初起寒热交作，头面一处作肿，红赤发热疼痛者易。已成高肿，发热疼痛，有时语声清朗，汤药易入者轻。
已溃脓稠，坚肿渐消，疼痛渐减，饮食渐进、身温者吉。溃后脓水渐止，肿退肌宽，神彩精宁，睡卧安稳者顺。
初起多寒少热，头面耳项俱肿，光如水晶、不热者险。已成漫肿无头，牙关紧闭，汤水不入，声音不出者
逆。已溃脓水清稀，气味败臭，肿痛不除，如尸发胖者死。溃后臭水淋漓，肿不知痛，手足多冷，常出谵语者
死。
寒热交作，头眩体痛，六脉浮紧，邪在表也，宜汗散之。头面赤肿作痛，口燥咽干，大便秘实，邪在里也，
下之。外有寒热，内亦口干，脉弦有力，表里俱实，发表攻里。表里俱解，肿痛仍不消者，乃瘀血凝滞，宜砭
去恶血。砭血之后，肿痛仍作不消者，已欲作脓，宜托脓健脾。肿痛日多而胀痛者，已有脓，急针之，更兼补
托脾胃。溃后肿痛不减，脓清腥秽，脾胃弱也，更宜温中健脾。饥年时毒流行传染者，忌用攻发，当和解、宜
养正气。
一男子耳项肿痛，发寒热，脉浮数。以荆防败毒散一剂，寒退热存；又以连翘消毒饮一剂，便行三次，内
热顿退，余肿不消，本方去大黄加川芎数剂而愈。
一男子先发寒热，次日头面俱肿，又二日，口噤汤水不入，诊之脉洪数而有力，此表里俱实也。又咽喉妨
碍，汤药难下，先用针刺咽间，去恶血钟许，牙关稍开；以防风通圣散一剂徐徐服之，便去三、四次，肿上砭
去恶血，以金黄散敷之。次日肿势稍退，又以普济消毒饮二剂，面肿渐消，惟两耳下坚肿不退，此必作脓；又
以托里消毒散数服，候脓熟而针之，次以十全大补汤去肉桂加陈皮十余剂而敛。
一男子牙根肿痛，次传腮、项俱肿，顿生寒热。此阳明湿热上攻，用荆防败毒散加石膏一剂，寒热顿退，
惟腮肿不消，以针刺牙根肿上出毒血，以冰硼散搽之，外敷真君妙贴散，内服牛蒡子汤，数服而愈。
一男子冬月耳面赤肿，发热口干，脉洪实而便秘，此三阳蕴热症也。必舍时从症治之，以五利大黄汤一剂，
便行二次，赤肿稍退，内热稍疏，又以升麻解毒汤二服，肿亦消而病愈。此为用寒远寒之意也。
一妇人冬月面肿咽痛，口噤难开，脉诊洪数有力；又见房中暖气如烘，此因炉火盛也。以黄连解毒汤加玄
参一剂，次日肿消咽利，又用二剂，其疾痊愈。
一男子劳甚，鬓间肿硬，肉色不变。予曰∶劳伤气血，湿痰凝滞之症，与夫外感时毒不同。又诊脉细数而
无力，为内伤损病。治当养气血、调经脉，理劳续损治之。彼欲内消，自服仙方活命饮二服，肿不觉消，脾胃
已损。又请一医，乃行攻利，复
损脏腑；数日后饮食不进，便泄不止，肿硬愈坚，痰涎愈甚。复请视之，辞不可治。予曰∶凡疗理，病有主末，
治有权宜。此病初起肉色不变者，血不足也；坚硬不热者；脾胃弱也；脉细数而无力，正气衰也；岂可用前有
余之药以攻不足之病。后又强投温中补剂，不应而死。
初起时寒热交替发作，头面部某一处出现肿胀，红肿发热且疼痛的，病情较轻易治。若已成高肿，发热疼痛，但患者声音清朗，汤药容易服下的，属于轻症。
已经溃破，脓液稠厚，坚硬肿胀逐渐消退，疼痛逐渐减轻，饮食逐渐恢复，身体温暖的，预后良好。溃破后脓水逐渐停止，肿胀消退，肌肉松弛，精神神色安宁，睡眠安稳的，属于顺证。
初起时恶寒重而发热轻，头、面、耳、颈部全部肿胀，皮肤光亮如水晶，局部不热的，病情危险。若已成漫肿无头，牙关紧闭，汤水无法入口，声音发不出来的，属于逆证。已经溃破，脓水清稀，气味腐臭败坏，肿痛不消除，身体浮肿如尸体般的，主死。溃破后臭水淋漓不止，肿胀部位不知疼痛，手足多冰冷，经常说胡话（谵语）的，主死。
寒热交替发作，头晕目眩，身体疼痛，六脉浮紧，说明邪气在表，适宜用发汗法疏散。头面部赤肿疼痛，口燥咽干，大便秘结坚实，说明邪气在里，适宜用泻下法。体表有寒热，体内也有口干，脉象弦而有力，表里俱实，应同时使用解表和攻里的方法。表里之邪都已解除，但肿痛仍然不消的，是瘀血凝滞所致，适宜用砭石疗法去除恶血。砭刺放血之后，肿痛仍然发作不消的，说明即将成脓，适宜用托毒排脓兼健脾的方法。肿痛日益增多且伴有胀痛感的，说明已有脓液，急需针刺排脓，并配合补益托毒、调理脾胃的方法。溃破后肿痛不减，脓液清稀腥秽，是脾胃虚弱所致，更宜用温中健脾的方法。饥荒年份时毒流行传染时，忌用攻伐发散的药物，应当采用和解之法，适宜养护正气。
有一个男子耳部和颈部肿痛，出现寒热症状，脉象浮数。服用荆防败毒散一剂，寒退但热仍存；又服用连翘消毒饮一剂，大便通行三次，内热顿时消退，剩余肿胀未消，在原方基础上去掉大黄，加入川芎，服用数剂后痊愈。
有一个男子先出现寒热，第二天头面部全部肿胀，再过两天，牙关紧闭，汤水无法入口，诊察其脉象洪数而有力，这是表里俱实的证候。又见咽喉妨碍吞咽，汤药难以下咽，先用针刺咽喉部位，放出恶血约一顿饭时间，牙关稍微张开；然后徐徐服用防风通圣散一剂，大便排出三、四次，肿胀处用砭石去除恶血，外敷金黄散。第二天肿胀势头稍退，又服用普济消毒饮两剂，面部肿胀逐渐消退，只有双耳下方坚硬肿胀不退，这必定是要化脓了；又服用托里消毒散数剂，等待脓熟后针刺排脓，随后服用十全大补汤去掉肉桂，加入陈皮，十余剂后疮口收敛愈合。
