大凡疮疡皆由五脏不和。六腑壅滞。则令经络不通而所生焉。疮之初起。未溃之先。肿 大痛。
脉洪数实大。欲作脓时。大便秘结者。宜托里散泻心汤内倍加硝黄以治之。即发表攻里之剂是也。如
已溃后。脉微芤数涩者。必脓血大出。气体衰弱者。宜八珍汤丸圣愈汤内加桃仁天麻子当归。少加熟
地黄大黄以润之。如弱甚以胆汁导之更妙。切不可以巴豆牵牛等药驱逐峻利之药治之。恐老幼虚实不
等故以度之。
经云。诸痛痒疮疡者属心火。盖火之为物。能销烁万
物。残败百端故也。盖人之肌肤附近火灼则为疮。近火则痛，微远则痒。此火之用也。或有痒痛如针
尖轻刺者。犹飞迸火星灼之然也。然痒者美疾也。又有疮痒时炙之以火。渍之以汤。而痒转甚者是微
热助之所使也。有因而不痒者。是热令皮肤舒缓。腠理开通。阳气得泄热气易散。而故不痒也。有痒
而用冷水沃之。临时少退。良久复大痒者。乃寒主收敛。阳气郁结不得散越。怫热内作。故复痒转甚
也。又有痒得爬而解者。爬主动。动为阳。阳属火化。故轻轻爬而能痒。亦火之微也。重重爬则痒去
者。是皮肤爬得辛辣而属金化辛能散。故金化见火力而解。故不痒也。经云。痛者为实。痒者为虚。
非为虚寒之虚。乃火热微甚之意也。又有疮疡麻木而不知痛痒者。是气虚而不运。又兼疮毒壅塞。经
络不通。致令麻木而不知有无也。亦分轻重耳。盖麻者木之轻也。木者麻之重也。假如人坐久有腿膝
木而不知有无。少顷舒伸。良久复疏则麻。乃壅之少通。气血复行之意也。大抵未溃之先有麻木者。
毒塞轻重之分也。已溃之后有麻木者。乃肌
肉腐烂。血气已亏。是虚之轻重也。余粗知至此。录之以示后人耶。
大凡疮疡（皮肤及皮下组织的化脓性感染）都是由五脏功能不和、六腑气机壅滞，导致经络不通而产生的。疮疡初起、尚未溃破之前，表现为肿胀、疼痛剧烈，脉象洪大、数急、实大；当即将化脓时，若出现大便秘结的情况，适宜在托里散泻心汤中加倍加入芒硝和大黄来治疗，这属于发表攻里的方剂。如果疮疡已经溃破之后，脉象呈现微细、芤（中空）、数急或涩滞的，必定是脓血大量流出，导致气血衰弱，适宜使用八珍汤、丸圣愈汤，并加入桃仁、天麻子、当归，少量加入熟地黄和大黄以润燥通便。如果身体极度虚弱，用胆汁导便的方法更为巧妙。切不可使用巴豆、牵牛子等药性峻烈猛烈的药物进行驱逐攻下，这是考虑到老人与儿童体质虚实不一的缘故。
《内经》说：各种疼痛、瘙痒、疮疡都属于心火。因为火的特性，能够销蚀万物，造成各种残败破坏。人的肌肤靠近火灼烧就会形成疮疡，离火近则感到疼痛，离火稍远则感到瘙痒，这就是火的作用。有的瘙痒疼痛像针尖轻轻刺扎一样，就像飞溅的火星灼烧皮肤那样。然而，瘙痒通常被认为是病情较轻的美疾（好现象）。又有疮疡瘙痒时用火灸、用热水浸渍，反而瘙痒加剧的，这是微热助长火势所致。有因此而不痒的，是因为热使皮肤舒缓，腠理（皮肤纹理和汗孔）开通，阳气得以宣泄，热气容易散发，所以就不痒了。有的瘙痒用冷水浇洗，暂时缓解，过一会儿又剧烈瘙痒的，这是因为寒主收敛，导致阳气郁结不能发散，郁热在内产生，所以再次瘙痒且加重。还有通过抓挠而缓解瘙痒的，抓挠动作属动，动为阳，阳属火化，所以轻轻抓挠能止痒，也是火气轻微的表现。重重抓挠则瘙痒去除的，是因为皮肤被抓得辛辣（刺激），属金化，辛能发散，所以金化见到火力而解，因此不痒了。《内经》说：痛属于实证，痒属于虚证。这里的“虚”不是指虚寒之虚，而是指火热邪气的微弱与强盛之意。又有疮疡麻木而不知痛痒的，这是气虚不能运行，又兼有疮毒壅塞，经络不通，导致麻木而不知有无。这也分轻重情况。大概“麻”是“木”的轻症，“木”是“麻”的重症。比如人坐久了腿膝发木而不知有无，过了一会儿伸展，过很久再舒展则感觉麻，这是壅滞稍微通畅，气血重新运行的意思。大致未溃破之前有麻木的，是毒邪壅塞轻重的区别；已溃破之后有麻木的，是肌肉腐烂，血气已亏损，是正气虚弱的轻重区别。我粗略知晓这些道理，记录下来以展示给后人。
Generally, sores and ulcers (purulent infections of the skin and subcutaneous tissues) arise from disharmony among the Five Zang Organs and stagnation in the Six Fu Organs, leading to blockage of the meridians. In the initial stage of a sore or ulcer, before it suppurates, there is swelling and severe pain, with a pulse that is洪大 (Hongda, large and forceful), 数 (Shu, rapid), 实 (Shi, full/excess), and 大 (Da, large). When pus is about to form, if constipation occurs, it is appropriate to treat this by doubling the dosage of Mangxiao (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) in Tuoli Sanxie Xin Decoction; this belongs to the category of formulas that release the exterior and purge the interior. If, after the sore has ulcerated, the pulse appears 微 (Wei, faint), 芤 (Kou, empty/bamboo-sheath), rapid, or 涩 (Se, choppy), it indicates massive discharge of pus and blood, leading to Qi and Blood deficiency. It is appropriate to use Bazhen Tang (Eight Treasure Decoction) or Wanshengyu Tang (Pill for Replenishing Life and Vitality), adding Taoren (Persicae Semen), Tianmazi (Cannabis Fructus), Danggui (Angelicae Sinensis Radix), and a small amount of Shudihuang (Rehmanniae Radix Praeparata) and Dahuang to moisten and unblock. If the weakness is extreme, using bile as a suppository is even better. One must absolutely avoid using harsh purgatives such as Badou (Crotonis Fructus) or Qianniuzi (Semen Phytolaccae) for aggressive evacuation, considering that the constitution varies between the elderly, children, and those with differing degrees of deficiency and excess.
