初起红色光亮，微热微痛，根脚浮浅、不坚实者为易。已成红赤高肿，作热 痛，顶破皮穿，脓溃肿消者
易。已溃脓稠
色鲜，根脚缩小，内肉渐生，外皮渐紧者顺。溃后气体平和，饮食如故，肿消痛止，口平收敛者顺。
初起肉色不变，寒热渐生，根脚散漫，时或阴痛者险。已成坚硬如石，举动牵强，咳嗽生痰，皮寒食少者
逆。已溃无脓，惟流血水，肿不消，痛不止，脾气衰弱者逆。破后血水不止，肿硬更增，败腐不脱， 气恶心
者死。
初起自无表里之症相兼，但结成形者，宜行散气血。已成无痛无痒，或软或硬色白者，痰聚也，行痰顺气。
已成色红坚硬，渐大微痒微疼者，补肾气、活血散坚。形如茄蒂，瘤大下垂者，用药点其蒂茄落，生肌收敛。
已破流脓不止，瘤仍不消，宜健脾胃为主，佐以化坚。已溃出血不常，瘤口开泛者，宜养血凉血，佐以清肝。
溃后瘤肿渐消，脾弱不能收敛者，补肾气、兼助脾胃。
一男子臀瘤五年，形如复瓢，按之隐隐黑色，此黑粉瘤也。以针破之，按出黑砂兼黑粉共约碗许，用三品
一条枪插入患内十余日，每次捺出黑膜，其瘤渐消。内服十全大补汤健脾胃，养气血，月余而敛。
一男子腮上生瘤半年，形若复桃，皮色不变，按之微红，此粉瘤也。针破之，捺出脂粉，插前药半月而愈。
一义乌兵士，肩膊上连生小瘤五枚三月余，渐发痒异状，以手扪之，内则歙歙攻动。予视之，内动果如虾
鞠，此必有异虫；以针破其一枚，先出红水一匙，少顷攻出黑嘴粉红虫一条，形如蛆样，长六、七分；又破一
枚，依然如是，其人渐觉昏晕，此
泄气之过也。余瘤停止，服补中益气汤数剂，外以膏盖，又五、六日，患者方健，渐渐破之，仍以补药十余服
而愈。
一妇人并一女子，耳后、发际下一寸各生一瘤半年余，渐渐而大，此乃粉瘤。用针破之，先出脂粉，后出
头发数根，长约二尺余，齐根剪断，出血微许；俱用插药，数日化出内膜而愈。从此观之，知有发瘤也。
一妇人腰间生一肉瘤，三年余方渐微痛，一日溃后出小蛔三条，长约五寸，置温汤中游动半时方息。其时
患者形体衰弱，面黄肌瘦，口干发热，朝以八味丸，午用人参养荣汤，服至百日外，元气渐醒，又百日，其口
方收。予意度之，其蛔乃经络气血所化。
一妇人气冲穴生瘤，红紫坚硬，乃血瘤也。请视之，心、肝二脉俱已洪数，其患得之心气郁结，肝气受伤
之故，辞不可治。后请京师明公医治，其时头已穿溃，虽强投补托、化坚、凉血等剂，日溃日烂，终至不应。
破经两月，一旦涌出紫血盆许，随即身亡。后人问曰∶何以致此？予曰∶心脉洪数，心火旺也；肝脉弦数，肝
气伤也；火旺逼血妄行，肝气伤不能藏血，后破之必出血不止，多致危亡，预辞不治者此意也。
初起时，患处皮肤呈红色且光亮，伴有轻微发热和疼痛，病灶根基浮浅、质地不坚实，属于易治之证。若病情发展至已成阶段，表现为红赤高肿，灼热疼痛，顶部破溃穿皮，脓液排出后肿胀消退，也属易治。若已溃破，脓液稠厚、色泽鲜亮，病灶根基缩小，内部肌肉逐渐生长，外部皮肤逐渐收紧，为顺证（预后良好）。溃破后患者气息平和，饮食正常，肿胀消退、疼痛停止，疮口平整并逐渐愈合，亦为顺证。
若初起时肤色无变化，寒热症状逐渐显现，病灶根基散漫不定，偶尔出现隐痛，属于险证（难治）。若病情发展至已成阶段，肿块坚硬如石，活动受限牵强，咳嗽生痰，皮肤寒冷、食欲减退，属于逆证（预后不良）。若已溃破却无脓液，仅流出血水，肿胀不消，疼痛不止，脾气衰弱，属于逆证。若破溃后血水淋漓不止，肿胀硬结更加严重，腐肉败坏无法脱落，气息恶臭，属于死证（必死）。
初起时无表证与里证兼夹，仅结成有形肿块者，宜采用行气散血之法。若已成肿块，无痛无痒，或软或硬、色白者，属痰聚所致，宜化痰理气。若已成肿块，色红坚硬，逐渐增大，微痒微痛者，宜补肾气、活血散坚。若形状像茄子蒂，瘤体大而下垂者，用药点涂其蒂部使瘤脱落，再用生肌收敛药物。若已破溃流脓不止，瘤体仍不消退，应以健脾胃为主，辅以化坚散结。若溃破后出血断续不止，瘤口开张外翻者，宜养血凉血，辅以清肝火。若溃破后瘤肿逐渐消退，但因脾弱导致不能收敛者，宜补肾气，兼助脾胃功能。
有一男子臀部生瘤五年，形状像倒扣的瓢，按压时隐约可见黑色，此为黑粉瘤。用针刺破后，挤出黑砂和黑粉共约一碗许，将三品一条枪插入患处十余日，每次按压挤出黑膜，瘤体逐渐消退。内服十全大补汤以健脾胃、养气血，月余后疮口愈合。
有一男子腮上生瘤半年，形状像倒扣的桃子，皮色不变，按压时微红，此为粉瘤。针破后，挤出脂粉，插入前述药物半月而愈。
有一名义乌士兵，肩膊上连续生出五枚小瘤，历时三月余，逐渐发痒出现异常，用手触摸，感觉内部收缩攻动。我观察发现，内部跳动确实如虾弯曲状，这必定有异虫；用针刺破其中一枚，先流出一匙红水，片刻后又攻出一条黑嘴粉红虫，形状像蛆，长六、七分；再刺破一枚，情况依然如此，此人逐渐感到昏晕，这是泄气过度的缘故。其余瘤体停止处理，服用补中益气汤数剂，外用膏药覆盖，又过五六日，患者才恢复健康，随后逐渐刺破其他瘤体，仍以补药十余剂而痊愈。
