李东垣曰∶夫疮疽之候，证候不一，针烙之法，实非小端。盖有浅有深，有迟有
速，宜与不宜，不可不辨。盖疽肿皮浓口小，肿多脓水出不快者，宜用针烙，疖皮
薄，惟用针以决其脓血，不可烙也。如有未成脓以前，不可以诸药贴 ， 渍救疗，
以待自消。久久不消，内溃成脓，即当弃药，从其针烙。当用火针，如似火筋，磨
令头尖，如枣核样圆满，用灯焰烧须臾，作炬数温油，烧令赤，于疮头近下烙之。一
烙不透，即须再烙令透，要在脓水易出，不假按抑。近代良医，仓卒之际，但以金银
铁锭其样如针者可通用之，实在泄其毒也。或只以木炭熟火，猛烧通赤，蘸油烙之尤
妙。烙后实者捻发为 ，虚者以纸为 ，上蘸药 之，上以帛摊，温热软粘膏药贴之。
常令滋润，勿令燥也。夫疮疽既作，毒热聚攻，蚀其膏膜，肌肉腐烂，若不针烙，毒
气无从而解，脓瘀无从而泄，过时不烙，反攻其内，内即消散，欲望其生，岂可得乎！
嗟乎！此疾针烙取差，实为当理，然忌太早，亦忌稍迟。尝见粗工，不审其证浅深，
妄施针烙之法，或疮深针浅烙，毒瓦斯不得泄，以致内溃。或疮浅烙深，误伤良肉，筋
骨腐烂；或抑擦掀动，益加烦痛；或针之不当，别处作头；或实时无脓，经灸方溃，
遂使痛中加痛，真气转伤，详其所由，不遇良医也。以此推之，凡用医者，不可不
择，纵常医疗之得痊者，幸矣。（《十书》）
蒋示吉曰∶又有烙法，脓已成而皮浓肉深难溃，若不用针烙，使腐肉挟毒热之
气，久留肉腠间，将好肉亦化为脓血，此烙法所以有功于溃疡也。若根浅而皮薄者，
又何必假此以卖弄乎！由此观之，皮薄者用白降丹，皮稍浓者，则用针，皮极浓而
毒附骨者，非烙不可。其法看疮头最大者，即是脓窍，用熟铁五六寸长大针，下半截
用竹箸劈开，夹针在内，以意消息。用半寸即露针尖半寸于外。用一寸即露针尖一
寸于外。以线扎紧，庶深浅不致有误也。将针于麻油灯火上烧令红透，量疮深浅及所
生之处，深浅虚实，插入一寸或至二三寸，若未有脓，临时以纸捻 入，候次日取出。
脓色黄白即愈，赤黑防出鲜血。若在虚处，及筋骨节缝处。不得乱行针烙。针烙入肉，
犹宜稍斜，恐透内膜也。烙迟固为不佳，太早亦生变证，脓深针浅，内脓不出，外血
反泄，疮浅针深，内脓虽出，好肉受伤，此用针烙之难也。（《说约》）
申斗垣曰∶顽疖疮瘤妒其脓，半载医治不得愈者，当用烙法，烙之易愈也。
周文采曰∶夫顽疖疮瘤妒其脓，半载整年不得愈者，何也？盖于男妇不慎房欲，
故多有之，小儿亦因吮其欲乳，更是一理
也。亦有因跌撞妒其脓血，未及将愈，又跌之，故此成其顽疖。不能得愈，百药不
效，当用银钱、银匙烧赤，于疖上烙之，不数日而痊，先勿令知之。此真良法也。如
无银钱，以铜钱代之，亦可。
胡公弼曰∶凡火烙针圆如箸，大如苇，挺头圆平长六七寸，一样二枚，蘸香油于
炭火中烧红，看疮头形处烙之，宜斜入向软处一烙，不透再烙，必得脓。非其时所
出皆生血，当其时所出黄脓瘀肉。不假按抑，仍以纸捻 之，勿令口合。
又曰∶凡疮毒发在虚处，及筋脉骨节之处、断不可乱行针烙，即用针烙法，宜
稍斜防透膜也。
李东垣说：疮疽的证候，表现不一，针烙疗法，确实不是小事。因为操作有浅有深，有快有慢，适宜与不适宜的情况，不可不仔细辨别。大概疽肿皮肤厚、口小，肿胀多且脓水排出不畅的，适宜用针烙；疖子皮肤薄，只需用针穿刺排出脓血，不可用火烙。如果有尚未成脓之前，不可以用各种药物贴敷、浸泡来救治，而应等待其自行消散。如果久久不能消散，内部溃烂成脓，就应当放弃药物治疗，改用针烙。应当使用火针，形状像火筋一样，磨得头部尖锐，呈枣核般圆满的样子，在灯焰上烧片刻，蘸几温热的油，烧至通红，在疮头近下方进行烙治。一次烙透不了，就必须再次烙直至穿透，关键在于让脓水容易流出，不需要借助按压。近代的好医生，在匆忙之际，只要是用金银铁锭做成类似针形状的都可以通用，这实在能泄出毒气。或者只用木炭熟火，猛烈烧至通红，蘸油进行烙治尤其妙。烙后，体质实的人用头发捻成线状，虚的人用纸捻成线状，上面蘸药涂抹，再用帛摊开，贴上温热软粘的膏药。常令患处滋润，不要让它干燥。既然疮疽已经发作，毒热聚集攻冲，腐蚀膏膜，肌肉腐烂，如果不进行针烙，毒气没有途径解除，脓瘀没有途径排泄，过时不进行烙治，反而攻入体内，内部就会消散，想要指望生存，怎么可能呢！唉！这种病通过针烙取得痊愈，确实是合理的道理，然而忌讳太早，也忌讳稍晚。我曾见过粗劣的工匠，不审察证候的深浅，妄施针烙之法，有的疮深针浅烙，毒气不得排泄，导致内部溃烂。有的疮浅烙深，误伤好肉，筋骨腐烂；有的按压摩擦掀动，更加烦痛；有的针法不当，别处形成疮头；有的当时没有脓，经过灸后才溃破，于是使痛苦中增加痛苦，真气转而受伤，详细探究其原因，是没有遇到良医。由此推断，凡是使用医者，不可不选择，即使平常医疗得以痊愈的，也是侥幸罢了。（出自《十书》）
蒋示吉说：又有烙法，脓已成但皮肤厚、肌肉深难以溃破，如果不用针烙，使腐肉挟带毒热之气，长久留在肉腠之间，将好肉也化为脓血，这就是烙法对溃疡有益的原因。如果根基浅而皮肤薄的，又何必假借这种方法来卖弄呢！由此看来，皮肤薄的用白降丹，皮肤稍厚的，则用针，皮肤极厚且毒气附着于骨的，非烙不可。其方法是看疮头最大的，就是脓窍，用长五六寸的熟铁针，下半截用竹筷子劈开，夹住针在里面，凭心意调节。用半寸即露出针尖半寸在外面。用一寸即露出针尖一寸在外面。用线扎紧，这样深浅就不会有误。将针在麻油灯火上烧至红透，根据疮的深浅及所生之处，判断深浅虚实，插入一寸或至二三寸，如果没有脓，临时用纸捻塞入，等到次日取出。脓色黄白即愈，赤黑防备流出鲜血。如果在虚处，以及筋骨节缝处，不得乱行针烙。针烙入肉，还应当稍微倾斜，恐怕穿透内膜。烙迟固然不好，太早也会产生变证，脓深针浅，内部脓出不来，外部血反而泄露，疮浅针深，内部脓虽出来，好肉受伤，这就是用针烙的难点。（出自《说约》）
申斗垣说：顽固的疖疮肿瘤妒其脓，半年医治不得痊愈的，应当用烙法，烙之容易痊愈。
周文采说：顽固的疖疮肿瘤妒其脓，半年整年不得痊愈的，为什么呢？大概因为男女不慎房事欲望，所以多有此病，小儿也因吮吸带有欲气的乳汁，也是一样的道理。也有因跌撞导致妒其脓血，还没来得及痊愈，又跌倒，因此成为顽疖。不能痊愈，百药无效，应当用银钱、银匙烧红，在疖子上烙治，不几天就痊愈，事先不要让患者知道。这真是良法。如果没有银钱，用铜钱代替，也可以。
胡公弼说：凡火烙针圆如筷子，大如芦苇杆，挺头圆平长六七寸，同样的两枚，蘸香油在炭火中烧红，看疮头形状的地方烙治，宜斜入向软处一烙，不透再烙，必须得到脓液。非其时（未成脓时）所出的都是生血，当其时（成脓时）所出的是黄脓瘀肉。不需要按压，仍以纸捻引流，不要让疮口闭合。
