《外科枢要》曰∶疮疡之证，当祭经之传受，病之表里，人之虚实，而攻补之。假如肿
痛热渴，大便秘结者，邪在内也，疏通之。 肿作痛，寒热头疼者，邪在表也，发散之。
肿痛甚者，邪在经络也，和解之。微肿微痛，而不作脓者，气血虚也，补托之。漫肿不痛，
或不作脓，或脓成不溃者，气血虚甚也，峻补之。色黯而微肿微痛，或脓成不出，或腐肉不
溃，阳气虚寒也，温补之。若泥其未溃，而概用败毒，复损脾胃，不惟肿者不能成脓，而溃
者亦难收敛，七恶之证蜂起，多致不救。马益卿曰∶肿疡内外皆壅，宜以托里表散为主。如
欲用大黄，宁无孟浪之非。溃疡内外皆虚，宜以托里补接为主，如欲用香散，未免虚虚之失，治者审之。
齐德之曰∶凡疮疽丹肿，结核瘰 ，初觉有之，即用内消之法。经久不除，血气渐衰，
肌寒肉冷，脓汁清稀，毒瓦斯不出，疮口不合，聚肿不赤，结核无脓，外证不明者，并宜托里
。脓未成者，使脓早成。脓已溃者，使新肉早生。血气虚者，托里补之。阴阳不和，托里调
之。大抵托里之法，使疮无变坏之证。凡为疮医不可一日无托里之药。然而寒热温凉，烦渴利
呕，临证宜审其缓急耳。
马益卿曰∶痈疽因积毒在脏腑，当先助胃壮气，使根本坚固，次以行经活血药为佐，参
以经络时令，务使毒瓦斯外泄，治之早者，可以内消。此托里之旨也。
立斋曰∶大凡疮疡之作，由胃气不从。疮疡之溃，由胃气腐化。疮疡之敛，由胃气营养
。余尝治初结未成脓者，托而散之。已成欲作脓者，托而腐之。脓成未溃者，托而开之。脓
已溃者，托而敛之。东垣云∶脾为仓廪之官，胃为水谷之海，主养四旁以生血气，故胃气乃
生发之源，为人身之本。厥有旨哉。
《外科枢要》说：治疗疮疡病症，应当根据经络的传变规律、病位的表里深浅以及患者体质的虚实情况，来决定采用攻法还是补法。例如，出现肿胀疼痛、发热口渴、大便秘结等症状，说明邪气在体内（脏腑），应当使用疏通的方法。如果肿胀疼痛伴有恶寒发热、头痛，说明邪气在体表，应当使用发散的方法。如果肿痛剧烈，说明邪气在经络中，应当使用和解的方法。如果轻微肿胀疼痛，且不化脓，说明是气血虚弱，应当使用补益托毒的方法。如果漫肿无头且不痛，或者不化脓，或者脓成后不能溃破，说明气血极度虚弱，应当使用峻猛的补益方法。如果患处颜色暗红且微肿微痛，或者脓成后不能排出，或者腐肉不能脱落，说明是阳气虚寒，应当使用温补的方法。如果拘泥于疮疡未溃破的阶段，一概使用败毒（清热解毒）的药物，反而会损伤脾胃，不仅肿胀处不能化脓，即使已经溃破的疮口也难以愈合，导致“七恶”等危重证候蜂拥而至，大多会导致死亡。马益卿说：对于未溃破的疮疡，内外都壅滞，应当以托里透脓和发表散邪为主。如果想要使用大黄这类泻下药，恐怕会有鲁莽之嫌。对于已溃破的疮疡，内外都虚弱，应当以托里补接为主，如果想要使用香燥耗散的药物，未免会造成虚者更虚的错误，治疗者务必审慎。
齐德之说：凡是疮疽丹肿、结核瘰疬等疾病，初起感觉有病灶时，就立即使用内消的方法。如果经久不愈，气血逐渐衰弱，肌肉寒冷僵硬，脓汁清稀，毒邪无法排出，疮口不合拢，聚集的肿胀不发红，结核无脓，外部症状不明确，都适宜使用托里法。脓液尚未形成的，促使脓液早日形成；脓液已经溃破的，促使新肉早日生长。气血虚弱的，用托里法补益；阴阳不和的，用托里法调和。大体上，托里法的作用是使疮疡不产生变坏的症状。凡是从事疮疡治疗的医生，不可一日没有托里药物。然而，面对寒热、温凉、烦渴、腹泻呕吐等情况，临证时必须审察其缓急轻重。
马益卿说：痈疽是因为积毒存在于脏腑，应当先助益胃气、强壮元气，使根本坚固，其次配合使用行经活血的药物作为辅助，参考经络与时令的变化，务必使毒邪向外排泄，治疗得早，可以使毒邪在内消散。这就是托里法的宗旨。
薛立斋说：大凡疮疡的发生，是由于胃气不从顺；疮疡的溃破，是由于胃气的腐化作用；疮疡的愈合，是由于胃气的营养作用。我曾经治疗初起结块尚未成脓的，用托里法使其消散；已经形成即将成脓的，用托里法使其腐熟；脓成但未溃破的，用托里法使其开泄；脓已溃破的，用托里法使其收敛。李东垣说：脾是仓廪之官，胃是水谷之海，主要滋养四周以生成气血，所以胃气是生发的源头，是人身的根本。这其中的道理确实深远啊。
The *Waike Shuyao* (Key to External Medicine) states: In treating sores and ulcers, one must consider the transmission along the meridians, the location of the disease in the exterior or interior, and the deficiency or excess of the patient's constitution, to decide whether to employ attacking or tonifying methods. For instance, if there is swelling, pain, heat, thirst, and constipation, it indicates that the pathogenic factor is inside (the zang-fu organs), and one should use unblocking methods. If there is swelling and pain accompanied by aversion to cold, fever, and headache, it indicates that the pathogenic factor is on the exterior, and one should use dispersing methods. If the swelling and pain are severe, it indicates that the pathogenic factor is in the meridians, and one should use harmonizing methods. If there is slight swelling and pain without suppuration, it indicates a deficiency of Qi and Blood, and one should use tonifying and pushing-out methods. If there is diffuse swelling without pain, or failure to suppurate, or failure of the pus to rupture after formation, it indicates a severe deficiency of Qi and Blood, and one should use vigorous tonification. If the color is dark with slight swelling and pain, or if the pus forms but does not discharge, or if necrotic tissue does not slough off, it indicates Yang deficiency and cold, and one should use warming and tonifying methods. If one adheres rigidly to the stage before ulceration and indiscriminately uses detoxifying (clearing heat and resolving toxicity) herbs, it will further damage the Spleen and Stomach. Not only