病中肝脾两败，肝不藏血，脾不统血，正气下陷，故下黑血，或下大黑血块，为坏血，皆
不治。
（是病久胃虚，易生变幻，虽医药频更，始则中焦犹暂受，继则气力莫能当，无非尽其
人事耳）
有病日久，初服此医之方一二帖颇效，再服则不效。又延彼医，不问药对症与不对症，
初服一二帖亦效，再服又不效。及屡更数十医皆如此，为戏药，终不治。
凡肌枯肉瘦，则气不能行血，血不能辅气，经络阻碍，周身酸痛，串走似痹，或漫肿如
注痰，针之无脓血，消之不退，饮食日减，精神日败，多见不治。
内外诸症，经针灸后，即劳动伤筋脉。若外症则僵肿不消，毒瓦斯四散，又难化脓。外敷
散药，内进和营活络方，非一两月不得愈。
风热上壅阳明，致耳下漫肿，牙关胀痛，为骨槽痈。以针刺牙根尽处，出血即松。内服
清散方。若牙关紧闭，滴水不入，名骨槽风。若牙痛见牙根，肿凸一点，即是牙疔。
病久脾虚，湿邪浸淫肌肉周身，皆可破皮流水，色黑形陷，不肯生肌，是土气已败，迁绵
难愈。
辛香气味，性最温窜，透入鼻窍，内达脏腑，元气暗被销耗，令人不觉，每见成痨。凡佩
香袋香珠，及焚辟秽诸香，皆宜弃去。惟阿魏能制香气。因此致虚者，多服补剂为佳。
疾病过程中，肝脾两脏功能严重受损。肝脏失去藏血的功能，脾脏失去统摄血液的功能，正气下陷，导致大便排出黑色血液，或者排出大块的黑血块，这些都属于败坏之血，均属于难以治愈的危重症候。
（此病日久，胃气虚弱，容易病情多变。虽然频繁更换药物，起初中焦脾胃尚能暂时承受药力，随后则体力无法支撑，医生只能尽力而为罢了。）
有一种情况是：患病日久，初服某位医生的方剂一两张时颇为有效，再服用时却无效。又请另一位医生诊治，不问药证是否相符，初服一两张也有效，再服用又不效。等到频繁更换数十位医生都是如此，把医药当作儿戏，最终无法治愈。
凡是肌肉干枯消瘦的人，气就不能推动血液运行，血也不能辅助气的运行，经络阻滞，全身酸痛，疼痛游走不定类似痹症，或者全身漫肿如同注痰，针刺没有脓血流出，消散治疗也不见效，饮食日渐减少，精神日渐衰败，大多属于难治之症。
内外各种病症，经过针灸治疗后，如果过早劳动就会损伤筋脉。如果是外症，就会出现僵硬肿胀不消退，毒邪四散，又难以化脓。外用散药，内服调和营卫、活血通络的方剂，需要一到两个月才能痊愈。
风热之邪上壅于阳明经，导致耳下漫肿，牙关胀痛，称为骨槽痈。用针刺破牙根尽头处，出血后症状即缓解。内服清热疏散的方剂。如果牙关紧闭，滴水不进，称为骨槽风。如果牙痛且能看到牙根，肿胀凸起一点，就是牙疔。
疥疮的湿毒向下流注，腿部和小腿外侧结成黄色的痂皮，内部流出脂水，按照湿热证的治疗方法处理。
病程长久导致脾气虚弱，湿邪浸淫周身肌肉，都会导致皮肤破损流水，颜色发黑，形态凹陷，不肯生肌长肉，这是土气（脾胃之气）已经败坏，迁延缠绵难以痊愈。
辛香类气味，性质最温热走窜，透过鼻窍，内达脏腑，暗中消耗元气，使人不知不觉，常常导致形成劳损虚证。凡是佩戴香袋、香珠，以及焚烧辟秽的各种香料，都应该丢弃去除。只有阿魏能够制约香气的影响。因此导致身体虚弱的，多服用补益药剂为佳。
In the course of the disease, both the Liver and Spleen are severely damaged. The Liver fails to store blood, and the Spleen fails to control blood. The Healthy Qi (Zheng Qi) sinks downward, resulting in the passage of black blood from the anus, or large black blood clots. These are considered ruined blood (Bad Blood), all of which are untreatable critical conditions.
(This disease has persisted for a long time, leading to Stomach deficiency, making it prone to unpredictable changes. Although medications are frequently changed, initially the Middle Jiao can temporarily tolerate them, but subsequently the physical strength cannot withstand them. Physicians can only do their utmost.)
There is a condition where, after being ill for a long time, one initially takes one or two doses of a physician's prescription with good effect, but subsequent doses have no effect. Another physician is consulted; regardless of whether the medicine matches the syndrome, the first one or two doses are effective, but subsequent doses are not. This pattern repeats with dozens of physicians, treating medicine as a game, ultimately resulting in untreatability.
When muscles are withered and emaciated, Qi cannot move Blood, and Blood cannot support Qi. Meridians and collaterals are obstructed, causing whole-body soreness and pain that wanders like Bi Syndrome (Obstruction Syndrome). There may be generalized swelling resembling phlegm accumulation; acupuncture yields no pus or blood, and resolving treatments fail to reduce the swelling. Food intake decreases daily, and spirit deteriorates daily. Such cases are mostly untreatable.
After acupuncture treatment for various internal and external syndromes, premature labor injures the sinews and vessels. If it is an external lesion, stiffness and swelling persist without subsiding, toxic factors scatter, and suppuration becomes difficult. External application of powders and internal administration of formulas to harmonize Ying (Nutritive Qi) and activate collaterals require one to two months for recovery.
Wind-Heat congests upward in the Yangming channel, causing diffuse swelling below the ear and distending pain in the jaw, known as Gu Cao Yong (Bone Trough Abscess). Pricking the end of the tooth root with a needle to release blood provides immediate relief. Internally administer a formula to clear and disperse. If the jaw is tightly closed and unable to swallow even water, it is called Gu Cao Feng (Bone Trough Wind). If toothache reveals the tooth root with a single swollen protrusion, it is Ya Ding (Tooth Carbuncle).
Damp-toxin from Scabies flows downward, forming yellow crusts on the outer aspect of the legs and shins, with oozing serous fluid internally. Treat according to the methods for Damp-Heat.
Prolonged illness leads to Spleen deficiency, allowing Dampness to infiltrate the muscles throughout the body. The skin breaks and weeps fluid; the color is black, the shape is sunken, and flesh does not regenerate. This indicates the failure of Earth Qi (Spleen/Stomach Qi), resulting in a lingering, difficult-to-cure condition.
Acrid-aromatic substances have the most warming and penetrating nature. They enter through the nasal orifices and reach the Zang-Fu organs internally, secretly consuming Yuan Qi (Source Qi) without people noticing, often leading to Lao (Consumption/Deficiency Disease). Therefore, wearing incense bags or beads, and burning various aromatic incenses for purifying purposes, should all be abandoned. Only Asafoetida (Asafetida) can counteract the effects of aromatics. For those who become deficient due to this, taking tonic prescriptions is advisable.