初起顶高根活，色红皮薄，作疼 热，肿不开散者顺。已成无论偏正，疮形献起，疼痛发热，易脓易腐者
顺。已溃脓稠，肉色红活，瘀腐易脱， 肿渐消，痛减者顺。溃后腐脱，新肉便生，疮口渐敛凝结，痴脓作痒
者顺。
初生一点黄泡，或似疙瘩，不肿不疼，自不知觉者逆。已成不发高肿，亦不 痛，疮顶软陷，根脚平散者
逆。已溃脓清，肉色紫黑，外皮不腐，内生臭秽，不食者逆。腐肉虽尽，新肉不生，疮口散大软陷，无神色败
者逆。
初生有头或无头，大痛或不痛，俱隔蒜灸，兼服解毒。已成坚硬，发热 痛，口干便秘者，邪在内也，宜
泄之。坚肿不痛，发热恶寒，头痛四肢拘急者，兼发表攻里。肿硬日深，形色紫黑，外皮不腐，内脓不溃，宜
行拔法。项强头面 热，口燥、恶心、呕吐者，邪在上也，宜清之。 热肿痛，红色光亮，疼苦有时，内
脓胀痛者，急开之。将溃不溃，微热微红，不作腐溃者，脾胃虚也，宜补之。溃后腐肉不脱，脓水清稀，肿痛
仍作者，当大养气血。大便多溏，小便短涩，自汗食少，脉细身凉，温中健脾。
一男人项疽十余日，视其疮势颇甚，根连左右，耳项并肿，红赤 热，脉浮而数。先用黄连消毒散二服退
其大势；根脚消定后，用托里消毒散，数服不觉腐溃，但诊脉浮无力。询知患者年过五旬，久艰嗣息，房中又
有外家人，多兼思虑劳欲大过，损伤元气故也。又疮情势大，止能起发，不能培养为脓，更用十全大补汤加桔梗、
白芷，倍人参。白术各三钱，外用桑木灸法，早晚二次灸之。又涂紫霞膏，数日患者头面俱肿，双目合缝，形
状可畏，然后腐溃，并作脓出，日至数升，如此半月，因前药不胜其事，内加烦躁不宁，五心烦热，饮食渐少
等症，此谓脓水出多，气血走泄，为虚火假症之故，虽变不妨。随用圣愈汤，一服不应；又进一服，加熟附子
二钱方应，前症悉退。次以人参养荣汤加麦冬、五味、参、术，常倍至三钱，调理月余。后至脑骨腐肉连发片
片脱下，其状野狼狈，不可观瞻，凡相视者无不点头惊讶！又恐腐溃深大，补不及事，每日粥食中用人参三钱，
凡餐分入同煮食之以接补脾元。后方元气渐醒，调理四月方愈。
彼后一年，反生其子，以承后祀也。
一监生项疮初起，请视疮头偏于右半，不可轻待，必用艾灸为上；隔蒜灸至十五壮，知痛乃住。后彼视为
小恙，失用内药，又四日，其疮复作，颈肿项强，红紫木痛，便秘，脉实有力，以内疏黄连汤加玄明粉二钱通
其大便；次用消毒救苦汤二服，肿势仍甚。此内毒外发也，不可再消之，换服托里消毒散，至近二十日，因患
者肥甚，外肉多紧，不作腐溃，予欲行针开放，彼家坚执强阻，岂后变症一出，烦闷昏愦，人事不醒，彼方惊
悔。随用披针左右二边并项之中各开一窍，内有脓腐处剪割寸许顽肉，放出内积瘀毒脓血不止碗许，内服健脾
胃、养气血、托脓补虚之药，其脓似泉水不歇，每朝夕药与食中共参六、七钱，服至腐肉脱尽，新肉已生，又
至四十日外，患者方得渐苏，始知人事，问其前由，径不知其故也。此患设若禁用针刀，不加峻补，岂有生乎
？因其子在庠，见识道理，从信予言，未百日而愈也。
一男子项疮五六日，就肆看视，头便黄色，根亦平散，予曰∶此当急治方可。彼面色不悦而去。又请里中
一医视之，乃曰∶小恙也。因喜其说，用药又至五日外，其疮势坚硬，根脚开大，毒瓦斯已过两肩，流注前项，
胸乳皆肿，呕吐恶心，寒热不食，疮势形色俱觉可畏，始信前言。复请予治，其疮形状不可观也，此非药力可
