立斋曰∶疮疡阳气脱陷，或因克伐之剂，或因脓血大泄，或因吐泻之后，或因误以入房
。大凡溃后劳后，元气亏损，或梦遗精脱，或脉数便血，或外邪乘虚而入，以致发热头痛，
小便淋涩，或目赤烦喘，气短头晕，体倦热渴，意欲饮水投水，身热憎寒恶衣，扬手掷足，
腰背反张，郑声自汗，脉浮洪大，此无根虚火之假热证也。若畏寒头痛，咳逆呕吐，耳聩
目蒙，小便自遗，泻利肠鸣，里急腹痛，玉茎短缩，齿牙浮痛，肢体麻痹，冷汗时出，或厥冷
身痛，咬舌啮唇，舌本强硬，呃逆喘促，脉微沉细，此阳气脱陷之真寒证也。凡此危候，无
论脉证，但见有一二，急用参附汤，或用托里消毒散去连翘、白芷、金银花三味，急加桂附
大剂补之，多有复生者。
内翰杨皋湖，孟夏患背疽，服克伐之剂，二旬余矣，漫肿坚硬，重如负石，隔蒜灸五十
余壮，背遂轻，以六君加砂仁两剂，涎沫涌出，饮食愈少。此脾虚阳气脱陷也。剂用温补，
反呕不食，仍用前药作大剂加附子姜桂，又不应。遂以参 各一斤，归术陈皮各半斤，附子
一两，煎服三日而尽，流涎顿止，腐肉顿溃，饮食顿进。再用姜桂等药，托里健脾，腐脱而疮愈矣。
少参史南湖之内，夏患疽，不起发，脉大而无力，发热作渴，自汗盗汗，用参 大补之
剂，益加手足逆冷，大便不实，喘促时呕，脉细微，按之如无，唯太冲不绝。仍以参、
、白术、当归、茯苓、陈皮，计斤许，加附子五钱，水煎二钟作一服，诸证悉退，脉息顿复
。翼日疮起而溃，仍用前药四剂后，日用托里药，调理两月余而愈。（薛按）
一妇人，于癸卯冬，失物发怒，缺盆内微肿，甲辰春，大如覆碗，左肩胛亦肿，肉色如
故。或针出鲜血三碗许，腹痛如锥，泄泻不止，四肢逆冷，呕吐恶寒，或时发热，绝食已七
日矣。其脉洪大，时或微细，此阳气脱陷也。用六君加炮姜三钱、附子二钱，早服至午，不
应。再剂加附子五钱，熟睡觉来，诸证顿退六七，可进稀粥。再四剂，诸证悉退，饮食如故
，缺盆始痛。针出清脓二碗许，诸证复生，此虚极也。以十全大补加姜、桂、附各一钱，三
剂而安。后减姜、附各五分，与归脾汤兼服五十余剂而愈。（薛按）
薛立斋说：疮疡出现阳气脱陷的证候，可能是因为使用了攻伐（损伤正气）的药物，也可能是因为脓血大量流失，或者是在剧烈呕吐腹泻之后，又因误犯房事所致。大凡在疮疡溃破后或劳累后，元气亏损，或者出现梦遗、精液滑脱，或者脉象数疾且便血，或者外邪趁虚而入，导致发热头痛，小便淋漓涩痛，或者眼睛发红、烦躁气喘，气短头晕，身体疲倦、发热口渴，心里想喝水却怕水冷，身体发热却厌恶穿衣，双手挥舞双脚乱踢，腰背向后反张，说话声音低微重复（郑声）并伴有自汗，脉象浮洪而大，这是无根虚火引起的假热证。如果表现为畏寒头痛，咳嗽气逆呕吐，耳聋目眩，小便失禁，腹泻肠鸣，里急后重腹痛，生殖器收缩，牙齿浮动疼痛，肢体麻木，冷汗不时流出，或者四肢厥冷身体疼痛，咬舌咬唇，舌体僵硬，呃逆气喘，脉象微细沉弱，这是阳气脱陷的真寒证。凡是这些危重的征候，不论脉象和症状如何，只要见到其中一两种，就应立即使用参附汤，或者使用托里消毒散去掉连翘、白芷、金银花这三味药，紧急加入桂枝、附子的大剂量来补益，大多能起死回生。
翰林杨皋湖，在初夏时节患背疽，服用了攻伐性质的药物二十多天，患处漫肿坚硬，沉重得像背着石头一样，经过隔蒜灸五十多壮后，背部感觉轻松了一些，服用六君子汤加砂仁两剂后，涎沫涌出，饮食反而更少。这是脾虚导致的阳气脱陷。本应用温补药物，却反而呕吐不食，再次使用前药做成大剂量并加入附子、干姜、肉桂，也没有见效。于是用人参、黄芪各一斤，当归、白术、陈皮各半斤，附子一两，煎服三天全部喝完，流涎立刻停止，腐肉立刻溃破，饮食立刻增加。再用干姜、肉桂等药物，托毒排脓健脾，腐肉脱落而疮口愈合。
少史南湖的夫人，夏季患疽，疮疡不起发，脉象大而无力，发热口渴，自汗盗汗，使用人参、黄芪等大补的药剂后，手足逆冷更加严重，大便不成形，气喘急促时常呕吐，脉象细微，按之几乎摸不到，只有太冲穴处的脉搏不绝。仍然使用人参、黄芪、白术、当归、茯苓、陈皮，共计一斤左右，加入附子五钱，加水煎煮成两碗作为一次服用，各种症状全部消退，脉搏气息顿时恢复。第二天疮疡起发并溃破，仍然使用前面的药物四剂后，每天使用托里药物，调理两个多月而痊愈。（薛立斋按语）
一位妇女，在癸卯年冬天，因丢失物品而发怒，锁骨窝内轻微肿胀，到了甲辰年春天，肿块大如倒扣的碗，左肩胛处也肿胀，皮肤颜色如常。有人针刺放出鲜血约三碗，随后腹痛如锥刺，腹泻不止，四肢厥冷，呕吐恶寒，有时发热，已经七天不吃东西了。她的脉象洪大，时而微细，这是阳气脱陷。使用六君子汤加炮姜三钱、附子二钱，早上服用到中午，没有见效。再服药时加入附子五钱，熟睡醒来后，各种症状退去六七成，可以喝稀粥。再服四剂，各种症状全部消退，饮食恢复正常，此时锁骨窝开始疼痛。针刺放出清脓约两碗，各种症状又复发，这是因为极度虚弱。使用十全大补汤加干姜、肉桂、附子各一钱，三剂后病情安定。后来减少干姜、附子各五分，配合归脾汤一起服用五十多剂而痊愈。（薛立斋按语）
