背疽之方，所传百余，然有验者极少。其间（一作中）又有用药偏重，或太冷，或太热，
或药性有毒者，今皆不录，独择尝用而经验者录之，庶几不至有误活人治病之意。
天行一；瘦弱气滞二；怒气三；肾气虚四；饮冷酒、食炙 物、服药热毒五。盖治背疽，不
可一概将为热毒，其治之法难易，当自一而至五。
初发疽时，一粒如麻豆大，身体便发热，生疽处肉亦热，肿大而高，多生疼痛，破后肉
色红紫，此为外发。虽大若盆碗，如用药有理，有百人百可活。
如初发疽时，不拘小大，身体无热，自觉倦怠，生疽处亦不热，数日之间，渐渐开大，不
肿不高，不疼不痛，低陷而坏烂，破后肉紫黑色，此为内发。有此证者，未发见之先，脏腑已
有溃烂，百人百不救，虽有神仙药，亦付之无可奈何。
自泻，呕吐，不思饮食，诊脉而肾脉最虚，此等古人皆以为不治之证，然尚有救疗之理。
肾脉虚甚，当用补药而有 牾处∶如用鹿茸、附子之药，是抱薪救火；如用平补之药，肾
气又猝难平复，若俟河之清。向来有一贵人苦疽疾，正生此一证，诸医无策。愚云∶昔尝闻一
名医讲论，凡人遇五更初，肾气必开，若一语言、咳嗽，即肾气复合。遇肾开时，进一服平补
药，其功效胜寻常服峻补之药十数服。愚以此策献之。遂选用山药丸，所用皆平补肾气，全
无燥偏重之药，根据此法而进，详以告病者与其侍旁之子弟，如法而服药。三日之后，医有
诊脉，知其肾脉已平复矣。则有疽疾人，肾脉虚弱，未可便如古人之论，以为不可治。若人
有痼冷、虚弱、危困之疾，如其法而用药，可谓用力寡而收功倍矣（案∶山药丸缺）。
治疗背疽的方剂，流传下来的有一百多种，但真正有效的极少。其中有的用药偏重，或者过于寒凉，或者过于温热，或者药性有毒的，现在都不收录，只选择曾经使用过且确有疗效的记录下来，希望不至于违背救活病人、治病救人的初衷。
病因分为五类：一为时行邪气；二为身体瘦弱且气机阻滞；三为怒气郁结；四为肾气虚弱；五为饮用冷酒、食用烤炙食物、服用热毒药物所致。大概治疗背疽，不能一概认为是热毒所致，其治疗的难易程度，应当从第一类到第五类依次递进（指病情由轻到重或治法由易到难）。
初发背疽时，疮疡如麻豆大小，身体随即发热，生疽处的肌肉也发热，肿胀高大，多伴有疼痛，破溃后肉色红紫，这属于外发。虽然疮面大如盆碗，如果用药得当，一百人中几乎可以救活一百人。
如果初发背疽时，无论疮疡大小，身体没有发热，自觉倦怠乏力，生疽处也不热，几天之间，疮面渐渐扩大，不肿不高，不疼不痛，低陷而坏烂，破溃后肉呈紫黑色，这属于内发。有此证候的人，在症状显现之前，脏腑内部已经发生溃烂，一百人中无法救活一人，即使有神仙般的药物，也无能为力。
出现自发性腹泻，呕吐，不想吃东西，诊脉发现肾脉最虚，这些情况古人皆认为是不可治愈的病证，然而仍有救治的道理。
肾脉极度虚弱，当用补药时会有矛盾之处：如果使用鹿茸、附子等温热峻补的药物，如同抱薪救火（加重热毒）；如果使用平和的补药，肾气又难以迅速恢复，犹如等待黄河水变清一样困难。过去有一位贵人苦于背疽之疾，正好出现这一证候，众医无计可施。我说：以前曾听一位名医讲解，凡是人在五更初（凌晨3-5点），肾气必然开启，如果此时说话、咳嗽，肾气就会重新闭合。遇到肾气开启之时，服用一剂平和的补药，其功效胜过平时服用十数剂峻补药物。我以此策略献出。于是选用山药丸，所用药物皆为平和地补肾气，完全没有燥热偏重的药物，按照此法服药，并详细告知患者及其侍奉在旁的子弟，依法服药。三天之后，医生诊脉，发现肾脉已经平复了。因此，对于患有背疽且肾脉虚弱的人，不可以立刻像古人所说的那样，认为不可治疗。如果人有顽固性寒冷、虚弱、危困的疾病，按照这种方法用药，可以说是用力少而收效加倍（按语：山药丸方剂缺失）。
Formulas for treating back carbuncles (back abscesses) have been transmitted in over a hundred varieties, yet very few are effective. Among them, some prescriptions are overly heavy in dosage, or too cold, or too hot, or possess toxic properties; these are not recorded here. I have selected only those that I have personally used and found to be effective, hoping not to deviate from the original intention of saving lives and curing diseases.
