夫疮疽丹肿结核瘰 ，初觉有之，即用内消之法，经久不除，气血渐衰，肌寒肉冷，脓
稀，毒不出，疮口不合，成聚肿不赤，结核无脓，外证不明者，并宜托里。脓未成者，使脓
早成；脓已溃者，使新肉早生。血气虚者，托里补之；阴阳不和，托里调之。大抵托里之法
，使疮无变坏之证。凡为疮医，不可一日无托里之药。然而寒热温凉，烦渴利呕，临证宜审
其缓急耳！
夫疮疽之证候不同，寒热虚实皆能为痛。止痛之法，殊非一端。世人皆谓乳、没珍贵之
可住疼痛。殊不知临病制宜，自有方法。盖热毒之痛者，以寒凉之剂折其热，则痛自止也；
寒邪之痛，以温热之药熨其寒，则痛自除矣；因风而痛者，除其风；因湿而痛者，导其湿；
燥而痛者润之；塞而痛者通之；虚而痛者补之；实而痛者泻之；因脓郁而闭者开之；恶肉侵
溃者引之；阴阳不和者调之；经络秘涩者利之。临机应变，方为上医，不可执方而无权也。
古人用药，因病制宜，治不执方，随病增损。积聚补益，可用丸药，以从旧不改方增损
疮疽危要之际，证候多种，安有执方之论，固可临时加减，以从其法。只如发背、脑疽、恶
疔、肿脓溃前后虚而头痛者，于托里药内加五味子；恍惚不宁加人参、茯苓；虚而发热者，
加地黄、栝萎根；往来寒热者，并潮热者，加柴胡、地骨皮；渴不止者，加知母、赤小豆；
大便不通者，加芒硝；小便不通者，加木通、灯草；虚烦者，加枸杞子、天门冬；自利者，
加浓朴；四肢厥逆者，加附子、生姜；呕逆者，加丁香、藿香；多痰者，加半夏并陈皮；脓
多者，加当归、川芎；痛甚者，加芍药、乳香；肌肉迟生者，加白蔹、官桂；有风邪者，加
独活、防风；心惊怯者，加丹砂；口目 动者，加羌活、细辛。愚虽不才，自幼及老，凡治
疮疽，常根据此法加减用药，取效如神。后之学人，宜细详焉。
疮疡、疽病、丹毒、肿胀、结核、瘰疬等病症，在初起阶段若发现症状，应立即采用内消法（通过内服药物使肿块消散）治疗。如果经久不愈，导致气血逐渐衰弱，肌肉寒冷僵硬，脓液稀薄，毒邪无法排出，疮口难以愈合，或者表现为局部聚肿但颜色不红，结核无脓，外部证候不明显者，都适宜使用托里法（扶助正气以托毒外出）。对于脓液尚未形成的情况，托里法能使脓液早日形成；对于脓液已经溃破的情况，托里法能使新肉早日生长。对于血气虚弱者，用托里法进行补益；对于阴阳失调者，用托里法进行调和。大抵托里法的作用，是防止疮疡出现恶化变坏的证候。凡是从事疮疡治疗的医生，不可一日没有使用托里法的药物。然而，面对寒热温凉等不同性质，以及烦渴、腹泻、呕吐等症状，临证时必须仔细审察病情的缓急轻重！
疮疡和疽病的证候各不相同，寒、热、虚、实都能引起疼痛。止痛的方法，并非只有一种。世人普遍认为乳香、没药这些珍贵药材可以制止疼痛。殊不知临病制宜，自有其方法。如果是热毒引起的疼痛，使用寒凉性质的药剂来折损其热势，疼痛自然停止；如果是寒邪引起的疼痛，使用温热性质的药物来温熨驱散其寒邪，疼痛自然消除；因风邪引起的疼痛，祛除风邪即可；因湿邪引起的疼痛，引导湿邪排出即可；因燥邪引起的疼痛，滋润之即可；因阻滞引起的疼痛，疏通之即可；因虚损引起的疼痛，补益之即可；因实证引起的疼痛，泻下之即可；因脓液郁闭引起的疼痛，开泄之即可；因恶肉侵蚀溃烂引起的疼痛，引流之即可；因阴阳不和引起的疼痛，调和之即可；因经络闭塞涩滞引起的疼痛，通利之即可。根据病情灵活应变，才算是高明的医生，不可拘泥于固定方剂而不知权变。
古人用药，因病制宜，治疗不固守成方，而是随病情增减调整。对于积聚类疾病需要补益时，可以使用丸药，因为丸药作用缓和，适合长期调理而不轻易改变方剂。但在疮疡危急紧要之际，证候多种多样，哪有固守一方不变的道理？应当临时加减，以符合治疗法则。例如发背疽、脑疽、恶疔等病，在肿脓未溃或已溃前后，若患者体虚且头痛，可在托里药中加入五味子；若出现心神恍惚、不安宁，加入人参、茯苓；若体虚且发热，加入地黄、栝萎根（天花粉）；若出现往来寒热或潮热，加入柴胡、地骨皮；若口渴不止，加入知母、赤小豆；若大便不通，加入芒硝；若小便不通，加入木通、灯草；若虚烦不安，加入枸杞子、天门冬；若自发性腹泻，加入厚朴；若四肢厥冷逆乱，加入附子、生姜；若呕吐逆气，加入丁香、藿香；若痰多，加入半夏和陈皮；若脓液过多，加入当归、川芎；若疼痛剧烈，加入芍药、乳香；若肌肉生长迟缓，加入白蔹、官桂（肉桂）；若有风邪侵袭，加入独活、防风；若心惊胆怯，加入丹砂；若口眼歪斜抽动，加入羌活、细辛。我虽然才能平庸，但从幼年至老年，凡治疗疮疡疽病，常依据此法加减用药，取得如神一般的疗效。后学之人，应当仔细详察。
When sores, carbuncles, erysipelas, swelling, nodules, or scrofula are first detected, the method of internal resolution (dissolving masses through internal medication) should be employed immediately. If they persist for a long time without being resolved, Qi and Blood gradually decline, muscles become cold and stiff, pus is thin, toxins fail to discharge, and sore openings fail to heal; or if there is localized swelling without redness, nodules without pus, or unclear external manifestations, the method of supporting the interior (fortifying healthy Qi to expel toxins outward) is appropriate. For cases where pus has not yet formed, this method facilitates early pus formation; for cases where pus has already ulcerated, it promotes early regeneration of new tissue. For those with deficient Qi and Blood, the interior is supported and tonified; for those with disharmony of Yin and Yang, the interior is supported and regulated. Generally, the method of supporting the interior prevents sores from developing deteriorating complications. Physicians treating sores must always have access to formulas for supporting the interior. However, regarding conditions of cold, heat, warmth, coolness, as well as symptoms such as restlessness, thirst, diarrhea, and vomiting, one must carefully assess the urgency and severity during clinical practice.
