《内经》云∶五脏不和，九窍不通，六腑不和，留结为痈。又云∶形伤痛，气伤肿。此
则脏腑不和，疮发于外也。明矣！涂贴寒凉，岂能调和脏腑，宣通气血耶。设使肿痛热渴，脉滑
数而有力，属纯阳，宜内用济阴丹，外用益阳散，则热毒自解，瘀滞自散。若似肿非肿，似
痛非痛，似溃不溃，似赤不赤，脉洪数而无力，属半阳半阴，宜内用冲和汤，外用阴阳散，
则气血自和，瘀滞自消。若微肿微痛，或色黯不痛，或坚硬不溃，脉洪大，按之微细软弱，
属纯阴，宜内服回阳汤，外敷抑阴散，则脾胃自健，阳气自回。丹溪先生云∶敷贴之剂，应
酬轻小热症耳，若不辨其阴症阳症之所由分，而妄敷寒凉之剂，迷塞腠理，凝滞气血，毒反
内攻而肉反死矣。况运气得寒而不健，瘀血得寒而不散，瘀肉得寒而不溃，新肉得寒而不生
治验
阁老翟石门子，耳下作痛，内服外敷，皆寒凉败毒，更加肿痛，项间肿硬，肉色如故，
内连胸。余适考满到京，邀视之。虽肿坚而脉滑数，此脓内溃也，虽足三阳，热毒之症，为寒
凉凝结，不能外溃，先用六君子、补中益气各二剂，谓补脾胃，升发阳气，患处亦软，针出
瘀脓甚多，仍服至数剂而愈。
地官李北川腿患痈，内外用败毒寒凉，因痛极，刺出瘀脓，方知为痈。疮口开张，肉紫
冷陷，外无肿势，此阳气虚寒而不能收敛，用豆豉饼、六君子加藿香、砂仁、炮姜，饮食进而患
处暖；再以十全大补汤，元气复而疮口愈。
一男子腿肿一块，经年不消，饮食少思，强食则胀，或作泻，日渐消瘦，两尺脉微细，
此命门火衰不能生土，以致脾胃虚寒，以八味丸治之，饮食渐进，肿患亦消。
《黄帝内经》说：五脏功能失调，九窍就会闭塞不通；六腑功能失调，邪气停留凝结就会形成痈肿。又说：形体受伤导致疼痛，气机受伤导致肿胀。这说明了脏腑不和，疮疡就会发作于体表，这是很明显的道理！涂抹贴敷寒凉性质的药物，怎么能调和脏腑、宣通气血呢？假如出现肿痛、发热、口渴，脉象滑数且有力，属于纯阳证，适宜内服济阴丹，外敷益阳散，那么热毒自然解除，瘀滞自然消散。如果症状像肿又不完全肿，像痛又不完全痛，像溃烂又不完全溃烂，像发红又不完全发红，脉象洪数但无力，属于半阳半阴证，适宜内服冲和汤，外敷阴阳散，那么气血自然调和，瘀滞自然消除。如果轻微肿胀疼痛，或者颜色暗紫且不痛，或者坚硬不溃烂，脉象洪大，重按却微细软弱，属于纯阴证，适宜内服回阳汤，外敷抑阴散，那么脾胃自然强健，阳气自然恢复。朱丹溪先生说：敷贴的药物，只适用于应对轻微的小热症罢了。如果不辨别阴证和阳证的成因区别，而胡乱敷用寒凉药物，会导致腠理闭塞，气血凝滞，毒邪反而向内攻陷，肌肉反而死亡。况且运气（人体正气）遇到寒凉就不能健旺，瘀血遇到寒凉就不能消散，瘀肉遇到寒凉就不能溃破，新肉遇到寒凉就不能生长。
【治疗案例】
阁老翟石门的儿子，耳下部位发生疼痛，内服和外敷都使用了寒凉败毒的药物，结果肿痛更加严重，颈部两侧肿胀坚硬，肤色如常，内部牵连到胸部。我正好考满期满来到京城，被邀请去诊治。虽然肿块坚硬但脉象滑数，这是脓液在内部已经形成的迹象，虽然属于足三阳经的热毒病症，但因为寒凉药物凝结，导致不能向外溃破。我先用了六君子汤和补中益气汤各两剂，目的是补益脾胃，升发阳气，患处也随之变软，针刺后排出大量瘀脓，继续服用几剂后痊愈。
地官李北川腿部患痈，内服外敷都使用了败毒寒凉的药物，因为疼痛剧烈，刺破排出了瘀脓，这才知道是痈。疮口张开，肌肉呈紫色且寒冷下陷，外部没有肿胀之势，这是阳气虚寒而不能收敛所致。使用豆豉饼灸，配合六君子汤加入藿香、砂仁、炮姜，患者饮食增加，患处变暖；再用十全大补汤，元气恢复后疮口愈合。
有一个男子腿部肿胀一块，经过一年都没有消退，饮食减少不想进食，勉强进食则腹胀，有时腹泻，日渐消瘦，两尺脉微细，这是命门火衰不能生助脾土，导致脾胃虚寒。用八味丸治疗，饮食逐渐增加，肿胀患处也消退了。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When the Zang organs are in disharmony, the nine orifices become blocked; when the Fu organs are in disharmony, pathogenic factors remain and knot to form carbuncles. It also states: Injury to the form causes pain, injury to Qi causes swelling. This clearly indicates that disharmony of the Zang and Fu organs leads to the manifestation of sores on the exterior. How can applying cold-natured topical medications harmonize the Zang and Fu organs or promote the circulation of Qi and Blood? If there is swelling, pain, fever, and thirst, with a slippery, rapid, and forceful pulse, it belongs to the Pure Yang syndrome. It is appropriate to internally administer Jiyin Dan (Nourish Yin Pill) and externally apply Yiyang San (Benefit Yang Powder), so that heat-toxin will naturally resolve and stasis will dissipate. If the condition appears swollen but not fully swollen, painful but not fully painful, ulcerated but not fully ulcerated, red but not fully red, with a flooding, rapid but forceless pulse, it belongs to the Half-Yang Half-Yin syndrome. It is appropriate to internally administer Chonghe Tang (Harmonizing Decoction) and externally apply Yinyang San (Yin-Yang Powder), so that Qi and Blood will naturally harmonize and stasis will eliminate. If there is slight swelling and pain, or dark discoloration without pain, or hardness without ulceration, with a flooding pulse that becomes minute, fine, and weak upon deep pressure, it belongs to the Pure Yin syndrome. It