一、疮疡用药，当审其经络受症，标本虚实，以治之。不可泥于热毒内攻，专用寒凉克伐
之剂，亏损脾胃气血，多致有误。若肿高 痛者，邪气实也，先用仙方活命饮，后用托里消
毒散。漫肿微痛者，真气虚也，用托里散。如不应，加姜、桂。若不作脓，不腐溃，阳气虚
也，用四君子加黄 、肉桂。若脓既出而反痛，气血虚也，用八珍散。不生肌，不收敛，脾
气虚也，四君子加芍药、木香。又当舍时从症，如肿痛烦躁，发热饮冷，便秘，脉洪数实，
是为五实，虽在严寒，必用大苦寒之剂，泻其阳以救其阴。若脉细皮寒，泻利肠鸣，不食呕
吐，手足逆冷，是为五虚，虽在盛暑，必用大辛热之剂，散其阴以回其阳。若执其常法则
误矣。
一、疮疡作呕，如热盛 痛，邪气实也，用仙方活命饮解之。若因作脓 痛，胃气虚
也，用托里消毒散主之。脓熟胀痛，气血虚也，用托里散或针以泄之。 痛便秘，热蕴于内
也，用内 黄连汤导之。寒药伤胃者，托里健中汤。食少胃寒者，托里益中汤。中虚寒淫
者，托里温中汤。肝木乘脾土者，托里益青汤。胃脘停痰者，托里清中汤。脾虚自病者，托
里益黄散。郁结伤脾者，托里越鞠汤。
一、疮疡用围药，如肿痛热渴，症属纯阳，宜内服济阴丹，外敷抑阳散。若似肿非肿，
似痛非痛，似溃不溃，属半阴半阳，宜内服冲和汤，外敷阴阳散。若微肿微痛，或色黯不
痛，或坚硬不溃，症属纯阴，宜内服回阳汤，外敷抑阴散。
一、疮疡作痛，若大便秘结者，用内 黄连汤。热毒炽盛者，仙方活命饮。瘀血凝滞
者，乳香定痛散。作脓而痛者，托里消毒散。脓胀而痛者针之，脓溃而痛者补之。气虚而痛
者，四君、归、 。血虚而痛者，四物、参、 。肾虚而痛者，六味地黄丸。口干作渴，或
小便频数，加减八味丸。
一、疮疡阳气脱陷，或误服克伐，或脓血大泄，或吐泻劳役，或误行房事。若发热烦
热，头痛头晕，便血目赤，烦喘自汗盗汗，气短唾痰，体倦热渴，意欲饮水投水，身热恶
寒，憎寒恶衣，扬手掷足，汗出如水，腰背反张，呻吟音不绝，脉浮洪大，此无根虚火假热
之症。若畏寒头痛，咳逆呕吐，耳聩目蒙，小便自遗，或时淋沥，泻利肠鸣，里急腹痛，玉
茎短缩，冷汗时出，齿牙浮痛，肢体麻痹；或厥冷身痛，咬舌啮唇，舌本强硬，吃逆喘促，脉
微沉细，此危殆之症。但见一二，急用大剂参附汤补之，多得复生。
一、疮疡溃后，发热烦躁，若发热无寐，血虚也，圣愈汤。自汗不止，气虚也，四君子
加黄 、五味子。发热烦躁，肉 筋惕，气血虚也，八珍汤。大渴面赤，脉洪大而浮，阴虚
发热也，当归补血汤。肢体微热，烦躁面赤，脉沉微，阴盛发躁也，四君、姜、附。
一、疮疡大便秘结，若作渴饮冷，其脉洪数而有力者，属实火，宜用内 黄连汤。若口
干饮汤，其脉浮大而无力者，属气虚，宜用加味八珍汤。若饮食虽多，肚腹不胀，此内火销
铄，切不可通。若腹痞胀而不通者，乃因直肠干涸，以猪胆汁导之。若误行 导，复伤元
气，则不能溃敛。
一、疮疡大便泄泻，若因寒凉伤脾，六君加砂仁。脾气虚弱，六君煎送二神丸。脾虚下
陷，补中益气送二神丸。命门火衰，用八味丸料煎送四神丸。肾虚不固，姜附汤加吴茱、五
味。脾肾虚寒，参附汤送四神丸。脉沉而细，饮食不下，用姜附汤，多有复生者。
一、疮疡小便频数，或茎中涩痛者，乃肾经阳气亏损，阴无以化之，恶症也，用加减八
味丸以补阴。足胫逆冷者，用八味丸以补阳。小便频而黄者，四物加参、术、麦门、五味以
补肾。若热结膀胱而不利者，五淋散以清热。脾肺气燥而不化者，黄芩清肺饮以滋阴。若膀
胱阴虚，阳无以生者，宜滋肾丸。膀胱阳虚，阴无以化者，宜肾气丸。若老人阴痿，精内败
者，用加减八味丸加车前、牛膝。如不应，加附子。若大小便牵痛，愈痛则愈便，愈便则愈
牵痛，以前药加附子，多有生者。苟用黄柏、知母淡渗之剂，既泻真阳，复损真阴，速其危矣。
一、疮疡作渴， 痛发热，便利调和者，上焦热也，用竹叶石膏汤。肿痛发热，大便秘
涩者，五内热也，用四顺清凉饮。 肿痛盛者，热毒蕴结者，用仙方活命。漫肿微痛者，气
血虎壅也，用补中益气汤。若因胃火消烁，而津液短少者，用竹叶黄 汤。若因胃气虚而不
能生津液者，用补中益气汤。若因胃气伤而内亡津液者，用七味白术散。若因肾水干涸作
渴，或口舌干燥者，用加减八味丸。或先口干作渴，小便频数，而后患疽，或疽愈后作渴
