齐氏曰∶夫疔疮者，以其疮形如丁盖之状者是也。古方之论，凡有十种。华元化之论，
有五色疔，《千金方》说疔有十三种，以至《外台秘要》《神巧万全》，其论颇同，然皆不离毒
气客于经络，及五脏内蕴热毒。凡初生一头，凹而肿痛，青黄赤黑无复定色，令人烦躁闷乱
，或憎寒头痛，或呕吐心逆，以针刺疮不痛无血，是其候也。多因肥甘过度，不慎房酒，以
邪致毒蓄结，遂生疔疮。《内经》曰∶膏粱之变，足生大疔。此之谓也。其治之法，急以艾
炷灸之。若不觉痛者，针疔四边，皆令血出，以夺命丹或回生丹从针孔 之，上用膏药贴
之
，仍服五香连翘汤、漏芦汤等剂，疏下之为效。若或针之不痛无血者，以猛火烧铁针通红，
于疮上烙之，令如焦炭，取痛为效，亦 前药，用膏药贴之，经一二日脓溃根出，服托里
汤
散，根据常疗之，以取平复。如针之不痛，其人眼黑，或见火光者，不可治也。此邪毒之气，
入于脏府故也。《养生方》云∶人汗入肉食，食之则生疔疮。不可不慎也。
立斋曰∶此证多由膏粱浓味之所致，或因卒中饮食之毒，或感四时不正之气，或感蛇虫
之毒，或感死畜之秽，各宜审而治之。其毒多生于头面四肢，形色不一，或如小疮，或如水
泡，或疼痛，或麻木，或寒热作痛，或呕吐恶心，或肢体拘急，并宜隔蒜灸之。痛则灸至不
痛，不痛灸至痛。若灸而不痛，则明灸之。及针疔四畔去恶血，以夺命丹一粒入疮头孔内，
仍以膏药贴之，并服解毒之剂，或用荆防败毒散。若针之不痛无血者，宜用烧针，治如前齐氏
之法。若不省人事，或牙关紧急者，以夺命丹为末，葱酒调灌之。候醒更服败毒散，或夺命
丹，甚效。若生两足者，多有红丝至脐。生两手者，多有红丝至心腹。生唇面口内者，多有
红丝入喉。皆为难治。急宜用针于血丝尽处挑破，使出恶血。若红丝近心腹者，更挑破疮头
去恶水，以泄其毒，亦以膏药贴之，多有生者。若患于偏僻下部之处，药力所难到者。若专
假药力，则缓不及事，惟灸之，则大有回生之功。疔之名状虽有十三种之不同，而治法，但
当审其元气虚实，邪之表里，庶不误人之夭札也。若专泥于疏利表散，非为无益而反害之。
凡人暴死者，多是疔毒，急取灯遍照其身，若有小疮，即是其毒，宜急灸之。并服夺命丹等
药，亦有复苏者。
又曰∶脉浮数者散之，脉沉实者下之。表里俱实者，解表攻里。麻木或大痛及不痛者，
并灸之，更兼攻毒。
操江张恒山，左足次指患之，痛不可忍，急隔蒜灸三十余壮，即能举步。彼欲速愈，自
敷凉药，遂致血凝肉死，毒瓦斯复炽。再灸百壮，服活命饮，出紫血，其毒方解，脚底通溃
，腐筋烂肉甚多。及将愈，予因考绩北上，又误用生肌药，反助其毒，使元气亏损，疮口难
敛。予回用托里药补之。喜其禀实，且客处，至三月余方瘥。
表甥居富，右手小指患之，或用针出血，敷以凉药，掌指肿三四倍，六脉洪大，此真气
夺则虚，邪气盛则实也。先以夺命丹一服，活命饮二剂，势稍缓。余因他往，或又遍刺出血
，肿延臂腕，如大瓠，手指肿大数倍，不能消溃，乃真气愈虚，而邪气愈盛也。余回，用大剂
参归术之类及频灸。遍手肿势渐消后，大便不实，时常泄气，此元气下陷，以补中益气汤
加补骨脂、肉豆蔻、吴茱萸、五味子，又以生脉散代茶饮。大便渐实，手背渐溃，又用大补药
五十余剂渐愈。（薛按）
齐氏说：所谓疔疮，是指其疮形像钉子盖住一样的病症。古代医方论述中，共有十种类型。华元化的论述中有五色疔，《千金方》记载疔有十三种，直到《外台秘要》和《神巧万全》，其论述大致相同，但都不离毒气客居经络，以及五脏内部蕴藏热毒这一根本原因。凡是初起时生出一个头，凹陷且红肿疼痛，颜色青、黄、赤、黑没有固定常态，使人烦躁闷乱，或者憎恶寒冷并头痛，或者呕吐、心胃逆乱，用针刺疮口不痛且不出血，这就是它的征候。多因过食肥甘厚味，不慎节制房事和饮酒，导致邪气引发毒气蓄结，从而生出疔疮。《内经》说：“膏粱之变，足生大疔。”说的就是这种情况。治疗的方法，紧急时用艾炷灸治。如果感觉不到疼痛，就针刺疔疮四周，都要令血液流出，将夺命丹或回生丹从针孔纳入其中，上面再用膏药贴敷，同时服用五香连翘汤、漏芦汤等药剂，通过疏利通下的方法以求见效。如果针刺后仍不痛且无血，就用猛火烧红铁针，在疮上烙烫，使其像焦炭一样，以产生痛感为有效，也使用前面的药物，并用膏药贴敷，经过一两天脓液溃破、病根排出，再服用托里汤散，按照常规疗法治之，以求康复。如果针刺后不痛，且患者眼睛发黑，或者看见火光，这是不可治愈的。这是因为邪毒之气已经深入脏腑的缘故。《养生方》说：“人汗进入肉食中，吃了就会生疔疮。”不可不谨慎啊。
