疮疡作渴，若 痛发热，便利调和者，上焦热也，用竹叶石膏汤。肿痛发热，大便秘涩
者，五内热也，用四顺清凉饮。 肿痛甚者，热毒蕴结也，用仙方活命饮。漫肿微痛者，气血虚
壅也，用补中益气汤。若因胃火消烁而津液短少者，用竹叶黄 汤。若因胃气虚而不能生津
液者，用补中益气汤。若因胃气伤而内亡津液者，用七味白术散。若因肾水干涸作渴，或口
舌
黄干硬，小便数而疽生者，尤其恶也。苟能逆知其因，预服加减八味丸、补中益气汤，以
滋化源，可免后患。
疮疡出血，因五脏之气亏损，虚火动而错经妄行也，当求其经，审其因而治之。若肝热
而血
，四物、炒连、丹皮、芩、术。脾虚热而不能统血者，四君、炒栀、丹皮。若脾经郁结，用
归脾汤加五味子。脾肺气虚，用补中益气加五味子。气血俱虚，用十全大补。阴火动，用六
味丸加五味子。大凡失血过多，见发热作渴等症，勿论其脉，急用独参汤以补气。经云∶血
生于气。苟非参、 、归、术，甘温等剂，以生心肝之血，决不能愈。若发热脉大者，不治
。凡患血症，皆当以犀角地黄汤为主。
治验
翰林屠渐山年四十，患湿毒疮疾，误用轻粉之剂，亏损元气，久不能愈。一日将晡之际
，诊之肝脉急洪，数而有力。余曰∶何肝脉之如此。侵晨疮出黯血三四碗，体倦自汗，虽甚可畏
，所喜血黯而脉静。余曰∶此轻粉之热，血受其毒而妄行，轻粉之毒，亦得以泄，邪气去而
真气虚也，当急用独参汤主之。余重其为人，体恤甚笃，但惑于他言不果，致邪气连绵不已
一男子背疮出血，烦躁作渴，脉洪大，按之如无，此血脱发躁，用当归补血汤，二剂少
愈；又以八珍汤加黄 、山栀，数剂全愈。
一妇人溃后，吐鲜血三碗许，余用独参汤而血止，用四君、熟地、芎、归而疮愈。此血
脱补气，阳生阴长之理也。若用凉血降火沉阴之剂，脾胃生气复伤，不惟血不归源，而死无疑矣。
一老妇手大指患疔，为人针破出鲜血，手背俱肿，半体皆痛，神思昏愦五日矣，用活命
饮，
出毒水；又各一剂，赤肿渐溃；又用托里药而瘥。
南仪部贺朝卿，升山西少参，别时，余见其唇鼻青黑，且时搔背，问其故？曰∶有一小
疮耳。余视之，果疽也，此脾胃败坏，为不治之症。余素与善，悲其途次不便殡殓，遂托其僚友
张东沙辈，强留之，勉与大补，但出紫血，虚极也。或谓毒炽不能为脓，乃服攻毒药一钟，
以致呕逆脉脱，果卒于南都。
佥宪张碧崖腰患疽，醉而入房，脉洪数，两尺更大，余辞不治，将发舟，其子强留，顷
间吐臭血五六碗，余意此肾经虚火，而血妄行，血必从齿缝出，将合肉桂等补肾制火之药，各用
罐别煎熟听用，血止拭齿视之果然。遂合一钟，冷服之，热渴顿止，少顷，温服一钟，脉细
欲说，气息奄奄，得药则脉少复，良久仍脱。其子疑内有脓欲刺之，余曰∶必无。乃以鹅翎
管衽内，果如余言。次日脉脱，脚寒至膝，腹内如冰，急用六君加姜、附，腹始温，脓始溃
，疮口将完。彼因侍者皆爱外家，又患小便不通，此阴已痿，而思色以降其精，精内败不出而
然耳，用加减八味丸料加参、 、白术一剂，小便虽愈，疮口不敛而殁。
疮疡出现口渴症状，如果伴有疼痛、发热，且大小便调和正常的，属于上焦有热，使用竹叶石膏汤。如果肿痛明显并伴有发热，且大便秘结不通的，属于五脏内部有热，使用四顺清凉饮。如果肿胀疼痛非常剧烈的，属于热毒蕴结体内，使用仙方活命饮。如果是漫肿（肿胀范围广泛但边界不清）且疼痛轻微的，属于气血虚弱导致壅滞，使用补中益气汤。如果是由于胃火炽盛消耗津液而导致津液短少引起的口渴，使用竹叶黄汤（注：原文此处可能有脱字，通常指竹叶石膏汤或含竹叶、黄芩等之剂，依原文直译）。如果是由于胃气虚弱不能生成津液引起的口渴，使用补中益气汤。如果是由于胃气受损导致体内津液亡失引起的口渴，使用七味白术散。如果是由于肾水干涸引起的口渴，或者口舌生黄色干燥硬痂，小便频数且伴有疽症发生的，这尤其属于难治的恶证。如果能预先知晓病因，提前服用加减八味丸、补中益气汤，以滋养化源（脾胃生化之源），可以避免后续的祸患。
疮疡出血，是由于五脏之气亏损，虚火妄动导致血液错乱溢出经脉所致，应当追溯所属经络，审察病因进行治疗。如果是肝经有热导致血液妄行，使用四物汤加炒黄连、牡丹皮、黄芩、白术。如果是脾虚有热而不能统摄血液的，使用四君子汤加炒栀子、牡丹皮。如果是脾经气机郁结，使用归脾汤加五味子。如果是脾肺气虚，使用补中益气汤加五味子。如果是气血俱虚，使用十全大补汤。如果是阴火妄动，使用六味丸加五味子。大凡失血过多，出现发热、口渴等症状时，不论脉象如何，都应紧急使用独参汤来补气。医经说：血生于气。如果不是用人参、黄芪、当归、白术等甘温性质的药物，来生养心肝之血，决不能痊愈。如果发热且脉象大的，属于不治之症。凡是患有血症的，都应当以犀角地黄汤为主方。
治疗案例：
翰林屠渐山四十岁时，患有湿毒疮疾，误用了含有轻粉的药剂，导致元气亏损，久治不愈。一天傍晚时分，诊察发现其肝脉急洪，数而有力。我说：“为什么肝脉会如此？”清晨疮口流出暗红色血液三四碗，身体疲倦自汗，虽然看起来很可怕，但庆幸的是血色暗红且脉象相对平静。我说：“这是轻粉的热毒，血液受其毒性影响而妄行，轻粉的毒素也得以随血排出，邪气已去但真气虚弱，应当紧急使用独参汤主治。”我重视他的为人，体恤甚深，但他被其他言论迷惑而没有采纳我的建议，导致邪气连绵不断。
一男子背部疮疡出血，烦躁口渴，脉象洪大，但重按却感觉空虚，这是血脱后引发的烦躁，使用当归补血汤，两剂后症状稍减；又用八珍汤加黄芪、栀子，数剂后完全痊愈。
一妇人疮疡溃破后，呕吐鲜血约三碗，我用独参汤使血止住，再用四君子汤、熟地黄、川芎、当归使疮口愈合。这是“血脱补气”，遵循阳生阴长的道理。如果使用凉血降火的沉寒阴冷药剂，会再次损伤脾胃的生气，不仅血液不能回归本源，而且必然导致死亡。
一老妇人大拇指患疔疮，被人针刺破流出鲜血，手背全部肿胀，半身皆痛，神志昏沉迷糊已达五天，我用仙方活命饮，引出毒水；又各服一剂，红肿逐渐溃破；再用托里药而痊愈。
