勿灸；内无客邪，勿导引；外无淫气，勿按摩；皮肤不痹，勿蒸熨；肌肉不寒，勿
暖洗；神不凝迷，勿愉悦；气不奔急，勿和缓；顺此者生，逆此者死耳。
论曰∶汗家不可发汗，阳虚不得重发汗。（万灵丹发汗药，不可妄投。）
《生气通天论》曰∶膏粱之变，足生大疔，受如持虚。
《痈疽篇》∶黄帝曰∶血气已调，形气乃持，余已知血气之平与不平，未知痈疽
之所从生，成败之时，死生之期，或有远近，何以度之，可得闻乎？岐伯曰∶经脉
流行不止，与天同度，与地合纪，故天宿失度，日月薄蚀；地经失纪，水道流溢，草
HT不成，五谷不殖；径路不通，民不往来，巷聚邑居，则别离异处，血气犹然，请
言其故。夫血脉营卫，周流不休，上应星宿，下应经数。寒邪客于经络之中，则血
泣，血泣则不通，不通则卫气归之，不得复反，故痈肿。寒气化为热，热胜则腐肉，
肉腐则为脓，脓不泻则烂筋，筋烂则伤骨，骨伤则髓消，不当骨空，不得泄泻，血枯
空虚，则筋骨肌肉不相荣，经脉败漏，熏于五脏，脏伤故死矣。
黄帝曰∶愿尽闻痈疽之形，与忌日名。岐伯曰∶痈发于嗌中，名曰猛疽。猛疽不
治，化为脓，脓不泻，塞咽，半日死；其化为脓者，泻则合豕膏，无冷食，三日
已。发于颈，名曰夭疽。其痈大以赤黑，不急治，则热气下入渊腋，前伤任脉，内熏
肝肺，熏肝肺，十余日而死矣。阳气大发，消脑留项，名曰脑烁。其色不乐，项痛而
如刺以针，烦心者，死不可治。发于肩及 ，名曰疵痈。其状赤黑，急治之，此令
人汗出至足，不害五脏，痈发四五日，逞 之。发于腋下赤坚者，名曰米疽。治之
以砭石，欲细而长，疏砭之，涂以豕膏，六日已，勿裹之。其痈坚而不溃者，为马刀
挟缨，急治之。发于胸，名曰井疽。其状如大豆，三四日起，不早治，下入腹，不
治，七日死矣。发于膺，名曰甘疽。色青，其状如谷实， KT ，常苦寒热，急治之，去
其寒热，不治，十岁死，死后出脓。发于
胁，名曰败疵。败疵者，女子之病也，灸之，其病大痈脓，治之，其中乃生肉，大
如赤小豆，治之，锉 翘草根各一升，以水一斗六升煮之，竭取三升，则强饮浓衣
坐于釜上，令汗出至足已。发于股胫，名曰股胫疽。其状不甚变，而痈脓搏骨，不
急治，三十日死矣。发于尻，名曰锐疽。其状赤坚大，急治之，不治，三十日死矣。发
于股阴，名曰赤施。不急治，六十日死，在两月之内，不治，十日而当死。发于膝，名
曰疵痈。其状大痈，色不变，寒热如坚石，勿石，石之者死，须其柔乃石之生。诸痈
疽之发于节而相应者，不可治也。发于阳者，百日死；发于阴者，三十日死。发于
胫，名曰兔啮。其状赤至骨，急治之，不治害人也。发于内踝，名曰走缓。其状痈
也，色不变，数石其输，而止其寒热，不死。发于足上下，名曰四淫。其状大痈，急
治之，百日死。发于足旁，名曰厉痈。其状不大，初如小指发，急治之，去其黑者，
不消辄益，不治，百日死。发于足指，名脱痈。其状赤黑，死不治；不赤黑，不死；
不衰，急斩之；不则死矣。
《玉版》篇∶黄帝曰∶病之生时，有喜怒不测，饮食不节，阴气不足，阳气有余，
营气不行，乃发为痈疽。阴阳不通，两热相搏，乃化为脓，小针能取之乎？岐伯曰∶
以小治小者，其功小，以大治大者，多害，故其已成脓血者，其唯砭石铍锋之所取也。
黄帝曰∶多害者其不可全乎？岐伯曰∶其在逆顺焉，以为伤者，其白眼青黑眼小，是
一逆也；内药而呕者，是二逆也；腹痛渴甚，是三逆也；肩项中不便，是四逆也；音
嘶色脱，是五逆也；除此五者为顺矣。
《寒热病篇》曰∶五脏身有五部，伏兔一，腓二，（腓者 也。）背三，（五脏之俞在背。）俞
四，项五，此五部有痈疽者死。凡刺之害，中而不去，则精泄，不中而去，则致气，精
泄则病甚而 ，致气则生为痈疽也。
《生气通天论》曰∶汗出见湿，乃生痤
痱，陷脉为 ，留连肉腠。因而饱食，筋脉横解，肠 为痔。
《阴阳别论》曰∶三阳为病，发寒热，下为痈肿。
《气穴论》曰∶肉之大会为谷，肉之小会为溪，肉分之间，溪谷之会，以行荣卫，
以会大气，邪溢气壅，脉热肉败，荣卫不行，必将为脓。内消骨髓，外破大 ，留
于节凑，必将为败，积寒留舍，荣卫不居，卷肉缩筋，胁肘不得伸，内为骨痹，外为
不仁，命曰不足，大寒留于溪谷也。
《刺节真邪论》曰∶虚邪之中人也，洒淅动形，起毫毛而发腠理，其入深，内搏
于骨则为骨痹，搏于筋则为筋挛，搏于脉中则为血闭，不通则为痈。虚邪之入于身
也深，寒与筋挛搏，久留而内着，寒胜其热，则骨疼内枯，热胜其寒，则烂肉腐肌
为脓，内伤骨，内伤骨为骨蚀。有所疾前筋，筋屈而不得伸，邪气居其间而不反，发
为筋溜。有所结，气归之，卫气留之，不得反，津液久留，合而为肠溜。久者数岁
乃成，以手按之柔，已有所结，气归之，津液留之，邪气中之，凝结日以易甚，连以
聚居，为昔瘤。以手按之坚，有所结，深中骨，气因于骨，骨与气并，日以益大，则
为骨疽。有所结，中于肉，宗气归之，邪留不去，有热则化为脓，无热则为肉疽。凡
此数气者，其发无常处，而有常名也。
《气交变大论》曰∶岁火太过，民病身热骨痛，而为浸淫。岁金太过，民病两胁
下少腹痛，目赤痛 疡，耳无所闻。岁木不及，复则炎暑流火，湿性燥病，寒热疮
疡，痱疹痈痤。岁金不及，复为寒雨暴至，民病口疮。岁水不及，民病寒疡流水。
