李氏云∶大抵疽口紧小而硬者，盖因风毒所胜，合用蚣蝎散掺疮口，以神异膏贴之。
蚣蝎散
赤足蜈蚣（一条去头足） 全蝎（三个去足生用）
上为末，用猪蹄汤净洗，搽之。
愚按∶前症乃风寒滞于疮口，而未传于内也。凡伤损之症，尤多此患。经云∶风症善行
而数变，入脏甚速，死生在乎反掌，当急分表里虚实而治之。其邪在表者，善伸数欠，筋脉
拘急，恶寒惕搦，脉浮而弦，宜羌活防风汤和解之。传于里者，舌强口噤，项背反张，筋惕
搐搦，痰涎壅盛，胸腹满闷，或便溺闭赤，时或汗出，脉洪数而弦，宜大芎黄汤 导之。其
汗初出者，由风热郁于里，亦宜大芎黄汤之类下之。若热既退，脏腑已和，而汗仍出者，表
虚也，宜白术防风汤以实其表。然解散、和解、 导三法，此治暴患之症，气血未损者。若
脓瘀内 ，而见前症者，宜针之，急投十全大补。或口噤遗尿，乃气血虚极，亦用十全大补
加炮附子。大抵此症，若因脓血去多，宜以补中益气加羌活主之。或人素多痰，因伤损而见
风症，宜二陈、白术、芎、归、栀子、芩、连。气虚加四君，血虚加四物，血气俱虚内热甚
而生风者，宜四物、参、术、柴、芩、栀子。若因怒伤而见前症，宜小柴胡汤倍加川芎、山
栀、天麻、钩藤钩。若患破伤风，至三五年忽然复发，或跌扑而患者，皆气虚有痰所致也，
用二陈加参、术、芎、归主之（治验见正体部）。
李氏说：大抵疮口紧缩、细小且坚硬的情况，是因为风毒邪气亢盛所致，应当使用蚣蝎散掺敷在疮口上，并用神异膏贴敷。
蚣蝎散
赤足蜈蚣（一条，去掉头和足） 全蝎（三个，不去足，生用）
以上药材研为细末，用猪蹄汤洗净疮口后，将药粉搽涂其上。
我按语认为：上述症状是由于风寒之邪滞留于疮口，尚未传入体内。凡是损伤类的病症，大多会出现这种情况。医经云：风邪致病善于游走且变化迅速，一旦侵入脏腑速度极快，生死往往就在一瞬间，因此应当紧急辨别表里虚实并进行治疗。如果邪气在体表，表现为身体容易伸展、频繁打哈欠，筋脉拘挛紧急，怕冷并伴有惊惕抽搐，脉象浮而弦，适宜用羌活防风汤来和解表邪。如果邪气传入体内，表现为舌体僵硬、牙关紧闭，项背强直反张，筋肉跳动抽搐，痰涎壅盛，胸腹部胀满闷痛，或者大小便闭塞不通且颜色红赤，时常出汗，脉象洪大而数且弦，适宜用大芎黄汤来导下泄热。如果是刚刚出汗的情况，这是由于风热郁结在体内，也适宜用大芎黄汤之类的方剂攻下。如果热势已经消退，脏腑功能已经调和，但汗出仍然不止，这是表虚的表现，适宜用白术防风汤来固护肌表。然而，解散、和解、导下这三种方法，是用于治疗突发急症且气血尚未受损的患者。如果脓血瘀滞在内，而出现上述症状的，应当针刺排脓，并急投十全大补汤。如果出现牙关紧闭、遗尿等症状，这是气血极度虚弱，也使用十全大补汤加炮附子。大抵这类病症，如果是因为脓血流失过多引起的，适宜用补中益气汤加羌活为主进行治疗。或者患者平素多痰，因受伤而引发风症，适宜用二陈汤、白术、川芎、当归、栀子、黄芩、黄连。气虚的加上四君子汤，血虚的加上四物汤，气血俱虚且内热严重而生风的，适宜用四物汤、人参、白术、柴胡、黄芩、栀子。如果是因愤怒伤肝而出现上述症状的，适宜用小柴胡汤加倍加入川芎、山栀、天麻、钩藤。如果是患破伤风，经过三五年忽然复发，或者是因跌扑损伤而发病的，都是由于气虚有痰所致，使用二陈汤加人参、白术、川芎、当归为主治疗（治疗验案见《正体类要》部分）。
Li stated: Generally, when the opening of a carbuncle or ulcer is tight, small, and hard, it is due to the predominance of wind-toxin. One should apply Gongxie San (Centipede and Scorpion Powder) to the wound surface and cover it with Shenyi Gao (Miraculous Ointment).
