立斋曰∶脓出而反痛者，虚也，宜补之。脉数虚而痛者，属虚火，宜滋阴。脉数实而
痛者，邪气实也，宜泄之。脉实便秘而痛者，邪在内也，宜下之。脉涩而痛者，气血虚寒也
，温补之。大抵疮之始作也，先发为肿，气血郁积，蒸肉为脓，故多痛。脓溃之后，肿退肌
宽，痛必渐减。若反痛者，乃虚也，宜补之。亦有秽气所触者，宜和解之；风寒所逼者，宜温散之。
丁兰，年二十余，股内患毒日久，欲求内消。诊其脉滑数，知脓已成，因气血虚不溃，
遂刺之。脓出作痛，以八珍汤治之，少可。但脓水清稀，更以十全大补汤加炮附子五分，数
剂渐愈。仍服十全大补汤，三十余剂而痊。
一僧股内患肿一块，不痛不溃，治以托药二十余剂，脓成，刺之作痛。予谓∶肿而不溃
，溃而反痛，此气血虚甚也，宜峻补之。彼云∶气无补法。予谓∶正气不足，不可不补，补
之则气化而痛，邪自除。遂以参、 、归、术、熟地黄治之，两月余而平。（薛按）
用手摸热有三法∶以轻手扪之则热，重按之则不热，是热在皮毛血脉也。重按之至筋
骨之分则热蒸手极甚，轻手则不热，是邪在筋骨之间也。不轻不重按之而热，是热在筋骨之
上，皮毛血脉之下，乃热在肌肉也。
仲景曰∶脉虚则血虚，血虚生寒，阳气不足也。寸口脉微，为阳不足，阴气上入阳中，
则洒淅恶寒。尺脉弱为阴不足，阳气下陷入阴中，则发热也。
王氏曰∶病热而脉数，按之不鼓动，乃寒盛格阳而致之，非热也。形证似寒，按之而脉
气鼓击于指下盛者，此为热甚，拒阴而生病，非寒也。
东垣曰∶发热恶热，大渴不止，烦躁肌热，不欲近衣，或目痛鼻干，但脉洪大，按之无
力者，非白虎汤证也，此血虚发躁，当以当归补血汤主之。又有火郁而热之证，如不能食而
热，自汗气短者，虚也，当以甘寒之剂泻热补气。如能食而热，口舌干燥，大便难者，当以
辛苦大寒之剂下之，以泻火保水。又曰∶昼则发热，夜则安静，是阳气自旺于阳分也。昼则
安静，夜则发热烦躁，是阳气下陷入阴中也，名曰热入血室。昼夜发热烦躁，是重阳无阴也
，当急泻其阳，峻补其阴。
立斋曰∶脉浮或弱而热，或恶寒者，阳气虚也，宜补气。脉涩而热者，血虚也，宜补血
。脉浮数发热而痛者，邪在表也，宜散之。脉沉数发热而痛者，邪在里也，当下之，午前热
者，补血为主；午后热者，补气为主。左手脉小于右手而热者，用血药多于气药；右手脉小
于左手而热者，用气药多于血药。
薛立斋说：脓液排出后反而疼痛的，是虚证，应当用补法。脉象数而虚弱且疼痛的，属于虚火，应当滋阴。脉象数而有力且疼痛的，是邪气盛实，应当泻实。脉象实且大便秘结并疼痛的，是邪气在体内，应当攻下。脉象涩且疼痛的，是气血虚寒，应当温补。
大抵疮疡刚开始发作时，先出现肿胀，这是气血郁积，熏蒸肌肉化为脓液，所以大多会痛。脓液溃破之后，肿胀消退，肌肉松弛，疼痛必然逐渐减轻。如果反而疼痛，那是虚证，应当补益。也有因秽浊之气触犯的，应当和解；因风寒逼迫的，应当温散。
丁兰，二十多岁，大腿内侧患毒日久，想要通过内服药物消除。诊察他的脉象滑数，知道脓已经形成，但因为气血虚弱不能自行溃破，于是为他针刺排脓。脓出后感到疼痛，用八珍汤治疗，稍有好转。但脓水清稀，又用十全大补汤加入炮附子五分，服用几剂后逐渐痊愈。继续服用十全大补汤，三十多剂后完全康复。
一位僧人大腿内侧患肿一块，不痛也不溃破，用托毒外出的药物治疗二十多剂，脓成后针刺，感到疼痛。我说：肿胀而不溃破，溃破后反而疼痛，这是气血非常虚弱，应当峻补。他说：补气没有这种治法。我说：正气不足，不可不补，补了则气化通畅而疼痛缓解，邪气自然除去。于是用人参、白术、当归、白术、熟地黄治疗，两个多月后平复。（薛己按语）
用手摸热有三种方法：用手轻摸皮肤感觉热，重按时却不热，说明热在皮毛血脉之间。重按至筋骨部位感觉热气蒸腾手掌很厉害，轻手摸却不热，说明邪气在筋骨之间。不轻不重按压感觉热，说明热在筋骨之上、皮毛血脉之下，即热在肌肉层。
