伍氏曰∶凡治痈疽发背疔疮，不痛者，必灸使痛，痛者，必灸使不痛。若初灸即痛者，
由毒瓦斯轻浅，灸而不痛者，乃毒瓦斯深重，悉宜内服追毒排脓，外敷消毒之药。大抵痈疽不可
不痛，又不可大痛，闷乱不知痛者，难治。
愚按∶前论惟疔疮一症，其状不一，其色不同，或如小疮，或如水泡，或作痛，或麻木，
或有红丝，或寒热头疼，或呕吐恶心，或肢体拘急，其候多端。非前灸法并解毒之剂，卒难
济事。若不省人事，或牙关紧急者，即以夺命丹为末灌之。若生两足，多有红丝至脐；生于
两手，多有红丝至心；生于唇面，多有红丝入喉。俱难治。若针其红丝出血，多有生者。若
患于肢末之处，毒愈凝滞，药难导达，艾灸之功为大。如妄服 利之剂，耗损真气，不惟无
以去毒，而害反随之矣。
附治验
操江都宪张恒山，左足次指患之，痛不可忍。急隔蒜灸三十余壮，即将举步。彼欲速
愈，自敷凉药，遂致血凝肉死，毒瓦斯复炽。再灸百壮，服活命饮，出紫血，其毒方解。脚底
通溃，腐筋烂肉甚多，将愈，予因考绩北上。又误用生肌药，反助其毒，使元气亏损，疮口
难敛。予回，用托里药补之，喜其禀实且客处，至三月余方瘥。
表甥居富，右手小指患之。或用针出血，敷以凉药，掌指肿三四倍，六脉洪大，此真气
夺则虚，邪气胜则实也。先以夺命丹一服，活命饮二剂，势稍缓，余因他往。或又遍刺出
血，肿延臂腕如大瓠，手指肿大数倍，不能消溃，乃真气愈虚，邪气愈盛。余回，用大剂参
归术之类，及频灸遍手，肿势渐消。后大便不实，时常泄气，此元气下陷。以补中益气汤
加补骨脂、肉豆蔻、吴茱萸、五味子，又以生脉散代茶饮，大便渐实，手背渐溃，又用大补
药五十余服渐愈。
一男子唇患之，有紫脉自疮延至口内。余曰∶此脉过喉，则难治矣，须针紫脉并疮头出
恶血，以泄其毒则可。不信，乃别用解毒之剂，头面俱肿。复请治，脉洪数，按之全无，恶
症悉具。余曰∶无能为也。彼求治甚笃、时口内肿胀，针不能入。为砭肿处出血，势虽少
退，终至不起。
伍氏说：凡是治疗痈疽、发背、疔疮，如果不痛，必须通过艾灸使其产生痛感；如果已经疼痛，必须通过艾灸使其停止疼痛。如果刚开始艾灸就感到疼痛的，是因为毒邪轻浅；如果艾灸后仍不痛的，是因为毒邪深重。这些情况都应当内服追毒排脓的药物，外敷消毒的药膏。大抵上，痈疽不能完全不痛，但也不能剧烈疼痛，如果出现神志昏乱、不知疼痛的情况，属于难治之症。
我按语认为：前面的论述中只有疔疮这一病症，其症状表现不一，颜色各异，有的像小疮，有的像水泡，有的疼痛，有的麻木，有的伴有红丝蔓延，有的出现寒热头痛，有的呕吐恶心，有的肢体拘挛紧急，症状多种多样。如果不是采用前面的艾灸方法以及解毒的药剂，很难见效。如果患者神志不清，或者牙关紧闭，立即将夺命丹研成粉末灌服。如果疔疮生在两足，多有红丝蔓延至肚脐；生在手部，多有红丝蔓延至心脏部位；生在嘴唇面部，多有红丝蔓延入喉。这些情况都难以治疗。如果用针挑破红丝放出血液，大多可以存活。如果患病在肢体的末端，毒邪更加凝滞，药物难以到达，艾灸的作用就非常大了。如果胡乱服用泻利性质的药物，会耗损人体的真气，不仅不能去除毒邪，反而会带来危害。
附治疗验案
操江都宪张恒山，左足第二趾患病，疼痛难以忍受。急忙隔着蒜片艾灸三十多壮，随即就能迈步行走。他想要快速痊愈，自行敷用凉性药物，导致血液凝固、肌肉坏死，毒邪再次炽盛。再次艾灸一百壮，服用活命饮，排出紫黑色血液，毒邪才得以解除。脚底完全溃烂，腐筋烂肉很多，快要痊愈时，我因考核政绩北上。他又误用生肌药，反而助长毒邪，导致元气亏损，疮口难以愈合。我回来后，使用托里药进行补益，庆幸他体质结实且客居他乡，过了三个多月才痊愈。
表甥居富，右手小指患病。有人用针刺出血，并敷用凉性药物，手掌和手指肿胀三四倍，六脉洪大，这是真气被剥夺而呈现虚象，邪气亢盛而呈现实象。先服用一剂夺命丹，两剂活命饮，病情稍缓解，我因其他事情外出。有人又遍身刺络放血，肿胀蔓延至手臂手腕像大葫芦一样，手指肿大数倍，无法消散溃破，这是真气更虚，邪气更盛。我回来，使用大剂量的参、归、术等药物，以及频繁艾灸整个手部，肿胀逐渐消退。后来大便不成形，时常排气，这是元气下陷。使用补中益气汤加入补骨脂、肉豆蔻、吴茱萸、五味子，又以生脉散代替茶水饮用，大便逐渐成形，手背逐渐溃破，又服用五十多剂大补药物才逐渐痊愈。
一名男子嘴唇患病，有紫色脉络从疮口延伸至口腔内部。我说：这条脉络经过喉咙，就难以治疗了，必须针刺紫色脉络和疮头放出恶血，以泄出毒邪才可以。他不相信，另外使用解毒药剂，导致头面部全部肿胀。再次请求治疗，脉象洪数，重按完全无力，所有恶症具备。我说：无能为力了。他求治心切，当时口腔内肿胀严重，针无法进入。为他在肿胀处砭石放血，病情虽然稍微减退，最终还是没有挽回生命。
Wu stated: In the treatment of carbuncles, ulcers, back sores, and ding sores (hard, deep-seated infections), if there is no pain, moxibustion must be applied to induce pain; if there is already pain, moxibustion must be applied to alleviate it. If pain occurs immediately upon starting moxibustion, it indicates that the pathogenic toxin is light and superficial; if there is still no pain after moxibustion, it indicates that the pathogenic toxin is deep and severe. In all such cases, internal administration of formulas to expel toxins and drain pus, along with external application of detoxifying medicaments, is appropriate. Generally speaking, carbuncles and ulcers should not be completely painless, nor should they cause severe pain. Cases presenting with mental confusion and insensitivity to pain are difficult to treat.