及。先用葱艾汤洗净旧药，连煮药筒拔提二处，拔出瘀血碗余，随用银针斜斜插入根脚，透通患底数处，以蟾酥
条插入孔内。此最解毒为脓，总以膏盖，走散处以真君妙贴散敷之。日渐日消，其毒收归后项原处，又兼服内
托、降火、化痰之药，三、四日候其大势已退，内脓已通，换服十全大补汤。凡坚而不化者照之，腐而不痛者
取之，新血生迟者培之，如此调理将近三月，方得完口平复。此为患者讳疾忌医之过，几乎至
于丧命者多矣。
一女人年过六旬，系宦族，素禀怯弱，项间患疽，初起头便如粟，谓里可容谷之病也。喜其形体不肥，虽
发之后，必易于腐溃，此则不妨。前说先用隔蒜灸之，次用蟾酥饼贴灸上，四边以吸毒散敷之，收其根脚不散；
内服托里消毒散，数服疮势坚硬，疼苦不止。予曰∶到某日方止。况今疮不腐溃，诊其脉细数而无力，此内虚
之故，不能解毒为脓，以疼为要，岂可得止。次换益气养荣汤加角针、白芷三服，肿亦渐起；外用桑木灸法，
其坚渐软，脓出稠而不多。前方去角针、白芷加香附倍用参、 ，又数服方得脓溃，溃后痛亦不止。予曰∶再
三日，午后痛可止也。至期腐肉将脱小半，临午用乳香定痛散一服，午后疼痛顿退，安睡不醒。患家欣悦，予
曰∶不然，此在用药适其时也。虽半月之言，应于今刻，惟信则不失耳。后当某日腐尽，某日肌平，某日完口。
此二者患家以墨绳记候期日，果实并无过与不及也。此法要在眼力精巧，量病难易，新腐迟速，补助有无，用
药合式，然后相量日数，可决于前发之必中也。
一妇壮年，项疮三日，其形径对前口，彼家相畏，人胖不当疮发此穴也。予视顶高脚活，虽发不妨。彼欲
内消之方妥，予曰∶药消则不能，针消则可取。彼从之，用披针当顶针入六、七分，点至软肉方住，随去瘀血，
又以蟾酥条插入孔内，服蟾酥丸得大汗而解。次日疮上微脓出之渐消，尤恐内毒未尽，又用消毒清热之药数服，
不出十日而安。大抵凡欲消疮，先断根本，次泄毒瓦斯，使毒自衰无得内攻为妙。
一男子耳后生疽十余日，自谓小恙不治。将近半月，根脚渐大，疮头惟流血水，稀恶污秽，四边紫黑，软
陷无脓，面惨鼻掀，手冷气促，脉诊散大无根，此内败症也，何必治之。辞不用药。又延客医治之。因询无事，
患者恨予不治，凡遇亲友，勉
力支持，厉声自嘱决不甘死。予曰∶心不服死也，再五日必死。果然。予尝观疮，但犯此症，虽山岳之躯，一
败无不倾倒。
一妇人正对口四、五日，自灸廿余壮，径不知痛，灸疤焦黑，平塌如故。诊之脉微数而无力，此内虚症也
，若假药力则误其事。用披针当顶刺入寸许，不知痛，亦无血出，此毒滞而未发扬者；用蟾酥条插入针孔，每
日一次，膏盖其上，至七日后周遭裂缝出脓；内服纯补之药，至十四日，落出疮根一块，指大长寸余，后以玉
红膏平长肌肉。又半月，其口已平，以珍珠散掺上，即刻生皮而愈。此症设若不用针工，专假药力攻托，
虽不至死，岂能得其速愈者哉。
一妇人四旬肥甚，项疮五、六日，视之肉肿疮不肿，必竟生疑恐，又兼口燥心烦，坚硬色紫，根脚散平，
六脉洪大，此大过症也，后必无脓，相辞不治。彼又请医视之，有言外托者，又言内消者，有称年壮不妨，又
说脉大易治。众人纷纷不定，仍各用药，又至七、八日，前后胸、项俱肿，木闷坚硬，仍复请视决之。予曰∶
此不治者何也？初起肉肿疮不肿，顶陷者一也；根脚平散，真气内败，不能收束毒瓦斯二也；口燥心烦，邪火内
淫三也；形色紫暗，血死毒滞，不作腐溃者四也；六脉洪大，疮毒大盛，正气受克，无以抵当，故疮终变软陷，
