痈疽发背为何生，好好身驱出此形。
凡人处世而无疾病者，水升火降精秘血盈也。养生篇曰∶毋摇尔精，毋劳尔形，皈心静默，可以长生，此
皆远世俗、忘名利、无贪嗔、却疾病，此惟修身保命之士所能，今人岂能及哉！盖谓静则生水，动则生火；又
水能生万物，火能克万物，故百病由火而生。火既生，七情六欲皆随应而入之；既入之后，百病发焉。发于内
者，为风劳、蛊膈、痰喘、内伤；发于外者，成痈疽、发背、对口、疔疮，此皆言其大略也。故成痈者壅也，
为阳，属六腑毒腾于外，其发暴而所患浮浅，因病原禀于阳分中。盖阳气轻清浮而高起，故易肿、易脓、易腐、
易敛，诚为不伤筋骨易治之症也。疽者沮也，为阴，属五脏毒攻于内，其发缓而所患深沉，因病原禀于阴分中。
盖阴血重浊性质多沉，故为伤筋蚀骨难治之症也。凡年壮气血胜毒则顺，年老毒胜气血则险。治法载于第二论
中，宜详观之。
内被七情干脏腑，忧愁思虑总关心。
七情六欲者，盗人元气之贼也。人能疏于此者，无不多安多寿，人若亲于此者，无不有损有伤，但人能味
之者鲜矣。盖情欲之动作，无所不好，无所不为，故喜伤心，怒伤肝，忧伤肺，思伤脾，悲伤于魂魄，恐伤肾，
惊伤胆。此等七情，皆耗人一身元气之萌孽也。至于六欲者，耳听声音，眼观物色，鼻闻香气，舌贪滋味，心
帷大地，意幄万方，此等六欲，皆损人三世钟灵之真性也。又所以为苦、为疾、为夭、为疼，以及休废衰败，
诸病诸疮，尽皆出于此等之情欲也。医者患者亦宜慎察之。
外又六淫伤气血，风寒暑湿火相临。
六淫者，风、寒、暑、湿、燥、火是也。风为四时不正浩荡肃杀之气，发而最能中人；寒乃节候不调、疾
风豪雨、冰雪严寒所伤，或口贪生冷之物；暑因亢阳酷日、烁火流金、湿热熏蒸而中，湿从坐卧久阴卑湿之地，
或身骤临风雨潮气所侵；燥为阴虚内热，消烁津液，不能滋润脏腑，以致皮肤枯槁、便干为燥；火生于心绪烦
扰、醇酒膏粱、房欲不闲所动。此六淫者，皆从外而入之，体实之人遇而不中者有，体弱之人感而随发者多。
又有感之不发，邪气客于脏腑、经络、关节之内，积袭日久，或待内伤，或因外感，邪气触而发之，既发之后
，当参寒热温凉、邪正胜负而治之。
膏粱浓味多无忌，劳伤房欲致亏阴。
膏粱者，醇酒肥鲜炙爆之物也。时人多以火炭烘熏，或以油酥燥煮，其味香燥甘甜，其性咸酸辛辣，又至
于涂藏浓料，顿煮重汤，以取其爽口快心，罔顾其消阴烁脏。又得于宠外家满前，精神飞旷，温床浓被，炉火围
匡，每至于未饥先食，未冷先绵，快意从心，色力太过，稍有不及，便去兴阳，惟取快意于一时，不觉阴消于
平日。况所生是疾者，不起于藜藿，尽属于膏粱，谁识膏粱味短不及藜藿味长，凡知命者，当远之避之，择而
用之可也。
故将五脏多乖变，自然六腑不调匀。
五脏属五行，金、木、水、火、土是也。常欲相顺相生，所得木生火，火生土，土生金，金生水，水生木。
此五脏相合相生，理禀太和之气，其疾何以生焉。是为疾者，五脏必相反相克，所被木克土，土克水，水克火，
火克金，金克木。此五脏相刑相克，理返互变之机，其疾再无不作者，所谓相生者昌，相克者亡。此诚为万物
生克一定之理，岂止于疾病言哉！又谓五脏不和则六腑不通，六腑不通则九窍疲癃，九窍疲癃则留结为痈。盖
痈疽必出于脏腑乖变，开窍不得宣通而发也。治当寒邪而痛者，以温热散之；湿肿强痛者，渗而导之；燥搐挛
痛者，滋而润之；泄而痛者温之，塞而痛者通之，虚而痛者补之，实而痛者泻之，阴阳不和者调燮之，经络秘
涩者冲和之，脓胀而痛者开之，恶肉侵蚀者去之，劳而痛者逸之，损而痛者续之，此等皆为活法，惟在用者详之。
发于心上多危险，五脏相干事可明。
五脏者，心、肝、脾、肺四脏皆系于背，惟肾经一脏独居于下。虽居于下，其脏精华、津液、元气、元神
尽行灌溉荣注于上，故四脏之火，皆赖一脏之水以济之，所谓五脏根本皆系于背，即此之意也，凡发痈疽者，
未有不先伤五脏而后发之，况背乃太阳膀胱、督脉所主，太阳者，六经之首领也；督脉者，十二经络之统脉也。
所以疮生于背，毒犯于此，况心乃又属君主之位，岂容毒相犯之。凡发于此，故多成危险难治之症，医者不
可不慎而察之。
心之已下多成顺，六腑之因亦许评。
凡疮生于心之以下者，除肾俞一穴外皆为缓。六腑者，足阳明胃经、手太阳小肠经、足太阳膀胱经、手厥
阴心包络经、手少阳三焦经、足少阳胆经，此六经，其名属腑，其形在下，其气主表，其病为痈。故疾发于五
脏者为重，生于六腑者为轻，此为表里脏腑轻重之别也。
脾家积毒生肩脊。
发生于肩下脊上者，乃因饮食膏粱积毒所致。发出高肿鲜明，根脚不过两肩者为顺。先宜解毒护心为主，
次宜内托清心为要，间用蜡矾丸、护心散防毒攻心。如肿平坚硬，渐大渐开，攻注两肩胸项、肿而不定者危。
