夫症之有标本。如五运为本。六气为标。五脏为本。六腑为标。初病为本。传病为标。元气为本。病气为标。
治宜本而标之。如有呕吐、泄泻、食少、不寐等症。宜先治之。所谓内症愈而外症易瘥。是标而本之也。仍
兼外治。
标使治宜 如肿疡初起。审症处方。必以一药为标使。如神授卫生散用金银花、当归。苍术复煎散用
苍术。十全大补汤用夏枯草。蜡矾丸用菊花汤。通圣散用漏芦之类。每用一两煎汤。复煎群药。其应如
响。此飞霞子之秘诀也。溪云。阿胶饮、牛胶丸。属金属土。补肺气实大肠。壮胃止泻。黄蜡丸入大肠有补。
国老膏化毒行经。远志酒、金银花酒。皆有补性。归血归心。善用者以之配入。肿疡之散结。溃疡之补虚。
亦奏捷效。宜触类而长之可也。又如诸毒生于巅顶者。诸药俱宜酒浸、酒炒、酒煎、酒服。为使为因。所为
在上者因而射之也。
书云。汗之则疮已。为外有六经之形症。内无便溺之阻隔。饮食如故。清便自调。知不在里也。左脉洪缓。
关脉带弦。外感客邪也。故宜汗之。使荣卫通邪气去矣。如冬月寒致腠理。必用辛温之剂以托之。如托
里温中汤、绀珠丹之类。又云。助表不以取汗为功。为蟾酥、朱砂、雄黄等解毒之类。乃取汗之峻剂也。又
云。疮家虽不疼痛。不可发汗。汗之则痉。为无表症也。即有表症。然亦不可大汗。大汗则表虚不脓。后必
难治。汗出不利小便。汗止则阳气复。小便自利也。
肿疡时见五实者。为邪气在里。宜寒凉药攻利之。如内疏黄连汤之类。次以托里排脓之药补之。溃疡
时虽有口干便闭等症。由内亡津液所致。必脉细而数。口和而干。食少喜热。乃虚火也。惟补气血。养津
液。健脾胃。则二便自和。庶无变症。如小便闭。虽肿疡时。不必猪苓、泽泻以导水。惟用参、 、归、芍及托里
消毒散消息之。自效。疮疡面赤。火郁也。发之。见风脉风症者。散之。大便燥急者。润之。郁冒者。为
昏迷也。俱宜汗之。以上之症。慎不可下。是以疮疡惟在闭而不结。通而不泻为规。
疮疡作呕。不问已溃未溃。惟以脉实而数喜饮冷者。为毒瓦斯内攻。下之。脉弱而喜温者。为阳气不足。补
之。身热而欲衣者。热在皮毛。寒在骨髓。温之。身不热而欲去衣者。寒在皮毛。热在骨髓。清之。
寒热虚实。皆能为痛。止痛之法。殊非一端。如热毒 痛者。下之。便闭作痛者。导之。瘀血作痛者。和之。更
以桑柴烘之。寒邪作痛者。温散之。湿肿强痛者。渗导之。燥搐挛痛者。滋润之。劳而作痛者。益之。脓胀作
痛者。针之。脓出反痛者。虚也。补之。瘀腐蚀痛者。去之。秽气触痛者。和之。风寒逼痛者。温散之。随症施之。
其痛自止。不必拘拘于乳、没也。又疮疡不可不痛。不痛为胃气虚极也。不治。不可大痛。兼烦闷者不治。
再麻痒者。更为恶候。
肿时不食为痛伤胃气。溃后痛止。自能食也。垣云。疮疡食肉。反补胃气。乃自弃也。此禁之膏粱丹石之
变。非藜藿及虚弱者之通论也。若脾胃弱者。即有所禁忌。亦当少与之。不与。则逆其胃气。反不思食。禁
忌之要。在生冷伤脾。硬物难化。肥腻滑肠。惟宜斟酌与之可也。又服药后忌饮冷水。犯之效迟。脓必再
作。
疾病的标本关系，就像五运是根本，六气是标象；五脏是根本，六腑是标象；初发病是根本，传变后的病是标象；元气是根本，病邪之气是标象。
治疗应当以治本为主，兼顾治标。如果有呕吐、泄泻、食欲不振、失眠等症状，应当先治疗这些症状。这就是所谓内部病症痊愈后，外部病症就容易治愈，这是通过治标来稳固根本的方法。同时仍要配合外治法。
关于使用“标使”（引经药或辅助药）的治疗原则：如肿疡（体表化脓性感染初期）初起时，审察病情开具处方，必须有一种药物作为标使。例如神授卫生散中使用金银花、当归；苍术复煎散中使用苍术；十全大补汤中使用夏枯草；蜡矾丸中使用菊花汤；通圣散中使用漏芦等类药材。每味药用量一两，煎成汤剂，再用此汤去煎煮其他群药。疗效迅速显著。这是飞霞子的秘诀。溪云认为：阿胶饮、牛胶丸，属性属金土，能补肺气、实大肠、壮胃止泻；黄蜡丸入大肠有补益作用；国老膏（甘草制剂）能化毒行经；远志酒、金银花酒，都有补益性质，能使归血归心。善于用药的人将其配伍使用，对于肿疡的消散结块、溃疡的补虚，也能取得快速疗效。应当触类旁通，加以推广。又如各种毒疮生于头顶者，诸药都适宜用酒浸泡、酒炒、酒煎、酒送服。以此作为使药或因势利导，符合“病位在上者，因而引导之”的原则。
古书说：“发汗则疮疡自愈。”这是因为外有六经（太阳、阳明、少阳、太阴、少阴、厥阴）的形症，内无大小便的阻隔，饮食正常，二便自调，知道病不在里。左脉洪缓，关脉带弦，是外感客邪所致。所以适宜发汗，使营卫通畅，邪气去除。如在冬季受寒导致腠理闭塞，必须用辛温的药物来托毒外出，如托里温中汤、绀珠丹之类。又说：“助表不以取汗为功”，是指蟾酥、朱砂、雄黄等解毒类药物，乃是发汗的峻猛药剂。又说：“患疮疡的人即使没有疼痛，也不可以发汗。如果发汗会导致痉病。”这是因为没有表证。即使有表证，也不可以大汗。大汗则导致表虚不能化脓，后来必定难以治疗。发汗后小便不利，汗止则阳气恢复，小便自然通利。
肿疡时期出现五实（脉盛、皮热、腹胀、前后不通、闷瞀）症状的，是因为邪气在里，宜用寒凉药物攻下通利，如内疏黄连汤之类。其次再用托里排脓的药物进行补益。溃疡时期虽然有口干、便秘等症状，这是由于体内津液亡失所致，必然脉细而数，口中和但觉干，食少喜热，这是虚火。只有补气血、养津液、健脾胃，那么二便自然调和，才不会有变证。如小便闭阻，即使是肿疡时期，也不必用猪苓、泽泻来导水，只用人参、[缺字，推测为黄芪或白术]、当归、芍药及托里消毒散斟酌使用，自然有效。疮疡面部发红，是火郁于内，宜发散；见到风脉、风症的，宜疏散；大便燥急的，宜润下；郁冒（昏迷）的，也是由于火郁，俱宜发汗。以上这些症状，千万不可攻下。因此治疗疮疡的规则在于：闭合而不结聚，通畅而不泻下。
