薛立斋治府庠彭碧溪，患腰疽，服寒凉败毒之药，色黯不痛，疮头如铺黍，背重不能安寝，耳
目白，面赤无神，小便频涩，作渴迷闷，气粗短促，脉浮数，重按如无。先用滋水之药一剂，少顷，
便利渴止，背即轻爽。乃砭出瘀血，以艾半斤许，明灸患处，外敷乌金膏，内服参、 、归、术、肉
桂等药至数剂，元气稍复。自疑肉桂辛热，一日不用，手足并冷，大便不禁。仍用肉桂及补骨脂二钱，
肉豆蔻一钱，大便复常，其肉渐溃。更用当归膏以生肌肉，八珍汤以补气血而愈。
锦衣傅允承母，年逾七十，腰生一 ，作痒异常，脉浮数，反恶寒，曰∶此疮疡症也。未溃而先
弱，何以收敛？况大便不通，则真气已竭，治之无功。因恳请不得已，用六君加藿香、神曲。数剂饮
食渐进，大便始通，更用峻补之剂，溃而脓清作渴。再用参、 、归、地、麦冬、五味，渴止。彼喜
曰∶可无虞矣。曰∶尚难收敛，先日之言也。彼疑，遂速他医，卒致不起。
举人顾东溪，久作渴。六月初，腰患疽，不慎起居，疮溃尺许，色黯败臭，小便如淋，唇裂口刺。
七月终请治，左尺洪数，左关浮涩，谓先渴而患疽者，乃肾水干涸，虚火上炎，多致不起。今脓水败
臭，色黯不痛，疮口张大，乃脾气败而肌肉死也；小便如淋，痰壅喘促，口干舌裂，乃脾肺败而肾水
绝也。左尺洪数，肾无所
生也；左关浮涩，肺克肝也。况当金旺之际，危殆速矣。二日后果殁。盖此症发于两月方殁者，乃元
气虚不能收敛也。若预为调补，使气血无亏，亦有得生者。
一男子腰患毒，脓熟不溃。针之，脓大泄，反加烦躁，以圣愈散汤四剂而宁。更以人参养荣汤加
麦冬、五味，两月而愈。此人后患湿气，遂为痼疾。凡疮脓血去多，疮口难合，尤当补益，务使气血
平复，否则更患他症，必难治疗。慎之。
一男子腰中患疽，发而不溃，其气血止能发起，不能培养为脓也。投大补药数剂而溃，又数剂脓
出尚清。乃服参 归术膏斤余，脓少稠。数斤，脓渐稠，肌肉顿生。大凡痈疽藉血气为主，若患而不
起，或溃而不腐，或不收敛，及脓少或清，皆气血之虚也。宜大补之，最忌攻伐之剂。亦有脓反多者，
乃气血不能禁止故也。若溃后发热作渴，脉大而脓愈多，属真气虚而邪气实也，俱不治。常见血气充
实之人，患疮皆肿高色赤，易腐溃而脓且稠，又易于收敛。怯弱之人多不起发，不腐溃，又难于收敛。
若不审察而妄投攻剂，虚虚之祸不免矣。若患后当调养，若瘰 流注之症，尤当补益也。否则更患他
症，必难于措治。慎之。
有人腰间生一毒痈，红肿未破皮，痛不可忍，俯躬而行。一人取新杀牡猪肝，切片如疮粘贴，外
以布缠定。一对昼，其病良已。肝色变黑，臭不可近，弃之地，犬不食。下有小指大一点尚硬，乃肝
少未贴满所致，竟亦无他。
薛立斋治昆山张举人元忠，盂秋患腰疽，疮头如大豆粒，根大三寸许，微肿略赤，虚症悉具。用
桑枝灸患处，服活命饮一剂，肿起色赤，饮食仍少。用香砂六君子汤四剂，食渐进。后用大补药，脓
虽成而不溃。乃每剂加附子一片，二剂后，脓自涌出，旬日而愈。
陆氏女初嫁患腰痛，不肿，脉沉滑，神思倦怠，此为内发七情之火，饮食之毒所致。以托里药一
剂，下瘀脓升许。陈良甫曰∶疮未溃内陷，面青唇黑者不治。果殁。
王洪绪治一人患腰疽，根盘围阔二尺余，前连腹，后接背，不红不肿，不痛不软，按之如木。王
举方用炮
姜、肉桂。他医以为暑月，安可用此热剂？改服攻托清凉。阅五日，病者神昏无主。复延诊，患仍不
痛，色如隔宿猪肝，言语不清，饮食不进。王曰∶过今晚商治，是夜即毙。
又一人患此，服以阳和汤，次日觉松。又一帖，疽消小半。赶合犀黄丸与阳和汤轮转间服，五日
而愈。阳和汤方∶熟地一两，麻黄五分，鹿角胶三钱，白芥子二钱，肉桂一钱，甘草一钱，炮姜炭五
分。此方麻黄得熟地不发表，熟地有麻黄不凝膈，神用在斯。主治骨槽风、流注、阴疽、脱骨疽、鹤
膝风、乳岩、结核、石疽、附骨疽及漫肿无头、平塌白陷，一切阴凝等证。犀黄丸方∶乳香一两，没
药一两，麝香一钱五分，牛黄三分。共为末，用饭捣丸，每服三钱，陈酒送。上部临卧服，下部空心
服。主治一切阴疽大毒。
薛立斋治疗府庠生彭碧溪，他患有腰疽（腰部发生的痈疽），服用了寒凉败毒的药物后，疮面色泽黯淡且不痛，疮头像铺开的黍米一样平塌，背部沉重无法安睡，耳目昏花，面色赤红但无神气，小便频数且涩滞，感到口渴、意识模糊闷乱，呼吸粗重短促，脉象浮数，但重按则感觉空虚无力。先用滋补肾水的药物一剂，不久后，大小便通畅，口渴停止，背部立刻感到轻松爽快。接着用砭石刺破排出瘀血，用约半斤艾绒在患处进行直接灸法，外部敷上乌金膏，内部服用人参、白芍、当归、白术、肉桂等药物，经过多剂后，元气稍微恢复。患者自己怀疑肉桂辛热，有一天没有服用，结果手脚都变冷，大便失禁。仍然使用肉桂和补骨脂二钱，肉豆蔻一钱，大便恢复正常，肌肉逐渐开始溃烂化脓。随后使用当归膏来促进肌肉生长，用八珍汤来补益气血，最终痊愈。