Li Dongyuan stated: The manifestations of sores and carbuncles vary, and the methods of needling and cauterization are indeed significant. There are variations in depth (shallow or deep) and speed (fast or slow); one must carefully distinguish between what is appropriate and what is not. Generally, for carbuncles with thick skin and small openings, where swelling is extensive and pus drainage is sluggish, needling and cauterization are suitable. For boils with thin skin, only needling to drain pus and blood is required; cauterization should not be used. If before suppuration occurs, one should not rely on various medicinal pastes or soaks to treat it, waiting for spontaneous resolution. If it persists without resolving and internally suppurates, medication should be abandoned in favor of needling and cauterization. One should use a fire needle, shaped like a fire rod, ground to a sharp, round tip resembling a jujube pit. Heat it briefly over a lamp flame, dip it in warm oil several times, heat until red-hot, and cauterize near the lower part of the sore head. If one application does not penetrate, repeat until penetration is achieved. The key is to facilitate easy pus drainage without relying on pressure. In recent times, skilled physicians, in urgent situations, can generally use needles made of gold, silver, or iron rods similar in shape, which effectively drains toxic qi. Alternatively, heating charcoal until red-hot and dipping it in oil for cauterization is particularly excellent. After cauterization, for patients with excess conditions, twist hair into a thread; for deficiency conditions, twist paper into a thread. Apply medicine to the thread, cover with cloth, and apply a warm, soft, sticky plaster. Keep the area moist and avoid dryness. Once sores and carbuncles arise, toxic heat gathers and attacks, eroding the fascia and causing muscle rot. Without needling and cauterization, toxic qi has no outlet, and pus stagnation cannot be drained. If cauterization is delayed, the pathogen may attack internally, leading to internal dissolution. To hope for survival under such circumstances is impossible! Alas, while using needling and cauterization to cure this disease is reasonable, one must avoid acting too early or too late. I have seen incompetent practitioners who fail to assess the depth of the condition and recklessly apply these methods. Sometimes the sore is deep but the needle/cautery is shallow, preventing toxin discharge and causing internal ulceration. Sometimes the sore is shallow but the cautery is deep, injuring healthy flesh and causing bone and tendon rot. Sometimes pressing or rubbing exacerbates pain. Sometimes improper needling causes new sores to form elsewhere. Sometimes there is no pus initially, and only after moxibustion does it ulcerate, adding pain to pain and damaging true qi. Investigating the cause, it is due to not encountering a skilled physician. Therefore, when seeking medical treatment, one must choose carefully. Even if ordinary treatment leads to recovery, it is merely luck. (From *Ten Books*)
Jiang Shiji said: There is also a cauterization method. When pus has formed but the skin is thick and muscles deep, making spontaneous rupture difficult, if needling and cauterization are not used, the necrotic tissue carrying toxic heat will remain in the interstices for a long time, turning healthy flesh into pus and blood. This is why cauterization benefits ulcerative lesions. However, for those with shallow roots and thin skin, why resort to this method? From this perspective, for thin