Xue Lizhai stated: In cases of sores and ulcers where Yang Qi collapses and sinks, it may be due to the use of purgative or draining agents that damage healthy Qi, excessive loss of pus and blood, following severe vomiting and diarrhea, or mistakenly engaging in sexual intercourse. Generally, after the ulceration of sores or after exertion, when Yuan Qi (Original Qi) is depleted, or if nocturnal emissions or spermatorrhea occur, or if the pulse is rapid with hematochezia, or if external pathogens invade due to deficiency, leading to fever and headache, dysuria with astringency, red eyes with restlessness and panting, shortness of breath, dizziness, fatigue, fever, thirst, desire for water but aversion to cold water, body heat with aversion to clothing, flinging hands and kicking feet, opisthotonos (backward arching of the back), *Zhengsheng* (repetitive, low-pitched speech) with spontaneous sweating, and a floating, surging, and large pulse, this is a false heat syndrome caused by rootless deficient fire. If there is aversion to cold and headache, cough with counterflow vomiting, deafness and blurred vision, urinary incontinence, diarrhea with borborygmus, tenesmus and abdominal pain, retraction of the penis, floating toothache, limb numbness, cold sweat occurring from time to time, or cold limbs with body pain, biting the tongue or lips, stiffness of the tongue base, hiccups and panting, and a minute, deep, and fine pulse, this is a true cold syndrome of Yang Qi collapse and sinking. For all these critical conditions, regardless of the pulse and symptoms, if one or two are observed, Shenfu Tang (Ginseng and Aconite Decoction) should be used urgently, or Tuoli Xiaodu San (Support Interior and Eliminate Toxin Powder) with Lianqiao (Forsythiae Fructum), Baizhi (Angelicae Dahuricae Radix), and Yinjinhua (Lonicerae Japonicae Flos) removed, and large doses of Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata) added urgently for tonification; many patients recover.