锦衣卫傅允承的母亲，年龄超过七十岁，腰部生了一个疖肿（此处原文似缺字，结合语境指疮疡），瘙痒异常，脉象浮数，反而怕冷。我说：这是疮疡病症。在未溃破之前就先出现虚弱症状，怎么能够收敛愈合呢？况且大便不通，说明真气已经衰竭，治疗不会有功效。因为对方恳请，不得已之下，使用六君子汤加入藿香、神曲。服用几剂后饮食逐渐进步，大便才开始通畅，再用峻猛的补益药剂，疮疡溃破后脓液清稀并感到口渴。再次用人参、白芍、当归、地黄、麦冬、五味子，口渴停止。病人高兴地说：可以没有忧患了。我说：还难以收敛，这是我之前的判断。病人产生疑虑，于是急忙找其他医生，最终导致死亡。
举人顾东溪，长期感到口渴。六月间，腰部患疽，起居不慎，疮疡溃破有一尺多长，色泽黯淡腐败发臭，小便像淋证一样，嘴唇开裂，口舌干燥刺痛。七月末请我诊治，左尺脉洪大数急，左关脉浮涩。我说：先有口渴而后患疽的，是肾水干涸，虚火上炎，大多导致死亡。现在脓水腐败发臭，色泽黯淡不痛，疮口张大，这是脾气败坏而肌肉死亡；小便像淋证，痰壅喘促，口干舌裂，这是脾肺败坏而肾水枯竭。左尺脉洪数，说明肾无所生；左关脉浮涩，说明肺克伐肝。况且正值金旺的季节，危险紧迫很快就要死亡。两天后果然去世。大概这种病症发作两个月后死亡的，是元气虚弱不能收敛所致。如果预先调补，使气血不亏损，也有得以生存的。
一个男子腰部患毒疮，脓液成熟但不溃破。针刺后，脓液大量流出，反而加重烦躁，用圣愈散煎汤服用四剂后平静下来。再用的人参养荣汤加入麦冬、五味子，两个月后痊愈。这个人后来患上湿气，于是成为顽固疾病。凡是疮疡脓血流失过多，疮口难合，尤其应当补益，务必使气血平复，否则再患其他病症，必定难以治疗。要谨慎。
一个男子腰部患疽，发出但不溃破，他的气血只能发起疮形，不能培养化为脓液。投以大补药物几剂后溃破，又几剂后脓出尚且清稀。于是服用人参、白芍、当归、白术制成的膏方一斤多，脓液变得少而稠厚。服用几斤后，脓液逐渐稠厚，肌肉顿时生长。大凡痈疽依靠血气作为根本，如果患病而不发起，或者溃破后不腐烂，或者不收敛，以及脓液少或清稀，都是气血虚弱的表现。应当大补，最忌讳攻伐的药物。也有脓液反而增多的，是气血不能固摄的缘故。如果溃破后发热口渴，脉大而脓液更多，属于真气虚弱而邪气实盛，都不治。常见血气充实的人，患疮疡都会肿胀高起色赤，容易腐烂溃破且脓液稠厚，又易于收敛。怯弱的人多不起发，不腐烂溃破，又难于收敛。如果不审察而妄投攻伐药剂，造成虚者更虚的祸害是不可避免的。如果患病后应当调养，像瘰疬、流注这类病症，尤其应当补益。否则再患其他病症，必定难以处置。要谨慎。
有人腰间生了一个毒痈，红肿但未破皮，疼痛不可忍受，弯腰行走。一个人取新杀的公猪肝，切成片像疮面一样粘贴，外部用布缠紧固定。一天一夜后，病情良好痊愈。猪肝颜色变黑，臭味不可靠近，丢弃在地上，狗都不吃。下面有一个小指大的点还硬，是因为猪肝少了一块未贴满所致，最终也没有其他问题。
薛立斋治疗昆山张举人元忠，孟秋时节患腰疽，疮头像大豆粒大小，根部直径三寸左右，微肿略赤，虚症全部具备。用桑枝灸患处，服用活命饮一剂，肿胀起来色赤，饮食仍然很少。用香砂六君子汤四剂，饮食逐渐进步。后用大补药，脓虽然形成但不溃破。于是每剂药加一片附子，两剂后，脓自然涌出，十天痊愈。
陆氏女子刚出嫁时患腰痛，不肿，脉沉滑，神思倦怠，这是内伤七情之火，加上饮食之毒所致。用托里药一剂，排出瘀脓一升多。陈良甫说：疮疡未溃破而内陷，面色青唇黑的不可治。果然死亡。
王洪绪治疗一人患腰疽，根盘周围宽阔二尺多，前面连腹部，后面接背部，不红不肿，不痛不软，按压像木头一样。王洪绪处方用炮姜、肉桂。其他医生认为是在暑月，怎么可以用这种热性药剂？改为服用攻托清凉药物。过了五天，病人神志昏迷无主。再次延请诊治，患处仍然不痛，颜色像隔夜的猪肝，言语不清，饮食不进。王洪绪说：过完今晚商量的时间，这天夜里就会死亡。