疮疡发作呕吐，不问已经溃破还是未溃破，只要脉实而数、喜欢喝冷水的，是毒瓦斯内攻，宜攻下；脉弱而喜欢喝温水的，是阳气不足，宜补益。身体发热却想穿衣的，是热在皮毛，寒在骨髓，宜温补；身体不发热却想脱衣的，是寒在皮毛，热在骨髓，宜清解。
寒、热、虚、实都能引起疼痛，止痛的方法不止一种。如热毒引起的疼痛，宜攻下；便秘引起的疼痛，宜导滞；瘀血引起的疼痛，宜调和；再配合桑柴火烘烤。寒邪引起的疼痛，宜温散；湿肿强痛，宜渗利导下；干燥抽搐挛缩疼痛，宜滋润；劳累引起的疼痛，宜补益；脓胀引起的疼痛，宜针刺；脓出后反而疼痛，是虚证，宜补益；瘀血腐蚀引起的疼痛，宜去除瘀腐；秽气触痛，宜调和；风寒逼迫引起的疼痛，宜温散。随症施治，疼痛自然停止，不必拘泥于乳香、没药。另外，疮疡不可以不痛，不痛是胃气极度虚弱，属于不治之症；不可以剧烈疼痛，兼有烦闷的也不治。再者，麻木瘙痒的，更是恶候。
肿胀时不进食，是因为疼痛损伤了胃气；溃破后疼痛停止，自然就能进食了。垣（李东垣）说：疮疡患者吃肉，反而补益胃气，那是自我抛弃（指不当进补）。这是针对膏粱厚味及丹石药物变证的禁忌，并非针对粗茶淡饭饮食及虚弱者的通用理论。如果脾胃虚弱，即使有所禁忌，也应当少量给予。如果不给，就会违背胃气，反而不想吃东西。禁忌的重点在于：生冷伤脾，硬物难消化，肥腻滑肠。只应当斟酌适量给予即可。另外，服药后忌饮冷水，违反此条则疗效迟缓，脓液必会再次生成。
The relationship of root (Ben) and branch (Biao) in diseases is such that: The Five Movements (Wu Yun) are the root, and the Six Qi (Liu Qi) are the branch; the Zang organs are the root, and the Fu organs are the branch; the initial disease is the root, and the transmitted disease is the branch; the Yuan Qi (Primal Qi) is the root, and the pathogenic Qi is the branch.
Treatment should prioritize addressing the root while managing the branch. If symptoms such as vomiting, diarrhea, poor appetite, or insomnia occur, these should be treated first. This is what is meant by "when internal diseases heal, external diseases become easier to cure," which is treating the branch to stabilize the root. External treatments should still be combined.
Regarding the use of "branch guides" (Yin Jing Yao / guiding herbs): When a carbuncle (Zhong Yang - early stage suppurative infection) first appears, after examining the condition and prescribing, one herb must be used as a branch guide. For example, Shen Shou Wei Sheng San uses Honeysuckle Flower (Jinyinhua) and Angelica Sinensis Root (Danggui); Cang Zhu Fu Jian San uses Atractylodes Rhizome (Cangzhu); Shi Quan Da Bu Tang uses Prunella Vulgaris Spike (Xiakucao); La Fan Wan uses Chrysanthemum Decoction (Juhua Tang); Tong Sheng San uses Agrimoniae Herba (Loulu), and similar herbs. Each is used in an amount of one liang, decocted into a soup, and then this soup is used to decoct the other herbs in the prescription. The response is immediate and effective. This is the secret