黄鸿轩手臂忽生痈疖。蔓肿无头。痛极莫耐。外科医者。咸谓热毒所致。揆之平素。淡泊明志。宁静居
心。绝无生热致毒之因。究莫识其所起也。尊公我兼。谓昌善议病。盍舍樽俎而一代庖人乎。昌曰。吾议
此证。请先为致贺。后乃言之。疮疡之起。莫不有因。外因者。天行不正之时毒也。起居传染之秽毒也。内因
者。醇酒浓味之热毒也。郁怒横决之火毒也。治火毒与治诸毒。原自天渊。盖火与元气。势不两立。以寒凉折
之。则元气转漓矣。鸿轩于四者总无其因。不问知为胎毒之余也。凡人禀受天地之气。有清浊之不同。惟纯
粹以精之体。其福泽寿算。俱不可限量。然从父母媾精而有身。未免夹杂欲火于形骸。所赖者。惟
在痘疮一举。暗将所藏欲火。运出躯外。复其粹精之恒体。如矿金相似。必经红炉 炼。而渣滓与精莹。始
分之为两。吾常以此法观出痘者之眸子。七八日后。眼开之时。黑白分明者。精金
也。赤筋红膜包裹者。混金也。至于瞳人模糊。神光不现。则全
非金矣。鸿轩幼时出痘太多。元气不能充灌。又为杂证所妨。脏腑中之火毒虽尽。而躯壳间之留滞犹存。所以
痘痈之发。必于手足之委中曲池者。则以零星小毒。无处可容。而潜避于呼吸难到之处耳。今之痈疖。正当
委中之穴。其为痘毒何疑。毒伏肘腋之下。原无所害。但粹精之体。微有夹杂。是亦宝鉴之纤尘。白璧之微瑕
也。日者太和元气。充满周身。将十五年前之余滓。尽欲化为脓血而出。他人见之为毒。吾蚤已卜其为兴者机
矣。岂有畅于四肢。而不发于事业者哉。治法外用马齿苋熬膏。攻之速破。内用保元汤。托之尽出。仍以痘
痈门药为治。即日自当痊愈。必不似疮毒之旷日持久。但不识证。而以治疮毒寒凉泻火诸药投之。适以增楚贻
患耳。孰谓外科小恙。可无樽俎折冲之人耶。如法治之。溃出脓水甚多。果不用生肌长肉而自愈。
胡卣臣先生曰。以慧心辨证。竟出恒理。而降衷所以不齐。受衷所以
相远之故。尽逗毫端。治火一法。矿金一喻。验目一诀。种种指示。俱足令人心开神爽。
黄鸿轩的手臂突然长了痈疖。肿胀蔓延且没有脓头，疼痛剧烈难以忍受。外科医生都认为是热毒所致。考察他平素的状况，生活淡泊以明志，心境宁静以养心，完全没有产生内热导致毒素的原因，终究无法识别其起因。他的父亲黄兼对我说：“喻先生善于辨析病症，何不放下酒杯（停止宴饮）来代替厨师（亲自诊治）呢？”我说：“我分析这个病症，请先让我道贺，然后再说明原因。”疮疡的发生，无不有其原因。外因，是天地间不正的气候时毒，或者是起居环境中传染的秽浊之毒；内因，是饮用烈酒、食用厚味食物产生的热毒，或者是抑郁愤怒爆发产生的火毒。治疗火毒与治疗各种其他毒邪，原本有着天壤之别。因为火与元气，势力不相两立，如果用寒凉药物去折损它，元气反而会更加耗散。黄鸿轩在这四种病因中都没有，不问可知这是胎毒的余留。大凡人禀受天地之气，有清浊的不同。只有那纯粹精微的身体，其福泽寿命都是不可限量的。然而从父母交合精气而受孕怀胎，难免在形体中夹杂了欲念之火。所依赖的是，通过出痘疮这一过程，暗中将所藏的欲火，运化排出到躯体之外，恢复其纯粹精微的本然状态，就像矿石中的黄金一样，必须经过红炉冶炼，渣滓与精纯的部分，才能分离为两样。我常常用这种方法观察出过痘疮的人的眼睛，七八天后，眼睛睁开时，黑白分明的是精金，被赤色筋络和红膜包裹的是混金，至于瞳孔模糊、神光不现的，那就完全不是金了。黄鸿轩小时候出痘太多，元气不能充盈灌注，又被杂病所妨碍，脏腑中的火毒虽然排尽了，但躯壳间的残留仍然存留。所以痘毒引发的痈肿，一定发在手足部位的委中穴和曲池穴，这是因为零星的小毒，无处容身，而潜伏躲避在呼吸之气难以到达的地方罢了。现在的痈疖，正当好位于委中穴的位置，这难道是痘毒吗？毒邪潜伏在肘腋之下，原本没有什么害处，只是纯粹精微的身体，稍微有些杂质，这也是宝镜上的纤尘、白玉上的微瑕。近日太和元气充满全身，想要将十五年前的残余渣滓，全部化为脓血排出。别人看见以为是毒邪，我早就预卜这是兴盛的机兆。难道气机畅达于四肢，却不在事业上有所发挥吗？治疗方法：外用马齿苋熬成的膏药，促使它迅速破溃；内服保元汤，托举毒邪使其尽数排出。仍以治疗痘痈的药物进行调理，当天自然就会痊愈，绝不会像普通疮毒那样旷日持久。如果不识病症，而用治疗疮毒的寒凉泻火诸药投喂，恰好会增加痛苦并留下祸患。谁说外科的小毛病，不需要有运筹帷幄的人才呢？按照这个方法治疗，溃破后流出很多脓水，果然不用生肌长肉的药物就自愈了。胡卣臣先生说：“凭借聪慧的心胸辨析病症，竟然超出了常理。而降生时所赋予的天命之所以不齐，承受天命之所以相远的原因，都详尽地流露在笔端。治疗火毒的方法、矿金冶炼的比喻、验证眼睛的法诀，种种指示，都足以让人心胸开阔、精神爽朗。”
Huang Hongxuan suddenly developed carbuncles and furuncles on his arm. The swelling spread extensively without a head, and the pain was extreme and unbearable. Surgeons all attributed it to heat-toxin. Examining his usual condition, he lived simply to clarify his aspirations and maintained a tranquil mind, having absolutely no cause for generating internal heat or toxins; thus, its origin remained unknown. His father, Huang Jian, said to me, "Master Yu is skilled at discussing diseases. Why not put aside your wine vessels and act as a physician?" I replied, "In analyzing this case, please allow me to offer congratulations first, and then explain." The onset of sores and ulcers always has a cause. External causes include seasonal miasmas from abnormal weather patterns or filth-toxins transmitted through living environments. Internal causes include heat-toxins from rich foods and strong alcohol, or fire-toxins from suppressed anger and frustration. Treating fire-toxin differs fundamentally from treating other toxins. Fire