心经火毒对心临
对心发者，乃心火妄动热极而发之也。况心为主宰，周身蕴热流会于此，其结为患，又称毒 。君位最易
伤人，刑截督经，害非轻浅。况此穴背脊多坑，固难起发，疮形落陷，肿不高尖，治当大降心火，急疏蕴热，
顶用针通，随行拔法，务使毒瓦斯内外疏通，各从门出，庶不内攻，方为成守。保至十五日后，内无变症，得脓
为解。如是期变症渐生，坚硬渐大不作脓者，死在二十二朝先后。但此症贵在乎早治，十中可保其三、四也。
两肩左右双生发，肺肝积受不虚名。
左搭属肝，右搭属肺，俱生于左、右肩骨移动之处为可治。古云∶左
搭串右，右搭串左，俱为难治。今治不然。余每医左、右相串者，未尝见其死，惟在治法得宜。有此症者，先
用万灵丹发汗疏通内外，次以清肝解郁汤、柴胡清肝汤；气用四君子汤，血用四物汤，溃后八珍汤，俱兼六
郁汤参而调治，诚为妥当。但此症原起于痰凝、气滞、火郁，气血不调所生。正谓郁者开之，滞者行之，如误
用疮科解毒泄气、误补误攻之药，必致多危。
莲子蜂窠防毒陷
蜂窠、莲子二发，多生于背，与心相近，与脊中平，轻者形长高肿，或偏半背；重者形斜平塌，两胁俱伤，
孔似蜂窠，突如莲子，疮形虽畏，常能多险。多生老弱不堪，反取常安常稳。大规只怕不纯阳，治法何妨疮势
恶。护心护膜，丸丹须要调停；执药执方，活法在乎医意。机参总论，法决存亡。
腰间肾俞发难生。
肾俞发者，生于两腰内肾陷肉之间，或正中亦发，凡生于此者，最为险候。盖内肾乃为性命根本，藏精、
藏气、藏神，又谓受命先天，育女、育男、育寿，此等皆出于肾脏之一窍也。是为疾者，房劳过度，气竭精伤，
欲火消阴，外阳煽惑，以致真水真阴从此而耗散，既散之后，其脏必虚，所以诸火诸邪乘虚而入，既入之后，
浑结为疮。如本脏稍有真阴制火，疮形自可红活高肿为脓，治以人参养荣汤加山萸、五味子、黄柏、知母及加
减八味丸以救其源也；若疮形色紫黑干枯、坚硬不作脓者，为真阴内败，再无可生之理，必死在十五日前后为
期也。
督脉经虚从项发，俗名对口故相称。
对口者，生于项后而对前口者是也，但有偏正之不同。发于正者，属督脉所主；发于偏者，乃太阳膀胱所
司。二者皆起于湿热上攻凝结而成也。督脉者，发疮虽正而反为易治，因督脉起于下，而贯脊行于上，故毒
气得之，反能冲突高肿，使邪毒不致下流低陷，乃为外发，故多易治。膀胱者，发疮虽偏，而每为难治，盖膀
胱之脉起于巅顶，贯项两旁、顺下而行，乃与疮毒交会下流，故疮多平塌；又太阳膀胱主司寒水，其质多冷多
沉，故疮于此多难起发，形色多难红活，坚硬难溃，又易流注，两肩、胸、项作肿，十五日外无脓者，必然变
黑归阴，故多不治。俗呼以正为重，以偏为轻，此皆庸说，不得其消息故也，治以黄连消毒饮主之，余皆降火、
化痰、解毒、清心、托里为要也。
何期耳后多生发，夭疽锐毒不非轻。
发生于耳后一寸三分致命之处，诚为险恶之候。又左为夭疽，右为锐毒，夭者妖变之物也，故属肝木；锐
者锋利之器也，是属肺金。二者皆起于积想在心，谋虑不决，致火旺而又郁，郁而又旺以成此疾也。故形多坚
硬，头多隐伏，未溃先黑，未脓先腐，臭秽易生，元气易败，常得此者，毒瓦斯多致不得外发，后必内攻而死。
但此症者，初生起于隐微，令人多不知觉，及其知觉，毒已入内矣，如红活高肿，易脓易腐者无妨。
又有脱疽生手足，□□□□□□□。
脱疽之发，脱者，落也；疽者，黑腐也。此毒皆……多生手足。发在骨筋，初生如粟，色似枣形，渐开渐
大，筋骨伶仃，乌乌黑黑，痛割伤心，残残败败，污气吞人，延至踝骨，性命将倾，此非天命，自丧其身，古
人有法，截割可生，今人谁肯，割截为名，治法虽有，详在后文。
慢肿难治 肿易，总论中间法可凭。
慢肿者，肉肿疮不肿是也； 肿者，疮肿肉不肿亦是也。此二者，发疮阴阳之大体，辨症顺逆之末节，由
此观之，一决而定也，疮之初起，理当升发；溃脓之后，不可用内消，宜用托药。如不应者，乃毒胜气血，死
在旬日。或已发出而不腐溃，根脚坚硬；或软而散大者，急投托药，大补脾胃，不应死在二旬。若已溃而色不
变红活，亦不生肌收敛，疮口晕大，肿痛不减，胃气不回，急须峻补；不应者，乃脾崩，死在月余。
诸疮另有分门说，岂许轻于紊此呈。
