逆证黍米不知疼，漫肿不热顶塌平，未老白头坚且硬，舌干烦躁不生脓。肉肿疮陷猪肝紫，遗尿直视并撮空，眼神
透露精神短，身缩循衣唇吻青，面若涂脂皮枯槁，唇白腹胀定难生。已溃内坚皮破烂，腐后心烦脓水清，新肉不生多臭
秽，头低项软憔悴容。阳病指甲青必绝，阴病颧红命必终。鼻生烟煤谵妄语，新肉板片泻直倾，面色土黄耳枯黑，
人中抽缩沟坦平。口张气出无回返，鼻孔相扇随息行，汗出如珠不易散，血水如肺痰胶
凝。肉绽烂斑神离乱，满面黑气惨天庭，绵溃内似葡萄嵌，眼眶迷漫黑气浓。以上无论肿与溃，但逢此证悉属凶。
【注】痈疽初起，形如黍米，不知疼痛，漫肿不热，顶见平塌，未溃白头，按之坚硬，
舌干烦躁，此等逆证，决不化脓。肉肿疮不肿而陷，其色如猪肝之紫者，是毒邪已深也。
若更见遗尿直视，神露神短，撮空循衣，唇吻青，面若涂脂，皮肤枯槁，唇白腹胀，种
种恶候，断无生理。已溃后，内坚皮烂，腐后心烦，脓水清稀，新肉不生，臭秽难近，头
低项软，形容惟悴，阳病指甲青色，阴病两颧红赤，以至眼眶迷漫黑气浓等证，无论毒
之肿溃，但逢此数者，皆为凶证难治也。
虚漫实高火 红，寒肿木硬紫黯青，湿深肉绵浅起 ，风肿宣浮微热疼，痰肿硬绵
不红热，郁结更硬若岩棱，气肿皮紧而内软，喜消怒长无热红。瘀血跌扑暴肿热，产后闪
挫久瘀经，木硬不热微红色，将溃色紫已成脓。
【注】人之气血，周流不息，稍有壅滞，即作肿矣。然肿有虚肿、实肿、寒肿、湿肿、
风肿、痰肿，有郁结伤肝作肿，有气肿，有跌扑瘀血作肿，有产后与闪挫瘀血作肿，诸
肿情势各异。如虚者，漫肿；实者，高肿；火肿者，色红皮光， 热僵硬；寒肿者，其势
木硬，色紫黯青；湿肿者，皮肉重坠，深则按之如烂棉，浅则起光亮水 ，破流黄水；风
肿者，皮肤拘皱不红，其势宣浮微热微疼；痰肿者，软如绵，硬如馒，不红不热；郁结伤
肝作肿者，不红不热，坚硬如石棱角，状如岩凸；气肿者，以手按之，皮紧而内软，遇
喜则消，遇怒则长，无红无热，皮色如常；跌仆瘀血作肿者，暴肿大热，胖胀不红；产后与闪挫瘀血作肿者，瘀血久滞
于经络，忽发则木硬不热微红，若脓已成而将溃者，其色必紫。诸肿形状如此，不可一概而论也。
【痈疽逆证歌】
如果疮疡初起像黍米大小，患者却感觉不到疼痛，肿胀弥漫且局部不发热，疮顶塌陷平坦，尚未化脓白头时质地坚硬，伴有舌干、烦躁、不能化脓的症状。
如果肌肉肿胀但疮口凹陷，颜色像猪肝一样紫暗，出现遗尿、两眼直视、手抓空动作、眼神外露、精神短少、身体蜷缩、手指循摸衣角、嘴唇和口角发青，面色红润得像涂了脂粉但皮肤干枯，嘴唇苍白、腹部胀满，这些情况必定难以生存。
如果疮疡已经溃破，内部依然坚硬，表皮破烂，腐肉脱落后心烦意乱，脓水清稀，新肉不生且气味臭秽，低头项软，面容憔悴。
如果是阳证疾病，指甲发青必定死亡；如果是阴证疾病，颧骨发红生命必终。
如果鼻部生出如烟煤般的黑气，胡言乱语，新肉像木板片一样僵硬，腹泻不止，面色土黄，耳朵枯黑，人中穴部位抽缩或沟纹平坦。
如果口张气出无法收回，鼻孔随呼吸扇动，出汗如珠粒不易消散，血水像肺叶样，痰液胶凝。
如果肌肉绽裂、烂斑遍布、神志离乱，满面黑气笼罩天庭（额头），慢性溃烂内部似葡萄嵌结，眼眶周围迷漫浓重的黑气。
以上无论肿胀还是溃破，只要遇到这些症状，都属于凶险之证。
【注】痈疽初起时，形状像黍米，患者不知疼痛，肿胀弥漫且不发热，疮顶平塌，尚未溃破出现白头，按压时坚硬，舌干烦躁，这些属于逆证，绝不会化脓。
如果肌肉肿胀而疮口不肿反而凹陷，颜色像猪肝一样紫暗，这是毒邪已经深入的表现。
