有一患者，去其患处瘀血，用四物、柴胡、红花治之， 痛顿止，但寒热口干，饮
食少思，用四物白术、茯苓、柴胡、黄芩、花粉四剂，寒热即退。用六君芎归、藿香而饮
食进，腐肉虽溃，脓水清稀，以前药倍用参、 、归、术、茯苓二十余剂，腐肉俱溃，脓
水渐稠。误服下药一盅，连泻四次，患处色黯，喜其脉不洪数，乃以十全大补倍加肉桂、
麦门、五味数剂，肉色红活，新肉渐生，喜
在壮年，易于调理，又月余而愈，否则不救。凡杖疮跌扑之证，患处如有瘀血，止宜砭去，
服壮元气之剂。盖其气血已损，切不可再用行气下血之药，复损脾胃，则运气愈难营达
于下，而反为败证，怯弱者，多致夭枉。
有一患者，肿痛，敷寒凉之药，欲内消于血，反致臀腿俱冷，瘀血并胸腹痞闷。薛
急去所敷之药，以热童便酒，洗患处，服六君、木香、当归；敷回阳膏，臀腿渐温。又
以前药去木香、加川芎、藿香、肉桂、四剂，瘀血解乃刺之，更以壮脾胃，养气血得痊。盖
气血得温则行，得寒则凝，寒极生热，变化为脓，腐溃深大，血气既败，肌肉无由而生，
欲望其生难矣。 云间曹子容，为室人中风灌药。误咬去指半节， 痛寒热，外敷大黄
等药，内服清热败毒，患处不痛不溃脓清，寒热愈甚。薛曰∶此因凉药遏绝隧道而然也，遂
敷玉龙膏以散寒气；更服六君子汤以壮脾胃，数日后，患处微痛，肿处渐消，此阳气运达
患处也，果出稠脓，不数日，半指溃脱，更服托里药而敛。 上舍王天爵，伤足 肿，内
热作渴，外敷内服，皆寒凉败毒，患处益肿而不溃，且恶寒少食，欲作呕吐。薛曰∶此
气血俱虚，又因寒药凝结隧道，损伤胃气，以致前证耳。遂用香砂六君子、芎、归、炮姜，
外症悉退，惟体倦晡热，饮食不甘，以补中益气汤加地骨皮、五味、麦门，治之而愈。
州守王廷用，伤指即用帛裹之，瘀血内溃， 肿至手。薛谓宜解患处，以出瘀血，更用推
陈致新之剂。不信，乃敷凉药，痛虽少止，次日复作，又敷之，数日后，手心背俱溃出瘀
秽脓水，尚服败毒之剂，气血益虚，色黯脓清，饮食少思。仍请予治，投以壮脾胃，生
气血之剂，由是脓水渐稠而愈。
有一位患者，患处有瘀血，医生去除瘀血后，使用四物汤、柴胡、红花进行治疗，疼痛立刻停止，但出现了寒热往来、口干、饮食减少且缺乏食欲的症状。随后使用四物汤合白术、茯苓、柴胡、黄芩、天花粉，服用四剂后，寒热症状消退。接着使用六君子汤加川芎、当归、藿香，饮食逐渐增进；虽然腐肉溃破，但脓水清稀，于是以前方为基础，加倍使用人参、黄芪、当归、白术、茯苓，服用二十余剂后，腐肉全部溃破，脓水逐渐变得浓稠。
患者误服了一盅泻下药，导致连续腹泻四次，患处颜色变暗。庆幸的是脉象不洪大急促，于是使用十全大补汤，加倍加入肉桂、麦冬、五味子，服用数剂后，患处肌肉颜色红润鲜活，新肉逐渐生长。庆幸患者正值壮年，易于调理，又过一个多月痊愈，否则将无法救治。凡是杖疮或跌打损伤的病症，如果患处有瘀血，只应当用砭石刺破排出瘀血，服用补益元气的药物。因为此时气血已经受损，切不可再使用行气破血、攻下逐瘀的药物，以免再次损伤脾胃，导致元气更加难以输布到达患处，反而变成败证，体弱的人多因此夭折。
有一位患者，患处肿痛，敷用寒凉性质的药物，想要使瘀血在体内消散，反而导致臀部和大腿都发冷，瘀血停滞并伴有胸腹部痞闷胀满。薛己急忙去掉所敷的药物，用热童便和酒清洗患处，内服六君子汤加木香、当归；外敷回阳膏，臀部和大腿逐渐变暖。接着用前方去掉木香，加入川芎、藿香、肉桂，服用四剂后，瘀血化解，然后进行针刺排脓，再用补益脾胃、滋养气血的方法治疗而痊愈。大概是因为气血遇温则运行，遇寒则凝滞，寒气极盛而生热，变化为脓液，导致腐烂溃烂深大，气血既然败坏，肌肉就无法生长，想要存活很难了。
