夫痈疽之症，本由心经而发，何以发自心经，因实火动而成痈疽，虽有各症，亦当分内因、外因、不内外因。内因
者，乃心、肝、脾、肺、肾及心包络等处，或因寒热而血凝气滞，或膏粱浓味而遗诸毒；外因者，乃肩挑背负，劳苦奔
趋，而迎暑湿风邪，扰动气血不和，此外因也；不内外因者，乃五脏受伤而邪毒透入也。痈疽之发，分筋、骨、韧、皮、
肤五类。痈发于血脉之间，属阳，为顺症；疽发于筋骨之内，属阴，为逆症。发于皮内者为疡，发于肤上者为疖。凡症
宜视阴阳，详察善恶，若见三善，纵然沉重，亦无大害；如见四恶，虽然微小，亦必丧亡。凡业医者，不可徒从表里、
寒热而辨阴阳，以贻害于人也。
痈疽原是火毒生，经络阻隔气血凝，外因六淫八风感，内因六欲并七情，饮食起居多失慎，肩挑背负损其身，膏粱
之变营卫过，藜藿之躯气血贫，疽由筋骨阴分发，痈从阳分肉脉生，疡起皮里肉之外，疮发皮肤为失荣，阳盛 肿赤痛
易，阴盛色暗陷不疼，半阴半阳不高肿，微痛微热红亦轻，五善为顺七恶逆，见三见四可分明，临症色脉须详察，温凉
补汗攻应分，善治伤寒杂症易，能察痈疽肿毒精。
经云∶“诸痛痒疮，皆属心火。故曰痈疽原是火毒生也。痈疽皆因营卫不和，气血凝结，经络阻隔而生，故曰经络
阻隔气血凝也。其因有三，内因、外因、不内外因是也。外因者，由于春之风，夏之暑湿，秋之燥，冬之寒也，当其时
而至，则为正气，非其时而至，或过盛，则为淫邪。凡此六淫为病，皆属外因。亦有因八风相感，如冬至日正北大刚风，
春分日正东婴儿风，秋分日正西罡风，立夏日东南弱风，立冬日西北折风，应时而至，则生养万物，不应时而至，则杀
害生灵万物，若人感受，则内生重病，外发痈疽。凡此八风为病，皆属于外，故亦曰外因六淫、八风感也。内因者，耳
听淫声，目视邪色，鼻闻过臭，舌食滋味，心思过度，意念妄生，皆损人神，凡此六淫为病，皆属内因，故曰内因六欲
并七情也。不内外因者，饮食不节，起居不慎，过饮醇酒则生火，消烁阴液，过饮茶水则生湿，过食五辛则损气血，过
饥过饱则伤脾胃，凡此种种，皆饮食之致病；昼夜过劳，担轻负重，跌扑损坠等类，损其身形，夜不静息，强力入房，
劳伤精气，此起居之病也。其起于膏粱浓味者，多令人营卫不和，火毒内结，起于藜藿薄食者，多令人胃气不充，气血
亏少，凡此种种，皆不内外因也。人之身体，计有五层，皮、脉、肉、筋、骨也。发于筋骨间者曰疽，属阴；发于血脉
间者曰痈，属阳；发于皮里肉外者曰疡毒，只发于皮肤上者名曰疮疖。凡痈疽阳盛者，初起 肿，色赤，疼痛，则易溃
易敛，顺而易治，以其为阳症也。阴盛者，初起色黯，不红，塌陷，不肿，木硬不疼，则难溃难敛，逆而难治，以其为
阴症也。半阴半阳者，漫肿不高，微痛不甚，色不甚红，此症属险，若能随症施治，不失其时，则亦可转险为顺，否则
逆矣。五善者，五善之症也，诸疮见之则为顺，则易治；七恶者，七恶之症也，诸疮见之则为逆，则难治。凡患痈疽者，
五善为顺，七恶为逆，如见三善者必生，见四恶者必死矣。尔后学业医者，当于临症之际详察其色，宜温者则温之，宜
凉者则凉之，宜补则补，宜汗则汗，宜攻则攻，果能如是，庶有济而不误也。然而外症痈疽，犹如内症伤寒，能善治伤
寒者，则杂症无不易治，能善疗痈疽者，则诸疮无不精妙，盖以其能辨表里、阴阳、虚实、寒热也。
痈疽这类病症，原本是由心经引发的。为什么说是从心经引发呢？因为实火亢动而形成了痈疽。虽然症状表现各异，但也应当区分内因、外因和不内外因。
所谓内因，是指心、肝、脾、肺、肾以及心包络等脏腑部位，或者因为寒热失调导致血液凝滞、气机阻滞，或者因为食用肥甘厚味而遗留各种毒邪；
所谓外因，是指肩挑背负、劳苦奔波，从而感受暑湿风邪，扰动气血使其不和，这就是外因；
所谓不内外因，是指五脏受到损伤，致使邪毒透入体内。
痈疽的发生，分为筋、骨、韧、皮、肤五类。痈发于血脉之间，属于阳证，是顺症；疽发于筋骨之内，属于阴证，是逆症。发于皮内的是疡，发于皮肤表面的是疖。
凡是病症，应当观察阴阳属性，详细辨别善恶预后。如果见到“三善”征象，即使病情沉重，也不会有大害；如果见到“四恶”征象，即使病灶微小，也必然导致死亡。
凡是行医之人，不可仅仅根据表里、寒热来辨别阴阳，以免贻误害人。
痈疽原本是由火毒产生的，经络阻隔导致气血凝结。外因包括六淫和八风的侵袭，内因包括六欲和七情的影响，饮食起居大多失于谨慎，肩挑背负损害身体，膏粱厚味导致营卫过盛，粗茶淡饭导致气血贫乏。疽由筋骨阴分发生，痈从阳分肌肉血脉产生，疡起于皮里肉外，疮发于皮肤称为失荣。阳盛则肿赤痛容易（治疗），阴盛则色暗陷而不疼，半阴半阳则不高肿，微痛微热红色也轻。五善为顺，七恶为逆，见到三种或四种可以分明。临症时须详细察视神色脉象，温凉补汗攻法应当分清。善于诊治伤寒杂症容易，能察辨痈疽肿毒则技艺精妙。
经文说：“各种疼痛、瘙痒、疮疡，都归属于心火。”所以说痈疽原本是由火毒产生的。痈疽都是因为营卫不和，气血凝结，经络阻隔而生成的，所以说经络阻隔气血凝。其病因有三类：内因、外因、不内外因。