南仪部贺朝卿，升任山西少参，告别时，我看见他唇鼻青黑，且时常搔背，询问原因？他说：“有一个小疮罢了。”我看那确实是疽症，这是脾胃败坏，属于不治之症。我平时与他交好，悲叹他在旅途中不便殡殓，于是托付他的僚友张东沙等人，强行挽留他，勉强给予大补药物，只流出紫黑色血液，说明极度虚弱。有人说毒气炽盛不能化为脓，于是他服了一钟攻毒药，导致呕吐逆乱、脉象脱绝，果然在南京去世。
佥宪张碧崖腰部患疽，醉酒后行房事，脉象洪数，两尺脉更大，我推辞说不治，准备开船离开，他的儿子强行挽留。片刻间吐出臭血五六碗，我心想这是肾经虚火，血液妄行，血液必定从齿缝流出，于是合成了肉桂等补肾制火的药物，分别用罐煎熟备用。血止后擦拭牙齿查看，果然如此。于是让他喝下一钟，冷服，热渴顿时停止，过了一会儿，温服一钟，脉象细弱欲绝，气息奄奄，得到药后脉象稍微恢复，良久之后仍然脱绝。他的儿子怀疑里面有脓想要刺破，我说：“一定没有。”于是用鹅翎管插入鼻孔内，果然如我所言。第二天脉象脱绝，脚冷至膝盖，腹内如冰，紧急使用六君子汤加生姜、附子，腹部才温暖，脓才开始溃破，疮口即将愈合。他因为侍者都偏爱岳家（外家），又患小便不通，这是阴气已经痿废，因贪恋色欲而耗损精气，精气在内败坏无法排出而导致的，使用加减八味丸料加人参、黄芪、白术一剂，小便虽然好了，但疮口不收敛而死亡。
When sores and ulcers are accompanied by thirst, if there is pain, fever, and normal bowel movements and urination, it indicates heat in the Upper Jiao (Upper Burner); use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). If there is swelling, pain, fever, and constipation, it indicates heat within the five Zang organs; use Sishun Qingliang Yin (Four-Compliant Cooling Beverage). If swelling and pain are severe, it indicates accumulation and binding of heat-toxin; use Xianfang Huoming Yin (Immortal Life Saving Decoction). If there is diffuse swelling with slight pain, it indicates stagnation due to deficiency of Qi and Blood; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If thirst is caused by stomach fire consuming fluids leading to a shortage of body fluids, use Zhuye Huang Tang (Bamboo Leaf and [Huang] Decoction - *Note: Text likely implies a variation containing Bamboo Leaf and Huang*). If thirst is caused by deficiency of stomach Qi failing to generate fluids, use Buzhong Yiqi Tang. If thirst is caused by injury to stomach Qi leading to internal loss of fluids, use Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). If thirst is caused by dryness and depletion of Kidney Water, or if yellow, dry, and hard crusts appear on the mouth and tongue, accompanied by frequent urination and the development of carbuncles, this is particularly a malignant and difficult condition. If the cause can be anticipated in advance, taking Jiaban Bawei Wan (Modified Eight-Ingredient Pill) and Buzhong Yiqi Tang to nourish the source of transformation (the Spleen and Stomach as the source of post-heaven Qi and Blood) can prevent subsequent complications.