又有一个人患此病，服用阳和汤，第二天觉得松快。又一帖后，疽消退了小一半。赶制犀黄丸与阳和汤轮流间隔服用，五天痊愈。阳和汤方：熟地黄一两，麻黄五分，鹿角胶三钱，白芥子二钱，肉桂一钱，甘草一钱，炮姜炭五分。这个方子中麻黄得到熟地就不发表，熟地有麻黄就不凝滞膈膜，神妙之处就在这里。主治骨槽风、流注、阴疽、脱骨疽、鹤膝风、乳岩、结核、石疽、附骨疽以及漫肿无头、平塌白陷，一切阴凝等证候。犀黄丸方：乳香一两，没药一两，麝香一钱五分，牛黄三分。共研为末，用米饭捣成丸，每次服用三钱，陈酒送服。上部病变临睡前服，下部病变空腹服。主治一切阴疽大毒。
Xue Lizhai treated Peng Bixi, a government school student (Fuxiang), who suffered from a lumbar carbuncle (Yao Ju). After taking cold-natured detoxifying medicines, the lesion's color became dark and painless, with the head of the sore lying flat like scattered millet grains. The patient felt heavy in the back and could not sleep comfortably; his eyes and ears were dim, face red but lacking spirit, urination frequent and difficult, thirst present with confusion and oppression, breathing coarse and short, pulse floating and rapid but empty upon deep pressure. First, one dose of medicine to nourish Kidney Water was administered. Shortly after, bowel movements and urination became smooth, thirst ceased, and the back felt light and comfortable. Then, bloodletting with a stone knife was performed to drain stasis. Approximately half a jin of moxa was applied directly to the affected area for moxibustion. Wujin Gao (Black Gold Ointment) was applied externally, while internally, Ren Shen (Ginseng Root), Bai Shao (White Peony Root), Dang Gui (Angelica Sinensis), Bai Zhu (Atractylodes Macrocephala), and Rou Gui (Cinnamon Bark) were taken over several doses, gradually restoring Yuan Qi (Original Qi). Suspecting Rou Gui's pungent heat, the patient omitted it for one day, resulting in cold limbs and fecal incontinence. Rou Gui (2 qian) and Bu Gu Zhi (Psoralea Fruit) (2 qian), along with Rou Dou Kou (Nutmeg) (1 qian), were readministered, normalizing bowel movements and allowing gradual suppuration. Subsequently, Dang Gui Gao (Angelica Ointment) was used to regenerate flesh, and Bazhen Tang (Eight Treasures Decoction) was employed to tonify Qi and Blood, leading to recovery.