and vital energy (Yuan Qi) are mutually exclusive; using cold-cooling herbs to suppress fire will further deplete vital energy. Huang Hongxuan had none of these four causes, so it can be known without asking that this is residual fetal toxin. Humans inherit qi from heaven and earth, varying in clarity and turbidity. Only those with pure and refined constitutions possess boundless blessings and longevity. However, conception involves the union of parental essence, inevitably mixing desire-fire into the physical form. Reliance is placed on the eruption of smallpox to secretly transport this stored desire-fire out of the body, restoring the original pure state, much like gold ore requiring smelting in a red furnace to separate dross from purity. I often use this method to observe the eyes of those who have had smallpox: seven or eight days after eruption, when eyes open, clear black and white indicate pure gold; red veins and membranes wrapping the eye indicate mixed gold; blurred pupils and absent spirit-light indicate no gold at all. Huang Hongxuan suffered severe smallpox in childhood, failing to fully nourish his vital energy, and was hindered by miscellaneous ailments. Although fire-toxins in the zang-fu organs were exhausted, residues remained in the body shell. Therefore, sores arising from smallpox toxins must appear at Weizhong (BL40) and Quchi (LI11) points on the limbs, because scattered minor toxins have nowhere to reside and hide where breath-qi rarely reaches. The current carbuncle is precisely located at the Weizhong point; could there be doubt it is smallpox toxin? Toxin lurking under the elbow and armpit originally causes no harm; it is merely dust on a precious mirror or a flaw in white jade due to slight impurity in a pure constitution. Recently, Taihe (Great Harmony) qi fills the body, attempting to transform fifteen years' worth of residual dross into pus and blood for expulsion. Others see it as toxin, but I foresaw it as an omen of prosperity. How could qi flow freely through the limbs without manifesting in career success? Treatment: externally apply Ma Chi Xian paste to hasten rupture; internally administer Baoyuan Tang to support expulsion. Continue with formulas for smallpox sores. Recovery should occur immediately, unlike chronic ulcerative toxins. Misdiagnosing this and using cold-cooling purgatives would only increase suffering and create lasting harm. Who says minor surgical issues do not require strategic wisdom? Following this treatment, abundant pus drained upon rupture, and healing occurred spontaneously without flesh-regenerating drugs. Mr. Hu Youchen stated, "Using an insightful mind to differentiate symptoms surpasses common logic. The reasons for unequal endowments and distant destinies are fully revealed in writing. Methods for treating fire, metaphors of smelting gold, and diagnostic keys for eyes provide guidance sufficient to open the mind and refresh the spirit."