Bleeding from sores and ulcers is caused by the deficiency of Qi in the five Zang organs, where deficient fire moves recklessly, causing blood to flow erratically outside its vessels. One must identify the affected meridian, examine the cause, and treat accordingly. If liver heat causes blood to run wild, use Siwu Tang (Four Substances Decoction) plus Chao Lian (Stir-fried Coptis Rhizoma), Mudan Pi (Moutan Cortex), Qin (Scutellaria Radix), and Zhu (Atractylodis Rhizoma). If spleen deficiency with heat fails to control blood, use Sijunzi Tang (Four Gentlemen Decoction) plus Chao Zhi (Stir-fried Gardenia Fructus) and Mudan Pi. If there is depression and binding in the spleen meridian, use Guipi Tang (Restore the Spleen Decoction) plus Wuweizi (Schisandrae Fructus). If there is deficiency of Qi in the spleen and lungs, use Buzhong Yiqi Tang plus Wuweizi. If both Qi and Blood are deficient, use Shiquan Dabu Tang (Ten-Agent Great Tonifying Decoction). If yin fire moves recklessly, use Liuwei Wan (Six-Ingredient Pill) plus Wuweizi. Generally, when excessive blood loss presents with symptoms such as fever and thirst, regardless of the pulse, one should urgently use Dushen Tang (Single Ginseng Decoction) to tonify Qi. The Classics state: "Blood is born from Qi." Without using sweet-warm agents such as Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma) to generate the blood of the Heart and Liver, recovery is impossible. If there is fever and a large pulse, it is untreatable. For all hemorrhagic conditions, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) should be used as the primary formula.
Clinical Cases:
Tu Jianshan, a Hanlin Academician, aged forty, suffered from damp-toxin sores. Due to the mistaken use of calomel-containing preparations, his primal Qi was damaged, and the condition persisted for a long time. One evening, upon examination, his Liver pulse was urgent, surging, rapid, and forceful. I asked, "Why is the Liver pulse like this?" In the early morning, three to four bowls of dark blood were discharged from the sore. He felt fatigued and sweated spontaneously. Although this appeared frightening, fortunately, the blood was dark and the pulse was relatively calm. I said, "This is the heat toxicity of calomel; the blood has been affected by its poison and flows recklessly. The toxin of calomel is also being expelled through the blood. The pathogenic factor has left, but the True Qi is deficient. We must urgently use Dushen Tang as the main treatment." I valued his character and felt deep sympathy, but he was confused by others' advice and did not follow my recommendation, resulting in the continuous persistence of pathogenic factors.