外因方面，是由于春季的风、夏季的暑湿、秋季的燥、冬季的寒。在相应季节到来时，它们就是正气；如果不是相应季节到来，或者过于强盛，就成为淫邪。凡是这六淫致病，都属于外因。也有因为感受八风引起的，比如冬至日正北的大刚风，春分日正东的婴儿风，秋分日正西的罡风，立夏日的东南弱风，立冬日的西北折风。顺应时节到来，则生养万物；不顺应时节到来，则杀害生灵万物。如果人感受了这些邪风，就会内生重病，外发痈疽。凡是这八风致病，都属于外因，所以也说外因包括六淫、八风感。
内因方面，耳朵听淫靡之声，眼睛看邪僻之色，鼻子闻过分的气味，舌头吃滋味浓烈之物，心思过度，意念妄生，都会损伤人的精神。凡此种种六淫（此处指感官欲望之邪）致病，都属于内因，所以说内因包括六欲并七情。
不内外因方面，饮食不节制，起居不慎，过量饮用美酒则生火，消烁阴液；过量饮茶则生湿；过量食用五辛（葱、蒜、韭、薤、兴渠）则损伤气血；过饥过饱则伤害脾胃。凡此种种，都是饮食导致的疾病；昼夜过度劳累，担轻负重，跌打损伤坠落等类，损害身形；夜间不能安静休息，强力行房事，劳伤精气，这是起居导致的疾病。那些起于膏粱厚味的，多让人营卫不和，火毒内结；起于藜藿薄食的，多让人胃气不充，气血亏少。凡此种种，都是不内外因。
人的身体，共有五层：皮、脉、肉、筋、骨。发于筋骨间的叫疽，属于阴；发于血脉间的叫痈，属于阳；发于皮里肉外的叫疡毒，只发于皮肤上的名叫疮疖。
凡是痈疽中阳盛的，初起肿胀，颜色红赤，疼痛，则容易溃破也容易收敛，顺而易治，因为它是阳证。阴盛的，初起颜色黯黑，不红，塌陷，不肿，木硬且不疼，则难溃难敛，逆而难治，因为它是阴证。半阴半阳的，漫肿不高，微痛不甚，颜色不甚红，这种病症属险，如果能随症施治，不失时机，则可以转险为顺，否则就转为逆证了。
五善，是指五种善的征象，诸疮见到则为顺，则易治；七恶，是指七种恶的征象，诸疮见到则为逆，则难治。凡是患痈疽的人，五善为顺，七恶为逆，如见到三善者必生，见到四恶者必死。
你们后来学习医术的人，应当在临症之际详细察视患者的神色，适宜用温法的就用温法，适宜用凉法的就用凉法，适宜补的就补，适宜发汗的就发汗，适宜攻下的就攻下，果真能这样做，大概就能有所救治而不犯错误了。然而外科的痈疽病症，犹如内科的伤寒病症，能善于治疗伤寒的，那么杂症就没有不易治疗的；能善于疗治痈疽的，那么各种疮疡没有不精妙的，大概是因为他们能辨别表里、阴阳、虚实、寒热啊。
The disease of carbuncle and furuncle (Yongju) originates from the Heart Meridian. Why does it originate from the Heart Meridian? Because excessive fire moves and generates carbuncle and furuncle. Although there are various symptoms, one must distinguish between internal causes, external causes, and causes neither internal nor external.
Internal causes refer to the Zang-Fu organs such as the Heart, Liver, Spleen, Lung, Kidney, and Pericardium. Due to cold-heat imbalance, blood may coagulate and Qi stagnate; or due to a diet rich in fatty and sweet foods, various toxins may remain.
External causes refer to carrying heavy loads on shoulders or backs, laboring and rushing, thereby being exposed to summer heat, dampness, and wind pathogens, which disturb Qi and Blood causing disharmony. This is the external cause.
Causes neither internal nor external refer to injuries to the Five Zang organs allowing pathogenic toxins to penetrate inward.