凡是人在世间生活而没有疾病的人，是因为肾水上升、心火下降，精气秘藏、血液充盈的缘故。养生篇说：“不要动摇你的精气，不要劳累你的形体，使心神归静沉默，就可以长生。”这些都是远离世俗、忘记名利、没有贪婪和嗔怒、从而避免疾病的方法，这只有修身保命的人才能做到，现在的人哪里能赶得上呢！大概说来，静则生水，动则生火；水能生养万物，火能克制万物，所以百病都是由火而产生的。火既已产生，七情六欲就会随之进入体内；一旦进入之后，百病就发作了。发于体内的，表现为风劳、蛊膈、痰喘、内伤；发于体外的，形成痈疽、发背、对口疔疮，这里只是说个大概。所以“痈”就是壅塞的意思，属于阳证，是六腑的毒热腾越于体表，发病急骤且患处浮浅，因为病因禀受于阳分。阳气轻清上浮而高起，所以容易肿胀、容易化脓、容易腐烂、容易收敛，确实是不伤筋骨、容易治疗的病症。“疽”就是阻塞的意思，属于阴证，是五脏的毒气攻注于体内，发病缓慢且患处深沉，因为病因禀受于阴分。阴血重浊性质多沉潜，所以是损伤筋骨、难以治疗的病症。凡是年壮气血旺盛胜过毒邪的就顺，年老毒邪胜过气血的就危险。治疗方法记载在第二论中，应当详细观看。
七情六欲，是偷盗人体元气的贼寇。人如果能疏远这些，无不平安长寿；人如果亲近这些，无不有损健康受伤，但人们真正体味并避开这些的人很少啊。大概情欲的动作，没有什么不好，没有什么不做，所以喜伤心，怒伤肝，忧伤肺，思伤脾，悲伤魂魄，恐伤肾，惊伤胆。这七种情志，都是耗损人体一身元气的萌芽孽根。至于六欲，耳朵听声音，眼睛看颜色，鼻子闻香气，舌头贪滋味，心里想着大地，意念笼罩万方，这六种欲望，都是损害人世代钟灵毓秀的真性。又因此成为痛苦、疾病、夭折、疼痛，以及废疾衰败，各种病症疮疡，全都出于这些情欲。医生和患者也应当谨慎考察。
六淫，就是风、寒、暑、湿、燥、火。风是四季不正浩荡肃杀之气，发作时最能中人；寒是节候不调、疾风豪雨、冰雪严寒所伤，或者口贪生冷之物；暑是因为亢阳酷日、烁火流金、湿热熏蒸而中，湿从坐卧久阴卑湿之地，或者身体骤然临风雨潮气所侵；燥为阴虚内热，消烁津液，不能滋润脏腑，以致皮肤枯槁、大便干燥为燥；火生于心绪烦扰、醇酒膏粱、房事不节制所动。这六淫，都是从外而入的，体质实的人遇到而不中邪的有，体质弱的人感邪而随即发病的多。又有感邪后不立即发病，邪气客居在脏腑、经络、关节之内，积袭日久，或者等待内伤，或者因为外感，邪气触动而发作，既然发作之后，应当参详寒热温凉、邪正胜负来治疗。
膏粱，指醇酒肥鲜炙爆之物。时人多用火炭烘熏，或者用油酥燥煮，其味香燥甘甜，其性咸酸辛辣，又至于涂抹储藏浓料，顿煮重汤，以取其爽口快心，不顾及其消阴烁脏。又得到宠爱美女满前，精神飞旷，温床浓被，炉火围匡，每每到了未饥先食，未冷先绵，快意从心，色力太过，稍有不及，便去兴阳，只取快意于一时，不觉阴精消损于平日。何况所生的疾病，不起于粗茶淡饭，尽属于膏粱厚味，谁认识膏粱味道短促不如藜藿（粗菜）味道长久，凡知天命的人，应当远离避开它，选择使用才可以。
所以将五脏多有乖变，自然六腑不调匀。
五脏属五行，金、木、水、火、土是也。常欲相顺相生，所得木生火，火生土，土生金，金生水，水生木。这五脏相合相生，理禀太和之气，其病怎么会发生呢。这是生病的人，五脏必相反相克，所被木克土，土克水，水克火，火克金，金克木。这五脏相刑相克，理返互变之机，其病再无不发生的，所谓相生者昌，相克者亡。这确实是万物生克一定之理，岂止于疾病而言哉！又说五脏不和则六腑不通，六腑不通则九窍疲癃（功能衰退），九窍疲癃则留结为痈。盖痈疽必出于脏腑乖变，开窍不得宣通而发也。治疗应当：寒邪而痛者，以温热散之；湿肿强痛者，渗利而导之；燥搐挛痛者，滋润而润之；泄泻而痛者温之，闭塞而痛者通之，虚而痛者补之，实而痛者泻之，阴阳不和者调燮之，经络秘涩者冲和之，脓胀而痛者开之，恶肉侵蚀者去之，劳倦而痛者逸之，损伤而痛者续之，这些皆为活法，只在使用者详细斟酌。
发于心上多危险，五脏相干事可明。
五脏中，心、肝、脾、肺四脏皆系于背，惟肾经一脏独居于下。虽居于下，其脏精华、津液、元气、元神尽行灌溉荣注于上，故四脏之火，皆赖一脏之水以济之，所谓五脏根本皆系于背，即此之意也。凡发痈疽者，未有不先伤五脏而后发之，况背乃太阳膀胱、督脉所主，太阳者，六经之首领也；督脉者，十二经络之统脉也。所以疮生于背，毒犯于此，况心乃又属君主之位，岂容毒相犯之。凡发于此，故多成危险难治之症，医者不可不慎而察之。
心之已下多成顺，六腑之因亦许评。
凡疮生于心之以下者，除肾俞一穴外皆为缓。六腑者，足阳明胃经、手太阳小肠经、足太阳膀胱经、手厥阴心包络经、手少阳三焦经、足少阳胆经，此六经，其名属腑，其形在下，其气主表，其病为痈。故疾发于五脏者为重，生于六腑者为轻，此为表里脏腑轻重之别也。
发生于肩下脊上者，乃因饮食膏粱积毒所致。发出高肿鲜明，根脚不过两肩者为顺。先宜解毒护心为主，次宜内托清心为要，间用蜡矾丸、护心散防毒攻心。如肿平坚硬，渐大渐开，攻注两肩胸项、肿而不定者危。