《五常政大论篇》曰∶委和之纪，其病支废，痈肿疮疡。卑监之纪，其动疡涌，分
溃痈肿。赫羲之纪，其病笑疟疮疡。坚成之纪，其动暴折疡疰。少阳司天，火气下
临，鼻窒疮疡。太阳司天，寒气下临，甚则 肿身后痈。少阴司天，热气下临，甚
则疮疡。地有高下，气有温凉，高者气寒，下者气热，故适寒凉者胀，适温热者疮，下
之则胀已，汗之则疮已。
经曰∶诸痛痒疮疡，皆属心火。
经曰∶诸痈肿筋挛管痛者，此寒气之肿，八风之变也。
经曰∶邪之所凑，其正必虚，着而不去，其病为实。
又曰∶荣气不从，逆于肉里，乃生痈肿。（营逆则血郁，气郁则热聚为脓，故为痈肿也。）热
之所过，则亦痈肿。（热胜则阳气内郁，故浮肿暴作，荣气亦逆于肉里，聚为痈脓之肿矣。）
又曰∶寒伤形，热伤气，气伤痛，形伤肿。（热之阳气，则热结于肉分而故痛，寒之伤形，则
寒薄于皮腠，所以坚凝而肿斯作也。）先痛而后肿者，气先受伤，而形亦受伤也；先肿而后痛者，
形先受伤，而气亦受伤也。故有形不痛者阳伤，无形有痛者阴伤，更有汗方发泄，寒
水浴之，以致热郁皮里，湿邪凝结，甚为痤疖，轻为痱疮；亦有阳气不固，邪气入
于陷脉，陷脉者谓寒邪陷缺其脉，积寒于中，经血稽凝，久瘀内攻，积于肉里，发为鼠 。
又曰∶膏粱之变，足生于大疔。
又曰∶五脏不和，九窍不通，六腑不和，留结为痈。凡疮肿高而软者，发于血
脉，下而坚者，发于筋脉，肉色不变者，发于骨髓，故分气血虚实，热毒深浅为要。切
不可一见其肿，便谓热毒实热，辄投下剂，意谓毒从泻出，殊不知阳者红肿 起，阴
者青白而陷，疽者附筋骨而生，皆赖血气为主。经所谓气主煦之，血主濡之，倘元
气受伤，而不能煦濡，则下陷不脓，能禁其不内攻乎？
经曰∶天空西北，左寒而右凉，地不满东南，右温而左湿。东南方，阳也，阳
精降于下，故右热而左湿；西北方，阴也，阴精奉于上，故左寒而右凉；适寒凉者胀，
而湿热者疮，下之则胀已，汗之则疮已。夫东南二方，在人则丙小肠热，甲胆风，皆
俱下性炎上，其疮外有六经形证，内无便溺阻隔，饮食如故，小便自调，知不在里，
非疽也；痈疖，小为疖，大为痈，其邪受风湿地气，自外而来侵内。经云∶荣气不
从，逆于肉理，乃生痈肿。诸疮痛痒，皆属心火。此疮自外而入，是丙小肠左迁入
胆，作痛而非痒，此二方皆主血为病为痛，此元气不足，荣气逆行，其初出未有传变，
在于肌肉之上，皮肤之间，只于风热六经所行经络地分出也，宜泻风湿热。医者只
知阴复其阳，则宜汗，此宜汗者，乃湿热郁手足少阳，致血脉凝逆，荣卫不能周身，
元气消弱也。其风湿热滞于下，故面赤肿微黯，风水惟上冲，颜色多怒，其疮色肿
微黯，疮热高起，结硬作痛，其脉止在左手，左属表，左寸外洪缓而阴，是客邪在
血脉之上，皮肤之间，宜急发汗，通荣卫，则邪去矣。宜内托荣卫汤。
经曰∶脉细皮寒，泻痢前后，饮食不进，此为五虚，疮疡最忌。
张仲景曰∶痈疽最难治，外尚未现真形，内已先溃大穴。古人云∶外大如豆，内
大如拳，外大如拳，内大如盘，信不爽也。
刘河间曰∶人近火者，微热则痒，热甚则痛，附近则灼而为疮，皆火之用也。或
痒痛如针轻刺者，犹飞迸火星灼之然也。或疑疮疡，皆属火热，而反腐出脓水者，何
也？犹谷肉果菜，热极则腐烂而溃为污水，大热过极，反兼水化也。
李东垣曰∶疽初生如黍米大，痒痛有异，误触破之，即 展四畔，赤肿沉闷，牵
引胁肋疼痛，数日之后，渐觉肌肤壮热，恶寒烦渴，肿晕侵展， 浆汁出，积日不溃，
抑之则流血者，谓之发背疽也。发于脑者为脑疽，发于鬓眉髯者，以类呼也。又有
其状无头，肿阔三四寸，如觉注闷疼痛，因循数日，皮光微软者，甚则亦令人恶寒发
热，头痛烦渴者，谓之发背痈也。又有初生一头，色浮赤而无根，肿见于皮肤之间，
大小一二寸者，疖也。三者，惟疽最重，此
疾皆因滋味与浓衣，衣服浓暖则表易招寒，滋味过多则五脏生热，脏腑积热，则血脉
不流而毒瓦斯凝滞，邪气伏留，热抟于血，血聚则肉溃成疮，浅则为疖，实则为痈，深
则为疽矣。亦有因服金石发动而成，亦有平生不服金石药而患者，乃由父母曾服饵
者，其毒瓦斯流传子孙。此病初起认是疽，则宜速疗之。（《十书》）
又曰∶夫疮肿之患，莫大乎痈疽。然而痈疽何以别之？经所谓荣卫稽留于筋脉
之中，则涩不行，血脉不行，则阳气郁遏而不通，故生寒热，秽毒之气腾出于外，蓄
结为痈，久而不散，热气乘之，腐化为脓，然而骨髓不焦枯，脏腑不伤败，可治而愈
也。何为疽？五脏风毒积热，毒热炽甚，下陷肌肤，骨髓将枯，血气涸竭，其肿色夭
坚如牛领之皮，故命曰疽。痈者，其肿皮薄以泽，此其候也。痈疽之生，有内有外，
内生胸腹脏腑之中，外生肤肉筋骨之表，凡此二毒，发无定处，而有常名。夫郁滞之
本，始于喜怒哀乐不时，饮食居处不节，或金石草药之发动，寒暑燥湿之不调，使阴
阳之不平而蕴结于外，使荣卫凝涩而腐溃，轻者起于六腑，浮达而为痈，气行经络而
浮也；重者发于五脏，沉涩而为疽，气行经络而沉也。明乎二者，肿毒丹疹，可以类推矣。
又曰∶夫疮候多端，欲辨深浅，直须得法，若不素知方论，而妄生穿凿者，如
大匠舍其绳墨，以意度量，安能中于规矩哉。尝闻古人有言曰∶多则惑，少则得。简
