针灸之法∶有太乙人神，周身血忌，逐年尻神，逐日人神。而其穴有禁针禁灸之论，犯
之者，其病难瘳，理固然也。但疮疡气血已伤，肌肉已坏，宜迎而夺之，顺而取之，非平人针灸
之比，何忌之有。《外科精义》云∶疮疡之症，毒瓦斯无从而解，脓瘀无从而泄，反攻于内，
内既消败，欲望其生，岂可得乎？危恶之发于致命之所，祸在反掌。腹痈囊痈，二便不通，
胸腹胀闷，唇疔喉痹，咽喉肿塞，其祸尤速，患者审之。
疮疡阳气脱陷，或因克伐之剂，或因脓血大泄，或因吐泻之后，或因误而入房。若发热
头痛，小便淋涩，或滑数便血，目赤烦喘，自汗发热，气短头晕，体倦热渴，意欲饮水投水，恶
寒憎寒，身热恶衣，扬手掷足，汗出如水，腰背反张，掷声不绝，此无根虚火之假热症。若
畏寒头痛，咳逆呕吐，耳 目蒙，小便遗难，泻利肠鸣，里急腹痛，玉茎短缩，冷汗时出，
牙齿浮痛，肢体麻痹，或厥冷身痛，或咬舌啮唇，舌根强硬，此阳气脱陷之真寒症。皆勿论
其脉，勿论其疮，但见一二，急用参附汤补之，多有复生者。大凡溃后劳役，元气亏损，或
梦遗精脱，或滑数便血，或外邪乘之，或误用寒凉，气血脱陷而致斯症，治以前药，亦有复
治验
内翰杨皋湖，孟夏患背疽，服克伐之剂，二旬余矣，漫肿坚硬，重如负石，隔蒜灸五十
余壮
食；仍用前药，作大剂，加附子、姜、桂；又不应，遂以参、 各一斤，归、术、陈皮各半
斤，附子一两，煎服三日而尽，流涎顿止，腐肉顿溃，饮食顿进；再用姜、桂等药托里健脾
，腐脱而疮愈矣。
少参史南湖之内，夏患疽，不起发，脉大而无力，发热作渴，自汗盗汗，用参、 大补
之剂
术、当归、茯苓、陈皮，计斤许，加附子五钱，水煎二钟作一服，诸症顿退，脉息顿复。翌
日疮起而溃，仍用前药四剂后，日用托里药，调理两月余而消。
逊妇卧床十三年矣，嘉靖癸卯遭回禄，益加忧郁，甲辰三月，右肩下发一块， 肿如瓯
中赤外白，先用凉药一剂，不解，次用十宣散四剂，加痛略红。迎徐南楼视之，连投参、 、丁
、桂、防、芷之剂，脓溃。徐云∶无恙矣。辞后，眩晕呕逆，恶寒战栗，项陷脓清。偶检翁
《外科发挥》，至发背门云∶若初起一头如黍，不肿不赤，烦躁便秘，四五日间，生头不计
其数，疮口各如含一粟，名曰“莲房发”云云。始骇为恶症，治法虽详，不谙于行，迎翁至
诊云∶辛凉解散，气血两虚者忌之，连投参、 、归、术、地黄、姜、附大剂，肿高脓稠，
兼衽乌金膏。数日果腐落筋如脂膜者数片，人参每服加至八钱，日进二服，逾两月平复。立
斋翁术之渊薮，他医孰能知之！病妇非翁，必误入鬼录矣。谨附此以告后人，毋为时医之误
，当知翁术之奇，布在方策，德泽普济，与天地同悠久矣。晚生陈逊顿首识。
针灸疗法中，存在太乙人神、周身血忌、逐年尻神、逐日人神等禁忌理论，并且穴位有禁针和禁灸的说法，如果触犯这些禁忌，疾病就难以痊愈，道理确实如此。但是疮疡患者气血已经受损，肌肉已经坏死，治疗应当顺势而为之（迎而夺之，顺而取之），这与健康人的针灸治疗不同，有什么可忌讳的呢？《外科精义》说：疮疡病症，毒气无法通过体表化解，脓液瘀血无法排出，反而攻入体内，内部正气既然已经消败，想要指望患者生存，怎么可能呢？危重恶症发生在致命部位，祸患就在转瞬之间。腹部痈肿、阴囊痈肿导致大小便不通，胸部腹部胀闷，唇部疔疮、喉痹，咽喉肿胀堵塞，其灾祸尤其迅速，患者务必审慎对待。
疮疡阳气脱陷，可能是因为过度使用攻伐药物，或者因为脓血大量流失，或者因为呕吐腹泻之后，或者因为误犯房事。如果出现发热头痛，小便淋沥涩痛，或滑数脉象伴便血，眼睛发红烦躁气喘，自汗发热，气短头晕，身体疲倦口渴，想喝水却怕水（注：此处原文“意欲饮水投水”疑为笔误或特定语境，结合后文假热症，通常指真寒假热或渴不欲饮/渴喜热饮，但直译为想喝水又接触水/冷水，或指烦躁不安欲近水以解热感，鉴于后文有“身热恶衣”，此处暂译为：心中烦热想喝水，甚至想接触冷水），怕冷畏寒，身体发热厌恶衣物，扬手掷足，出汗如水，腰背反张，呻吟声不断，这是无根虚火引起的假热症状。如果怕冷头痛，咳嗽气逆呕吐，耳目昏蒙，小便失禁或排尿困难，腹泻肠鸣，里急后重腹痛，阴茎短缩，冷汗不时流出，牙齿浮痛，肢体麻木，或者四肢厥冷身体疼痛，或者咬舌咬唇，舌根僵硬，这是阳气脱陷的真寒症状。对于这些情况，不要拘泥于脉象，也不要拘泥于疮疡形态，只要见到其中一两个症状，就应立即使用参附汤进行补益，大多能起死回生。大凡溃烂后劳累，元气亏损，或者梦遗精脱，或者滑数脉象伴便血，或者外邪侵袭，或者误用寒凉药物，导致气血脱陷而出现上述症状，用前面的药物治疗，也有治愈的验案。