邪毒内攻而死者五也。当备后事为要，此终于二十七朝前后足矣。后果至期而殁。观此言正顺理之病，可叹时
人何为纷纷妄治也。
初起时，疮顶高耸、根基鲜活，颜色红赤、皮薄，伴有疼痛和发热，但肿胀未能消散的，属于顺证。
疮形已成后，无论偏侧还是正中，疮形隆起，伴有疼痛和发热，容易化脓且易于腐溃的，属于顺证。
已经溃破后，脓液稠厚，肌肉颜色红活，瘀滞腐肉容易脱落，肿胀逐渐消退，疼痛减轻的，属于顺证。
溃破后腐肉脱尽，新肉随即生长，疮口逐渐收敛闭合，结痂化脓并伴有瘙痒感的，属于顺证。
初生时仅有一点黄泡，或像疙瘩一样，不肿不痛，患者自身毫无知觉的，属于逆证。
疮形已成后，不高肿，也不疼痛，疮顶软陷，根基平散无根的，属于逆证。
已经溃破后，脓液清稀，肌肉颜色紫黑，外皮不腐，内部散发臭秽气味，食欲减退的，属于逆证。
腐肉虽然排尽，但新肉不生，疮口散大且软陷，神色衰败的，属于逆证。
初生时有头或无头，剧烈疼痛或不疼痛的，都采用隔蒜灸法，并兼服解毒药物。
疮形已成且坚硬，伴有发热疼痛，口干便秘的，是邪气在体内，宜用泻下法。
肿胀坚硬但不疼痛，伴有发热恶寒，头痛及四肢拘急的，需兼用解表攻里法。
肿胀硬结日益加深，颜色紫黑，外皮不腐，内部脓液未溃出的，宜用拔毒法。
颈部僵硬，头面发热，口燥、恶心、呕吐的，是邪气在上部，宜用清热法。
红肿热痛，红色光亮，疼痛有时发作，内部脓液胀痛的，需紧急切开引流。
即将溃破却未溃破，微热微红，不能腐溃的，是脾胃虚弱，宜用补益法。
溃破后腐肉不脱，脓水清稀，肿痛依旧的，应当大补气血。
大便多溏泄，小便短少涩滞，自汗、食少，脉细身凉的，宜温中健脾。
有一个男子项部患疽十余日，观察其疮势很严重，根基连及左右，耳朵和颈部都肿胀，发红发热，脉象浮而数。先用黄连消毒散服用两剂以退去大势；待根基消退稳定后，用托里消毒散，服用数剂后不觉腐溃，只诊得脉象浮而无力。询问得知患者年过五十，长久难以生育子嗣，家中又有外室，多因思虑劳欲过度，损伤元气所致。加上疮情势大，只能起发而不能培养为脓，于是改用十全大补汤加桔梗、白芷，人参、白术各加倍至三钱。外用桑木灸法，早晚各灸两次。又涂抹紫霞膏。数日后患者头面部全部肿胀，双目紧闭，形状可畏，然后才腐溃，流出脓液，每日达数升。如此半月，因为前药不胜任病情，出现内烦躁不安、五心烦热、饮食渐少等症状，这是脓水流出过多，气血耗泄，导致虚火假症的原因，虽然变化但无妨。随即使用圣愈汤，一剂无效；再进一剂，加入熟附子二钱才见效，前症悉退。接着用人参养荣汤加麦冬、五味子，人参、白术常倍增至三钱，调理月余。后来脑骨处的腐肉成片脱下，状貌狼狈不堪，凡观看者无不点头惊讶！又担心腐溃深大，补益不及事，每天粥食中加入人参三钱，每餐分次同煮食用，以接续补益脾元。后方元气逐渐恢复，调理四月才痊愈。
此后一年，他反而生了儿子，以承继宗祀。
一个监生项部生疮初起，请我视诊，疮头偏向右侧半边，不可轻视，必须用艾灸为上策；隔蒜灸至十五壮，感到疼痛才停止。后来他认为这是小病，失于使用内服药，又过了四天，疮复发，颈肿项强，红紫麻木疼痛，便秘，脉实有力，用内疏黄连汤加玄明粉二钱通导大便；接着用消毒救苦汤服用两剂，肿势仍然很严重。这是内毒外发，不可再消解，换服托里消毒散。将近二十日，因为患者肥胖，外部肌肉紧绷，不能腐溃，我想行针开放，但他家人坚决阻止。岂料后来变症一出，烦闷昏愦，人事不省，他才惊悔。随即用披针在左右两边及项部中间各开一窍，内有脓腐处剪割寸许顽肉，放出积聚的瘀毒脓血不止一碗许。内服健脾胃、养气血、托脓补虚的药物，脓液如泉水般不停流出，每早晚餐药与食物中共用人参六、七钱。服用至腐肉脱尽，新肉已生，又过了四十多天，患者才渐渐苏醒，开始知晓人事，问起前因，全然不知其故。此患如果禁用针刀，不加峻补，岂能有生机？因为其子在学宫读书，见识道理，听从信任我的建议，不到百日便痊愈了。