will the swollen area fail to form pus, but even ulcerated wounds will struggle to heal, leading to the emergence of the "Seven Evil" syndromes, often resulting in death. Ma Yiqing said: For non-ulcerated sores where both interior and exterior are obstructed, the primary approach should be tonifying the interior and releasing the exterior. If one wishes to use Rhubarb (Rhei Radix et Rhizoma), it may be considered rash. For ulcerated sores where both interior and exterior are deficient, the primary approach should be tonifying and connecting the interior; if one wishes to use aromatic and dissipating herbs, it inevitably leads to the error of making the deficient even more deficient. Practitioners must exercise caution.
Qi Dezhi said: Regarding all types of sores, carbuncles, erysipelas, swellings, tubercles, and scrofula, as soon as they are perceived, internal resolution methods should be employed immediately. If they persist for a long time without removal, Qi and Blood gradually decline, muscles become cold and stiff, pus becomes thin and watery, toxic factors do not exit, the wound fails to close, aggregated swelling is not red, tubercles lack pus, and external signs are unclear, all these cases are suitable for interior-tonifying methods. For those where pus has not yet formed, promote early suppuration; for those already ulcerated, promote early granulation. For Qi and Blood deficiency, tonify the interior via interior-tonifying methods. For disharmony of Yin and Yang, regulate the interior via interior-tonifying methods. Generally, the function of interior-tonifying methods is to prevent the sore from developing deteriorating signs. Any physician treating sores should not be without interior-tonifying medicines for a day. However, regarding cold, heat, warmth, coolness, vexation, thirst, diarrhea, and vomiting, one must assess the urgency during clinical practice.
Ma Yiqing said: Carbuncles and sores arise from accumulated toxins in the zang-fu organs. One should first assist Stomach Qi and strengthen Yuan Qi to solidify the root, then use blood-invigorating and meridian-unblocking herbs as auxiliaries, referencing the meridians and seasonal timing, ensuring that toxic factors are excreted externally. If treated early, the toxin can be resolved internally. This is the essence of interior-tonifying methods.
Xue Lizhai said: Generally, the occurrence of sores and ulcers is due to Stomach Qi failing to follow its normal course. The ulceration of sores is due to the putrefying action of Stomach Qi. The healing of sores is due to the nourishing function of Stomach Qi. I have treated initial nodules that have not yet formed pus by using interior-tonifying methods to disperse them; those that have formed and are about to suppurate by using interior-tonifying methods to promote suppuration; those with formed pus but not yet ulcerated by using interior-tonifying methods to open them; and those already ulcerated by using interior-tonifying methods to promote closure. Li Dongyuan said: The Spleen is the official of the granary, and the Stomach is the sea of water and grain, primarily nourishing the four peripheries to generate Qi and Blood. Therefore, Stomach Qi is the source of growth and development and the foundation of the human body. The principle here is indeed profound.