夫痈疽者。头少肿处多出脓。不快者宜针烙。脓未盛以前。不可不以诸药贴 救疗。以
安病者之心。脓成。即当弃药从针烙也。既至脓成。即当决生死际。不可疑惧痛。顷刻之间。
以
夫
而
若不针烙决溃。热毒无从而解。脓瘀无从而泄。或过时不针。即反攻于内。内既消败。欲望
其生。岂可得乎。嗟夫。此疾针烙取瘥。实为从容。疑而受毙。亦岂容易。此为必死之患。
或隐讳此疾。或惧痛不针。此神夺其识。死期将至。诸可知也。痈则皮薄宜针。疽则皮浓宜
烙。古法无烙。唯有针刺。烙即火也。亦谓之燔。针劫刺以其有劫病之功也。今用烙法多瘥
殊稳。妙于铍针法。本用铍针。烙法当用火针。如似火筋。磨头令大小如枣核丸滑。用灯焰
烧。须臾火作。炬数 油烧令赤。皆须近下面烙之。一烙不透。即再烙之。令透。若其攻
稍广。即须散烙数处。并令透。则气疏达。脓水易出。不假按抑。实者捻发为维。虚者以纸
为
令
其
针
良
也。务求速瘥。肿内余脓及脓根未尽。便令疮合。后必有再发之理。熟能言之。诸发肿都软
而不痛者。即并宜针烙。若发于背者。即须用水角乃得痊矣。
凡疗痈疽发背。肿高坚硬。脓稠 盛色赤者。宜水角。陷下肉色不变。软慢稀者。不用
水角。角法。于宽静室中不当风处。平实地。掘一小坑。口稍阔于疮肿。深一尺以下。去此
坑二
背下
侧。
被
或
乖
智
早
毒瓦斯内坚。肉变为脓。以致内溃。深可哀也。疽之已盛。而乃火攻。则火毒相击。令人烦闷
。加其虚惫。可不慎乎。或富贵之人。遭遇此疾。多贮水银以为水角。尤妙。用水银角法。
上拣稳实地。穿一坑。口稍阔于疮肿处。深可四五寸。先于坑中布纸五六重。衬水银。
诸余铺设。一依前方。其水银多至一升已来。如无。只三五合亦得。
痈疽这类疾病，头部肿胀较轻的地方容易出脓。病情发展不顺畅的，适宜采用针烙法治疗。在脓液尚未成熟之前，不能不用各种药物外贴来救治，以此来安定患者的心理。一旦脓液形成，就应当放弃药物治疗而改用针烙法。既然已经到了脓液成熟的阶段，这就到了决定生死的关键时刻，不可因为怀疑或恐惧疼痛而犹豫不决。在短时间内，如果不通过针烙使脓肿破溃，热毒就无法解除，瘀积的脓液也无法排出。如果错过时机不进行针刺，病邪就会反过来攻入体内。体内正气既然已经消败，想要指望患者存活，怎么可能呢？唉！这种疾病通过针烙取效，其实是很从容的；若因疑虑而接受死亡，难道也是轻易的事吗？这是必然导致死亡的病患。有的人隐瞒此病，有的人因害怕疼痛而不愿针刺，这真是精神恍惚、神志丧失，死期将至，这些情况都是显而易见的。痈症皮肤薄，适宜针刺；疽症皮肤厚，适宜火烙。古代的方法没有火烙，只有针刺。所谓“烙”就是火，也称之为“燔”。针刺劫刺是因为它有劫夺病邪的功效。现在使用烙法大多能痊愈，非常稳妥，比铍针法更妙。原本使用铍针，但烙法应当用火针，形状像火筋一样，将针头磨得大小如同枣核丸般光滑，用灯焰烧灼，片刻后起火，再用油脂涂抹燃烧至通红。都必须贴近患处下方进行烙治。一次烙不透，就再烙一次，直到穿透为止。如果病灶范围稍广，就需要分散在几处烙治，都要使其穿透，这样气机就能疏通，脓水就容易流出，不需要按压挤压。实证患者可以用头发捻成线作为牵引固定，虚证患者则用纸片垫衬。务必追求快速痊愈。如果肿内剩余的脓液及脓根没有排尽，就急于让疮口愈合，日后必定有复发的道理，谁能说得清其中的利害呢？所有发肿部位整体柔软且不痛的，都适宜针烙。如果发生在背部的，就必须用水角法才能痊愈。
凡是治疗痈疽发背，肿块高突坚硬，脓液稠密丰盛且颜色赤红的，适宜用水角法。如果肿块凹陷，肌肉颜色不变，质地软慢且脓液稀薄的，不适宜用水角法。水角法的操作：在宽敞安静的房间中，避开风口，地面平整实地，挖掘一个小坑，坑口稍微宽于疮肿，深度在一尺以下。距离这个坑二尺远的地方（此处原文可能有脱漏或语序问题，结合下文理解为操作位置），背部下方侧卧或被覆盖。或者乖违智慧，早知有毒瓦斯内坚，肉变为脓，以致内部溃烂，真是令人哀痛啊。疽病已经严重，却用火攻，那么火毒与病邪相互搏击，令人烦闷，再加上身体虚弱疲惫，能不谨慎吗？或者富贵之人，遭遇这种疾病，多贮存水银用来制作水角，尤其巧妙。用水银角法：上面选择稳固实地，挖一个坑，坑口稍微宽于疮肿处，深度四五寸。先在坑中铺设五六层纸，衬垫水银。其余铺设，完全依照前面的方法。水银多用一升左右，如果没有，只三五合也可以。
For carbuncles and sores (Yongju, 痈疽), where the head has slight swelling, pus often emerges. If the condition is not progressing smoothly, needle cauterization (Zhenlao, 针烙) is suitable. Before the pus matures, one must not fail to apply various medicinal plasters for treatment, in order to stabilize the patient's mind. Once the pus has formed, one should abandon medication and switch to needle cauterization. Since the pus has matured, this is the critical juncture determining life and death; one must not hesitate due to doubt or fear of pain. Within a short period, if the abscess is not ruptured by needle cauterization, the heat-toxin cannot be resolved, and the stagnant pus cannot be drained. If the timing for needling is missed, the pathogen may counter-attack internally. Once the internal righteous qi has collapsed, how can one hope for survival? Alas! Treating this disease with needle cauterization is actually quite manageable; succumbing to death due to hesitation is certainly not easy. This is a fatal affliction. Some conceal this disease, some fear pain and refuse needling; this indicates spiritual depletion and loss of consciousness, with death imminent, which is evident. Carbuncles