代指俗名 爪，生指甲身之内。三、四日后，甲面上透一点黄色。初起先肿 热，
疼痛应心，宜用甘草、朴硝各五钱，煎汤浸洗即瘥。如甲面透黄，即系内脓已成，但无路得
泄，须用线针在指甲身就脓近处挑一小孔，脓方得出；随后轻手挤尽余脓，用黄连膏贴之易
愈。若失治，以致脓毒浸淫好肉，爪甲溃空，必然脱落。宜用琥珀膏贴之，日久收功。
蛀节疔，又名蛇节疔，生于手指中节接骨处，绕指俱肿，其色或黄或紫。由火毒凝结而
成。治同疔疽。
鳅肚疔者，一名蛇腹疔。生于手指中节里面，形如鱼肚，故又名鱼肚毒。一指通肿 热
，痛连肘臂。由辛热风湿之毒，上干心经，故发此毒，乃心经受证也。但中指通连五指，若
中指疔色紫黑者，其毒必恶，易于攻心；心若受毒，即呕吐不食，神识昏迷，而为不治之证
矣。务用护心丹时时呷之，再服夺命丹以追其毒。余治同疔疽。
夫失营马刀，一为不可治，一为可治，以患处部位相同而形又相似，故并而论之。失营
者，由肝阳久郁，恼怒不发，营亏络枯，经道阻滞，如树木之失于荣华，枝枯皮焦故名也。
生于耳前后及项间，初起形如栗子，顶突根收，如虚痰 瘤之状，按之石硬无情，推之不肯
移动，如钉着肌肉者是也。不寒热，不觉痛，渐渐加大；后遂隐隐疼痛，痛着肌骨，渐渐溃
破，但流血水无脓，渐渐口大内腐，形似湖石，凹进凸出，斯时痛甚彻心，胸闷烦躁，是精
神不收，气不 纳也；随有疮头放血如喷壶状，超时而止。体怯者，实时而毙；如气强血能
来复者，亦可复安。若再放血，则不能久矣（亦有放三、四次而毙者，余曾见过）。此证为四
绝之一，难以治疗。若犯之者，宜戒七情，适心志；更以养血气、解郁结之药，常常服之，
庶可绵延岁月，否则促之命期已。其应用之方，如加味逍遥散、归脾汤、益气养营汤、补中
益气汤、和营散坚丸等，酌而用之可也。
马刀由肝胆二经郁逆气火所结，亦生在颈项间，其形长而坚硬，按之有情，甚有连发累
累，沿至胁下胸前者，亦恶证也。倘患者能使情怀舒畅，调养得宜，治之以疏肝散邪、和营
软坚，则可于半载一年之内而获全愈。设不能自爱，又或境遇不齐，证则有增无减，绵延日
久，疮头破烂，脓血大溃，肿势愈坚，遂成损怯而毙者多矣。然究非若失营之不可治也。故
合二证而论之，以明其生死不同如此。用药与瘰 同。
代指，俗称“爪”，生于指甲内部。三、四天后，指甲表面透出一点黄色。初起时先出现肿胀、发热，疼痛直达心脏（形容疼痛剧烈），适宜用甘草、朴硝各五钱，煎汤浸泡清洗即可痊愈。如果指甲表面透出黄色，说明内部脓液已经形成，但缺乏排出的通道，必须用线针在指甲内靠近脓液处挑开一个小孔，脓液才能流出；随后轻轻挤尽剩余的脓液，用黄连膏贴敷，容易愈合。如果延误治疗，导致脓毒侵蚀健康肌肉，指甲溃烂中空，必然脱落。此时适宜用琥珀膏贴敷，日久可收效。
蛀节疔，又名蛇节疔，生于手指中节与接骨连接之处，环绕手指全部肿胀，颜色或黄或紫。由火毒凝结而成。治疗方法同疔疽。
鳅肚疔，一名蛇腹疔。生于手指中节内侧，形状像鱼肚，所以又名鱼肚毒。整个手指通体肿胀发热，疼痛牵连到肘部和手臂。由辛热风湿之毒，上犯心经，因此发生此毒，这是心经受邪的表现。但是中指贯通连接五指，如果中指疔疮颜色紫黑，其毒势必定凶恶，容易攻心；如果心受到毒邪侵害，就会出现呕吐、不能进食、神志昏迷等症状，成为不治之证。务必让患者时时小口服用护心丹，再服用夺命丹以追拔毒邪。其余治法同疔疽。
至于失营和马刀，一个是不可治愈的，一个是可治愈的，因为患处部位相同且形态又相似，所以一并论述。失营，是由于肝阳长期郁结，恼怒不得发泄，导致营血亏虚、络脉枯槁，经络通道阻滞，就像树木失去了荣华，枝条枯萎、树皮焦枯而得名。生于耳前后及颈部之间，初起时形状像栗子，顶部突起根部收敛，像虚痰瘤的状态，按上去石头一样坚硬无情，推动它不肯移动，像钉子钉在肌肉里一样。不寒不热，不觉疼痛，逐渐增大；后来隐隐作痛，疼痛深入肌骨，逐渐溃破，但只流血水没有脓液，逐渐创口变大内部腐烂，形状像湖石，凹进凸出，这时疼痛非常剧烈直达内心，胸闷烦躁，这是精神涣散、气不收纳的表现；随后有疮头出血如喷壶状，持续一段时间后停止。体质虚弱的人，会立即死亡；如果正气强盛、气血能够恢复的人，也可以重新安宁。如果再出血，则生命不能长久（也有出血三四次而死亡的，我曾见过）。此证属于四绝之一，难以治疗。如果患病者，应当戒除七情刺激，调适心志；再用养血气、解郁结的药物，经常服用，或许可以延长寿命，否则将加速死亡。其应用的方剂，如加味逍遥散、归脾汤、益气养营汤、补中益气汤、和营散坚丸等，酌情使用即可。
