凡疮不起者托而起之。不成脓者补而成之。使不内攻。脓成宜及时针之。若畏痛而不肯
。又有恐伤良肉而不肯针。殊不知疮虽发于肉薄之处。若脓成。其肿亦高寸余。疮皮又浓分
许。用针深不过二分。若发于背。肿高必有三四寸。针入止于寸许。况患处肉已坏矣。何痛
之有。何伤之虑。怯弱之人。及患附骨疽。待脓自通。必致大溃不能收敛。血气沥尽而亡者
上部脉数实而痛者。宜降火。
上部脉数虚而痛者。宜滋阴降火为主。
尺部脉数而作渴者。滋阴降火。如四物加黄柏、知母。
大抵疮之寒热虚实。皆能为痛。热毒痛者。药用寒凉折之。寒邪痛者。药用温热散之。
痛者除风。因湿痛者导湿。燥而痛者润之。塞而痛者通之。虚而痛者补之。实而痛者泄之。
脓郁而闭者开之。恶肉侵蚀者去之。阴阳不和者调之。经络闭涩者利之。慎勿概用寒凉之药
。盖血脉喜温而恶寒。若冷气入里。血即凝滞。反难瘥矣。又曰。大抵疮疽之症虽发疼痛。
情势高硕。烦渴不宁。脉若有力。饮食颇进。可保无虞。其脓一溃。诸症悉退。多有因脓不
得外泄以致疼痛。若用败毒寒药攻之。反致悟事。若有脓急针之。脓出痛止。脓未成而热毒
作痛。用解毒之药。亦有腐烂尺余者。若无恶症。投以大补之剂。肉最易生。亦无所妨。
凡是疮疡不起发的，用托法使其起发。不能化脓的，用补法使其成脓。从而使毒邪不向内攻陷。脓液形成后应当及时针刺排脓。如果因为畏惧疼痛而不肯接受针刺，或者担心损伤健康组织而不肯针刺，却不知道：虽然疮疡发于肌肉较薄的部位，但若脓已成熟，肿胀也会高出一寸多，疮皮也有几分厚，使用针刺深度不超过二分；如果发于背部，肿胀高度必然有三四寸，针刺进入深度只到一寸左右罢了。况且患处肌肉已经坏死，有什么疼痛可言？有什么损伤的顾虑呢？体质怯弱的人，以及患有附骨疽的患者，如果等待脓液自行通畅，必然导致溃烂巨大而不能收敛，气血耗竭而死亡。
上部脉象数且实而疼痛的，适宜降火。
上部脉象数且虚而疼痛的，适宜以滋阴降火为主。
尺部脉象数且伴有口渴的，采用滋阴降火法，如四物汤加黄柏、知母。
大抵疮疡的寒热虚实，都能引起疼痛。热毒引起的疼痛，用药性寒凉的来折服它；寒邪引起的疼痛，用药性温热的来散除它。
因风致痛的祛风，因湿致痛的利湿，因燥致痛的润燥，因闭塞致痛的通利，因虚致痛的补益，因实致痛的泄泻。
脓液郁闭不通的开通它，恶肉侵蚀的去除恶肉，阴阳不和的调和它，经络闭涩的疏通它。千万不要一概使用寒凉药物。因为血脉喜欢温暖而厌恶寒冷，如果冷气侵入体内，血液就会凝滞，反而难以痊愈了。又说：大抵疮疽的症状虽然发作疼痛，情势严重，烦躁口渴不安，但如果脉象有力，饮食尚可，可以保全无虞。一旦脓液溃破，各种症状全部消退。有很多因为脓液不得外泄而导致疼痛的情况，如果使用败毒寒药攻伐，反而会导致误事。如果有脓液，应当紧急针刺，脓出则痛止。脓未形成而热毒作痛，使用解毒的药物，也有腐烂一尺多的情况。如果没有恶症，投以大补的药剂，肌肉最容易生长，也没有妨碍。
For any carbuncle that fails to rise, employ the method of supporting and raising it. For those that fail to suppurate, employ tonification to induce suppuration, thereby preventing the pathogenic factor from attacking inward. Once pus has formed, timely needle drainage should be performed. Some patients refuse needling due to fear of pain, or hesitate for fear of damaging healthy tissue. They fail to realize that although the lesion may arise in areas with thin muscle, once pus is mature, the swelling can exceed one cun in height, and the skin thickness may reach several fen. The depth of needle insertion should not exceed two fen. If the lesion arises on the back, the swelling height must be three to four cun, and the needle insertion depth should only reach about one cun. Moreover, since the tissue at the affected site is already necrotic, what pain could there be? What concern for damage is warranted? Weak individuals, as well as patients suffering from deep-seated bone abscess (Fugu Ju), who wait for pus to drain spontaneously, will inevitably suffer massive ulceration that fails to heal, leading to exhaustion of Qi and Blood and death.
For pain accompanied by a rapid and excess pulse in the upper position, fire-clearing (Jiang Huo) is appropriate.
For pain accompanied by a rapid and deficient pulse in the upper position, nourishing Yin and clearing fire should be the primary approach.
For thirst accompanied by a rapid pulse in the Chi (Cun Cun) position, employ nourishing Yin and clearing fire, such as Si Wu Tang (Four Substances Decoction) added with Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma).
Generally, the cold, heat, deficiency, and excess patterns of carbuncles can all cause pain. Pain caused by heat toxin is treated with cold-natured medicines to subdue it; pain caused by cold pathogen is treated with warm-natured medicines to disperse it.
Pain due to wind is treated by dispelling wind; pain due to dampness by promoting dampness drainage; pain due to dryness by moistening; pain due to obstruction by unblocking; pain due to deficiency by tonifying; pain due to excess by purging.
Obstruction due to stagnant pus is opened; erosion by foul flesh is removed; disharmony of Yin and Yang is regulated; blockage and stagnation of meridians are smoothed. One must not indiscriminately use cold-natured medicines. This is because blood vessels prefer warmth and dislike cold; if cold qi enters the interior, blood coagulation and stasis occur, making recovery more difficult. It is also said: Generally, although carbuncles and sores present with pain, severe symptoms, restlessness, and thirst, if the pulse is forceful and dietary intake is adequate, prognosis is good. Once the pus drains, all symptoms recede. Many cases involve pain due to pus retention without external drainage; using toxic-resolving and cold medicines to attack this condition often leads to mishaps. If pus is present, urgent needle drainage is required; once pus exits, pain ceases. If heat toxin causes pain before pus formation, detoxifying medicines are used, which may result in tissue necrosis spanning over one chi. If no malignant signs are present, administering strong tonifying agents facilitates easy tissue regeneration without adverse effects.