云间的曹子容，给患中风的妻子灌药时，误咬去了手指半节，出现疼痛、恶寒发热，外敷大黄等药物，内服清热败毒之药，结果患处不痛、不化脓、脓水清稀，寒热症状更加严重。薛己说：“这是因为凉药遏制了经络通道所致。”于是外敷玉龙膏以散寒气；内服六君子汤以强壮脾胃，几天后，患处微痛，肿胀逐渐消退，这是阳气输布到达患处的表现，果然流出稠脓，没过几天，半截手指溃烂脱落，再服用托里透脓的药物而收敛愈合。
上舍王天爵，脚部受伤肿胀，内热作渴，外敷和内服的都是寒凉败毒药物，导致患处更加肿胀且不溃破，并且恶寒、食欲不振，想要呕吐。薛己说：“这是气血俱虚，又因寒凉药物凝结经络通道，损伤胃气，从而导致上述症状。”于是使用香砂六君子汤加川芎、当归、炮姜，外部症状全部消退，只是身体疲倦、午后发热、饮食不甘美，改用补中益气汤加地骨皮、五味子、麦冬治疗而痊愈。
州守王廷用，手指受伤后立即用帛布包裹，导致瘀血在内溃散，肿胀蔓延至手部。薛己认为应当解开患处，让瘀血排出，再使用推陈致新的药物。他不相信，反而敷用凉药，疼痛虽然稍止，第二天又发作，再次敷药，几天后，手心手背都溃烂流出瘀秽脓水，还继续服用败毒药物，导致气血更加虚弱，肤色暗紫、脓水清稀、饮食减少且缺乏食欲。仍然请我治疗，投予补益脾胃、生养气血的药物，从此脓水逐渐浓稠而痊愈。
A patient had stasis blood in the affected area. After removing the stasis, the physician treated him with Siwu Tang (Four Substances Decoction), Chaihu (Bupleurum Root), and Honghua (Safflower). The pain ceased immediately, but he developed alternating chills and fever, dry mouth, reduced appetite, and lack of desire for food. He was then prescribed Siwu Tang combined with Baizhu (Atractylodes Rhizome), Fuling (Poria), Chaihu, Huangqin (Scutellaria Root), and Huafen (Trichosanthes Root). After four doses, the chills and fever subsided. Next, Liu Jun Zi Tang (Six Gentlemen Decoction) plus Xiongkuai (Ligusticum Rhizome), Danggui (Angelica Sinensis), and Huoxiang (Patchouli) were used, leading to improved appetite. Although the necrotic tissue ulcerated, the pus was clear and thin. Therefore, the previous formula was modified by doubling the dosage of Renshen (Ginseng), Huangqi (Astragalus Root), Danggui, Baizhu, and Fuling. After more than twenty doses, all necrotic tissue ulcerated, and the pus gradually became thick.