马刀由于肝胆二经郁逆的气火凝结而成，也生在颈项间，形状长而坚硬，按上去感觉有情（指有根底，非死症），甚至有的连续发作，蔓延至胁下胸前的，也是恶证。如果患者能使心情舒畅，调养得当，用疏肝散邪、和营软坚的方法治疗，可以在半年到一年之内获得痊愈。如果不能自爱，或者境遇不顺，病症则有增无减，拖延日久，疮头破烂，脓血大溃，肿势更加坚硬，最终成为虚损怯弱而死的人很多了。然而终究不像失营那样不可治愈。所以将这两种证候合在一起论述，以阐明它们生死不同的道理如此。用药方法与瘰疬相同。
Dai Zhi (Nail Paronychia), commonly known as "Zhao," arises within the nail body. Three to four days later, a yellow spot appears on the nail surface. Initially, there is swelling and heat, with pain severe enough to affect the heart; it is advisable to use 5 qian of Licorice Root (Gancao) and Mirabilite (Puxiao), decocted in water for soaking and washing, which will lead to recovery. If the nail surface turns yellow, it indicates that internal pus has formed but lacks an outlet. A small hole must be pricked with a thread needle near the pus within the nail body to allow drainage; subsequently, gently squeeze out any remaining pus and apply Huanglian Ointment (Coptis Ointment) for easy healing. If treatment is delayed, pus toxicity may invade healthy flesh, causing the nail to become hollow and ulcerated, inevitably leading to its detachment. At this stage, Hupo Ointment (Amber Ointment) should be applied, and recovery can be achieved over time.
Zhu Jie Ding (Segmental Tendon Sheath Infection), also known as She Jie Ding (Snake Joint Carbuncle), occurs at the junction of the middle phalanx and the proximal phalanx of the finger. The entire finger swells around the joint, with color ranging from yellow to purple. It is caused by the coagulation of fire-toxin. The treatment is the same as for Ding Ju (Carbuncles and Ulcers).
