痈疽之起，总由血气壅滞所致，如河渠淤塞者然。苟使血气流畅，何痈疽之有。故火毒
壅滞则红肿 痛而成痈；寒痰壅滞则白塌木肿而成疽。痈作突热治，疽作虚寒治，一目了然
，不俟诊脉可知也。及其壅滞既久，变好血而成脓，创好肌而破口，苦矣哉！当初未作脓之时，急
随痈疽证治消治之，俾其痛止肿平，安然畅适，岂不快欤？每见恃能刀针，不细察病情当用
刀针否，漫云泄毒，乃杀人不转睫之徒也。不但病患负痛已甚，又何能堪此痛苦。更有妄施
刀针，以致溃烂难敛，七恶蜂起，仁心仁术者，谅不妄为若此也。
痈疽初起失治，致肌肤溃烂。凡痈将溃之时，则先消其未成脓之地，而溃不致于延烂；
既溃
头膏，无有不溃。如气血壮盛，皮肉粗浓之人，即以针刺分许亦可。但疽始终总以温补、开
腠、消解为治。王洪绪先生云∶疽初起即见平塌，安可用托，托则致溃。即流注瘰 、恶核
等证。倘有溃者，仍不敢托，托则溃者纵敛，增出者又如何耶？旨哉言也。
洪氏曰∶凡大痈溃后，世人往往投炙草、炙 ，或用半炙、半生，殊不知内托散等方，
用人参者，非以补其虚，不过以人参助黄 托毒之力，而无补毒之害。盖炙 止补气不能托毒，
炙草只补中不能解毒。倘毒瓦斯未尽，误投炙 、炙草致毒反受补助，大痛内攻，将如之何？
余之治，凡遇初溃大痈，止其痛，痛息则毒散，其肿亦退，色转红活。体虚年老者，参、
、甘草皆炙也。如体旺家贫者，无参亦可收功。
痈疽的发生，总归是由气血壅滞阻塞所致，就像河渠淤塞一样。如果能使气血流畅，哪里还会有痈疽呢？所以，火毒壅滞会导致红肿疼痛而形成痈；寒痰壅滞则导致患处平塌、麻木肿胀而形成疽。治疗时，痈当作实热证处理，疽当作虚寒证处理，这道理一目了然，不需要诊脉就可以知道。等到壅滞时间长久，将好血变为脓液，破坏好肌肉而破口，真是痛苦啊！在当初尚未化脓的时候，应当急忙根据痈疽的证候采用消散的方法治疗，使疼痛停止、肿胀消退，安然舒适，难道不快乐吗？我常常见到那些倚仗自己能使用刀针的人，不仔细考察病情是否应当使用刀针，就随意声称要泄毒，这是眨眼间就能杀人的家伙。这不仅让病患承受极大的痛苦，他们又怎能忍受这种痛苦呢？更有甚者，胡乱施用刀针，导致溃烂难以愈合，七恶证（中医外科危重证候）蜂拥而起，有仁心仁术的医生，想必不会妄为到这种地步。
痈疽初期若失治，导致肌肤溃烂。凡是痈将要溃破的时候，先消除未成脓的部位，那么溃破后就不会蔓延腐烂；已经溃破后，使用头膏（外用膏药），没有不能治愈的。如果是气血壮盛、皮肉粗厚的人，即使只用针刺少许也可以。但是，疽从始至终总是以温补、开腠理（打开毛孔/皮肤纹理）、消解作为治疗方法。王洪绪先生说：疽初起时就见平塌，怎么可以用托法（托毒外出），用托法反而会导致溃破。即使是流注（深部脓肿）、瘰疬（颈部淋巴结结核）、恶核等病证，如果有溃破的，仍然不敢用托法，如果用托法，已经溃破的虽然收敛了，但新增出的病灶该怎么办呢？这话很有深意啊。
王氏说：凡是大的痈溃破后，世人往往投用炙甘草、炙黄芪，或者一半炙一半生，却不知道内托散等方剂中用人参，并不是为了补其虚弱，不过是用人参辅助黄芪托毒外出的力量，而没有补助毒邪的危害。大概炙黄芪只补气而不能托毒，炙甘草只补中气而不能解毒。如果毒气未尽，误投炙黄芪、炙甘草，导致毒邪反而受到补助，剧烈疼痛向内攻冲，那该怎么办呢？我的治疗方法，凡是遇到初溃的大痈，首先止住疼痛，疼痛平息则毒气消散，肿胀也会消退，颜色转为红润鲜活。对于体虚年老者，人参、黄芪、甘草都使用炙制品。如果是体质旺盛且家境贫寒的人，不用人参也可以取得疗效。
The onset of carbuncles and sores is generally caused by the stagnation and obstruction of Qi and blood, similar to the blockage of river channels. If Qi and blood could flow smoothly, how could carbuncles and sores arise? Therefore, when fire-toxin stagnates, it causes redness, swelling, and pain, forming a carbuncle (Yang sore); when cold-phlegm stagnates, it causes flatness, numbness, and swelling, forming a sore (Yin sore). Carbuncles should be treated as excess-heat patterns, while sores should be treated as deficiency-cold patterns; this is clear at a glance and does not require pulse diagnosis. However, once the stagnation persists for a long time, healthy blood transforms into pus, and healthy muscle tissue breaks open, which is truly painful! In the early stage before pus formation, one should urgently treat according to the syndrome of the carbuncle or sore using resolving methods, so that pain stops and swelling subsides, leaving the patient comfortable and at ease, would this not be delightful? I often see those who rely on their skill with knives and needles without carefully examining whether such instruments are indicated for the condition, casually claiming to drain toxin; these are people who kill within the blink of an eye. This not only subjects patients to extreme pain but also makes them endure such suffering. Moreover, reckless use of knives and needles can lead to difficult-to-heal ulcers and the sudden appearance of the "Seven Evils" (seven critical syndromes in external medicine). Physicians with benevolent hearts and skills would surely not act so recklessly.