而论之，则疮疽概举有三种∶高而软者发于血脉，肿下而坚者发于筋骨，肉皮色不相辨者，发于骨髓。
又曰∶凡疗疮疽，以手按摇疮肿，根牢而大者深也，根小而浮者浅也。又验其
人，初生疮之时，便觉壮热恶寒，拘急头痛，精神不宁，烦躁饮冷者，其患疮疽必
深也。若人虽患疮疽，起居和平，饮食如常，其疾浮浅也。恶疮初生，其头如米粟，
微似有痛痒，误触破之，即 展觉有深意，速服犀角汤及漏芦汤、通气丸等取通利疏
畅，兼用浴毒汤塌浸之类，若浮浅者 贴膏亦瘥。以此推之。浅深之辨，始终之次者也。
又曰∶夫热发于皮毛之间，是以浮肿根小，至大不过二三寸者，疖也；六腑积
热，腾出于外，肌肉之间，其发暴甚，肿皮光软，侵展广大者，痈也；五脏风积热
攻于肌骨，风毒猛暴，初生一头如 ，白焦枯触之应心者，疽也。盖痈发于六腑，
若燎原之火，外溃肤肉；疽生五脏，沉涩难疗，若陶室之燧，内销骨髓；痈则易疗，
惟难将息而迟瘥；疽则难疗，易得痊复。夫疖与疮初生，并宜灸之，谓其气本淫达，以
导其热，令速畅也。疽则烙，不宜灸，谓其根本深沉，须达其原也。凡疮生于外，皆
由热毒蕴于内，明乎三者，其余可以类推矣。盖皮肤微高起而肌浓，或痛或痒，移
走无常者，谓之肿。有因风而得之者，有因风热相搏而得之者，久久而不消，热胜
于风，若不即治，血不流通，与气乘之，以成脓也。
又曰∶风多则痒，热多则痛，此为验也。
又曰∶夫患痈疽之人，慎勿着恼，若触着多致脓成败溃。
不要施灸；体内没有外感邪气，不需要导引；体表没有淫邪之气，不需要按摩；皮肤没有麻木不仁，不需要蒸熨；肌肉没有寒冷感，不需要暖洗；精神没有凝滞迷乱，不需要愉悦（情志调节）；气机没有奔冲急迫，不需要和缓（调理气机）。顺应这些原则的就能生存，违背这些原则的就会死亡。
论述说：平素多汗的人不可发汗，阳气虚弱的人不得再次发汗。（万灵丹是发汗药，不可随意投用。）
《生气通天论》说：饮食肥甘厚味的变化，足以导致大疔的发生，受邪就像拿着空容器一样容易接受。
《痈疽篇》记载：黄帝说：血气已经调和，形体正气得以维持，我已经知道血气的平和与不平，但还不知道痈疽是从哪里产生的，成败的时间，死生的期限，有的远有的近，如何判断它，可以讲给我听吗？岐伯说：经脉气血流行不止，与天体的度数相同，与大地的纪法相合，所以天上的星宿失去度数，日月就会发生亏损蚀害；大地的经路失去纪法，水道就会泛滥溢出，草木不能成熟，五谷不能种植；道路不通，百姓不能往来，村落城邑分离异处，血气也是这样，请让我讲讲其中的缘故。那血脉营卫，周流不息，上应星宿，下应地里的经纬数目。寒邪客居在经络之中，则血液凝涩，血液凝涩则不通畅，不通畅则卫气归向于此，不能再返回，所以形成痈肿。寒气化为热，热盛则腐蚀肌肉，肌肉腐烂则化为脓，脓液不排出则烂筋，筋烂则伤骨，骨伤则髓消，如果不从骨孔中泄泻，脓毒不得排泄，血液枯竭空虚，则筋骨肌肉不相荣养，经脉败坏渗漏，熏灼于五脏，脏气受伤所以死亡。
黄帝说：希望详尽地听闻痈疽的形状，以及禁忌的日子名称。岐伯说：痈发于咽喉中间，名叫猛疽。猛疽不治疗，化为脓，脓不排出，堵塞咽喉，半天就会死亡；如果已经化为脓，排出脓液后配合服用豕膏（猪油膏），不要吃冷的食物，三天就好了。发于颈部，名叫夭疽。它的痈大而呈赤黑色，不紧急治疗，则热气向下进入渊腋穴，向前损伤任脉，向内熏灼肝肺，熏灼肝肺，十多天后就会死亡。阳气大发，消耗脑髓留滞于项部，名叫脑烁。其面色不乐，项痛如针刺，心烦意乱的，是死证不可治。发于肩部及腋下，名叫疵痈。其状赤黑，紧急治疗，此病使人出汗直到脚底，不伤害五脏，痈发四五日，应当逞快（迅速）治疗。发于腋下且赤色坚硬的，名叫米疽。用砭石治疗，砭石要细而长，稀疏地刺破，涂上豕膏，六天痊愈，不要包扎。如果痈坚硬而不溃破的，为马刀挟缨，紧急治疗。发于胸部，名叫井疽。其状像大豆，三四天起病，不早治疗，向下进入腹部，不治疗，七天死亡。发于胸膺部，名叫甘疽。颜色青，其状像谷实，疼痛，常苦于寒热，紧急治疗，去除其寒热，不治疗，十年后死亡，死后出脓。发于胁部，名叫败疵。败疵是女子的病，施灸，其病变成大痈脓，治疗时，其中生出肉芽，大如赤小豆，治疗时，锉碎翘草根各一升，用水一斗六升煮取三升，然后强饮，穿厚衣服坐在锅上，令出汗直到脚底痊愈。发于大腿和小腿，名叫股胫疽。其状变化不明显，但痈脓搏结于骨，不紧急治疗，三十天死亡。发于臀部，名叫锐疽。其状赤色坚硬大，紧急治疗，不治疗，三十天死亡。发于大腿内侧，名叫赤施。不紧急治疗，六十天死亡，如果在两个月之内，不治疗，十天就会死亡。发于膝盖，名叫疵痈。其状大痈，颜色不变，寒热像坚石，不要用石针刺破，刺破的会死亡，必须等其变软后再刺破才能生还。各种痈疽发于关节且相应的，不可治疗。发于阳分的，百日死亡；发于阴分的，三十天死亡。发于小腿，名叫兔啮。其状赤色至骨，紧急治疗，不治疗危害人。发于内踝，名叫走缓。其状是痈，颜色不变，多次用石针刺其输穴，以止住寒热，不会死亡。发于足上下，名叫四淫。其状大痈，紧急治疗，百日死亡。发于足旁，名叫厉痈。其状不大，起初像小指头那样突起，紧急治疗，去掉黑色的部分，不消退就增加，不治疗，百日死亡。发于足趾，名叫脱痈。其状赤黑，死证不可治；不赤黑，不死；不衰退，紧急截肢；不这样就会死亡。
