夫流注腿痈，证虽殊而治则一，要在辨其阴阳，明其虚实而已。若因于风寒客热，或暑
湿交蒸，内不得入于脏腑，外不能越于皮毛，行于营卫之间，阻于肌肉之内，或发于周身数
处而为流注（有生于四肢关节者，有生于胸腹腰臀者），或发于腿上而为腿痈，此属实邪阳证
。初起憎寒壮热，或微恶寒发热，遍身骨节疼痛，其肿处渐渐加大，斯时宜以发散透解，或
亦可以消散；如身热无汗，即能成脓（大抵阳证流注出脓，即似伤寒之出汗）。其色虽白，不
可认作阴证虚证（流注腿痈，大率皆色白）。或亦有根盘白而顶微红者，此必脓已成（流注腿
痈成功，即顶色白而脉见滑数，按之软熟，其脓已成），即欲开之，以泄其邪；邪泄后方得
热退身凉，而元气自然来复，脾胃亦醒，饮食有加，数日间气血充盈，即能收口矣。其有体
虚之人，元气不足，或因郁结伤脾，暴怒伤肝，气凝血滞，或湿气逆于肉凑，或寒邪入于筋
络，或湿痰阻于经隧，或瘀血注于关节，又或病后余邪发散未尽，种种病由，皆因真气不能
营运，使邪气壅滞而为患也。其发为流注也，或结块，或漫肿，或一或三或五或七（流注总
是仄数），此犹未穿，彼又肿起，外候则恶寒发热，饮食减少，脉来细弱。此必培其脾胃，
祛其寒湿，调其营血，脾胃健则血自生而气自营运，岂可不固其本根，妄用寒凉克伐之剂，
而蹈虚虚之戒哉。其发为腿痈也，则漫肿无头，皮色不变，乍寒乍热，时痛时酸，筋屈不伸
，不能转动。苟非大补气血，温经通络，何以能使之消散？更何以使之速起速溃、易敛易愈
也？此虚证属阴之治法。异证同揆，惟贵学人审察而明辨之耳。
阳证流注腿痈，必欲辨明风寒暑热，客于何部经络，总以发表和营。如正旺邪实，宜万
消化坚丸攻透，方能无脓即消，有脓即溃，屡用屡验，切勿以药味峻猛而避之。如溃脓后，
急欲调和脾胃；若久不敛口者，方可补托。如阴寒着骨而发，足不能伸舒，或身不能转动，
必须用阳和汤温经通络，溃后调治与前同。
流注和腿痈，虽然证候表现不同，但治疗原则是一致的，关键在于辨别阴阳属性，明确虚实状态。如果是由于风寒客热侵袭，或者暑湿交蒸所致，病邪内不能进入脏腑，外不能透达皮毛，运行于营卫之间，阻滞在肌肉之内，有的发于周身多处而成为流注（有的生于四肢关节，有的生于胸腹腰臀），有的发于腿部而成为腿痈，这属于实邪阳证。初起时憎寒壮热，或者微恶寒发热，全身骨节疼痛，肿胀处逐渐加大，此时适宜用发散透解的方法，或许也可以使肿块消散；如果身热无汗，就能成脓（大抵阳证流注出脓，就像伤寒病的出汗一样）。其颜色虽然发白，不可误认为是阴证虚证（流注腿痈，大多颜色发白）。也有根盘发白而顶部微红的，这必定是脓已成（流注腿痈成功，即顶部色白且脉象滑数，按压感觉软熟，说明脓已形成），此时应当切开排脓，以泄出邪气；邪气泄出后，才能热退身凉，元气自然恢复，脾胃功能也苏醒，饮食增加，几天后气血充盈，伤口就能愈合。那些体质虚弱的人，元气不足，或者因为郁结损伤脾胃，暴怒损伤肝脏，导致气凝血滞，或者湿气逆乱于肌肉间隙，或者寒邪侵入经络，或者湿痰阻滞于经脉隧道，或者瘀血注于关节，又或者病后余邪发散未尽，种种病因，都是因为真气不能正常运行，致使邪气壅滞而产生危害。它们发为流注时，有的结成块状，有的漫肿无边，有的一个，有的三个、五个或七个（流注总是奇数个），这些还没有破溃，彼处又肿起，外部表现为恶寒发热，饮食减少，脉象细弱。这必须培补脾胃，祛除寒湿，调和营血，脾胃健运则血液自然生成而气自然运行，怎么能不固护根本，妄用寒凉克伐的药物，而犯虚虚之戒呢？它们发为腿痈时，则漫肿无头，皮色不变，乍寒乍热，时而疼痛时而酸楚，筋脉屈曲不能伸展，不能转动。如果不是大补气血，温经通络，怎么能使之消散？又怎么能使之迅速起效、迅速溃破、容易收敛、容易痊愈呢？这是虚证属阴的治疗方法。不同的证候遵循相同的道理，只贵在学者仔细审察并明确分辨罢了。
阳证流注腿痈，必须辨明风寒暑热，客居于哪一部经络，总的治疗方法是发表和营。如果正气旺盛邪气实盛，适宜使用万消化坚丸攻逐透散，才能做到无脓即消，有脓即溃，屡用屡验，千万不要因为药味峻猛而回避它。如果溃破流脓后，急于调和脾胃；如果久不敛口，才可以采用补托法。如果是阴寒着骨而发，足部不能伸直舒展，或者身体不能转动，必须使用阳和汤温经通络，溃破后的调治与前文相同。
Liu Zhu (Flowing Abscess) and Tui Yong (Leg Carbuncle), although presenting with different clinical manifestations, share the same treatment principles. The key lies in distinguishing between Yin and Yang patterns and clarifying Deficiency and Excess conditions. If caused by pathogenic Wind-Cold or Heat lingering externally, or by the steaming interaction of Summer-Heat and Dampness, the pathogens cannot enter the Zang-Fu organs internally nor reach the skin and hair externally. Instead, they circulate between Ying (Nutrient) and Wei (Defensive) levels and obstruct within the muscles. They may manifest as Liu Zhu (Flowing Abscess) at multiple sites throughout the body (some arising in the joints of the limbs, others in the chest, abdomen, waist, or buttocks), or as Tui Yong (Leg Carbuncle) on the legs. These belong to Excess patterns and Yang syndromes. In the initial stage, there is aversion to cold accompanied by high fever, or slight aversion to cold with fever, and pain throughout the body's joints. The swelling gradually increases. At this time, it is appropriate to use methods that disperse and resolve the exterior, which may also lead to the resolution of the swelling. If there is fever without sweating, pus will form (generally, the discharge of pus in Yang-pattern Liu Zhu resembles sweating in Shang Han [Cold Damage] disease). Although the color may appear white, it must not be mistaken for a Yin or Deficiency pattern (Liu Zhu and Tui Yong are predominantly white in color). There may also be cases where the base is white but the apex is slightly red; this indicates that pus has already formed (the maturation of Liu Zhu and Tui Yong is characterized by a white apex, a slippery and rapid pulse, and a soft, ripe sensation upon palpation). At this point, incision should be made to drain the pus and expel the pathogenic factors. After the pathogens are expelled, the fever subsides, the body becomes cool, Yuan Qi (Original Qi) naturally recovers, Spleen and Stomach function resumes, appetite increases, and after a few days, when Qi and Blood are abundant, the wound will heal.
