治外科，始起欲其不大，将成欲其不痛。大则伤
肌烂肤，腐骨穿筋，难以收口；痛则冲心犯胃，耗血亡
津，恶症丛生矣。故始起之时最重围药，束其根盘，
截其余毒，则顶自高而脓易成，继则护心托毒治其
内，化腐提脓治其外，自然转危为安。乃始则不能束
毒使小，又无护心定痛之方，惟外用五灰、三品，
内服桂、附热毒等药，必至腐肠烂肉，更轻用刀针。
割肉断筋，以致呼号瞀乱，神散魂飞，宛转求死，仁
人之所不忍见也。况痈疽用刀太早，最难生肌收口。
凡毒药刀针，只宜施于顽肉老皮，余者自有提头呼脓
之法，至于恶肉，自有消腐化水之方，故能使患者绝无
痛苦，收功速而精神易复。乃此等良法，一切不问。
岂传授之不真，抑或别有他念也。更可骇者，疮疡之症
最重忌口，一切鲜毒，毫不可犯，无书不载。乃近人
反令病者专服毒物，以为以毒攻毒。夫解毒尚恐无
效，岂可反增其毒，种种谬误，不可殚述。间有患
外症之人，若用安稳治法，全不以为妙，用毒药刀
针者，血肉淋漓，痛死复活，反以为手段高强，佩服
深挚，而遍处荐引。因知疾痛生死，皆有定数，非人
所能自主，而医者与病患以苦楚，亦病者有以召之也。
凡病只服煎药而愈者，惟外感之症为然，其余诸
症，则必然丸、散、膏、丹、针、灸、砭、镰，浸
洗、熨、 ，蒸、提、按摩等法，因病施治。乃今之
医者，既乏资本，又惜功夫，古方不考，手法无传，
写一通治煎方，其技已毕。而病家不辞远涉，不惜重
聘，亦只求得一煎方，已大满其愿。古昔圣人穷思极
想，制造治病诸法，全不一问，如此而欲愈大症痼疾，
无是理也。所以今人患轻浅之病，犹有服煎药而愈
者，若久病大症，不过迁延岁月，必无愈理也。故为医
者，必广求治法，以应病者之求。至常用之药，一
时不能即合者，亦当预为修制，以待急用，所谓工欲
善其事，必先利其器，奈何欲施救人之术，而全无救人之具也。
治疗外科疾病，初期要使病灶不扩散扩大，即将化脓时要避免剧烈疼痛。如果病灶扩大，就会损伤肌肉、溃烂皮肤，甚至腐蚀骨骼、穿透肌腱，导致伤口难以愈合；如果疼痛剧烈，就会冲击心脏、侵犯胃腑，耗伤血液和津液，从而引发各种恶症。因此，在疾病初起时，最重要的是使用围药（外用药物以限制病灶范围），束缚其根基盘结，截断其余留的毒邪，这样肿头自然会高耸，脓液也易于形成。随后，则需内服护心托毒的药物来调理内部，外用化腐提脓的药物来处理外部，自然就能转危为安。
然而，有些人起初不能束毒使病灶缩小，又没有护心定痛的内服方剂，只在外用五灰散、三品一条枪等腐蚀性药物，内服桂枝、附子等大热解毒之药，必然导致肠道腐烂、肌肉溃烂，更轻率地使用刀针切割。割肉断筋，致使患者呼号痛苦、神志昏乱，神魂离散，辗转反侧只求一死，这是仁人君子所不忍见到的景象。况且痈疽类疾病过早使用刀针，最难生肌收口。凡是毒药和刀针，只适宜用于顽固的死肉和陈旧的厚皮，其他情况自有提脓拔毒的方法。至于恶肉，自有消腐化水的方剂，所以能使患者完全没有痛苦，见效快且精神容易恢复。然而这些良法却被一概忽视。难道是传授不真，还是另有其他念头呢？
更令人惊骇的是，疮疡病症最忌讳饮食禁忌，一切生冷腥膻及有毒食物，丝毫不可触犯，所有医书都有记载。然而近代的人反而让病人专门服用毒物，认为这是“以毒攻毒”。既然解毒尚且担心无效，怎么可以反而增加毒性呢？种种谬误，无法一一陈述。偶尔有患外症的人，如果使用稳妥的治疗方法，他们完全不觉得高明；而使用毒药和刀针，弄得血肉模糊，痛得死去活来，他们反而认为医生手段高强，深深佩服，并在各处推荐引荐。由此可知，疾病的痛苦和生死，似乎都有定数，非人力所能自主，而医者给病患带来苦楚，也是病患自己招致的。
大凡只靠服用汤药就能痊愈的疾病，只有外感病是这样，其余各种病症，则必须根据病情施用丸剂、散剂、膏剂、丹剂、针刺、艾灸、砭石、镰刀放血、浸泡洗涤、热敷、熏蒸、提脓、按摩等方法。然而现在的医者，既缺乏资金储备，又吝惜功夫，不考究古方，手法也无传承，只是抄写一个通用汤方，便自以为技艺已毕。而求医的病家也不辞路途遥远，不惜重金聘请，也只求得一个汤方，就已经大大满足了心愿。古代的圣人穷尽心思，制造了各种治病方法，现在却全都不问，像这样却想治愈大病顽疾，是没有道理的。所以现在的人患上轻微浅表的疾病，还有靠喝汤药痊愈的，如果是久病重症，不过是拖延岁月，必定没有痊愈的道理。所以作为医者，必须广泛寻求治疗方法，以满足患者的需求。至于常用的药物，一时不能立即配齐的，也应当预先炮制好，以备急用，这就是所谓的“工匠想要做好工作，必须先磨利他的工具”，怎么能想要施展救人的技术，却完全没有救人的器具呢？
In the treatment of surgical diseases (Waike), it is crucial at the onset to prevent the lesion from enlarging, and as it matures, to ensure it does not cause severe pain. If the lesion enlarges, it damages muscles and ulcerates the skin, potentially rotting bones and piercing tendons, making wound closure difficult; if pain is severe, it may shock the heart and invade the stomach, depleting blood and body fluids, thereby giving rise to various malignant conditions. Therefore, at the initial stage, the most critical measure is the application of Wei Yao (external restraining medicaments) to bind the root and base of the lesion, intercept residual toxins, so that the swelling will naturally elevate and pus will form easily. Subsequently, internal treatment with Hu Xin Tuo Du (Heart-protecting and toxin-expelling methods) should be employed, while external treatment with Hua Fu Ti Nong (putrefaction-resolving and pus-elevating methods) should be applied, naturally leading to a transition from danger to safety.
