阴疽之形，皆阔大平塌，根盘坚硬，皮色不异，或痛或不痛，乃外科最险之证。倘误服
寒凉，其色变如隔宿猪肝，毒攻五内，神昏即死。治之之法，非麻黄不能开其腠理，非肉桂、炮
姜不能解其凝寒；腠理一开，寒凝一解，气血流行，则患随消矣。血气不能化毒者，则宜温
补排脓，虽当溃脓，而毒瓦斯未尽，肿硬未消，亦仍以温气血开腠理为要。大抵初起患轻，未
经误药者，可用加味二陈汤（通用十八。）纳阳和丸（通用六。）同煎数服消之。如曾经误药，
或皮色稍变，须服阳和汤（通用五。）其甚者，与犀黄丸（通用四十八。）早晚轮服。溃后亦然
。如失荣、恶核、石疽等证，初起毒根深固者，须更兼紫元丹（通用五十一。）间服方能全消
。凡详见于各部中，宜同参用。
一、初起兼头痛、发热、恶寒、肢体拘急等表证者，先以保安万灵丹（通用五十四。）汗
之，或人参败毒散（通用三。）去独活加桂枝一钱汗之，待表证退，按前法治之。
一、溃后忽见表证，则以托邪饮（通用十二。）加桂枝一钱煎服。少倾，啜热粥一瓯，暖
卧微汗取效，不可令大汗。如未效，再进。待表势解，须接补元气，用补中益气汤加茯苓、半夏
、熟地最妙。
一、初起或溃后欲呕，而别无表证者，胃气虚也，六君子汤（通用二十一。）加炮干姜主
之。
一、溃后但恶寒而不发热者，阳气虚也，十全大补汤（通用二十六。）加姜、附主之。
一、溃后见晡热、内热证者，阴血虚也，四物汤（通用二十三。）去川芎，倍熟地，加参
、术、地骨皮、甘草主之。
一、大患久溃，或脓血去多，忽见发热恶寒，面赤烦躁，口虽渴而喜热饮者，此血虚发
躁，急以当归补血汤，（通用三十三。）或当归黄 汤（通用三十四。）服之。否则发痉。
一、溃后口干作渴，饮水不歇，小便频数，或淋漓作痛，或舌上燥黄如金色者，乃肾水
枯竭，心火炎炽，此证最恶，急用加减八味丸（通用四十六。）以滋补之，否则不救，迟治亦不救
一、溃后喘促咳嗽，脾肺虚也，补中益气汤，去升麻加茯苓、半夏、五味子主之。或加
熟地，口燥者加麦门冬。
一、溃延日久，病患脾虚气滞者，则先服六君子汤加芎、归数剂，参、术、草宜生，忌
炙。待其饮食复常，再按前法治之。凡经表汗后，亦如是治。
一、好饮之人，每发酒毒，如阴疽状，发无定处。初起漫肿，内似结核，不红或淡红，
重着板痛，多有兼头晕发热汗出呕吐之证。此元气大伤，酒毒熏蒸，结滞经隧。治宜清利湿热，
培补元气。内服加味解酲汤，（见发无定处痼发下。）外以赤小豆为末，滚水或米醋调敷，或
以乌龙膏（通用六十。）敷之。若误投阳和汤，小金丹等甘热之药，轻则呕吐脓血，重则神昏
发狂，成痉不救。此证从前未经发明，余历视颇多，特表揭于此。毫厘千里，生死攸关，业
医者细心审辨焉。
一、凡色白大少阴疽，忌贴洞天、千捶、鲫鱼等膏。盖寒凉不利于阴疽，且内有巴豆、
蓖麻子，未溃者贴则致溃，已溃者贴则致命，有孕者贴则堕胎。故凡阴疽未溃者，宜敷抑阴散，
（通用五十八。）既溃后，宜贴阳和解凝膏。（通用七十七。）
一、犀黄丸、（通用四十八。）小金丹、（通用五十二。）内有麝香，妊妇忌服，当以阳和
汤愈之。愈后再服三、四剂，以代小金丹，永杜后患。
一、小儿不能服煎剂者，以小金丹化服代之。
阴疽的形态，都是宽阔巨大、平坦下陷，根部盘结坚硬，皮肤颜色没有明显变化，或者疼痛或者不痛，这是外科中最危险的证候。如果误服寒凉药物，患处颜色会变成像隔夜的猪肝一样，毒邪攻入五脏，患者神志昏迷随即死亡。治疗的方法，非用麻黄不能打开腠理（皮肤毛孔及汗腺），非用肉桂、炮姜不能解除凝滞的寒邪；一旦腠理打开，寒凝解除，气血流通，那么患处就会随之消散。如果血气不能化解毒邪，则适宜采用温补排脓的方法，虽然应当溃破流脓，但毒气未尽，肿胀硬结未消，仍然以温养气血、开通腠理为关键。大抵初起时病情较轻，未经过误治用药的，可以使用加味二陈汤（通用方第十八）与阳和丸（通用方第六）同煎服用数次使其消散。如果曾经误服药物，或者皮肤颜色稍有变化，必须服用阳和汤（通用方第五）。病情严重的，早晚交替服用犀黄丸（通用方第四十八）。溃破后也是如此处理。如果是失荣、恶核、石疽等证候，初起时毒根深固的，必须兼服紫元丹（通用方第五十一），间隔服用才能完全消除。凡是详细记载在各部中的，应当参照使用。
一、初起时兼有头痛、发热、恶寒、肢体拘急等表证的，先用保安万灵丹（通用方第五十四）发汗解表，或者用人参败毒散（通用方第三）去掉独活，加入一钱桂枝发汗，待表证消退后，按照前面的方法治疗。
一、溃破后忽然出现表证的，用托邪饮（通用方第十二）加入一钱桂枝煎服。过了一会儿，喝一碗热粥，盖好被子暖睡，通过微微出汗来取效，不可令其大汗淋漓。如果没有效果，再进服一次。待表势解除后，必须接续补益元气，用补中益气汤加入茯苓、半夏、熟地黄最为巧妙。
一、初起或溃破后想要呕吐，而没有其他表证的，是胃气虚弱，用六君子汤（通用方第二十一）加入炮干姜主治。
一、溃破后只怕冷而不发热的，是阳气虚弱，用十全大补汤（通用方第二十六）加入生姜、附子主治。
一、溃破后见到傍晚发热、内热的证候，是阴血虚弱，用四物汤（通用方第二十三）去掉川芎，加倍使用熟地黄，加入人参、白术、地骨皮、甘草主治。