The etiologies are categorized into five types: 1. Epidemic pathogenic factors (seasonal infectious diseases); 2. Emaciation with qi stagnation; 3. Anger-induced stagnation; 4. Kidney qi deficiency; 5. Consumption of cold wine, roasted foods, or intake of hot-toxic medications. Generally, when treating back carbuncles, one cannot uniformly attribute them to heat-toxin. The difficulty of treatment varies, progressing from the first type to the fifth.
When a carbuncle first appears, it is as small as a hemp seed or bean. The body immediately develops fever, and the flesh at the site of the carbuncle also becomes hot, swollen, elevated, and painful. After rupture, the tissue color is red and purple; this is classified as an external manifestation (external onset). Even if the lesion is as large as a basin or bowl, if the medication is administered correctly, nearly all patients can be saved.
Conversely, if upon initial appearance, regardless of size, the body has no fever, the patient feels fatigued and weak, and the site of the carbuncle is not hot. Over several days, the lesion gradually enlarges without swelling or elevation, is painless, sunken, and necrotic. Upon rupture, the tissue turns dark purple or black; this is classified as an internal manifestation (internal onset). In such cases, the internal organs have already undergone necrosis before the external symptoms appear. Such cases are incurable, even with divine medicine.
Symptoms include spontaneous diarrhea, vomiting, and loss of appetite. Pulse diagnosis reveals the most deficient kidney pulse. Ancient physicians considered these conditions untreatable; however, there remains a rationale for intervention.
When the kidney pulse is extremely deficient, the use of tonifying herbs presents a dilemma: using warming and potent tonics like Deer Antler (Rusa alces Cornu) or Aconite Root (Aconiti Lateralis Radix Praeparata) would be like adding fuel to the fire; whereas using mild tonics may fail to restore kidney qi quickly, akin to waiting for the Yellow River to clear. Once, a nobleman suffered from a severe carbuncle presenting this specific syndrome, and all physicians were at a loss. I stated: I once heard a renowned physician explain that at dawn (Wugeng, approx. 3–5 AM), the kidney qi naturally opens. If one speaks or coughs during this time, the kidney qi closes. Administering a dose of mild tonic herb while the kidney qi is open yields efficacy superior to taking dozens of doses of strong tonics at other times. I proposed this strategy. Consequently, Shanyao Wan (Dioscorea Pill) was selected. Its ingredients mildly tonify kidney qi without any drying or heating bias. Following this method, and instructing the patient and attending family members carefully, the medication was administered. Three days later, pulse diagnosis showed the kidney pulse had normalized. Thus, for carbuncle patients with weak kidney pulses, one should not blindly follow ancient assertions of incurability. For patients with chronic coldness, weakness, or critical conditions, applying this method allows for minimal effort with doubled results. (Note: The formula for Shanyao Wan is missing.)