东垣曰。疮疡食肉。乃自弃也。疮疡乃营气而作。今反补之。自弃何异。虽用药治。不
精要曰。羊、鸡、牛、鹅、鱼、面、煎爆、炒、炙、酒等味。犯之必发热。用栀子黄苓
丹溪曰。栀苓、苦参、犀角。佐辅人参。固可解食毒之热。若寒月与虚人。宁无加减乎
经谓膏粱之变。足生大丁。此言疮疽之因也。禁戒浓味。恐其引起宿火之热。此诚富贵豢养
口腹者所当谨。若素贫者大不然矣。
予治一人。背痈径尺。穴深而黑。家贫得此。急作参 归术膏。多肉馄饨与之而安。多
肉馄饨补气之有益者也。
精要曰。凡血气闻香则行。闻臭则逆。饮食调令香美。益脾土。养真气。疮疡或为秽气
所触。可用香药熏之。
丹溪曰。甘而淡者可养脾土。若香美者但能起火。故经以热伤脾、热伤气为戒。今曰益
脾养气。施之肿疡。似有畅达之益。溃疡后用香美。恐有发湿热、损真阴之患。
夫痈、疽、疮、疖。皆由气血壅滞而生。当推虚、实、表、里而早治之。可以内消。此
里之意也。若毒瓦斯已结者。勿泥此内消之法。当辨脓之有无浅深。急酌量刺之。缓则穿通脏
腑。腐烂筋骨。可不慎哉。若脉紧而数。为脓未成。紧去但数。为脓已成。以手按上。热者
有脓。不热无脓。按之牢硬未有脓。按之半软半硬已有脓。大软方是脓成。若大按之痛者脓
深。按之不甚痛者脓未成。按之即复痛者为有脓。不复痛者无脓。薄皮剥起。起者脓浅。
皮色不变。不高阜者脓深。浅者宜砭。深者宜针。手足指梢及乳上。宜脓大软方开。麻豆后
肢疖有痈。稍觉有脓。便用决破。迟则成挛曲之疾。
李东垣说：疮疡患者食用肉类，是自暴自弃的行为。疮疡是由营气运行不畅而形成的，现在反而用滋腻的肉食来补益，这与自暴自弃有何区别？虽然用药治疗，但若不忌口，也难以取得精要的效果。
《外科精要》说：羊肉、鸡肉、牛肉、鹅肉、鱼肉、面食、油炸、爆炒、烧烤、酒类等食物，如果触犯这些禁忌，必然会导致发热。
朱丹溪说：使用栀子、黄芩、苦参、犀角等药物，配合人参作为辅助，固然可以解除因饮食不当引起的热毒。但是，如果是寒冷的季节或者体质虚弱的人，难道不需要根据情况进行加减调整吗？
经典医籍说：“膏粱之变，足生大丁”，这是指疮疽产生的原因。禁止食用浓烈厚味的食物，是担心它们引发体内宿积的火邪热毒。这确实是那些富贵人家只顾满足口腹之欲的人所应当谨慎对待的。但对于一向贫寒的人来说，情况则完全不是这样了。
我治疗过一个人，背部痈肿直径有一尺深，疮口深陷且颜色发黑。此人家境贫寒，得了这个病后，我急忙给他服用参归术膏（人参、当归、白术制成的膏剂），并让他多吃多肉馄饨，结果病情安定好转。多吃馄饨对于补气是有好处的。
《外科精要》说：凡是人体的血气，闻到香气就会顺畅运行，闻到臭气就会逆乱阻滞。通过饮食调理使其味道香美，有助于健脾土，养护真气。疮疡如果受到秽浊之气的影响，可以用香药进行熏治。
朱丹溪说：味甘而淡的食物可以滋养脾土。但如果气味过于香美，却容易引动火邪。所以经典医籍以“热伤脾”、“热伤气”作为告诫。现在有人说吃香美的食物能益脾养气，这在疮疡初期（肿疡阶段）施用，似乎有通畅达郁的好处；但在溃疡后期使用香美食物，恐怕会有引发湿热、损伤真阴的隐患。
至于痈、疽、疮、疖，都是由气血壅滞不通而产生的。应当推究其虚、实、表、里的证候，尽早治疗，可以使病灶在内部消散，这就是“内消”的道理。如果毒邪已经结聚成形，就不要拘泥于这种内消的方法，应当辨别脓液的有无以及深浅程度，紧急斟酌决定刺破排脓。如果拖延，脓毒就会穿透脏腑，腐烂筋骨，能不谨慎吗？如果脉象紧而数，说明脓液尚未形成；紧象消失仅见数脉，说明脓液已经形成。用手按压患处，感觉发热的有脓，不发热的无脓；按上去坚硬牢固的没有脓，按上去半软半硬的已有脓；非常柔软才是脓已成熟。如果重按才感到疼痛，说明脓位较深；按下去疼痛不明显的，说明脓未形成；按之即痛的是有脓，不按不痛的则是无脓。表皮薄而隆起，隆起明显者脓位浅；皮色不变、不高突者脓位深。脓位浅的用砭石刺破，脓位深的用针具穿刺。手足指尖及乳房上方，宜等到脓液大而柔软时才切开引流。大腿后侧小腿部位的疖肿若发展成痈，稍微觉得有脓时，就要立即决破排脓，如果迟缓，则会变成肢体挛曲畸形的疾病。
Li Dongyuan stated: For patients with sores and ulcers, consuming meat is an act of self-neglect. Sores and ulcers arise from the stagnation of Ying-Qi (Nutritive Qi). To tonify them now with rich meats is no different from self-neglect. Even with medicinal treatment, without dietary precision, essential results cannot be achieved.
