夫痈疽之源，因于气，或因于热。以仆之管见，亦有因于膏粱房劳、金石等药。故治
法，用绿豆、犀角、矾石、国老膏、追毒丸，其属毒明矣。华佗《中藏》所言，是毒服宣热败
毒之药，不必疑矣。
愚按∶前症若因金石所致，元气充实者，诚宜此法。若膏粱积热，房劳过度，脾肾亏损
者，当滋其化源，不可拘执。
夫痈疽疮肿之作，皆五脏六腑蓄毒不流，非独因荣卫壅塞而发也。其行也有处，其主也
有归。假令发于喉舌者心之毒；发于皮毛者肺之毒；发于肌肉者脾之毒；发于骨髓者肾之
毒；发于下者，阴中之毒；发于上者，阳中有毒；发于外者，六腑之毒；发于内者，五脏之
毒。故内曰坏，外曰溃，上曰从，下曰逆。发于上者得之速，发于下者得之缓。感于六腑则
易治，感于五脏则难瘳。又近骨者多冷，近肤者多热。近骨者久不愈，则化成血虫；近肤者
久不愈，则传气成漏。成虫则多痒少痛，或先痒后痛，成漏则多痛少痒，或不痛不痒，内虚
外实者，多痛少痒，血不止则多死，溃脓则多生。或呕逆无度，饮食无时，皆痈疽使然。症
候多端，要当详治。
愚按∶疮疡生虫，乃肝经风热；其成漏，乃元气虚弱；其出血，乃脾虚有火；其溃脓，
乃元气充实。至于呕逆等症，属脾胃亏损所致，当调补元气，庶保无虞。
痈疽的成因，有的源于气机失调，有的源于热邪。以我浅陋的见解，也有因食用肥甘厚味、房事过度以及服用金石类药物所致的。因此治疗方法，使用绿豆、犀角、矾石、国老膏（甘草制剂）、追毒丸等药物，其性质属于解毒是明确的。华佗在《中藏经》中所言，也是服用宣散热邪、败毒的药物，不必怀疑。
我按语：上述病症如果是由金石类药物引起的，对于元气充实的人，确实适宜这种方法。如果是因肥甘厚味积滞化热，或房劳过度导致脾肾亏损的，应当滋生化之源，不可拘泥固执于前法。
痈疽疮肿的发生，都是五脏六腑蓄积毒素不能流通所致，不仅仅是因为营卫之气壅塞而引发的。它们发作有固定的部位，主治也有归属。假如发于喉舌的，是心的毒素；发于皮毛的，是肺的毒素；发于肌肉的，是脾的毒素；发于骨髓的，是肾的毒素；发于身体下部的，是阴分的毒素；发于身体上部的，是阳分的毒素；发于体表的，是六腑的毒素；发于体内的，是五脏的毒素。所以内部溃烂称为“坏”，外部破溃称为“溃”，病势向上发展的称为“从”（顺证），病势向下发展的称为“逆”（逆证）。发于上部的发病迅速，发于下部的发病缓慢。感受于六腑的容易治疗，感受于五脏的难以痊愈。又靠近骨骼的多表现为寒证，靠近皮肤的多表现为热证。靠近骨骼的久不愈合，会化成血虫（指坏死组织或寄生虫样病变）；靠近皮肤的久不愈合，会传变气机形成瘘管。形成血虫的多痒少痛，或者先痒后痛；形成瘘管的多痛少痒，或者不痛不痒。内虚外实的，多痛少痒；出血不止的多数死亡，溃破流脓的多数存活。如果出现频繁呕吐呃逆，饮食没有定时，这都是痈疽导致的。症状表现多种多样，应当详细诊治。
我按语：疮疡生虫，乃是肝经风热所致；形成瘘管，乃是元气虚弱所致；出血，乃是脾虚有火所致；溃破流脓，乃是元气充实的表现。至于呕吐呃逆等症状，属于脾胃亏损所致，应当调补元气，这样才能保证平安无事。
The origin of carbuncles and ulcers lies in Qi dysfunction or Heat pathogen. From my limited perspective, there are also cases caused by a diet rich in fatty and sweet foods, excessive sexual activity, and the ingestion of mineral-based medicines (Jinshi). Therefore, the treatment methods involve using Mung Bean (Lüdou), Rhinoceros Horn (Xijiao), Alum (Fanshi), Guolao Gao (Licorice Paste), and Zhuodu Wan (Poison-Chasing Pill), clearly indicating their nature as detoxifying agents. The statements made by Hua Tuo in *Zhongzang Jing* (Middle Cabinet Classic) also advocate the use of herbs that disperse heat and eliminate toxins; this need not be doubted.
My commentary: For the aforementioned conditions caused by mineral-based medicines, if the patient's Yuan Qi (Original Qi) is robust, this method is indeed appropriate. However, if the condition arises from accumulated heat due to dietary excesses or Spleen and Kidney deficiency resulting from excessive sexual activity, one should nourish the source of transformation and metabolism, rather than rigidly adhering to previous methods.
The occurrence of carbuncles, sores, and swellings results from the accumulation of toxins within the Five Zang and Six Fu organs that fail to circulate freely; it is not solely due to the obstruction of Ying (Nutritive) and Wei (Defensive) Qi. Their manifestation has specific locations, and their management has specific correspondences. For instance, lesions appearing on the throat and tongue stem from Heart toxins; those on the skin and hair follicles stem from Lung toxins; those on muscles stem from Spleen toxins; those in the bone marrow stem from Kidney toxins; those appearing on the lower body stem from Yin toxins; those on the upper body stem from Yang toxins; those on the exterior stem from Fu organ toxins; and those on the interior stem from Zang organ toxins. Therefore, internal necrosis is termed "Huai" (Destruction), external ulceration is termed "Kui" (Ulceration), upward progression is considered "Cong" (Favorable/Compliant), and downward progression is considered "Ni" (Adverse/Opposing). Lesions on the upper body develop rapidly, while those on the lower body develop slowly. Infections involving the Fu organs are easier to treat, whereas those involving the Zang organs are difficult to cure. Furthermore, lesions close to bones often present with cold signs, while those close to the skin often present with heat signs. If lesions near bones do not heal for a long time, they may transform into "blood worms" (necrotic tissue or parasitic-like lesions); if lesions near the skin do not heal for a long time, they may transmit qi abnormalities forming fistulas. Fistula formation typically presents with more itching than pain, or no pain and no itching. Blood worm formation typically presents with more pain than itching, or initially itching followed by pain. Conditions characterized by internal deficiency and external excess present with more pain than itching. Uncontrolled bleeding often leads to death, while suppuration (drainage of pus) often indicates survival. Frequent vomiting and regurgitation, along with irregular eating habits, are all consequences of carbuncles and ulcers. The symptoms are manifold and require detailed diagnosis and treatment.
My commentary: The generation of worms in sores is due to Wind-Heat in the Liver channel; the formation of fistulas is due to weak Yuan Qi (Original Qi); bleeding is due to Spleen deficiency with Fire; and suppuration indicates robust Yuan Qi. As for symptoms such as vomiting and regurgitation, these are caused by Spleen and Stomach deficiency. One should regulate and tonify Yuan Qi to ensure safety and recovery.