齐氏曰∶疮疽之证候不同，凡寒热虚实，皆能为痛，故止痛之法，殊非一端。世人皆谓
，乳没珍贵之药，可住疼痛，而不知临病制宜，自有方法。盖热毒之痛者，以寒凉之药折
其热，而痛自止也。寒邪之痛，以温热之剂熨其寒，则痛自除也。因风而痛者，除其风。因
湿而痛者，导其湿。燥而痛者，润之。塞而痛者，通之。虚而痛者，补之。实而痛者，泻之
。因脓郁而闭者，开之。恶肉侵溃者，去之。阴阳不和者，调之。经络秘涩者，利之。临机
应变，方为上医，不可执方而无权也。
立斋曰∶疮疡之作，由六淫七情所伤。其痛也，因气血凝滞所致。假如热毒在内，便秘
而作痛者，内疏黄连汤导之。热毒炽盛， 肿而作痛者，黄连解毒汤治之。不应，仙方活
命饮解之。瘀血凝滞而作痛者，乳香定痛丸和之。作脓而痛者，托里消毒散排之。脓胀而痛者
，针之。脓溃而痛者，补之。若因气虚而痛，四君加归 。血虚而痛，四物加参 。肾虚而
痛，六味地黄丸。口干作渴，小便频数者，加减八味丸。此皆止痛之法也，慎勿概用寒凉之
药。况血气喜温而恶寒，若冷气入里，血即凝滞，反为难瘥之证矣。丹溪云∶脓出而反痛，
此为虚也，宜补之。秽气所触者，和解之。风寒所逼者，温散之。若专用龙竭生肌，乳没止
痛，吾知其必无效也。
凡痈毒 肿赤痛之甚者，虽内治之法已具如前，然煎剂功缓，而痛急难当者，必须外
用敷药，既欲其止痛，又欲其散毒，则无如降痈散之神妙也。
齐氏说：疮疽的证候各不相同，凡是寒、热、虚、实等因素，都能引起疼痛，所以止痛的方法，并非只有一种。世人都认为乳香、没药是珍贵的药物，可以制止疼痛，却不知道根据病情灵活制宜，自有其方法。大概因热毒引起的疼痛，用寒凉的药物来折服其热，疼痛自然停止；因寒邪引起的疼痛，用温热的药剂熏熨以驱散其寒，疼痛自然消除。因风邪引起的疼痛，祛除风邪；因湿邪引起的疼痛，引导排出湿气；因燥邪引起的疼痛，滋润它；因阻滞引起的疼痛，疏通它；因虚损引起的疼痛，补益它；因实证引起的疼痛，泻下它。因脓液郁闭不通引起的疼痛，开通它；因恶肉侵蚀溃烂引起的疼痛，去除它；因阴阳不和引起的疼痛，调和它；因经络闭塞涩滞引起的疼痛，通利它。随机应变，才是上等的医生，不可拘泥于固定方剂而不知变通。
立斋说：疮疡的发生，是由六淫（风、寒、暑、湿、燥、火）和七情（喜、怒、忧、思、悲、恐、惊）所损伤所致。其疼痛，是因为气血凝滞造成的。假如热毒在体内，导致便秘并引发疼痛的，用内疏黄连汤导泄之；热毒炽盛，导致红肿并引发疼痛的，用黄连解毒汤治疗；如果无效，用仙方活命饮解之；瘀血凝滞引起疼痛的，用乳香定痛丸调和它；正在化脓并引起疼痛的，用托里消毒散排脓；脓胀引起疼痛的，用针刺破；脓已溃破并引起疼痛的，用补法。如果是因气虚引起的疼痛，用四君子汤加当归；血虚引起的疼痛，用四物汤加人参；肾虚引起的疼痛，用六味地黄丸。口干口渴，小便频数的，用加减八味丸。这些都是止痛的方法，千万不要一概使用寒凉的药物。况且气血喜欢温暖而厌恶寒冷，如果冷气进入体内，血液就会凝滞，反而变成难以治愈的病症了。丹溪说：脓出之后反而疼痛，这是虚证，应当用补法。被秽气触犯的，和解它；被风寒逼迫的，温散它。如果专门只用血竭、儿茶等生肌，乳香、没药止痛，我知道这必定没有效果。
凡是痈毒肿胀赤痛严重的，虽然内治的方法已经像前面所说那样完备，但是煎剂的药效缓慢，而疼痛急迫难以忍受的，必须外用敷药，既然想要止痛，又想要散毒，那么没有比降痈散更神妙的了。
Qi stated: The manifestations of sores and carbuncles vary. Pain can be caused by cold, heat, deficiency, or excess conditions; therefore, methods for relieving pain are not limited to a single approach. People generally believe that costly herbs such as Ru Xiang (Frankincense) and Mo Yao (Myrrh) can stop pain, unaware that one must adapt treatment to the specific condition. For pain caused by heat-toxin, cooling herbs are used to subdue the heat, and the pain ceases naturally. For pain caused by cold pathogen, warming agents are applied to dispel the cold, and the pain is eliminated naturally. For pain due to wind, the wind is removed; for pain due to dampness, the dampness is guided out; for pain due to dryness, it is moistened; for pain due to obstruction, it is unblocked; for pain due to deficiency, it is tonified; for pain due to excess, it is purged. For pain caused by pus retention and blockage, the blockage is opened; for pain caused by foul tissue erosion and ulceration, the foul tissue is removed; for pain due to disharmony of Yin and Yang, harmony is restored; for pain due to blocked and stagnant meridians, flow is facilitated. Adapting to changing circumstances is the mark of an excellent physician; one must not rigidly adhere to fixed prescriptions without flexibility.
