立斋曰∶大抵此证，多由劳伤气血，腠理不密，或醉后房劳沐浴，或登山涉水，外邪所
乘，卫气相搏，湿热相火，血随火化而致。故淮扬闽广间多患之。近代先哲云∶感天地肃杀
恶气所致。其上体先见或多者，毒在上也；下体先见或多者，毒在下也。盖气分受邪则上多
，血分受邪则下多，气血俱受则上下斋见。凡眉毛先落者，毒在肺；面发紫泡者，毒在肝；
脚底先痛或穿者，毒在肾；遍身如癣者，毒在脾；目先损者，毒在心，此五脏受病之重者也
。又一曰皮死，麻木不仁；二曰肉死，针刺不痛；三曰血死，溃烂；四曰筋死，指脱；五曰
骨死，鼻柱坏。此五脏受伤之不可治者也。若声哑目盲，尤为难治。又治法当辨本证、兼证
、变证、类证、阴阳虚实而斟酌焉。若妄投燥热之剂，脓水淋漓则肝血愈燥，肾水愈枯，相
火愈旺，反成败证矣。
一、疠疡所患，非止一脏。然其气血无有弗伤，兼证无有弗见，况积岁而发见于外。须
分经络之上下，病势之虚实，不可概施攻毒之药，当先助胃壮气，使根本坚固，而后治其疮
可也。经云∶真气夺则虚，邪气胜则实。凡云病属有余者，当察其元气不足。
《耆婆恶病论》曰∶疾风有四百四种，总而言之不出五种，即是五风∶一曰黄风，二曰
青风，三曰白风，四曰赤风，五曰黑风，其风合五脏，故曰五风。五风生五虫∶黄风生黄虫
，青风生青虫，白风生白虫，赤风生赤虫，黑风生黑虫，食人五脏。若食人脾，语变声散。
食人肝，眉睫堕落。食人心，遍身生疮。食人肺，鼻柱崩倒，鼻中生 肉。食人肾，耳鸣啾
啾，或如车行雷鼓之声。若食人皮，皮肤顽痹。食人筋，肢节堕落。五风合五脏，虫生致多
，入于骨髓，往来无碍，坏于人身，名曰疾风。疾风者，是疠风之根本也。病之初起，或如
针锥所刺，名曰刺风。或如虫走，名曰游风。遍身掣动，名曰 风。不觉痛痒，名曰
顽风。肉起如桃李小枣核，从头面起者，名曰顺风。从两脚起者，名曰逆风。如连钱团圆，
赤白青乌斑驳，名曰KT 风。或遍体生疮，或如疥癣，或如鱼鳞，或如榆荚，或痒或痛
，黄汁流出，肢节坏烂，为脓为血，或不痒不痛，或起或灭，青黄赤白黑，变易不定。病起
之由，皆因冷热不调，流于五脏，通彻骨髓，用力过度，饮食杂秽，房室不节，虚劳动极，
汗流遍体。因兹积热于五脏，致生多虫，食人五脏、骨髓、皮肉、筋节，久久败坏，名曰疠
风。惟见黑虫者，最为难治，人得此疾，速宜弃家室财物，离妻外家，入山静养疗治，无有不
瘥。
薛立斋说：大抵这种病证，多是由于劳倦损伤气血，腠理（皮肤纹理及汗孔）不致密，或者醉酒后行房事、沐浴，或者登山涉水，外邪趁虚而入，卫气与邪气相搏结，湿热与相火交织，血液随着火势而化生毒邪所致。因此，在淮河、扬州、福建、广东等地多见此病。近代的先贤曾说：这是感受天地肃杀恶气所致。如果上部身体先出现症状或症状较多，说明毒邪在上部；下部身体先出现症状或症状较多，说明毒邪在下部。大概气分受邪则上部症状多，血分受邪则下部症状多，气血都受邪则上下都会出现症状。凡是眉毛先脱落的，说明毒邪在肺；面部出现紫色水泡的，说明毒邪在肝；脚底先疼痛或溃烂穿孔的，说明毒邪在肾；全身像癣一样的，说明毒邪在脾；眼睛先受损的，说明毒邪在心，这是五脏受病较重的情况。另外有一种说法是“皮死”，表现为麻木不知痛痒；第二种是“肉死”，针刺没有痛感；第三种是“血死”，表现为溃烂；第四种是“筋死”，表现为手指脱落；第五种是“骨死”，表现为鼻梁塌陷。这是五脏受伤后无法治愈的情况。如果声音嘶哑、双目失明，更是难以治疗。另外治疗方法应当辨别本证、兼证、变证、类证以及阴阳虚实来斟酌施治。如果妄用燥热性质的药物，导致脓水淋漓，那么肝血会更加干燥，肾水更加枯竭，相火更加旺盛，反而会导致败证。
一、疠疡（麻风病等严重皮肤病）所患，不仅仅涉及一个脏腑。然而它的气血没有不受伤的，兼证没有不出现的，何况积累多年而在体外发作。必须区分经络的上下部位，病势的虚实状况，不能一概施用攻毒的药物，应当先扶助胃气、壮大元气，使根本坚固，然后才能治疗其疮疡。经书说：真气亏损就是虚证，邪气亢盛就是实证。凡是说病属有余（实证）的，应当考察其元气是否不足。
《耆婆恶病论》说：疾风（麻风病）有四百多种，总而言之不出五种，即五风：第一种叫黄风，第二种叫青风，第三种叫白风，第四种叫赤风，第五种叫黑风，这风合应五脏，所以叫五风。五风产生五虫：黄风生黄虫，青风生青虫，白风生白虫，赤风生赤虫，黑风生黑虫，这些虫子吃人的五脏。如果吃人脾脏，语言改变声音散乱。如果吃人肝脏，眉毛睫毛脱落。如果吃人心脏，全身生疮。如果吃人肺脏，鼻梁崩塌倒塌，鼻中长出息肉。如果吃人肾脏，耳鸣嗡嗡作响，或者像车行雷鼓的声音。如果吃人皮肤，皮肤顽痹无知觉。如果吃人筋脉，肢体关节脱落。五风合应五脏，虫子滋生众多，进入骨髓，往来无阻，破坏人身，名叫疾风。疾风，就是疠风的根本。疾病初起时，有的像针锥刺入一样，名叫刺风。有的像虫子爬行，名叫游风。全身抽搐牵动，名叫掣风。不觉痛痒，名叫顽风。肌肉隆起像桃李小枣核，从头面开始的，名叫顺风。从两脚开始的，名叫逆风。像连钱团圆，红白青黑斑驳，名叫KT风（注：原文此处可能有缺字或异体字，依原文保留）。或者遍体生疮，或者像疥癣，或者像鱼鳞，或者像榆荚，或者痒或者痛，流出黄色汁液，肢体关节坏烂，化为脓血，或者不痒不痛，或者时起时灭，颜色青黄赤白黑，变化不定。疾病产生的原因，都是因为冷热不调，流窜于五脏，通达骨髓，用力过度，饮食杂乱污秽，房事不节制，虚劳动极，汗水流遍全身。因此积热于五脏，导致生出许多虫子，吃人五脏、骨髓、皮肉、筋节，久久败坏，名叫疠风。只见到黑虫的，最为难治，人得了这种病，应当迅速抛弃家室财物，离开妻子和外家，进山静养治疗，没有不痊愈的。
