平人饮食仍旧，气体如常而脉数者，多发痈疽。夫外感脉数，骤然而来，饮食为之一变。兹之脉数，何以
饮食仍旧也？内伤脉数，由渐而进，气体为之少减。兹之脉数，何以气体如常也？其为痈疽也，明矣。发于外
者，痈疽并称，后犹可疗，发于内者，但以痈论，务须先知。凡属肺痈与胃脘诸痈，总是热毒蕴结，四字该之。
其先少发寒热，渐隐隐作痛，斯时清其热、解其毒、疏其气（经验方∶桔梗、天冬、黄芩、葶苈子五分，秦
归、生甘草），易易耳。倘辨脉未清，视为他病，万一肺腑能语，则呼冤实属可怜，直待吐脓呕血，而后知焉，
则已晚矣。士君子穷理于平日，辨脉于临时，一遇内毒，立剖当前，诚有不必为之试黄豆而验红点
者。昔扁鹊视病，窥见脏腑之微结。留心脉学人，安见古今不相及也矣！
（痈疽一症，迄我朝《医宗金鉴》及《证治全生》等书出。前代所不能医者，皆能医之，独涌泉症，不出
前代论定。千总刘兰生童 知交胶漆友也，患是症，流毒十有余年。未发之前，卜其必发者，验其脉数也；已
发之后，断其不死者，验其脉缓也。费尽千金，总难全愈。游湘三年，不知亦有人能医否，录之以志，知己之
感。）
天下事之信以为然者，必其理之无不然者也。然仅言其常然，而弗揭其偶然，非惟无以坚其信，或反益以
滋其疑。即如定缓为平脉，是宜无病不瘳，讵知噎膈反胃外，不可治者，又有三焉。肌肉大脱，九候虽调，不
可治者，一也；病到喘促，脉忽还元，不可治者，二也；全受而体无亏，全归而脉不变，不可治者，三也。有
理外之事，便有理外之理。第恐于理中之理，未能洞悉无疑，斯与理外之理，愈觉昧没而杂。既于理外之理，
弗克明辩以晰，遂于理中之理，转至惝恍无凭。而缓为平脉之说，不几于捃摭陈言，究无主宰乎？爰摘三条，
明着于编，使知以缓为宗，滴滴归原允矣。一经旧德（《汉书》∶韦贤以诗书授，七十余为相，少子元成复以
明经，历位至丞相。谚曰∶“遗子黄金满 ，不如
一经。”沈诠期诗∶“一经传旧德。”是编缓为平脉，本《内经》旧德），丝丝入扣，森然五字长城（《唐书》∶
秦系与刘长卿善为诗赋，权德舆曰∶“长卿自以为五字长城，系用偏师攻之，虽老益壮。《丹铅总录》∶司马
景王命虞松作表，再呈不可意。钟会取草为定五字，松悦服，以呈景王，景王曰∶“不当尔也。”松曰∶“钟
会也。”景王曰∶“如此可大用。”沈诠期诗∶“五字擢英才。”用此事也。解者以五字为诗误矣”）。
平素饮食正常，身体状态如常，但脉搏跳动急促的人，大多会发展为痈疽。外感病引起的脉数，是突然出现的，此时饮食状况会发生改变。这里的脉数，为什么饮食却保持正常呢？内伤病引起的脉数，是逐渐加重的，身体状态会逐渐减弱。这里的脉数，为什么身体状态依然如常呢？由此可以明确判断这是痈疽之症。发于体表的，统称为痈疽，后期尚可治疗；发于体内的，仅以“痈”论治，必须事先知晓。凡是属于肺痈和胃脘部的各种痈，总是由热毒蕴结所致，用这四个字概括即可。初期会有轻微的寒热症状，随后隐隐作痛，此时只要清热、解毒、疏理气机（经验方：桔梗、天冬、黄芩、葶苈子五分，秦归、生甘草），治疗起来非常容易。如果辨脉不清，将其误认为其他疾病，万一肺腑能说话，那呼冤实在可怜，直到出现吐脓呕血的症状后才知晓，那就太晚了。君子应当在平日穷究医理，在临证时辨别脉象，一旦遇到内毒，立即剖析当前病情，确实有不必像试黄豆验红点那样去验证的道理。从前扁鹊看病，能窥见脏腑内部的细微结聚。留心脉学的人，难道看不出古今医理是相通的吗！
关于痈疽这一病症，直到本朝《医宗金鉴》及《证治全生集》等书出版后，前代无法治疗的病症，现在都能治愈了，唯独涌泉症，不在前代论述确定的范围内。千总刘兰生是我的挚友，患此症，流毒十余年。未发作之前，通过诊察其脉数，预测他必然发病；已发作之后，断言他不会死，是通过诊察其脉象缓和来确定的。花费千金，始终难以完全痊愈。我在湖南游历三年，不知是否有人能治愈此病，记录下来以表达我对知己的感激之情。
天下事之所以确信无疑，是因为其道理没有不成立的。然而只说其常规情况，而不揭示其偶然情况，不仅不能坚定人们的信心，反而会增加疑惑。例如规定缓脉为平脉（正常脉象），按理说应该无病不愈，岂知除了噎膈（吞咽困难）和反胃之外，还有三种不可治的情况。肌肉极度消瘦，虽然三部九候脉象调和，不可治，这是一条；病势发展到气喘急促，脉象忽然恢复常态（指虚阳外越或真脏脉现前的假象），不可治，这是第二条；先天禀赋充足且身体无亏损，临终时脉象不变（指阴阳离决前的平静），不可治，这是第三条。有理之外的事情，就有理之外的道理。只怕对于道理之中的道理，未能透彻了解而没有疑问，这样与理外的道理相比，就更加显得模糊混杂。既然对理外的道理不能明辨清楚，于是对理中的道理，反而变得恍惚无凭据。那么“缓脉为平脉”的说法，岂不是拾取陈旧的言论，终究没有主宰吗？因此摘录这三条，明确写在书中，使人们知道以缓脉为根本，点点滴滴回归本源，确实是正确的。一经传授旧有的德行（《汉书》记载：韦贤因精通诗书被授官，七十多岁担任丞相，小儿子韦元成也凭借明经科，历任职位直至丞相。谚语说：“留给子孙满箱黄金，不如传授一部经书。”沈佺期诗句：“一经传旧德。”本书将缓脉定为平脉，本是依据《内经》的旧有德行），丝丝入扣，严谨如五字长城（《唐书》记载：秦系与刘长卿擅长写诗赋，权德舆说：“刘长卿自认为是五字长城，秦系用偏师攻打他，虽然年老却更加强壮。《丹铅总录》记载：司马景王命令虞松起草表文，两次呈上都不满意。钟会取草稿修改定稿五个字，虞松心悦诚服，呈给景王，景王说：“不该是这样。”虞松说：“是钟会改的。”景王说：“像这样的人才可以重用。”沈佺期诗句：“五字擢英才。”用的就是这件事。解释者把五字当作诗歌错误理解了”）。