对心发者，乃心火妄动热极而发之也。况心为主宰，周身蕴热流会于此，其结为患，又称毒 。君位最易伤人，刑截督经，害非轻浅。况此穴背脊多坑，固难起发，疮形落陷，肿不高尖，治当大降心火，急疏蕴热，顶用针通，随行拔法，务使毒瓦斯内外疏通，各从门出，庶不内攻，方为成守。保至十五日后，内无变症，得脓为解。如是期变症渐生，坚硬渐大不作脓者，死在二十二朝先后。但此症贵在乎早治，十中可保其三、四也。
左搭属肝，右搭属肺，俱生于左、右肩骨移动之处为可治。古云∶左搭串右，右搭串左，俱为难治。今治不然。余每医左、右相串者，未尝见其死，惟在治法得宜。有此症者，先用万灵丹发汗疏通内外，次以清肝解郁汤、柴胡清肝汤；气用四君子汤，血用四物汤，溃后八珍汤，俱兼六郁汤参而调治，诚为妥当。但此症原起于痰凝、气滞、火郁，气血不调所生。正谓郁者开之，滞者行之，如误用疮科解毒泄气、误补误攻之药，必致多危。
莲子蜂窠防毒陷
蜂窠、莲子二发，多生于背，与心相近，与脊中平，轻者形长高肿，或偏半背；重者形斜平塌，两胁俱伤，孔似蜂窠，突如莲子，疮形虽畏，常能多险。多生老弱不堪，反取常安常稳。大规只怕不纯阳，治法何妨疮势恶。护心护膜，丸丹须要调停；执药执方，活法在乎医意。机参总论，法决存亡。
肾俞发者，生于两腰内肾陷肉之间，或正中亦发，凡生于此者，最为险候。盖内肾乃为性命根本，藏精、藏气、藏神，又谓受命先天，育女、育男、育寿，此等皆出于肾脏之一窍也。是为疾者，房劳过度，气竭精伤，欲火消阴，外阳煽惑，以致真水真阴从此而耗散，既散之后，其脏必虚，所以诸火诸邪乘虚而入，既入之后，浑结为疮。如本脏稍有真阴制火，疮形自可红活高肿为脓，治以人参养荣汤加山萸、五味子、黄柏、知母及加减八味丸以救其源也；若疮形色紫黑干枯、坚硬不作脓者，为真阴内败，再无可生之理，必死在十五日前后为期也。
对口者，生于项后而对前口者是也，但有偏正之不同。发于正者，属督脉所主；发于偏者，乃太阳膀胱所司。二者皆起于湿热上攻凝结而成也。督脉者，发疮虽正而反为易治，因督脉起于下，而贯脊行于上，故毒气得之，反能冲突高肿，使邪毒不致下流低陷，乃为外发，故多易治。膀胱者，发疮虽偏，而每为难治，盖膀胱之脉起于巅顶，贯项两旁、顺下而行，乃与疮毒交会下流，故疮多平塌；又太阳膀胱主司寒水，其质多冷多沉，故疮于此多难起发，形色多难红活，坚硬难溃，又易流注，两肩、胸、项作肿，十五日外无脓者，必然变黑归阴，故多不治。俗呼以正为重，以偏为轻，此皆庸说，不得其消息故也，治以黄连消毒饮主之，余皆降火、化痰、解毒、清心、托里为要也。
发生于耳后一寸三分致命之处，诚为险恶之候。又左为夭疽，右为锐毒，夭者妖变之物也，故属肝木；锐者锋利之器也，是属肺金。二者皆起于积想在心，谋虑不决，致火旺而又郁，郁而又旺以成此疾也。故形多坚硬，头多隐伏，未溃先黑，未脓先腐，臭秽易生，元气易败，常得此者，毒瓦斯多致不得外发，后必内攻而死。但此症者，初生起于隐微，令人多不知觉，及其知觉，毒已入内矣，如红活高肿，易脓易腐者无妨。
脱疽之发，脱者，落也；疽者，黑腐也。此毒皆……多生手足。发在骨筋，初生如粟，色似枣形，渐开渐大，筋骨伶仃，乌乌黑黑，痛割伤心，残残败败，污气吞人，延至踝骨，性命将倾，此非天命，自丧其身，古人有法，截割可生，今人谁肯，割截为名，治法虽有，详在后文。
慢肿者，肉肿疮不肿是也； 肿者，疮肿肉不肿亦是也。此二者，发疮阴阳之大体，辨症顺逆之末节，由此观之，一决而定也，疮之初起，理当升发；溃脓之后，不可用内消，宜用托药。如不应者，乃毒胜气血，死在旬日。或已发出而不腐溃，根脚坚硬；或软而散大者，急投托药，大补脾胃，不应死在二旬。若已溃而色不变红活，亦不生肌收敛，疮口晕大，肿痛不减，胃气不回，急须峻补；不应者，乃脾崩，死在月余。
诸疮另有分门说，岂许轻于紊此呈。
Why do carbuncles, ulcers, and back eruptions arise, appearing on a healthy body?
Those who live in the world without disease are so because Kidney Water ascends, Heart Fire descends, Essence is conserved, and Blood is abundant. The Chapter on Health Preservation states: "Do not agitate your Essence, do not overwork your Form; return the mind to stillness and silence, and you may