有一个男子牙根肿痛，接着蔓延至腮部、颈部全部肿胀，突然产生寒热。这是阳明经湿热上攻所致，用荆防败毒散加石膏，服用一剂，寒热顿时消退，只有腮部肿胀未消，用针刺牙根肿胀处放出毒血，外用冰硼散搽涂，外敷真君妙贴散，内服牛蒡子汤，服用数剂后痊愈。
有一个男子在冬季耳面部赤肿，发热口干，脉象洪实且大便秘结，这是三阳经蕴热证。必须舍去时令因素而从症状论治，用五利大黄汤一剂，大便通行两次，赤肿稍退，内热稍疏，又服用升麻解毒汤两剂，肿胀也消退，病愈。这就是“用寒远寒”（寒冷季节慎用寒凉药，此处指因症施治，不拘泥于时令）的意思。
有一个妇人在冬季面部肿胀，咽喉疼痛，牙关紧闭难以张开，诊脉洪数有力；又见房中暖气如烘烤般热，这是因为炉火旺盛所致。用黄连解毒汤加玄参，服用一剂，第二天肿胀消退，咽喉通畅，又用两剂，疾病痊愈。
有一个男子劳累过度，鬓角间肿胀坚硬，肤色不变。我说：这是劳伤气血，湿痰凝滞的病症，与外感时毒不同。又诊察脉象细数而无力，属于内伤损病。治疗应当调养气血、调理经脉，按理劳续损的方法治疗。他想要内消肿块，自行服用仙方活命饮两剂，肿胀不觉消退，反而损伤了脾胃。又请一位医生诊治，医生采用攻下利导的方法，再次损伤脏腑；几天后饮食不进，腹泻不止，肿胀坚硬更加严重，痰涎更多。再请我去看，我推辞说不可治。我说：凡是诊疗，病有主次本末，治疗有权宜之计。此病初起肤色不变的，是血不足；坚硬不热的，是脾胃弱；脉细数而无力，是正气衰败；怎么可以用前面有余（实证）的药物来攻伐不足（虚证）的病。后来病人强行投用温中补益药剂，无效而死。
At the initial stage, with alternating chills and fever, swelling in one area of the head and face, accompanied by redness, heat, and pain, is easy to treat. If it has progressed to high swelling with fever and pain, but the patient's voice remains clear and liquids/medicines are easily swallowed, it is a mild condition.
After ulceration, if the pus is thick, the indurated swelling gradually subsides, pain decreases, diet progressively improves, and body temperature is normal, it is auspicious. After ulceration, if the discharge gradually stops, swelling recedes, muscles relax, spirit and complexion are calm, and sleep is peaceful, it is a favorable course.
At the initial stage, with severe chills and slight fever, swelling involving the head, face, ears, and neck, where the skin is shiny like crystal and not hot locally, is dangerous. If it progresses to diffuse swelling without a head, trismus (lockjaw), inability to take in liquids or food, and loss of voice, it is an adverse condition. After ulceration, if the discharge is thin and watery, foul-smelling, pain and swelling persist, and the body swells like a corpse, death ensues. If after ulceration, foul water drips continuously, the swollen area is insensible to pain, hands and feet are cold, and delirium occurs frequently, death ensues.