The onset of carbuncle and furuncle is categorized into five types: tendon, bone, ligament, skin, and flesh. Carbuncle (Yong) arises between blood vessels and meridians, belongs to Yang, and is a favorable prognosis (Shun syndrome). Furuncle (Ju) arises within bones and sinews, belongs to Yin, and is an unfavorable prognosis (Ni syndrome). Those arising within the skin are called ulcers (Yang), and those arising on the surface of the skin are called boils (Jie).
In all cases, one should observe Yin and Yang, and carefully examine for good or bad omens. If three "good" signs are seen, even if the condition is severe, there will be no major harm. If four "bad" signs are seen, even if the lesion is small, death is inevitable.
Practitioners must not rely solely on exterior-interior or cold-heat differentiation to determine Yin and Yang, lest they cause harm.
Carbuncle and furuncle originally arise from fire-toxin. Obstruction of meridians leads to coagulation of Qi and Blood. External causes include invasion by the Six Excesses (Liu Yin) and Eight Winds. Internal causes include the Six Desires and Seven Emotions. Diet and daily life are often imprudent. Carrying heavy burdens damages the body. Rich diets cause excess in Ying and Wei (Nutritive and Defensive Qi); coarse diets lead to deficiency of Qi and Blood. Furuncles arise from the Yin aspect of bones and sinews; carbuncles arise from the Yang aspect of muscles and vessels. Ulcers arise outside the flesh but inside the skin; sores arising on the skin are termed "Shi Rong" (Loss of Glory/Nourishment). Yang excess presents with swelling, redness, and pain, which are easy to treat; Yin excess presents with dark color, depression, and lack of pain, which are difficult to treat. Half-Yin half-Yang presents with diffuse swelling without elevation, slight pain and heat, and mild redness. The Five Goods indicate favorable outcomes; the Seven Evils indicate unfavorable outcomes. Observing three or four can clarify the prognosis. In clinical practice, colors and pulses must be examined in detail; warming, cooling, tonifying, sweating, and purging methods should be distinguished appropriately. It is easy to treat Shaoyang diseases and miscellaneous disorders if one is skilled; one becomes precise in treating carbuncles and furuncles by observing them well.