method of Fei Xia Zi. Xi Yun states: E Jiao Yin and Niu Jiao Wan belong to Metal and Earth elements; they tonify Lung Qi, strengthen the Large Intestine, fortify the Stomach, and stop diarrhea. Huang La Wan enters the Large Intestine with a tonifying effect. Guo Lao Gao (Licorice preparation) resolves toxicity and promotes meridian circulation. Yuan Zhi Wine and Jinyinhua Wine both have tonifying properties, returning blood to the Heart. Those skilled in medication use them in combination, achieving rapid results in resolving nodules in carbuncles and tonifying deficiency in ulcers. One should extrapolate from these examples. Furthermore, for various toxic sores arising on the vertex, all herbs are suitable for wine soaking, wine frying, wine decocting, or wine administration. These serve as guiding herbs or follow the principle of "treating disorders above by inducing upward movement."
Ancient texts state: "Sweating cures the sore." This applies when there are exterior manifestations of the Six Meridians (Liu Jing), but no internal obstruction of urination or defecation, normal diet, and regular bowel and bladder movements, indicating the disease is not interior. The left pulse is surging and slow, and the Guan position pulse is wiry, indicating exogenous pathogenic factors. Therefore, sweating is appropriate to unblock Ying and Wei (Nutritive and Defensive Qi) and expel pathogens. In winter, cold causes pore closure; pungent-warm formulas must be used to support the interior and expel pathogens, such as Tuo Li Wen Zhong Tang or Gan Zhu Dan. It is also said: "Supporting the exterior does not aim solely at inducing sweat"; this refers to detoxifying agents like Toad Venom (Chansu), Cinnabar (Zhusha), and Realgar (Xionghuang), which are harsh agents for inducing sweat. It is further stated: "Patients with sores, even if painless, should not be sweated. Sweating will cause spasms." This is because there is no exterior syndrome. Even if an exterior syndrome exists, heavy sweating should be avoided. Heavy sweating leads to exterior deficiency and inability to form pus, making later treatment difficult. After sweating, if urination is difficult, stopping the sweat allows Yang Qi to recover, and urination becomes normal.
