夫疮疡之证候不同，寒热虚实，皆能为痛。止痛之法，殊非一端。世人皆谓乳没可
以止痛，殊不知因病制宜，自有活法。故因热而痛者，以寒凉之剂折其热，则痛自止也。
因寒而痛者，以温热之药熨其寒，则痛自除也。因风而痛者，除其风。因湿而痛者，除
其湿。燥而痛者润之，塞而痛者通之，虚而痛者补之，实而痛者泻之，脓郁而闭者开之，
恶肉浸溃者引之，阴阳不和者调之，经络滞涩者利之，忧愁者远志酒饮之，虚塞而痛者
乳香没药止之。大抵痈疽不可不痛，不可大痛，若大痛闷乱者危。
薛新甫云∶疮疡之作，由六淫七情所伤，其痛也，因气血凝滞所致。假如热毒在内，便
秘而作痛者，内疏黄连汤导之。热毒炽盛， 肿而作痛者黄连解毒散治之，不应，仙方活
命饮解之。瘀血凝滞而作痛者，乳香定痛散和之。作脓而痛者，托里消毒散排之。脓胀
而痛者针之，脓溃而痛者补之，若因气虚而痛，四君加归 。血虚而痛，四物加参 。肾
虚而痛，六味地黄丸。口干作渴，小便频数者，加减八味丸。此皆止痛之法也。
若高肿 痛，热毒也，加黄连。漫肿微痛，气虚也，去金银花、连翘，加参、术。肿
赤作痛，血凝滞也，加乳香、没药，如不应，暂用仙方活命饮。脓出反痛，气血虚也，去
金银花、连翘、白芷，加参、 、归、地。漫肿不痛，或肉死不溃，脾气虚也，去三味，加
人参、白术；如不应，加姜、桂；更不应，急加附子。（《准绳》 三味金银花、连翘、白芷）
寒热虚实，皆能为痛。止痛之法，殊非一端，随症施之，其痛自止。不必拘拘于乳
没也。又疮疡不可不痛，不痛为胃气虚极也，不治。不可大痛，兼烦闷者不治。再麻痒者
更为恶候。（《大成》）
疮疡的证候各不相同，寒、热、虚、实等各种因素都能导致疼痛。止痛的方法，并非只有一种。世人普遍认为乳香和没药可以止痛，却不懂得根据病情灵活制宜，其实自有灵活多变的治疗方法。因此，因热邪而痛的，用寒凉的药物来折服其热，疼痛自然停止；因寒邪而痛的，用温热的药物来温熨其寒，疼痛自然消除；因风邪而痛的，祛除风邪；因湿邪而痛的，祛除湿邪；因燥邪而痛的，滋润之；因气机闭塞而痛的，疏通之；因正气虚弱而痛的，补益之；因邪气盛实而痛的，泻下之；因脓液郁结而闭阻的，开泄之；因恶肉浸淫溃烂的，引流之；因阴阳不和的，调和之；因经络滞涩的，通利之；因忧愁导致的，饮用远志酒；因气血虚弱且阻滞而痛的，用乳香和没药来止痛。大抵痈疽这类疾病，不可能完全不痛，但也不能剧烈疼痛，如果疼痛剧烈到令人烦闷昏乱的程度，则病情危重。
薛新甫说：疮疡的发生，是由六淫（风、寒、暑、湿、燥、火）和七情（喜、怒、忧、思、悲、恐、惊）所损伤引起的，其疼痛是由于气血凝滞所致。假如热毒在体内，导致便秘并引起疼痛的，用内疏黄连汤引导排泄；热毒炽盛，红肿并引起疼痛的，用黄连解毒散治疗，如果无效，用仙方活命饮解除；瘀血凝滞而引起疼痛的，用乳香定痛散调和；正在化脓并引起疼痛的，用托里消毒散排脓；脓液胀满并引起疼痛的，针刺排脓；脓液溃破后仍疼痛的，补益正气；如果是因气虚而疼痛的，在四君子汤基础上加当归和黄芪；血虚而疼痛的，在四物汤基础上加人参和黄芪；肾虚而疼痛的，用六味地黄丸；口干口渴，小便频数的，用加减八味丸。这些都是止痛的方法。
如果局部高肿且疼痛，是热毒的表现，加入黄连；漫肿且轻微疼痛，是气虚的表现，去掉金银花、连翘，加入人参、白术；肿胀发红且疼痛，是血行凝滞的表现，加入乳香、没药，如果无效，暂时使用仙方活命饮；脓液排出后反而疼痛，是气血虚弱的表现，去掉金银花、连翘、白芷，加入人参、黄芪、当归、地黄；漫肿不痛，或者肌肉坏死不溃烂，是脾气虚弱的表现，去掉上述三味药，加入人参、白术；如果无效，加入干姜、肉桂；再无效，紧急加入附子。（《医学准绳六要》注：这三味药指金银花、连翘、白芷）
寒、热、虚、实等各种因素都能导致疼痛。止痛的方法，并非只有一种，应根据症状施治，疼痛自然停止。不必拘泥于只用乳香和没药。另外，疮疡不可能完全不痛，如果不痛，说明胃气极度虚弱，属于不治之症。疮疡也不能剧烈疼痛，如果伴有烦躁闷乱，也属不治之症。再有出现麻木瘙痒的，更是恶候。（《外科大成》）
The manifestations of sores and ulcers vary, and pain can be caused by cold, heat, deficiency, or excess. The methods for relieving pain are not limited to a single approach. People generally believe that Ru Xiang (Frankincense) and Mo Yao (Myrrh) can relieve pain, failing to realize that treatment must be tailored to the specific condition, employing flexible methods. Therefore, when pain is caused by heat, cooling agents should be used to subdue the heat, and the pain will cease naturally. When pain is caused by cold, warming agents should be used to dispel the cold, and the pain will be eliminated naturally. When pain is caused by wind, the wind should be expelled; when caused by dampness, the dampness should be removed. If caused by dryness, moisten it; if caused by obstruction, unblock it; if caused by deficiency, tonify it; if caused by excess, purge it. If caused by pus retention and blockage, open the blockage; if caused by foul tissue erosion and ulceration, guide the discharge out; if caused by disharmony of Yin and Yang, harmonize them; if caused by stagnation and涩 (obstruction) in the meridians, promote circulation. If caused by sorrow, administer Yuan Zhi Jiu (Polygala Wine). If caused by Qi and Blood deficiency with stagnation, use Ru Xiang (Frankincense) and Mo Yao (Myrrh) to stop the pain. Generally speaking, carbuncles and sores cannot be completely painless, but they should not cause severe pain. If the pain is so severe as to cause confusion and distress, the condition is critical.