The manifestations of sores and carbuncles vary, and pain can arise from cold, heat, deficiency, or excess. The methods for relieving pain are manifold. People generally believe that precious herbs like *Boswelliae Resina* (Ruxiang, 乳香) and *Olibanum* (Moyao, 没药) can stop pain. They do not realize that treatment must be adapted to the specific disease, employing appropriate methods. For pain caused by heat-toxin, cooling agents reduce the heat, and the pain ceases naturally; for pain caused by cold pathogen, warming agents dispel the cold, and the pain is eliminated naturally; for pain due to wind, remove the wind; for pain due to dampness, guide out the dampness; for pain due to dryness, moisten it; for pain due to obstruction, unblock it; for pain due to deficiency, tonify it; for pain due to excess, purge it; for pain due to pus retention and closure, open it; for pain due to foul flesh erosion and ulceration, drain it; for pain due to Yin-Yang disharmony, regulate it; for pain due to meridian blockage and stagnation, promote circulation. Adapting to changes according to the situation is the mark of an excellent physician; one must not rigidly adhere to fixed prescriptions without flexibility.
Ancients prescribed medicines according to the disease, did not stick to fixed formulas, and adjusted them based on the condition. For accumulations requiring tonification, pill forms could be used because pills act gently and suit long-term regulation without frequently changing the formula. However, at critical moments in severe sores and carbuncles, where manifestations are diverse, how can one rigidly adhere to a single prescription? One must adjust temporarily to follow the therapeutic principles. For example, in cases of back carbuncle, neck carbuncle, or malignant疔 (ding), before or after the swelling and pus appear or ulcerate, if the patient is deficient and suffers from headache, add *Schisandrae Fructus* (Wuweizi, 五味子) to the interior-supporting formula; if there is mental confusion and restlessness, add *Ginseng Radix* (Renshen, 人参) and *Poria* (Fuling, 茯苓); if deficient and feverish, add *Rehmanniae Radix* (Dihuang, 地黄) and *Trichosanthis Radix* (Gualougen, 栝萎根); if experiencing alternating chills and fever or tidal fever, add *Bupleuri Radix* (Chaihu, 柴胡) and *Lycii Cortex* (Digupi, 地骨皮); if thirst persists, add *Anemarrhenae Rhizoma* (Zhimu, 知母) and *Adzuki Bean* (Chixiaodou, 赤小豆); if constipated, add *Mirabilite* (Mangxiao, 芒硝); if urinary retention occurs, add *Akebia Caulis* (Mutong, 木通) and *Juncus Effusus* (Dengcao, 灯草); if suffering from deficiency-related irritability, add *Lycii Fructus* (Gouqizi, 枸杞子) and *Asparagi Radix* (Tianmendong, 天门冬); if spontaneous diarrhea occurs, add *Magnoliae Officinalis Cortex* (N Houpo, 浓朴); if limbs are cold and inverted, add *Aconiti Lateralis Radix Praeparata* (Fuzi, 附子) and *Zingiberis Rhizoma* (Shengjiang, 生姜); if vomiting and rebellious Qi occur, add *Symplocos Fructus* (Dingxiang, 丁香) and *Agastache Herba* (Huoxiang, 藿香); if there is excessive phlegm, add *Pinelliae Tuber* (Banxia) and *Citri Reticulatae Pericarpium* (Chenpi, 陈皮); if there is excessive pus, add *Angelicae Sinensis Radix* (Danggui) and *Chuanxiong Rhizoma* (Chuanxiong, 川芎); if pain is severe, add *Paeoniae Radix Alba* (Shaoyao, 芍药) and *Boswelliae Resina* (Ruxiang, 乳香); if muscle regeneration is slow, add *Ampelopsis Radix* (Bailian, 白蔹) and *Cinnamomi Cortex* (Guangui, 官桂); if wind-pathogen is present, add *Angelicae Pubescentis Radix* (Duohuo, 独活) and *Saposhnikoviae Radix* (Fangfeng, 防风); if heart fright and timidity occur, add *Cinnabaris* (Dansha, 丹砂); if there is twitching of the mouth and eyes, add *Notopterygii Rhizoma et Radix* (Qianghuo, 羌活) and *Asari Radix et Rhizoma* (Xixin, 细辛). Although I am mediocre, from youth to old age, whenever I treated sores and carbuncles, I often adjusted medications according to this method, achieving miraculous results. Those who study later should examine this carefully.