一个男子项部生疮五六日，到药店看视，疮头呈黄色，根基也平散，我说：这应当紧急治疗才行。他面色不悦地离去。又请乡里一位医生看视，医生说：是小病。因此喜欢这个说法，用药又过了五天，疮势坚硬，根基开大，毒气已过两肩，流注前项，胸乳皆肿，呕吐恶心，寒热交作，不思饮食，疮势形色都觉得可畏，才相信之前的话。再次请我治疗，其疮形状不可观，这不是药力所能及的。先用葱艾汤洗净旧药，连煮药筒拔提两处，拔出瘀血碗余，随后用银针斜插入根基，透通患处底部数处，以蟾酥条插入孔内。这最能解毒化脓，总以膏药覆盖，走散处以真君妙贴散敷之。日渐消退，其毒收归后项原处，又兼服内托、降火、化痰的药物。三、四天后候其大势已退，内脓已通，换服十全大补汤。凡是坚而不化的照此处理，腐而不痛的取除，新血生迟的培补，如此调理将近三月，才得疮口平复。这是为患者讳疾忌医造成的过错，几乎丧命者太多了。
一个女人年过六十，出身宦族，素来体质怯弱，项间患疽，初起疮头就像粟米，说是可以容纳谷物的病（指疮口大）。庆幸她形体不胖，虽然发作后，必然易于腐溃，这倒不妨碍。前述先用隔蒜灸之，其次用蟾酥饼贴灸上，四边以吸毒散敷之，以收束根基不散；内服托里消毒散，数剂后疮势坚硬，疼痛不止。我说：到某日才会停止。况且现在疮不腐溃，诊其脉细数而无力，这是内虚的缘故，不能解毒为脓，以疼痛为主要表现，怎么可能停止。其次换用益气养荣汤加角针、白芷三剂，肿胀也渐渐起发；外用桑木灸法，其坚硬渐渐变软，脓出稠而不多。前方去掉角针、白芷，加香附，倍用人参、白术，又数剂才得脓溃，溃后疼痛仍不止。我说：再过三日，午后疼痛可止。到期时腐肉将脱小半，临午时用乳香定痛散一剂，午后疼痛顿退，安睡不醒。患家欣喜，我说：不然，这是在用药适得其时。虽然是半月的预言，应验在今刻，只有信任才不会失误。后来在某日腐尽，某日肌平，某日完口。这两件事患家用墨绳标记等候日期，确实并无过早或过晚。这种方法关键在于眼力精巧，衡量病情的难易，新肉与腐肉生长的迟速，补助有无，用药合式，然后相量日数，可以决断先发必中。
一个妇人在壮年，项部生疮三日，其形状正对着前口（哑门穴附近），她家人害怕，认为人胖不当疮发此穴。我看其顶高脚活，虽然发作也无妨。他们想要内消的方法稳妥，我说：药物消解则不能，针刺消解则可以取得效果。他们听从了我的建议，用披针当顶针入六、七分，点到软肉才住，随即去除瘀血，又以蟾酥条插入孔内，服用蟾酥丸得大汗而解。次日疮上微有脓出，随之渐消，尤其担心内毒未尽，又用消毒清热之药数剂，不出十日而安。大抵凡想要消疮，先断根本，其次泄毒瓦斯，使毒自衰无得内攻为妙。
一个男子耳后生疽十余日，自认为是小病不治。将近半月，根基渐渐变大，疮头惟流血水，稀恶污秽，四边紫黑，软陷无脓，面色惨淡鼻翼煽动，手脚冷气息促，脉诊散大无根，这是内败症，何必治疗。推辞不用药。又延请客医治疗。因为询问无事，患者恨我不治，凡遇亲友，勉力支持，厉声自嘱决不甘死。我说：心不服死也，再五日必死。果然。我曾观察疮疡，只要犯此症，虽如山岳之躯，一旦败坏无不倾倒。