张仲景说：脉虚则血虚，血虚生寒，是阳气不足。寸口脉微，是阳气不足，阴气上入阳分，就会洒淅恶寒。尺脉弱是阴气不足，阳气下陷入阴分，就会发热。
王氏说：生病发热而脉数，按之无力鼓动，这是寒盛格阳所致，并非真热。形体症状像寒证，但按之脉气鼓击指下有力的，这是热甚拒阴而生病，并非寒证。
李东垣说：发热恶热，大渴不止，烦躁肌热，不想穿衣，或目痛鼻干，但脉洪大按之无力的，不是白虎汤证，这是血虚发躁，应当用当归补血汤主治。又有火郁而热的证候，如不能进食而发热，自汗气短的，是虚证，应当用甘寒药剂泻热补气。如果能进食而发热，口舌干燥，大便困难的，应当用辛苦大寒药剂攻下，以泻火保水。又说：白天发热，夜间安静，是阳气在阳分旺盛。白天安静，夜间发热烦躁，是阳气下陷入阴分，名叫热入血室。昼夜发热烦躁，是重阳无阴，应当急泻其阳，峻补其阴。
薛立斋说：脉浮或弱且发热，或恶寒的，是阳气虚，应当补气。脉涩且发热的，是血虚，应当补血。脉浮数发热且疼痛的，是邪气在表，应当发散。脉沉数发热且疼痛的，是邪气在里，应当攻下。午前发热的，以补血为主；午后发热的，以补气为主。左手脉小于右手且发热的，用药血药多于气药；右手脉小于左手且发热的，用药气药多于血药。
Xue Lizhai stated: If pain persists after the discharge of pus, it indicates deficiency; tonification is indicated. If the pulse is rapid and weak accompanied by pain, it belongs to deficient fire; nourishing yin is indicated. If the pulse is rapid and full accompanied by pain, it indicates excess pathogenic factors; draining is indicated. If the pulse is full with constipation and pain, the pathogen is internal; purgation is indicated. If the pulse is choppy accompanied by pain, it indicates deficiency-cold of qi and blood; warming and tonifying are indicated.
Generally, when a sore first appears, swelling occurs initially due to the stagnation of qi and blood, which steams the flesh into pus, thus causing pain. After the pus breaks, the swelling subsides and the tissue relaxes, so the pain must gradually decrease. If pain persists or worsens, it is due to deficiency, and tonification is required. There are also cases caused by contact with foul pathogens, where harmonizing is appropriate; or those forced by wind-cold, where warming and dispersing are appropriate.