attain longevity." These methods involve distancing oneself from worldly affairs, forgetting fame and profit, eliminating greed and anger, thereby avoiding disease. Only those who cultivate their nature and preserve life can achieve this; how can modern people compare! Generally speaking, stillness generates Water, movement generates Fire; Water can generate all things, while Fire can overcome all things. Therefore, all diseases arise from Fire. Once Fire arises, the Seven Emotions and Six Desires enter accordingly; once inside, various diseases manifest. Those manifesting internally present as Wind-Lao (chronic deficiency syndromes), Gu-Ge (abdominal masses and dysphagia), Phlegm-Asthma, and Internal Injury; those manifesting externally form Carbuncles, Ulcers, Back Eruptions, Opposite-to-Mouth Sores, and Ding Sores (hard boils). This covers only the general outline. Thus, "Carbuncle" (Yang Abscess) implies obstruction; it belongs to Yang, representing the toxicity of the Six Fu Organs surging outward. Its onset is sudden, and the lesion is superficial because the pathogen originates in the Yang aspect. Since Yang Qi is light, clear, floating, and high-rising, it easily swells, suppurates, putrefies, and heals. It is indeed a condition that does not damage sinews and bones and is easy to treat. "Ulcer" (Yin Abscess) implies blockage; it belongs to Yin, representing the toxicity of the Five Zang Organs attacking inward. Its onset is slow, and the lesion is deep because the pathogen originates in the Yin aspect. Since Yin Blood is heavy, turbid, and sinking, it is a condition that damages sinews and bones and is difficult to treat. In young individuals with strong Qi and Blood overcoming the toxin, the prognosis is favorable; in the elderly where the toxin overcomes Qi and Blood, the prognosis is dangerous. Treatment methods are recorded in the Second Discourse; please study them carefully.