Xue Lizhai stated: Generally, this syndrome is mostly caused by labor and fatigue damaging Qi and Blood, leading to loose Cou Li (skin texture and pores). It may also result from sexual intercourse or bathing after drunkenness, or climbing mountains and wading through water, allowing external pathogens to take advantage of the deficiency. When Wei Qi (Defensive Qi) contends with pathogens, Damp-Heat and Ministerial Fire interact, causing Blood to transform into toxic heat due to fire. Therefore, this disease is prevalent in the Huai River, Huaiyang, Fujian, and Guangdong regions. Recent sages have said that it is caused by inhaling the harsh and evil Qi of heaven and earth. If symptoms appear first or are more numerous on the upper body, the toxin is located above; if they appear first or are more numerous on the lower body, the toxin is located below. Generally, when Qi aspect is affected by pathogens, upper symptoms predominate; when Blood aspect is affected, lower symptoms predominate; when both Qi and Blood are affected, symptoms appear both above and below. If eyebrows fall out first, the toxin is in the Lung; if purple blisters appear on the face, the toxin is in the Liver; if pain or perforation occurs first on the soles of the feet, the toxin is in the Kidney; if the whole body resembles tinea, the toxin is in the Spleen; if the eyes are damaged first, the toxin is in the Heart. These are severe conditions affecting the Five Zang Organs. Another classification includes "Skin Death," characterized by numbness and insensitivity; "Flesh Death," where needle pricks cause no pain; "Blood Death," manifested as ulceration; "Tendon Death," resulting in finger detachment; and "Bone Death," marked by the collapse of the nasal bridge. These represent incurable injuries to the Five Zang Organs. Hoarseness and blindness are particularly difficult to treat. Furthermore, treatment methods must be carefully considered based on differentiation of the primary syndrome, concurrent syndromes, transformed syndromes, similar syndromes, and Yin-Yang excess-deficiency patterns. If one recklessly administers drying and hot agents, causing profuse discharge of pus and fluid, Liver Blood will become increasingly dry, Kidney Water increasingly depleted, and Ministerial Fire increasingly vigorous, ultimately leading to a fatal condition.
