问曰∶五善七恶，可得闻乎？曰∶饮食如常，一善也；实热而大小便涩，二善也；内外
病相应，三善也；肌肉好恶分明，四善也；用药如所料，五善也。渴发而喘，眼角向鼻，大
小便反滑，一恶也；气绵绵而脉濡，与病相反，二恶也；目不了了，睛明内陷，三恶也；未
溃肉黑而陷，四恶也；已溃青黑，腐筋骨黑，五恶也；发痰，六恶也；呕吐，七恶也。
愚按∶善恶形症治法见附录。
问曰∶病有甚而至生，有微而至死，病症难辨，死生何从决乎？答曰∶发背溃透内膜者
死（此言肝俞以上）；未溃内陷、面青唇黑、便污者死（此言脏坏便瘀血）；溃喉者不治；阴患
入腹者不治；入囊者不治；鬓深数寸者不治，在颐后一寸三分名锐毒，亦不治。无此者生。
流注虽多，疗之必愈。
愚按∶前症有因元气虚弱而毒瓦斯内陷者，有因初作，失于内 托里，和荣卫者，有因毒
盛失于消解者，有因虚弱失于补托者，有因脓成失于针刺者，有因腐溃失于补养者。若发背
脑疽，属湿热上壅者，黄连消毒散、补中益气汤以除湿毒，补脾肺滋肾水。若鬓疽锐毒，
属风热者，柴胡山栀散以清肝火，养肝血，若阴虚，用六味地黄丸以生肾水，滋化源；若患
于小腹，补足三阴之血，养脾胃之气 庶可保其生也。其流注之症，或因饮食劳倦，房室阴
虚，或七情内动，六淫外侵，以致血虚，互相凝滞，或产后血瘀，随虚流注，或结块，或漫
肿，宜用益气养荣汤以固元气，佐以葱熨解散凝滞，更以豆豉饼祛散寒邪，溃久内有瘀肉，
用针头散腐之，多有生者。设若不守禁调摄，多致不起，慎之！
问：五善七恶，可以讲给我听吗？答：饮食正常，是一善；身体实热但大小便不通畅，是二善；体表病症与体内状况相互对应，是三善；肌肉好坏界限分明，是四善；用药效果如预期般准确，是五善。口渴且气喘，眼角向鼻梁方向收缩，大小便反而滑泄失禁，是一恶；气息微弱连绵而脉象濡软，与病情表现相反，是二恶；眼神模糊不清，眼球内陷，是三恶；未溃破时肌肉发黑且凹陷，是四恶；已溃破后疮口呈青黑色，筋骨腐烂发黑，是五恶；出现痰多症状，是六恶；呕吐，是七恶。
我按语：善恶形症的治疗方法见附录。
问：有的病势严重却导致生存，有的病势轻微却导致死亡，病症难以辨别，如何判断生死呢？答：发背疽溃破穿透内膜的（这里指肝俞穴以上的部位），主死；未溃破时毒气内陷、面色青紫、嘴唇发黑、大便污浊的（这里指脏腑损坏导致瘀血），主死；溃烂至咽喉部位的无法治疗；阴部患疽深入腹部的无法治疗；进入阴囊的无法治疗；鬓角处深达数寸的无法治疗，位于颐后一寸三分处名为锐毒，也无法治疗。没有上述情况的可以存活。流注虽多发，经过治疗必定痊愈。
我按语：前述病症有因元气虚弱导致毒邪内陷的，有因初起时未能及时使用托里法调和营卫的，有因毒邪炽盛未能及时消散化解的，有因体质虚弱未能及时补益托毒的，有因脓液形成未能及时针刺排脓的，有因腐肉溃烂未能及时补养气血的。若发背疽、脑疽，属于湿热上壅的，用黄连消毒散、补中益气汤来清除湿毒，补益脾肺以滋养肾水。若鬓疽锐毒，属于风热的，用柴胡山栀散来清泻肝火，滋养肝血；若属阴虚，用六味地黄丸来滋生肾水，滋养化源；若患处位于小腹，需补足三阴经之血，滋养脾胃之气，才可以保全生命。至于流注病症，或因饮食劳倦、房事过度导致阴虚，或七情内伤、六淫外侵，导致血虚，互相凝滞，或产后血瘀，随虚邪流注，或结成肿块，或漫肿无头，宜用益气养荣汤来固护元气，配合葱熨法解散凝滞，再用豆豉饼祛除寒邪；若溃破日久内有瘀肉，用针头散腐蚀去除，大多能生还。如果不遵守禁忌进行调养摄生，大多会导致不治，务必谨慎！
Q: May I ask about the Five Good Signs and Seven Bad Signs? A: Normal appetite and digestion constitute the first good sign; excessive internal heat accompanied by difficulty in urination and defecation constitutes the second good sign; consistency between external lesions and internal symptoms constitutes the third good sign; clear distinction between healthy and necrotic muscle tissue constitutes the fourth good sign; therapeutic effects matching expectations constitute the fifth good sign. Thirst with wheezing, eyes retracted towards the nose, and involuntary diarrhea or urinary incontinence constitute the first bad sign; a feeble, continuous breath with a soggy pulse (Ru Mai), which contradicts the disease state, constitutes the second bad sign; blurred vision with sunken eyeballs constitutes the third bad sign; blackening and depression of flesh before ulceration constitutes the fourth bad sign; greenish-black discoloration after ulceration with blackened, rotting bone and tendon constitutes the fifth bad sign; excessive phlegm production constitutes the sixth bad sign; vomiting constitutes the seventh bad sign.
My commentary: The treatment methods for good and bad signs are detailed in the appendix.
