxify, unaware that the toxin here is essentially Cold. Resolving Cold transforms the toxin; clearing Heat congeals it further. Toxin transformation necessarily proceeds through pus; pus generation relies on Qi and Blood; Qi and Blood transformation relies on Warmth. How can cooling agents be used? Cooling medicines are only applicable to red, swollen Yong and boils. For Ju in dangerous, Yin-Cold locations, warming and tonifying may still be insufficient; how can one recklessly use clearing and resolving methods, damaging Stomach Qi? This could lead to failure of Yang-Harmony, difficulty in ulceration or resolution, and toxin attacking internal organs—is this not terrifying? Since the Spleen and Stomach determine life and death, priority is given to stopping pain, followed by strengthening the Spleen. Pain cessation allows evil Qi to transform; Spleen strengthening allows muscle regeneration. With harmonized and vigorous Yang, reddish skin regenerates, relying entirely on formulas that harmonize and tonify Qi and Blood. Medicines with cold properties should strictly be avoided throughout.
Ma stated: Boils of a few fen must also be assessed by location. If occurring at critical acupoints, they cannot be disregarded. Who says small boils are harmless!
He also said: White, sinking lesions are Phlegm disorders manifesting in the flesh, caused by Qi stagnation. If hard and condensed, adhering to sinews and bones, it is a Blood-level pathology. It must initially present as red, hard, and headed to be called Ju. However, Yin and Yang must be differentiated.
He further said: Individuals with Yin Deficiency and Yang Prosperity may have Toxic-Fire結 (knotting) in the Ying (Nutritive) level. The sore is hard, flat, purple, and feels burning hot to touch. One must drain the Fire-Toxin. Only when Yin is filled and Blood harmonized can the sore rise. How can this be considered Cold-Ju treated with warming methods? Administering warming agents would dry Yin further and intensify Fire. Diagnosis relies entirely on observing pulse, color, and form.
He added: Generalizing all toxins as Cold is incorrect. One must know that Yang contains Yin, and Yin contains Yang. There are True Cold with False Heat, and True Heat with False Cold. If one clings to the "white color" criterion, what about lesions that are white but feel burning hot to touch with a surging, rapid pulse? Should these be treated as Ju? If one sticks to the "red color" criterion, what about lesions that are red but feel cool to touch with a non-surging, non-rapid pulse? Should these be treated as Yong? Without proficiency in pulse diagnosis, how can errors be avoided?
Tao stated: Chinese "sores and toxins" are referred to as inflammation in Western countries. There are names for Internal Inflammation and External Inflammation. External inflammation corresponds to Yong and Ju; Internal inflammation corresponds to Lung Abscess (Fei Yong, 肺痈) and Intestinal Abscess (Chang Yong, 肠痈), etc. Applying several leeches (Qi, 蜞) to the swollen area and sucking out the toxin is effective.
He also said: If a boil occurs at a critical acupoint, apply ground Golden-Shelled Comb (Jin Ke Zhi, 金壳栉, produced in Guangdong) with water. This can shift the toxicity to a non-lethal area within one or two cun. However, this medicine is toxic and must not be ingested. Additionally, the *Yan Fang Xin Bian* (New Compilation of Verified Prescriptions) in the chapter on miscellaneous treatments for carbuncles and toxins lists Yishan Guohai San (Mountain-Moving Sea-Crossing Powder) and Gandu San (Toxin-Chasing Powder), both capable of shifting sores to non-lethal locations.
He concluded: Xu Lingtai also stated: Redness does not always indicate Yong, and whiteness does not always indicate Ju.