The patient mistakenly ingested one cup of a purgative medicine, resulting in four episodes of diarrhea. The affected area turned dark. Fortunately, the pulse was not rapid and surging. Consequently, Shiquan Dabu Tang (Ten Great Tonifying Decoction) was administered with added Rougui (Cinnamon Bark), Maimen (Ophiopogon Tuber), and Wuwei Zi (Schisandra Berry). After several doses, the flesh color became red and vibrant, and new granulation tissue began to grow. Fortunately, the patient was in his prime, making recovery easier; after another month or so, he healed completely. Otherwise, the condition would have been incurable. For injuries from beating or falls, if there is stasis blood in the affected area, it should only be removed via bian stone (stone lancet) therapy, followed by administration of formulas that strengthen primordial qi. Since qi and blood are already depleted, one must strictly avoid using qi-moving and blood-breaking purgatives, which would further damage the spleen and stomach. This would make it even harder for vital energy to reach the lower extremities/affected area, potentially leading to a critical failure syndrome, often causing premature death in the weak.
Another patient presented with swelling and pain in the affected area. After applying cold-natured topical medicines to resolve the stasis internally, both buttocks and legs became cold, accompanied by stasis blood and chest/abdominal fullness and oppression. Xue Ji urgently removed the applied medicine, washed the affected area with hot child’s urine and wine, and administered Liujun Zi Tang (Six Gentlemen Decoction) with Muxiang (Aucklandia Root) and Danggui (Angelica Sinensis). Topically, Huiyang Gao (Return Yang Ointment) was applied, and the buttocks and legs gradually warmed. Subsequently, the previous formula was modified by removing Muxiang and adding Chuanxiong (Ligusticum Chuanxiong Rhizome), Huoxiang, and Rougui (Cinnamon Bark). After four doses, the stasis resolved, and puncture was performed to drain it. Further treatment focused on strengthening the spleen and stomach and nourishing qi and blood, leading to recovery. Generally, qi and blood flow when warm but coagulate when cold. Extreme cold generates heat, transforming into pus. If the decay and ulceration are deep and extensive, and qi and blood are ruined, muscle regeneration is impossible, making survival difficult.
Cao Zirong from Yunjiang accidentally bit off half a segment of his finger while administering medication to his wife who suffered from wind-stroke (stroke). He experienced pain, chills, and fever. He applied external Da Huang (Rhubarb Root) and other medicines and took internal heat-clearing and detoxifying remedies. However, the affected area did not hurt, did not suppurate, and the pus was clear, while the chills and fever worsened. Xue Ji stated: "This is due to cooling medicines obstructing the meridians." Thus, Yulong Gao (Jade Dragon Ointment) was applied externally to disperse cold qi; internally, Liujun Zi Tang (Six Gentlemen Decoction) was taken to strengthen the spleen and stomach. After several days, the affected area became slightly painful, and the swelling gradually subsided, indicating the arrival of yang qi to the site. Indeed, thick pus appeared, and within a few days, half the finger ulcerated and fell off. Finally, tonifying interior medicines were taken to promote healing.
Wang Tianjue, a Shangshe (Imperial Student), suffered foot injury and swelling with internal heat and thirst. Both external applications and internal medications were cold-natured detoxifiers. This caused increased swelling without ulceration, along with aversion to cold, poor appetite, and nausea. Xue Ji said: "This is due to deficiency of both qi and blood, compounded by cold medicines congealing the meridians and damaging stomach qi, leading to these symptoms." He prescribed Xiangsha Liujun Zi Tang (Aromatic and Sand Ginger Six Gentlemen Decoction) plus Chuanxiong, Danggui, and Pao Jiang (Prepared Ginger). All external symptoms receded, leaving only fatigue and afternoon tidal fever, with unpalatable food taste. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Digupi (Lycium Bark), Wuwei Zi, and Maimen was administered, leading to recovery.
Wang Tingyong, a Prefectural Governor, injured his finger and immediately wrapped it with cloth, causing internal rupture of stasis blood and swelling extending to the hand. Xue Ji advised unwrapping the area to release the stasis and using formulas to eliminate old and generate new. The patient did not believe this and instead applied cooling medicines. Although pain decreased slightly, it returned the next day. After repeated application, pus mixed with blood and filth erupted from the palm and back of the hand after several days. He continued taking detoxifying medicines, worsening qi and blood deficiency, resulting in dark complexion, clear pus, and poor appetite. He requested my treatment again. I administered formulas to strengthen the spleen and stomach and generate qi and blood. Consequently, the pus gradually thickened, and he recovered.