附骨疽有因露卧，风寒深袭于骨者；有因形气损伤，不能起发者；有因克伐之剂，亏损
元气
，不能发出者；有因外敷寒药，血凝结于内者。凡此皆宜灸熨患处，解散毒瓦斯，补接阳气，
温补脾胃为主。若饮食如常，先用仙方活命饮，解毒散郁，随用六君子汤，补托荣气。若体
倦食少，但用前汤，培养诸脏，使邪不得胜正。若脓已成，即针之，使毒不得内侵。带生用
针亦无妨，如用火针，亦不痛，且使易敛。其隔蒜灸，能解毒行气，葱熨法能助阳气行壅滞
，此虽不见于方书，余常用之，大效。其功不能尽述，惟气血虚脱者，不应。
治验
南司马王荆山腿肿作痛，寒热作渴，饮食如常，脉洪数而有力。此足三阳经湿热壅滞，
用槟苏
晕散漫，用活命饮二剂而痛缓；又用八珍汤，加柴胡、山栀、丹皮，而痛止。复因劳役，倦
怠懒食，腿重头晕，此脾胃气虚而不能升举也。用补中益气，加蔓荆子而安。
一儒者左腿微肿，肉色如故，饮食少思，此真气虚而湿邪内袭也。盖诸气皆禀于胃，法
当补
一儒者两腿肿痛，肉色不变，恶寒发热，饮食少思，肢体倦怠，脾气不足，湿痰下注也
以补中益气加茯苓、半夏、芍药，二剂，寒热退而肿痛消；又十余剂，脾胃壮而形体健。
一男子患此入房，两臂硬肿，二便不通。余谓∶肾开窍于二阴，乃肝肾亏损也。用六味
丸料加车前、牛膝而二便利；用补中益气，而肿硬消。喜其年少得生。
一上舍内痛如锥，肉色如故，面黄懒食，痛甚作呕，此痛伤胃也。用六君子以壮其脾胃
，用
一男子因负重，饮食失节，胸间作痛，误认为疮毒。服大黄等药，右腿股肿，肉色如故
，头痛恶寒，喘渴发热，脉洪大而无力。此劳伤元气，药伤胃气而然耳。用补中益气汤四剂，又
用十全大补汤数剂，喜其年少而得愈。
附骨疽（一种深部骨骼感染性疾病）的成因，有因露天睡卧，风寒之邪深入侵袭骨骼的；有因形体与正气受损，导致毒邪不能向外透发的；有因过度使用攻伐类药物，亏损了元气，导致毒邪不能发出的；有因外敷寒凉药物，导致血液凝结于体内的。凡是上述情况，都适宜在患处进行艾灸和熨烫治疗，以解散毒气，补接阳气，并以温补脾胃为主要治法。如果患者饮食正常，先用仙方活命饮，以解毒散郁，随后使用六君子汤，以补益托举营气。如果身体疲倦、食欲减少，仅使用前一方剂（指六君子汤），以培养五脏功能，使正气不被邪气战胜。如果脓液已经形成，立即用针刺排脓，使毒邪不得向内侵染。即使带着未溃破的皮肤用针穿刺也无妨，如果使用火针，也不会感到疼痛，而且有利于伤口愈合。隔蒜灸能解毒行气，葱熨法能助阳气运行以消除壅滞，这些方法虽然未在医方书籍中记载，但我经常使用，效果显著。其功效无法详尽叙述，唯独气血极度虚弱脱失的患者，不适用此法。
治验案例：
南司马王荆山腿部肿胀疼痛，伴有寒热交替及口渴，饮食正常，脉象洪大、数且有力。这是足三阳经湿热壅滞所致，先用槟苏晕散漫（此处原文可能有误，结合语境应为外用消肿止痛之法或特定散剂，依原文直译），配合使用仙方活命饮两剂，疼痛缓解；又使用八珍汤，加入柴胡、山栀、丹皮，疼痛停止。后来因为劳累，出现倦怠、懒食、腿重头晕，这是脾胃气虚而不能升举清阳所致。使用补中益气汤，加入蔓荆子，病情安定。
一位儒生左腿轻微肿胀，肌肉颜色如常，饮食减少思虑不足，这是真气虚弱而湿邪内袭所致。盖因诸气皆禀受于胃，治法应当补益……（原文此处中断）。
另一位儒生双腿肿痛，肌肉颜色不变，恶寒发热，饮食减少思虑不足，肢体倦怠，这是脾气不足，湿痰下注所致。使用补中益气汤加入茯苓、半夏、芍药，两剂后，寒热退去，肿痛消除；又服用十余剂，脾胃强壮，形体健康。
一名男子患此病期间行房事，导致双臂硬肿，大小便不通。我说道：肾开窍于二阴，这是肝肾亏损所致。使用六味丸料加入车前子、牛膝，使大小便通畅；使用补中益气汤，使肿胀硬结消退。庆幸他年少得以存活。
一位上舍（国子监学生）内部疼痛如锥刺，肌肉颜色如常，面色黄，懒食，疼痛剧烈导致呕吐，这是疼痛损伤了胃气。使用六君子汤以壮盛脾胃……（原文此处中断）。
一名男子因为负重，饮食不节制，胸部作痛，误认为是疮毒。服用大黄等药物后，右腿大腿肿胀，肌肉颜色如常，头痛恶寒，气喘口渴发热，脉象洪大但无力。这是劳伤元气，药物损伤胃气所致。使用补中益气汤四剂，又使用十全大补汤数剂，庆幸他年少而痊愈。
Fugu Ju (Deep-seated bone abscess) may arise from exposure to cold and wind due to sleeping outdoors, where pathogenic factors deeply invade the bones; it may result from damage to physical constitution and vital qi, preventing the expulsion of pathogens; it may stem from the excessive use of purgative or attacking agents, which deplete yuan qi (original qi), hindering the emergence of toxins; or it may be caused by the external application of cold-natured medicines, leading to blood coagulation internally. In all such cases, moxibustion and warming therapy should be applied to the affected area to dissipate toxic heat, supplement and reconnect yang qi, with a primary focus on warming and tonifying the spleen and stomach. If the patient's diet remains normal, Xianfang Huoming Yin (Immortality Elixir Decoction) should be used first to resolve toxicity and disperse stagnation, followed by Liujunzi Tang (Six Gentlemen Decoction) to tonify and support ying qi (nutritive qi). If the body feels fatigued and appetite is reduced, only the aforementioned decoction (Liujunzi Tang) should be used to nourish the zang organs, ensuring that righteous qi prevails over pathogenic factors. If pus has already formed, immediate needle drainage is required to prevent internal invasion of toxins. Needle puncture even through intact skin is permissible; if fire needles are used, pain is minimized, and wound healing is facilitated. Garlic-separated moxibustion can resolve toxicity and promote qi circulation, while scallion-warming therapy can assist yang qi in resolving stagnation. Although these methods are not recorded in standard medical formularies, I frequently employ them with great efficacy. Their full merits cannot be exhaustively described, except that they are contraindicated for patients with severe deficiency and collapse of qi and blood.