With alternating chills and fever, dizziness, body pain, and floating-tight pulse throughout all six positions, the pathogen is in the exterior; sweating dispersal method should be used. With red and swollen head and face, dry mouth and throat, and constipation with hard stool, the pathogen is in the interior; purgation should be used. With exterior chills and fever, internal dry mouth, and strong wiry pulse, both exterior and interior are excess; release the exterior and attack the interior simultaneously. If both exterior and interior pathogens are resolved but swelling and pain persist, it is due to blood stasis coagulation; scarification to remove evil blood should be used. After scarification, if swelling and pain persist, suppuration is imminent; promoting suppuration and strengthening the spleen should be used. If swelling and pain increase daily with distending pain, pus has formed; urgent needle drainage is required, combined with tonifying and promoting methods for the spleen and stomach. After ulceration, if swelling and pain do not decrease, and pus is thin and fishy/foul, the spleen and stomach are weak; warming the middle and strengthening the spleen should be further employed. In years of famine when epidemic toxins spread contagiously, attacking and dispersing methods are contraindicated; harmonizing methods and nourishing healthy qi should be preferred.
A man presented with swelling and pain in the ear and neck, with chills and fever, and a floating-rapid pulse. One dose of Jingfang Baidu San (Jing-Jie and Fang-Feng Decoction to Overcome Toxicity) was administered; chills subsided but fever remained. Then, Liaoqiao Xiaodu Yin (Forsythia Decoction to Eliminate Toxins) was given; bowel movements occurred three times, internal heat suddenly subsided, but residual swelling persisted. The original formula had Da Huang (Rhubarb Rhizome) removed and Chuan Xiong (Szechwan Lovage Rhizome) added; several doses resulted in recovery.