Gongxie San (Centipede and Scorpion Powder)
Gecko Centipede (Scolopendra subspinipes mutilans) (one strip, remove head and feet)
Whole Scorpion (Buthus martensii) (three, keep feet, use raw)
Grind the above into powder. Clean the wound thoroughly with pig trotter soup, then apply the powder.
My commentary: The aforementioned symptoms are caused by wind-cold stagnating at the wound site without having transmitted inward. This condition is particularly common in trauma cases. The Classics state: "Wind diseases move freely and change frequently; once entering the zang organs, the progression is very rapid, and life or death depends on a moment's notice." Therefore, one must urgently differentiate between exterior and interior, excess and deficiency, and treat accordingly. If the pathogen is in the exterior, manifesting as frequent stretching and yawning, tendon and vessel spasm, aversion to cold, and tremors or convulsions, with a floating and wiry pulse, Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) should be used to harmonize the exterior. If the pathogen has transmitted to the interior, manifesting as a stiff tongue, trismus, opisthotonos, muscle twitching and convulsions, profuse phlegm-saliva, chest and abdominal fullness and oppression, or constipation and dark urine, accompanied by occasional sweating and a surging, rapid, and wiry pulse, Daxiong Huang Tang (Large Cyperi and Rhubarb Decoction) should be used to guide out the heat via purgation. If sweating occurs initially, it is due to wind-heat郁结 (stagnating) in the interior, and purgatives such as Daxiong Huang Tang are also appropriate. If the heat has subsided, the internal organs have harmonized, but sweating persists, this indicates exterior deficiency; Baizhu Fangfeng Tang (Atractylodes Macrocephala and Saposhnikovia Decoction) should be used to consolidate the exterior. However, the methods of dispersing, harmonizing, and guiding/purging are applicable only to acute conditions where qi and blood have not yet been depleted. If pus and blood are stagnant internally presenting with these symptoms, acupuncture should be employed to drain them, followed immediately by Shiquan Dabu Tang (Complete Ten Tonics Decoction). If trismus and urinary incontinence occur, indicating extreme deficiency of qi and blood, Shiquan Dabu Tang combined with Pao Fuzi (Prepared Aconite Root) should be used. Generally, if this condition arises from excessive loss of pus and blood, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Qianghuo (Notopterygium Rhizome) should be the primary treatment. Or, if a patient who is constitutionally prone to phlegm develops wind symptoms after trauma, Erchen Tang (Two-Cured Decoction), Baizhu (Atractylodes Macrocephala Rhizome), Xiong (Cyperi Rhizoma), Gui (Angelicae Sinensis Radix), Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), and Lian (Coptidis Rhizoma) should be used. For qi deficiency, add Sijunzi Tang (Four Gentlemen Decoction); for blood deficiency, add Siwu Tang (Four Substances Decoction); for simultaneous qi and blood deficiency with severe internal heat generating wind, Siwu Tang, Renshen (Ginseng Radix), Baizhu, Chaihu (Bupleuri Radix), Huangqin, and Zhizi should be used. If the symptoms arise from anger injuring the liver, Xiaochaihu Tang (Minor Bupleurum Decoction) with increased doses of Chuanxiong (Ligusticum Chuanxiong Rhizome), Zhizi, Tianma (Gastrodiae Rhizoma), and Goutenggou (Uncariae Ramulus cum Uncis) should be used. If traumatic tetanus recurs suddenly after three to five years, or results from falls and blows, it is caused by qi deficiency with phlegm; Erchen Tang added with Renshen, Baizhu, Chuanxiong, and Danggui (Angelicae Sinensis Radix) should be the main treatment (clinical cases see Zhengti Bu [Standard Treatment for Traumatology]).