有一名妇人和一名女子，耳后及发际下一寸处各生一瘤，历时半年余，逐渐变大，此为粉瘤。用针刺破后，先流出脂粉，后流出头发数根，长约二尺余，齐根剪断，流出少许血液；均使用插药治疗，数日后内膜化出而愈。由此可知存在发瘤这一病症。
有一名妇人腰间生一肉瘤，三年多后才逐渐微痛，一日溃破后流出三条小蛔虫，长约五寸，放入温水中游动半小时才停止。当时患者形体衰弱，面黄肌瘦，口干发热，早晨服用八味丸，中午服用人参养荣汤，服药百日之后，元气逐渐恢复，又过百日，疮口才愈合。我推测，这些蛔虫乃经络气血所化生。
有一名妇女在气冲穴生瘤，颜色红紫坚硬，此为血瘤。诊视发现，心脉和肝脉均洪数，此病得于心气郁结、肝气受伤的缘故，告知不可治愈。后来请京城名医医治，此时头部已穿溃，虽然强行投用补托、化坚、凉血等药剂，但每日溃烂加重，最终无效。破溃经两个月，一天突然涌出紫血约一盆，随即身亡。后人问道：为何导致这种结果？我说：心脉洪数，说明心火旺盛；肝脉弦数，说明肝气受伤；火旺逼迫血液妄行，肝气受伤不能藏血，破溃后必然出血不止，多致危亡，预先告知不可治愈即是此意。
At the initial stage, if the lesion is red and shiny, with slight heat and pain, and the base is superficial and not firm, it is easy to treat. If the condition has progressed to a formed state, presenting as red, high swelling, with burning pain, the apex breaking through the skin, and the swelling subsiding after pus discharge, it is also easy to treat. If already ulcerated, with thick, bright-colored pus, a shrinking base, gradually regenerating internal flesh, and tightening external skin, it is a favorable prognosis (Shun). If after ulceration, the patient's breath is calm, diet remains normal, swelling subsides, pain stops, and the wound heals flatly, it is also a favorable prognosis.
If at the initial stage, the skin color does not change, cold and heat symptoms gradually appear, the base is diffuse, and occasional dull pain occurs, it is a dangerous prognosis (Xian). If the condition has progressed to a formed state, with hardness like stone, restricted movement, coughing with phlegm, cold skin, and poor appetite, it is an adverse prognosis (Ni). If already ulcerated but without pus, only bleeding fluid, with no reduction in swelling or pain, and weak Spleen Qi, it is an adverse prognosis. If after rupture, blood and fluid flow incessantly, swelling and hardness increase further, necrotic tissue fails to shed, and foul odor emanates from the breath, it is a fatal prognosis (Si).
