痈疽肿赤走不定，赤游丹毒红丝疔，时毒瘀血壅盛证，砭石治法最宜行。只须刺皮
无伤肉，瓷锋对患最宜轻，毒血遇刺皆出尽，肿消红散有奇功。
【注】凡痈疽红肿色赤，游走不定，及赤游丹毒，红丝疔走散，时毒瘀血壅盛等证，皆
宜行砭石之法。然忌其太深，《内经》所谓刺皮无伤肉也。法用细瓷器击碎，取有锋芒者
一块，用箸一根，将头劈开，夹而缚之，用二指轻捺箸梢，以瓷锋对患处，悬寸许，再
用重箸一根，频击箸头，令毒血遇刺皆出，至次日肿未全消，再量行砭之，以肿消红散为度。
痈疽初起七日内，开结拔毒灸最宜，不痛灸至痛方止，疮疼灸至不疼时。法以湿纸
覆其上，干处先灸不宜迟，蒜灸黄蜡附子灸，豆豉蛴螬各用之。
【注】凡痈疽初起，七日以前，开结拔毒，非灸不可。不痛者灸至知痛，疮疼者灸至不
疼。盖着毒则不痛，至好肉则痛，必灸至知痛者，令火气至好肉方止也。着皮肉未坏处
则痛，着毒则不痛，必灸至不疼者，令火气着毒方止也。法以纸蘸水满覆患上，看纸先
干处，即先灸之。但灸法贵于早施，如证起二、三日即灸，十证可全八九；四、五日灸
者，十证可全六七；六、七日灸者，十证可全四五，愈早愈妙。其法不一，有隔蒜灸者，
有当肉灸者，有用黄蜡灸者，有用附子灸、豆豉灸、蛴螬灸者。一壮灸至百壮，以效为度。
至艾壮之大小，则量疮势以定之。然灸有应忌者，如肾俞发不宜灸，恐消肾液；手指不
宜灸，因皮肉浇薄，恐皮裂肉 。至于头乃诸阳之首，诸书俱云禁灸，若误灸逼毒入里，
令人痰喘上涌，反加大肿。然遇纯阴下陷之证，必当灸之，不灸则不能回阳。若半阴半
阳之证，则仍当禁而不灸。
隔蒜灸法
大蒜切成片，约三钱浓，安疮头上，用大艾壮灸之，三壮即换一蒜片。若漫肿无头
者，以湿纸覆其上，视其先干处，置蒜片灸之。两三处先干，两三处齐灸之。有一点白
粒如粟，四围红肿如钱者，即于白粒上灸之。若疮势大，日数多者，以蒜捣烂，铺于疮上，
艾铺蒜上灸之。蒜败再易，以知痛甚为效。凡痈疽流注、鹤膝风，每日灸二三十壮。痈疽
阴疮等证，艾数必多，宜先服护心散，以防火气入内。灸小儿，先将蒜置大人臂上，燃
艾候蒜温，即移于小儿毒上，其法照前。经云∶寒邪客于经络之中则血泣，血泣则不通，
不通则卫气从之，壅遏而不得行，故热；大热不止则肉腐为脓。盖毒原本于火，然与外
寒相搏，故以艾火、蒜灸之，使开结其毒，以移深居浅也。
黄蜡灸法
凡痈疽、发背、恶疮、顽疮，先以湿面随肿根作圈，高寸余，实贴皮上，如井口形，
勿令渗漏，圈外围布数重，防火气烘肤，圈内铺蜡屑三四分浓，次以铜漏杓盛桑木炭火，
悬蜡上烘之，令蜡化至滚，再添蜡屑，随添以井满为度。皮不痛者毒浅，灸至知痛为度、
皮痛者毒深，灸至不知痛为度。去火杓，即喷冷水少许于蜡上，俟冷起蜡，蜡底之色青
黑，此毒出之征也。如漫肿无头者，亦以湿纸试之，于先干处灸之，初起者一二次即消，
已成者二三次即溃。疮久溃不敛，四围顽硬者，即于疮口上灸之，蜡从孔入，愈深愈妙，
其顽腐瘀脓尽化，收敛甚速。
附子饼灸法
生川附子为末，黄酒合作饼如三钱浓，安疮上以艾壮灸之，每日灸数壮，但令微热，勿
令疼痛。如饼干，再易饼灸之，务以疮口红活为度。治溃疡气血俱虚，不能收敛，或风
寒袭之，以致血气不能营运者，实有奇验。
豆豉饼灸法
痈疽发背，已溃未溃，用江西淡豆豉为末，量疮大小，黄酒合作饼，浓三分，置患
处灸之，饼干再易饼。如已有疮孔，勿覆孔上，四布豉饼，列艾其上灸之，使微热，勿
令肉破，如热痛急易之。日灸三度，令疮孔出汗即瘥。
