经云。黄帝问于岐伯曰。夫痈疽何以别之。岐伯答曰。荣卫稽留于经脉之中。则血涩不
行。血涩不行。则卫气壅遏而不通。故生大热。热盛则肉腐为脓。然不能陷肌于骨髓。骨髓
不为
骨髓
已
流
血
而
狠
聚
内则生胸腹腑脏之中。外则生肤肉筋骨之表。凡此二毒。发无定处。而有常名。夫壅滞之本
者。始于血老不作汗。肉陈不脱垢。蒸气不能外达。留积遂成内热所为也。夫痈疽生脓水之
成。非天降。非地出。盖微之所成也。大保命全生者。谒医于无伤。防萌于未形。理之于未
成。是谓朝觉而夕理。使身被痈疽之疾。致令脓血之聚者。不亦去道远乎。脓水已成。则死
者十有八九矣。岂不慎欤。然而发有多端。感动不一。为疮为疖为痈为疽。初觉小异。须怀
大怖
唯宜
惧不
极刑。
岁。人
且须及
痈疽疖
必愈。
间。其
一头如
疽生于
易得痊
灸。为
皆由内
液疏其
热多者
时苍黄。何能辨于此疾浅深。是以毙也。疗痈疽者。同夫暴蹶之疾。有足
而发有缓急。发于喉舌头面脑项间。肩背上胸腹里。四肢大节。女子妒乳
为缓。若生险处。朝觉而夕理。或可获痊。忽不遇良医。自复不明此喻。
痊者幸矣。然痈疽所发有二等。肿高而软者。发于血脉。肿下而坚者。发
变者。发于骨髓。浅疮者欲在浓处。深疮者欲在薄处。痈疽肿。大按乃痛
者脓浅。所按之处不复者无脓。必是水也。
发肿日渐增长而不大热。时时牵痛者气瘤也。谓气结为肿。久久而不消。后亦成痈。此是寒
气
排
决
应当发热而又恶寒者。痈疽也。论曰。簪贵发肿。危困者多。市俗有之。所殆者少。何则。
人受气同禀阴阳。共食醋咸。病有殊异。答曰。夫勋赫英杰。嗜欲非常。冬不履于冻寒。夏
不伤于炎暑。击钟鼎食。兼饵乳石之流。积阴滞阳。遂致涩凝之弊。郁气伤于血脉。痈疽随
积而生。重者旬日而终。轻者逾月而殒。是故市俗则不然矣。何者。蔬食不给于口。寒暑屡
中于形。当卫纵有沉 。力役毒随汗泄。寝御理异。病故殊途。将逸性类于劳生。岂可同日
而语哉。是以晋尚书褚澄。疗寡妇尼僧。虽无房室之劳。而有忧思之苦。此乃深达其性者也
。审其浮沉之针。艾若灸烙合度。实不足忧。或任庸愚。危毙立致。遇良医者必保十全。或
因循侮慢。或询于凡流。或自以委命。或祈以自瘥。或犯以诸类。盖疑谋之丧生也。古人患
痈。已成大脓者。十不存一二。有疽生于指上。疗者于后节截去之。传曰卢淳有截指之效
静而思之。非良法也。何者。夫疗痈疽。未精识别。一概施之以针艾。用之铍割。为毒则剧
保效诚难。刘涓卢扁之流。虽擅名于前。审详理趣。亦未得全通也。是以古人见痈有大脓而
弃之。有疽在指。断之而不疑。弃脓则舍重而非工。截手则伤本而
哉。今之所疗。则不然矣。何者。调脏腑致其疏通。和营卫使无壅
气血聚散之源。内则补虚而泻实。调浮而和沉。外则以汤水淋注以
者使筋骨保安。浅者令肤肉不坏。至于将摄条例。并有铨次。然而
之于心。非愚能尽。医者意也。随时之义。略陈梗概。以定大纲云
《黄帝内经》记载：黄帝向岐伯问道：“痈和疽应该如何区分？”岐伯回答说：“营气和卫气在经脉中滞留，就会导致血液运行涩滞不畅。血液运行不畅，卫气就会壅塞遏阻而不能通达，因此产生大热。热势炽盛则肌肉腐败化为脓液。然而，这种病邪不能深陷至骨髓，骨髓也不会被侵蚀流注；它停留在血脉之中，使得血液凝滞聚结。在内则生于胸腹脏腑之中，在外则生于皮肤、肌肉、筋骨的表层。凡是这两种毒邪，发作没有固定的部位，但有固定的名称。导致壅滞的根本原因，开始于血液陈旧不能通过发汗排出，肌肉陈腐不能脱去污垢，蒸腾之气不能向外达散，留积从而形成内热所致。
痈疽化脓成水的形成，不是天降的，也不是地出的，而是由细微之处逐渐积累而成的。想要保全性命的人，应当在未受伤害时寻求医治，在症状未显现时加以预防，在疾病未形成时进行调理，这叫作早上察觉晚上就处理，使身体不遭受痈疽之疾，致使脓血聚集，这难道不是离大道很远了吗？如果脓水已经形成，那么死亡的人十有八九了，这能不谨慎吗？
然而，发病有多种原因，感动不一，有的成为疮，有的成为疖，有的成为痈，有的成为疽。初起时感觉稍有不同，必须怀着极大的恐惧心理，如同面临极刑一般警惕。只要及时救治，痈疽疖肿必定痊愈。其间，有一头如……（原文此处有缺漏或错简，意指初期症状细微），疽生于……（原文此处有缺漏），容易得到痊愈，灸治……（原文此处有缺漏）。皆由内部……（原文此处有缺漏）液体疏泄其……（原文此处有缺漏）热多者……（原文此处有缺漏）时而苍黄，怎么能辨别此病的深浅呢？因此导致死亡。治疗痈疽，如同治疗突然昏厥的疾病一样，有足……（原文此处有缺漏）而发作有缓急之分。发作在喉头、舌头、面部、脑项之间，肩背、上胸、腹部内部，四肢大关节处，女子妒乳（哺乳期乳房肿痛）等属于发作较缓的情况。如果生在危险部位，早上察觉晚上处理，或许可以痊愈。忽然遇到良医，自己又不明白这个道理，能痊愈算是幸运了。