Internally, the Seven Emotions disturb the Zang Organs; worry and anxiety always concern the mind.
The Seven Emotions and Six Desires are thieves that steal the body's Primordial Qi. If one can distance oneself from these, one will be peaceful and long-lived; if one engages with them, one will inevitably suffer harm. Yet few people truly understand and avoid them. The movements of emotions and desires are seemingly harmless and ubiquitous. Joy injures the Heart, Anger injures the Liver, Sorrow injures the Lungs, Pensive thought injures the Spleen, Grief harms the Hun and Po (Soul and Corporeal Soul), Fear injures the Kidneys, and Shock injures the Gallbladder. These seven emotions are the germs of destruction that consume the body's Primordial Qi. As for the Six Desires: ears listening to sounds, eyes observing colors, nose smelling fragrances, tongue craving flavors, the heart encompassing the earth, and the intention covering all directions—these six desires damage the true nature endowed by generations of spiritual essence. They cause suffering, illness, premature death, pain, disability, and decay. All diseases and sores arise from these emotions and desires. Both physicians and patients should examine this cautiously.
Externally, the Six Excesses damage Qi and Blood; Wind, Cold, Summer-heat, Dampness, and Fire invade sequentially.
The Six Excesses are Wind, Cold, Summer-heat, Dampness, Dryness, and Fire. Wind is the irregular, vast, and killing qi of the four seasons; when it arises, it most readily affects humans. Cold results from irregular seasons, fierce winds, heavy rains, ice, snow, and severe cold, or from consuming raw and cold foods. Summer-heat strikes due to intense sun, scorching heat, steaming dampness, and heat. Dampness comes from sitting or lying in long-standing yin, low, and damp places, or from sudden exposure to wind, rain, and moisture. Dryness is internal heat due to Yin deficiency, consuming fluids and failing to nourish the Zang Organs, leading to withered skin and dry stools. Fire arises from mental agitation, rich wine and fatty foods, and unregulated sexual activity. These Six Excesses enter from outside. Those with strong constitutions may encounter them without being affected, but those with weak constitutions often contract them and develop symptoms immediately. Sometimes, after contracting them, symptoms do not appear immediately; the pathogenic qi lodges in the Zang Organs, meridians, and joints. After accumulating for a long time, triggered by internal injury or external sensation, the pathogenic qi erupts. Once erupted, treatment must consider cold, heat, warmth, coolness, and the balance between pathogenic and righteous factors.
Rich and greasy foods are consumed without restraint; labor and sexual excess lead to Yin deficiency.
"Gao Liang" refers to fine wines, rich meats, roasted, fried, and grilled foods. People today often smoke them over charcoal or boil them in oil and lard. Their taste is fragrant, dry, sweet, and mellow; their nature is salty, sour, pungent, and spicy. They are stored with strong seasonings, boiled heavily, and cooked intensely to satisfy the palate and heart, disregarding their ability to consume Yin and damage the viscera. Surrounded by beauties, spirits soaring, warm beds, thick quilts, and surrounding fires, one eats before hunger and sleeps before coldness, seeking immediate pleasure and excessive sexual exertion. Taking pleasure only for the moment, one unknowingly consumes Yin daily. Moreover, diseases arising from such habits do not stem from coarse vegetables but from rich foods. Who realizes that the benefit of rich food is short-lived compared to the longevity derived from coarse vegetables? Those who understand destiny should avoid them and use them selectively.
Thus, the Five Zang Organs undergo many abnormalities, and naturally, the Six Fu Organs become imbalanced.
The Five Zang Organs correspond to the Five Elements: Metal, Wood, Water, Fire, and Earth. Normally, they follow mutual generation: Wood generates Fire, Fire generates Earth, Earth generates Metal, Metal generates Water, and Water generates Wood. When the Five Zang Organs harmonize and generate each other, they possess the Qi of Great Harmony, and disease cannot arise. However, in disease, the Five Zang Organs mutually overcome: Wood overcomes Earth, Earth overcomes Water, Water overcomes Fire, Fire overcomes Metal, and Metal overcomes Wood. This mutual punishment and overcoming reverse the mechanism of change. Disease is inevitable. As stated, "Mutual generation leads to prosperity; mutual overcoming leads to decline." This is the fixed principle of generation and overcoming in all things, not just in disease. Furthermore, if the Five Zang Organs are disordered, the Six Fu Organs become blocked; if the Six Fu Organs are blocked, the Nine Orifices become dysfunctional; if the Nine Orifices are dysfunctional, stagnation forms Carbuncles. Thus, carbuncles and ulcers arise from Zang-Fu abnormalities, where orifices fail to circulate freely. Treatment principles: For pain due to Cold pathogens, disperse with warmth; for swelling and stiffness due to Dampness, drain and guide; for spasms and cramps due to Dryness, moisten and lubricate; for diarrhea and pain, warm; for constipation and pain, unblock; for deficiency and pain, tonify; for excess and pain, purge; for Yin-Yang disharmony, regulate; for meridian blockage, harmonize; for abscess swelling and pain, incise; for necrotic flesh erosion, remove; for fatigue and pain, rest; for injury and pain, reconnect. These are flexible methods requiring careful application by the practitioner.