内翰杨皋湖，在孟夏时节患背疽，服用了攻伐性质的药物二十多天，患处漫肿坚硬，沉重得像背着石头一样，隔蒜灸了五十多壮艾炷，饮食依然如故；仍然使用前药，加大剂量，加入附子、生姜、肉桂；还是没有见效，于是用人参、黄芪各一斤，当归、白术、陈皮各半斤，附子一两，煎服三天喝完，流涎立刻停止，腐肉立刻溃破，饮食立刻增加；再用生姜、肉桂等药物托里健脾，腐肉脱落而疮口愈合。
少参史南湖的妻子，夏季患疽，疮疡不起发，脉象大而无力，发热口渴，自汗盗汗，使用人参、黄芪大补剂，加上白术、当归、茯苓、陈皮，共计一斤左右，加入附子五钱，水煎煮成两碗作为一次服用，各种症状立刻消退，脉搏气息立刻恢复。第二天疮疡隆起并溃破，仍然使用前药四剂后，每天使用托里药物，调理两个多月而消散。
陈逊的妻子卧床十三年了，嘉靖癸卯年遭遇火灾，更加忧郁，甲辰年三月，右肩下长出一块肿块，肿得像碗一样，中间红外面白，先用了一剂凉药，没有缓解，接着用了四剂十宣散，疼痛稍微减轻，颜色略微变红。请徐南楼来看诊，连续投用含人参、黄芪、丁香、肉桂、防风、白芷的药物，脓液溃出。徐南楼说：“没事了。”辞别之后，出现眩晕呕吐气逆，怕冷战栗，项部凹陷脓液清稀。偶然翻阅翁仲儒的《外科发挥》，看到发背门记载说：如果初起时像黍米大小的一个头，不肿不红，烦躁便秘，四五天内，生出的头不计其数，疮口各像含着粟米一样，名叫“莲房发”。这才惊骇认为是恶症，治疗方法虽然详细，但不熟悉如何施行，请翁仲儒来诊察，他说：辛凉解散的方法，气血两虚的人禁忌使用，连续投用含人参、黄芪、当归、白术、地黄、生姜、附子的大剂量药物，配合使用乌金膏敷贴。几天后果然腐肉脱落，露出像脂膜一样的筋膜几片，人参每次服用量加到八钱，每天进服两次，过了两个月完全康复。立斋翁（翁仲儒）是医术的渊薮，其他医生谁能知道这些！这位病妇如果不是遇到翁先生，必定会误入鬼录了。谨附上此段以告诫后人，不要被当时庸医的错误所误导，应当知道翁先生医术的神奇，记载在方策之中，恩德泽被广泛救济，与天地同长久。晚生陈逊顿首记述。
Acupuncture and Moxibustion Therapy: There are taboos such as Taiyi Renshen (Taiyi Human Spirit), Zhouxue Xunji (Blood Taboo of the Whole Body), Niannian Koushen (Annual Buttock Spirit), and Zhuri Renshen (Daily Human Spirit). Furthermore, there are discussions regarding acupoints that are contraindicated for needling or moxibustion. Violating these leads to difficult-to-cure diseases, which is indeed logical. However, in cases of sores and ulcers (Chuangyang), Qi and Blood are already damaged, and muscles are necrotic. Treatment should follow the path of least resistance and take advantage of the situation (Ying Er Duo Zhi, Shun Er Qu Zhi); this is not comparable to acupuncture in healthy individuals. Why should there be any taboo? *Waike Jingyi* (Essentials of Surgery) states: In sore and ulcer conditions, if toxic factors cannot be resolved through the exterior, and pus and stasis cannot be drained, they attack inward. Once the internal Zhengqi (Upright Qi) is depleted, how can one hope for survival? Critical manifestations occurring at vital locations bring disaster in an instant. Abdominal carbuncles and scrotal abscesses causing obstruction of urination and defecation, chest and abdominal distension and stuffiness, lip ding (carbuncle), Houbi (throat obstruction), and swelling and blockage of the throat and pharynx—these disasters occur especially rapidly. Patients must exercise caution.