一、严重疮疡久溃不愈，或者脓血流失过多，忽然出现发热恶寒，面色红赤烦躁，口虽渴却喜欢热饮的，这是血虚导致的烦躁，急需服用当归补血汤（通用方第三十三），或者当归黄芪汤（通用方第三十四）。否则会发生痉挛。
一、溃破后口干作渴，喝水不停，小便频数，或者淋漓作痛，或者舌上干燥发黄如金色者，这是肾水枯竭，心火炎炽，这个证候最恶劣，急需使用加减八味丸（通用方第四十六）来滋补，否则无法救治，治疗迟缓也无法救治。
一、溃破后气喘急促咳嗽，是脾肺虚弱，用补中益气汤，去掉升麻，加入茯苓、半夏、五味子主治。或者加入熟地黄，口燥的加入麦门冬。
一、溃烂拖延日久，病患脾虚气滞的，则先服用六君子汤加入川芎、当归数剂，人参、白术、甘草宜用生品，忌用炙制品。待其饮食恢复正常，再按照前面的方法治疗。凡是经过发汗解表治疗后，也这样治疗。
一、喜好饮酒的人，常常引发酒毒，症状类似阴疽，发作部位不定。初起时漫肿，内部似有结核，不红或淡红，沉重且板硬疼痛，多伴有头晕、发热、出汗、呕吐等症状。这是元气大伤，酒毒熏蒸，结滞于经络隧道。治疗宜清利湿热，培补元气。内服加味解酲汤（见“发无定处痼发”篇下），外用赤小豆研末，用滚水或米醋调敷，或者用乌龙膏（通用方第六十）外敷。如果误投阳和汤、小金丹等甘热性质的药物，轻则呕吐脓血，重则神志昏迷发狂，发生痉挛无法救治。这个证候从前未曾阐明，我诊治过很多例，特此揭示于此。毫厘之差，千里之远，关乎生死，从业的医生务必细心审辨。
一、凡是颜色苍白、面积较大的少阴疽，忌讳贴洞天膏、千捶膏、鲫鱼膏等膏药。因为寒凉药物不利于阴疽，且这些膏药内含有巴豆、蓖麻子，未溃破者贴上会导致溃破，已溃破者贴上会致命，孕妇贴上会导致堕胎。所以凡是阴疽未溃破的，宜敷抑阴散（通用方第五十八），既溃破后，宜贴阳和解凝膏（通用方第七十七）。
一、犀黄丸（通用方第四十八）、小金丹（通用方第五十二）内有麝香，孕妇忌服，应当用阳和汤治愈它。痊愈后再服用三四剂，用来代替小金丹，永远杜绝后患。
一、小儿不能服用煎剂的，用小金丹化开服用来替代。
The morphology of Yin Ju (Yongorous Abscess) is characterized by being broad, large, flat, and depressed, with a hard base and no obvious change in skin color. It may be painful or painless, representing the most dangerous condition in surgery. If cold-natured medicines are mistakenly taken, the color of the lesion will turn like a liver from the previous night; if the toxin attacks the five internal organs, the patient will fall into coma and die immediately. The method of treatment requires Ephedrae Herba (Mahuang, 麻黄) to open the Couli (skin pores and interstices), and Cinnamon Twig Decoction (Rougui Tang, 肉桂) combined with Prepared Ginger Rhizome (Paojiang, 炮姜) to resolve the coagulated cold. Once the Couli are opened and the cold resolved, Qi and Blood circulate freely, and the lesion will subside. If Qi and Blood cannot transform the toxin, warm tonification and pus drainage should be employed. Even when suppuration occurs, if the toxic vapor is not fully exhausted and swelling/hardness persists, the key remains warming Qi and Blood and opening the Couli. Generally, for mild cases at the initial stage that have not been mistreated, Jiawei Erchen Tang (Modified Two-Aged Decoction) can be decocted together with