Individuals whose diet remains normal and physical condition is usual, yet whose pulse is rapid (Shu Mai, rapid pulse), are prone to developing carbuncles and sores (Yong Ju, general term for suppurative infections). The rapid pulse caused by external contraction appears suddenly, accompanied by a change in dietary habits. In this case, why does the rapid pulse occur while dietary habits remain unchanged? The rapid pulse caused by internal injury progresses gradually, accompanied by a slight decline in physical condition. In this case, why is the physical condition still normal? Thus, it is clear that this is a case of carbuncle or sore. Those manifesting externally are collectively called carbuncles and sores; treatment is still possible in later stages. Those manifesting internally are discussed solely as "carbuncles" (Yong); this must be known in advance. All cases involving lung carbuncle (Fei Yong) and various carbuncles of the stomach region are always due to the accumulation and binding of heat-toxin (Re Du Yun Jie), which can be summarized in these four characters. Initially, there may be mild chills and fever, followed by dull pain. At this stage, clearing heat, resolving toxin, and regulating qi (Empirical Formula: Platycodonis Radix (Jiegeng), Asparagi Rhizoma (Tiandong), Scutellariae Radix (Huangqin), Lepidii Semen (Tinglizi) 5 fen, Angelicae Sinensis Radix (Qinguang), Raw Glycyrrhizae Radix et Rhizoma (Sheng Gancao)) makes treatment quite easy. If the pulse differentiation is unclear and it is mistaken for another disease, if the viscera could speak, their cries of injustice would indeed be pitiful. Only when pus vomiting and hematemesis occur is the diagnosis made, but by then it is too late. A gentleman should investigate medical principles in daily life and differentiate pulses at the time of illness. Upon encountering internal toxins, he should immediately analyze the current situation, truly having no need to test with soybeans to verify red spots (a metaphor for unnecessary empirical testing). In the past, Bian Que, upon examining patients, could perceive the subtle accumulations within the viscera. Those who pay attention to pulse studies, how can they not see that ancient and modern medical theories are connected!