立斋说：此证多由过食膏粱浓味所致，或因突然中受饮食之毒，或感受四时不正之气，或感受蛇虫之毒，或感受死畜的秽浊之气，各应仔细审察而进行治疗。其毒多生于头面四肢，形色不一，有的像小疮，有的像水泡，有的疼痛，有的麻木，有的寒热交替作痛，有的呕吐恶心，有的肢体拘急痉挛，都适宜用隔蒜灸法。痛的灸到不痛为止，不痛的灸到痛为止。如果灸了还不痛，就进行直接灸（明灸）。然后针刺疔疮四周放出恶血，将一粒夺命丹放入疮头孔内，仍然用膏药贴敷，并服用解毒药剂，或者使用荆防败毒散。如果针刺后不痛且无血，适宜用烧红的针治疗，方法如前文齐氏所述。如果不省人事，或者牙关紧闭的，将夺命丹研成末，用葱酒调匀灌服。待苏醒后再服用败毒散，或夺命丹，效果很好。如果生在两足，多有红丝延伸至肚脐；生在手部，多有红丝延伸至心腹；生在嘴唇、面部或口腔内，多有红丝延伸至咽喉。这些都属于难治之症。紧急应用针在红丝尽头处挑破，使恶血流出。如果红丝靠近心腹，更要挑破疮头放出恶水，以泄出毒气，也用膏药贴敷，大多能存活。如果患病部位在偏僻的下部，药力难以到达之处，若专门依赖药力，则缓慢来不及救治，只有用灸法，才有极大的起死回生之功。疔的名称形状虽然有十三种的不同，但治疗方法，只应当审察元气的虚实，邪气的表里，这样才不会误人性命。如果专门拘泥于疏利表散的方法，不仅无益反而有害。凡是人突然死亡的，多是疔毒所致，紧急取灯火遍照全身，如果有小疮，就是疔毒，宜紧急灸治。并服用夺命丹等药，也有复苏的。
又说：脉象浮数的，用发散法；脉象沉实的，用攻下法。表里俱实的，解表攻里。出现麻木、剧烈疼痛或不痛的，都用灸法，兼用攻毒之法。
操江张恒山，左足次趾患病，疼痛难以忍受，紧急用隔蒜灸三十多壮，就能行走。他想要快速痊愈，自行敷用凉药，导致血液凝滞、肌肉坏死，毒瓦斯再次炽盛。再次灸一百壮，服用活命饮，排出紫黑色血液，其毒方才解除，脚底全面溃烂，腐筋烂肉很多。等到快要痊愈时，我因考核政绩北上，他又误用生肌药，反而助长毒气，使元气亏损，疮口难以收敛。我回来后，用托里药补益。庆幸他禀赋结实，且客居他乡，过了三个多月才痊愈。
表甥居富，右手小指患病，有人用针出血，敷用凉药，手掌手指肿胀三四倍，六脉洪大，这是真气被夺则虚，邪气盛则实。先用一服夺命丹，两剂活命饮，病情稍缓。我因其他事情外出，有人又遍身刺络出血，肿胀蔓延至手臂手腕，像大葫芦一样，手指肿大数倍，不能消散溃破，这是真气更虚，而邪气更盛。我回来，用大剂量人参、当归、白术之类及频繁灸治。遍手肿胀逐渐消退后，大便不成形，时常排气，这是元气下陷，用补中益气汤加补骨脂、肉豆蔻、吴茱萸、五味子，又以生脉散代茶饮。大便逐渐成形，手背逐渐溃破，又用大补药五十多剂才逐渐痊愈。（薛己按）
Qi stated: The so-called Ding Chuang (Ding carbuncle) refers to a lesion whose shape resembles the cover of a nail. Ancient prescriptions discuss ten types. Hua Yuanhua's discussion includes five-colored Ding; the *Qianjin Fang* states there are thirteen types of Ding. Even in the *Waitai Miyao* and *Shenqiao Wanquan*, the discussions are similar, yet all revolve around toxic qi lodging in the meridians and heat-toxin accumulating within the five zang organs. When initially appearing as a single head, it is concave, swollen, and painful, with colors varying among