Yanghe Wan (Yanghe Pill) for several doses to eliminate the condition. If there has been prior medication error or slight changes in skin color, Yanghe Tang (Yanghe Decoction) must be taken. For severe cases, Xihuang Wan (Xihuang Pill) should be administered alternately morning and evening. This approach applies equally after suppuration. For conditions such as Shiyun (Loss of Prosperity), Ehe (Malignant Nodule), and Shiju (Stone Abscess), where the toxin root is deep-seated at onset, Ziyuan Dan (Ziyuan Pill) should be taken intermittently along with other treatments to ensure complete resolution. Refer to detailed descriptions in respective sections for combined use.
1. If initial symptoms include headache, fever, aversion to cold, and limb stiffness (Exterior Syndrome), first administer Bao'an Wanling Dan (Bao'an Ten-Thousand Spirit Pill) to induce sweating, or Ren Shen Baidu San (Ginseng Detoxifying Powder) minus Achyranthis Bidentatae Radix (Duhuo, 独活) plus one qian of Cinnamon Twig (Guizhi, 桂枝) to induce sweating. After exterior symptoms resolve, treat according to the aforementioned methods.
2. If exterior symptoms suddenly appear after suppuration, administer Tuoxie Yin (Toxin-Expelling Infusion) plus one qian of Cinnamon Twig (Guizhi, 桂枝). Shortly after, drink a bowl of hot porridge, keep warm, and aim for slight sweating. Profuse sweating must be avoided. If ineffective, repeat the dose. Once exterior symptoms resolve, proceed to tonify Yuan Qi (Original Qi) using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Poria (Fuling, 茯苓), Pinellia (Banxia, 半夏), and Prepared Rehmannia Root (Shudi, 熟地) for best results.
3. If nausea occurs at onset or after suppuration without other exterior symptoms, it indicates Stomach Qi deficiency. Treat with Liujunzi Tang (Six Gentlemen Decoction) added with Prepared Dried Ginger (Paoganjiang, 炮干姜).
4. If only aversion to cold without fever occurs after suppuration, it indicates Yang Qi deficiency. Treat with Shiquan Dabu Tang (Ten Complete Tonifying Decoction) added with Fresh Ginger (Shengjiang, 生姜) and Aconite Root (Fuzi, 附子).
