疮疡之症，有五善，有七恶。五善见三则瘥，七恶见四则危。夫善者∶动息自宁，饮食
知味，便利调匀，脓溃肿消，水鲜不臭，神彩精明，语声清朗，体气和平是也，此属腑症，病微
邪浅，更能慎起居，节饮食，勿药自愈。恶者∶乃五脏亏损之症，多因元气虚弱，或因脓水
出多，气血亏损；或因汗下失宜，荣卫消铄；或因寒凉克伐，气血不足；或因峻厉之剂，胃
气受伤；以致真气虚而邪气实，外似有余而内实不足，法当纯补胃气，多有可生。不可因其
恶，遂弃而不治。若大渴发热，或泄泻淋闭者，邪火内淫，一恶也，竹叶黄 汤。
气血俱虚，八珍汤，加黄 、麦门、五味
、山茱萸；如不应，佐以加减八味丸煎服。脓血既泄，肿毒尤甚，脓色败臭者，胃气虚而火
盛，二恶也，人参黄 汤；如不应，用十全大补汤加麦门、五味。目视不正，黑睛紧小，白
睛青赤，瞳子上视者，肝肾阴虚而目系急，三恶也，六味丸料加炒山栀、麦门、五味；如不
应，用八珍汤加炒山栀、麦门、五味。喘粗气短，恍惚嗜卧者，脾肺虚火，四恶也，六君加
大枣、生姜；如不应，用补中益气汤加麦门、五味。心火刑克肺金，人参平肺散。阴火伤肺
，六味丸加五味子煎服。肩背不便，四肢沉重者，脾肾亏损，五恶也，补中益气汤加山茱萸
、山药、五味；如不应，用十全大补汤加山茱萸、山药、五味。不能下食，服药而呕，食不
知味者，胃气虚弱，六恶也，六君子汤加木香、砂仁；如不应，急加附子。声嘶色败，唇鼻
青赤，面目四肢浮肿者，脾肺俱虚，七恶也，补中益气汤加大枣、生姜；如不应，用六君子
汤加炮姜；更不应，急加附子，或用十全大补汤加附子、炮姜。腹痛泄泻，咳逆昏愦者，阳
气虚，寒气内淫之恶症，急用托里温中汤，复用六君子汤加附子，或加姜、桂温补。此七恶
之治法者也。此外更有溃后发热，恶寒作渴；或怔忡惊悸，寤寐不宁，牙关紧急；或头目赤
痛，自汗盗汗，寒战切牙，手撒身热，脉洪大，按之如无；或身热恶衣，欲投于水，其脉浮
大，按之微细，衣浓仍寒，此血气虚极，传变之恶症也。若手足逆冷，肚腹疼痛，泄痢肠鸣
，饮食而入，呃逆呕吐，此阳气虚，寒气所乘之恶症也。若有汗而不恶寒，或无汗而恶寒，
口噤足冷，腰背反张，颈项劲强，此血气虚极，变痉之恶症也，急用参、 、归、术、附子
救之，间有可生者。大抵虚中见恶症者，难治。实症无恶候者，易治。宋时齐院令虽尝纂其
状，而未具其因。皇明陶节庵，虽各立一方，亦简而未悉，余故补其缺云。
疮疡这类疾病，有五善证和七恶证。五善证中出现三项则病情好转，七恶证中出现四项则病情危重。所谓善证：是指呼吸平稳安宁，饮食有味，大小便调匀，脓液排出后肿胀消退，脓液颜色鲜亮且不臭，精神光彩精明，声音清朗，身体气息平和，这属于腑病（六腑病变），病邪轻微浅表，如果能谨慎起居，节制饮食，甚至不用药也能自愈。
所谓恶证：是五脏亏损的病症，多因元气虚弱，或因脓水流出过多导致气血亏损；或因发汗、攻下治疗不当，导致营卫之气消减耗损；或因过用寒凉药物克伐正气，导致气血不足；或因使用猛烈峻厉的药物，损伤了胃气；以致真气虚弱而邪气实盛，外表看似有余而内部实则不足，治法应当纯然补益胃气，大多可以生还。不能因为它是恶证，就放弃不治疗。
如果出现大渴、发热，或泄泻、淋证、小便闭塞，这是邪火内侵，属于一恶，用竹叶黄芪汤。
如果气血俱虚，用八珍汤，加黄芪、麦冬、五味子、山茱萸；如果无效，配合加减八味丸煎服。
如果脓血已泄，但肿毒反而更严重，脓色败坏发臭，这是胃气虚而火盛，属于二恶，用人参黄芪汤；如果无效，用十全大补汤加麦冬、五味子。
如果目光不正，黑睛紧缩变小，白睛青赤，瞳仁上视，这是肝肾阴虚而目系拘急，属于三恶，用六味地黄丸料加炒山栀、麦冬、五味子；如果无效，用八珍汤加炒山栀、麦冬、五味子。
如果气喘粗重、气短，神志恍惚、嗜睡，这是脾肺虚火，属于四恶，用六君子汤加大枣、生姜；如果无效，用补中益气汤加麦冬、五味子。若心火刑克肺金，用人参平肺散。若阴火伤肺，用六味地黄丸加五味子煎服。
如果肩背不便，四肢沉重，这是脾肾亏损，属于五恶，用补中益气汤加山茱萸、山药、五味子；如果无效，用十全大补汤加山茱萸、山药、五味子。
如果不能进食，服药即呕吐，食物不知味道，这是胃气虚弱，属于六恶，用六君子汤加木香、砂仁；如果无效，紧急加入附子。
如果声音嘶哑、面色败坏，唇鼻青赤，面目及四肢浮肿，这是脾肺俱虚，属于七恶，用补中益气汤加大枣、生姜；如果无效，用六君子汤加炮姜；再无效，紧急加入附子，或用十全大补汤加附子、炮姜。
如果腹痛泄泻，咳嗽气逆、昏愦，这是阳气虚，寒气内侵的恶症，紧急用托里温中汤，再用六君子汤加附子，或加干姜、肉桂温补。这是七恶的治疗方法。
此外还有溃破后发热、恶寒作渴；或怔忡惊悸，醒睡不宁，牙关紧急；或头目赤痛，自汗盗汗，寒战咬牙，手撒身热，脉象洪大但按之如无；或身热怕衣，欲投入水中，其脉浮大但按之微细，穿衣仍觉寒冷，这是气血极度虚弱，传变而成的恶症。
如果手足逆冷，肚腹疼痛，泄痢肠鸣，饮食入口即呃逆呕吐，这是阳气虚，寒气乘袭的恶症。
