凡治疮疡。不审元气虚实。病在表里。便服败毒流气等药。盖败毒散。发表药也。果有
。止宜一二服。多则元气损。毒愈盛。虽有人参亦莫能补。流气饮耗血药也。果气结胸满。
只宜二三服。多则血反致败。虽有芎、归。亦难倚仗。丹溪曰。此不系膏粱丹毒之变。因虚
劳气郁所故也。
一人肩患毒。肿硬作痛。恶症迭见。用矾末三钱糊丸。以葱白七茎煎汤调下。肿痛悉退
矾末葱汤调下。因末难服。故以蜡为丸。一方士治疮疽。不问肿溃。先用此药二三服。后用
消毒药甚效。常治刍荛之人。用此即退。不用托里亦愈。盖止热毒为患。血气不亏。故用多
效若金石毒药发疽者。尤效。以矾能解金石之毒也。一方用矾末五钱。朱砂五分。热酒下。
亦效此药托里固内、止泄、解毒、排脓。不动脏腑。不伤气血。有益无损。其药易得。其功
甚大。偏僻之处不可不知此方。或虫犬所伤。溶化热涂患处。更以热酒调末服皆效。
东垣曰。其疮外有六经之形症。内无便溺之阻隔。饮食如故。清便自调。知不在里。非
也。小则为疖。大则为痈。其邪所受于下。风湿之地气。自外而来。侵于身也。经曰。营气
不从。逆于肉理。乃生痈肿。诸痛痒疮疡。皆属心火。此元气不足。营气逆行。其疮初出。
未有传变。在于肌肉之上。皮肤之间。只为风热六经所行经络地分出矣。宜泄其风湿热疮之
情势。亦旧然高起。结硬作痛。此疮自外而入。其脉只在左手。左手主表。左寸外洪缓。左
关洪缓而弦是客邪客于血脉之上。皮肤之间。宜急发汗而通其荣卫。则邪气出矣。托里荣卫
汤此足太阳药表里气血之剂。
黄 红花 桂枝（各五钱） 苍术（三钱） 柴胡 连翘（各二钱） 羌活 防风 归身
甘草（炙） 黄芩（各半钱） 人参（一钱）
上锉。每服一两。水酒各半。煎。
凡是治疗疮疡，如果不审察患者元气的虚实状况，也不分辨病位在表还是在里，就贸然服用败毒散、流气饮等药物。败毒散是发表（发散表邪）的药物，如果确实有表证，只适宜服用一到两剂，服多了就会损伤元气，导致毒邪更加炽盛，即使方中有的人参也无法补救。流气饮是耗伤血液的药物，如果确实存在气结胸满的症状，只适宜服用二到三剂，服多了反而会导致血液败坏，即使方中有川芎、当归，也难以依靠其补血功效。朱丹溪说：这类病症不属于因食用膏粱厚味或丹药引起的毒变，而是由于虚劳和气机郁滞所导致的。
有一人肩部患毒，局部肿胀坚硬且疼痛，各种恶症接连出现。使用矾末三钱，用面糊制成丸药，用七根葱白煎汤送服。肿痛完全消退。因为矾末难以直接服用，所以用蜡将其包裹制成丸剂。有一位方士治疗疮疽，不问是否已经肿胀或溃破，先使用该药服用二到三剂，然后再使用消毒药物，效果非常好。常用于治疗普通百姓，使用后症状即退，甚至不使用托里（补益气血以托毒外出）的方法也能痊愈。这主要是因为该药仅针对热毒为患，且患者血气未亏损，所以多用有效。如果是金石类药物引发的疽症，效果尤其显著，因为矾能解金石之毒。另有方子用矾末五钱，朱砂五分，用热酒送服，也有效果。此药具有托里固护内脏、止泻、解毒、排脓的功效，不扰动脏腑，不损伤气血，有益无害。该药容易获取，功效很大，偏僻之处的人不可不知道这个方子。如果是被虫犬咬伤，可将药溶化后热敷患处，再用热酒调服药末，都有效果。
李东垣说：疮疡在外表现为六经的形症，在内没有大小便的阻隔，饮食正常，清便自调，可知病不在里，而是在表。小的称为疖，大的称为痈。这种邪气受于下部，风湿之地气从外而来，侵袭身体。《内经》说：营气运行不畅，逆乱于肌肉纹理之间，就会发生痈肿。各种痛痒疮疡，都属于心火。这是因为元气不足，营气逆行。疮疡初起时，尚未发生传变，位于肌肉之上、皮肤之间，只是风热在六经所行经络分布区域的表现。应当疏泄风湿热疮的情势。此时疮疡依然高起，结硬作痛。这是疮疡从外而入，脉象只在左手显现。左手主表，左寸脉洪大而缓，左关脉洪缓而弦，这是客邪客于血脉之上、皮肤之间。应当紧急发汗以通畅营卫，这样邪气就能排出。托里荣卫汤是足太阳经治疗表里气血的方剂。
黄芪 红花 桂枝（各五钱） 苍术（三钱） 柴胡 连翘（各二钱） 羌活 防风 归身 甘草（炙） 黄芩（各半钱） 人参（一钱）
以上药材切碎，每次服用一两，用水和酒各一半的比例煎煮。
Whenever treating sores and ulcers, if one does not examine the deficiency or excess of Yuan Qi (Original Qi), nor determine whether the pathology is in the exterior or interior, and rashly administer medicines such as Baidu San (Decoction for Overcoming Toxins) or Liuqi Yin (Flowing Qi Drink), it is erroneous. Baidu San is an exterior-releasing formula; if there is indeed an exterior syndrome, only one or two doses are appropriate. Excessive use will damage Yuan Qi, causing toxins to become more vigorous; even with Ginseng Radix et Rhizoma (Renshen) present, it cannot compensate for the loss. Liuqi Yin contains blood-consuming herbs; if there is indeed qi stagnation and chest fullness, only two or three doses are suitable. Excessive use will instead ruin the blood; even with Ligusticum Chuanxiong Rhizome (Chuanxiong) and Angelica Sinensis Radix (Danggui) present, their efficacy in nourishing blood is hard to rely upon. Zhu Danxi stated: This condition is not a transformation caused by toxins from rich foods or elixirs, but rather results from consumptive fatigue and qi depression.