饮水，或舌黄干硬，小便数，而疽生者，尤其恶也。苟能逆知其因，预服加减八味丸、补中
益气汤，以滋化源，可免是患。
一、疮疡出血，因五脏之气亏损，虚火动而错经妄行也。若因肝热而血妄行者，四物加
炒栀、丹皮、苓、术。肝虚不能藏血者，六味地黄丸。心虚不能主血者，四物加炒连、丹
皮、苓、术。若脾虚热不能统血者，四君加炒栀、丹皮。若脾经郁结者，用归脾汤加五味
子。若脾肺气虚者，用补中益气加五味子。若气血俱虚者，用十全大补。若阴火动者，用六
味丸加五味子。
一、疮疡用针，当辨生熟浅深。若小按即痛者，脓浅也。大按方痛者，脓深也。按之而
不复起者，脓未成也。按之而即起者，脓已成也。若脓生而即针，则徒泄其气血，而脓反难
成。若脓熟而不针，则腐溃益深，疮口难敛。若疮深而针浅，则内脓不出，外血反泄。若疮
浅而针深，则内脓虽出，良肉反伤。其元气虚弱，必先补而后针，不论尻神。若脓出而反
痛，或烦躁呕逆，皆由血气亏损，宜急补之。不论尻神者，盖因患处已溃故也。
一、疮疡肌肉不生，若赤色而不生者，血热也，四物汤加牡丹皮。晡热内热，血虚也，
四君子加归、地、丹皮。若脓水清稀，气血俱虚也，十全大补汤。食少体倦，脾气虚也，补
中益气汤。烦热作渴，起居如常，胃火也，竹叶黄 汤。烦热作渴，日晡热甚，肾虚也，用
加减八味丸。
一、治疗疮疡用药，应当审察其经络受邪的症状，辨别标本虚实，从而进行治疗。不可拘泥于热毒内攻的说法，专门使用寒凉克伐的药物，以免亏损脾胃气血，导致误治。如果肿势高突且疼痛，这是邪气实盛的表现，先用仙方活命饮，后用托里消毒散。如果漫肿无头且微痛，这是真气虚弱的表现，用托里散。如果服用后无效，加入生姜、肉桂。如果不化脓、不腐溃，这是阳气虚弱的表现，用四君子汤加黄芪、肉桂。如果脓液排出后反而疼痛，这是气血虚弱的表现，用八珍散。如果不生肌、不收敛，这是脾气虚弱的表现，用四君子汤加芍药、木香。又应当根据症状舍弃时令的常规法则，如出现肿痛烦躁、发热喜冷饮、便秘、脉象洪数有力，这称为“五实”，即使在严寒季节，也必须使用大苦寒的药物，泻其阳热以救阴液。如果脉象细弱、皮肤寒冷、腹泻肠鸣、不能进食呕吐、手足逆冷，这称为“五虚”，即使在盛夏季节，也必须使用大辛热的药物，散其阴寒以回阳。如果固执于常规法则就会造成错误。
一、疮疡出现呕吐，如果是热盛疼痛，属于邪气实盛，用仙方活命饮来解表清热。如果是因化脓引起的疼痛，属于胃气虚弱，用托里消毒散为主治。如果脓熟胀痛，属于气血虚弱，用托里散或针刺排脓。如果疼痛伴有大便便秘，是热邪蕴结于内，用内疏黄连汤导泄热邪。如果是寒凉药物损伤胃气，用托里健中汤。如果饮食少、胃寒，用托里益中汤。如果是中焦虚寒湿盛，用托里温中汤。如果是肝木乘脾土，用托里益青汤。如果是胃脘停痰，用托里清中汤。如果是脾虚自病，用托里益黄散。如果是郁结伤脾，用托里越鞠汤。
一、疮疡使用围药（外敷药），如果肿痛热渴，症状属于纯阳证，宜内服济阴丹，外敷抑阳散。如果似肿非肿、似痛非痛、似溃不溃，属于半阴半阳证，宜内服冲和汤，外敷阴阳散。如果微肿微痛，或者颜色暗紫不痛，或者坚硬不溃，症状属于纯阴证，宜内服回阳汤，外敷抑阴散。
一、疮疡疼痛，如果大便秘结，用内疏黄连汤。如果热毒炽盛，用仙方活命饮。如果瘀血凝滞，用乳香定痛散。如果化脓而痛，用托里消毒散。如果脓胀而痛，用针刺；如果脓溃而痛，用补法。如果气虚而痛，用四君子汤加当归、黄芪。如果血虚而痛，用四物汤加人参、黄芪。如果肾虚而痛，用六味地黄丸。如果口干作渴，或者小便频数，用加减八味丸。
一、疮疡阳气脱陷，或者误服克伐药物，或者脓血大量流失，或者吐泻劳役过度，或者误行房事。如果出现发热烦热、头痛头晕、便血目赤、烦喘自汗盗汗、气短唾痰、体倦热渴、想喝水甚至投水降温、身热恶寒、怕冷不想穿衣、扬手掷足、汗出如水、腰背反张、呻吟声不断、脉象浮洪大，这是无根虚火假热的症状。如果出现畏寒头痛、咳逆呕吐、耳聋目蒙、小便失禁或时淋沥、腹泻肠鸣、里急腹痛、阴茎短缩、冷汗时出、牙齿浮痛、肢体麻痹；或者四肢厥冷身痛、咬舌啮唇、舌本强硬、呃逆喘促、脉象微沉细，这是危殆的症状。只要见到其中一二种情况，立即使用大剂量参附汤进行补益，大多能恢复生机。
