托者起也上也。痈毒之发外之内者。邪必攻内。自然之理。当用托里汤液。内加升麻金银花。使荣卫
通行。血脉调和。疮毒消散。故云疮家无一日不托里也。
言补者治虚之法也。经云。虚者补之。如气虚四君子汤。乃人参黄 白术甘草。血虚当归川芎芍
药地黄四物汤合而为八物汤。或为八珍丸内详寒热加黄连附子随症活法加减。无出此二方之妙。自然
肌生肉长气血和而体自强矣。
夫痈疽疔毒。瘰 瘤疖其名甚多。故余总谓疮疡是也。然各有形。其形不同。其苦不一。十四经
络部位之高下。血气之多少。症之善恶。疮之大小浅深。腑脏之源。感之轻重所发也。故有阴有阳。
有表有里。有标有本之异也。经云。诸痛痒疮疡皆属心火。又云。营气不从。逆于肉理。乃生痈肿是
也。然形大而浮者。痈也。乃六腑积毒之所生。初起有头。一如 。白色焦枯。触之痛应心者。疽
也。肿浮根小。至大不过二三寸者。疖也。至于疔者。形有二十三种。余今分为三十四种。其形小顶
如钉 。故名之。如有红丝直皈于心。当刺其头。泻去毒血。 入蟾酥等药。不刺则皈心必死矣。然
痈疖初则宜灸。谓其气本浮。令其气血通达畅快矣。痈则易疗。而将息难瘥迟。疽则难医。易得痊。
宜烙不宜灸。诸疮之中。惟有疔疮发背最凶。须明五善七恶之理。当察其前论。篇篇有味。卷卷出奇。
虽云疮科。古之未竭其奥。未尽其传。余虽不敏。详之至微其理。大至痈疽。小至于痤痱。无不选其精秘。然方法无
不择其良验。故云之外科启玄。又图之形症。鸣之经络。施之治法。后学人可一览而即为上志矣。
托法，意为扶持、提升。痈毒由外入内或由内发外时，邪气必然向内攻伐，这是自然的规律。此时应当使用托里汤液，并在其中加入升麻和金银花，以使营卫之气通行，血脉调和，疮毒得以消散。所以说，治疗疮疡病没有一天可以不运用托里法的。
所谓补法，是治疗虚证的方法。《内经》说：“虚则补之。”例如气虚用四君子汤，由人参、黄芪、白术、甘草组成；血虚用四物汤，由当归、川芎、芍药、地黄组成。将两方合用即为八物汤，或制成八珍丸。再根据寒热症状的不同，加入黄连或附子，随症灵活加减，其妙处不出这两首方剂之外。自然能使肌肉生长，气血调和，身体强健。
至于痈、疽、疔、毒，瘰疬、瘤、疖等名称繁多，所以我统称为疮疡。然而它们各有形态，形状不同，痛苦各异。这取决于十四经络部位的高低、气血的多少、病症的善恶、疮口的大小深浅、脏腑的来源以及感邪的轻重。因此有阴证与阳证、表证与里证、标证与本证的差异。《内经》说：“各种疼痛、瘙痒、疮疡都归属于心火。”又说：“营气运行不畅，逆乱于肌肉纹理之间，就会发生痈肿。”形体大而浮肿的是痈，乃六腑积毒所生。初起时有头，像粟米一样，白色焦枯，触碰时痛彻心脏的是疽。肿胀浮浅、根部小，最大不过二三寸的是疖。至于疔疮，形态有二十三种，我现在将其分为三十四种。因其形小顶尖如钉状，所以得名。如果有红丝直通于心，应当刺破其头部，泻去毒血，并纳入蟾酥等药物，若不刺破，毒气归心必死无疑。然而痈和疖初期适宜艾灸，因为其病气本属浮浅，艾灸可使气血通达畅快。痈容易治疗但调养难愈，病程较长；疽难以医治却容易痊愈。疽适宜烙法而不宜灸法。在所有疮疡中，只有疔疮和发背最为凶险，必须明白五善七恶的道理，参照前面的论述。每一篇都有深意，每一卷都出奇招。虽然说的是外科，但古人对其中奥妙的探索尚未穷尽，传承也未完全普及。我虽然不才，但也详细探究了极其微妙的道理，大到痈疽，小到痤疮痱子，无不精选精秘之法。所有方法都选择疗效确切者，因此书名为《外科启玄》。又绘制了形态症状图，阐明了经络原理，应用了治疗方法，后学者可以一览无余，从而确立高远的志向。
The method of "Tuo" (Supporting/Promoting) means to lift and support. When carbuncles and toxins manifest from the exterior to the interior or from the interior to the exterior, pathogenic factors inevitably attack the interior; this is a natural principle. In such cases, one should employ *Tuoli Tangye* (Decoction for Supporting the Interior), adding *Shengma* (Cimicifugae Rhizoma) and *Yinhuahua* (Lonicerae Japonicae Flos) to facilitate the circulation of Ying and Wei (Nutritive and Defensive Qi), harmonize the blood vessels, and dissipate the toxin. Hence it is said that in treating sores and ulcers, there is not a single day when supporting the interior is omitted.