The *Waike Jingyao* (Essentials of Surgery) states: Consuming mutton, chicken, beef, goose, fish, wheat noodles, fried foods, roasted meats, and alcohol will inevitably cause fever if these taboos are violated.
Zhu Danxi stated: Using Gardenia (Gardeniae Fructus), Scutellaria (Scutellariae Radix), Sophora (Sophorae Flavescentis Radix), and Rhinoceros Horn (Rhinocerotis Cornu) assisted by Ginseng (Ren Shen) can indeed resolve the heat caused by dietary toxicity. However, in cold months or for patients with deficiency constitutions, should adjustments not be made accordingly?
The Classics state: "Changes from rich and greasy food are sufficient to produce large carbuncles." This refers to the etiology of sores and ulcers. Prohibiting strong-flavored and rich foods is to prevent the triggering of latent internal fire-heat. This is indeed a caution for those of wealth who indulge their appetites. For those who have always been poor, however, the situation is entirely different.
I treated one patient with a back carbuncle measuring one chi in diameter, with a deep cavity and black discoloration. Being poor, upon contracting this illness, I urgently prescribed a paste made of Ginseng (Ren Shen), Angelica Sinensis (Danggui), and Atractylodes Macrocephala (Baizhu), and provided him with wonton dumplings containing abundant meat, resulting in stabilization of the condition. Consuming ample meat in wontons is beneficial for tonifying Qi.
The *Waike Jingyao* (Essentials of Surgery) states: Blood and Qi flow smoothly when exposed to fragrant aromas but become reversed and obstructed by foul odors. Regulating diet to be aromatic and delicious benefits the Spleen Earth and nourishes True Qi. If sores and ulcers are touched by turbid qi, they can be fumigated with aromatic herbs.
Zhu Danxi stated: Foods that are sweet and bland can nourish Spleen Earth. However, those that are overly aromatic may only ignite fire-heat. Therefore, the Classics warn against "Heat injuring the Spleen" and "Heat injuring Qi." Now, it is said that aromatic and delicious foods benefit the Spleen and nourish Qi; applying this during the early stage of swelling (Zhongyang) seems to have the benefit of promoting free flow. However, using aromatic and delicious foods after ulceration (Kuyang) may pose the risk of inducing damp-heat and damaging True Yin.
Carbuncles (Yong), deep abscesses (Ju), sores (Chuang), and boils (Jie) all arise from the stagnation of Qi and Blood. One must deduce the patterns of Deficiency, Excess, Exterior, and Interior and treat them early to allow for internal resolution (Neixiao). This is the meaning of internal resolution. If the pathogenic factors have already condensed, do not rigidly adhere to this method of internal resolution. Instead, differentiate the presence and depth of pus, and urgently decide on incision and drainage. Delaying allows the toxin to penetrate viscera and rot bones and sinews. Can one be too cautious? If the pulse is tight and rapid, pus has not yet formed; if the tightness disappears and only rapidness remains, pus has formed. Pressing the area: if hot, there is pus; if not hot, there is no pus. If hard and firm upon pressure, there is no pus; if half-soft and half-hard, pus has formed; if very soft, the pus is mature. If pain occurs only upon deep pressure, the pus is deep; if pain upon pressure is not severe, pus has not formed. If pain occurs immediately upon pressing, there is pus; if there is no pain even after pressing, there is no pus. If the skin is thin and elevated, the pus is shallow; if the skin color does not change and there is no elevation, the pus is deep. Shallow pus should be treated with Bian stone (Bianshi) pricking; deep pus requires needle puncture. On the tips of fingers and toes and on the breasts, incision and drainage should only be performed when the pus is large and soft. For boils on the posterior limbs that develop into carbuncles, if one senses the formation of pus, immediate rupture and drainage should be used. Delay will result in contracture deformities of the limbs.