一、疮疡溃破后，出现发热烦躁，如果发热无法入睡，是血虚，用圣愈汤。如果自汗不止，是气虚，用四君子汤加黄芪、五味子。如果发热烦躁、肌肉跳动筋惕，是气血虚弱，用八珍汤。如果大渴面赤、脉象洪大而浮，是阴虚发热，用当归补血汤。如果肢体微热、烦躁面赤、脉象沉微，是阴盛发躁，用四君子汤加生姜、附子。
一、疮疡大便秘结，如果口渴喜冷饮，脉象洪数有力，属实火，宜用内疏黄连汤。如果口干想喝热汤，脉象浮大而无力，属气虚，宜用加味八珍汤。如果饮食虽多，肚腹不胀，这是内火消烁津液，切不可通下。如果腹部痞胀而不通，是因为直肠干涸，用猪胆汁导引通便。如果误用通下导泄，再次损伤元气，则伤口不能溃破也不能收敛。
一、疮疡大便泄泻，如果是因寒凉伤脾，用六君子汤加砂仁。如果是脾气虚弱，用六君子煎送二神丸。如果是脾虚下陷，用补中益气汤送二神丸。如果是命门火衰，用八味丸料煎送四神丸。如果是肾虚不固，用姜附汤加吴茱萸、五味子。如果是脾肾虚寒，用参附汤送四神丸。如果脉象沉而细，饮食不下，用姜附汤，大多能恢复生机。
一、疮疡小便频数，或者尿道涩痛，这是肾经阳气亏损，阴液无法气化，属于恶症，用加减八味丸来补阴。如果足胫逆冷，用八味丸来补阳。如果小便频而黄，用四物汤加人参、白术、麦冬、五味子来补肾。如果热结膀胱而不利，用五淋散来清热。如果脾肺气燥而不能化生津液，用黄芩清肺饮来滋阴。如果膀胱阴虚，阳气无法生成，宜用滋肾丸。如果膀胱阳虚，阴液无法气化，宜用肾气丸。如果老人阳痿，精液败坏，用加减八味丸加车前子、牛膝。如果无效，加附子。如果大小便牵拉疼痛，越痛越想排便，越排便越牵拉疼痛，用前面的药加附子，大多能存活。如果使用黄柏、知母等淡渗利湿的药物，既泻真阳，又损真阴，会加速死亡。
一、疮疡作渴，伴有痈疽疼痛发热，大小便调和，这是上焦热，用竹叶石膏汤。如果肿痛发热，大便秘涩，这是五脏内热，用四顺清凉饮。如果痈疽肿痛严重，热毒蕴结，用仙方活命饮。如果漫肿微痛，是气血壅滞，用补中益气汤。如果是因胃火消烁，导致津液短少，用竹叶黄芪汤。如果是因胃气虚而不能生津液，用补中益气汤。如果是因胃气伤而内部亡失津液，用七味白术散。如果是因肾水干涸作渴，或者口舌干燥，用加减八味丸。如果先口干作渴、小便频数，而后患疽，或者疽愈合后作渴饮水，或者舌苔黄干硬、小便数而长疽，这尤其恶劣。如果能预先知道原因，提前服用加减八味丸、补中益气汤，以滋养化源，可以避免这种祸患。
一、疮疡出血，是因为五脏之气亏损，虚火扰动导致经脉错乱妄行。如果是因肝热而血妄行，用四物汤加炒栀子、牡丹皮、茯苓、白术。如果是肝虚不能藏血，用六味地黄丸。如果是心虚不能主血，用四物汤加炒黄连、牡丹皮、茯苓、白术。如果是脾虚有热不能统血，用四君子汤加炒栀子、牡丹皮。如果是脾经郁结，用归脾汤加五味子。如果是脾肺气虚，用补中益气汤加五味子。如果是气血俱虚，用十全大补汤。如果是阴火动，用六味丸加五味子。
一、疮疡使用针刀，应当辨别脓的生熟深浅。如果小按即痛，说明脓浅。大按才痛，说明脓深。按压后凹陷不复起，说明脓未成。按压后立即弹起，说明脓已成。如果脓未生就针刺，只会徒然泄露气血，反而使脓更难形成。如果脓已熟不针刺，则腐溃更深，疮口难敛。如果疮深而针浅，则内部脓液不出，外部血液反而泄露。如果疮浅而针深，则内部脓液虽出，但好肉反而受伤。对于元气虚弱者，必须先补益后针刺，不论尻神（注：古代择日禁忌）。如果脓出后反而疼痛，或者烦躁呕逆，都是由血气亏损引起，宜紧急补益。不论尻神，是因为患处已经溃破的缘故。
一、疮疡肌肉不生，如果颜色红而不生肌，是血热，用四物汤加牡丹皮。如果傍晚发热内热，是血虚，用四君子汤加当归、地黄、牡丹皮。如果脓水清稀，是气血俱虚，用十全大补汤。如果食少体倦，是脾气虚，用补中益气汤。如果烦热作渴，起居如常，是胃火，用竹叶黄芪汤。如果烦热作渴，傍晚热甚，是肾虚，用加减八味丸。