The Classic states: "All pain, itching, and sores belong to Heart Fire." Thus, it is said that carbuncle and furuncle originally arise from fire-toxin. Carbuncle and furuncle are generated because Ying and Wei are disharmonious, Qi and Blood coagulate, and meridians are obstructed. Hence, it is said that obstruction of meridians leads to coagulation of Qi and Blood. There are three causes: internal, external, and neither internal nor external.
Regarding external causes, they stem from Spring wind, Summer heat-dampness, Autumn dryness, and Winter cold. When these arrive in their proper seasons, they are righteous Qi; when they arrive out of season or are excessive, they become Excess Pathogens (Yin Xie). All diseases caused by the Six Excesses belong to external causes. Also, there are invasions by the Eight Winds, such as the Great Rigid Wind from the North on the Winter Solstice, the Infant Wind from the East on the Spring Equinox, the Gang Wind from the West on the Autumn Equinox, the Weak Wind from the Southeast on the Start of Summer, and the Breaking Wind from the Northwest on the Start of Winter. When arriving in season, they nourish all things; when out of season, they kill living beings. If humans contract these winds, severe internal diseases arise, and carbuncles/furuncles manifest externally. These Eight Winds causing disease belong to external causes; thus, it is also said that external causes include the Six Excesses and Eight Winds.
Regarding internal causes, listening to licentious sounds, viewing lewd sights, smelling foul odors, eating flavorful foods, mental overexertion, and delusional thoughts all damage the Spirit. These sensory desires constitute internal causes; thus, it is said that internal causes include the Six Desires and Seven Emotions.
Regarding causes neither internal nor external: immoderate diet and imprudent lifestyle. Drinking too much fine wine generates fire, consuming Yin fluids; drinking too much tea generates dampness; eating too much of the Five Pungents (Garlic, Scallion, Chives, Leek, Asafoetida) damages Qi and Blood; hunger or overeating injures the Spleen and Stomach. These are diseases caused by diet. Overwork day and night, bearing light or heavy loads, falls and injuries damage the body structure. Lack of quiet rest at night and forced sexual activity injure Essence and Qi. These are diseases caused by lifestyle. Conditions arising from rich diets often cause Ying-Wei disharmony and internal binding of fire-toxin. Conditions arising from coarse diets often cause insufficient Stomach Qi and deficiency of Qi and Blood. All these are causes neither internal nor external.
The human body has five layers: Skin, Vessels, Flesh, Tendons, and Bones. Arising between bones and tendons is Ju (Furuncle/Deep Abscess), belonging to Yin. Arising between blood vessels is Yong (Carbuncle/Superficial Abscess), belonging to Yang. Arising outside the flesh but inside the skin is Yang Du (Ulcer Toxin). Arising only on the skin is Chuang Jie (Sore/Boil).
In Yang-excess carbuncles/furuncles, initial presentation includes swelling, red color, and pain; they easily suppurate and heal, representing a favorable course because they are Yang syndromes. In Yin-excess cases, initial presentation includes dark color, lack of redness, depression, no swelling, woody hardness, and no pain; they are difficult to suppurate and heal, representing an unfavorable course because they are Yin syndromes. Half-Yin half-Yang cases present with diffuse swelling without elevation, slight pain, and mild redness. This condition is dangerous. If treated according to symptoms without delay, danger can turn to favorability; otherwise, it becomes unfavorable.
The Five Goods refer to five favorable signs; seeing them in sores indicates favorability and ease of treatment. The Seven Evils refer to seven unfavorable signs; seeing them indicates unfavorability and difficulty of treatment. For patients with carbuncles/furuncles, Five Goods are favorable, Seven Evils are unfavorable. Seeing three Goods implies survival; seeing four Evils implies death.
Future practitioners must carefully observe the patient's complexion during clinical examination. Apply warming methods where appropriate, cooling methods where appropriate, tonification where appropriate, diaphoresis where appropriate, and purgation where appropriate. If done correctly, treatment will be effective and error-free. However, external diseases like carbuncles and furuncles are analogous to internal diseases like Cold Damage (Shang Han). One who is skilled in treating Cold Damage can easily treat miscellaneous disorders; one who is skilled in treating carbuncles and furuncles will master all sores. This is because they can differentiate Exterior-Interior, Yin-Yang, Deficiency-Excess, and Cold-Heat.