Xue Xinpu stated: Sores and ulcers arise from injuries caused by the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). The pain results from the stagnation of Qi and Blood. For instance, if internal heat-toxin causes constipation and pain, Nei Shu Huang Lian Tang (Internal Draining Coptis Decoction) should be used to guide the expulsion. If heat-toxin is flourishing, causing swelling and pain, Huang Lian Jie Du San (Coptis Detoxification Powder) should be used; if ineffective, Xian Fang Huo Ming Yin (Immortal Formula for Preserving Life) should be used to resolve it. If pain is caused by blood stasis and stagnation, Ru Xiang Ding Tong San (Frankincense Pain-Stopping Powder) should be used to harmonize. If pain occurs during suppuration, Tuo Li Xiao Du San (Supporting Interior and Eliminating Toxin Powder) should be used to drain the pus. If pain is caused by distension of pus, needle drainage should be employed. If pain persists after the pus has drained, tonification should be applied. If pain is due to Qi deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) should be modified with Dang Gui (Angelica Sinensis) and Huang Qi (Astragalus). If pain is due to Blood deficiency, Si Wu Tang (Four Substances Decoction) should be modified with Ren Shen (Ginseng) and Huang Qi (Astragalus). If pain is due to Kidney deficiency, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) should be used. If there is dry mouth with thirst and frequent urination, Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) should be administered. These are all methods for relieving pain.
If there is high swelling with pain, it indicates heat-toxin; add Huang Lian (Coptis). If there is diffuse swelling with slight pain, it indicates Qi deficiency; remove Jin Yin Hua (Honeysuckle), Lian Qiao (Forsythia), and add Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala). If there is red swelling with pain, it indicates blood stagnation; add Ru Xiang (Frankincense) and Mo Yao (Myrrh); if ineffective, temporarily use Xian Fang Huo Ming Yin (Immortal Formula for Preserving Life). If pain increases after pus drainage, it indicates Qi and Blood deficiency; remove Jin Yin Hua (Honeysuckle), Lian Qiao (Forsythia), and Bai Zhi (Angelica Dahurica); add Ren Shen (Ginseng), Huang Qi (Astragalus), Dang Gui (Angelica Sinensis), and Di Huang (Rehmannia). If there is diffuse swelling without pain, or necrotic flesh that does not ulcerate, it indicates Spleen Qi deficiency; remove the aforementioned three herbs, and add Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala); if ineffective, add Gan Jiang (Dried Ginger) and Rou Gui (Cinnamon Bark); if still ineffective, urgently add Fu Zi (Prepared Aconite). (Note from *Zhun Sheng*: The "three herbs" refer to Jin Yin Hua, Lian Qiao, and Bai Zhi.)
Pain can be caused by cold, heat, deficiency, or excess. The methods for relieving pain are not limited to one approach; treat according to symptoms, and the pain will cease naturally. Do not rigidly rely solely on Ru Xiang (Frankincense) and Mo Yao (Myrrh). Furthermore, sores and ulcers cannot be completely painless; if there is no pain, it indicates extreme deficiency of Stomach Qi, which is untreatable. They should not cause severe pain either; if accompanied by irritability and distress, it is also untreatable. Additionally, numbness and itching constitute a more ominous prognosis. (From *Wai Ke Da Cheng*)