1. When prescribing medication for sores and ulcers, one must examine the symptoms affected by the meridians, distinguish between root and branch, excess and deficiency, and treat accordingly. One should not rigidly adhere to the notion of internal attack by heat-toxin and exclusively use cold and purgative agents, which would damage the spleen and stomach's qi and blood, often leading to misdiagnosis and mistreatment. If the swelling is high and painful, it indicates an excess of pathogenic factors; initially use Xianfang Huoming Yin (Immortal Life Elixir), followed by Tuoli Xiaodu San (Support Interior and Eliminate Toxin Powder). If the swelling is diffuse with slight pain, it indicates a deficiency of true qi; use Tuoli San (Support Interior Powder). If there is no response, add Shengjiang (Zingiberis Rhizoma Recens) and Rougui (Cinnamomi Cortex). If pus does not form and the ulcer does not suppurate, it indicates a deficiency of yang qi; use Sijunzi Tang (Four Gentlemen Decoction) added with Huangqi (Astragali Radix) and Rougui (Cinnamomi Cortex). If pain persists after pus discharge, it indicates a deficiency of qi and blood; use Bazhen San (Eight Treasures Powder). If granulation tissue does not grow and the wound does not contract, it indicates a deficiency of spleen qi; use Sijunzi Tang (Four Gentlemen Decoction) added with Shaoyao (Paeoniae Radix Alba) and Muxiang (Aucklandiae Radix). Furthermore, one must prioritize symptoms over seasonal norms. For instance, if there are symptoms such as swelling, pain, irritability, fever, preference for cold drinks, constipation, and a surging, rapid, and full pulse, this constitutes "Five Excesses." Even in severe cold, bitter-cold agents must be used to drain yang heat and rescue yin fluids. Conversely, if the pulse is fine, skin is cold, there is diarrhea with borborygmus, anorexia, vomiting, and cold extremities, this constitutes "Five Deficiencies." Even in peak summer, pungent-hot agents must be used to disperse yin cold and restore yang. Adhering rigidly to conventional rules leads to error.