The term "Bu" (Tonifying/Supplementing) refers to the method of treating deficiency syndromes. The Classics state: "Deficiency should be tonified." For example, for Qi deficiency, use *Sijunzi Tang* (Four Gentlemen Decoction), composed of *Renshen* (Ginseng Radix), *Huangqi* (Astragali Radix), *Baizhu* (Atractylodis Macrocephalae Rhizoma), and *Gancao* (Glycyrrhizae Radix et Rhizoma). For Blood deficiency, use *Siwu Tang* (Four Substances Decoction), composed of *Danggui* (Angelicae Sinensis Radix), *Chuanxiong* (Chuanxiong Rhizoma), *Shaoyao* (Paeoniae Radix), and *Dihuang* (Rehmanniae Radix). Combining these two formulas yields *Bawu Tang* (Eight Substances Decoction), or they can be processed into *Bazhen Wan* (Eight Treasures Pill). Depending on cold or heat symptoms, *Huanglian* (Coptidis Rhizoma) or *Fuzi* (Aconiti Lateralis Radix Praeparata) may be added, with flexible modifications based on specific conditions. The efficacy lies essentially within these two formulas. Naturally, muscles will grow, flesh will regenerate, Qi and Blood will harmonize, and the body will become strong.
Regarding carbuncles (*Yong*), deep abscesses (*Ju*), hard boils (*Ding*), toxins, scrofula (*Luoli*), tumors (*Liu*), and furuncles (*Jie*), the names are numerous. Therefore, I generally refer to them collectively as "Chuanyang" (Sores and Ulcers). However, each has its own morphology; their shapes differ, and the suffering varies. This depends on the location along the fourteen meridians, the abundance or scarcity of Qi and Blood, the severity of the syndrome, the size and depth of the sore, the source organ involved, and the degree of pathogenic invasion. Thus, there are differences between Yin and Yang, Exterior and Interior, Biao (Branch/Symptom) and Ben (Root/Etiology). The Classics state: "All pain, itching, sores, and ulcers belong to Heart Fire." It also states: "When Ying Qi does not flow smoothly and reverses into the muscle tissue, carbuncles and swellings arise." A large, floating swelling is a *Yong* (Carbuncle), generated by accumulated toxins in the Six Fu Organs. Initially presenting with a head, resembling a millet grain, white and scorched, where touching causes pain piercing the heart, is a *Ju* (Deep Abscess). A swelling that is superficial, with a small root, reaching no more than two or three cun in diameter, is a *Jie* (Furuncle). As for *Ding* (Hard Boils), there are twenty-three forms; I currently classify them into thirty-four types. They are named so because their shape is small with a pointed top like a nail. If red threads extend directly to the heart, the head should be pricked to drain toxic blood, and substances like *Chansu* (Bufonis Venenum) should be applied. If not pricked, the toxin returning to the heart will certainly cause death. However, for initial *Yong* and *Jie*, moxibustion is suitable because their pathogenic Qi is superficial; moxibustion allows Qi and Blood to circulate freely. *Yong* is easy to treat but difficult to heal completely, often lingering; *Ju* is difficult to treat but easier to cure. *Ju* is suitable for cauterization rather than moxibustion. Among all sores, only *Dingchuang* (Hard Boil Sores) and *Fabei* (Back Carbuncle) are the most fierce. One must understand the principles of "Five Auspicious Signs" and "Seven Ominous Signs," referring to the previous discussions. Every chapter contains profound meaning, every volume reveals unique insights. Although this concerns surgery, the ancients had not exhausted its mysteries nor fully transmitted its teachings. Though I am not talented, I have detailed the subtle principles extensively, from major carbuncles and abscesses down to minor acne and miliaria, selecting only the most refined and secret methods. All prescriptions are chosen for their proven efficacy. Hence the book is titled *Waike Qixuan* (Enlightenment on External Medicine). Furthermore, diagrams of morphologies and symptoms are provided, meridian pathways are explained, and treatment methods are applied, so that future students may grasp the essentials at a glance and establish high aspirations.