临溪吴天威丈，年七十有三，客邸远归，偶坠马跌伤，左胁作痛，随治而愈。后半年，
忽左
胯肿痛，憎寒作热，动止极艰，里中诸公有认湿痰者，有认风气者，有认湿热者，总罔效。
闻歙外科洪氏能，且识杂病，迓以为治，居数日，视为疝气，率投荔枝核、大小茴香、川楝
子、橘核之类，痛躁不可当，乃欲引绳自绝。诸子百般慰解，洪乃辞去，竟不知为何疾也。
其婿汪开之，予之表弟也。邀予诊之，六脉浮而洪数，左寸尤甚，验其痛处，红肿光浮如瓠
，抚之烙手。予曰∶此便痈也，洪系外科专门，胡独忽此？盖渠素慎重，见患者年高，乌敢
认
为便痈治哉!此殆千虑一失，毋足怪。诸郎君闻予言皆骇然，诘予曰∶家严不御色者十载，
顾安得此，愿先生再思。予曰∶此非近色而得，审胯属足厥阴肝经，肝为血海，乃昔时坠马
，恶血消之未尽，瘀蓄经络，无门可出，化而为脓，由年高气虚，又被香燥克伐太过，不
能溃而即出，故散漫浮肿。观其色，青中隐黑，浓已成腐，必须外用 针，引而出之，内用
千金托里，庶可排脓生肉。但予生平心慈，不能用针。予弟警吾，外科良手，可延而决之。
至，即以 针深入寸余，出青黑脓五六碗许，臭秽难近，即语诸郎君曰∶使早决三日，可免
一月之苦，今即日大补之，非百日不能痊，此俗名石米疮也。诸郎君及患者见脓色如是，始
信予言不爽，急以请剂。予乃用内托十宣散，参、 每帖三钱，后加至五钱，一日两进，两
越月，脓尽肉满而愈。一市称奇。
临溪的吴天威先生，享年七十三岁。他从外地客居处归来，偶然从马上摔下跌伤，导致左胁部疼痛，经过治疗后痊愈。半年后，他突然感到左侧胯部肿胀疼痛，伴有怕冷发热，行动极其困难。当地各位先生有的认为是湿痰，有的认为是风气，有的认为是湿热，但总的治疗都没有效果。
听说歙县的外科医生洪氏医术高明，且通晓杂病治疗，大家便请他来诊治。过了几天，洪医生将其诊断为疝气，按照常规投以荔枝核、大茴香、小茴香、川楝子、橘核等药物。结果患者疼痛烦躁难以忍受，甚至想要用绳子自尽。他的儿子们百般安慰劝解，洪医生才辞去，最终也不知道这是什么疾病。
吴先生的女婿汪开之，是我的表弟。他邀请我为患者诊脉。我诊得六脉浮而洪数，左寸脉尤为明显。检查疼痛部位，红肿光亮浮肿如同瓠瓜（一种葫芦），触摸时感觉烫手。我说：“这是便痈（发生于大腿根部内侧的痈肿）。”洪医生是外科专门家，为什么唯独忽略了这种病呢？大概是因为他平时行事慎重，见患者年事已高，怎敢轻易认定为便痈来治疗呢！这大概是千虑之一失，不足为怪。各位公子听我这么说都感到惊骇，质问我说：“家父十年不近女色，怎么能得这个病呢？希望先生再仔细考虑一下。”我说：“这不是因为近色而得的病。审察胯部属于足厥阴肝经，肝为血海，这是由于昔日坠马时，恶血消散未尽，瘀血蓄积在经络中，没有出路，化而为脓。加上年高气虚，又被香燥药物克伐太过，不能溃破排出，所以散漫浮肿。看其颜色，青中隐黑，脓液已经浓稠成腐，必须外用针具刺破，引出脓液；内服千金托里散（具有托毒排脓、补益气血功效的方剂），才可以排脓生肌。但我生平心地仁慈，不忍心使用针刺。我的弟弟孙警吾是外科好手，可以请他来决断处理。”
孙警吾到来后，立即用针深入一寸多，排出青黑色脓液约五六碗，气味臭秽难闻。随即对各位公子说：“如果早三天决断，可免去一个月的痛苦。现在当天就要大补元气，非百日不能痊愈，这就是俗名‘石米疮’的病。”各位公子及患者看到脓色如此，才开始相信我的话不错，急忙请求开药。我便使用内托十宣散，人参、黄芪每帖各三钱，后来加至五钱，一天服用两次。两个月后，脓排尽，肌肉长满而痊愈。一市人称奇。
Mr. Wu Tianwei of Linxi, aged seventy-three, returned from a sojourn elsewhere and accidentally fell from a horse, injuring himself. He suffered pain in the left hypochondrium, which healed after treatment. Half a year later, he suddenly experienced swelling and pain in the left groin, accompanied by aversion to cold and feverish sensations, making movement extremely difficult. Various local physicians attributed the condition to damp-phlegm, wind-pathogen, or damp-heat, but none of the treatments were effective.
