夫恶疮，诸痛痒疮，皆属于心；诸湿肿满，皆属于脾。心主血，脾主肉，血热而肉湿，
湿热相合，浸淫不休，溃败肌肤，而诸疮生矣。然有辨焉，如疥癣瘾疹之属，怫郁气血，在
皮肤腠理间者，可以表而散，《内经》有谓汗之则疮已是矣。若怫郁气血在肌肉之分，外达
皮肤，作寒热而生脓者；或七情所招，或膏粱之变，皆宜解内热，不宜发汗，仲景所谓疮家
不可发汗，汗出则痉者是矣。一疮而有宜汗不宜汗之戒，盖热有浅深表里故也。故疮在皮肤
，则当因其轻而扬之，汗之浴之；外以杀虫润燥，皆解凝结涎沫之药敷之。疮之在肌肉，则
当因其重而减之，泻经络之热，清凉气血；外以化脓生肌膏贴之。疮在头巅，则当射而取之
，须酒制寒凉剂，更以风药升而上之；外以杀虫解热药敷之。明此三者，其于治疮，思过半
矣。
疮者，生于两 ，初起发肿，久而腐溃，或浸淫瘙痒，破而脓水淋漓。乃风热湿毒相
聚而成；或因饮食起居，亏损肝肾，阴火下流，外邪相搏而致。外 属三阳经湿热，易治；
内属三阴经湿，兼血分虚热，难治。蒋示吉谓∶色红者多热，肿者多湿，痒者多风，痛者
属实，早宽而暮肿者，属气虚下陷。初起者，风热湿毒为多；日久者，下陷湿热为胜。初宜
用独活、防己、黄柏、苍术、萆 、牛膝、归尾、苡仁、丹皮、赤芍、银花、黑栀、猪苓、
泽泻等；又二妙丸、四妙丸之类。若脾虚湿热下注，则用补中益气，或八珍汤加萆 、银花
之属，外用夹纸膏贴之。
血风疮，多生在两小腿里外 ，上至膝，下至踝骨，乃风热、湿热、血热交感而成。初
起瘙痒无度，破流滋水，日渐沿开，形同针眼。宜服四物汤加防已、萆 、丹皮、苡仁、黄
柏、银花等；外搽解毒雄黄散，或如意金黄散俱可。如年久紫黑坚硬，气血不行者，用磁锋
砭去恶血，以解郁毒，然后敷药。
恶疮，各种疼痛、瘙痒的疮疡，都归属于心；各种湿邪导致的肿胀和腹满，都归属于脾。心主司血液，脾主司肌肉，血分有热而肌肉湿气重，湿热相互结合，浸淫肌肤不停止，导致肌肤溃烂败坏，于是各种疮疡就产生了。然而需要加以辨别，比如疥癣、瘾疹这类疾病，是气血郁结在皮肤腠理之间的，可以用发汗解表的方法使邪气散出，《内经》中说过“用发汗法治疗则疮疡可愈”。如果是气血郁结在肌肉的分野，向外通达至皮肤，出现寒热症状并化脓的；或者是由于七情内伤，或者饮食肥甘厚味变化引起的，都应当清解内部的热邪，不适宜发汗，张仲景所说的患疮疡的人不可发汗，发汗后会导致痉挛就是这种情况。一个疮病却有宜汗和不宜汗的禁忌，大概是因为热邪有浅深、表里的区别啊。所以疮疡在皮肤层面，就应当顺着其轻浅的特性而发散它，用发汗、药浴的方法；外用杀虫润燥的药物，都是解除凝结涎沫的药物敷贴。疮疡在肌肉层面，就应当顺着其沉重的特性而削减它，泻除经络的热邪，清凉气血；外用化脓生肌膏贴敷。疮疡在头顶部位，就应当采用射法取之，必须用酒炮制的寒凉药剂，再用风药升提向上；外用杀虫解热的药物敷贴。明白这三点，对于治疗疮疡，就已经掌握了一半以上的要领了。
疳疮（此处指下疳或类似生殖器溃疡），生长在两阴部，初起时发生肿胀，时间久了腐烂溃破，或者浸淫瘙痒，破溃后脓水淋漓不断。这是由风热湿毒聚集而成；或者因为饮食起居不当，亏损了肝肾，阴火向下流注，与外邪相搏结而导致。外部的疳疮属于三阳经的湿热，容易治疗；内部的疳疮属于三阴经的湿邪，兼有血分的虚热，难以治疗。蒋示吉说：颜色红的多属热证，肿胀的多属湿证，瘙痒的多属风证，疼痛的多属实证，早晨减轻傍晚肿胀的，属于气虚下陷。初起的，多是风热湿毒；日久不愈的，以下陷的湿热为主。初起时宜用独活、防己、黄柏、苍术、萆薢、牛膝、当归尾、薏苡仁、丹皮、赤芍、金银花、黑栀子、猪苓、泽泻等药材；又有二妙丸、四妙丸之类的方剂。如果是脾虚导致湿热下注，则使用补中益气汤，或者八珍汤加萆薢、金银花之类的药物，外用夹纸膏贴敷。
血风疮，多生长在小腿的内侧和外侧，上至膝盖，下至脚踝骨，这是由风热、湿热、血热交感互结而成的。初起时瘙痒无度，破溃后流出滋水，日渐蔓延扩大，形状如同针眼。宜服用四物汤加防己、萆薢、丹皮、薏苡仁、黄柏、金银花等；外用搽抹解毒雄黄散，或者如意金黄散都可以。如果患病多年，患处紫黑坚硬，气血运行不畅的，用磁锋砭石刺破放出恶血，以解除郁积的毒邪，然后再敷药。
Malignant sores, various painful and itchy ulcers, all belong to the Heart; various swellings and fullness caused by dampness all belong to the Spleen. The Heart governs Blood, and the Spleen governs flesh. When blood is hot and flesh is damp, damp-heat combines and permeates ceaselessly, causing skin and muscle to ulcerate and decay, thus giving rise to various sores. However, differentiation is necessary. For conditions such as scabies, tinea, and urticaria, where qi and blood are constrained in the skin and interstices (coul i), they can be dispersed through sweating (diaphoresis). The *Nei Jing* states that "treating with diaphoresis will cure the sore." If, however, qi and blood are constrained in the muscular layer, extending outward to the skin, presenting with chills and fever and suppuration; or if caused by emotional disturbances or dietary excesses of rich and sweet foods, one should resolve internal heat rather than induce sweating. Zhang Zhongjing stated that patients with sores should not undergo diaphoresis, as sweating may lead to spasms (jing zheng). The prohibition against sweating for a single sore arises because heat has varying depths and locations (exterior vs. interior). Therefore, when