A man suffered from bleeding back sores, restlessness, and thirst. His pulse was surging and large but empty upon deep pressure. This was restlessness following blood depletion. He used Danggui Buxue Tang (Dong Quai Decoction for Tonifying Blood) for two doses, with slight improvement; then he used Bazhen Tang (Eight-Treasure Decoction) plus Huangqi and Zhizi for several doses, achieving full recovery.
A woman vomited about three bowls of bright red blood after her sore ulcerated. I used Dushen Tang to stop the bleeding, followed by Sijunzi Tang, Shudi (Prepared Rehmanniae Radix), Xiong (Ligusticum Chuanxiong Rhizome), and Danggui to heal the sore. This follows the principle of "tonifying Qi for blood depletion" and "Yang generating Yin." If cold and yin-cooling agents that clear heat and descend fire were used, the vital Qi of the Spleen and Stomach would be further injured. Not only would the blood fail to return to its source, but death would be inevitable.
An elderly woman developed a ding (carbuncle/furuncle) on her thumb. After being pricked by someone, bright red blood flowed out, and her entire hand dorsum swelled, with pain affecting half her body. She had been in a stupor for five days. I used Huoming Yin (Life-Saving Decoction) to drain toxic fluid; after another dose, the redness and swelling gradually ulcerated; finally, she recovered after using Toli medicines (supportive therapies to promote pus discharge and tissue regeneration).
He Zhaoqing, a Secretary in the Ministry of Rites, was promoted to Vice Minister of Shanxi Province. Upon parting, I noticed his lips and nose were cyanotic and black, and he frequently scratched his back. When asked, he replied, "It is just a small sore." I observed that it was indeed a ju (deep-seated abscess/cancerous sore). This indicated failure of the Spleen and Stomach, an untreatable condition. As we were friends, I pitied his inconvenience regarding funeral arrangements during travel, so I entrusted him to his colleagues, Zhang Dongsha, etc., and strongly urged him to stay. I reluctantly administered strong tonics, but only purple blood was discharged, indicating extreme deficiency. Some suggested that intense toxin prevented pus formation, so he took a cup of attacking/purgative medicine, leading to vomiting, reversal of Qi, and pulse collapse. He indeed died in Nanjing.
Zhang Biya, a Surveillance Commissioner, developed a ju on his lower back. After drinking heavily and engaging in sexual activity, his pulse was surging and rapid, with the Chi (Kidney) pulses at both wrists being even larger. I declined treatment and prepared to depart by boat. His son insisted I stay. Shortly after, he vomited foul-smelling blood, five to six bowls. I reasoned this was deficient fire in the Kidney meridian causing reckless blood movement, and the blood would likely emerge from the gum margins. I compounded herbs such as Rougui (Cinnamon Bark) to tonify the Kidney and control fire, decocting them separately in jars for use. After the bleeding stopped, wiping the teeth confirmed my prediction. He drank one cup, taken cold, which instantly relieved heat and thirst. After a while, he drank another cup, taken warm. His pulse became fine and nearly imperceptible, his breath faint. The medicine temporarily revived his pulse slightly, but it collapsed again after a long time. His son suspected pus inside and wanted to puncture it. I said, "There certainly is none." I inserted a goose-quill tube into his nostril, which proved me correct. The next day, his pulse collapsed, his feet were cold up to the knees, and his abdomen felt like ice. I urgently used Liujunzi Tang (Six-Gentlemen Decoction) plus Shengjiang (Fresh Ginger) and Fuzi (Prepared Aconite Root). Only then did his abdomen warm up, pus begin to discharge, and the sore opening start to close. However, because his attendants favored his wife's family, and he suffered from urinary retention, this indicated impotence of the Yin mechanism due to lust-induced essence depletion, causing internal corruption of essence that could not be expelled. I prescribed Jiaban Bawei Wan material plus Renshen, Huangqi, and Baizhu for one dose. Although his urination improved, the sore opening failed to heal, and he died.