If carbuncles and sores are neglected in the initial stage, it leads to ulceration of the skin and flesh. Whenever a carbuncle is about to suppurate, one should first resolve the area where pus has not yet formed, so that upon ulceration, it will not spread and rot; after ulceration, applying head ointment (topical plaster) ensures healing. For individuals with robust Qi and blood and thick skin and flesh, even slight needle pricking may suffice. However, sores always require treatment focused on warming and tonifying, opening the interstices (pores/skin texture), and resolving stagnation throughout their course. Mr. Wang Hongxu stated: When a sore initially presents as flat, how can one use the method of supporting and expelling (Tuo Fa)? Using Tuo Fa would cause ulceration. This applies even to conditions like flowing abscesses (Liuzhu), scrofula (Luoli), and malignant nodules (Ehe). If there are already ulcerated cases, one still dares not use Tuo Fa; if Tuo Fa were used, although the existing ulcers might heal, what would happen to the newly emerging lesions? These words are profound.
Mr. Wang said: After large carbuncles ulcerate, people often administer roasted Licorice Root (Zhi Gancao) or roasted Astragalus Root (Zhi Huangqi), or a mixture of half-roasted and half-raw. They fail to realize that in formulas like Neituo San (Internal Support Powder) containing Ginseng Radix et Rhizoma (Renshen), the purpose is not merely to tonify deficiency, but to assist Astragalus Root (Huangqi) in expelling toxin, avoiding the harm of nourishing the pathogen. Roughly speaking, roasted Astragalus only tonifies Qi but cannot expel toxin, and roasted Licorice only tonifies the Middle Jiao but cannot resolve toxin. If the toxic qi is not fully cleared, mistakenly administering roasted Astragalus and Licorice may inadvertently aid the toxin, causing severe internal pain; what then? My treatment approach for large carbuncles that have just ulcerated is to first stop the pain; once pain ceases, the toxin disperses, swelling recedes, and the color turns vibrant red. For elderly patients with weak constitutions, Ginseng, Astragalus, and Licorice are all used in their roasted forms. For those with strong constitutions and poor financial means, omitting Ginseng can still achieve therapeutic success.