然而痈疽的发作主要有两类：肿胀高突且柔软的，是发于血脉；肿胀低平且坚硬的，是发于骨髓。浅表的疮疡希望脓液浓稠，深部的疮疡希望脓液稀薄。痈疽肿胀，用力按压才疼痛的，说明脓液位置浅；按压后凹陷不复起的，说明没有脓液，一定是水肿。
如果发肿日渐增长但热势不大，时时牵拉疼痛的，是气瘤，说是气结聚而成肿，久久不消散，后来也会变成痈。这是寒气……（原文此处有缺漏）排……（原文此处有缺漏）决……（原文此处有缺漏）应当发热而又恶寒的，是痈疽。
论述说：簪贵（指权贵之人）发生痈疽，危困的多，市井百姓中有发生的，但危害较少。为什么呢？人禀受的气相同，都禀赋阴阳，共同食用醋咸食物，但生病却有差异。回答说：那些功勋显赫的英雄豪杰，嗜欲非常，冬天不踩冻寒之地，夏天不伤于炎暑，击钟列鼎而食，兼服乳石类药物，导致阴气积聚阻滞阳气，遂造成涩滞凝结的弊端。郁结之气损伤血脉，痈疽随着积滞而生。重的十天半月就死亡，轻的超过一个月也殒命。所以市井百姓就不是这样了。为什么呢？蔬菜食物供给不足于口腹，寒暑屡次侵袭形体，当卫气纵然有沉滞，体力劳动毒素随汗液排泄，寝卧御理不同，病因故而有殊途。将安逸的生活与劳苦的生活相比，难道可以同日而语吗？
因此晋朝尚书褚澄，治疗寡妇尼僧，虽然没有房室劳损，但有忧思之苦。这是深刻洞察人性啊。审察浮沉脉象施以针刺，艾灸如果灸烙合乎法度，实在不值得担忧。如果任由庸医愚夫诊治，危重濒死立刻到来。遇到良医必然保证十全十美。或者因循守旧傲慢轻敌，或者咨询于凡俗之辈，或者自己听天由命，或者祈求自我痊愈，或者触犯各种禁忌，这都是因为猜疑谋划而导致丧生。
古人患痈，已经形成大脓的，十个人中存活的不到一两个。有疽生在手指上，治疗者在后节将其截去。传说卢淳有截指的疗效。静心思量，这不是良法。为什么呢？治疗痈疽，如果没有精熟识别，一概施用针艾，使用铍刀割切，毒邪就会加剧，保证疗效确实很难。刘涓子、扁鹊之类的人，虽然在前世享有盛名，但仔细推究理趣，也未得完全通晓。所以古人见痈有大脓就放弃（不治或保守治疗），见疽在手指就断除而不迟疑。放弃脓液则是舍弃重病而非高明工匠，截断手指则是伤害根本……（原文此处有缺漏）呢。现在的治疗，就不是这样了。为什么呢？调理脏腑使其疏通，调和营卫使其没有壅滞，掌握气血聚散之源，在内则补虚泻实，调浮和沉，在外则以汤水淋注……（原文此处有缺漏）使筋骨保安，浅的令肤肉不坏。至于将摄条例，都有权衡次序。然而……（原文此处有缺漏）在于心，非愚钝所能尽述。医者意也，随时之义，略陈梗概，以此定大纲云。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) records: The Yellow Emperor asked Qibo, "How can one distinguish between a carbuncle (Yong) and a deep-seated abscess (Ju)?" Qibo replied, "When Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) stagnate within the meridians, blood flow becomes sluggish and obstructed. When blood flow is obstructed, Wei Qi becomes congested and blocked, failing to circulate freely, thus generating intense heat. Excessive heat causes flesh to rot and transform into pus. However, this pathogen cannot sink deeply into the bone marrow, nor does it erode or drain from the bone marrow; it remains within the blood vessels, causing blood to coagulate and accumulate. Internally, it arises in the chest, abdomen, and zang-fu organs; externally, it appears on the surface of skin, flesh, sinews, and bones. These two types of toxins have no fixed location of onset but possess standard names. The root cause of such stagnation begins with old blood failing to be expelled through sweating, and stale flesh failing to shed impurities. The steaming qi fails to reach the exterior, accumulating to form internal heat.