2. Vomiting in sores and ulcers: If accompanied by intense heat and pain, it indicates excess pathogenic factors; use Xianfang Huoming Yin (Immortal Life Elixir) to resolve it. If caused by pus formation and pain, it indicates deficiency of stomach qi; use Tuoli Xiaodu San (Support Interior and Eliminate Toxin Powder) as the primary treatment. If there is distending pain due to ripe pus, it indicates deficiency of qi and blood; use Tuoli San (Support Interior Powder) or puncture to drain. If pain is accompanied by constipation, it indicates heat accumulation internally; use Neishu Huanglian Tang (Internal Draining Coptis Decoction) to guide out the heat. If cold medicines have damaged the stomach, use Tuoli Jianzhong Tang (Support Interior and Strengthen Middle Decoction). If there is poor appetite and cold stomach, use Tuoli Yizhong Tang (Support Interior and Benefit Middle Decoction). If there is middle jiao deficiency with cold-dampness, use Tuoli Wenzhong Tang (Support Interior and Warm Middle Decoction). If liver wood overacts on spleen earth, use Tuoli Yiqing Tang (Support Interior and Benefit Green/ Liver Decoction). If phlegm stagnates in the epigastrium, use Tuoli Qingzhong Tang (Support Interior and Clear Middle Decoction). If spleen deficiency causes self-pathology, use Tuoli Yihuang San (Support Interior and Benefit Yellow/ Spleen Powder). If depression injures the spleen, use Tuoli Yueju Tang (Support Interior and Resolve Stagnation Decoction).