Eruptions on the upper heart area are dangerous; the interaction of the Five Zang Organs clarifies this.
Among the Five Zang Organs, the Heart, Liver, Spleen, and Lungs are connected to the back, while only the Kidney resides lower. Although lower, the Kidney's essence, fluids, Primordial Qi, and Shen irrigate the upper body. Thus, the Fire of the four upper organs relies on the Water of the Kidney to balance them. This is why the root of the Five Zang Organs is linked to the back. Any carbuncle or ulcer first injures the Zang Organs before manifesting. Moreover, the back is governed by the Bladder Meridian of Foot-Taiyang and the Du Mai (Governing Vessel). Taiyang is the leader of the Six Meridians; Du Mai is the commander of the Twelve Meridians. Therefore, sores on the back face toxic invasion. Since the Heart holds the position of the Sovereign, how can it tolerate toxic invasion? Eruptions here are often dangerous and difficult to treat; physicians must be cautious.
Eruptions below the heart are generally favorable; the causes related to the Six Fu Organs can also be evaluated.
Sores arising below the heart, except at the Shenshu point, are generally mild. The Six Fu Organs include the Stomach Meridian of Foot-Yangming, Small Intestine Meridian of Hand-Taiyang, Bladder Meridian of Foot-Taiyang, Pericardium Meridian of Hand-Jueyin, Sanjiao Meridian of Hand-Shaoyang, and Gallbladder Meridian of Foot-Shaoyang. These six meridians belong to the Fu category, are located inferiorly, govern the exterior, and manifest as carbuncles. Diseases originating in the Zang Organs are severe; those in the Fu Organs are mild. This distinguishes the severity based on interior-exterior and Zang-Fu relationships.
Accumulated toxicity in the Spleen manifests on the shoulders and spine.
Eruptions between the shoulders and upper spine result from accumulated toxicity due to rich diet. High, bright swelling with roots confined within the shoulders indicates a favorable course. Initially, prioritize detoxification and protecting the Heart; subsequently, use internal support and clearing Heart heat. Occasionally use Larfan Wan (Wax and Alum Pill) and Huxin San (Heart-Protecting Powder) to prevent toxin from attacking the Heart. If swelling becomes flat and hard, gradually enlarging and spreading to both shoulders, chest, and neck with unstable swelling, the prognosis is critical.
Heart Fire Toxin Approaches the Center (Opposite-to-Mouth)
"Eruption Opposite-to-Mouth" arises from reckless Heart Fire and extreme heat. As the Heart is the sovereign, heat accumulates and converges here, forming a lesion known as "Du" (toxic nodule). The Sovereign position is easily harmed; it obstructs the Du Meridian, causing significant damage. Since the vertebrae in this area have depressions, eruption is difficult; the sore shape sinks, and swelling is not sharp. Treatment requires strongly descending Heart Fire, urgently dispersing accumulated heat, using needles to open the apex, and applying extraction methods to ensure toxins vent internally and externally through openings, preventing internal attack. Maintain care until day fifteen; if no complications arise and pus forms, it resolves. If complications arise gradually, hardness increases, and no pus forms, death occurs around day twenty-two. Early treatment is crucial; three or four out of ten cases may survive.
Simultaneous Eruptions on Both Shoulders: Lung and Liver Accumulation Justify the Name.
Left eruptions relate to the Liver, right eruptions to the Lungs. Occurring at movable points of the shoulder bones, they are treatable. Ancient texts say cross-infection (left to right, right to left) is difficult to treat. Modern practice differs. I have never seen death in such cases if treatment is appropriate. For this condition, first use Wanling Dan (Ten Thousand Spirits Pill) to induce sweating and unblock interior/exterior; then use Qinggan Jieyu Tang (Clear Liver and Resolve Depression Decoction) or Chaihu Qinggan Tang (Bupleurum Clear Liver Decoction). For Qi issues, use Sijunzi Tang (Four Gentlemen Decoction); for Blood, Siwu Tang (Four Substances Decoction); after ulceration, Bazhen Tang (Eight Treasures Decoction). Combine with Liuyu Tang (Six Depressions Decoction) for regulation. This is appropriate. The condition originates from Phlegm coagulation, Qi stagnation, and Fire depression, caused by Qi-Blood imbalance. As stated, "Depression requires opening; stagnation requires moving." Misusing detoxifying, Qi-draining, mistaken tonifying, or attacking herbs will lead to danger.
Lotus Seed and Beehive Sores: Prevent Toxin Collapse.