The formation of pus and fluid in Yong and Ju is neither descended from heaven nor emerged from earth, but accumulates gradually from minute origins. Those who wish to preserve life should seek medical treatment before injury occurs, prevent symptoms before they manifest, and regulate the condition before the disease forms. This is called detecting it in the morning and treating it by evening, thereby preventing the body from suffering from Yong and Ju, leading to the accumulation of pus and blood. Is this not far removed from the Great Dao? Once pus and fluid have formed, eight or nine out of ten patients will die. How can one not be cautious?
However, there are many causes for onset, varying in nature. Some become sores (Chuang), some boil-like lesions (Jie), some carbuncles (Yong), and some deep abscesses (Ju). Initially, the sensations may differ slightly, but one must harbor great fear, as if facing capital punishment. If treated promptly, Yong, Ju, Jie, and Chuang will certainly heal. [Text missing/corrupted here regarding specific early signs]. Ju arising in... [Text missing] ...is easy to cure with moxibustion... [Text missing]. All stem from internal... [Text missing] liquid draining its... [Text missing] excessive heat... [Text missing] turning yellow at times. How can one distinguish the depth and superficiality of this disease? Therefore, death results. Treating Yong and Ju is like treating sudden syncope (Bao Jue); there are sufficient... [Text missing] and onset varies in speed. Onset in the throat, tongue, face, brain, and nape, shoulders, back, upper chest, abdominal interior, large joints of limbs, and women's mastitis (Du Ru) belong to slower onset. If occurring in dangerous locations, detecting it in the morning and treating it by evening might lead to recovery. Suddenly encountering a good physician while oneself not understanding this analogy, recovery is merely luck.