一个妇人正对口（哑门穴）四、五日，自己灸了二十多壮，径直不知疼痛，灸疤焦黑，平塌如故。诊之脉微数而无力，这是内虚症，若假借药力则误事。用披针当顶刺入寸许，不知疼痛，也无血出，这是毒滞而未发扬；用蟾酥条插入针孔，每日一次，膏药覆盖其上，至七日后周遭裂缝出脓；内服纯补之药，至十四日，落出疮根一块，指大长寸余，后以玉红膏平长肌肉。又半月，其口已平，以珍珠散掺上，即刻生皮而愈。此症如果不用针工，专假药力攻托，虽不至死，岂能得其速愈者哉。
一个妇人四十岁，非常肥胖，项部生疮五、六日，视之肉肿疮不肿，必定产生疑惑恐惧，又兼口燥心烦，坚硬色紫，根基散平，六脉洪大，这是大过症，后来必然无脓，相辞不治。她又请医生看视，有的说外托，有的说内消，有的称年壮不妨，又说脉大易治。众人纷纷不定，仍各用药，又至七、八日，前后胸、项俱肿，木闷坚硬，仍复请我决断。我说：为什么不治呢？初起肉肿疮不肿，顶陷者一也；根基平散，真气内败，不能收束毒瓦斯二也；口燥心烦，邪火内淫三也；形色紫暗，血死毒滞，不作腐溃者四也；六脉洪大，疮毒大盛，正气受克，无以抵当，故疮终变软陷，邪毒内攻而死者五也。应当备办后事为要，这终于二十七朝前后足矣。后果至期而殁。观此言正顺理之病，可叹时人何为纷纷妄治也。
At the initial stage, if the sore's apex is high and its base is vital, with red color and thin skin, accompanied by pain and heat, but the swelling fails to dissipate, it is a favorable condition (Shun).
Once the sore has formed, regardless of whether it is lateral or central, if the sore shape protrudes, accompanied by pain and fever, and easily suppurates and putrefies, it is a favorable condition.
After ulceration, if the pus is thick, the flesh color is red and vital, necrotic tissue detaches easily, swelling gradually subsides, and pain decreases, it is a favorable condition.
After ulceration, when necrotic tissue falls off and new flesh grows immediately, the wound margin gradually contracts and closes, scabbing occurs with pus formation accompanied by itching, it is a favorable condition.