如果再见到遗尿、直视、眼神外露、精神短少、撮空理线、唇吻发青、面若涂脂、皮肤枯槁、唇白腹胀等种种恶候，断定没有生机。
疮疡溃破后，内部坚硬表皮破烂，腐肉脱落后面烦，脓水清稀，新肉不生，臭秽难闻，低头项软，形容憔悴，阳证指甲青色，阴证两颧红赤，以至于眼眶迷漫黑气浓重等症状，无论毒邪是处于肿胀阶段还是溃破阶段，只要遇到上述几种情况，都是凶险难治的证候。
【痈疽辨肿歌】
虚证肿胀弥漫，实证肿胀高突，火邪致红肿色鲜艳，寒邪致肿木质坚硬呈紫黯青色，湿邪深重则肉质绵软，浅表则起泡，风邪致肿宣浮微热疼痛，痰邪致肿硬中带绵软且不红不热，郁结致肿更硬如岩石棱角，气滞致肿皮紧内软，情绪高兴时消退愤怒时增大且无红热。
瘀血因跌打损伤突然肿胀发热，产后或闪挫导致的瘀血久留经络，肿胀木质坚硬不热微红，即将溃破时颜色紫暗表示已成脓。
【注】人体的气血周流不息，稍有壅滞就会发生肿胀。然而肿胀有虚肿、实肿、寒肿、湿肿、风肿、痰肿，有因郁结伤肝引起的肿胀，有气肿，有跌打瘀血引起的肿胀，有产后与闪挫瘀血引起的肿胀，各种肿胀的情势各不相同。
例如：虚证表现为漫肿；实证表现为高肿；火邪致肿表现为色红皮光、灼热僵硬；寒邪致肿表现为势如木硬、色紫黯青；湿邪致肿表现为皮肉重坠，病位深则按之如烂棉，病位浅则起光亮水泡，破溃流出黄水；风邪致肿表现为皮肤拘挛皱缩不红，势如宣浮、微热微疼；痰邪致肿表现为软如棉、硬如馒头，不红不热；郁结伤肝致肿表现为不红不热，坚硬如石且有棱角，状如岩凸；气滞致肿表现为用手按压，皮紧而内软，遇喜则消退，遇怒则增大，无红无热，皮色如常；跌仆瘀血致肿表现为暴肿大热，胖胀不红；产后与闪挫瘀血致肿表现为瘀血久滞于经络，忽然发作则木硬不热微红，若脓已成熟将溃破时，其颜色必然紫暗。各种肿胀的形状如此，不可一概而论。
[Song on Adverse Syndromes of Carbuncles and Ulcers]
If the initial lesion resembles a millet seed, yet the patient feels no pain; if the swelling is diffuse and local heat is absent, with the apex flat and collapsed; if it remains hard before forming a white head for suppuration, accompanied by dry tongue, irritability, and failure to suppurate.
If muscle swelling occurs but the ulcer sunken, with color resembling the purple of pig liver; if incontinence, fixed gaze, grasping at empty air, protruding eyes, shortness of spirit, body curling up, fingers tracing clothes, cyanosis of lips and corners of mouth, facial ruddiness like applied rouge but with withered skin, pale lips, and abdominal distension are present, survival is impossible.