蛴螬灸法
疳 恶疮，诸药不验者，取蛴螬剪去两头，安疮口上，以艾灸之，七壮一易，不过
七枚，无不效者。
麦冬粳米饮
此方治痈疽阴疮，法当艾灸，或灸太过者，或阳疮不应灸而误灸者，以致火毒入里，
令患者头项浮肿，神昏痰涌，吁吁作喘，急服此药，以清解火毒甚效。
麦门冬（去心） 粳米（各三钱）
水二盅，煎一盅，徐徐热服。
【方歌】麦冬粳米各等分，能医灸后头项肿，神昏痰涌作喘声，水煎徐徐功最勇。
痈疽红肿且颜色赤红，游走不定；赤游丹毒、红丝疔（一种以皮肤出现红线为特征的急性感染性疾病）；时行疫毒导致瘀血壅盛等证候，使用砭石疗法最为适宜。只需刺破皮肤，不要伤及肌肉，用瓷锋对准患处操作要轻，毒血一旦受刺便能全部排出，肿胀消退、红色散开具有奇效。
【注】凡是痈疽红肿色赤，游走不定，以及赤游丹毒、红丝疔走散，时行疫毒瘀血壅盛等证候，都适宜施行砭石之法。然而忌讳针刺过深，《黄帝内经》所说的“刺皮无伤肉”就是这个意思。操作方法是用细瓷器击碎，选取有锋芒的一块，用一根筷子，将头部劈开，夹住瓷片并捆绑固定，用两个手指轻轻按压筷梢，使瓷锋对准患处，悬空约一寸许，再用一根较重的筷子，频繁敲击筷头，使毒血遇刺皆出。到第二天如果肿胀未完全消退，再酌情施行砭法，以肿胀消退、红色散开为标准。
【痈疽灸法歌】
痈疽初起七日内，采用艾灸来开结拔毒最为适宜。不痛的疮疡，灸到感到疼痛为止；疮痛者，灸到不痛为止。操作方法是将湿纸覆盖在疮面上，纸干的地方先施灸，不宜迟缓。可以使用隔蒜灸、黄蜡灸、附子饼灸，也可以用豆豉饼灸、蛴螬灸。
【注】凡是痈疽初起，七日以前，想要开结拔毒，非用灸法不可。不痛的，灸到知道痛为止；疮痛的，灸到不痛为止。因为毒邪附着则不痛，火气到达好肉则痛，必须灸到感到疼痛，说明火气已经到达好肉才停止。火气接触皮肉未受损处则痛，接触毒邪处则不痛，必须灸到不痛，说明火气已经深入毒邪才停止。操作方法是用纸蘸水完全覆盖在患部，看纸先干的地方，就先在那里施灸。但灸法贵在早期施用，如病症起二、三天就施灸，十个病例可以痊愈八九个；四、五天施灸的，十个病例可以痊愈六七个；六、七天施灸的，十个病例可以痊愈四五个，越早越好。其方法有多种，有隔蒜灸的，有直接灸在肉上的，有用黄蜡灸的，有用附子饼灸、豆豉饼灸、蛴螬灸的。一壮灸到一百壮，以见效为标准。至于艾壮的大小，则根据疮势大小来决定。然而灸法也有禁忌，如肾俞发（生于肾俞穴部位的痈疽）不宜灸，恐怕消耗肾液；手指部位不宜灸，因为皮肉单薄，恐怕导致皮裂肉烂。至于头部是诸阳之首，各书都说是禁灸，如果误灸逼迫毒邪入里，使人痰喘上涌，反而加大肿胀。然而遇到纯阴下陷的证候，必须当灸，不灸就不能回阳。若是半阴半阳的证候，则仍应当禁止而不灸。
【隔蒜灸法】
大蒜切成片，约三钱厚，放在疮头上，用大艾壮施灸，三壮就换一片蒜。如果是漫肿无头的，用湿纸覆盖在上面，观察先干的地方，放置蒜片施灸。如果有两三处先干，就同时在两三处施灸。如果有一点白粒如粟米大小，四周红肿如铜钱大小的，就在白粒上施灸。如果疮势大、天数多的，将蒜捣烂，铺在疮上，将艾铺在蒜上施灸。蒜坏了再更换，以感到剧烈疼痛为有效。凡是痈疽流注、鹤膝风，每天灸二三十壮。痈疽阴疮等证候，艾的数量必须多，宜先服用护心散，以防火气内入。给小儿施灸，先将蒜放在大人手臂上，点燃艾草等候蒜温热，然后移到小儿毒疮上，方法照前所述。经云：寒邪客于经络之中则血液凝涩，血液凝涩则不通，卫气随之聚集，壅遏而不能运行，所以发热；大热不止则肌肉腐败化为脓。大概毒原本源于火，但与外寒相搏结，所以用艾火、蒜灸之，使开结毒邪，将深陷的毒邪移至浅表。