《玉版》篇记载：黄帝说：疾病产生时，有喜怒无常，饮食不节制，阴气不足，阳气有余，营气运行不畅，于是发为痈疽。阴阳不通，两热相搏，于是化为脓，用小针能取效吗？岐伯说：用小针治小病，功效小，用大针治大病，多有危害，所以那些已经成脓血的，只有用砭石、铍锋来取效。黄帝说：多有危害的难道就不能完全治愈吗？岐伯说：这在于逆证和顺证的区别。认为是伤者，如果白眼青黑、眼珠变小，这是一逆；服药即呕吐，这是二逆；腹痛渴甚，这是三逆；肩项不便，这是四逆；声音嘶哑、面色脱失，这是五逆；除去这五种就是顺证了。
《寒热病》篇说：五脏在身体上有五个部位，伏兔是一，腓肠肌二是，背三是，俞穴四是，项五是，这五个部位有痈疽的会死亡。凡是针刺的危害，刺中了不拔针，则精气泄漏，没刺中而拔针，则导致气聚，精气泄漏则病加重而消瘦，气聚则生为痈疽。
《生气通天论》说：出汗见湿，乃生痤痱，邪气陷入脉络成为瘘，留连于肌肉腠理之间。如果因此饱食，筋脉松弛横解，肠道变为痔。
《气穴论》说：肌肉的大聚会叫谷，肌肉的小聚会叫溪，肌肉分界之间，溪谷的交会处，用来运行营卫，汇聚大气，邪气溢满气机壅塞，脉热肉败，营卫不行，必将化为脓。向内消磨骨髓，向外破溃大络，留于节凑，必将败坏，积寒停留，营卫不居，卷缩肌肉筋脉，胁肘不能伸展，内为骨痹，外为不仁，名为不足，是大寒留于溪谷。
《刺节真邪论》说：虚邪侵入人体，洒淅恶寒动摇形体，毫毛竖起腠理开泄，如果深入，内搏于骨则为骨痹，搏于筋则为筋挛，搏于脉中则为血闭，不通则为痈。虚邪侵入身体很深，寒与筋挛相搏，久留而内着，寒胜其热，则骨疼内枯，热胜其寒，则烂肉腐肌为脓，内伤骨，内伤骨为骨蚀。如果有疾在前筋，筋屈曲不得伸展，邪气居于其间而不返，发为筋溜。如果有结聚，气归向之，卫气留滞，不能返回，津液久留，合而为肠溜。久的数年才形成，用手按之柔软，已有结聚，气归向之，津液留之，邪气侵入其中，凝结日益严重，连聚聚居，为昔瘤。用手按之坚硬，结聚深中于骨，气因于骨，骨与气并，日益增大，则为骨疽。有结聚，中于肉，宗气归向之，邪气留去不去，有热则化为脓，无热则为肉疽。凡这几类气，它们的发作没有固定地方，但有固定的名称。
《气交变大论》说：岁火太过，百姓病身热骨痛，而为浸淫疮。岁金太过，百姓病两胁下少腹痛，目赤痛疡，耳无所闻。岁木不及，复气则为炎暑流火，湿性燥病，寒热疮疡，痱疹痈痤。岁金不及，复气为寒雨暴至，百姓病口疮。岁水不及，百姓病寒疡流水。
《五常政大论篇》说：委和之纪，其病肢体废用，痈肿疮疡。卑监之纪，其动疡涌，分溃痈肿。赫羲之纪，其病笑疟疮疡。坚成之纪，其动暴折疡疰。少阳司天，火气下临，鼻窒疮疡。太阳司天，寒气下临，甚则跗肿身后痈。少阴司天，热气下临，甚则疮疡。地有高下，气有温凉，高处气寒，低处气热，所以适寒凉者胀，适温热者疮，下之则胀已，汗之则疮已。
经文说：各种痛痒疮疡，都归属于心火。
经文说：邪气所凑集的地方，正气必然虚弱，附着而去不掉，病邪就转为实证。
又说：营气不从，逆于肉里，乃生痈肿。（营气逆则血郁，气郁则热聚为脓，所以为痈肿。）热之所过，也生痈肿。（热盛则阳气内郁，所以浮肿暴作，营气亦逆于肉里，聚为痈脓之肿。）
又说：寒伤形，热伤气，气伤痛，形伤肿。（热的阳气，则热结于肉分而故痛，寒伤形，则寒薄于皮腠，所以坚凝而肿斯作也。）先痛而后肿者，气先受伤，而形亦受伤；先肿而后痛者，形先受伤，而气亦受伤。所以有形不痛的属阳伤，无形有痛的属阴伤。更有汗方发泄时，用寒水沐浴，以致热郁皮里，湿邪凝结，甚为痤疖，轻为痱疮；也有阳气不固，邪气入于陷脉，陷脉是指寒邪陷缺其脉，积寒于中，经血稽留凝滞，久瘀内攻，积于肉里，发为鼠瘘。
又说：膏粱之变，足生于大疔。
又说：五脏不和，九窍不通，六腑不和，留结为痈。凡是疮肿高而软的，发于血脉，下而坚的，发于筋脉，肉色不变的，发于骨髓，所以要分辨气血虚实，热毒深浅为关键。切不可一见其肿，便谓热毒实热，辄投下剂，意谓毒从泻出，殊不知阳者红肿高起，阴者青白而陷，疽者附筋骨而生，皆赖血气为主。经所谓气主煦之，血主濡之，倘若元气受伤，而不能煦濡，则下陷不脓，能禁其不内攻乎？
经文说：天空西北，左寒而右凉，地不满东南，右温而左湿。东南方，阳也，阳精降于下，故右热而左湿；西北方，阴也，阴精奉于上，故左寒而右凉；适寒凉者胀，而湿热者疮，下之则胀已，汗之则疮已。夫东南二方，在人则丙小肠热，甲胆风，皆具下性炎上，其疮外有六经形证，内无便溺阻隔，饮食如故，小便自调，知不在里，非疽也；痈疖，小为疖，大为痈，其邪受风湿地气，自外而来侵内。经云：营气不从，逆于肉理，乃生痈肿。诸疮痛痒，皆属心火。此疮自外而入，是丙小肠左迁入胆，作痛而非痒，此二方皆主血为病为痛，此元气不足，营气逆行，其初出未有传变，在于肌肉之上，皮肤之间，只于风热六经所行经络地分出也，宜泻风湿热。医者只知道阴复其阳，则宜汗，此宜汗者，乃湿热郁手足少阳，致血脉凝逆，营卫不能周身，元气消弱也。其风湿热滞于下，故面赤肿微黯，风水惟上冲，颜色多怒，其疮色肿微黯，疮热高起，结硬作痛，其脉止在左手，左属表，左寸外洪缓而阴，是客邪在血脉之上，皮肤之间，宜急发汗，通营卫，则邪去矣。宜内托营卫汤。
