病患目中赤脉。从上下贯瞳仁。一脉一年死。二脉二年死。若脉下者。疗之瘥。面上忽
贯上下如脂赤色。从额上下至鼻。黑色出额上。大如指。及连鼻上至肩。又有赤色垂。并为
机按赤脉属火。瞳仁属水。赤脉贯瞳。火反乘水。面属阳。阳部赤色。阳胜阴微。额上
黑色。阳微阴胜。故多危也。
天行一 瘦弱气滞二 怒气三 肾气虚四 服法酒食炙爆服丹药热毒五
盖治痈疽不可一概视为热。其治难易。当自一而至五动。
膏粱之变。足生大丁。受如持虚。膏粱浓味。热毒内积。其变多生大疽。受毒部分。其
毒从虚处受之。大丁、大疽也。以其根深在内也。此言疽因浓味内热为变而生。
阳气者精则养神。柔则养筋。开阖不得。寒气从之。乃生大偻。陷脉为 。留连肉腠。
人身阳气。其精微以养神。其柔和以养筋。阳气在身表。开阖失宜。在外寒气从而袭之
袭其筋络。则筋络拘急为偻俯。如陷入经脉。则经脉凝瘀为疡 。留连分肉节腠间。不易散
此言疡 因阳气开阖失宜。外寒袭陷。经脉凝瘀而生。
营气不从逆于肉理。乃生痈肿。
营生血。营气流行失宜。不从其道阻逆于肉理。则血郁热。聚而为痈肿。
此言痈肿因营气失宜。逆于肉理。血郁热聚而生。
三阳为病发寒热。下为痈肿。
三阳。手阳明大肠。太阳小肠。足太阳膀胱。其三阳为病。在上发寒热。在下为痈肿。
此言痈肿在下。从三阳而生。当视三阳脉而辨。
东方之域。鱼盐之地。其民食鱼嗜咸。安其处。美其食。鱼热中。盐胜血。故其民黑色
疏理。其病为痈疡。
此言痈疽。因土地濒海。食鱼嗜咸。安居不劳。美味不节。鱼热中。盐胜血而生。
诸痈肿。筋挛骨痛。此寒气之肿。八风之变也。
经曰。寒伤形。形伤肿。八风。八方之风。灵枢云。东南方来名弱风。伤人也在肌。西
名谋风。伤人也在肉。东方来名婴儿风。伤人也在筋。北方来名大刚风。伤人也在骨。此寒
气之肿。八风之变。而为痈肿。筋挛。骨痛。
此言痈疽。因四方寒气。八风过伤而生。
肾移寒于脾。痈肿少气。
夫肾伤于寒。转移于脾。脾主肉。分肉之间。卫气行处。肾寒复传脾。则分肉寒而卫气
凝。故肾结为痈肿。肉结血伤而少气。
此言痈肿。因肾寒传脾而生。
脾移寒于肝。痈肿筋挛。
脾主肉。肝主筋。肉温则筋舒。今脾传寒于肝。故肉寒则卫气结聚为痈肿。筋寒则急为
此言痈肿。因脾寒传肝而生。
肝满。肺满。肾满。皆实。则为肝肺肾痈。
满实。脉气满实也。以脏气邪盛满实。故脉气如是。
此言肝肺肾痈。因脏气邪盛满实而生。当视脉气满实而辨。
患者眼睛中出现赤色血脉。从上下方向贯穿瞳孔。一条脉一年死亡，两条脉两年死亡。如果脉象向下延伸的，治疗可以痊愈。面部突然呈现贯通上下的脂状赤红色，从额头上下延伸至鼻子，黑色出现在额头上，大如手指，以及连接鼻子上方直至肩膀。又有赤色下垂，汪机按语认为赤色血脉属于火，瞳孔属于水，赤色血脉贯穿瞳孔，是火反克水。面部属阳，阳部出现赤色，是阳胜阴微。额头上的黑色，是阳微阴胜，所以大多危险。
天行（时行疫病）一，瘦弱气滞二，怒气三，肾气虚四，服用酒食炙爆及丹药热毒五。
大概治疗痈疽不可一概视为热证。其治疗的难易程度，应当从这五种情况逐一分析。
膏粱之变，足生大丁（大疔疮）。受邪如同持空器接受东西。膏粱浓味，热毒内积，其变化多产生大疽。受毒的部位，其毒从虚弱处侵入。大丁、大疽，是因为病根深在内里。这是说疽因为浓味内热为变而生。
阳气者精则养神，柔则养筋。开阖不得，寒气从之，乃生大偻。人身阳气，其精微用以养神，其柔和用以养筋。阳气在体表，开阖失宜，在外寒气从而侵袭，袭击其筋络，则筋络拘急导致俯偻。如陷入经脉，则经脉凝瘀形成疡。留连分肉节腠间，不易消散。这是说疡因阳气开阖失宜，外寒袭陷，经脉凝瘀而生。
营气不从，逆于肉理，乃生痈肿。营生血，营气流行失宜，不从其道阻逆于肉理，则血郁热，聚而为痈肿。这是说痈肿因营气失宜，逆于肉理，血郁热聚而生。
三阳为病发寒热，下为痈肿。三阳，指手阳明大肠经、太阳小肠经、足太阳膀胱经。其三阳为病，在上发寒热，在下为痈肿。这是说痈肿在下，从三阳而生，应当视三阳脉而辨别。
东方之域，鱼盐之地。其民食鱼嗜咸，安其处，美其食。鱼热中，盐胜血。故其民黑色疏理，其病为痈疡。这是说痈疽，因土地濒海，食鱼嗜咸，安居不劳，美味不节，鱼热中，盐胜血而生。
诸痈肿，筋挛骨痛，此寒气之肿，八风之变也。经曰：寒伤形，形伤肿。八风，指八方之风。《灵枢》云：东南方来名弱风，伤人也在肌；西名谋风，伤人也在肉；东方来名婴儿风，伤人也在筋；北方来名大刚风，伤人也在骨。此寒气之肿，八风之变，而为痈肿、筋挛、骨痛。这是说痈疽，因四方寒气，八风过伤而生。
