凡疮口黑晕而无血色者，乃凉药太过，宜用冲和膏加肉桂、当归，温活死血，则
黑晕自退也。如颜色未撤消，仍以冲和膏敷之。
夫疮之始发，肉色未辨，经络初滞之时，宜表散，以托里之剂，使经络易通，而
毒瓦斯亦散，则毒瓦斯引令外出，为顺。《内经》云∶汗之则疮已。俾营卫通行，妙在
斯矣。有等庸俗之人，不知斯理，而自高傲，强自内疏，不知脉浮在表之理，反使
邪毒内罨，如伤寒证，当汗而误下之义同。以致外如麻而里如瓜，憎寒壮热，邪已内
攻，惟有急以蒜灸以接其阳，引毒外出，更以托里大剂治之，或有可生者。常见有疮
疥之人，熏燃捻子等药，亦令入内，俱自取伤生之祸尔。
夫疮疡面赤，虽伏大热，禁不得攻里，为阳气怫郁，邪气在经，宜发表以去之。故
曰∶火郁则发之。虽大便秘结，只宜多发其表，以发散阳火，少加润燥之药。若见
风脉、风证，只可用发表风药，便可以通利也。若只干燥秘涩，只宜润之，亦不可下。
凡患疮疡，或泄泻，或出汗，或不进饮食，或夜不寐，宜先治内证，内证一愈，
则外证易痊，此乃急则治标之法，膏围二药，仍照旧用之，勿缺。
东垣云∶夫痈疽得之有内外之别，治之有寒温之异，受之外者，法当托里以温，
若反用寒药，则是以皮毛之邪，引入骨髓矣。受之内者，法当疏利以寒，若反用温
剂托里，则是以骨髓之病，上彻皮毛矣。是必表里通溃，共为一疮，助邪为毒，苦楚
百倍，轻则令危，重则死矣。
凡是疮口出现黑色晕圈且没有血色，这是因为寒凉药物使用过度所致，应当使用冲和膏加入肉桂、当归，以温通并活化停滞的死血，这样黑晕自然就会消退。如果颜色仍未消散，继续用冲和膏外敷即可。
疮疡在刚开始发作时，肌肉颜色尚未分明，经络初现阻滞之时，适宜采用解表发散的方法，配合托里（扶助正气、透达毒邪）的药剂，使经络容易通畅，毒邪随之消散，从而引导毒邪向外排出，这是顺证。《黄帝内经》说：“发汗则疮疡可愈。”其奥妙在于使营气与卫气通行无阻。然而有些平庸俗气的医生，不懂这个道理，却自视甚高，强行使用内疏（攻下通便）的方法，不懂得脉象浮起代表病邪在表的道理，反而导致邪毒郁闭在内，这与伤寒证应当发汗却误用攻下法的含义相同。这会导致外表看似轻微如麻疹，内部却严重如瓜实胀满，出现怕冷和高热，邪气已经向内攻陷，此时只有紧急使用蒜灸法来接续阳气，引导毒邪外出，再加大剂量使用托里方剂治疗，或许还有生机。常见患有疮疥的人，使用熏燃捻子等药物，也往往导致药力内入，这都是自取伤害生命的灾祸。
疮疡患者面部发红，虽然体内潜伏着大热，但严禁使用攻下里的方法，因为这是阳气被郁遏、邪气在经络所致，适宜用发表（解表）的方法来祛除它。所以说：“火郁结则应发散它。”即使大便秘结，也只宜多从表面发散，以疏散阳火，少量加入润燥的药物。如果见到风脉、风证，只可用发表祛风的药物，就可以达到通利的效果。如果只是单纯的干燥秘涩，只宜润燥，也不可使用攻下法。
凡是患疮疡的人，如果出现泄泻、出汗、不能进食或夜间失眠等症状，应当先治疗内部的证候，内部证候痊愈后，外部疮疡就容易康复，这是“急则治标”的方法，外用膏药和围药仍然按照旧例使用，不可缺失。
李东垣说：痈疽的发生有内部和外部的区别，治疗上有寒法和温法的不同。感受外部邪气的，治疗方法应当是托里兼用温法；如果反而使用寒凉药物，那就是将皮毛的邪气引入骨髓了。感受内部邪气的，治疗方法应当是疏利兼用寒法；如果反而使用温补剂托里，那就是将骨髓的病邪上透到皮毛了。这种情况必然导致表里同时溃烂，合为一个疮口，助长邪气成为剧毒，痛苦百倍，轻则导致危重，重则死亡。
Wherever the ulcer opening presents with a black halo and lacks blood color, it is due to the excessive use of cooling herbs. It is advisable to apply Chonghe Gao (Harmonizing Ointment) augmented with Rougui (Cinnamon Bark) and Danggui (Angelica Sinensis) to warm and revitalize stagnant dead blood, whereupon the black halo will naturally recede. If the discoloration persists, continue applying Chonghe Gao externally.
