伍氏曰∶凡用蒜饼灸者，盖蒜味辛温有毒，主散痈疽，假火势以行药力。有只用艾炷灸
者，此可施于顽疽痼发之类。凡赤肿紫黑毒甚者，须以蒜艾同灸为妙。
愚按∶前法诚有回生之功。若顽疮痼疾，脾胃虚弱，营气不能滋养患处，以致寒邪内
袭而不愈，宜用小艾炷频灸疮口，以祛寒邪，补接营气。其内补之法说，见首论及三十二论。
伍氏方论曰∶夫痈疽发背，皆有所困，前篇言之详矣。凡初觉赤肿，先从背脊骨第二陷
中两傍，相去同身寸各一寸五分，名热腑穴，二处各灸七壮，此能 泄诸阳热气，永无痈疽
之苦。或隔蒜灸，不论壮数，则邪无所容，而真气不损。但头项见疮，宜用骑竹马法及足三里灸之。
愚按∶前论诚为良策，其调理之法，当求首论。
史氏引证
甲戌年，疡医常器之，诊太学史氏之母云∶内有蓄热，防其作疽。至辛巳六月，果背胛
微痒，疮粒如黍，灼艾即消，隔宿复作。用膏药覆之，晕开六寸许，痛不可胜，归咎于艾。
适遇一僧，自云病疮甚危，尝灸八百余壮方苏。遂用大艾壮如银杏者，灸疮头及四傍各数壮，
痛止，至三十余壮，赤晕悉退。又以艾作团，如梅杏大者四十壮，乃食粥安寝，疮突四寸，
小窍百许，患肉俱坏而愈。
愚按∶灼艾之法，必使痛者不痛，不痛者痛，则其毒随火而散。否则，非徒无益，而又害之。
附治验
秋官高竹真，患背疽，色黯坚硬，重如负石，神思昏愦可畏。其亲廷评郑沙村请同往
治。郑云∶竹真先任湖广某县时，以某河涉险不便，竹真为整治有功。其民为立生祠，凡渡
河者，无不祷祭。竹真患此，悉疑立祠致祟。余曰∶不然，病因元气虚寒，积毒炽盛所致。
遂以杵蒜摊患处，用钱大艾炷灸二十余壮，尚不知。乃摊蒜补艾灸，亦不知。乃着肉灸，良
久方知。再灸方痛，内服参附大补之剂而起。
伍氏说：大凡使用蒜饼灸法，是因为大蒜味道辛温且有毒性，主要功效是消散痈疽，借助艾火的热势来推动药力发挥。也有仅用艾炷直接施灸的情况，这种方法适用于顽固性疽疮、陈旧性发背等病症。凡是患处呈现赤红肿胀或紫黑色、毒邪严重的，必须采用蒜与艾同灸的方法才为妙策。
我认为：前面的方法确实有起死回生的功效。如果是顽固的疮疡或久治不愈的疾病，患者脾胃虚弱，营气无法滋养患处，导致寒邪内侵而难以痊愈，适宜用小艾炷频繁地灸疮口，以祛除寒邪，补接和恢复营气。关于内部调理补益的方法，详见本书首论及第三十二论。
伍氏方论说：痈疽发背的发生，都有其致病原因，前篇已经论述得很详细了。凡是初起感觉局部赤红肿胀时，应从背部脊柱骨第二凹陷处两旁，距离中线各一寸五分的位置（即热腑穴），每处各灸七壮，这能泄除诸阳经的热气，永远免除痈疽的痛苦。或者采用隔蒜灸法，不论灸多少壮，都能使邪气无处容身，而人体真气不受损伤。但如果头颈部出现疮疡，适宜采用骑竹马灸法以及灸足三里穴。
我认为：前面的论述确实是良策，其调理方法，应当参考本书首论。
史氏引用的医案：
甲戌年，外科医生常器之，诊治太学博士史氏的母亲时说：“体内有蓄积的热邪，担心会发作成疽。”到了辛巳年六月，果然背部肩胛处微微发痒，出现如黍米大小的疮粒，灼烧艾条后暂时消退，过了一夜又复发。用膏药覆盖患处，红肿范围扩大至六寸左右，疼痛难忍，于是归咎于艾灸不当。恰逢一位僧人，自称患疮病非常危急，曾灸了八百多壮才苏醒。于是采用如银杏果般大的大艾炷，在疮头及其四周各灸数壮，疼痛停止；灸到三十多壮时，赤色晕肿全部消退。又以艾绒做成团状，大小如梅杏，共灸四十壮，之后患者能吃粥并安睡，疮口突起四寸，有一百多个小孔，患病肌肉虽然坏死但随后痊愈。
我认为：灼烧艾条的方法，必须做到让痛的人不觉痛，不痛的人感到痛，这样毒邪就会随着火气而散开。否则，不仅没有益处，反而会造成伤害。
附治疗验案：
秋官（刑部官员）高竹真，患有背疽，疮色暗哑坚硬，沉重得像背着石头一样，神志昏沉迷糊，令人畏惧。他的亲友廷评郑沙村邀请我一同前往诊治。郑某说：“高竹真先前在湖广某县任职时，因为某条河流渡河危险不便，高竹真整治河道有功。当地百姓为他建立了生祠，凡是渡河的人，无不祈祷祭祀。高竹真患上此病，大家都怀疑是建立祠堂招致了鬼祟。”我说：“不是这样的，病因是元气虚寒，积毒炽盛所致。”于是将捣碎的蒜泥涂抹在患处，用铜钱垫着的大艾炷灸二十多壮，他尚且不知道；再涂抹蒜泥继续艾灸，他也不知道；直到艾炷直接接触皮肤灸治，过了很久他才感觉到。再次灸治后才感到疼痛，同时内服人参、附子等大补元气的药剂，最终痊愈。
Wu stated: Whenever garlic cake moxibustion is used, it is because garlic has a pungent and warm flavor and is slightly toxic; its primary function is to dissipate carbuncles and sores. It relies on the heat of fire to promote the medicinal power. There are cases where only moxa cones are used for direct moxibustion; this method can be applied to stubborn carbuncles or chronic back infections. For cases presenting with redness, swelling, purple-black discoloration, and severe toxicity, it is essential to use simultaneous garlic and moxa moxibustion for optimal results.