3. Use of external encircling medications for sores and ulcers: If there is swelling, pain, heat, and thirst, indicating a pure-yang syndrome, internally administer Jiyin Dan (Nourish Yin Pill) and externally apply Yangsan San (Suppress Yang Powder). If the swelling is indistinct, pain is vague, and the ulcer does not fully break, indicating a half-yin half-yang syndrome, internally administer Chonghe Tang (Harmony Decoction) and externally apply Yinyang San (Yin-Yang Powder). If there is slight swelling and pain, dark discoloration without pain, or hardness without suppuration, indicating a pure-yin syndrome, internally administer Huiyang Tang (Return Yang Decoction) and externally apply Yinyin San (Suppress Yin Powder).
4. Pain in sores and ulcers: If accompanied by constipation, use Neishu Huanglian Tang (Internal Draining Coptis Decoction). If heat-toxin is vigorous, use Xianfang Huoming Yin (Immortal Life Elixir). If blood stasis is stagnant, use Ruxiang Dingtong San (Frankincense Pain-Relieving Powder). If pain occurs during pus formation, use Tuoli Xiaodu San (Support Interior and Eliminate Toxin Powder). If pain is due to pus distension, puncture; if pain persists after rupture, tonify. If pain is due to qi deficiency, use Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix) and Huangqi (Astragali Radix). If pain is due to blood deficiency, use Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Radix) and Huangqi (Astragali Radix). If pain is due to kidney deficiency, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If there is dry mouth and thirst, or frequent urination, use Jiawei Bawei Wan (Modified Eight-Ingredient Pill).
5. Collapse and sinking of yang qi in sores and ulcers may result from误taking purgatives, massive loss of pus and blood, vomiting/diarrhea due to overwork, or sexual misconduct. Symptoms include fever, irritability, headache, dizziness, hematochezia, red eyes, panting with spontaneous and night sweats, shortness of breath with sputum, fatigue with heat and thirst, desire for water or even immersing in water, body heat with aversion to cold, aversion to wearing clothes, tossing limbs, profuse sweating like water, opisthotonos, continuous groaning, and a floating, surging, large pulse. These are symptoms of rootless deficient fire and false heat. Symptoms including aversion to cold, headache, cough with regurgitation, deafness, blurred vision, urinary incontinence or dribbling, diarrhea with borborygmus, tenesmus and abdominal pain, retraction of the penis, cold sweat, floating toothache, limb numbness; or cold extremities with body pain, biting tongue and lips, stiff tongue, hiccups with panting, and a minute, deep, fine pulse indicate critical danger. If any one or two of these appear, urgently administer a large dose of Shenfu Tang (Ginseng and Aconite Decoction) to tonify; recovery is likely.