张仲景说：痈疽最难治，外尚未现真形，内已先溃大穴。古人说：外大如豆，内大如拳，外大如拳，内大如盘，确实不差。
刘河间说：人近火者，微热则痒，热甚则痛，附近则灼而为疮，都是火的作用。或痒痛如针轻刺者，犹飞迸火星灼之然也。或疑疮疡，皆属火热，而反腐出脓水者，何也？犹谷肉果菜，热极则腐烂而溃为污水，大热过极，反兼水化也。
李东垣说：疽初生如黍米大，痒痛有异，误触破之，即蔓延四畔，赤肿沉闷，牵引胁肋疼痛，数日之后，渐觉肌肤壮热，恶寒烦渴，肿晕侵展，脓汁出，积日不溃，抑之则流血者，谓之发背疽也。发于脑的为脑疽，发于鬓眉髯的，以类呼也。又有其状无头，肿阔三四寸，如觉注闷疼痛，因循数日，皮光微软者，甚则亦令人恶寒发热，头痛烦渴的，谓之发背痈也。又有初生一头，色浮赤而无根，肿见于皮肤之间，大小一二寸的，疖也。三者，惟疽最重，此疾皆因滋味与浓衣，衣服浓暖则表易招寒，滋味过多则五脏生热，脏腑积热，则血脉不流而毒瓦斯凝滞，邪气伏留，热抟于血，血聚则肉溃成疮，浅则为疖，实则为痈，深则为疽矣。亦有因服金石发动而成，亦有平生不服金石药而患病的，乃由父母曾服饵的，其毒瓦斯流传子孙。此病初起认是疽，则宜速疗之。（《十书》）
又说：夫疮肿之患，莫大乎痈疽。然而痈疽何以别之？经所谓营卫稽留于筋脉之中，则涩不行，血脉不行，则阳气郁遏而不通，故生寒热，秽毒之气腾出于外，蓄结为痈，久而不散，热气乘之，腐化为脓，然而骨髓不焦枯，脏腑不伤败，可治而愈也。何为疽？五脏风毒积热，毒热炽甚，下陷肌肤，骨髓将枯，血气涸竭，其肿色夭坚如牛领之皮，故命曰疽。痈者，其肿皮薄以泽，此其候也。痈疽之生，有内有外，内生胸腹脏腑之中，外生肤肉筋骨之表，凡此二毒，发无定处，而有常名。夫郁滞之本，始于喜怒哀乐不时，饮食居处不节，或金石草药之发动，寒暑燥湿之不调，使阴阳之不平而蕴结于外，使营卫凝涩而腐溃，轻者起于六腑，浮达而为痈，气行经络而浮也；重者发于五脏，沉涩而为疽，气行经络而沉也。明乎二者，肿毒丹疹，可以类推矣。
又说：夫疮候多端，欲辨深浅，直须得法，若不素知方论，而妄生穿凿者，如大匠舍其绳墨，以意度量，安能中于规矩哉。尝闻古人有言曰：多则惑，少则得。简而论之，则疮疽概举有三种：高而软者发于血脉，肿下而坚者发于筋骨，肉皮色不相辨者，发于骨髓。
又说：凡疗疮疽，以手按摇疮肿，根牢而大的深，根小而浮的浅。又验其人，初生疮之时，便觉壮热恶寒，拘急头痛，精神不宁，烦躁饮冷的，其患疮疽必深也。若人虽患疮疽，起居和平，饮食如常，其疾浮浅也。恶疮初生，其头如米粟，微似有痛痒，误触破之，即蔓延觉有深意，速服犀角汤及漏芦汤、通气丸等取通利疏畅，兼用浴毒汤塌浸之类，若浮浅者贴膏亦差。以此推之。浅深之辨，始终之次者也。
又说：夫热发于皮毛之间，是以浮肿根小，至大不过二三寸的，疖也；六腑积热，腾出于外，肌肉之间，其发暴甚，肿皮光软，侵展广大的，痈也；五脏风积热攻于肌骨，风毒猛暴，初生一头如粟，白焦枯触之应心的，疽也。盖痈发于六腑，若燎原之火，外溃肤肉；疽生五脏，沉涩难疗，若陶室之燧，内销骨髓；痈则易疗，惟难将息而迟瘥；疽则难疗，易得痊复。夫疖与疮初生，并宜灸之，谓其气本淫达，以导其热，令速畅也。疽则烙，不宜灸，谓其根本深沉，须达其原也。凡疮生于外，皆由热毒蕴于内，明乎三者，其余可以类推矣。盖皮肤微高起而肌浓，或痛或痒，移走无常的，谓之肿。有因风而得的，有因风热相搏而得的，久久而不消，热胜于风，若不即治，血不流通，与气乘之，以成脓也。
又说：风多则痒，热多则痛，此为验也。
Do not apply moxibustion; if there is no external pathogenic factor inside, do not perform Daoyin (guiding and pulling exercises); if there is no excessive pathogenic qi outside, do not massage; if the skin is not numb, do not apply steaming or ironing heat therapy; if the muscles are not cold, do not use warm washing; if the spirit is not stagnant or confused, do not rely on emotional pleasure (for regulation); if the Qi is not rushing urgently, do not use harmonizing and soothing methods. Those who follow these principles will live; those who go against them will die.
