〔薛〕腿痈之证，所主之经不同，而所治之法亦异。发于内侧者，属肝脾二经，
发于外侧者，属胆胃二经，漫肿坚硬者，元气虚弱也，用内补黄 汤。肿势高 者，
元气未虚也，用内托柴胡黄 汤，外并用隔蒜熨法。若瘀血凝滞而不消，或不作脓
者，用活命饮。血气虚弱而不能溃，及不生肌肉者，用托里散。此其梗概、云尔。
一小儿腿内侧前 患毒，溃后肿硬色黯，脓清不敛，面色青黄。此脾虚肝旺，兼寒
邪袭于患处也。当壮元气为主，先用异功散加柴胡、升麻，及葱熨法，脾气渐复，
患处渐愈，佐以八珍汤、豆豉饼、而愈。一小儿腿外侧痛肿，肉色如故，用托里消
毒散二剂而肿始赤，又四剂而肿赤亦退，又六剂溃而脓出清稀，食少体倦，用异功
散加芎、归，仍用托里散补其元气而愈。一小儿漫肿坚硬，肉色不变，此阳气虚而
不能成脓也，用托里散、如圣饼，肿起色赤，用托里消毒散，而脓成，针之，用八珍
汤加肉桂渐愈。因伤食吐泻，患处夭白，饮食少思，先用六君、干姜，次用八珍汤
及葱熨法而愈。一小儿患此久不愈，脓水清稀，面色痿黄，腹大青筋，此脾气虚，
为肝所侮也。朝用补中益气汤，夕用五味异功散，元气稍复，乃佐以四味肥儿丸及
葱熨之法，两月余而愈。一小儿腿外 肿一块，服消毒之药，其肿益甚，肢体羸
瘦，饮食少思，更加作痛。余曰先肿而后痛者，形伤气也，先痛而后肿者，气伤形
也。当补接阳气。不信，仍投疏泄之药，后果殁。《机要》云∶荣卫之气充满，抑遏
不能行，故闭塞气血，腐而为痈者，当泄之，以夺盛热之气。若人饮食疏，精神衰，
气血弱，肌肉消薄，故荣卫之气短促而涩滞，故寒搏腠理，闭郁而为痈者，当补之，
以接虚怯之气，信矣！
【薛己】腿痈这一病证，所涉及的经络不同，因此治疗的方法也各异。发于大腿内侧的，属于肝经和脾经；发于大腿外侧的，属于胆经和胃经。如果肿胀弥漫且质地坚硬，这是元气虚弱所致，应使用内补黄芪汤。如果肿势高突，说明元气尚未虚弱，应使用内托柴胡黄芪汤，并配合外用的隔蒜灸法。如果有瘀血凝滞而不消散，或者不能化脓的，使用仙方活命饮。如果气血虚弱导致不能溃破，以及不能生肌长肉的，使用托里散。以上是大致的原则，就是这样。
有一个小孩大腿内侧前方患毒疮，溃烂后肿胀坚硬、颜色暗紫，脓液清稀且不收敛，面色青黄。这是脾虚肝旺，兼有寒邪侵袭患处所致。应当以培补元气为主，先用异功散加柴胡、升麻，并配合葱熨法，待脾气逐渐恢复，患处逐渐好转，再辅以八珍汤、豆豉饼，最终痊愈。
有一个小孩大腿外侧疼痛肿胀，肌肉颜色如常，服用托里消毒散两剂后，肿胀才开始发红，又服四剂后红肿消退，再服六剂后溃破流出清稀脓液，伴有食欲减退、身体疲倦，使用异功散加川芎、当归，仍然用托里散补益元气而痊愈。
有一个小孩大腿漫肿坚硬，肌肉颜色不变，这是阳气虚弱而不能化脓，使用托里散、如圣饼，肿胀隆起且颜色变红，改用托里消毒散，脓液形成后针刺排脓，再用八珍汤加肉桂逐渐痊愈。因伤食导致呕吐腹泻，患处皮肤苍白，饮食减少，先用六君子汤加干姜，随后用八珍汤及葱熨法而痊愈。
有一个小孩患此病久治不愈，脓水清稀，面色萎黄，腹部胀大且有青筋暴露，这是脾气虚弱，被肝气克制（木乘土）。早晨服用补中益气汤，晚上服用五味异功散，元气稍作恢复后，再辅以四味肥儿丸及葱熨法，两个多月后痊愈。
有一个小孩大腿外侧肿起一块，服用清热解毒的药物，肿胀反而更加严重，肢体消瘦，食欲不振，疼痛加剧。我说：先肿胀而后疼痛的，是形体受伤影响了气机；先疼痛而后肿胀的，是气机受伤影响了形体。应当补接阳气。患者不信，仍然投用疏泄攻伐的药物，后果死亡。《医学发明》中说：营卫之气充满，受抑遏而不能运行，导致气血闭塞，腐败而成痈的，应当用泻法，以消除亢盛的热气。如果人饮食清淡不足，精神衰弱，气血虚弱，肌肉消薄，导致营卫之气短促而涩滞，寒气搏结腠理，闭郁而成痈的，应当用补法，以接续虚怯的气机，这话确实可信！
[Xue Ji] For leg carbuncles (leg abscess), the meridians involved differ, and consequently, the treatment methods vary. Those occurring on the medial side belong to the Liver Meridian and Spleen Meridian; those on the lateral side belong to the Gallbladder Meridian and Stomach Meridian. Diffuse swelling with induration indicates deficiency of Yuan Qi (Original Qi); use Neibu Huangqi Tang (Internal Tonification Decoction of Astragalus). High-rising swelling indicates that Yuan Qi is not yet deficient; use Nituo Chaihu Huangqi Tang (Internal Support Decoction of Bupleurum and Astragalus), combined externally with Garlic-Separator Moxibustion (Ge Suan Wen Fa). If blood stasis lingers without resolving, or if pus fails to form, use Xianfang Huoming Yin (Immortal Life Elixir). If Qi and Blood are too weak to ulcerate, or if flesh fails to regenerate, use Tuoli San (Supporting Interior Powder). This outlines the general principles.
A child suffered from a toxic sore on the anterior-medial aspect of the thigh. After ulceration, the area remained swollen, hard, and dark-colored, with thin pus that failed to heal, and the complexion was greenish-yellow. This indicated Spleen deficiency with Liver hyperactivity, compounded by Cold pathogen invading the affected site. The primary approach should be to strengthen Yuan Qi. Initially, Yigong San (Extraordinary Skill Powder) was administered with added Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma), along with Scallion-Moxibustion (Cong Wen Fa). As Spleen Qi gradually recovered and the lesion improved, it was supplemented with Bazhen Tang (Eight Treasures Decoction) and Fermented Soybean Cake (Douchi Bing), leading to recovery.