When an ulcer first erupts, and the flesh color is indistinct while the meridians are initially obstructed, it is appropriate to employ exterior-releasing methods combined with formulas that support the interior (tonifying qi and expelling toxins), thereby facilitating the unblocking of meridians and dispersing toxic pathogens. This guides the toxins outward, constituting a favorable progression. The *Neijing* states: "Sweating cures ulcers." The subtlety lies in ensuring the smooth circulation of Ying (Nutritive Qi) and Wei (Defensive Qi). However, some mediocre practitioners, ignorant of this principle yet arrogant, forcibly resort to internal purgation. They fail to understand that a floating pulse indicates pathology at the exterior, inadvertently causing the entrapment of evil toxins within. This parallels the error in treating Taiyang disease (Exterior Syndrome) by mistakenly using purgatives when sweating is indicated. Such errors result in a condition where the exterior appears mild like miliary rash, while the interior becomes distended like a melon, accompanied by aversion to cold and high fever, indicating that the pathogen has attacked inward. In such cases, only urgent application of garlic moxibustion can reconnect Yang Qi and guide toxins outward, followed by large doses of interior-supporting formulas; survival may still be possible. It is commonly observed that patients with sores and scabies using fumigating or burning thread-like medicaments often suffer from internal penetration of these agents, bringing about self-inflicted harm and death.
In cases of carbuncles and sores where the face is red, despite the presence of latent intense heat, internal purgation is strictly prohibited. This is because Yang Qi is constrained and the pathogen resides in the meridians; thus, exterior-releasing methods should be used to dispel it. Hence it is said: "What is constrained by fire must be dispersed." Even if constipation occurs, one should primarily focus on releasing the exterior to dissipate Yang-fire, adding only a small amount of moistening and drying-relieving herbs. If wind-pulse or wind-symptoms are present, only exterior-releasing wind-dispelling herbs should be used to achieve unblocking and free flow. If there is merely dryness and constipation, moistening is appropriate, but purgation remains contraindicated.
For patients suffering from carbuncles and sores who exhibit diarrhea, sweating, anorexia, or insomnia at night, internal syndromes should be treated first. Once the internal condition resolves, the external lesions will heal more easily. This exemplifies the principle of "treating the branch in acute situations." External applications, such as plaster rings and surrounding medicines, should continue to be used according to established protocols without omission.
Li Dongyuan stated: Carbuncles and gangrene have distinctions between internal and external origins, and their treatments differ between cold and warm approaches. For those caused by external factors, the method should involve supporting the interior with warm properties. Conversely, using cold herbs would draw the pathogen from the skin and hair follicles into the bone marrow. For those caused by internal factors, the method should involve draining and promoting movement with cold properties. Conversely, using warm tonics to support the interior would drive the disease from the bone marrow up to the skin and hair follicles. Such scenarios inevitably lead to simultaneous ulceration of both interior and exterior, merging into a single wound, assisting the evil to become highly toxic, resulting in hundredfold suffering. Mild cases become critical, and severe cases result in death.