green, yellow, red, and black without a fixed hue, causing restlessness and confusion, or aversion to cold with headache, or vomiting and cardiac reversal. If needling the lesion causes no pain and yields no blood, this is its characteristic sign. It often arises from excessive consumption of rich and sweet foods, lack of restraint in sexual activity and alcohol intake, leading to evil pathogens inducing toxin accumulation, thereby generating Ding Chuang. As stated in the *Neijing*: "Changes from rich and fatty foods can produce large Ding." This is what is meant. The treatment method urgently requires moxibustion with moxa cones. If there is no sensation of pain, needle the four sides of the Ding until blood flows, insert Du Ming Dan (Life-Restoring Pill) or Hui Sheng Dan (Reviving Life Pill) into the needle holes, apply a plaster on top, and simultaneously administer decoctions such as Wuxiang Liaoqiao Tang (Five-Spice Forsythia Decoction) or Loulu Tang (Euphorbia Decoction), aiming for efficacy through purgation and drainage. If needling still yields no pain or blood, use a hot iron needle heated red-hot to cauterize the lesion until it resembles charcoal, aiming for pain sensation as effectiveness. Also use the aforementioned medicines and apply a plaster. After one or two days, when pus discharges and the root emerges, administer Tuoli Tang San (Support the Interior Powder/Decoction) and treat according to standard Ding protocols to achieve recovery. If needling yields no pain, and the patient has darkened eyes or sees flashes of light, it is incurable. This is because the toxic qi has entered the zang-fu organs. The *Yangsheng Fang* states: "If human sweat enters meat food, consuming it will generate Ding Chuang." One must be extremely cautious.
