或问，痈疽五善七恶，何谓也。答曰∶五善者，饮食知味，一也；便溺调匀，二也；脓
溃肿消，脓水不臭，三也；神气清爽，动息自宁，四也；脉息有神，不违时令，五也。七恶
者，大渴发热，泄泻淋闭，一也；脓溃尤肿，脓稀臭秽，二也；目睛无神，语声不亮，三也
；食少不化，服药作呕，四也；恍惚嗜卧，气短乏力，腰背沉重，五也；唇青鼻黑，面目浮
肿，六也；脉息无神，或躁动不和，七也。古语云∶五善得三则吉，七恶得四则凶。余谓七
恶之凶，不待四矣。然而急救之方，正不容以不讲。大抵热渴淋闭，喘急内热，皆真阴受伤
，宜六味汤加麦冬、五味。如不应，用八珍汤加麦冬、五味。更不应，用十全大补汤，兼服
六味地黄丸。此乃补阴生阳之说也。若气短倦怠，昏愦乏力，饮食不化，乃阳虚之候，宜用
补中益气汤。若卧睡不宁，宜用归脾汤。若饮食减少，面目浮肿，宜用香砂六君子汤。若兼
脾胃虚寒，更用理中汤。肾气虚寒须用桂附八味丸，兼用十全大补汤加附子，此温补回阳之
法。若痈疽溃后，脓血去多，变为角弓反张，手足搐搦，肢体振摇而发痉者，并用参 归术
并附子等药以救之。如不应，用十全大补汤，间有可生者。当此时势，性命急如悬缕，司命
者宜叮咛反复，熟思而审处之。
有人问：痈疽的“五善”和“七恶”，具体是指什么？
回答说：“五善”是指：饮食能知味道，这是一善；大小便调和均匀，这是二善；脓液排出、肿胀消退，且脓水没有臭味，这是三善；精神清爽，呼吸平稳安宁，这是四善；脉搏有神气，不违背时令规律，这是五善。
“七恶”是指：极度口渴、发热、腹泻、小便淋沥或闭塞不通，这是一恶；脓液排出后肿胀反而更甚，脓液稀薄且气味臭秽，这是二恶；眼睛目光无神，说话声音嘶哑不清亮，这是三恶；进食少且难以消化，服药后发生呕吐，这是四恶；神情恍惚、嗜睡懒卧，气短乏力，腰背沉重，这是五恶；嘴唇发青、鼻头发黑，面目浮肿，这是六恶；脉搏无神气，或者躁动不安、节律不调，这是七恶。
古语说：“五善”中具备三项则预后吉祥，“七恶”中具备四项则预后凶险。我认为对于“七恶”的凶险征兆，不需要等到出现四项就已经危险了。然而急救的方法，确实不能不进行探讨。
大抵上，热渴、小便淋闭、气喘急促、体内发热，这些都是真阴受损的表现，适宜使用六味汤（由熟地黄、山茱萸、山药、泽泻、牡丹皮、茯苓组成）加入麦冬、五味子。如果无效，使用八珍汤（由人参、白术、茯苓、甘草、当归、川芎、白芍、熟地黄组成）加入麦冬、五味子。如果再无效，使用十全大补汤（在八珍汤基础上加黄芪、肉桂），并兼服六味地黄丸。这是补益阴精以滋生阳气的说法。
如果是气短倦怠、昏沉困倦、乏力、饮食不消化，这是阳气虚弱的征候，适宜使用补中益气汤（由黄芪、人参、白术、甘草、当归、陈皮、升麻、柴胡组成）。
如果是睡眠不安宁，适宜使用归脾汤（由白术、茯神、黄芪、龙眼肉、酸枣仁、人参、木香、甘草、当归、远志组成）。
如果是饮食减少、面目浮肿，适宜使用香砂六君子汤（由人参、白术、茯苓、甘草、陈皮、半夏、木香、砂仁组成）。
如果兼有脾胃虚寒，更应使用理中汤（由人参、干姜、白术、甘草组成）。
肾气虚寒必须使用桂附八味丸（即金匮肾气丸，在六味地黄丸基础上加肉桂、附子），并兼用十全大补汤加入附子，这是温补并回阳的方法。
如果是痈疽溃破后，脓血流失过多，导致身体变成角弓反张（背部肌肉强直痉挛，身体向后弯曲如弓状），手足抽搐，肢体震颤摇晃而引发痉病（筋脉拘急挛缩的病证），应当并用党参、当归、白术、附子等药物来抢救。
如果无效，使用十全大补汤，偶尔也有救活的情况。
在这种危急时刻，性命悬于一线，医生应当反复叮嘱，深思熟虑并审慎处理病情。
A question was asked: What are the "Five Good Signs" (Wu Shan) and "Seven Bad Signs" (Qi E) in carbuncles and sores?