如果有汗但不恶寒，或无汗而恶寒，口噤足冷，腰背反张，颈项强直，这是气血极度虚弱，变为痉病的恶症，紧急用人参、黄芪、当归、白术、附子救治，间或有可生者。
大抵虚证中出现恶症的，难治。实证没有恶候的，易治。宋代齐州院令虽然曾编纂这些症状，但未详述原因。明代陶节庵虽然分别设立方剂，但也简略而未详尽，所以我补充其中的缺失。
In the disease of sores and ulcers, there are five favorable signs (Wu Shan) and seven unfavorable signs (Qi E). If three of the five favorable signs appear, the condition will improve; if four of the seven unfavorable signs appear, the condition is critical.
The favorable signs are: calm breathing and rest, food tasting good, regular bowel movements and urination, reduction of swelling after pus discharge, fresh and odorless pus, bright and clear spirit, clear voice, and harmonious body qi. These belong to fu-organ diseases (diseases of the six fu organs), where the pathogenic factor is slight and superficial. With careful daily routine and dietary restraint, self-healing may occur without medication.
The unfavorable signs refer to deficiencies of the five zang organs, often caused by weak primordial qi, excessive loss of blood and qi due to profuse pus drainage, depletion of ying and wei qi due to improper sweating or purging, insufficiency of blood and qi from overuse of cold-cooling drugs that suppress healthy qi, or injury to stomach qi from harsh and drastic medicines. This results in deficiency of true qi and excess of pathogenic qi, appearing externally as excess but internally as actual deficiency. The treatment method should purely tonify stomach qi, and survival is often possible. One must not abandon treatment simply because it is an unfavorable sign.
If there is extreme thirst, fever, diarrhea, stranguria, or urinary retention, this indicates internal flooding of pathogenic fire, which is the first unfavorable sign. Use Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction).
If both qi and blood are deficient, use Bazhen Tang (Eight Treasure Decoction), adding Huangqi (Astragali Radix), Maidong (Ophiopogonis Tuber), Wuweizi (Schisandrae Fructus), and Shanzhuyu (Corni Fructus). If ineffective, administer Jiajian Bawei Wan (Modified Eight-Ingredient Pill) decocted and taken orally.