My commentary: Among the previous discussions, only ding sores exhibit diverse symptoms and varying colors. They may appear as small sores or blisters; they may be painful or numb; they may present with red streaks spreading from the lesion; or they may be accompanied by chills, fever, headache, vomiting, nausea, or limb stiffness and spasms. The manifestations are manifold. Without employing the aforementioned moxibustion methods and detoxifying decoctions, effective results are hard to achieve. If the patient loses consciousness or suffers from trismus (lockjaw), Duoming Dan (Life-Restoring Pill) should be ground into powder and administered via gavage. If the sore appears on either foot, red streaks often extend to the umbilicus; if on either hand, they extend toward the heart region; if on the lips or face, they extend into the throat. These conditions are all difficult to treat. However, pricking the red streaks to release blood can often lead to survival. When the lesion occurs at the extremities of the limbs, the toxin becomes more stagnant, and medicinal efficacy is difficult to reach; in such cases, the therapeutic value of moxibustion is significant. Indiscriminate use of purgative agents depletes the body's true qi (vital energy). Not only will this fail to eliminate the toxin, but it will also cause further harm.
Attached Treatment Cases
Zhang Hengshan, Censor of the River Command, suffered from a lesion on the second toe of his left foot, with unbearable pain. Urgent moxibustion was performed using garlic slices for over thirty moxa cones, after which he could immediately take steps. Desiring a rapid cure, he self-applied cooling medicaments, resulting in blood coagulation and muscle necrosis, causing the toxin to flare up again. He underwent another hundred moxa cones and took Huoming Yin (Life-Saving Decoction), which expelled purple-black blood, allowing the toxin to resolve. The sole of the foot became fully ulcerated with extensive necrotic tendons and flesh. As he was nearing recovery, I departed northward due to an official performance review. He then mistakenly used flesh-regenerating medicines, which exacerbated the toxin and depleted his yuan qi (original qi), making wound closure difficult. Upon my return, I administered Tuo Li medicines (formulas to support the interior and boost immunity) to tonify him. Fortunately, his constitution was robust and he was residing away from home; he recovered after more than three months.
My cousin-in-law, Ju Fu, suffered from a lesion on the little finger of his right hand. Someone pricked it to release blood and applied cooling medicaments, causing the palm and fingers to swell three to four times their normal size. The six pulse positions were surging and large, indicating deficiency due to depletion of true qi and excess due to the dominance of pathogenic factors. Initially, one dose of Duoming Dan and two doses of Huoming Yin were administered, slightly alleviating the condition, while I was away on other business. Someone else repeatedly pricked the area to release blood, causing swelling to extend to the arm and wrist like a large gourd, with fingers swollen several times their original size, unable to dissipate or ulcerate. This indicated further depletion of true qi and intensification of pathogenic factors. Upon my return, I prescribed large doses of Ginseng Radix (Renshen), Angelicae Sinensis Radix (Danggui), and Atractylodis Macrocephalae Rhizoma (Baizhu), combined with frequent moxibustion over the entire hand, gradually reducing the swelling. Later, he experienced loose stools and frequent flatus, indicating sinking of yuan qi. I prescribed Buzhong Yiqi Tang (Middle-Warming and Qi-Boosting Decoction) supplemented with Psoraleae Fructus (Buguzhi), Myristicae Semen (Roudoukou), Evodiae Fructus (Wuzhuyu), and Schisandrae Fructus (Wuweizi), and used Shengmai San (Generate the Pulse Powder) as a tea substitute. His stools gradually solidified, and the dorsum of the hand began to ulcerate. After taking over fifty doses of major tonic prescriptions, he gradually recovered.
A man suffered from a lesion on his lip, with a purple vein extending from the sore into the oral cavity. I stated: "If this vein passes through the throat, it will be difficult to treat. One must prick the purple vein and the head of the sore to release foul blood, thereby draining the toxin." He did not believe me and used other detoxifying agents instead, resulting in complete swelling of the head and face. He requested treatment again. The pulse was surging and rapid, but empty upon deep pressure, and all ominous signs were present. I said: "I am powerless to help." He sought treatment earnestly, but at that time, the intraoral swelling was so severe that needles could not be inserted. I performed phlebotomy with a stone needle on the swollen area. Although the condition slightly receded, he ultimately died.