Ding Lan, in his early twenties, had suffered from a toxic sore on the inner thigh for a long time and sought internal resolution. His pulse was slippery and rapid, indicating that pus had formed. However, due to deficiency of qi and blood, it failed to rupture spontaneously, so I punctured it. After the pus discharged, pain occurred. I treated him with Bazhen Tang (Eight Treasure Decoction), resulting in slight improvement. Since the pus was clear and thin, I prescribed Shiquan Dabu Tang (Ten Complete Tonifying Decoction) with five fen of Pao Fuzi (Prepared Aconite Root). After several doses, he gradually recovered. He continued taking Shiquan Dabu Tang for over thirty doses until fully healed.
A monk had a swollen lump on his inner thigh that did not hurt nor rupture. After treating him with resolving and expelling agents for over twenty doses, pus formed. Upon puncturing, he felt pain. I said: Swelling without rupture, and pain upon rupture, indicates severe deficiency of qi and blood; vigorous tonification is required. He replied: "Tonifying qi is not a method." I said: When righteous qi is insufficient, it must be tonified. Tonification promotes qi transformation, relieving pain, and the pathogen will naturally be expelled. I then treated him with Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Shudihuang (Rehmanniae Radix Praeparata). After more than two months, the condition resolved. (Note by Xue Ji)
There are three methods for palpating heat: If light palpation reveals heat but heavy pressure does not, the heat is in the skin and vessels. If heavy pressure down to the sinews and bones reveals intense heat steaming the hand, while light palpation shows no heat, the pathogen is between the sinews and bones. If moderate pressure reveals heat, the heat is above the sinews and bones but below the skin and vessels, i.e., in the muscles.
Zhang Zhongjing stated: A deficient pulse indicates blood deficiency; blood deficiency generates cold, reflecting insufficient yang qi. A faint pulse at the Cun position indicates insufficient yang qi; when yin qi enters the yang region, it causes shivering aversion to cold. A weak pulse at the Chi position indicates insufficient yin qi; when yang qi sinks into the yin region, it causes fever.
Wang Shi stated: In febrile disease with a rapid pulse that lacks force upon pressure, this is caused by extreme cold repelling yang, not true heat. If the clinical signs resemble cold, but the pulse qi beats vigorously under the fingers upon pressure, this is extreme heat repelling yin, not cold.
Li Dongyuan stated: Symptoms such as fever, aversion to heat, excessive thirst, restlessness, hot skin, desire to remove clothing, eye pain, and dry nose, combined with a flooding pulse that is empty upon pressure, do not constitute a Baihu Tang (White Tiger Decoction) syndrome. This is irritability due to blood deficiency; Danggui Buxue Tang (Angelica Tonifying Blood Decoction) should be used. There are also conditions of heat due to constrained fire, such as fever with inability to eat, spontaneous sweating, and shortness of breath, which indicate deficiency; sweet-cold herbs should be used to drain heat and tonify qi. If there is fever with ability to eat, dry mouth and tongue, and difficult defecation, bitter-hot and acrid-hot herbs should be used to purge, thereby draining fire and preserving fluids. He further stated: Fever during the day and quietness at night indicates yang qi flourishing in the yang aspect. Quietness during the day and fever/restlessness at night indicates yang qi sinking into the yin aspect, termed Heat Entering the Blood Chamber. Fever and restlessness both day and night indicate excessive yang and absence of yin; one should urgently drain yang and vigorously tonify yin.
Xue Lizhai stated: A floating or weak pulse with fever or aversion to cold indicates deficiency of yang qi; tonifying qi is indicated. A choppy pulse with fever indicates blood deficiency; tonifying blood is indicated. A floating and rapid pulse with fever and pain indicates the pathogen is in the exterior; dispersing is indicated. A deep and rapid pulse with fever and pain indicates the pathogen is in the interior; purging is indicated. Fever occurring before noon is primarily treated by tonifying blood; fever occurring after noon is primarily treated by tonifying qi. If the pulse on the left hand is smaller than the right with fever, blood-invigorating herbs should outweigh qi-tonifying herbs. If the pulse on the right hand is smaller than the left with fever, qi-tonifying herbs should outweigh blood-invigorating herbs.