If pus and blood have been discharged but the swelling and toxicity worsen, with foul-smelling and degenerated pus, this indicates deficiency of stomach qi and flourishing fire, which is the second unfavorable sign. Use Renshen Huangqi Tang (Ginseng and Astragalus Decoction). If ineffective, use Shiquan Dabu Tang (Complete Great Tonifying Decoction) adding Maidong and Wuweizi.
If gaze is misaligned, the black pupil is tight and small, the white sclera is blue-red, and the pupil looks upward, this indicates yin deficiency of the liver and kidney with tension of the eye meridians, which is the third unfavorable sign. Use Liuwei Dihuang Wan material (Six-Ingredient Pill with Rehmanniae Radix) adding Chao Shanzhi (Stir-fried Gardenia Fruit), Maidong, and Wuweizi. If ineffective, use Bazhen Tang adding Chao Shanzhi, Maidong, and Wuweizi.
If panting is coarse and breath is short, with mental confusion and drowsiness, this indicates deficiency-fire of the spleen and lung, which is the fourth unfavorable sign. Use Liujunzi Tang (Six Gentlemen Decoction) adding Dazao (Jujubae Fructus) and Shengjiang (Zingiberis Rhizoma Recens). If ineffective, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) adding Maidong and Wuweizi. If heart fire attacks lung metal, use Renshen Pingfei San (Ginseng Lung-Pacifying Powder). If yin fire injures the lung, use Liuwei Dihuang Wan adding Wuweizi, decocted and taken.
If the shoulder and back are stiff and limbs feel heavy, this indicates deficiency and damage of the spleen and kidney, which is the fifth unfavorable sign. Use Buzhong Yiqi Tang adding Shanzhuyu, Shanyao (Dioscoreae Rhizoma), and Wuweizi. If ineffective, use Shiquan Dabu Tang adding Shanzhuyu, Shanyao, and Wuweizi.
If unable to eat, vomiting after taking medicine, and food has no taste, this indicates weakness of stomach qi, which is the sixth unfavorable sign. Use Liujunzi Tang adding Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus). If ineffective, urgently add Fuzi (Aconiti Lateralis Radix Praeparata).
If hoarse voice and ruined complexion, blue-red lips and nose, and edema of face, eyes, and limbs, this indicates joint deficiency of spleen and lung, which is the seventh unfavorable sign. Use Buzhong Yiqi Tang adding Dazao and Shengjiang. If ineffective, use Liujunzi Tang adding Paojiang (Zingiberis Rhizoma Preparatus). If still ineffective, urgently add Fuzi, or use Shiquan Dabu Tang adding Fuzi and Paojiang.
If abdominal pain and diarrhea, cough with rebellious qi, and coma/confusion occur, this is a critical condition of yang qi deficiency with internal invasion of cold qi. Urgently use Tuoli Wenzhong Tang (Support Interior and Warm Middle Decoction), then use Liujunzi Tang adding Fuzi, or add Ganjiang (Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex) for warming and tonifying. These are the treatments for the seven unfavorable signs.
Additionally, there are unfavorable signs after ulceration such as fever, aversion to cold, and thirst; palpitations, fright, insomnia, and restless sleep; trismus (lockjaw); red and painful head and eyes; spontaneous and night sweats; chills with teeth grinding; flaccid hands and body heat with a surging pulse that feels empty upon pressure; or body heat with aversion to clothing, desire to throw oneself into water, yet the pulse is floating and large but fine upon pressure, and cold persists despite thick clothing. These are critical conditions resulting from extreme deficiency of blood and qi and transformation.
If extremities are cold, abdominal pain, diarrhea/dysentery with borborygmus, and hiccups/vomiting immediately after eating occur, this is a critical condition of yang qi deficiency with cold qi attacking.
If there is sweating without aversion to cold, or no sweating with aversion to cold, trismus, cold feet, opisthotonos (arching of the back), and neck stiffness, this is a critical condition of extreme blood and qi deficiency transforming into spasm (jing zheng). Urgently treat with Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Fuzi to rescue; survival is occasionally possible.
Generally, unfavorable signs appearing in deficiency patterns are difficult to treat. Patterns without unfavorable signs are easy to treat. In the Song Dynasty, Qi Yuanling compiled these symptoms but did not detail their causes. In the Ming Dynasty, Tao Jie'an established separate formulas for each, but they were brief and incomplete. Therefore, I supplement these deficiencies.