Regarding the syndrome of carbuncles and sores, only after the publication of books such as *Yizong Jinjian* (Golden Mirror of Medicine) and *Zhengzhi Quansheng Ji* (Complete Manual of Treatment and Life Preservation) in our dynasty were conditions previously untreatable now curable. However, the Yongquan syndrome (Yongquan Zheng) was not included in the determinations of previous dynasties. Liu Lansheng, a Qianzong (military officer) and my close friend like lacquer adhering to wood, suffered from this syndrome, with toxic effects persisting for over ten years. Before onset, predicting his inevitable illness was verified by his rapid pulse; after onset, determining he would not die was verified by his slow/relaxed pulse (Huan Mai). Despite spending a thousand pieces of gold, complete recovery remained difficult. During my three-year sojourn in Hunan, I do not know if anyone else could cure this. I record this to express my gratitude to my confidant.
Things in the world that are believed to be true must have reasons that are invariably correct. However, speaking only of the regularity without revealing the contingency cannot only fail to strengthen belief, but may反而 increase doubt. For example, defining the slow/relaxed pulse (Huan Mai) as the normal pulse (Ping Mai) suggests that all diseases should heal. Yet, aside from dysphagia (Ye Ge) and regurgitation (Fan Wei), there are three untreatable conditions. First, when muscles are severely wasted away, even if the pulses in all nine positions (Jiu Hou) are harmonious, it is untreatable. Second, when the disease progresses to panting and shortness of breath, and the pulse suddenly returns to its original state (indicating a false recovery or terminal sign), it is untreatable. Third, when one receives full endowment and the body is unimpaired, yet at death the pulse remains unchanged (indicating separation of yin and yang before calmness), it is untreatable. There are matters outside reason, and thus reasons outside reason. It is feared that if one has not thoroughly understood the reasons within reason without doubt, compared to reasons outside reason, one will feel even more confused and mixed up. Since one cannot clearly distinguish reasons outside reason, one becomes hesitant and baseless regarding reasons within reason. Then, isn't the theory that "the slow pulse is the normal pulse" merely picking up old words, ultimately lacking authority? Therefore, I extract these three points, explicitly stating them in this compilation, so that people know to take the slow pulse as the root, returning drop by drop to the source, which is indeed appropriate. This approach inherits the virtue of the classics (The *Book of Han* records: Wei Xian was appointed chancellor in his seventies for his mastery of poetry and books; his youngest son, Yuan Cheng, also became chancellor through the Mingjing examination. The proverb says: "Leaving children gold filling the house is not as good as leaving them one classic." Shen Quanqi's poem: "One classic transmits old virtues." This book's definition of the slow pulse as normal is based on the old virtues of the *Neijing*). It fits perfectly, standing firm like the Great Wall of Five Characters (The *Book of Tang* records: Qin Xi and Liu Changqing were good friends skilled in poetry and fu. Quan Deyu said: "Liu Changqing considers himself a Great Wall of five characters; Qin Xi attacked him with a flank force, becoming stronger despite his age. *Danqian Zonglu* records: Sima Jingwang ordered Yu Song to draft a memorial, which was rejected twice. Zhong Hui revised it into five characters, which Yu Song accepted gratefully. When presented to Jingwang, he said: "It shouldn't be like this." Yu Song replied: "Zhong Hui did it." Jingwang said: "Such talent can be greatly used." Shen Quanqi's poem: "Five characters promote outstanding talents" uses this story. Interpreters mistakenly took 'five characters' to refer to poetry).