If at birth there is only a single yellow blister, or like a nodule, without swelling or pain, and the patient feels nothing, it is an unfavorable condition (Ni).
Once formed, if it does not swell high, nor is painful, with a soft and depressed apex and a flat, scattered base, it is an unfavorable condition.
After ulceration, if the pus is clear, the flesh color is purple-black, the outer skin does not putrefy, the interior emits a foul odor, and appetite is lost, it is an unfavorable condition.
Although necrotic tissue is exhausted, if new flesh does not grow, the wound margin is scattered and soft-depressed, with a decadent complexion, it is an unfavorable condition.
Whether the initial lesion has a head or not, whether it causes severe pain or no pain, apply garlic-separated moxibustion (Gesan Jiu) and concurrently administer detoxifying formulas.
If the formed sore is hard, accompanied by fever, pain, dry mouth, and constipation, the pathogenic factor is internal; purgation should be used.
If the swelling is hard but painless, accompanied by fever, aversion to cold, headache, and limb stiffness, combine exterior-releasing and interior-purging methods.
If the swelling and hardness deepen daily, with purple-black color, outer skin not putrefying, and internal pus not erupting, employ extraction methods.
If there is neck stiffness, facial heat, dry mouth, nausea, and vomiting, the pathogen is in the upper jiao; clearing heat is indicated.
If there is redness, swelling, heat, and pain, with bright red color, intermittent severe pain, and internal distending pain from pus, urgent incision and drainage are required.
If it is about to ulcerate but does not, with slight heat and redness, failing to putrefy, it indicates Spleen and Stomach deficiency; tonification is indicated.
After ulceration, if necrotic tissue does not detach, pus water is clear and thin, and swelling and pain persist, substantial tonification of Qi and Blood is necessary.
For frequent loose stools, scanty and dysuric urination, spontaneous sweating, poor appetite, fine pulse, and cool body, warm the middle and strengthen the Spleen.
A man suffered from a carbuncle on the neck for over ten days. The lesion appeared severe, with the base extending to both sides, causing swelling and red-hotness in the ears and neck. The pulse was floating and rapid. Initially, two doses of Huanglian Xiaodu San (Coptis Detoxification Decoction) were used to reduce the major symptoms. After the base stabilized, Tuoli Xiaodu San (Support Interior and Detoxify Decoction) was administered. After several doses, no putrefaction occurred, and the pulse was found to be floating but weak. Inquiry revealed the patient was over fifty years old, had long struggled with infertility, had a concubine, and suffered from excessive mental worry and sexual indulgence, damaging his Yuan Qi. Given the severity of the lesion, which could raise but not generate pus, Shiquan Dabu Tang (Complete Great Tonifying Decoction) was modified with Jiegeng (Platycodon Root) and Baizhi (Angelica Dahurica), doubling the dosage of Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala) to three qian each. Externally, mulberry wood moxibustion was applied twice daily. Purple Xia Gao (Purple Rosin Ointment) was also applied. Several days later, the patient's head and face swelled completely, eyes closed shut, looking terrifying. Then putrefaction and suppuration began, discharging liters of pus daily. After half a month, due to the ineffectiveness of previous medicines, internal restlessness, five-palm heat, and reduced diet appeared. This was attributed to excessive loss of Qi and Blood from pus discharge, resulting in false symptoms of deficient fire. Although changes occurred, they were manageable. Shengyu Tang (Sage Renewal Decoction) was then used. One dose was ineffective; a second dose with Ershu Fuzi (Prepared Aconite Root) added proved effective, resolving previous symptoms. Subsequently, Renshen Yangrong Tang (Ginseng Nourishing Grace Decoction) with Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Fruit), and doubled Renshen and Baizhu up to three qian was used for over a month调理. Later, necrotic tissue from the brain bone area detached in sheets, looking gruesome, astonishing all observers. Fearing deep putrefaction outpaced tonification, three qian of Renshen were added to daily porridge meals to support Spleen Yuan. Gradually, Yuan Qi recovered, and after four months of regulation, he healed.