【黄蜡灸法】
凡是痈疽、发背、恶疮、顽疮，先用湿面粉随着肿根画圈，高一寸多，紧贴皮肤，像井口形状，不要让渗漏，圈外围布数层，防止火气烘烤皮肤，圈内铺蜡屑三四分厚，然后用铜漏勺盛桑木炭火，悬在蜡上烘烤，使蜡熔化至沸腾，再添蜡屑，随添随加直到填满井口为止。皮不痛的毒邪浅，灸到感到疼痛为止；皮痛的毒邪深，灸到不感到疼痛为止。去掉火勺，立即在蜡上喷少许冷水，等到冷却后取下蜡，蜡底颜色青黑，这是毒邪排出的征象。如果是漫肿无头的，也用湿纸测试，在先干处施灸，初起的病一二三次即可消散，已形成的病二三次即可溃破。疮久溃不收敛，四周顽固坚硬的，就在疮口上施灸，蜡从孔洞进入，越深越好，顽固腐肉和瘀脓全部化解，收敛非常迅速。
【附子饼灸法】
生川附子研末，用黄酒调和做成饼，约三钱厚，放在疮上以艾壮施灸，每天灸几壮，只要令微热，不要令疼痛。如果饼干了，再换饼施灸，务必以疮口红活为标准。治疗溃疡气血俱虚，不能收敛，或风寒侵袭，导致气血不能营运的，确有奇效。
【豆豉饼灸法】
痈疽发背，已溃或未溃，用江西淡豆豉研末，根据疮的大小，用黄酒调和做成饼，厚三分，放置在患处施灸，饼干了再换饼。如果已有疮孔，不要覆盖在孔上，在四周布置豆豉饼，排列艾条在其上施灸，使微热，不要让肉破损，如果热痛急迫就更换。每天灸三次，让疮孔出汗即痊愈。
【蛴螬灸法】
疳积恶疮，各种药物无效的，取蛴螬剪去两头，放在疮口上，用艾施灸，七壮更换一只，不超过七只，没有无效的。
【麦冬粳米饮】
此方治疗痈疽阴疮，本应艾灸，或者灸得太过，或者阳疮不应灸而误灸的，导致火毒入里，使患者头项浮肿，神志昏迷，痰涌气喘，急促服用此药，以清解火毒非常有效。
水两盅，煎成一盅，慢慢热服。
[Song on Scarification for Carbuncles and Ulcers]
Carbuncles and ulcers presenting with swelling, redness, and wandering migration; erysipelas (acute skin infection); filiform carbuncle (an acute infectious disease characterized by a red line on the skin); and patterns of epidemic toxins causing severe stagnation of blood stasis—all are most appropriately treated with scarification. One need only puncture the skin without injuring the flesh; using a porcelain edge against the affected area requires lightness. When toxic blood is expelled upon puncture, the swelling subsides and redness dissipates, demonstrating miraculous efficacy.
