夫呕者有声无物谓之呕。是气病也。有物无声谓之吐。是血病也。凡疮疡肿痛之时。即有呕声或吐。当
诊其脉。如洪数实大。或便秘而喜冷冻饮料者。宜降火清中。黄连解毒汤类治之。如喜热饮而恶寒者作呕。便
利如常。宜养胃调中汤治之。如脉微细肠鸣腹痛作泄而呕者。宜托里温中汤二神丸治之。再以香砂六君子
汤治之。饮食顿进。十全大补汤亦可治之。有患疮疡未溃而作呕及恶心者。乃疮毒之甚内攻。胃气原虚。
故有此症。宜六君子汤加香砂半夏生姜治之。如疮疡已溃。而作呕作恶心者。或不食痞满。肠鸣腹痛。大
便利。作呕。及哕声不绝。不得安眠。昏愦时发。宜托里温中汤治之。内经云。寒淫于内。治以辛热。佐
以苦温。姜附能温中外发。阳气自里之表。故为君。羌活苦辛温能透关节耳。
夫渴者乃销烁津液。因热极而能作渴。心火燔燃之所有也。如疮疡未溃而作渴者。是疮毒炽盛其心肺。脉
必洪数实大者。宜降火清金。芩连内疏之剂治之。如尺脉洪大而无力者。宜滋阴降火。大补气血等药
治之。或急用独参汤极妙。如已溃后。气血大虚。而有渴疾者。常十有八九。宜以黄 六乙汤加减八
味丸治之。如痈疽已发。已溃未溃。皆可以加减八味丸治之大效。如无有疮疡而肺脉洪数甚作渴者。
必发痈疽。此其候也。
呕吐是指有声音但没有食物吐出，这属于气机病变。吐是指有食物吐出但没有声音，这属于血分病变。凡是疮疡出现肿痛的时候，如果伴有呕吐声或吐出物，应当诊察患者的脉象。如果脉象洪大、数急、实大，或者大便干结且喜欢喝冷饮的，适宜采用降火清中的治法，用黄连解毒汤之类的方剂治疗。如果患者喜欢热饮且怕冷而作呕，大便通畅如常，适宜用养胃调中汤治疗。如果脉象微细，伴有肠鸣、腹痛、腹泻并兼有呕吐的，适宜用托里温中汤配合二神丸治疗，随后再用香砂六君子汤调理，饮食会立刻增进，十全大补汤也可以用于治疗。有的患者疮疡尚未溃破就出现呕吐及恶心症状，这是因为疮毒严重内攻，胃气原本虚弱，所以出现这种症状，适宜用六君子汤加入香附、砂仁、半夏、生姜治疗。如果疮疡已经溃破，却出现呕吐、恶心，或者食欲不振、胸脘痞闷胀满，肠鸣腹痛，大便稀溏，呕吐不止，以及呃逆声不断，无法安睡，时而昏沉意识模糊，适宜用托里温中汤治疗。《黄帝内经》说：“寒邪淫溢于体内，要用辛热之品治疗，辅以苦温之药。”干姜、附子能够温暖内外，发散阳气，使阳气从体内达于体表，所以作为君药。羌活味苦、辛、性温，能够透达关节。
口渴是由于津液被消灼耗损，因热势极盛而导致口渴，这是心火猛烈燃烧的表现。如果疮疡尚未溃破就出现口渴，说明疮毒炽盛侵犯心肺，脉象必定洪大、数急、实大，适宜采用降火清金的治法，用黄芩、黄连等内疏清热剂的方药治疗。如果尺部脉象洪大但无力，适宜采用滋阴降火的治法，用大补气血等药物进行治疗，或者紧急使用独参汤，效果极佳。如果疮疡已经溃破后，气血极度虚弱而出现口渴病症，这种情况十分常见（十有八九），适宜用黄芪建中汤加减配合八味丸治疗。如果痈疽已经发生，无论是否溃破，都可以用加减八味丸治疗，效果显著。如果没有疮疡，但肺脉洪数严重并出现口渴症状的，必然会发为痈疽，这就是其征兆。
Vomiting (Ou, 呕吐) refers to the act of producing sound without expelling matter; this is a disorder of Qi (vital energy). Expulsion (Tu, 吐) refers to expelling matter without producing sound; this is a disorder of Blood. When sores and ulcers present with swelling and pain, if there are sounds of vomiting or expulsion, one must examine the pulse. If the pulse is surging (Hong, 洪), rapid (Shu, 数), full (Shi, 实), and large, or if there is constipation accompanied by a preference for cold drinks, it is appropriate to reduce fire and clear the middle jiao, treating with formulas such as Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity). If the patient prefers hot drinks and fears cold while experiencing vomiting, and bowel movements are normal, Yangwei Tiaozhong Tang (Stomach-Nourishing and Middle-Regulating Decoction) should be used. If the pulse is faint and fine, accompanied by borborygmus, abdominal pain, diarrhea, and vomiting, Tuoli Wenzhong Tang (Supporting Interior and Warming the Middle Decoction) combined with Ershen Wan (Two Divine Pills) should be used, followed by Xiangsha Liujunzi Tang (Aucklandia and Amomum Six-Gentlemen Decoction); dietary intake will immediately improve, and Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) may also be used. In cases where patients with unruptured sores experience vomiting and nausea, it is due to severe toxin attacking internally and originally deficient Stomach Qi, hence these symptoms arise; treat with Liujunzi Tang (Six-Gentlemen Decoction) added with Xiangfu (Cyperi Rhizoma), Sharen (Amomi Fructus), Banxia (Pinelliae Rhizoma), and Shengjiang (Zingiberis Rhizoma Recens). If sores have ruptured yet vomiting and nausea persist, or if there is anorexia, chest and epigastric fullness, borborygmus, abdominal pain, loose stools, continuous vomiting, persistent hiccups (Yue, 哕), inability to sleep, and intermittent confusion, Tuoli Wenzhong Tang should be used. The Neijing states: "When cold invades the interior, treat with pungent-hot substances, assisted by bitter-warm substances." Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata) can warm the interior and exterior and emit Yang Qi from the interior to the exterior, thus serving as the sovereign drug. Qianghuo (Notopterygii Rhizoma et Radix), being bitter, pungent, and warm, can penetrate the joints.
Thirst (Ke, 渴) results from the consumption and depletion of body fluids, occurring when heat is extreme; it arises from the blazing of Heart Fire. If thirst occurs before the rupture of sores, it indicates that sore toxins are flourishing and invading the Heart and Lungs; the pulse will necessarily be surging, rapid, full, and large. It is appropriate to reduce fire and clear the Metal element (Lungs), treating with internal-draining agents containing Qin (Scutellariae Radix) and Lian (Coptidis Rhizoma). If the chi position of the pulse is surging and large but forceless, it is appropriate to nourish Yin and reduce fire, treating with herbs that greatly tonify Qi and Blood, or urgently using Danshen Tang (Ginseng Decoction), which is excellent. After the rupture of sores, if thirst persists due to severe deficiency of Qi and Blood—which occurs in eight or nine out of ten cases—treat with modified Huangqi Jianzhong Tang (Astragalus Building the Middle Decoction) combined with Bawei Wan (Eight-Ingredient Pill). For abscesses and carbuncles that have erupted, whether ruptured or not, modified Bawei Wan can be used with great efficacy. If there are no sores, but the Lung pulse is surging and rapid with severe thirst, an abscess or carbuncle will inevitably develop; this is the sign.