have thin skin and are suitable for needling; sores have thick skin and are suitable for cauterization. Ancient methods did not use cauterization, only needling. "Cauterization" refers to fire, also called "Fan" (燔). Needle劫刺 (Jieci,劫刺 - coercive needling) is named so because it has the function of coercing the disease. Currently, using the cauterization method often leads to recovery and is very stable, superior to the Pi needle (Biren, 铍针) method. Originally, Pi needles were used, but for cauterization, fire needles should be employed, resembling fire rods. The needle tip should be ground smooth and sized like a jujube pit pill. It is heated over a lamp flame until fire ignites, then coated with oil and burned until red-hot. Cauterization must be performed close to the lower aspect of the lesion. If one cauterization does not penetrate, repeat until penetration is achieved. If the attack area is slightly broad, cauterize at several scattered points, ensuring penetration everywhere, so that Qi can diffuse freely and pus-water can easily exit without requiring pressing or squeezing. For excess conditions, twisted hair can be used as a guide; for deficiency conditions, paper can be used as a liner. One must strive for rapid recovery. If residual pus within the swelling and the root of the pus are not fully expelled, and the wound is hastily closed, recurrence is inevitable later; who can explain the details? All swellings that are generally soft and non-painful are suitable for needle cauterization. If occurring on the back, water cupping (Shuijiao, 水角) is necessary for cure.
Whenever treating carbuncles and sores on the back, if the swelling is high and hard, with thick, abundant, and red-colored pus, water cupping is suitable. If the swelling is depressed, the flesh color remains unchanged, and the texture is soft, slow, and the pus is thin, water cupping is not suitable. The method of water cupping: In a spacious and quiet room, away from drafts, on a flat and solid ground, dig a small pit. The opening should be slightly wider than the swelling, with a depth of less than one chi. [Text gap/ambiguity here regarding distance/position]. Or deviating from wisdom, knowing early that toxic vapors are hard inside, flesh turns to pus, leading to internal ulceration, truly lamentable. When a sore is already severe, applying fire attacks causes fire-toxin to clash, causing irritability and stuffiness; compounded by weakness and exhaustion, how can one not be cautious? Or, wealthy individuals encountering this disease, often store mercury to make water cups, which is particularly excellent. The method for mercury cupping: Select a firm and solid place above, dig a pit, the opening slightly wider than the swelling, depth about four or five cun. First, lay five or six layers of paper in the pit to line the mercury. All other preparations follow the previous method exactly. Use about one sheng of mercury; if unavailable, three or five he is sufficient.