夫疮之始发。于阴于阳。岂有定规。调护失宜。致令阴阳偏胜。即有疮变之患也。如毒之初起。
筋挛骨痛之时。经云。此寒气之肿。八风之变。当以表散之。使邪易散。而毒易消。不知治此。再以
内疏之剂。敷以寒凉之药。或食冷物。使疮毒内陷阴极而方生。阳气渐回。令人烦闷谵语微渴。其脉
沉细而数。治宜补中益气汤而加温暖之药治之。为上工矣。
人之疮恶属心火乃正理也。亦有初起色紫赤而肿痛。脉沉细数。而恶寒喜暖。非真寒也。乃火极
似水。阳极生阴。亢则害。承乃制之理。或平时富贵享用浓味。服金石等药致之。故有阳极似阴。始
热终寒之变。宜顺其时而服内疏托里泻心等剂。治之即愈矣。
疮之始发。肉色未辨。经络初滞之时。宜表散。以托里之剂。使经易通。而毒亦散。况疮为阳。
而令外出为顺。内经云。汗之则疮已。令荣卫通行。妙在斯矣。有等通俗之人。不听良言。而自高
傲。强自内疏。不知脉浮在表之理。返使邪内罨。如伤寒症当汗而误下之意同。致令外如麻。里如爪。
增寒壮热。邪已内攻。急以蒜灸。以接其阳。令外出。更以托里大补之剂治之。若不如此法。必不能
生矣。常见有疮疥之人。熏燃拈子等药。亦令入内。皆自取其伤生之祸尔。
大凡妇女有孕。忽生痈疽疔毒。始发及未溃已溃之时。当知双见。而用药岂比寻常人也。如夺命
丹返魂丹内有砒 巴射等类。有犯于胎禁。及内疏硝黄大下之药。焉可例用。止宜调气血安胎托里之
剂。可保无虞。此乃警生死之大要。不可不知也。
疮疡在初发时，无论是属于阴证还是阳证，并没有固定的规律。如果调护不当，就会导致阴阳偏盛，从而产生疮疡变化的祸患。例如毒邪刚刚发作，出现筋脉拘挛、骨骼疼痛的时候，《内经》说：“这是寒气引起的肿胀，是八风邪气变化所致。”应当采用发散表邪的方法，使邪气容易消散，毒邪容易消除。如果不了解这种治法，反而使用内泻通里的药剂，外敷寒凉的药物，或者食用生冷食物，会导致疮毒内陷。等到阴气极盛而阳气开始恢复时，病人会出现心烦闷乱、胡言乱语、轻微口渴的症状，脉象沉细而数。治疗适宜用补中益气汤加入温热的药物来治疗，这才是高明的医生。
人的疮疡恶毒归属于心火，这本来是正理。但也有初起时颜色紫赤且肿痛，脉象沉细数，却怕冷喜欢温暖的，这并不是真正的寒证，而是“火极似水”、“阳极生阴”，即亢盛则有害，受制则平衡的道理。或者是平时富贵之人享用厚味，服用金石类药物导致的。所以有阳极似阴、始热终寒的变化。适宜顺应病势服用内疏托里、泻心等方剂治疗，即可痊愈。
疮疡刚开始发作，皮肉颜色尚未分辨清楚，经络刚刚开始阻滞的时候，适宜用发散表邪的方法，配合托里透脓的药剂，使经络容易通畅，毒邪也能消散。况且疮疡属阳，让毒邪向外排出为顺。《内经》说：“发汗则疮疡可愈。”这是因为能使营卫之气通行，奥妙就在这里。有一些通俗的人，不听良言，自视甚高，强行使用内泻通里的方法，不知道脉浮表示病邪在表的道理，反而使邪气内郁。这与伤寒症应当发汗却误用攻下法的意义相同，导致外表像麻疹一样（皮疹密集），内部像爪子抓挠一样痛苦，加重寒冷和高热，邪气已经内攻。此时急需使用蒜灸，以接续阳气，引导邪气外出，再配合大补气血、托里解毒的药剂治疗。如果不采用这种方法，必定无法存活。常见患有疮疥的人，使用熏燃拈子等药物，也会使毒邪入内，这都是自己招致伤生的灾祸罢了。
大凡妇女怀孕，忽然生出痈疽疔毒，在初发以及未溃破和已溃破的时候，应当知道用药要兼顾胎儿，用药怎能比同普通人呢？如夺命丹、返魂丹内含有砒霜、巴豆射干等药物，有触犯胎禁的危险，以及内泻通里、硝石大黄等大泻的药物，怎么可以一概使用？只适宜使用调和气血、安胎、托里的药剂，才可以保证平安无事。这是警示生死的关键要点，不可不知道。
When a sore first appears, whether it is Yin or Yang, there is no fixed rule. Improper care can lead to an imbalance of Yin and Yang, resulting in complications of the sore. For example, when the toxin initially manifests with muscle spasms and bone pain, the *Classic* states: "This is swelling caused by cold pathogenic Qi, a variation of the Eight Winds." It should be treated with exterior-releasing methods to facilitate the dispersion of the pathogen and the resolution of the toxin. If this treatment is not understood, and instead internal purgatives are used, cold-cooling herbs are applied externally, or cold foods are consumed, the toxin may sink inward. When Yin reaches its extreme and Yang begins to recover, the patient may experience restlessness, delirium, and slight thirst, with a deep, fine, and rapid pulse. The appropriate treatment is Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) combined with warming herbs; this constitutes the practice of a superior physician.