One year later, he fathered a son to continue the family line.
A student at the Imperial Academy presented with a neck sore initially appearing on the right side. It must not be taken lightly; moxibustion is superior. Garlic-separated moxibustion was applied for fifteen cones until pain was felt. He later considered it a minor ailment and neglected internal medicine. Four days later, the sore recurred with neck swelling and stiffness, red-purple numbness and pain, constipation, and a strong, forceful pulse. Neishu Huanglian Tang (Interior-Draining Coptis Decoction) with Xuanmingfen (Mirabilite) was used to unblock bowels. Two doses of Xiaodu Jiuku Tang (Detoxify and Save from Distress Decoction) failed to reduce swelling. This indicated internal toxin manifesting externally; further dissolving was inappropriate. Tuoli Xiaodu San was switched to. Near twenty days later, due to the patient's obesity and tight external flesh preventing putrefaction, I proposed needle opening, but his family firmly opposed it. Consequently, complications arose: irritability, confusion, and unconsciousness. Only then did they regret. I immediately used a lancet to open holes on both sides and the center of the neck. Necrotic flesh within pus pockets was cut away, releasing over a bowl of accumulated toxic pus and blood. Internally, herbs to strengthen Spleen/Stomach, nourish Qi/Blood, and support pus expulsion were given. Pus flowed continuously. Daily intake included six to seven qian of Renshen mixed with food. After necrotic tissue fell off and new flesh grew, forty more days passed before the patient regained consciousness, unaware of what happened. If needles/knives had been forbidden and strong tonification withheld, survival would have been impossible. Because his son valued reason and trusted my advice, he healed within one hundred days.
A man with a neck sore for five to six days visited a pharmacy. The head was yellow, and the base was flat and scattered. I advised urgent treatment. He left displeased. Another local doctor called it a minor illness. Trusting this, medication continued for five more days. The sore became hard, the base expanded, poison spread to shoulders and anterior neck, chest and breasts swelled, with nausea, vomiting, chills, fever, and anorexia. The appearance was terrifying, confirming my earlier warning. Upon re-examination, the sore was beyond simple medicinal reach. Old medicine was washed off with Cong Ai Tang (Scallion and Mugwort Decoction). Two areas were treated with boiling herbal cupping to extract over a bowl of stasis blood. Silver needles were inserted obliquely into the base to penetrate the bottom of the lesion. Chan Su strips (Toad Venom Strips) were inserted into the holes. This best detoxifies and promotes suppuration. Covered with ointment, Zhenjun Miao Tie San (True Lord Wonderful Paste Powder) was applied to spreading areas. Day by day, it subsided, drawing poison back to the posterior neck. Internal supportive, fire-descending, and phlegm-resolving herbs were taken. After three to four days, major symptoms receded and internal pus drained. Shiquan Dabu Tang was resumed. Hard non-melting areas were addressed, painless putrefied areas removed, and slow new blood generation supported. Regulation lasted nearly three months until complete healing. This outcome resulted from the patient's concealment of illness and avoidance of doctors, nearly costing his life.
A woman over sixty, from an official family, constitutionally weak, developed a carbuncle on the neck. The initial head resembled millet grains, indicating a large cavity ("able to hold grain"). Fortunately, her slender build suggested easy putrefaction. Garlic-separated moxibustion was applied first, followed by Chan Su Bing (Toad Venom Cake) on the moxa site, and Xi Du San (Absorb Poison Powder) around the edges to contain the base. Internally, Tuoli Xiaodu San was taken. After several doses, the sore hardened with unceasing pain. I predicted cessation on a specific day. However, since it hadn't putrefied and the pulse was fine, rapid, and weak (indicating internal deficiency unable to transform poison into pus, hence pain persists), stopping was impossible. Yi Qi Yang Rong Tang (Tonify Qi and Nourish Grace Decoction) with Jiaozhen (Antler Horn) and Baizhi was prescribed for three doses. Swelling rose slightly. Mulberry wood moxibustion softened the hardness. Pus became thick but scant. Jiaozhen and Baizhi were removed from the formula; Xiangfu (Cyperus Rhizome) was added, and Renshen and Baizhu were doubled. After several more doses, suppuration occurred, but pain persisted. I predicted pain cessation afternoons in three days. At that time, half the necrotic tissue detached. Rushing Ding Tong San (Frankincense Pain-Stopping Powder) was taken at noon. Pain ceased instantly, allowing deep sleep. The family rejoiced. I explained this was timely medication application. Though I spoke of half a month, it applied to the present moment; trust ensures accuracy. Later dates for full necrosis removal, muscle leveling, and closure were predicted precisely, marked by ink lines by the family, proving accurate without error. This method relies on skilled observation, assessing difficulty, speed of new/necrotic tissue growth, appropriateness of tonification, and correct prescription, allowing precise temporal prediction.