If the ulcer has already ruptured, yet the interior remains hard with torn epidermis; after sloughing, there is mental restlessness, thin pus, lack of new flesh, foul odor, drooping head with stiff neck, and emaciated appearance.
In Yang syndromes, cyanotic nails indicate certain death; in Yin syndromes, malar flush indicates imminent demise.
If coal-black smoke-like discoloration appears on the nose, accompanied by delirious speech, board-like induration of new flesh, uncontrolled diarrhea, sallow complexion, withered black ears, and contraction or flattening of the philtrum.
If the mouth opens with breath escaping without return, nostrils flapping with respiration, sweat beading like pearls and difficult to dissipate, bloody fluid resembling lung tissue, and phlegm coagulating.
If muscles split with widespread rotting spots, spirit disordered, dark qi covering the face and Tian Ting (forehead), chronic ulcers showing grape-like clusters internally, and dense dark qi obscuring the eye sockets.
Regardless of whether swelling or rupture, encountering any of these signs constitutes an ominous prognosis.
[Note] At the onset of carbuncles and ulcers, the shape resembles a millet seed, with no pain felt, diffuse swelling without heat, flat apex, hardness upon pressure before the white head forms, dry tongue, and irritability. These are adverse syndromes that will absolutely not suppurate.
If muscle swells but the ulcer sinks, with color like purple pig liver, this indicates deep penetration of toxic pathogens.
If additionally seen are incontinence, fixed gaze, protruding eyes, shortness of spirit, grasping at empty air, tracing clothes, cyanotic lips, facial ruddiness like rouge, withered skin, pale lips, and abdominal distension—these various malignant signs indicate no hope of life.
After rupture, if the interior is hard with torn skin, mental restlessness after sloughing, thin pus, lack of new flesh, foul odor, drooping head with stiff neck, emaciation, cyanotic nails in Yang syndromes, red malar cheeks in Yin syndromes, and dense dark qi in the eye sockets—regardless of whether the toxin is in the swelling or ruptured stage, encountering any of these constitutes an ominous and difficult-to-treat syndrome.
[Song on Differentiating Swelling in Carbuncles and Ulcers]
Deficiency-type swelling is diffuse; Excess-type swelling is elevated. Fire-induced swelling is red and shiny. Cold-induced swelling is woody-hard and purplish-dark cyan. Dampness-deep swelling yields soft flesh; superficial dampness causes blisters. Wind-induced swelling is floating, slightly hot, and painful. Phlegm-induced swelling is hard yet soft, non-red, and non-hot. Stagnation-induced swelling is harder, like rock edges. Qi-stagnation swelling has tight skin but soft interior, subsiding with joy and enlarging with anger, without redness or heat. Blood stasis from trauma causes sudden swelling and heat. Postpartum or sprain-induced blood stasis lingers in meridians, causing woody hardness without heat but slight redness; impending rupture shows purple color indicating pus formation.
[Note] Human Qi and Blood flow continuously; slight stagnation results in swelling. However, swellings vary: Deficiency swelling, Excess swelling, Cold swelling, Damp swelling, Wind swelling, Phlegm swelling; swelling due to stagnation injuring the Liver; Qi swelling; swelling due to traumatic blood stasis; swelling due to postpartum or sprain-induced blood stasis. The manifestations differ greatly.
For instance: Deficiency presents as diffuse swelling; Excess as elevated swelling; Fire as red, shiny skin, burning stiffness; Cold as woody hardness, purplish-dark cyan color; Damp as heavy sagging flesh, deep lesions feel like rotten cotton, superficial lesions form bright blisters leaking yellow fluid; Wind as contracted wrinkled skin without redness, floating nature with slight heat and pain; Phlegm as soft as cotton, hard like a steamed bun, non-red and non-hot; Liver-injuring stagnation as non-red/non-hot, stone-hard with angular edges, resembling rocky protrusions; Qi stagnation as tight skin over soft interior, subsiding with joy, enlarging with anger, no redness/heat, normal skin color; Traumatic blood stasis as sudden large swelling with heat, distended but non-red; Postpartum/sprain blood stasis as lingering stasis in meridians, sudden onset with woody hardness, no heat, slight redness; impending pus formation shows purple color. Such are the shapes of various swellings; they cannot be generalized.