A patient suffered from toxicity on the shoulder, presenting with swelling, hardness, pain, and successive malignant symptoms. Three qian of Alum powder were made into pills using starch paste and administered with a decoction of seven stalks of Scallion White (Congbai). The swelling and pain completely subsided. Because Alum powder is difficult to take directly, wax was used to coat the pills. A certain practitioner treated carbuncles and furuncles regardless of whether they were swollen or ulcerated, first administering this medicine for two or three doses, followed by detoxifying drugs, yielding excellent results. It is often used to treat common people; symptoms recede after use, and recovery occurs even without employing Tuoli (supporting the interior to push out toxins) methods. This is because the medicine addresses heat-toxin pathologies where blood and qi are not depleted, making frequent use effective. For carbuncles induced by mineral drugs, the effect is particularly remarkable, as Alum can resolve mineral toxicity. Another prescription uses five qian of Alum powder and five fen of Cinnabar (Zhusha), taken with hot wine, which is also effective. This medicine supports the interior, consolidates the viscera, stops diarrhea, resolves toxins, and discharges pus. It does not disturb the viscera nor injure blood and qi; it is beneficial without harm. The ingredients are easy to obtain, and its merit is great; those in remote areas must know this formula. In cases of insect or dog bites, the medicine can be melted and applied hot to the affected area, and the powder can be taken with hot wine, both being effective.
Li Dongyuan said: The sore presents exterior manifestations of the Six Channels, while internally there is no obstruction in urination or defecation, appetite remains normal, and stools are regular, indicating the pathology is not in the interior but in the exterior. Small lesions are called Jie (furuncles), large ones are called Yong (carbuncles). The pathogen is received from below; damp-heat from the earth arises from outside and invades the body. The Classics state: When Ying Qi (Nutritive Qi) fails to flow smoothly and reverses within the muscle tissue, abscesses and swellings occur. All painful, itching sores and ulcers belong to Heart Fire. This is due to insufficient Yuan Qi and reversed Ying Qi. At the initial stage of the sore, before any transmission has occurred, the lesion is located above the muscles and between the skin, representing merely the manifestation of wind-heat along the pathways of the Six Channels. One should vent the tendency of damp-heat and wind-toxins. The sore remains elevated, hard, and painful. This indicates the sore entered from the exterior. The pulse is found only in the left hand, which governs the exterior. A surging and moderate pulse at the Left Cun position, and a surging, moderate, and wiry pulse at the Left Guan position, indicate exogenous pathogens residing above the blood vessels and between the skin. Urgent sweating should be induced to unblock Ying and Wei (Defensive) Qi, thereby expelling the pathogenic factors. Tuoli Rongwei Tang is a formula for the Foot Taiyang channel that treats the exterior and interior aspects of blood and qi.
Astragali Radix (Huangqi) Safflower (Honghua) Cinnamon Twig (Guizhi) (each 5 qian) Atractylodis Rhizoma (Cangzhu) (3 qian) Bupleuri Radix (Chaihu) Forsythiae Fructus (Lianqiao) (each 2 qian) Notopterygii Rhizoma et Radix (Qianghuo) Saposhnikoviae Radix (Fangfeng) Angelicae Sinensis Radix (Guishen) Licorice Root (Gancao) (roasted) Scutellariae Radix (Huangqin) (each 0.5 qian) Ginseng Radix et Rhizoma (Renshen) (1 qian)
The above herbs are chopped. Each dose consists of one liang, decocted with half water and half wine.