轻痛肌肉皮肤浅，重痛身在骨筋间，虚痛饥甚不胀闭，喜人揉按临时安。实痛饱甚多胀闭，畏人挨按痛难言，寒痛
喜缓色不变，热痛 痛遇冷欢。脓痛鼓长按复起，瘀痛隐隐溃不然，风痛气痛皆走注，风刺气刺细心看。
【注】痛由不通，然亦种种不一，有轻痛、重痛、虚痛、实痛、寒痛、热痛、脓痛、瘀血凝结作痛、风痛、气痛之
别。轻痛者，肌肉皮肤作痛，属浅；重痛者，痛彻筋骨，属深。虚痛者腹饥则甚，不胀不闭，喜人揉按，临时可安；实
痛者，食饱则甚，又胀又闭，畏人挨按，痛不可言。寒痛者，痛处定而不移，皮色不变，遇缓则喜；热痛者，皮色 赤，
遇冷则欢。脓痛者，憎寒壮热，情势鼓长，按而复起。瘀血凝结作痛者，初起隐隐作痛，微热微胀；将溃则色紫微痛，
既溃则不疼。风痛者，走注甚速。气痛者，流走无定，刺痛难忍。诸痛如此，不可不详辨也。
痈疽未成宜消托，已成当辨有无脓。按之坚硬无脓象，不热无脓热有脓。大软应知脓已熟，半软半硬脓未成。按之
即起脓已有，不起无脓气血穷。深按速起稀黄水，深按缓起坏污脓。实而痛甚内是血，内是气兮按不疼。轻按即痛知脓
浅，重按方疼深有脓。薄皮剥起其脓浅，皮不高阜脓必浓。稠黄白脓宜先出，桃红红水次第行。肥人脓多瘦人少，反此
当究有变凶。稠黄气实虚稀白，粉浆污水定难生。汗后脓秽犹可愈，脓出身热治无功。
【注】凡看痈疽疮疡，情势未成者，即用内消之法；若情势已成，即用内托之法，当辨脓之有无浅深。以手按之坚
硬者，无脓之象。按之不热者无脓，热者有脓。按之大软者，内脓已熟；半软半硬者，脓未全成。按之指起即复者，有
脓；不复者无脓，其气血必穷而虚甚也。深按之而速起者，内是稀黄水；深按之而缓起者，内是坏污脓。按之实而痛甚
者，内必是血；按之虚而不疼者，内必是气。轻按即痛者，其脓浅；重按方痛者，其脓深。薄皮剥起者，其脓必浅；皮
色不变，不高阜者，其脓必稠。大抵痈疽疮疡，先宜出黄白稠脓，次宜出桃花脓，再次宜流淡红水。胖人宜于脓多，瘦
人宜于脓少。若胖人脓少，是肉不腐；瘦人脓多，是肉败坏，皆非吉也。又凡气实者多稠黄脓，气虚者多稀白脓，半虚
半实者多稠白脓。又有脓出如粉浆，如污水者，谓之败浆，不治之证也，命必难生。惟汗后脓秽者可愈，若脓已出，而
身犹大热不休者，治亦无功。盖痈疽之得脓，如伤寒之得汗，汗出而反大热者，坏伤寒也；脓出而身犹大热者，坏痈疽
也。
疼痛轻微者，病位在肌肉与皮肤之间，属浅表；疼痛剧烈者，病位在骨骼与筋腱之间，属深层。虚性疼痛者在饥饿时加重，腹部不胀满闭塞，喜欢被人揉按，按压后暂时缓解。实性疼痛者在饱食后加重，伴有腹胀和闭塞感，害怕被人触碰按压，疼痛难以言说。寒性疼痛喜得温暖舒缓，局部皮色无变化；热性疼痛遇冷则舒适。脓成之痛表现为肿胀高起，按压后凹陷随即弹起；瘀血阻滞之痛表现为隐隐作痛，溃破后仍不愈。风邪所致之痛和气滞所致之痛均表现为疼痛游走不定，需仔细辨别是风刺还是气刺。
【注】疼痛源于气血不通，但原因各不相同，分为轻痛、重痛、虚痛、实痛、寒痛、热痛、脓痛、瘀血凝结作痛、风痛、气痛等类别。轻痛是指肌肉和皮肤部位的疼痛，病位较浅；重痛是指疼痛深入筋骨，病位较深。虚痛表现为腹中饥饿时疼痛加剧，没有胀满闭塞感，喜欢被人揉按，按压后可暂时安宁；实痛表现为进食饱足后疼痛加剧，既有胀满又有闭塞，畏惧他人触碰按压，疼痛剧烈无法言语。寒痛表现为疼痛部位固定不移，皮肤颜色不变，遇温暖舒缓则感到舒适；热痛表现为皮肤发红，遇冷则感到欢悦舒适。脓痛表现为憎寒壮热（恶寒高热），病情呈现肿胀高耸状态，按压后凹陷立即恢复。瘀血凝结引起的疼痛，初起时隐隐作痛，伴有微热微胀；即将溃破时颜色发紫且微痛；已经溃破后反而不疼。风邪致痛的特点是疼痛游走迅速。气滞致痛的特点是疼痛流动无定处，刺痛难忍。各种疼痛如此不同，不可不详细辨别。