Hearing that Master Hong, a surgeon from Shexian, was skilled in surgery and also knowledgeable about miscellaneous diseases, they invited him to treat the patient. After a few days, Master Hong diagnosed it as hernia (Shan Qi) and administered herbs such as Litchi Seed, Big Fennel Fruit, Small Fennel Fruit, Sichuan Chinaberry Fruit, and Tangerine Seed. The patient's pain and restlessness became unbearable, leading him to attempt suicide with a rope. His sons comforted and persuaded him at length, after which Master Hong resigned, still unaware of the actual disease.
Wu Kai zhi, the patient's son-in-law and my cousin, invited me to examine him. I found the pulse floating and surging-rapid in all six positions, particularly pronounced in the left Cun position. Inspecting the painful area, I observed redness, swelling, brightness, and edema resembling a gourd; it felt hot to the touch. I stated, "This is a perineal abscess (Bian Yong). Master Hong is a specialist in surgery; why did he overlook this? It is likely because he is usually cautious and, seeing the patient's advanced age, dared not diagnose it as a perineal abscess." This was probably a minor oversight among many considerations, nothing surprising. Hearing my words, the gentlemen were startled and questioned me, saying, "Our father has abstained from sexual intercourse for ten years; how could he have contracted this? We beg you to reconsider." I replied, "This is not caused by sexual indulgence. The groin belongs to the Foot Jueyin Liver Meridian. The Liver is the Sea of Blood. The previous fall from the horse resulted in incomplete resolution of blood stasis, which accumulated in the meridians without an outlet, transforming into pus. Due to his advanced age and Qi deficiency, compounded by excessive use of aromatic-drying herbs that depleted healthy Qi, the pus could not rupture and discharge, resulting in diffuse edema. The color is greenish-black, indicating thick, necrotic pus. External incision with a needle is required to drain the pus, and internally, Qianjin Tuoli San (Thousand-Gold Supporting Interior Decoction) should be used to promote pus discharge and flesh regeneration. However, out of compassion, I cannot bring myself to use needles. My brother, Sun Jingwu, is a skilled surgeon; please invite him to decide on the procedure."
Upon arrival, Sun Jingwu immediately inserted a needle more than one cun deep, draining approximately five to six bowls of dark green-black pus, which had a foul odor. He then told the gentlemen, "Had this been decided three days earlier, a month of suffering could have been avoided. Now, immediate vigorous tonification is necessary; recovery will take at least one hundred days. This is commonly known as 'Stone Rice Sore'." Seeing the nature of the pus, the gentlemen and the patient finally believed my diagnosis was correct and urgently requested prescription. I prescribed Neituo Shixuan San (Interior-Supporting Ten-Accumulation Dispelling Powder), with Ginseng Root and Astragalus Root each at 3 qian per dose, later increased to 5 qian, administered twice daily. After two months, the pus was completely discharged, and the flesh regenerated, leading to recovery. The entire market marveled at the outcome.