skin, use White Reduction Paste; for slightly thicker skin, use needling; for extremely thick skin with toxins adhering to the bone, cauterization is indispensable. The method involves identifying the largest sore head as the pus aperture. Use a five-to-six-cun long熟 iron needle. Split the lower half of the needle with a bamboo chopstick to clamp the needle inside, adjusting by intent. If inserting half a cun, expose half a cun of the needle tip outside. If inserting one cun, expose one cun of the tip. Tie tightly with thread to ensure accurate depth. Heat the needle red-hot over a sesame oil lamp. Based on the depth and location of the sore, judge the depth and deficiency/excess status, and insert one cun or up to two or three cuns. If no pus is present, temporarily insert a paper wick and remove it the next day. Yellow-white pus indicates healing; red-black pus warns of potential bleeding. Do not perform needling or cauterization randomly in deficient areas or at joints/tendon-bone interfaces. When inserting needles or cauterizing, angle slightly to avoid penetrating internal membranes. Delayed cauterization is bad, but too early also causes complications. Deep pus with shallow needling prevents internal pus drainage but causes external bleeding. Shallow sores with deep needling allow internal pus drainage but injure healthy flesh. This illustrates the difficulty of using needling and cauterization. (From *Shuo Yue*)
Shen Douyuan said: For stubborn boils, tumors, or abscesses that have not healed after six months of treatment, cauterization should be used, as it facilitates quicker healing.
Zhou Wencai said: Why do stubborn boils, tumors, or abscesses persist for half a year or a year? It is often due to men and women failing to control sexual desire. Children may also contract it through sucking milk from mothers with such conditions. Another cause is trauma, such as falling or bumping, which disrupts the pus and blood before healing is complete, resulting in a stubborn boil. When hundred medicines fail, one should use silver coins or silver spoons heated red-hot to cauterize the boil. Recovery occurs within a few days. Inform the patient beforehand. This is a truly excellent method. If silver coins are unavailable, copper coins can be substituted.
Hu Gongbi said: Fire cauterization needles should be round like chopsticks, thick like reeds, with a flat, round tip 6-7 cun long. Two identical needles are used. Dip them in sesame oil and heat red-hot in charcoal fire. Cauterize the area corresponding to the sore head's shape. Insert obliquely towards the softer area. If not penetrated, cauterize again until pus is obtained. Discharge occurring out of season (before suppuration) is fresh blood; discharge occurring in season (during suppuration) is yellow pus and necrotic tissue. No pressure is needed. Use paper wicks for drainage and prevent the wound opening from closing.
He also stated: For toxic sores arising in deficient areas or at tendon-muscle-bone-joint sites, absolutely do not perform random needling or cauterization. If these methods are used, they should be angled slightly to prevent membrane penetration.