痈疽之证，发无定处，欲令内消，于初起红肿结聚之际，施行气活血解毒消肿之药
是也。当审浅深大小，经络处所，形脉虚实，如发于脑背腰项臀 者，皆太阳经也，宜黄
连、羌活。背连胁处，为近少阳，宜柴胡并宜败毒散、仙方活命饮。形实脉实者，宜漏
芦汤、内疏黄连汤、追毒丸等疏利之。气虚者参 为主，血虚者芎归为主，佐以消毒之
药，随分野以引经药，行至病所。六经分野上有痈疽，其五经各随本经，标本寒温，气
血多少，以行补泻。惟少阳一经，虽曰气多血少，而气血皆不足也，治与气虚血虚同法。
凡栝蒌、射干、穿山甲、金银花、夏枯草、蟾酥、连翘、地丁、黍粘子、木鳖子之类，为
内消之药；仙方活命饮、内消丸、柞木饮子、牛胶饮子、车螯散、返魂丹、消毒饮为内消
之方，众皆知之。殊不知补泻虚实，平治寒温，使气血各得其常，则可内消也。其外用
紫葛汤淋洗，及用散涂膏贴者，亦使气血和平，而肿热消退也。薛新甫曰∶疮疡之证，当
察经之传受，病之表里，人之虚实而攻补之。假如肿痛热渴，大便秘结者，邪在内也，疏
通之。肿 作痛，寒热头疼者，邪在表也，发散之。 肿痛甚者，邪在经络也，和解之。微
肿微痛，而不作脓者，气血虚也，补托之。漫肿不痛，或不作脓。或脓成不溃者，气血虚
甚也，峻补之。色黯而微肿痛，或脓成不出，或腐肉不溃者，阳气虚寒也，温补之。若泥
其未溃，而概用败毒，复损脾胃，不惟肿者不能成脓，而溃者亦难收敛，七恶之证蜂起，
多致不救。丹溪先生云∶肿疡内外皆壅，宜以托里表散为主，如欲用大黄，宁无孟浪之
非。溃疡内外皆虚，宜以托里补接为主，如欲用香散，末免虚虚之失，治者审之。
痈疽这类病症，发病部位没有固定之处，想要使其从内部消散，应当在初起出现红肿结聚的时候，使用行气、活血、解毒、消肿的药物进行治疗。此时应当审察病位的深浅、大小，所属经络的位置，以及形体和脉象的虚实情况。例如，发于脑、背、腰、项、臀部等部位的，都属于太阳经（足太阳膀胱经受邪），适宜使用黄连、羌活。发于背部连接胁肋处的，因为靠近少阳经（足少阳胆经受邪），适宜使用柴胡，并配合使用败毒散、仙方活命饮。形体壮实且脉象有力的患者，适宜使用漏芦汤、内疏黄连汤、追毒丸等具有疏通导滞作用的方药。气虚的患者以人参为主药，血虚的患者以川芎、当归为主药，辅助以消毒的药物，并根据病变所在的经络分野选用引经药，使药力直达病所。六经分野上发生的痈疽，其余五经各自根据本经的特点，辨别标本的寒热温凉，以及气血的多少，来施行补法或泻法。只有少阳一经，虽然说是气多血少，但实际上气血都显得不足，治疗方法与气虚血虚相同。凡是栝蒌、射干、穿山甲、金银花、夏枯草、蟾酥、连翘、地丁、黍粘子、木鳖子之类的药物，属于内消类药物；仙方活命饮、内消丸、柞木饮子、牛胶饮子、车螯散、返魂丹、消毒饮属于内消类方剂，这些大家都知晓。却不知道补法与泻法、虚证与实证、平治寒热温凉，使气血各自恢复常态，才能实现内消。其外用紫葛汤淋洗，以及使用散剂涂抹、膏药贴敷的方法，也是为了使气血平和，从而使肿胀和热势消退。薛新甫说：疮疡这类病症，应当观察经络的传变，病证的表里，人体的虚实，然后决定攻伐或补益。假如出现肿痛、发热、口渴、大便秘结等症状，说明邪气在体内，应当采用疏通的方法。如果肿胀发作疼痛，伴有恶寒、发热、头痛等症状，说明邪气在体表，应当采用发散的方法。如果肿痛严重，说明邪气在经络中，应当采用和解的方法。如果微肿微痛，且不化脓，说明气血虚弱，应当采用补益托毒的方法。如果漫肿不痛，或者不化脓，或者脓成但不溃破，说明气血极度虚弱，应当采用峻猛补益的方法。如果颜色暗红且轻微肿痛，或者脓成但不排出，或者腐肉不溃烂，说明阳气虚弱且有寒，应当采用温补的方法。如果拘泥于疮疡未溃破，就一概使用败毒药物，反而会损伤脾胃，不仅肿胀处不能化脓，而且已溃破处也难以收敛，导致七恶证（中医外科危重证候）蜂拥而起，大多导致无法救治。丹溪先生说：肿疡（未溃破的疮疡）内外都壅滞，应当以托里透表和发散为主，如果想要使用大黄，恐怕会有鲁莽之嫌。溃疡（已溃破的疮疡）内外都虚弱，应当以托里补接为主，如果想要使用香燥发散的药物，未免有使虚者更虚的过失，治疗者应当审慎对待。
The manifestation of carbuncles and sores (Yong Ju) occurs without a fixed location. To achieve internal resolution, one should administer herbs that promote Qi circulation, invigorate blood, resolve toxicity, and reduce swelling at the initial stage when redness, swelling, and nodulation appear. At this time, it is necessary to examine the depth and size of the lesion, its location along the meridians, and the deficiency or excess indicated by the physical constitution and pulse. For instance, lesions occurring on the head, back, waist, neck, and buttocks belong to the Taiyang Meridian (Foot-Taiyang Bladder Meridian), for which Huanglian (Coptidis Rhizoma) and Qianghuo (Notopterygii Rhizoma et Radix) are suitable. Lesions on the back extending to the hypochondrium are near the Shaoyang Meridian (Foot-Shaoyang Gallbladder Meridian); Chaihu (Bupleuri Radix) is suitable, along with Baidu San (Detoxification Powder) and Xianfang Huoming Yin (Immortal Life-Protecting Decoction). Patients with a robust physique and an excess pulse are suitable for Loulu Tang (Radix Euphorbiae Humifusae Decoction), Neishu Huanglian Tang (Internal-Draining Coptis Decoction), and Zhuidu Wan (Poison-Chasing Pill) to promote drainage and unblocking. For those with Qi deficiency, Renshen (Ginseng Radix et Rhizoma) serves as the principal herb; for Blood deficiency, Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelicae Sinensis Radix) serve as the principal herbs, assisted by detoxifying herbs, and guided by meridian-specific directing herbs according to the affected meridianal region to reach the disease site. For carbuncles and sores in the six meridianal regions, the other five meridians should be treated according to their respective characteristics, distinguishing between root and branch, cold and heat, and the relative abundance or scarcity of