6. Fever and irritability after ulceration: If fever prevents sleep, it indicates blood deficiency; use Shengyu Tang (Savior of Life Decoction). If spontaneous sweating persists, it indicates qi deficiency; use Sijunzi Tang (Four Gentlemen Decoction) added with Huangqi (Astragali Radix) and Wuweizi (Schisandrae Fructus). If fever, irritability, muscle twitching, and tendon tremors occur, it indicates qi and blood deficiency; use Bazhen Tang (Eight Treasures Decoction). If there is extreme thirst, red face, and a surging, floating pulse, it indicates yin-deficiency fever; use Danggui Buxue Tang (Danggui Tonifying Blood Decoction). If there is slight limb heat, irritability, red face, and a deep, minute pulse, it indicates agitation due to yin excess; use Sijunzi Tang (Four Gentlemen Decoction) added with Shengjiang (Zingiberis Rhizoma Recens) and Fuzi (Aconiti Lateralis Radix Praeparata).
7. Constipation in sores and ulcers: If accompanied by thirst for cold drinks and a surging, rapid, forceful pulse, it is excess fire; use Neishu Huanglian Tang (Internal Draining Coptis Decoction). If there is dry mouth desiring hot drinks and a floating, large, weak pulse, it is qi deficiency; use Jiawei Bazhen Tang (Modified Eight Treasures Decoction). If food intake is large but the abdomen is not distended, it is internal fire consuming fluids; do not use purgatives. If there is abdominal fullness and obstruction due to dry rectum, use pig bile for enema. Misusing purgatives damages primal qi, preventing ulceration and healing.
8. Diarrhea in sores and ulcers: If caused by cold-cold damaging the spleen, use Liujunzi Tang (Six Gentlemen Decoction) added with Sharen (Amomi Fructus). If spleen qi is weak, use Liujunzi Decoction taken with Ershen Wan (Two Spirits Pill). If spleen qi sinks, use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction) taken with Ershen Wan (Two Spirits Pill). If mingmen fire declines, use Bawei Wan (Eight-Ingredient Pill) decoction taken with Sishen Wan (Four Spirits Pill). If kidney deficiency fails to secure, use Jiangfu Tang (Ginger and Aconite Decoction) added with Wuzhuyu (Evodiae Fructus) and Wuweizi (Schisandrae Fructus). If spleen and kidney are cold, use Shenfu Tang (Ginseng and Aconite Decoction) taken with Sishen Wan (Four Spirits Pill). If the pulse is deep and fine with inability to eat, use Jiangfu Tang (Ginger and Aconite Decoction); recovery is common.
9. Frequent urination or painful涩 (astringency) in the urethra in sores and ulcers indicates kidney meridian yang qi deficiency failing to transform yin; this is a malignant symptom. Use Jiawei Bawei Wan (Modified Eight-Ingredient Pill) to tonify yin. If lower legs and calves are cold, use Bawei Wan (Eight-Ingredient Pill) to tonify yang. If urine is frequent and yellow, use Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Maidong (Ophiopogonis Radix), and Wuweizi (Schisandrae Fructus) to tonify the kidney. If heat binds the bladder causing difficulty, use Wulin San (Five Strangury Powder) to clear heat. If spleen and lung qi are dry failing to transform, use Huangqin Qingfei Yin (Scutellaria Lung-Clearing Drink) to nourish yin. If bladder yin is deficient failing to generate yang, use Zishen Wan (Nourish Kidney Pill). If bladder yang is deficient failing to transform yin, use Shenqi Wan (Kidney Qi Pill). For elderly men with impotence and deteriorated essence, use Jiawei Bawei Wan (Modified Eight-Ingredient Pill) added with Cheqianzi (Plantaginis Semen) and Niuxi (Achyranthis Bidentatae Radix). If ineffective, add Fuzi (Aconiti Lateralis Radix Praeparata). If defecation and urination cause pulling pain, worsening with each act, adding Fuzi (Aconiti Lateralis Radix Praeparata) to previous formulas often saves lives. Using bland-draining agents like Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma) drains true yang and damages true yin, accelerating death.