肾移寒于脾，痈肿少气。夫肾伤于寒，转移于脾。脾主肉，分肉之间，卫气行处。肾寒复传脾，则分肉寒而卫气凝。故肾结为痈肿，肉结血伤而少气。这是说痈肿，因肾寒传脾而生。
脾移寒于肝，痈肿筋挛。脾主肉，肝主筋。肉温则筋舒。今脾传寒于肝，故肉寒则卫气结聚为痈肿，筋寒则急为筋挛。这是说痈肿，因脾寒传肝而生。
肝满，肺满，肾满，皆实，则为肝肺肾痈。满实，指脉气满实。以脏气邪盛满实，故脉气如是。这是说肝肺肾痈，因脏气邪盛满实而生，应当视脉气满实而辨别。
The patient exhibits red vessels in the eyes, penetrating vertically through the pupil. One vessel indicates death within one year; two vessels indicate death within two years. If the vessels extend downward, treatment can lead to recovery. The face suddenly shows a reddish hue resembling grease, extending from the forehead down to the nose. Black discoloration appears on the forehead, as large as a finger, and connects from above the nose to the shoulder. Additionally, there is hanging redness. Wang Ji's commentary states that red vessels belong to Fire, while the pupil belongs to Water. Red vessels penetrating the pupil indicate Fire counter-attacking Water. The face belongs to Yang; redness in the Yang region indicates Yang excess and Yin deficiency. Blackness on the forehead indicates Yang deficiency and Yin excess; thus, the condition is mostly critical.
1. Epidemic pathogenic factors (Tianxing); 2. Emaciation with Qi stagnation; 3. Anger; 4. Kidney Qi deficiency; 5. Consumption of alcohol, roasted/fried foods, and hot toxins from elixirs.
Generally, treating carbuncles and sores should not be uniformly regarded as Heat syndromes. The difficulty or ease of treatment depends on analyzing these five categories sequentially.
Excesses from rich and greasy foods easily produce large Ding (severe furuncles). Susceptibility is like holding an empty vessel. Rich and greasy flavors accumulate internal heat toxins, often transforming into large Ju (deep-seated abscesses). The toxin enters through weak areas. Large Ding and large Ju are characterized by deep roots internally. This explains that Ju arises from transformations due to internal heat caused by rich flavors.