A young woman had a neck sore for three days, positioned directly opposite the anterior fontanelle area. Her family feared it because she was obese and believed sores shouldn't appear there. I observed a high apex and active base, deeming it safe despite eruption. They sought internal resolution. I stated drugs alone couldn't dissolve it, but needling could. Following my advice, a lancet was inserted six to seven fen into the apex until soft flesh was reached. Stasis blood was removed, and a Chan Su strip inserted. Chan Su Wan (Toad Venom Pill) induced profuse sweating, resolving the condition. Next day, slight pus appeared, and swelling subsided. To ensure internal toxin clearance, detoxifying and heat-clearing herbs were given. Peace returned within ten days. Generally, to resolve sores, sever the root first, then drain toxins, preventing internal invasion.
A man had a carbuncle behind the ear for ten days, ignoring it as minor. Near half a month, the base enlarged, the head wept bloody fluid, foul and thin. Edges were purple-black, soft and depressed without pus. Face pale, nose flared, hands cold, breath short. Pulse was scattered, large, and rootless—indicating internal collapse. I declined treatment. A guest physician was hired. The patient, resentful of my refusal, vowed to friends he wouldn't die. I said, "The heart refuses death, but in five days you will die." It came true. I observe that any sore presenting this sign, even with a mountain-like constitution, collapses upon failure.
A woman had a sore at Zhengduikou (Center Opposite Mouth) for four to five days. She self-moxibusted over twenty times, feeling no pain. The scar was black and flat. Pulse was slightly rapid, fine, and weak—internal deficiency. Medication alone would be mistaken. A lancet pierced the apex one cun deep; no pain, no blood—indicating stagnant toxin not yet rising. Chan Su strips were inserted daily, covered with ointment. After seven days, cracks appeared around the periphery with pus discharge. Purely tonifying herbs were taken internally. On the fourteenth day, a finger-sized piece of sore root, over an inch long, dropped out. Yuhong Gao (Jade Red Ointment) promoted muscle growth. Half a month later, the wound flattened. Zhenzhu San (Pearl Powder) was sprinkled, promoting immediate skin regeneration and healing. Without needling, relying solely on drugs, while not fatal, would not yield such rapid recovery.
A forty-year-old obese woman had a neck sore for five to six days. Flesh swelled but the sore itself didn't. She doubted and feared. Dry mouth, irritability, hardness, purple color, flat scattered base, and surging pulses indicated an excessive condition. No pus would form. I declined treatment. Other doctors suggested external support or internal dissolution, citing youth and strong pulse as good signs. Confusion ensued. Seven to eight days later, chest, neck, and front swelled, stiff and numb. Re-evaluation showed: 1) Flesh swollen, sore flat/depressed; 2) Base flat/scattered, true Qi failed, unable to contain toxin; 3) Dry mouth/irritability, evil fire invading internally; 4) Purple-dark color, dead blood/stagnant toxin, no putrefaction; 5) Surging pulses, overwhelming toxin suppressing righteous Qi, leading to soft depression and internal attack death. Prepare funeral arrangements; death expected around the 27th day. It happened. Observing this logical progression, one sighs at the chaotic, erroneous treatments of contemporaries.