10. Thirst in sores and ulcers: With carbuncle pain, fever, and normal bowel/bladder function, it is upper jiao heat; use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). With swelling, pain, fever, and constipation, it is internal five-zang heat; use Sishun Qingliang Yin (Four Smooth Cooling Drink). With severe carbuncle pain and heat-toxin accumulation, use Xianfang Huoming Yin (Immortal Life Elixir). With diffuse swelling and slight pain, it is qi and blood stagnation; use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction). If stomach fire consumes fluids causing shortness of fluids, use Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction). If stomach qi deficiency fails to generate fluids, use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction). If stomach qi injury causes internal fluid loss, use Qiwei Baizhu San (Seven-Ingredient Atractylodes Powder). If kidney water depletion causes thirst or dry mouth/tongue, use Jiawei Bawei Wan (Modified Eight-Ingredient Pill). If preceded by dry mouth/thirst and frequent urination before developing a carbuncle, or thirst/water drinking after healing, or yellow dry hard tongue with frequent urination while a carbuncle grows, this is particularly malignant. Anticipating the cause and preemptively taking Jiawei Bawei Wan (Modified Eight-Ingredient Pill) and Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction) to nourish the source of transformation can prevent this.
11. Bleeding in sores and ulcers results from亏损 (deficiency) of the five zang organs' qi, causing deficient fire to disturb and disrupt meridians. If due to liver heat causing wild bleeding, use Siwu Tang (Four Substances Decoction) added with fried Zhizi (Gardeniae Fructus), Mudanpi (Moutan Cortex), Fuling (Poria), and Baizhu (Atractylodis Macrocephalae Rhizoma). If liver deficiency fails to store blood, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If heart deficiency fails to govern blood, use Siwu Tang (Four Substances Decoction) added with fried Lianhua/Coptis (Coptidis Rhizoma), Mudanpi (Moutan Cortex), Fuling (Poria), and Baizhu (Atractylodis Macrocephalae Rhizoma). If spleen deficiency with heat fails to control blood, use Sijunzi Tang (Four Gentlemen Decoction) added with fried Zhizi (Gardeniae Fructus) and Mudanpi (Moutan Cortex). If spleen meridian stagnation, use Guipi Tang (Restore the Spleen Decoction) added with Wuweizi (Schisandrae Fructus). If spleen and lung qi are deficient, use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction) added with Wuweizi (Schisandrae Fructus). If both qi and blood are deficient, use Shiquan Dabu Tang (Ten Great Tonifying Decoction). If yin fire moves, use Liuwei Wan (Six-Ingredient Pill) added with Wuweizi (Schisandrae Fructus).
12. Needling for sores and ulcers requires distinguishing ripeness and depth. Pain upon light pressure indicates shallow pus; pain only upon heavy pressure indicates deep pus. Depression that does not rebound indicates unformed pus; immediate rebound indicates formed pus. Puncturing before pus forms merely leaks qi and blood, hindering pus formation. Not puncturing ripe pus deepens corruption and hinders healing. Puncturing too shallowly in deep wounds retains internal pus and leaks external blood. Puncturing too deeply in shallow wounds releases internal pus but damages healthy flesh. For weak primal qi, tonify first then needle, regardless of Keshen (auspicious timing/deity). Pain after drainage, irritability, or vomiting indicates qi and blood deficiency; urgent tonification is needed. Ignoring Keshen is acceptable because the lesion is already ulcerated.
13. Failure of muscle regeneration in sores and ulcers: Red color without growth indicates blood heat; use Siwu Tang (Four Substances Decoction) added with Mudanpi (Moutan Cortex). Afternoon fever and internal heat indicate blood deficiency; use Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), and Mudanpi (Moutan Cortex). Thin and watery pus indicates qi and blood deficiency; use Shiquan Dabu Tang (Ten Great Tonifying Decoction). Poor appetite and fatigue indicate spleen qi deficiency; use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction). Irritability, heat, thirst, with normal daily routine indicates stomach fire; use Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction). Irritability, heat, thirst, worse at afternoon indicates kidney deficiency; use Jiawei Bawei Wan (Modified Eight-Ingredient Pill).