[Note] For all conditions such as carbuncles and ulcers with red, wandering swelling; erysipelas; spreading filiform carbuncle; and severe blood stasis due to epidemic toxins, the method of stone scarification is suitable. However, excessive depth must be avoided, as stated in the *Neijing*: "Puncture the skin without injuring the flesh." The technique involves crushing fine porcelain and selecting a piece with a sharp edge. A chopstick is split at one end to clamp and bind the porcelain shard. Using two fingers to gently press the handle end, the porcelain edge is held about one cun away from the lesion. Another heavier chopstick is used to frequently tap the handle, allowing toxic blood to flow out upon puncture. If the swelling has not fully resolved the next day, scarification should be performed again according to judgment, stopping when the swelling subsides and redness dissipates.
[Song on Moxibustion for Carbuncles and Ulcers]
For carbuncles and ulcers in their initial stage within seven days, moxibustion is most suitable for resolving nodules and drawing out toxins. For painless lesions, moxa is applied until pain is felt; for painful sores, it is applied until the pain ceases. The method involves covering the area with wet paper; moxibustion should begin immediately where the paper dries first, without delay. Methods include garlic-interposed moxibustion, yellow wax moxibustion, prepared aconite cake moxibustion, fermented soybean cake moxibustion, and larva moxibustion.
[Note] For early-stage carbuncles and ulcers within seven days, moxibustion is indispensable for resolving nodules and extracting toxins. Painless areas are moxed until sensation returns; painful sores are moxed until pain stops. This is because toxin attachment causes numbness, while heat reaching healthy tissue causes pain. Moxibustion must continue until pain is felt, indicating that the fire qi has reached healthy tissue. Conversely, contact with undamaged skin causes pain, while contact with toxin causes no pain; thus, one must moxe until pain disappears, indicating the fire qi has penetrated the toxin. The technique involves soaking paper in water and covering the lesion completely. Observe where the paper dries first and apply moxa there. Early application is crucial: treating on days 2–3 yields an 80–90% cure rate; days 4–5 yield 60–70%; days 6–7 yield 40–50%. Earlier is better. Various methods exist: garlic-interposed, direct flesh moxibustion, yellow wax, prepared aconite cake, fermented soybean cake, and larva moxibustion. One session may involve up to one hundred moxa cones, stopping when effective. The size of the moxa cone depends on the severity of the sore. However, there are contraindications: *Shenshu* carbuncle (carbuncle at the Shenshu acupoint) should not be moxed to avoid depleting kidney fluids; finger lesions should not be moxed due to thin skin and flesh, risking cracking and rot. The head is the summit of all Yang meridians; classical texts prohibit moxibustion here. Mistaken moxibustion may force toxins inward, causing phlegm and wheezing, exacerbating swelling. However, in pure Yin sinking patterns, moxibustion is mandatory to restore Yang. In half-Yin half-Yang patterns, it remains prohibited.