痈疽（体表化脓性感染）未形成脓肿时宜用消散法，已形成脓肿时应辨别有无脓液。触摸患处坚硬无波动感者，无脓象；局部不发热者无脓，发热者有脓。按之非常柔软者，可知脓液已成熟；半软半硬者，脓液尚未完全形成。按之手指抬起后皮肤立即回弹者，说明有脓；不回弹者无脓，提示气血枯竭。深按后迅速回弹流出稀黄水者，为稀薄黄水；深按后缓慢回弹流出污浊液体者，为腐败污脓。触诊坚实且疼痛剧烈者，内部多为血液；内部为气者，按压时不疼痛。轻轻按压即痛者，脓液位置较浅；用力按压才痛者，脓液位置较深。表皮薄而隆起者，脓液较浅；表皮不高耸者，脓液必然浓稠。稠厚的黄白色脓液应优先排出，随后依次排出桃红色脓液及淡红水。肥胖之人脓液较多，消瘦之人脓液较少，若与此相反，应当探究是否有凶险变证。脓液稠黄者为气实，稀白者为气虚；如粉浆或污水般的脓液定难治愈。出汗之后排出的秽浊脓液尚可痊愈，若脓液已出而身体仍然发热，治疗便无效。
【注】凡是诊治痈疽疮疡，在病情尚未形成脓肿时，即采用内消法；若病情已成脓肿，即采用内托法，此时应当辨别脓液的有无、深浅。用手触摸患处坚硬的，是无脓的迹象。按之不热的无脓，发热的有脓。按之特别柔软的，说明内部脓液已成熟；半软半硬的，脓液未完全形成。按之手指离开后皮肤立即复原的，有脓；不复原的无脓，其气血必定穷竭且极度虚弱。深按之后迅速回弹的，内部是稀薄的黄水；深按之后缓慢回弹的，内部是腐败污浊的脓液。按之感觉坚实且疼痛剧烈的，内部必然是血；按之感觉空虚且不痛的，内部必然是气。轻按即痛的，脓液位置浅；重按才痛的，脓液位置深。表皮薄且隆起的，脓液必浅；皮色不变、不高耸的，脓液必稠。大抵痈疽疮疡，首先适宜排出黄白色的稠脓，其次适宜排出桃花样的脓液，再次适宜流出淡红色的水。胖人脓多为宜，瘦人脓少为宜。如果胖人脓少，说明肌肉未腐坏；瘦人脓多，说明肌肉败坏，都不是吉兆。另外，凡是气实的人多排出稠黄的脓液，气虚的人多排出稀白的脓液，半虚半实的人多排出稠白的脓液。又有脓液流出如粉浆、如污水的，称为败浆，属于不治之证，性命难保。只有在出汗之后排出秽浊脓液的可治愈，若脓液已出，而身体依然持续高热不退的，治疗也无效。大概痈疽出脓，就像伤寒病出汗一样，出汗后反而高热不退的，是坏伤寒；脓液排出后身体依然高热的，是坏痈疽。
Pain that is mild indicates the pathology is superficial, located in the muscles and skin; pain that is severe indicates the pathology is deep, located between the bones and sinews. Deficiency-type pain worsens with hunger, without abdominal distension or obstruction, and is relieved by massage, providing temporary comfort upon pressure. Excess-type pain worsens after eating, accompanied by distension and obstruction, and is aggravated by touch, making the pain unbearable to describe. Cold-type pain prefers warmth and relief, with no change in skin color; heat-type pain finds comfort in cold applications. Pain from abscess formation presents as swelling and elevation, where depression rebounds immediately upon release; pain from blood stasis presents as dull pain, which persists even after ulceration. Wind-type pain and Qi-type pain both manifest as wandering pain, requiring careful differentiation between wind-piercing and Qi-piercing sensations.