It is stated: Individuals who sweat profusely should not be induced to sweat again; those with Yang deficiency must not undergo repeated sweating therapies. (Wanling Dan is a diaphoretic formula and must not be administered recklessly.)
The *Suwen: Shengqi Tongtian Lun* states: Changes caused by rich and greasy foods can give rise to large Ding (severe carbuncles); susceptibility to such pathogens is as easy as holding an empty vessel.
In the *Yongju Pian*: The Yellow Emperor asked: Although the blood and Qi have been harmonized and the formative Qi is maintained, I know the balance and imbalance of blood and Qi, but I do not know from where Yongju (carbuncles and sores) arise, their timing of success or failure, and their periods of life and death, which may vary in distance. How can we judge this? Can you explain it to me? Qibo replied: The flow of meridians and collaterals never ceases, corresponding to the degrees of heaven and the records of earth. Thus, when celestial bodies lose their order, solar and lunar eclipses occur; when earthly paths lose their rhythm, waterways overflow, grass and trees fail to mature, and grains do not grow; roads become blocked, people cannot travel, and villages separate. Blood and Qi behave similarly. Let me explain the reason. The blood vessels and Ying-Wei (Nutritive and Defensive) Qi circulate continuously, corresponding to the stars above and the geographical measures below. When Cold pathogen lodges in the meridians, blood becomes viscous and stagnates. Stagnant blood leads to obstruction, causing Wei Qi to gather there and unable to return, resulting in swelling (Yong). Cold transforms into Heat; excessive Heat rots flesh, turning it into pus. If pus is not drained, tendons rot; rotted tendons damage bones; damaged bones cause marrow depletion. If drainage does not occur through bone apertures, blood becomes depleted and hollow, causing tendons, bones, and muscles to lose mutual nourishment. Meridians fail and leak, fuming into the Zang organs, leading to death due to organ damage.
The Yellow Emperor said: I wish to hear fully about the manifestations of Yongju, their names, and taboo days. Qibo said: Yong arising in the throat is called Mengju (Fierce Carbuncle). If untreated, it turns to pus; if pus is not discharged, blocking the throat, death occurs within half a day. If pus has formed, discharge it, apply Pig Fat Ointment (Shi Gao), avoid cold food, and recovery occurs in three days. Yong arising in the neck is called Yaoju (Premature Death Carbuncle). If large and red-black, and not treated urgently, Heat descends into Yuanye, damaging the Ren Mai anteriorly and fuming into the Liver and Lungs internally. Fuming into the Liver and Lungs leads to death in ten-plus days. Excessive expansion of Yang Qi consumes brain marrow and remains in the nape, called Nao Shuo (Brain Melting). With a displeased expression, nape pain like needle pricks, and vexation, it is a fatal untreatable condition. Yong arising in the shoulder and axilla is called Ci Yong. Red-black in color, treat urgently; this causes sweating down to the feet without harming the Zang organs. Treat swiftly within four to five days. Yong in the axilla that is red and hard is called Mi Ju (Rice Carbuncle). Treat with Bian stones (lancets), which should be fine and long, prick sparsely, apply Pig Fat Ointment, recover in six days, and do not bandage. If the Yong is hard and unbroken, it is Ma Dao Jia Ying (Horse Knife with Pendant), requiring urgent treatment. Yong in the chest is called Jing Ju (Well Carbuncle). Like a soybean, appearing in three to four days; if not treated early, it descends into the abdomen. Untreated, death occurs in seven days. Yong in the precordium is called Gan Ju (Sweet Carbuncle). Green in color, shaped like grain kernels, painful, suffering from alternating chills and fever. Treat urgently to remove chills and fever; untreated, death occurs in ten years, with pus discharging post-mortem. Yong in the hypochondrium is called Bai Ci. This is a disease specific to women. Apply moxibustion, which may cause a large abscess with pus. Treatment involves generating flesh, sized like a adzuki bean. Use one sheng each of Coptis chinensis root (Qiao Gen) decocted in 16 sheng of water to yield 3 sheng. Drink strongly, wear thick clothes, sit over a pot to induce sweating down to the feet for recovery. Yong in the thigh and calf is called Gu Ting Ju. Appearance changes little, but pus binds to bone. Untreated, death occurs in thirty days. Yong on the buttocks is called Rui Ju. Red, hard, and large. Treat urgently; untreated, death occurs in thirty days. Yong in the medial thigh is called Chi Shi. Untreated, death occurs in sixty days; if untreated within two months, death occurs in ten days. Yong on the knee is called Ci Yong. Large swelling, color unchanged, cold/heat sensation like hard stone. Do not lance; lancing leads to death. Wait until soft before lancing to ensure survival. Yongju arising at joints with corresponding symptoms are untreatable. Those arising in Yang aspects die in one hundred days; those in Yin aspects die in thirty days. Yong on the shin is called Tu Nie (Rabbit Bite). Redness extends to bone. Treat urgently; untreated, it harms the person. Yong on the medial malleolus is called Zou Huan. It appears as a Yong, color unchanged. Repeatedly lance the Shu points to stop chills and fever; death does not ensue. Yong on the top and bottom of the foot is called Si Yin. Large swelling. Treat urgently; death occurs in one hundred days. Yong on the side of the foot is called Li Yong. Not large, initially like a small finger protrusion. Treat urgently, remove blackened tissue. If not resolved and increases, untreated death occurs in one hundred days. Yong on the toes is called Tuo Yong. Red-black indicates fatal untreatable condition; non-red-black is not fatal. If it does not recede, amputation is urgent; otherwise, death ensues.