I observe: The aforementioned methods indeed possess the merit of restoring life. In cases of stubborn ulcers or chronic diseases where the Spleen and Stomach are weak, and Ying Qi (nutritive energy) fails to nourish the affected area, leading to internal invasion by cold pathogens that resist healing, it is advisable to frequently apply small moxa cones to the ulcer opening to dispel cold pathogens and replenish Ying Qi. Regarding internal supplementation methods, please refer to the first treatise and the thirty-second treatise.
Wu’s Formula Theory states: The occurrence of carbuncles, sores, and back infections stems from specific causes, which have been discussed in detail in previous chapters. When initial redness and swelling are perceived, moxibustion should be applied to both sides of the second depression along the spinal column, each located one cun five fen away from the midline at the point referred to as Refu (Heat Chamber). Seven moxa cones should be applied at each site. This can vent excess Yang heat and permanently prevent the suffering of carbuncles and sores. Alternatively, garlic-interposed moxibustion can be used regardless of the number of cones; this ensures that pathogenic factors have no place to reside while the True Qi remains undamaged. However, if sores appear on the head or neck, the Riding Bamboo Horse method and moxibustion at Zusanli (ST36) are appropriate.
I observe: The preceding discussion is indeed an excellent strategy. Its regulatory methods should be sought in the first treatise.
Case cited by Shi:
In the Ji Xu year, surgeon Chang Qizhi diagnosed the mother of Scholar Shi, stating: "There is accumulated heat within, posing a risk of developing a sore." By the sixth month of the Xin Si year, she indeed experienced slight itching on her back and shoulder blades, with lesions appearing like millet grains. Moxibustion temporarily resolved them, but they recurred overnight. A plaster was applied, causing the erythema to spread to approximately six cun, accompanied by unbearable pain, leading to blame being placed on moxibustion. Coincidentally, a monk met them, claiming his own critical sore condition had only resolved after receiving over eight hundred moxa cones. Consequently, large moxa cones the size of ginkgo nuts were used. Several cones were applied to the center of the sore and its surroundings. Pain ceased, and after more than thirty cones, the red erythema completely subsided. Subsequently, moxa balls the size of plums or apricots were applied, totaling forty cones. Afterward, the patient could eat porridge and sleep peacefully. The lesion protruded four cun, with about a hundred small openings; although the diseased tissue necrosed, the patient eventually recovered.
I observe: The method of burning moxa must ensure that those who feel pain do not feel it, and those who do not feel pain do feel it. Only then will the toxin disperse with the fire. Otherwise, it brings no benefit and causes harm.
Attached Treatment Case:
Gao Zhuzhen, an official of the Ministry of Justice, suffered from a back sore. The lesion was dark, hard, and heavy as if bearing a stone, with mental confusion that was alarming. His relative, Zheng Shacun, invited me to join him in treatment. Zheng remarked: "When Gao served in a certain county in Huguang, he improved a dangerous river crossing. The locals built a living shrine for him, and all who crossed prayed there. Now that he suffers this illness, people suspect the shrine caused malevolent spirits." I replied: "Not so. The etiology is deficiency-cold of Yuan Qi (primordial qi) combined with intense accumulation of toxins." Garlic paste was spread on the affected area, and large moxa cones placed on a coin were applied for more than twenty cones; he felt nothing. More garlic paste was applied with continued moxibustion; still, he felt nothing. Direct skin moxibustion was then performed. After a long time, sensation returned. Further application induced pain. Internally, a major tonic formula containing Renshen (Ginseng Radix) and Fuzi (Aconiti Lateralis Radix Praeparata) was administered, leading to recovery.