If five excess conditions (Wu Shi - full pulse, hot skin, abdominal distension, blockage of front and back, and dizziness/confusion) appear during the carbuncle stage, it indicates pathogenic factors in the interior. Cold-cooling purgatives should be used, such as Nei Shu Huang Lian Tang, followed by formulas that support the interior and drain pus. During the ulcer stage, although symptoms like dry mouth and constipation may occur due to the loss of body fluids internally, the pulse will be fine and rapid, the mouth feels neutral but dry, food intake is low and preference for warmth exists, indicating deficient fire. Only by tonifying Qi and Blood, nourishing body fluids, and strengthening the Spleen and Stomach will bowel and bladder functions normalize, preventing complications. If urinary retention occurs, even during the carbuncle stage, one need not use Polyporus (Zuling) or Alisma (Zexie) to drain water; instead, use Ginseng (Renshen), [missing character, likely Astragalus or Atractylodes], Angelica Sinensis Root (Danggui), Peony Root (Baishao), and Tuo Li Xiao Du San, adjusting as necessary, for natural efficacy. Facial redness in sores indicates Fire stagnation; disperse it. Wind pulse or wind symptoms indicate dispersion. Dry and urgent stool indicates moistening. Dizziness and confusion (Yu Mao) indicate heat stagnation; all should be treated with sweating. For the above conditions, purgatives must strictly be avoided. Thus, the rule for treating sores is: keep closed without knotting, keep open without purging.
Vomiting in sores, whether ulcerated or not, depends on the pulse and preference: if the pulse is excess and rapid with a desire for cold drinks, it is internal attack by toxic vapors, requiring purgation; if the pulse is weak with a desire for warm drinks, it is insufficient Yang Qi, requiring tonification. Body heat with a desire to wear clothes indicates heat in the skin/hair layer and cold in the bone marrow; treat with warming. No body heat with a desire to remove clothes indicates cold in the skin/hair layer and heat in the bone marrow; treat with clearing.
Cold, Heat, Excess, and Deficiency can all cause pain. Methods to relieve pain vary. Pain from Heat-Toxin requires purgation; pain from constipation requires guiding out stagnation; pain from Blood Stasis requires harmonizing, combined with roasting with Mulberry Wood fire. Pain from Cold-Pathogen requires warming and dispersing. Pain from damp swelling and stiffness requires leaching and draining. Pain from dryness, twitching, and cramping requires moistening. Pain from fatigue requires tonification. Pain from pus distension requires needle drainage. Pain returning after pus discharge indicates deficiency; tonify. Pain from ulceration/corrosion requires removing necrotic tissue. Pain from foul odors requires harmonizing. Pain from Wind-Cold requires warming and dispersing. Apply according to symptoms, and pain will cease. There is no need to rigidly rely on Frankincense (Ruxiang) and Myrrh (Moyao). Furthermore, sores should not be painless; painlessness indicates extreme deficiency of Stomach Qi and is incurable. Sores should not be severely painful; severe pain with irritability is also incurable. Numbness and itching are particularly ominous signs.
Not eating during the swelling stage is due to pain damaging Stomach Qi; after ulceration, when pain stops, appetite returns naturally. Yuan (Li Dongyuan) stated: Eating meat for sore patients tonifies Stomach Qi, which is self-abandonment. This prohibition applies to changes caused by rich foods and mineral drugs, not as a general rule for those eating coarse grains or who are weak. If the Spleen and Stomach are weak, even if there are taboos, small amounts should be given. Withholding food violates Stomach Qi and suppresses appetite. The key to taboos is avoiding raw/cold foods that damage the Spleen, hard-to-digest items, and greasy foods that cause loose stools. Moderation is key. Also, avoid drinking cold water after taking medicine; violating this delays efficacy and causes pus to recur.