Qi and Blood, applying tonification or purgation accordingly. The Shaoyang Meridian alone, although described as having abundant Qi and scarce Blood, actually presents with insufficiency in both Qi and Blood; its treatment follows the same principles as for Qi and Blood deficiency. Herbs such as Gualou (Trichosanthis Fructus), Shegan (Belamcandae Rhizoma), Chuanshanjia (Manis Squama), Jinyinhua (Lonicerae Japonicae Flos), Xiakucao (Prunellae Spica), Chansu (Bufonis Venenum), Lianqiao (Forsythiae Fructus), Diding (Violae Herba), Shunianzi (Arctii Fructus), and Mubiezi (Strychni Semen) are classified as internal-resolving herbs. Formulas such as Xianfang Huoming Yin (Immortal Life-Protecting Decoction), Neixiao Wan (Internal-Resolution Pill), Zuomu Yinzi (Zuomu Decoction), Niujiao Yinzi (Ox-Horn Decoction), Che'ao San (Chambered Nautilus Powder), Fanhun Dan (Soul-Returning Elixir), and Xiaodu Yin (Detoxification Decoction) are classified as internal-resolving formulas, which are well known. However, one must not forget that applying tonification and purgation, addressing deficiency and excess, and regulating cold and heat to restore the normal state of Qi and Blood is what enables internal resolution. External applications, such as washing with Zige Tang (Purple Vine Decoction) and applying powders or plasters, also aim to harmonize Qi and Blood, thereby reducing swelling and heat. Xue Xinfu stated: In treating sores and ulcers, one must observe the transmission through meridians, the interior or exterior nature of the disease, and the deficiency or excess of the person, then decide whether to attack or tonify. If there is swelling, pain, heat, thirst, and constipation, the pathogen is in the interior, and draining methods should be used. If swelling arises with pain, accompanied by aversion to cold, fever, and headache, the pathogen is in the exterior, and dispersing methods should be used. If swelling and pain are severe, the pathogen is in the meridians, and harmonizing methods should be used. If there is slight swelling and pain without suppuration, it indicates Qi and Blood deficiency, and tonifying and supporting methods should be used. If there is diffuse swelling without pain, or failure to suppurate, or suppuration without rupture, it indicates severe Qi and Blood deficiency, and vigorous tonification should be employed. If the color is dark with slight swelling and pain, or if pus forms but does not discharge, or if necrotic tissue does not slough off, it indicates Yang deficiency and cold, and warming and tonifying methods should be used. If one rigidly adheres to the idea that the sore has not yet ruptured and indiscriminately uses toxic-resolving drugs, it will further damage the Spleen and Stomach. Not only will the swollen area fail to suppurate, but the ruptured area will also have difficulty healing, leading to the emergence of the Seven Evil syndromes (critical conditions in TCM surgery), often resulting in untreatable cases. Master Danxi said: In external abscesses (Zhongyang), where there is blockage internally and externally, the primary approach should be supporting the interior and dispersing from the exterior. If one wishes to use Dahuang (Rhei Radix et Rhizoma), it may be considered rash. In ulcerated sores (Kuangyang), where there is deficiency internally and externally, the primary approach should be supporting the interior and replenishing. If one wishes to use aromatic dispersants, it inevitably leads to the error of further depleting the deficient. Practitioners must exercise caution.