Clinical Cases:
Wang Jingshan, a Southern Sima (Military Officer), presented with leg swelling and pain, alternating chills and fever, thirst, normal diet, and a surging, rapid, and forceful pulse. This was diagnosed as damp-heat stagnation in the three yang meridians of the foot. An external application was used, followed by two doses of Xianfang Huoming Yin (Immortality Elixir Decoction), which alleviated the pain. Subsequently, Bazhen Tang (Eight Treasures Decoction) was administered with added Chaihu (Bupleurum Root), Shanzhi (Gardenia Fruit), and Danpi (Moutan Cortex), resulting in the cessation of pain. Later, due to overwork, he experienced fatigue, anorexia, heavy legs, and dizziness, indicating spleen-stomach qi deficiency failing to raise clear yang. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Manjingzi (Vitex Fruit) stabilized the condition.
A scholar presented with slight swelling of the left leg, unchanged muscle color, and reduced appetite/mental desire. This indicated deficiency of true qi with internal invasion of dampness. Since all qi is derived from the stomach, the treatment principle should be to tonify... [Text incomplete].
Another scholar presented with swelling and pain in both legs, unchanged muscle color, aversion to cold, fever, reduced appetite, limb fatigue, insufficient spleen qi, and downward pouring of damp-phlegm. Two doses of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Fuling (Poria), Banxia (Pinellia Rhizome), and Shaoyao (Peony Root) resolved the chills, fever, swelling, and pain. After more than ten additional doses, the spleen and stomach strengthened, and the physique became robust.
A man contracted this disease after sexual intercourse, resulting in hard swelling of both arms and obstruction of urination and defecation. I stated: The kidneys open into the two yin orifices; this indicates liver-kidney deficiency. Liuwei Wan (Six-Ingredient Pill with Rehmannia) formula with Cheqianzi (Plantago Seed) and Niuxi (Achyranthes Root) restored normal excretion. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) resolved the hardness and swelling. Fortunately, his youth contributed to his survival.
A Shangshe (Imperial Academy Student) suffered from internal pain like a cone piercing, unchanged muscle color, sallow complexion, anorexia, severe pain causing vomiting, indicating pain damaging stomach qi. Liujunzi Tang (Six Gentlemen Decoction) was used to strengthen the spleen and stomach... [Text incomplete].
A man carried heavy loads and had irregular diet, causing chest pain, which was mistakenly identified as carbuncle toxin. He took Dahuang (Rhubarb Rhizome) and other purgatives, resulting in right thigh swelling with unchanged muscle color, headache, aversion to cold, panting, thirst, fever, and a surging but forceless pulse. This resulted from labor injuring yuan qi (original qi) and medications damaging stomach qi. Four doses of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) were given, followed by several doses of Shiquan Dabu Tang (Ten Complete Tonifying Decoction). Fortunately, his youth led to recovery.