Li Zhai stated: Sores and ulcers arise from injuries caused by the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). The pain results from stagnation of Qi and Blood. If heat-toxin is internal, causing constipation and pain, Nei Shu Huang Lian Tang (Internal Purging Coptis Decoction) is used to guide the evacuation. If heat-toxin is vigorous, causing swelling and pain, Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) is administered. If there is no response, Xian Fang Huo Ming Yin (Immortal Formula for Preserving Life) is used to resolve the toxicity. If pain is caused by blood stasis and stagnation, Ru Xiang Ding Tong Wan (Frankincense Pain-Relieving Pill) is used to harmonize. If pain occurs during suppuration, Tuo Li Xiao Du San (Support Interior and Eliminate Toxin Powder) is used to drain the pus. If pain is due to pus distension, acupuncture or lancing is employed. If pain persists after the pus has drained, tonification is used. If pain is due to Qi deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) with Dang Gui (Angelica Sinensis) is added. If pain is due to Blood deficiency, Si Wu Tang (Four Substances Decoction) with Ren Shen (Ginseng) is added. If pain is due to Kidney deficiency, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) is used. For symptoms of dry mouth, thirst, and frequent urination, Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) is prescribed. These are all methods for relieving pain; one must be cautious about indiscriminately using cold-natured herbs. Moreover, Qi and Blood prefer warmth and dislike cold; if cold qi enters the interior, Blood will stagnate, resulting in a difficult-to-cure condition. Danxi stated: Pain persisting after pus drainage indicates deficiency, which should be treated with tonification. If affected by foul odors, harmonization is required; if constrained by Wind-Cold, warming dispersion is needed. If one exclusively uses Xue Jie (Dragon's Blood) and Er Cha (Chernomorite/Catechu) for flesh regeneration, and Ru Xiang and Mo Yao for pain relief, I know this will certainly be ineffective.
In cases where carbuncle toxins cause severe swelling, redness, and pain, although internal treatments have been described above, decoctions act slowly. When pain is acute and unbearable, external applications must be used. To achieve both pain relief and toxin dispersion, there is nothing more miraculous than Jiang Yong San (Carbuncle-Reducing Powder).