1. Leprosy and similar ulcers do not affect only one Zang organ. However, Qi and Blood are invariably injured, and concurrent syndromes invariably appear, especially when the disease accumulates over years and manifests externally. One must distinguish the location along the meridians (upper or lower) and the excess-deficiency nature of the pathogenic trend. One cannot indiscriminately apply detoxifying drugs. Instead, one should first strengthen the Stomach Qi and boost Yuan Qi (Primary Qi) to consolidate the root, and only then treat the sores. The Classics state: "When True Qi is depleted, it is Deficiency; when Pathogenic Qi prevails, it is Excess." Whenever a disease is described as having "excess" characteristics, one must examine whether there is a deficiency of Yuan Qi.
The *Qipo's Treatise on Malignant Diseases* states: There are four hundred types of Ji Feng (Leprosy/Malignant Wind), but generally speaking, they fall into five categories, known as the Five Winds: 1. Yellow Wind, 2. Green Wind, 3. White Wind, 4. Red Wind, 5. Black Wind. Since these winds correspond to the Five Zang Organs, they are called the Five Winds. The Five Winds generate Five Worms: Yellow Wind generates Yellow Worms, Green Wind generates Green Worms, White Wind generates White Worms, Red Wind generates Red Worms, and Black Wind generates Black Worms. These worms consume the Five Zang Organs. If they consume the Spleen, speech becomes altered and voice scattered. If they consume the Liver, eyebrows and eyelashes fall out. If they consume the Heart, sores erupt all over the body. If they consume the Lungs, the nasal bridge collapses, and polyps grow in the nose. If they consume the Kidneys, tinnitus sounds like buzzing or the rumbling of thunder from chariots. If they consume the Skin, the skin becomes hard and numb. If they consume the Tendons, limbs and joints detach. The Five Winds correspond to the Five Zang Organs; the proliferation of worms enters the Marrow, moving freely without obstruction, destroying the human body, and is named Ji Feng. Ji Feng is the root of Li Feng (Leprosy). At the onset of the disease, some feel like being pierced by needles, named Ci Feng (Needle Wind); some feel like insects crawling, named You Feng (Wandering Wind); the whole body twitches and pulls, named Che Feng (Pulling Wind); insensitivity to pain and itch is named Wan Feng (Stubborn Wind); flesh nodules rise like peach pits or jujube kernels, starting from the head and face, named Shun Feng (Smooth Wind); starting from both feet, named Ni Feng (Reverse Wind); resembling connected coins, mottled with red, white, green, and black, named KT Feng (textual variant); or sores erupt all over the body, resembling scabies or tinea, fish scales, or elm seeds, with varying degrees of itch or pain, flowing yellow juice, with limbs and joints rotting into pus and blood, or remaining painless and itchy, appearing and disappearing intermittently, changing colors among green, yellow, red, white, and black unpredictably. The causes of this disease stem from imbalance of cold and heat, flowing into the Five Zang Organs, penetrating the marrow, excessive physical exertion, impure and mixed diet, irregular sexual activity, exhaustion from labor and deficiency, and profuse sweating throughout the body. Consequently, accumulated heat arises in the Five Zang Organs, generating numerous worms that consume the Zang organs, marrow, skin, flesh, tendons, and joints. Over time, this leads to decay, named Li Feng. Cases involving only Black Worms are the most difficult to treat. Upon contracting this disease, one should quickly abandon family, property, and wealth, leave wife and extended family, retreat to the mountains for quiet recuperation and treatment, and recovery is assured.