However, some practitioners fail to restrain the toxin to keep the lesion small at the beginning, and lack formulas for Heart-protection and pain relief. They rely solely on external applications such as Wu Hui San (Five Ash Powder) and San Pin Yi Tiao Qiang (Three Grades Single-Needle), and internally administer hot-toxin-clearing herbs like Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Aconite Root). This inevitably leads to intestinal rotting and flesh ulceration, followed by the reckless use of knives and needles. Cutting flesh and severing tendons causes patients to cry out in agony, become confused and disoriented, lose their spirit and soul, and writhe in torment seeking death, which is what benevolent physicians cannot bear to witness. Moreover, using knives too early for carbuncles and ulcers makes it extremely difficult for flesh to regenerate and wounds to close. Poisonous drugs and knives/needles are only suitable for stubborn dead flesh and old calloused skin; other situations have their own methods for elevating pus and drawing out toxins. For foul flesh, there are specific formulas to dissolve putrefaction and convert it into fluid, thus ensuring the patient feels no pain, achieving rapid results, and allowing quick recovery of spirit. Yet these excellent methods are entirely ignored. Is it due to inaccurate transmission, or perhaps ulterior motives?
Even more shocking is that dietary restrictions are paramount in treating sores and ulcers; all fresh, raw, and toxic foods must strictly be avoided, as recorded in every medical text. Yet modern practitioners often instruct patients to specifically ingest toxic substances, claiming this is "using toxicity to combat toxicity." If resolving toxicity is already feared to be ineffective, how can one increase toxicity? Such errors are too numerous to recount. Occasionally, patients with external lesions do not appreciate safe and steady treatments; instead, when treated with poisonous drugs and knives/needles, resulting in dripping blood and flesh, and experiencing near-death pain, they regard the physician's skills as highly proficient, express deep admiration, and recommend them widely. From this, we can infer that the suffering and life-and-death outcomes of diseases seem predetermined, beyond human control, and the suffering inflicted upon patients by physicians is also somehow invited by the patients themselves.
Generally, only exogenous diseases (Wai Gan Bing) can be cured solely by taking decoctions; for all other conditions, treatments must be tailored to the disease, utilizing pills, powders, ointments, elixirs, acupuncture, moxibustion, Bian stone therapy, scarification, soaking/washing, hot compresses, fumigation, pus-elevation, and massage. However, contemporary physicians, lacking capital and sparing effort, do not study ancient formulas nor inherit manual techniques. They merely copy a general-purpose decoction formula, believing their skills are complete. Meanwhile, patients travel great distances and pay heavy fees, satisfied simply to obtain a single decoction formula. The ancient sages exhausted their minds to create various therapeutic methods, yet today these are completely disregarded. It is unreasonable to expect curing major and chronic diseases under such circumstances. Thus, while mild and superficial illnesses may still be cured by decoctions today, chronic and severe diseases will merely drag on over years without hope of cure. Therefore, physicians must extensively seek various treatment methods to meet patients' needs. As for commonly used medicines that cannot be immediately prepared, they should be processed in advance for emergency use. As the saying goes, "A craftsman who wishes to do good work must first sharpen his tools." How can one wish to employ the art of saving lives while possessing no tools to save lives?