Beehive and Lotus Seed eruptions mostly occur on the back, near the Heart and level with the spine. Mild cases are elongated and highly swollen, or on half the back; severe cases are slanted and flat, injuring both flanks, with holes like a beehive and protrusions like lotus seeds. Though feared, they pose many risks. Common in frail elderly, they contrast with stable health. The main rule fears non-pure Yang; treatment method matters despite severe appearance. Protect the Heart and membranes; adjust pills and powders. Flexibility depends on the physician's intent. Refer to the General Discourse for mechanisms; methods determine survival.
Kidney Shu Eruption on the Waist is Difficult to Treat.
Kidney Shu eruptions occur between the kidneys in the waist or centrally. Those arising here are extremely dangerous. The inner Kidney is the root of life, storing Essence, Qi, and Spirit, governing先天 (innate constitution), reproduction, and longevity. These functions originate from the Kidney orifice. Disease results from excessive sexual labor, exhausting Qi and damaging Essence, desire fire consuming Yin, and external yang provocation, depleting True Water and True Yin. After depletion, the organ becomes deficient, allowing various fires and evils to enter and coalesce into sores. If the organ retains some True Yin to control fire, the sore will be red, vibrant, swollen, and suppurative. Treat with Renshen Yangrong Tang (Ginseng Nourishing Glory Decoction) plus Cornus, Schisandra, Phellodendron, and Anemarrhena, and Jiajian Bawei Wan (Modified Eight Flavor Pill) to save the source. If the sore is purple-black, dry, hard, and non-suppurating, it indicates internal failure of True Yin, with no hope of recovery; death occurs around fifteen days.
Du Mai Deficiency Leads to Neck Eruptions, Commonly Called Opposite-to-Mouth.
"Opposite-to-Mouth" refers to eruptions on the back of the neck facing the mouth, varying in central or lateral position. Central eruptions are governed by the Du Mai; lateral ones by the Bladder Meridian. Both arise from Damp-Heat attacking upward and coagulating. Du Mai eruptions, though central, are easier to treat because the Du Mai rises from below, pierces the spine, and travels upward. Pathogenic Qi conflicts, causing high swelling, preventing toxin from sinking, thus venting externally. Bladder eruptions, though lateral, are difficult to treat because the Bladder Meridian starts at the vertex, passes through the neck sides, and flows downward, intersecting with toxin flow, causing flat sores. Taiyang Bladder governs Cold Water; its nature is cold and sinking, making eruption difficult, color dull, hardness resisting suppuration, and prone to metastasis to shoulders, chest, and neck. No pus after fifteen days indicates transformation to Yin (blackening); thus, often untreatable. Folk belief considers central severe and lateral mild; this is incorrect due to misunderstanding of mechanisms. Treat primarily with Huanglian Xiaodu Yin (Coptis Detoxification Drink); other methods focus on descending fire, resolving phlegm, detoxifying, clearing Heart, and supporting the interior.
Unexpectedly, Many Eruptions Arise Behind the Ears; Tian Ju and Rui Du Are Not Minor.
Eruptions at one inch and three fen behind the ear are fatal and dangerous. Left is Tian Ju (Doomed Boil), belonging to Liver Wood (due to demonic transformation); Right is Rui Du (Sharp Toxicity), belonging to Lung Metal (due to sharp instruments). Both arise from persistent thoughts, indecision, leading to Fire flourishing and depression, alternating to create disease. Shapes are hard, heads hidden, blackening before ulceration, rotting before suppuration, foul odor generating easily, Primordial Qi failing easily. Toxins often fail to vent externally and attack internally, causing death. Initially subtle and unnoticed, by the time detected, toxin is internal. If red, vibrant, swollen, suppurating, and rotting easily, no harm.
There is also Tuojue (Falling Gangrene) on hands and feet...
Tuojue eruption: "Tuo" means falling; "Ju" means black rot. This toxin... mostly affects hands and feet. Originating in bone and sinew, initially like millet, color like jujube, gradually enlarging, sinews and bones emaciated, pitch black, cutting pain heartbreaking, ruinous, foul air swallowing the person, extending to ankles, life teetering. This is not fate but self-destruction. Ancients had methods: amputation can save life. Who is willing today? Amputation is stigmatized. Treatment methods exist, detailed later.
Slow Swelling is Hard to Treat; Fast Swelling is Easy; Methods in the General Discourse Can Be Trusted.
"Slow swelling" means flesh swells but the sore does not; "Fast swelling" means the sore swells but the flesh does not. These two represent the general Yin-Yang patterns of sores and details for distinguishing favorable/unfavorable courses. Decision is made here. At initial stage, promotion is indicated; after suppuration, internal resolution is contraindicated; use supporting drugs. If ineffective, toxin overcomes Qi-Blood; death in ten days. If erupted but not rotting/ulcerating, with hard roots; or soft and spreading, urgently administer supporting drugs, greatly tonify Spleen-Stomach. If ineffective, death in twenty days. If ulcerated but color not red/vibrant, no granulation/healing, large halo, pain/swelling unchanged, Stomach Qi not returning, urgently tonify severely. If ineffective, Spleen collapse; death in a month.
Various Sores Have Separate Classifications; Do Not Lightly Confuse This Presentation.