Another child presented with painful swelling on the lateral thigh, with normal skin color. Two doses of Tuoli Xiaodu San (Supporting Interior and Detoxifying Powder) resulted in reddening of the swelling; four more doses reduced the redness; six further doses led to ulceration with thin pus discharge, accompanied by poor appetite and fatigue. Yigong San was used with added Xiong (Chuanxiong Rhizoma) and Gui (Danggui Radix), while Tuoli San continued to tonify Yuan Qi, resulting in recovery.
A third child exhibited diffuse induration with unchanged skin color, indicating Yang Qi deficiency preventing pus formation. Tuoli San and Rusheng Bing (Rusheng Cake) were applied. When the swelling rose and turned red, Tuoli Xiaodu San was switched to, leading to pus maturation, which was then incised. Subsequently, Bazhen Tang with Rougui (Cinnamomi Cortex) promoted gradual recovery. Following food stagnation causing vomiting and diarrhea, the lesion turned pale white with anorexia; Liujun Zi Tang (Six Gentlemen Decoction) with Ganjiang (Zingiberis Rhizoma) was given first, followed by Bazhen Tang and Scallion-Moxibustion for cure.
A fourth child had a chronic non-healing lesion with thin pus, sallow complexion, abdominal distension with visible veins, indicating Spleen Qi deficiency with Liver overacting upon the Spleen. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was taken in the morning, and Wuwei Yigong San (Five-Ingredient Extraordinary Skill Powder) in the evening. Once Yuan Qi slightly recovered, Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) and Scallion-Moxibustion were added, leading to recovery after two months.
A fifth child had a lump on the lateral thigh. After taking detoxifying herbs, the swelling worsened, limbs became emaciated, appetite decreased, and pain intensified. I stated: Swelling preceding pain indicates injury to Form affecting Qi; pain preceding swelling indicates injury to Qi affecting Form. Yang Qi must be supplemented. Disregarding this advice, the patient continued with draining and purgative herbs, resulting in death. *Jiyao* states: When Ying and Wei Qi are abundant but obstructed from flowing, causing Qi and Blood blockage, putrefaction, and carbuncle formation, one should use draining methods to reduce excessive heat. However, if dietary intake is insufficient, spirit is depleted, Qi and Blood are weak, muscles are thin, leading to shortness and stagnation of Ying and Wei Qi, where Cold binds the Couli (pores/skin interstices), causing closure and carbuncle formation, one must use tonifying methods to support deficient Qi. This is indeed true!