It is theoretically correct that malignant sores belong to Heart Fire. However, some cases present with purple-red discoloration, swelling, and pain at the onset, along with a deep, fine, and rapid pulse, yet the patient fears cold and prefers warmth. This is not true Cold, but rather the principle of "Extreme Heat resembling Water" and "Extreme Yang generating Yin," where hyperactivity causes harm and control brings balance. This may result from a diet rich in heavy flavors or the consumption of mineral drugs by wealthy individuals. Thus, variations such as Extreme Yang resembling Yin, starting with heat and ending with cold, occur. Treatment should follow the timing, using formulas for internal drainage, supporting the interior, and draining Heart Fire, which will lead to recovery.
At the initial stage of a sore, when skin color is indistinct and meridians are just becoming stagnant, exterior-releasing methods should be employed, accompanied by formulas that support the interior and promote pus discharge, to facilitate the unblocking of meridians and the dispersion of toxins. Since sores are Yang in nature, allowing them to discharge outward is favorable. The *Inner Canon* states: "Sweating cures sores." This works by promoting the circulation of Ying and Wei Qi, which is the subtlety of the treatment. Some common people disregard good advice, become arrogant, and forcibly use internal purgatives. Ignoring the principle that a floating pulse indicates pathology in the exterior, they cause the pathogen to stagnate internally. This is similar to the error of using purgation instead of sweating in Taiyang syndrome (Exterior Syndrome), leading to symptoms resembling miliary rash on the exterior and severe internal pain, exacerbating chills and high fever, with the pathogen attacking inward. In such emergencies, garlic moxibustion should be applied immediately to restore Yang and guide the pathogen outward, followed by treatment with major tonifying and interior-supporting formulas. Without this method, survival is unlikely. It is common to see patients with sores and scabies using fumigating or burning thread-like preparations, which also drive toxins inward, bringing about self-inflicted fatal consequences.
Generally, when pregnant women suddenly develop carbuncles, ulcers, or hard boils, one must consider both the mother and the fetus during the initial stage, before ulceration, and after ulceration. Medication cannot be administered as for ordinary people. Formulas such as Duo Ming Dan (Life-Restoring Pill) and Fan Hun Dan (Resurrecting Soul Pill) contain arsenic and Croton seeds, which violate pregnancy contraindications. Similarly, strong purgatives containing Mirabilite and Rhubarb should not be used indiscriminately. Instead, formulas that harmonize Qi and Blood, calm the fetus, and support the interior should be used to ensure safety. This is a crucial point regarding life and death that must not be ignored.