5. If afternoon fever and internal heat occur after suppuration, it indicates Yin Blood deficiency. Treat with Siwu Tang (Four Substances Decoction) minus Ligusticum Chuanxiong Rhizome (Chuanxiong, 川芎), double the amount of Prepared Rehmannia Root (Shudi, 熟地), and add Ginseng (Renshen, 人参), Atractylodes Macrocephala Rhizome (Baizhu, 白术), Groundcherry Root (Digupi, 地骨皮), and Licorice Root (Gancao, 甘草).
6. In severe chronic ulcers with excessive loss of pus and blood, sudden onset of fever, aversion to cold, red face, irritability, thirst but preference for hot drinks indicates Blood deficiency causing restlessness. Immediately administer Danggui Buxue Tang (Angelica Tonifying Blood Decoction) or Danggui Huangqi Tang (Angelica and Astragalus Decoction). Otherwise, spasms may develop.
7. If dry mouth and thirst persist after suppuration, frequent urination, dysuria, or a dry yellow tongue resembling gold, this indicates exhaustion of Kidney Water and blazing Heart Fire. This is a dire prognosis requiring immediate administration of Jiajian Bawei Wan (Modified Eight-Ingredient Pill) for nourishment. Delayed treatment is also fatal.
8. If panting and coughing occur after suppuration, it indicates Spleen and Lung deficiency. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) minus Cyathulae Radix (Shengma, 升麻), added with Poria (Fuling, 茯苓), Pinellia (Banxia, 半夏), and Schisandra Fruit (Wuweizi, 五味子). Alternatively, add Prepared Rehmannia Root (Shudi, 熟地); if dry mouth exists, add Ophiopogon Tuber (Maidong, 麦门冬).
9. For prolonged ulcers with Spleen deficiency and Qi stagnation, first administer Liujunzi Tang (Six Gentlemen Decoction) added with Ligusticum Chuanxiong Rhizome (Chuanxiong, 川芎) and Angelica Sinensis Radix (Danggui, 当归) for several doses. Use raw Ginseng (Renshen, 人参), Atractylodes Macrocephala Rhizome (Baizhu, 白术), and Licorice Root (Gancao, 甘草); avoid honey-fried versions. Once diet normalizes, resume previous treatments. This applies similarly after diaphoresis.
10. Individuals fond of alcohol often suffer from Wine Toxin manifesting like Yin Ju, with unpredictable locations. Initial presentation involves diffuse swelling, internal nodules, non-red or pale-red skin, heaviness, board-like hardness, and pain, often accompanied by dizziness, fever, sweating, and vomiting. This indicates severe damage to Yuan Qi (Original Qi), steaming by wine toxin, and stagnation in meridians. Treatment should clear damp-heat and tonify Yuan Qi (Original Qi). Internally, take Jiawei Jiecheng Tang (Modified Sobering Decoction). Externally, apply powdered Adzuki Bean (Chixiaodou, 赤小豆) mixed with boiling water or rice vinegar, or apply Wulong Gao (Black Dragon Ointment). Mistakenly using Yanghe Tang (Yanghe Decoction) or Xiaojin Dan (Small Gold Pill), which are sweet and hot, can cause vomiting of pus and blood, coma, mania, spasms, and death. This condition was previously unclarified; I have treated many cases and reveal them here. A slight error leads to great consequences, affecting life and death; practitioners must examine carefully.
11. For large, pale-colored Shaoyin Yin Ju (Yongorous Abscess), avoid Dongtian Gao (Cave Heaven Ointment), Qianchui Gao (Thousand Hammer Ointment), and Crucian Carp Ointment. Cold-natured medicines are detrimental to Yin Ju. These ointments contain Croton Seed (Badou, 巴豆) and Castor Seed (Bimazi, 蓖麻子). Application on intact skin causes ulceration; on open wounds, it is fatal; in pregnancy, it causes abortion. Therefore, for un-ulcerated Yin Ju, apply Yiyin San (Suppress Yin Powder). For ulcerated Yin Ju, apply Yanghe Jiening Gao (Yanghe Resolving Hardness Ointment).
12. Xihuang Wan (Xihuang Pill) and Xiaojin Dan (Small Gold Pill) contain Musk (Shexiang, 麝香) and are contraindicated in pregnancy. Use Yanghe Tang (Yanghe Decoction) instead. After recovery, take three to four additional doses to substitute for Xiaojin Dan (Small Gold Pill) and prevent recurrence.
13. For children unable to take decoctions, dissolve Xiaojin Dan (Small Gold Pill) in water for administration as a substitute.