Yang Qi collapse and sinking in sores and ulcers may result from excessive use of purgative or attacking agents, massive loss of pus and blood, post-emesis or diarrhea, or erroneous indulgence in sexual activity. If fever and headache, dysuria with astringency, or a slippery and rapid pulse with hematochezia appear, along with red eyes, irritability, panting, spontaneous sweating, fever, shortness of breath, dizziness, fatigue, thirst with heat sensation, desire to drink water yet aversion to cold water (or restlessness seeking coolness), aversion to cold, feeling hot while disliking clothing, casting off hands and feet, profuse sweating like water, opisthotonos (back arching), and incessant groaning, these are false heat symptoms caused by rootless deficient fire. If chills and headache, cough and vomiting, blurred vision and hearing, urinary incontinence or difficulty, diarrhea with borborygmus, tenesmus and abdominal pain, retraction of the penis, intermittent cold sweat, floating toothache, limb numbness, cold limbs and body pain, biting tongue or lips, and stiff tongue root appear, these are true cold symptoms of Yang Qi collapse and sinking. Regardless of the pulse or the appearance of the sore, if even one or two of these signs are present, immediately administer Shenfu Tang (Ginseng and Aconite Decoction) to tonify. Many patients recover. Generally, after ulceration, labor depletes Yuanqi (Original Qi); or nocturnal emission and essence loss; or a slippery-rapid pulse with bleeding; or invasion by external pathogens; or misuse of cold-cooling herbs—all leading to Qi and Blood collapse manifesting as these symptoms. Treating with the aforementioned medicines has yielded verified results.