Qiu Du Ding (Loach Belly Carbuncle), also named She Fu Ding (Snake Belly Carbuncle), arises on the palmar side of the middle phalanx of the finger. Its shape resembles a fish belly, hence also called Yu Du Du (Fish Belly Toxicity). The entire finger is swollen and hot, with pain radiating to the elbow and arm. It is caused by toxic factors of acrid-heat, wind, and dampness invading the Heart Meridian, manifesting as a syndrome of the Heart Meridian. Since the middle finger connects to all five fingers, if the carbuncle on the middle finger turns purple-black, the toxicity is likely malignant and prone to attacking the Heart. If the Heart is affected by toxicity, symptoms such as vomiting, inability to eat, and coma will occur, constituting an incurable condition. It is essential to have the patient sip Hu Xin Dan (Heart-Protecting Pill) frequently, followed by taking Duo Ming Dan (Life-Snatching Pill) to draw out the toxin. Other treatments are the same as for Ding Ju.
Regarding Shi Ying (Loss of Nourishment) and Ma Dao (Hatchet Scrofula), one is incurable while the other is curable. Because their locations are similar and their shapes resemble each other, they are discussed together. Shi Ying results from long-term stagnation of Liver Yang, unexpressed anger, deficiency of Ying-Nutrient Blood, withering of collaterals, and obstruction of meridians. It is named so because it resembles a tree losing its lushness, with withered branches and scorched bark. It arises behind and in front of the ears and in the neck region. Initially, it resembles a chestnut, with a protruding top and contracted base, looking like a phlegm nodule. It feels hard as stone upon palpation, immovable when pushed, as if nailed into the muscle. There is no chills or fever, nor pain initially, but it gradually enlarges. Later, dull pain sets in, penetrating deep into muscles and bones, and it gradually ulcerates. However, only bloody fluid oozes out without pus. The wound opens wider with internal rotting, resembling a lake stone with concave and convex surfaces. At this stage, pain is excruciating, reaching the heart, accompanied by chest tightness and irritability, indicating scattered spirit and failing Qi reception. Subsequently, bleeding erupts from the sore head like a spray bottle, stopping after some time. Those with weak constitutions may die immediately; those with strong Qi and recovering blood may regain stability. If bleeding recurs, life cannot be prolonged (I have seen cases where death occurred after three or four episodes of bleeding). This syndrome is one of the "Four Desperations" and is difficult to treat. Patients should avoid emotional disturbances and regulate their minds. They should frequently take herbs that nourish blood and Qi and resolve stagnation to prolong life; otherwise, death will be hastened. Applicable formulas include Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), Guipi Tang (Restore the Spleen Decoction), Yiqi Yangying Tang (Tonify Qi and Nourish Ying Decoction), Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), and Heying Sanjian Wan (Harmonize Ying and Dissipate Hardness Pill), used according to circumstances.
Ma Dao (Hatchet Scrofula) is formed by the knotting of stagnant and rebellious Qi and Fire in the Liver and Gallbladder meridians. It also occurs in the neck region. Its shape is long and hard, but it feels substantial upon palpation (indicating it is not a dead lesion). Sometimes it occurs continuously, extending to the hypochondrium and anterior chest, which is also a malignant sign. If the patient can maintain a cheerful mood and proper care, and undergo treatment with methods to soothe the Liver, scatter pathogens, harmonize Ying, and soften hardness, full recovery can be achieved within half a year to one year. If the patient fails to care for themselves or faces adverse circumstances, the condition will worsen over time. The sore head will break down, discharging large amounts of pus and blood, with increasing induration. Many patients eventually die from consumptive weakness. However, it is not as incurable as Shi Ying. Therefore, these two syndromes are discussed together to clarify their different prognoses regarding life and death. The medicinal usage is the same as for Luoli (Scrofula).