Lizhai stated: This condition mostly results from excessive consumption of rich and greasy foods, or sudden poisoning from diet, or contracting abnormal qi of the four seasons, or being poisoned by snakes and insects, or contaminated by filth from dead livestock. Each case should be carefully examined and treated accordingly. The toxin often manifests on the head, face, and limbs, with varied shapes and colors: some resemble small sores, others blisters; symptoms may include pain, numbness, alternating chills and fever with pain, vomiting, nausea, or limb stiffness and spasm. All are suitable for garlic-separated moxibustion. Moaize until pain ceases if it was painful; moxaize until pain appears if it was numb/painless. If moxibustion still yields no pain, perform direct moxibustion (Ming Jiu). Then needle the periphery of the Ding to remove bad blood, insert one pill of Du Ming Dan into the sore's opening, cover with a plaster, and administer detoxifying agents, such as Jingfang Baidu San (Aristolochia and Saposhnikovia Decoction to Overcome Toxins). If needling yields no pain or blood, use a red-hot needle, treating as described in Qi's method above. If the patient loses consciousness or suffers from trismus (lockjaw), grind Du Ming Dan into powder, mix with scallion and wine, and force-feed. Once awake, administer Baidu San or Du Ming Dan again, which is very effective. If lesions occur on both feet, red threads often extend to the umbilicus; if on hands, to the heart and abdomen; if on lips, face, or inside the mouth, to the throat. These are difficult to treat. Urgently use a needle to pierce the end of the red thread to release bad blood. If the red thread is near the heart/abdomen, additionally pierce the sore head to drain bad fluid and vent the toxin, applying a plaster; many survive. If the lesion is in remote lower areas where medicinal power rarely reaches, relying solely on medicine is too slow; only moxibustion can achieve great life-saving effects. Although Ding names and forms vary among thirteen types, treatment methods should focus on assessing the deficiency or excess of yuan qi (primordial qi) and the exterior or interior nature of the pathogen, thus avoiding fatal errors. Relying exclusively on dispersing and releasing the exterior is not only useless but harmful. Sudden death in humans is often due to Ding toxin; urgently illuminate the body with a lamp; if small sores are found, they are the toxin, and urgent moxibustion is required. Administer Du Ming Dan etc., and recovery is possible.
Furthermore: For floating and rapid pulses, use dispersion; for deep and solid pulses, use purgation. For simultaneous exterior and interior excess, resolve the exterior and attack the interior. For numbness, severe pain, or absence of pain, apply moxibustion combined with anti-toxic measures.
Zhang Hengshan, Governor of Caojiang, suffered on his left foot's second toe. The pain was unbearable. He urgently underwent thirty-plus moxa cones via garlic separation and could immediately walk. Desiring quick recovery, he applied cooling medicines himself, causing blood coagulation and muscle necrosis, leading to renewed intensification of toxic vapors. He underwent another hundred moxa cones, took Huoming Yin (Life-Saving Decoction), expelled purple blood, and the toxin finally resolved. The sole of his foot ulcerated extensively, with much rotting tendon and flesh. As he was nearing recovery, I traveled north for an official review. He mistakenly used flesh-regenerating medicines, which further aided the toxin, depleting his yuan qi and making wound closure difficult. Upon my return, I used interior-supporting tonics. Fortunately, his constitution was robust, and being away from home, he recovered after more than three months.
My cousin-in-law, Ju Fu, suffered on his right hand's little finger. Someone bled him with needles and applied cooling medicines, causing the palm and fingers to swell three to four times their normal size. The six pulses were flooding. This indicates deficiency due to loss of true qi and excess due to flourishing pathogenic qi. Initially, one dose of Du Ming Dan and two doses of Huoming Yin slightly alleviated the condition. Due to other matters, I was away. Someone else repeatedly pricked for bleeding, causing swelling to spread to the arm and wrist, resembling a large gourd, with fingers swelling several times larger, unable to dissipate or suppurate. This indicated further depletion of true qi and intensification of pathogenic qi. Upon my return, I used large doses of Ginseng Radix (Renshen), Angelicae Sinensis Radix (Danggui), and Atractylodis Macrocephalae Rhizoma (Baizhu), along with frequent moxibustion. After the swelling in the entire hand gradually subsided, he experienced loose stools and frequent flatulence, indicating sinking of yuan qi. I prescribed Buzhong Yiqi Tang (Middle-Boosting Qi-Rescuing Decoction) supplemented with Psoraleae Fructus (Buguzhi), Myristicae Semen (Roudoukou), Evodiae Fructus (Wuzhuyu), and Schisandrae Fructus (Wuweizi), using Shengmai San (Generate the Pulse Powder) as tea substitute. As stools solidified and the back of the hand began to ulcerate, I administered over fifty doses of major tonic formulas until gradual recovery. (Commentary by Xue Ji)