At the initial stage, without concurrent exterior or interior syndromes, but merely forming a tangible mass, methods to move Qi and disperse Blood should be used. If the formed mass is painless and itchless, or soft or hard with white color, it indicates Phlegm accumulation; methods to resolve Phlegm and regulate Qi should be used. If the formed mass is red, hard, gradually enlarging, with slight itch and pain, Kidney Qi should be tonified, and Blood activated to scatter hardness. If shaped like an eggplant stem, with a large, pendulous tumor, apply medication to the stem to cause the tumor to fall off, followed by medications to generate flesh and promote healing. If already broken with incessant pus discharge and the tumor persists, focus on strengthening the Spleen and Stomach, assisted by resolving hardness. If ulcerated with intermittent bleeding and the wound opening everts, nourish Blood and cool Blood, assisted by clearing Liver Fire. If after ulceration the tumor swelling gradually subsides but the weak Spleen cannot promote healing, tonify Kidney Qi and assist the Spleen and Stomach.
A male patient had a tumor on his buttock for five years, shaped like an inverted bowl, appearing black upon pressure; this was a Black Fen Liu (Black Powder Tumor). It was punctured with a needle, and approximately one bowl of black sand and black powder were expressed. Sanpin Yitiao Qiang (Three-Piece Single-Spear) was inserted into the lesion for over ten days, pressing out black membranes each time, causing the tumor to gradually subside. Internally, Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) was administered to strengthen the Spleen and Stomach and nourish Qi and Blood, resulting in healing within a month.
A male patient had a tumor on his cheek for half a year, shaped like an inverted peach, with unchanged skin color but slight redness upon pressure; this was a Fen Liu (Powder Tumor). It was punctured, expressing lipid powder, and healed after inserting the aforementioned medicine for half a month.
A soldier from Yiwu developed five small tumors on his shoulder over three months, which gradually became itchy and abnormal. Palpation revealed internal contraction and movement. Upon examination, the internal movement resembled a curled shrimp, indicating the presence of heterodox insects. One tumor was punctured, yielding a spoonful of red water, followed shortly by the expulsion of a pink worm with a black mouth, resembling a maggot, six to seven fen long. Another tumor was punctured with similar results. The patient gradually felt faint due to excessive Qi leakage. Treatment ceased for other tumors; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was taken for several doses, and ointments were applied externally. After five to six days, the patient recovered health. Subsequently, the remaining tumors were punctured gradually, and cured after taking more than ten doses of tonic medicines.
A woman and a young girl each had a tumor behind the ear and one cun below the hairline for over half a year, gradually enlarging; these were Fen Liu (Powder Tumors). Puncturing them first expressed lipid powder, then several hairs, each over two chi long. The hairs were cut off at the root, causing slight bleeding. Insertion medicines were used for both, leading to healing after the inner membrane was resolved in a few days. From this, it is known that Hair Tumors exist.
A woman had a meat tumor on her waist for over three years, becoming slightly painful only recently. One day, after ulceration, three small roundworms were expelled, each about five cun long, moving in warm water for half an hour before stopping. At that time, the patient was emaciated, sallow-faced, thin-skinned, with dry mouth and fever. She took Bawei Wan (Eight-Ingredient Pill) in the morning and Renshen Yangrong Tang (Ginseng Nourishing Grace Decoction) at noon. After more than one hundred days of medication, her Yuan Qi gradually revived. After another hundred days, the wound finally closed. I surmised that these roundworms were transformed from the Qi and Blood of the meridians.
A woman had a tumor at the Qichong (ST30) acupoint, red-purple and hard, identified as a Xue Liu (Blood Tumor). Pulse diagnosis revealed both Heart and Liver pulses as flooding and rapid. The disease resulted from Heart Qi stagnation and Liver Qi injury. I declared it incurable. Later, renowned physicians in the capital treated her. By then, the head had ulcerated. Despite strong administration of tonifying, resolving-hardness, and cooling-blood formulas, the ulceration worsened daily until treatment failed. Two months after rupture, a basin full of purple blood gushed out suddenly, followed immediately by death. When asked why this happened, I replied: Flooding and rapid Heart pulse indicates excess Heart Fire; wiry and rapid Liver pulse indicates Liver Qi injury. Excess Fire forces Blood to move recklessly, and injured Liver Qi cannot store Blood. Thus, rupture inevitably leads to uncontrollable hemorrhage and critical danger. My declaration of incurability was based on this reasoning.