[Garlic-Interposed Moxibustion Method]
Slice fresh garlic to a thickness of approximately 3 qian. Place it on the sore and apply large moxa cones. Replace the garlic slice after three cones. For diffuse swelling without a head, cover with wet paper, identify the first drying spot, place garlic there, and moxa. If multiple spots dry simultaneously, moxa them together. If a white grain-sized nodule appears surrounded by coin-sized redness, moxa directly on the white grain. For large or long-standing sores, mash garlic, spread it on the sore, place moxa on top, and replace the garlic when it burns. Efficacy is indicated by intense pain. For carbuncles, flowing abscesses, and knee-crane wind, apply 20–30 cones daily. For yin-type sores, use abundant moxa; administer *Huxin San* (Heart-Protecting Powder) beforehand to prevent fire toxins from entering internally. For children, place garlic on an adult's arm, ignite moxa until the garlic warms, then transfer to the child's lesion, following the previous method. As stated in the classics: "When cold pathogens lodge in the collaterals, blood congeals and flows poorly. Wei Qi gathers there, obstructing flow and generating heat. Unchecked heat rots flesh into pus." Toxin originates from fire but combines with external cold; thus, moxa and garlic are used to resolve nodules and draw deep toxins to the surface.
[Yellow Wax Moxibustion Method]
For carbuncles, back carbuncles, malignant sores, and stubborn ulcers, first use wet dough to form a circle around the base of the swelling, about one cun high, adhering tightly to the skin like a well mouth, preventing leakage. Surround the circle with several layers of cloth to protect the skin from heat. Fill the circle with 3–4 fen thick yellow wax shavings. Suspend a copper scoop containing mulberry charcoal fire above the wax to melt it until boiling. Add more shavings until the circle is full. For painless skin (shallow toxin), moxa until pain is felt; for painful skin (deep toxin), moxa until pain ceases. Remove the heat source, spray a little cold water on the wax, wait for it to cool, and remove the wax. Blackish-green residue at the bottom indicates toxin expulsion. For diffuse swelling, test with wet paper and moxa the first drying spot. Early stages resolve in 1–2 sessions; established stages ulcerate in 2–3. For chronic non-healing ulcers with hard margins, moxa directly on the wound opening. Wax penetrates deeper for better results, dissolving stubborn necrotic tissue and pus rapidly, promoting quick healing.
[Prepared Aconite Cake Moxibustion Method]
Grind raw Sichuan aconite (*Radix Aconiti Lateralis Preparata*) into powder, mix with yellow wine to form cakes about 3 qian thick. Place on the sore and apply moxa cones. Apply a few cones daily, ensuring mild warmth without pain. Replace dried cakes. Continue until the sore becomes red and vibrant. This method is highly effective for ulcers with Qi and Blood deficiency failing to heal, or where Wind-Cold invasion impedes circulation.
[Fermented Soybean Cake Moxibustion Method]
For carbuncles and back carbuncles, whether ulcerated or not, grind Jiangxi light fermented soybeans (*Faber Semen Preparatum*) into powder. Mix with yellow wine to form cakes 3 fen thick based on sore size. Place on the lesion and moxa. Replace dried cakes. If an opening exists, do not cover it; arrange soybean cakes around the opening, place moxa on top, and apply mild heat without breaking the skin. Change if too hot/painful. Apply three times daily until the sore sweats, indicating recovery.
[Larva Moxibustion Method]
For malnutrition-related malignant sores unresponsive to other drugs, take larvae (*Megaselia scalaris*), cut off both ends, place on the sore, and apply moxa. Replace every seven cones, using no more than seven larvae total. This method is invariably effective.
[Mai Dong Jing Mi Yin]
This formula treats yin-type carbuncles and ulcers where moxibustion was either indicated but excessive, or contraindicated (Yang sores) but mistakenly applied, leading to fire toxins entering the interior. Symptoms include swelling of the head and neck, coma, phlegm surging, and panting. Administer this urgently to clear and resolve fire toxins effectively.
Ophiopogon Root (*Ophiopogonis Radix*, heart removed) and Coix Seed/Job's Tears? No, Rice (*Oryzae Sativa Germen*) — each 3 qian.
Decoct in two sheng of water until one sheng remains. Drink slowly while warm.
[Formula Song]
Mai Dong and Jing Mi in equal parts,
Cures head and neck swelling post-moxa.
Coma, phlegm, and panting cease,
Slow decoction brings greatest success.