In individuals with weak constitutions and insufficient Yuan Qi, or those whose Spleen is injured by emotional stagnation, or Liver damaged by sudden anger, leading to Qi stagnation and Blood stasis, or where Dampness rebels into the muscle clefts, Cold pathogens invade the meridians, Phlegm-Dampness obstructs the collaterals, or Blood stasis settles in the joints, or residual pathogens remain unresolved after illness—all these etiologies result from the failure of True Qi to circulate normally, causing pathogenic factors to stagnate and cause harm. When manifesting as Liu Zhu, there may be nodular masses or diffuse swelling, occurring singly or in odd numbers such as three, five, or seven (Liu Zhu typically occurs in odd numbers). These have not yet ruptured, while other areas swell up. External signs include aversion to cold, fever, reduced appetite, and a fine, weak pulse. Treatment must focus on fortifying the Spleen and Stomach, dispelling Cold and Dampness, and regulating Ying and Blood. When the Spleen and Stomach are robust, Blood is generated naturally, and Qi circulates smoothly. One must not neglect to secure the root and recklessly use cold-natured or draining medications, thereby committing the error of "depleting deficiency." When manifesting as Tui Yong, there is diffuse swelling without a distinct head, unchanged skin color, alternating chills and fever, intermittent pain and soreness, inability to extend the tendons, and restricted movement. Unless one employs substantial tonification of Qi and Blood and warming of the meridians to unblock collaterals, how can the swelling dissipate? How can one achieve rapid onset, quick suppuration, easy contraction, and swift healing? This constitutes the treatment method for Deficiency patterns belonging to Yin. Different syndromes follow the same logic; it is crucial for practitioners to examine carefully and distinguish clearly.
For Yang-pattern Liu Zhu and Tui Yong, one must clearly identify whether Wind, Cold, Summer-Heat, or Heat pathogens have invaded specific meridians. The general approach is to release the exterior and harmonize Ying. If Zheng Qi (Upright Qi) is strong and pathogens are excessive, Wan Xiao Hua Jian Wan (Myriad Resolution and Hardness-Dissolving Pill) should be used to attack and penetrate, ensuring that abscesses resolve without suppuration or rupture quickly if present. This formula has proven effective repeatedly; do not avoid it due to its potent nature. After suppuration and drainage, prioritize harmonizing the Spleen and Stomach. Only if the wound fails to close after a long period should Bu Tuo (Tonification and Support) methods be employed. If Cold-Dampness penetrates the bone, causing inability to extend the feet or move the body, Yang He Tang (Yang Harmony Decoction) must be used to warm the meridians and unblock collaterals. Post-suppuration management remains consistent with previous descriptions.