The Classic states: "All pain, itching, sores, and ulcers belong to Heart Fire." This is because fire has the nature to consume and melt all things, causing various forms of destruction. When human skin is near burning fire, sores are formed; being close to fire causes pain, while being slightly farther away causes itching; this is the function of fire. Some experience itching and pain like light pricks from needle points, similar to flying sparks burning the skin. However, itching is generally considered a mild condition (a favorable sign). There are cases where applying moxibustion or hot water immersion to an itchy sore exacerbates the itching; this is caused by slight heat assisting the fire. In other cases, itching ceases because heat relaxes the skin, opens the Couli (pores and interstices), allows Yang Qi to dissipate, and enables heat to scatter easily, thus resulting in no itching. If cold water is applied to relieve itching, providing temporary relief followed by intensified itching later, this is because cold causes contraction, leading to stagnation of Yang Qi which cannot disperse, generating internal郁热 (Yu Re, constrained heat), hence the recurrence and worsening of itching. Scratching can also relieve itching; scratching involves movement, movement is Yang, and Yang transforms into fire, so gentle scratching stops itching due to mild fire activity. Heavy scratching removes itching because the friction creates a pungent sensation belonging to Metal transformation; Pungency disperses, so when Metal transformation encounters fire energy, it resolves, and itching ceases. The Classic states: "Pain indicates Excess, itching indicates Deficiency." Here, "Deficiency" does not refer to Cold-Deficiency, but rather signifies the subtle intensity of Fire-Heat pathogenic factors. Additionally, numbness in sores and ulcers where pain and itching are not felt results from Qi deficiency failing to circulate, combined with toxin stagnation blocking the meridians, leading to numbness and insensitivity. This also varies in severity. Generally, "Ma" (numbness/tingling) is the mild form of "Mu" (woodiness/heavy numbness), and "Mu" is the severe form of "Ma". For instance, sitting for a long time may cause legs and knees to feel wooden and insensitive; after stretching and waiting, feeling tingling ("Ma") indicates that stagnation is slightly clearing and Qi-Blood circulation is resuming. Broadly speaking, numbness before ulceration reflects the degree of toxin blockage; numbness after ulceration reflects muscle rot and Qi-Blood depletion, indicating the degree of deficiency. I have roughly understood these principles and recorded them to show future generations.