Yang Qi, when refined, nourishes the Spirit; when soft, it nourishes the sinews. If opening and closing mechanisms fail, Cold pathogenic factors enter, leading to severe flexion deformities. Human body Yang Qi uses its essence to nourish the Spirit and its gentleness to nourish the sinews. When Yang Qi is at the body surface, improper opening and closing allow external Cold to invade. If it attacks the sinew collaterals, spasms cause flexion. If it penetrates the meridians, stasis forms ulcers. If it lingers between muscles and interstices, it is difficult to dissipate. This explains that ulcers arise from improper Yang Qi opening/closing, invasion by external Cold, and meridian stasis.
When Ying Qi does not follow its course and reverses within the muscle tissue, carbuncles and swellings arise. Ying generates Blood. If Ying Qi circulation is abnormal and obstructed/reversed in the muscle tissue, Blood stagnates and generates heat, accumulating into carbuncles and swellings. This explains that carbuncles arise from abnormal Ying Qi reversing in muscle tissue, causing Blood stagnation and heat accumulation.
Diseases of the Three Yang meridians manifest as chills and fever; below, they manifest as carbuncles and swellings. The Three Yang refer to the Hand-Yangming Large Intestine Meridian, Taiyang Small Intestine Meridian, and Foot-Taiyang Bladder Meridian. Diseases of these three Yang meridians manifest as chills and fever above, and as carbuncles and swellings below. This explains that lower-body carbuncles arise from the Three Yang meridians and should be differentiated by examining their pulses.
In the Eastern regions, lands of fish and salt, people eat fish and crave salt. They settle comfortably and enjoy their food. Fish generates internal heat; excessive salt damages Blood. Thus, people have dark skin and loose texture, prone to carbuncles and sores. This explains that carbuncles and sores arise from coastal living, consuming fish and salt, sedentary lifestyle, and lack of dietary moderation, leading to internal heat from fish and Blood damage from salt.
Various carbuncles and swellings, tendon spasms, and bone pain are swellings caused by Cold pathogenic factors and changes from the Eight Winds. The Classic states: "Cold injures the form; injury to the form causes swelling." The Eight Winds refer to winds from eight directions. *Ling Shu* states: Wind from the southeast is called Weak Wind, injuring the muscle layer; wind from the west is called Mou Wind, injuring the flesh; wind from the east is called Infant Wind, injuring the sinews; wind from the north is called Great Rigid Wind, injuring the bones. These cold-induced swellings and Eight Wind variations cause carbuncles, tendon spasms, and bone pain. This explains that carbuncles arise from Cold pathogens from four directions and excessive harm from the Eight Winds.
Kidney transferring Cold to the Spleen causes carbuncles and shortness of breath. If the Kidney is injured by Cold and transfers it to the Spleen, since the Spleen governs flesh and the space between muscles is where Wei Qi circulates, Kidney Cold transmitting to the Spleen causes Cold in the flesh and coagulation of Wei Qi. Thus, Kidney knotting leads to carbuncles, flesh knotting damages Blood, resulting in shortness of breath. This explains that carbuncles arise from Kidney Cold transmitting to the Spleen.
Spleen transferring Cold to the Liver causes carbuncles and tendon spasms. The Spleen governs flesh; the Liver governs sinews. Warm flesh allows relaxed sinews. Now, Spleen transmits Cold to the Liver; thus, Cold flesh causes Wei Qi aggregation forming carbuncles, and Cold sinews cause tension/spasms. This explains that carbuncles arise from Spleen Cold transmitting to the Liver.
Fullness in the Liver, Fullness in the Lung, and Fullness in the Kidney, all Excess patterns, result in Liver, Lung, and Kidney carbuncles. Fullness and Excess refer to pulse qi being full and excess. Due to organ Qi being pathological and excessively full, the pulse qi manifests accordingly. This explains that Liver, Lung, and Kidney carbuncles arise from excessive organ Qi and pathogenic fullness, and should be differentiated by observing full and excess pulse qi.