is appropriate to internally take Huiyang Tang (Restore Yang Decoction) and externally apply Yiyin San (Suppress Yin Powder), so that the Spleen and Stomach will naturally strengthen and Yang Qi will recover. Master Zhu Danxi said: Topical applications should only be used for minor, mild heat conditions. If one fails to distinguish the differentiation between Yin and Yang syndromes and recklessly applies cold-natured agents, it will block the interstices (Couli), stagnate Qi and Blood, causing the toxin to attack inwardly and the flesh to die. Moreover, if the vital energy encounters cold, it fails to thrive; if blood stasis encounters cold, it fails to disperse; if necrotic flesh encounters cold, it fails to ulcerate; if new flesh encounters cold, it fails to grow.
[Clinical Cases]
The son of Zhai Shiman, a Grand Secretary, suffered from pain below the ear. Both internal medication and external application consisted of cold-natured detoxifying herbs, which exacerbated the swelling and pain. The neck became swollen and hard, with normal skin color, extending internally to the chest. I happened to arrive in the capital after completing my term of office and was invited to examine him. Although the swelling was hard, the pulse was slippery and rapid, indicating that pus had formed internally. Although this was a heat-toxin syndrome of the Foot-Taiyang, Taiyang, and Yangming meridians, the cold-natured herbs caused condensation, preventing external ulceration. I first administered Liu Junzi Tang (Six Gentlemen Decoction) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), two doses each, to tonify the Spleen and Stomach and raise Yang Qi. The affected area subsequently softened. Upon puncture, a large amount of purulent exudate was discharged. After taking several more doses, he recovered.
Li Beichuan, an official of the Ministry of Works, suffered from a carbuncle on his leg. He used cold-natured detoxifying herbs both internally and externally. Due to extreme pain, he lanced it, releasing bloody pus, at which point he realized it was a carbuncle. The wound opened, the flesh turned purple and cold, sinking inward, with no external swelling. This indicated deficiency-cold of Yang Qi failing to consolidate. I used fermented soybean cakes (Douchi Bing) combined with Liu Junzi Tang added with Huoxiang (Patchouli Herb), Sharen (Amomum Fruit), and Paojiang (Prepared Ginger). His diet improved, and the affected area became warm. Subsequently, using Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction), his Yuan Qi (Original Qi) recovered, and the wound healed.
A man had a swelling on his leg that persisted for a year without subsiding. He had poor appetite and bloating after forced eating, occasional diarrhea, and progressive emaciation. His Chi pulses (at both wrists) were minute and fine. This indicated failure of the Fire of the Gate of Vitality (Mingmen) to generate Earth, resulting in deficiency-cold of the Spleen and Stomach. I treated him with Bawei Wan (Eight-Ingredient Pill). His diet gradually increased, and the swelling resolved.