Yang Gaohu, a Hanlin Academician, suffered from a carbuncle on the back in early summer. After taking purgative drugs for over twenty days, the swelling was diffuse and hard, feeling heavy as if carrying a stone. After undergoing garlic-partitioned moxibustion for over fifty moxa cones, the back felt lighter. He took Liu Jun Zi Tang (Six Gentlemen Decoction) with Sharen (Amomi Fructus) for two doses, resulting in gushing saliva and further decreased appetite. This indicated Spleen deficiency with Yang Qi collapse and sinking. Although warm tonification was indicated, he vomited and refused food. The previous prescription was made into a large dose with added Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma), and Rougui (Cinnamomi Cortex), but it was ineffective. Subsequently, Ren Shen (Panacis Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix), each one jin (approx. 500g), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Chen Pi (Citri Reticulatae Pericarpium), each half a jin, along with one liang (approx. 37.5g) of Fuzi, were decocted and taken over three days. Salivation stopped immediately, necrotic tissue sloughed off immediately, and appetite improved immediately. Thereafter, Ganjiang and Rougui were used to support the interior and strengthen the Spleen; the necrotic tissue fell off and the sore healed.
The wife of Vice Minister Shi Nanhu suffered from a carbuncle in summer. The lesion failed to rise, the pulse was large but forceless, accompanied by fever and thirst, spontaneous sweating, and night sweats. After using large tonifying doses of Ren Shen and Huang Qi, cold extremities worsened, stools became loose, panting and occasional vomiting occurred, and the pulse was minute and fine, barely palpable, except at the Taichong (LR3) point. Ren Shen, Huang Qi, Bai Zhu, Dang Gui, Fu Ling (Poria), and Chen Pi, totaling approximately one jin, with five qian (approx. 18.75g) of Fuzi, were decocted in water to yield two bowls for a single dose. All symptoms subsided, and the pulse recovered instantly. The next day, the sore rose and ulcerated. Four doses of the previous formula were continued, followed by daily administration of interior-supporting herbs for over two months until recovery. (Comment by Xue Lizhai)
In the winter of the Guimao year, a woman became angry after losing an item, resulting in slight swelling in the supraclavicular fossa. By the spring of the Jiachen year, the swelling was as large as an inverted bowl, with swelling also on the left scapula, while the skin color remained normal. Someone punctured it with a needle, releasing about three bowls of fresh blood. This was followed by stabbing abdominal pain, incessant diarrhea, cold limbs, vomiting, aversion to cold, intermittent fever, and seven days of fasting. Her pulse was surging and large, yet occasionally minute and fine, indicating Yang Qi collapse and sinking. Liu Jun Zi Tang with three qian of Pao Jiang (Zingiberis Rhizoma Preparatum) and two qian of Fuzi was administered in the morning until noon, without effect. In the second dose, Fuzi was increased to five qian. Upon waking from sleep, symptoms subsided by six or seven tenths, allowing her to consume thin congee. After four more doses, all symptoms disappeared, and appetite returned; only then did pain appear in the supraclavicular fossa. Puncture released about two bowls of clear pus, and symptoms recurred due to extreme deficiency. Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) with one qian each of Ganjiang, Rougui, and Fuzi was given for three doses, stabilizing the condition. Later, Ganjiang and Fuzi were reduced to five fen (approx. 1.875g) each, combined with Guipi Tang (Restore the Spleen Decoction), taken for over fifty doses until recovery. (Comment by Xue Lizhai)