Q: Some severe conditions lead to survival, while some mild conditions lead to death. Since symptoms are difficult to distinguish, how can one determine life from death? A: If a carbuncle on the back (Fabei) ulcerates through to the inner membrane (referring to areas above the Ganshu acupoint), it indicates death. If, before ulceration, there is internal sinking of toxin, cyanotic face, black lips, and foul stool (indicating organ failure and blood stasis), it indicates death. Ulceration reaching the throat is incurable. Yinxiong (Yin abscess) penetrating into the abdomen is incurable. Penetration into the scrotum is incurable. Deep penetration into the temple area (several inches deep) is incurable. Rui Du (Sharp Toxin), located 1.3 cun behind the chin, is also incurable. Cases not presenting these signs indicate survival. Although Liuzhu (Flowing Abscess) may be numerous, it will surely heal with treatment.
My commentary: The aforementioned conditions may arise from deficiency of Yuan Qi leading to internal sinking of toxins; or from initial stages where Tuoli therapy (supporting interior) was neglected to harmonize Ying and Wei; or from excessive toxin failing to be resolved; or from weakness failing to be supplemented and supported; or from formed pus failing to be drained via acupuncture; or from ulcerated decay failing to be nourished. For Fabei and Naoju (Brain Carbuncle) caused by damp-heat surging upward, Huanglian Xiaodu San (Coptis Decoction for Eliminating Toxicity) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to eliminate damp-toxin, tonify Spleen and Lung, and nourish Kidney Water. For Binju (Temple Carbuncle) and Rui Du caused by Wind-Heat, Chaihu Shanzhi San (Bupleurum and Gardenia Powder) should be used to clear Liver Fire and nourish Liver Blood; if Yin Deficiency is present, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) should be used to generate Kidney Water and nourish the source of transformation. If the lesion is on the lower abdomen, one must tonify the Blood of the Three Yin meridians and nourish the Qi of the Spleen and Stomach to ensure survival. Regarding Liuzhu conditions, they may result from dietary irregularities, overwork, sexual excess leading to Yin Deficiency, or emotional disturbances and invasion of Six Exogenous Pathogens, causing Blood Deficiency and mutual stagnation; or postpartum blood stasis flowing with deficiency; forming lumps or diffuse swelling. One should use Yiqi Yangrong Tang (Qi-Tonifying and Blood-Nourishing Decoction) to consolidate Yuan Qi, assisted by Congyi (Scallion Moxibustion) to dissipate stagnation, and Douchi Bing (Fermented Soybean Cake) to dispel Cold Evil. If chronic ulcers contain necrotic flesh, Zhentou San (Needle-Head Powder) should be used to cauterize and remove it; many patients survive. However, if one fails to observe dietary and lifestyle restrictions, recovery is unlikely. Exercise great caution!