a sore is on the skin, one should disperse it according to its lightness, using diaphoresis or medicated baths; externally, apply insecticidal and moisturizing agents to resolve condensed phlegm and foam. When a sore is in the muscle, one should reduce it according to its heaviness, draining heat from the meridians and cooling the qi and blood; externally, apply ointments that promote pus discharge and tissue regeneration. When a sore is on the vertex of the head, one should treat it via shooting methods (acupuncture techniques), using cold-natured formulas prepared with wine, and further lifting them upward with wind-dispersing herbs; externally, apply insecticidal and heat-clearing agents. Understanding these three principles means one has grasped more than half of the essentials for treating sores.
Chancre (here referring to genital ulcers) arises in the genital region. Initially, swelling occurs; after a long time, it rots and ulcerates, or permeates with itching, breaking open to discharge profuse pus and fluid. This results from the accumulation of wind-heat and damp-toxins; or it is caused by improper diet and lifestyle damaging the Liver and Kidney, leading to ministerial fire flowing downward and conflicting with external pathogens. External chancre belongs to damp-heat in the Yang-odd and Yang-brimming meridians and is easy to treat; internal chancre belongs to dampness in the Yin-odd and Yin-brimming meridians, complicated by deficiency-heat in the blood level, and is difficult to treat. Jiang Shiji stated: Red color indicates much heat; swelling indicates much dampness; itching indicates much wind; pain indicates excess; swelling that decreases in the morning and increases in the evening indicates qi deficiency with sinking. Early stages are mostly due to wind-heat and damp-toxins; chronic stages are dominated by sinking damp-heat. Early treatment should use Du Huo, Fang Ji, Huang Bo, Cang Zhu, Bi Xie, Niu Xi, Dang Gui Wei, Yi Yi Ren, Dan Pi, Chi Shao, Jin Yin Hua, Hei Zhi Zi, Zhu Ling, Ze Xie, etc.; also Er Miao Wan and Si Miao Wan formulas. If spleen deficiency leads to damp-heat pouring downward, use Bu Zhong Yi Qi Tang, or Ba Zhen Tang added with Bi Xie and Jin Yin Hua; externally apply Jia Zhi Gao.
Blood-wind sore (Xue Feng Chuang) often appears on the medial and lateral aspects of the lower legs, extending from the knee to the ankle bone. It is formed by the interaction of wind-heat, damp-heat, and blood-heat. Initially, there is severe itching; upon breaking, it exudes serum, spreading day by day with lesions resembling pinpricks. One should take Si Wu Tang added with Fang Ji, Bi Xie, Dan Pi, Yi Yi Ren, Huang Bo, and Jin Yin Hua; externally apply Jie Du Xiong Huang San or Ru Yi Jin Huang San. If the condition persists for years, becoming purple-black and hard with stagnant qi and blood, use magnetic bi stones to puncture and release evil blood to resolve郁毒 (depressed toxins), then apply medication.