Fu Yuncheng, a member of the Imperial Guard, sought treatment for his mother, aged over seventy, who had developed a boil on her waist with intense itching. Her pulse was floating and rapid, yet she felt aversion to cold. I stated: "This is a sores-and-maggots syndrome. Weakness appearing before ulceration makes healing impossible. Moreover, constipation indicates exhaustion of True Qi; treatment will be futile." Reluctantly, due to persistent requests, Liu Jun Zi Tang (Six Gentlemen Decoction) with Huo Xiang (Patchouli) and Shen Qu (Medicated Leaven) was prescribed. After several doses, diet improved, and bowels moved. Strong tonics were then given. Upon ulceration, pus was clear, and thirst appeared. Ren Shen (Ginseng Root), Bai Shao (White Peony Root), Dang Gui (Angelica Sinensis), Di Huang (Rehmannia Root), Mai Dong (Ophiopogon Tuber), and Wu Wei Zi (Schisandra Berry) stopped the thirst. The patient rejoiced, saying, "I am safe now." I replied, "Convergence remains difficult, as previously noted." Doubting my words, he sought another physician and eventually died.
Gu Dongxi, a Juren degree holder, suffered from chronic thirst. In early June, he developed a lumbar carbuncle due to careless living habits. The ulcer opened about one chi wide, with dark, foul-smelling tissue, urinary symptoms resembling strangury, cracked lips, and prickling dryness in the mouth and tongue. Seeking treatment at the end of July, his left Chi pulse was flooding and rapid, and the left Guan pulse was floating and choppy. I said: "Thirst preceding carbuncle indicates dried-up Kidney Water and flaming deficient fire, often fatal. Now, foul pus, dark color, painlessness, and gaping wound indicate Spleen Qi failure and muscle death. Urinary strangury, phlegm obstruction, panting, and dry cracked tongue indicate Spleen-Lung failure and exhaustion of Kidney Water. A flooding Chi pulse shows Kidney has no source; a floating-choppy Guan pulse shows Lung overcoming Liver. Amidst the peak of Metal energy, danger is imminent." He indeed died two days later. Such cases dying within two months result from deficient Yuan Qi failing to converge. If tonification had been provided early to preserve Qi and Blood, survival might have been possible.
A man suffered from a toxic swelling on his waist. The pus matured but did not rupture. Puncturing caused massive drainage and increased irritability. Sheng Yu San (Holy to Save Powder) decocted and taken for four doses calmed him. Ren Shen Yang Rong Tang (Ren Shen Nourishing Vigor Decoction) with Mai Dong and Wu Wei Zi cured him in two months. He later developed dampness, becoming a chronic ailment. When sores lose much pus and blood, making closure difficult, tonification is crucial to restore Qi and Blood balance; otherwise, secondary complications arise, making treatment hard. Caution is advised.
Another man had a lumbar carbuncle that emerged but did not ulcerate; his Qi and Blood could only raise the shape but not generate pus. Several doses of strong tonics induced ulceration, followed by more doses yielding thin pus. Consuming over one jin of a paste made of Ren Shen, Bai Shao, Dang Gui, and Bai Zhu thickened the pus. After consuming several jin, pus became thick, and flesh regenerated rapidly. Generally, carbuncles rely on Qi and Blood. Failure to rise, lack of suppuration, poor convergence, or thin/scanty pus all indicate Qi and Blood deficiency. Strong tonification is indicated; attacking agents are taboo. Excessive pus may also occur if Qi and Blood fail to contain it. Post-ulceration fever, thirst, large pulse, and increasing pus indicate deficient True Qi and excess pathogenic factors, which are untreatable. Healthy individuals with robust Qi and Blood typically present with swollen, red, easily suppurating, thick-pus lesions that heal quickly. Frail individuals often fail to rise, do not suppurate, and heal slowly. Blindly using attacking agents causes "deficiency compounding deficiency." Post-illness care, especially for Luoli (scrofula) and Liuzhu (flowing abscesses), requires tonification. Otherwise, secondary issues arise, complicating treatment. Caution is advised.