In the *Yuban Pian*: The Yellow Emperor asked: At the onset of disease, there are unpredictable emotions, irregular diet, insufficient Yin Qi, excess Yang Qi, and blocked Ying Qi flow, leading to Yongju. Yin and Yang are obstructed, two Heats clash, forming pus. Can small needles achieve this? Qibo replied: Treating minor issues with small needles yields minor results; treating major issues with large needles causes much harm. Therefore, for established pus and blood, only Bian stones and Pi Feng (scalpels) are suitable. The Yellow Emperor asked: Can those with much harm be fully cured? Qibo replied: It depends on Ni (Rebellious/Ominous) and Shun (Smooth/Favorable) patterns. Signs of injury include: white eyes with blue/black sclera and small pupils (First Ni); vomiting after taking medicine (Second Ni); abdominal pain with extreme thirst (Third Ni); stiffness in shoulders and nape (Fourth Ni); hoarse voice and sallow complexion (Fifth Ni). Excluding these five constitutes Shun.
In the *Hanre Bing Pian*: The five body parts associated with the Zang organs are: Futu (one), Calf (two), Back (three, where Zang Shu points are located), Shu points (four), and Nape (five). Yongju in these five parts leads to death. Harm from acupuncture: if needled correctly but left, essence leaks; if needled incorrectly and removed, Qi gathers. Essence leakage worsens disease and emaciation; Qi gathering generates Yongju.
The *Shengqi Tongtian Lun* states: Sweating followed by exposure to dampness generates Cuo Fei (miliaria/acne). Pathogens sinking into meridians cause fistulas, lingering in muscle intervals. Overeating after sweating causes sinews and vessels to relax horizontally, leading to hemorrhoids.
The *Yinyang Bie Lun* states: Disease of the Three Yang channels presents with chills and fever, and lower body swelling (Yongzhong).
The *Qixue Lun* states: Large muscle gatherings are Gu (valleys), small ones are Xi (streams). Interstices between muscles are where Ying and Wei circulate and Great Qi converges. If pathogen overflows and Qi stagnates, vessels heat and flesh fails, Ying and Wei cease, leading to pus. Internally consuming marrow, externally rupturing collaterals, remaining at joints, leads to decay. Accumulated cold stays, Ying and Wei do not reside, muscles roll up and sinews shrink, elbows and ribs cannot extend, internally Bi syndrome of bones, externally insensitivity, termed insufficiency, caused by great cold remaining in Xi Gu.
The *Cijie Zhenxie Lun* states: Deficient pathogen invading causes shivering, moving the form, raising hair follicles and opening pores. Deep invasion clashing with bone causes Bone Bi; with sinews causes cramping; with vessels causes blood closure, obstruction leading to Yong. Deep invasion of deficient pathogen, cold clashing with sinews, lingering internally, cold overcoming heat causes bone pain and internal dryness; heat overcoming cold causes rotten flesh and muscle pus, internal bone damage leading to Bone Shi (erosion). Pre-existing tendon disease with flexion inability allows pathogen residence, causing Jin Liu (tendon tumor). Qi accumulation leads to Wei Qi retention, fluid stasis, forming Chang Liu (intestinal tumor). Long-standing soft masses are Xi Liu. Hard deep masses involving bone are Gu Ju (bone carbuncle). Flesh masses with Zong Qi involvement and heat become pus (Nong); without heat become Rou Ju (flesh carbuncle). These Qi types have no fixed location but fixed names.
The *Jiaobi Da Lun* states: Excessive Fire year causes body heat, bone pain, and spreading sores. Excessive Metal year causes hypochondriac/lower abdominal pain, red/painful eyes and sores, deafness. Insufficient Wood year with rebound heat/dryness causes cold/heat sores, miliaria, and acne. Insufficient Metal year with cold rain causes mouth ulcers. Insufficient Water year causes cold sores with flowing fluid.
The *Wuchang Zheng Da Lun Pian* states: Wei Ji (weak harmony) causes limb paralysis, swelling, sores. Bei Jian (low supervision) causes ulceration, swelling, rupture. He Xi (blazing sun) causes laughter, malaria, sores. Jian Cheng (firm completion) causes sudden fracture, sores, infection. Shaoyang ruling Heaven with descending Fire causes nasal obstruction and sores. Taiyang ruling Heaven with descending Cold causes dorsal edema and sores. Shaoyin ruling Heaven with descending Heat causes severe sores. High altitudes are cold causing distension; low altitudes are hot causing sores. Distension resolves with purgatives; sores resolve with diaphoretics.
Classic says: All pain, itching, and sores belong to Heart Fire.
Classic says: All swelling, cramping, and tube-like pain are due to Cold swelling and Eight Winds variations.
Classic says: Where pathogen gathers, Zheng Qi is deficient; adhering and not departing makes the pathogen excess.
Also: Ying Qi not following its course, reversing in flesh, generates swelling. (Ying reversal causes blood stasis, Qi stasis causes heat aggregation into pus, hence swelling.) Heat passing through also causes swelling. (Heat excess causes internal Yang stagnation, acute edema, Ying reversing in flesh, aggregating into pus swelling.)
Also: Cold damages Form, Heat damages Qi. Qi damage causes pain, Form damage causes swelling. Heat Yang結s in flesh causing pain; Cold damages Form, thinning skin/collagen, causing hardness and swelling. Pain then swelling means Qi injured first, then Form; swelling then pain means Form injured first, then Qi. Form present but painless indicates Yang damage; Form absent but painful indicates Yin damage. Sweating followed by cold water bathing traps Heat internally and condenses Dampness, causing severe acne/furuncles or mild miliaria. Yang insecurity allows pathogen into Xian Mai (sunken meridians), where Cold accumulates, blood stagnates, attacking internally, forming Shu Lou (scrofula).
Also: Rich foods generate large Ding.
Also: Five Zang disharmony blocks nine orifices; Six Fu disharmony leaves knots forming Yong. High/soft sores arise from blood vessels; low/hard sores from sinews/vessels; unchanged color from bone marrow. Differentiate Qi/Blood deficiency/excess and Heat toxin depth. Do not assume all swelling is excess Heat and use purgatives blindly. Yang sores are red/swollen/high; Yin sores are blue/white/depressed. Ju attaches to bone/sinew, relying on Blood/Qi. Classic: Qi warms, Blood moistens. If Yuan Qi is damaged and cannot warm/moisten, depression occurs without suppuration, allowing internal attack.