[Note] Pain arises from blockage of flow, yet causes vary greatly, categorized into mild, severe, deficiency, excess, cold, heat, abscess, blood-stasis coagulation, wind, and Qi pains. Mild pain refers to pain in the muscles and skin, indicating a shallow location; severe pain penetrates to the bones and sinews, indicating a deep location. Deficiency pain intensifies when the abdomen is empty, without distension or closure, favors massage, and can be temporarily alleviated by pressure; excess pain intensifies after full meals, presenting with both distension and closure, fears touch, and involves pain too severe to articulate. Cold pain is fixed in location, with unchanged skin color, and feels pleasant with warmth/relief; heat pain presents with red skin and feels pleasant with cold. Abscess pain presents with aversion to cold and high fever, with a swollen and elevated condition, rebounding immediately upon pressure. Pain from blood-stasis coagulation initially presents as dull pain with slight heat and distension; just before ulceration, the color turns purple with slight pain; after ulceration, there is no pain. Wind pain moves rapidly. Qi pain flows without a fixed location, presenting as unbearable stabbing pain. Such are the various pains; they must not be distinguished in detail.
For carbuncles and sores (Yongju, 痈疽) that have not yet formed an abscess, resolution (Xiao, 消) methods should be used; once formed, one must distinguish the presence or absence of pus. If palpated as hard with no fluctuation, there is no pus; if not hot, there is no pus; if hot, there is pus. If very soft upon pressure, the pus is ripe; if half-soft and half-hard, the pus is not fully formed. If the skin rebounds immediately after pressing, pus is present; if it does not rebound, there is no pus, indicating exhaustion of Qi and Blood. Deep pressure causing rapid rebound yielding thin yellow fluid indicates thin yellow water; deep pressure causing slow rebound yielding foul liquid indicates corrupt pus. Firmness with severe pain upon palpation indicates blood inside; emptiness with no pain upon pressure indicates Qi inside. Pain upon light pressure indicates shallow pus; pain only upon heavy pressure indicates deep pus. Thin skin peeling up indicates shallow pus; skin that is not elevated indicates thick pus. Thick yellow-white pus should be discharged first, followed sequentially by peach-red pus and then pale red fluid. Fat individuals tend to have more pus, while thin individuals have less; deviations from this suggest ominous changes. Thick yellow pus indicates excess Qi, while thin white pus indicates deficient Qi; pus resembling flour paste or sewage is difficult to cure. Pus discharged after sweating can still be cured; however, if pus is discharged but body heat persists, treatment is futile.
[Note] In treating carbuncles, sores, and ulcers, if the condition has not yet formed an abscess, internal resolution methods are applied; if the condition has formed, internal support (Tuo, 托) methods are used, and one must distinguish the presence, depth, and quantity of pus. Hardness upon manual palpation indicates no pus. Lack of heat indicates no pus; presence of heat indicates pus. Extreme softness indicates ripe pus; half-soft/half-hard indicates incomplete pus formation. Immediate rebound after pressing indicates pus; lack of rebound indicates no pus, implying extreme deficiency and exhaustion of Qi and Blood. Rapid rebound upon deep pressure indicates thin yellow fluid; slow rebound upon deep pressure indicates corrupt pus. Firmness with severe pain indicates blood accumulation; emptiness with no pain indicates Qi accumulation. Light pressure causing pain indicates shallow pus; heavy pressure causing pain indicates deep pus. Peeling thin skin indicates shallow pus; unchanged skin color without elevation indicates thick pus. Generally, for carbuncles and sores, thick yellow-white pus should be discharged first, followed by "peach blossom" pus, and finally pale red fluid. Abundant pus is favorable for fat individuals, while scant pus is favorable for thin individuals. Scant pus in fat individuals suggests non-decaying flesh; abundant pus in thin individuals suggests decaying flesh; neither is auspicious. Furthermore, excess Qi typically yields thick yellow pus, while deficient Qi yields thin white pus; mixed excess-deficiency yields thick white pus. Pus resembling flour paste or sewage is termed "decayed paste," a hopeless condition with fatal prognosis. Only pus discharged after sweating can be cured; if pus is out but high fever persists, treatment is ineffective. The emergence of pus in carbuncles is analogous to sweating in Shanghan (Cold Damage); persistent high fever after sweating indicates deteriorating Shanghan, just as persistent high fever after pus discharge indicates deteriorating carbuncle.