A person had a toxic carbuncle on the waist, red and swollen but unbroken, causing unbearable pain requiring bending forward. Someone sliced fresh liver from a newly slaughtered male pig and applied it to the sore, securing it with cloth. After one day and night, the disease healed well. The liver turned black and emitted an unbearable odor; discarded on the ground, even dogs refused to eat it. A small spot the size of a little finger remained hard, likely due to incomplete coverage by the liver slice, but no other consequences occurred.
Xue Lizhai treated Zhang Yuanzhong, a Juren from Kunshan, who developed a lumbar carbuncle in early autumn. The head was bean-sized, base three cun wide, slightly swollen and reddish, with full manifestation of deficiency signs. Moxibustion with mulberry branches was applied to the site. One dose of Huo Ming Yin (Living Life Decoction) raised swelling and redness, though appetite remained low. Four doses of Xiang Sha Liu Jun Zi Tang (Aromatic Sand Ginseng Six Gentlemen Decoction) improved diet. Subsequent strong tonics formed pus but failed to rupture. Adding one slice of Fu Zi (Aconite Lateral Root) per dose allowed natural rupture after two doses, curing him in ten days.
Ms. Lu, newly married, suffered from lower back pain without swelling. Pulse was sinking and slippery; mental fatigue was evident. This resulted from internal emotional fire and dietary toxicity. One dose of Tuo Li medicine (Interior-Supporting Medicine) expelled over one sheng of bloody pus. Chen Liangfu stated: "Sores collapsing inward with blue face and black lips are untreatable." She indeed died.
Wang Hongxu treated a man with a lumbar carbuncle. The base spanned over two chi, extending from abdomen to back. It was non-red, non-swollen, non-painful, non-soft, feeling like wood upon pressure. Wang prescribed Pao Jiang (Prepared Ginger) and Rou Gui (Cinnamon Bark). Other physicians objected, citing summer heat and rejecting hot formulas, switching to attacking and cooling agents. Five days later, the patient became comatose. Re-examination showed unchanged painlessness, color like overnight pork liver, slurred speech, and inability to eat. Wang predicted death by the next evening.
Another patient took Yang He Tang (Yang Harmony Decoction), feeling relief the next day. After another dose, the carbuncle reduced by half. Xi Huang Wan (Rhino Horn Pill) was alternated with Yang He Tang, curing him in five days. Yang He Tang formula: Shu Di Huang (Prepared Rehmannia Root) 1 liang, Ma Huang (Ephedra Herb) 5 fen, Lu Jiao Jiao (Deer Antler Glue) 3 qian, Bai Jie Zi (White Mustard Seed) 2 qian, Rou Gui (Cinnamon Bark) 1 qian, Gan Cao (Licorice Root) 1 qian, Pao Jiang Tan (Charred Prepared Ginger) 5 fen. Here, Ma Huang paired with Shu Di Huang does not induce sweating; Shu Di Huang paired with Ma Huang does not stagnate the diaphragm. Its efficacy lies here. It treats Gu Cao Feng (Bone Channel Wind), Liuzhu (Flowing Abscess), Yin Ju (Yin Carbuncle), Tuo Gu Ju (Bone-Eating Carbuncle), He Xi Feng (Crane Knee Wind), Ru Yan (Breast Cancer), Jie He (Tubercles), Shi Ju (Stone Carbuncle), Fu Gu Ju (Bone-Adhering Carbuncle), and any diffuse swelling without head, flat collapse, white depression, or general Yin coagulation syndromes. Xi Huang Wan formula: Ru Xiang (Frankincense) 1 liang, Mo Yao (Myrrh) 1 liang, She Xiang (Musk) 1.5 qian, Niu Huang (Calculus Bovis) 3 fen. Ground to powder, mixed with rice paste into pills. Take 3 qian per dose with aged wine. Upper body lesions: take before bed. Lower body lesions: take on an empty stomach. It treats all severe Yin carbuncles and toxins.