A man first developed chills and fever. The next day, his entire head and face swelled. Two days later, he had trismus and could not take in liquids or food. His pulse was surging-rapid and forceful, indicating both exterior and interior excess. He also had throat obstruction making swallowing difficult. First, acupuncture needles were used in the throat area to release evil blood for about the time it takes to eat a meal, slightly opening the jaw. Then, Fangfeng Tongsheng San (Saposhnikovia Universal Benefit Powder) was administered slowly; bowel movements occurred three or four times. Evil blood was removed via scarification from the swollen areas, and Jinhuang San (Golden Yellow Powder) was applied externally. The next day, the swelling trend subsided slightly. Two doses of Puji Xiaodu Yin (Universal Benefit Decoction to Eliminate Toxins) were given; facial swelling gradually subsided. However, hardness and swelling below both ears persisted, indicating impending suppuration. Several doses of Tuoli Xiaodu San (Support Interior Decoction to Eliminate Toxins) were given. Once the pus matured, it was drained by needle. Subsequently, Shiquan Dabu Tang (Complete Great Tonifying Decoction) with Rou Gui (Cinnamon Bark) removed and Chen Pi (Tangerine Peel) added was taken for over ten doses, leading to wound contraction and healing.
A man presented with swelling and pain at the gum roots, which then spread to the cheeks and neck, accompanied by sudden chills and fever. This was damp-heat in the Yangming channel attacking upwards. One dose of Jingfang Baidu San (Jing-Jie and Fang-Feng Decoction to Overcome Toxicity) with Shi Gao (Gypsum Fibrosum) was given; chills and fever subsided suddenly, but cheek swelling persisted. Acupuncture needles were used on the swollen gum root area to release toxic blood. Bingpeng San (Ice and Borax Powder) was applied topically, Zhenjun Miaotie San (Miraculous Paste of the True Lord) was applied externally, and Niubangzi Tang (Arctostaphylis Decoction) was taken internally; several doses resulted in recovery.
A man presented with red and swollen ears and face in winter, with fever, dry mouth, surging-solid pulse, and constipation. This is a syndrome of heat accumulation in the Three Yang channels. Treatment must set aside seasonal considerations and focus on symptoms. One dose of Wuli Dahuang Tang (Five Benefits Rhubarb Decoction) was given; two bowel movements occurred, redness and swelling slightly subsided, and internal heat slightly dispersed. Two doses of Shengma Jiedu Tang (Cimicifuga Detoxification Decoction) were given; swelling also subsided and the disease healed. This illustrates the principle of "using cold remedies while avoiding cold seasons" (adapting treatment to pathology rather than rigidly following seasonal restrictions).
A woman presented with facial swelling and sore throat in winter, trismus making it hard to open the mouth, and a surging-rapid, forceful pulse. Additionally, the room felt hot as if roasted due to the stove fire. One dose of Huanglian Jiedu Tang (Coptis Detoxification Decoction) with Xuan Shen (Scrophularia Root) was given. The next day, swelling subsided and the throat cleared. Two more doses cured the disease.
A man presented with hard swelling in the temples after excessive labor, with unchanged skin color. I stated: This is a syndrome of Qi and Blood injury with stagnation of damp-phlegm, different from external epidemic toxin invasion. His pulse was fine-rapid and powerless, indicating an internal injury damage syndrome. Treatment should nourish Qi and Blood, regulate meridians, and follow the principles of treating chronic fatigue and repairing damage. He desired internal resolution and self-administered Xianfang Huoming Yin (Immortal Formula for Preserving Life) twice; the swelling did not subside, damaging the spleen and stomach. Another doctor was consulted who used purgative methods, further damaging the zang-fu organs. Days later, he could not eat, suffered continuous diarrhea, the swelling became harder, and phlegm-saliva increased. When asked again, I declined to treat, stating: In therapy, diseases have primary and secondary aspects, and treatments require flexibility. At the onset, unchanged skin color indicates insufficient Blood; hardness without heat indicates weak Spleen and Stomach; fine-rapid powerless pulse indicates decline of Healthy Qi. How can one use drugs for excess conditions to attack a deficiency disease? Later, warm middle-tonifying supplements were forcibly administered, which failed, and he died.