The answer is: The "Five Good Signs" are as follows: Ability to taste food, which is the first; regular and balanced urination and defecation, which is the second; discharge of pus with reduction of swelling, and the pus fluid is not foul-smelling, which is the third; clear spirit and calm breathing/rest, which is the fourth; a pulse that has spirit/vitality and conforms to the seasonal patterns, which is the fifth.
The "Seven Bad Signs" are as follows: Extreme thirst, fever, diarrhea, and stranguria or urinary retention, which is the first; increased swelling after pus discharge, with thin and foul-smelling pus, which is the second; eyes lacking spirit/luster and hoarse voice, which is the third; poor appetite with indigestion, and vomiting after taking medicine, which is the fourth; mental confusion, drowsiness, shortness of breath, fatigue, and heaviness in the waist and back, which is the fifth; blue lips and black nose, with edema of the face and eyes, which is the sixth; a pulse lacking vitality, or being restless/irregular, which is the seventh.
Ancient sayings state: If three of the Five Good Signs are present, the prognosis is auspicious; if four of the Seven Bad Signs are present, the prognosis is ominous. I believe that regarding the ominous nature of the Seven Bad Signs, danger arises before four signs even appear. However, emergency rescue methods must indeed be studied.
Generally speaking, heat, thirst, stranguria, rapid breathing, and internal heat indicate injury to True Yin (Zhen Yin). It is appropriate to use Liuwei Tang (Six-Ingredient Decoction) added with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). If there is no response, use Bazhen Tang (Eight-Treasure Decoction) added with Maidong and Wuweizi. If still ineffective, use Shiquan Dabu Tang (Ten Complete Tonifying Decoction), taken concurrently with Liuhui Dihuang Wan (Six-Ingredient Rehmannia Pill). This is the theory of tonifying Yin to generate Yang.
If there is shortness of breath, lassitude, mental cloudiness, fatigue, and food stagnation, this indicates Yang Deficiency (Yang Xu). It is appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
If sleep is restless, it is appropriate to use Guipi Tang (Restore the Spleen Decoction).
If food intake decreases and there is facial edema, it is appropriate to use Xiangsha Liujunzi Tang (Aucklandia and Tsaoko Six-Gentlemen Decoction).
If accompanied by Spleen-Stomach Deficiency-Cold (Pi Wei Xu Han), Lizhong Tang (Regulate the Middle Decoction) should be used additionally.
For Kidney Qi Deficiency-Cold (Shen Qi Xu Han), Guifu Bawei Wan (Cinnamon and Aconite Eight-Ingredient Pill) must be used, along with Shiquan Dabu Tang added with Fuzi (Aconiti Lateralis Radix Praeparata). This is the method of warming and tonifying to restore Yang.
If after the ulceration of carbuncles and sores, excessive loss of pus and blood leads to opisthotonos (body stiffening backward like a bow), convulsions of the hands and feet, tremors, and spasms, one should use herbs such as Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Fuzi to rescue the patient.
If there is no response, use Shiquan Dabu Tang; occasionally, survival is possible.
At such critical moments, when life hangs by a thread, physicians should give repeated instructions, think deeply, and handle the case prudently.