Yang Gaohu, a Hanlin Academician, suffered from a back carbuncle in early summer. After taking attacking medications for over twenty days, the swelling was diffuse and hard, heavy as if bearing a stone. He underwent garlic-separated moxibustion for more than fifty cones, yet his appetite remained normal. The previous formula was continued in a large dose, supplemented with Fuzi (Aconiti Lateralis Radix Praeparata), Shengjiang (Zingiberis Rhizoma Recens), and Rougui (Cinnamomi Cortex). When this failed, he took Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix), each one jin (approx. 500g), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Chen Pi (Citri Reticulatae Pericarpium), each half a jin, plus Fuzi one liang (approx. 37.5g). After three days of consumption, salivation stopped instantly, necrotic tissue sloughed off immediately, and dietary intake increased significantly. Subsequently, using ginger and cinnamon to support the interior and strengthen the spleen, the necrotic tissue fell away and the wound healed.
The wife of Shi Nanhu, Vice Minister, suffered from a carbuncle in summer. The lesion did not rise; the pulse was large but forceless. She experienced fever, thirst, spontaneous sweating, and night sweats. She was treated with a major tonifying decoction containing Ren Shen, Huang Qi, Bai Zhu, Dang Gui, Fu Ling (Poria), and Chen Pi, totaling about one jin, plus five qian (approx. 18.75g) of Fuzi. Boiled in water to yield two bowls taken as one dose, all symptoms subsided instantly, and the pulse recovered. The next day, the lesion rose and ulcerated. After four doses of the same formula, she used interior-supporting medicines daily and recovered after more than two months of regulation.
Chen Sun’s wife had been bedridden for thirteen years. During the Gui Mao year of the Jiajing era, she suffered a fire disaster, becoming increasingly depressed. In March of the Jia Chen year, a lump appeared below her right shoulder, swollen like a bowl, red in the center and white on the outside. Initially, one dose of cooling medicine was given without relief. Then, four doses of Shixuan San (Ten Acupoints Powder) were administered, slightly reducing pain and reddening. Xu Nanlou was consulted. He continuously prescribed formulas containing Ren Shen, Huang Qi, Ding Xiang (Caryophylli Flos), Rou Gui, Fang Feng (Saposhnikoviae Radix), and Bai Zhi (Angelicae Dahuricae Radix). Pus eventually drained. Xu said, "You are safe." After he left, she experienced vertigo, vomiting, aversion to cold, and shivering, with depression at the neck and clear pus. Reviewing Weng Zhongru's *Waike Fahui* (Exertion in Surgery), under the section on Back Carbuncles, it stated: "If initially appearing as a single millet-grain-sized head, non-swollen and non-red, with irritability and constipation, within four to five days numerous heads emerge, each sore opening resembling a grain of millet, named 'Lianfang Fa' (Lotus Pod Eruption)." Realizing it was a malignant condition, though treatment methods were detailed, he was unfamiliar with their application. He invited Weng Zhongru to diagnose. Weng stated: "Acrid-cool dispersing methods are contraindicated for those with dual deficiency of Qi and Blood." He continuously prescribed large doses of Ren Shen, Huang Qi, Dang Gui, Bai Zhu, Di Huang (Rehmanniae Radix), Sheng Jiang, and Fu Zi, combined with topical application of Wu Jin Gao (Black Gold Ointment). Days later, necrotic tissue sloughed off, revealing fascia-like membranes. The dosage of Ren Shen was increased to eight qian per dose, administered twice daily. After two months, she fully recovered. Master Lizhai (Weng Zhongru) is the source of surgical expertise; what other physicians could know this? Without Master Weng, this patient would certainly have died. I record this to warn future generations: do not be misled by contemporary mediocre physicians. Recognize the miraculous skill of Master Weng, recorded in medical texts, whose benevolence benefits all, enduring as long as heaven and earth. Junior Chen Sun bows and records.