However, the onset of Yong and Ju has two main categories: swelling that is high and soft indicates onset in the blood vessels; swelling that is low and hard indicates onset in the bone marrow. Superficial sores desire thick pus; deep sores desire thin pus. In Yong and Ju swelling, pain only upon firm pressure indicates shallow pus; indentation that does not rebound upon pressure indicates no pus, but rather edema.
If swelling increases daily without significant heat, accompanied by occasional pulling pain, it is a Qi Tumor (Qi Liu), caused by Qi knotting into swelling. If it persists for a long time without resolving, it may later become a Yong. This is due to cold qi... [Text missing] expelling... [Text missing] resolving... [Text missing]. Cases where fever should occur but are accompanied by aversion to cold indicate Yong or Ju.
The treatise states: Among the nobility (Zan Gui), cases of Yong and Ju often lead to critical distress; among the common people, occurrences are fewer and dangers less severe. Why? Humans receive Qi similarly, embodying Yin and Yang, and consume vinegar and salt alike, yet diseases differ. The answer is: Heroes and dignitaries have extraordinary desires. They do not tread on frozen cold in winter, nor suffer scorching heat in summer. They dine with ringing bells and bronze tripods, and ingest milk-stone (Ru Shi) preparations. This accumulates Yin and stagnates Yang, leading to obstruction and coagulation. Stagnant Qi damages the blood vessels, and Yong and Ju arise with the accumulation. Severe cases end within ten days; mild cases perish after a month. Thus, the common people are different. Why? Their vegetable food supply is insufficient, and their bodies are frequently struck by cold and heat. Although Wei Qi may have沉滞 (stagnation), physical labor allows toxins to be excreted with sweat. Sleep and regulation differ, hence paths of disease diverge. Comparing a life of ease to a life of toil, how can they be discussed on the same day?
Therefore, Chu Cheng, Minister of Works in the Jin Dynasty, treated widows and nuns. Although they lacked sexual exhaustion, they suffered from worry and thought. This demonstrates profound understanding of human nature. Examining pulse floating and sinking for acupuncture, and ensuring moxibustion/cauterization is regulated, truly requires no worry. If left to mediocre or ignorant practitioners, critical danger and death follow immediately. Encountering a good physician ensures complete recovery. However, if one follows routine practices arrogantly, consults ordinary folk, resigns oneself to fate, prays for self-healing, or violates various taboos, these are causes of death due to doubt and poor planning.
In ancient times, those with Yong forming large pus survived only one or two out of ten. For Ju on the finger, therapists amputated the distal segment. It is said Lu Chun had efficacy in finger amputation. Reflecting quietly, this is not a good method. Why? Treating Yong and Ju without precise identification, applying needles and moxa indiscriminately, using scalpels for cutting, makes the toxin more severe, making guaranteed efficacy difficult. Figures like Liu Juanzi and Bian Que, though famous in antiquity, did not fully comprehend the principles upon careful examination. Thus, ancients abandoned Yong with large pus (choosing conservative management or deeming it untreatable) and amputated Ju on fingers without hesitation. Abandoning pus means abandoning severe illness, which is not the work of a skilled artisan; amputating fingers harms the root... [Text missing] . Current treatment is different. Why? Regulating zang-fu to ensure unobstructed flow, harmonizing Ying and Wei to prevent congestion, mastering the source of Qi and Blood dispersion and gathering. Internally, tonifying deficiency and draining excess, regulating superficial and deep levels. Externally, irrigating with decoctions... [Text missing] to protect sinews and bones, ensuring superficial flesh does not necrose. Regarding care regulations, there are established standards. However... [Text missing] lies in the mind, beyond the capacity of the dull to fully articulate. Medicine is an art of intent. Adapting to the times, I briefly outline the general principles to establish the main framework."