Classic: Sky Northwest is cold/cool; Earth Southeast is warm/humid. Southeast is Yang, Yang essence descends, right hot/left humid. Northwest is Yin, Yin essence ascends, left cold/right cool. Distension from cold resolves with purgatives; sores from heat/damp resolve with sweating. In humans, Southeast corresponds to Small Intestine Heat and Gallbladder Wind, both flaring upward. Sores here have Six Channels exterior signs but no interior blockage, normal diet/urine, indicating exterior non-Ju. Small sores are Jie, large are Yong. Pathogens come from wind/damp externally. Classic: Ying reversal in flesh causes swelling. All sores pain/itch belong to Heart Fire. Exterior entry moves Small Intestine to Gallbladder, causing pain not itch. Both sides involve Blood pathology and pain due to insufficient Yuan Qi and Ying reversal. Initially superficial in muscle/skin, affecting Wind-Heat Six Channels meridians. Clear Wind-Damp-Heat. Physicians knowing Yin restores Yang might use sweating; here, sweating clears Damp-Heat stagnating in Hand-Foot Shaoyang, resolving blood vessel reversal and Wei-Ying blockage, strengthening Yuan Qi. Wind-Damp-Heat stagnating lower causes red/swollen/dull face. Wind-Water rushes up with anger. Sores here are red/swollen/dull, hot/high/hard/painful. Pulse confined to Left hand (Exterior). Left Cun is surging/slow/Yin, indicating exterior pathogen in vessels/skin. Urgent sweating to open Ying-Wei expels pathogen. Use Neituo Yingwei Tang.
Classic: Fine pulse, cold skin, diarrhea/constipation, poor appetite constitute Five Deficiencies, most contraindicated in sores.
Zhang Zhongjing said: Yongju is hardest to treat; exterior form not yet visible, interior acupoints already溃 (ulcerated). Ancients said: Exterior like bean, interior like fist; exterior like fist, interior like plate. Truly accurate.
Liu Hejian said: Near fire, slight heat causes itch, intense heat causes pain, close contact burns causing sores—all Fire functions. Itch/pain like needle pricks resembles flying sparks. Doubt arises: if all sores are Fire, why pus/water? Like grains/meat/fruit, extreme heat rots them into sewage; extreme Heat reverses to Water transformation.
Li Dongyuan said: Ju begins like millet, varying itch/pain. Touching breaks it, spreading sides red/swollen/heavy, pulling hypochondriac pain. Days later, skin hot, aversion to cold, vexation/thirst, swelling spreads, pus flows, days pass without breaking, pressing bleeds—called Faback Ju. Ju on head is Brain Ju; on beard/brows named accordingly. Headless, wide swelling 3-4 cun, heavy/painful, smooth/soft skin, with chills/fever/headache/thirst is Faback Yong. Single head, floating red/rootless, 1-2 cun, is Jie. Among these, Ju is heaviest. Caused by rich food/clothing. Thick clothes attract Cold externally; rich food generates Heat internally. Organ Heat blocks vessels, toxin stagnates, pathogen hides, Heat binds Blood, Blood gathers flesh rots into sore. Superficial is Jie, solid is Yong, deep is Ju. Also caused by mineral drugs or parental transmission of toxins. Recognize Ju early and treat quickly. (*Ten Books*)
Also: Sore afflictions, none greater than Yongju. How to distinguish? Classic: Ying-Wei滞留 in sinews/vessels causes涩 (viscosity) and blockage, Yang Qi depressed causing chills/fever, foul toxin emerging, accumulating as Yong. Long-term unresolved, Heat rots it to pus, but marrow/organs intact, curable. What is Ju? Five Zang Wind-Toxin accumulated Heat, intense, sinking into skin/marrow, marrow drying, Blood/Qi exhausted. Swelling pale/hard like ox neck skin, hence Ju. Yong has thin/shiny skin. Yongju arises internally (organs) or externally (skin/bone). Fixed names, shifting locations. Stagnation starts from irregular emotions/diet/lifestyle/mineral drugs/climate, causing Yin-Yang imbalance accumulating externally, Ying-Wei viscosity rotting. Light cases start in Six Fu, floating as Yong (Qi floats in meridians); heavy cases start in Five Zang, sinking as Ju (Qi sinks in meridians). Understand these two, and other rashes/swellings can be inferred.
Also: Many sore symptoms require method to distinguish depth. Without knowledge, guessing is like a carpenter abandoning rules. Ancients said: Much confuses, little gains. Briefly, three types: High/soft = blood vessels; Low/hard = sinews/bones; Unchanged skin color = bone marrow.
Also: Press/shake sore. Firm/large root = deep; small/floaty root = shallow. Check patient: initial high fever/chills/headache/restlessness/thirst indicates deep Yongju. Peaceful daily life/diet indicates shallow. Evil sore starting like millet, slight itch/pain, broken accidentally spreads deep. Quickly administer Xijiao Tang, Loulu Tang, Tongqi Wan for unblocking, plus Yud Tang compresses. Shallow sores heal with plasters. Depth distinction is primary.
Also: Heat in skin/hair causes small-root swelling <2-3 cun = Jie. Six Fu Heat rising to muscle causes sudden large/glossy/soft swelling = Yong. Five Zang Wind-Heat attacking bone/muscle, fierce toxin, single head like millet, white/dry/painful = Ju. Yong in Six Fu is like prairie fire, external erosion; Ju in Five Zang is like kiln fire, internal marrow consumption. Yong easy to treat but slow recovery; Ju hard to treat but easier recovery once started. Jie/Sore initial stage benefits from moxibustion to guide Heat. Ju requires cauterization, not moxibustion, due to deep root. External sores stem from internal Heat-Toxin. Understand these three, others follow. Skin slightly raised/thick, moving pain/itch = Zhong (swelling). Due to Wind or Wind-Heat. Long-standing Heat exceeds Wind, blood stagnation combines with Qi to form pus.
Also: More Wind = itch; more Heat = pain. Verified.
Also: Yongju patients must avoid anger/stress, as touching/agitation often leads to pus formation and breakdown.