立斋曰∶流注之证，多因郁结，或暴怒，或脾气虚湿气逆于肉理，或腠理不密，寒邪客
于经络，或湿痰，或闪扑，或产后瘀血流注关节，或伤寒余邪未尽为患，皆因真气不足，邪
得乘之，故气凝血聚为患也。然此证，或生于四肢关节，或生于胸腹腰臀，或结块，或漫肿
，或痛，或不痛，悉宜用葱熨法，及益气养营汤，固其元气，则未成者自消，已成者自溃，
可全愈也。若不补气血及节饮食，慎起居，戒七情，而专用寒凉克伐者，俱不治。又《治法
》曰∶常治此证，凡暴怒所致，胸膈不利者，调气为主。抑郁所致而不痛者，宜调经脉，补
气血。肿硬作痛者，行气和血。溃而不敛者，补气血为主。伤寒余邪未尽者，和而解之。脾
气虚，湿热凝滞肉理者，健脾除湿为主。闪跌，瘀血凝滞为患者，和血气，调经络。寒邪所
袭，筋挛骨痛，或遍身痛，宜温经络，养血气。若久而不敛，疮口无阳者，宜豆豉饼或附子
饼灸之，以祛散寒邪，接补阳气。或外用琥珀膏贴之。若内有脓管，或生瘀肉，而不敛者，
用针头散腐之自愈，锭子尤效。
《医林集要》云∶骨疽乃流注之败证也。如用凉药，则内伤其脾，外冰其血。脾主肌肉
，脾气受伤，饮食必减，肌肉不生。血为脉络血，受冰则气血不旺，而愈滞。宜用理脾，脾
健则血自生，而气自营运矣。又有白虎飞尸，留连周期，或展转数岁，冷毒朽骨出尽自愈。若
附骨腐者可痊，正骨腐则为终身废疾矣。有毒自手足，或头面肿起，或兼疼痛，上至颈项骨
节去处，如疡 贯珠，此风湿流气之证也，宜以加减小续命汤，及独活寄生汤治之。有两膝
肿痛起，或至遍身骨节疼痛者，此风湿痹，又名历节风，宜附子八物汤治之。又有结核在项
腋，或两乳旁，或两胯软肉处，名曰 痈，属冷证也。又有小儿宿痰失道，致结核于颈
项臀膊胸背之处，亦令证也，俱宜热药敷贴。以上诸证，皆缘于肾。肾主骨，肾虚则骨冷，而
为患也。所谓骨疽，皆起于肾，亦以其根于此也，故用大附子以补肾气，肾实则骨有生气，而疽不附骨矣。
一男子，臀肿一块微痛，脉弦紧，以疮科流气饮，四剂而消。
一妇人，暴怒，腰肿一块，胸膈不利，时或气走作痛，用方脉流气饮，数剂而止，更
以小柴胡汤对四物加香附、贝母，月余而愈。
一妇人，禀弱性躁，胁臂肿痛，胸膈痞闷，服流气败毒药反发热，以四七汤数剂，胸
宽气利。以小柴胡汤对四物加陈皮、香附，肿痛亦退。大抵妇人性情执着，不能宽解，多被
七情所伤，遂致遍身做痛。或肢节肿痛，或气填胸满，或如梅核塞喉咽吐不出，或痰涎壅盛
，上气喘急，或呕逆恶心，甚者渴闷欲绝。产妇多有此证。宜服四七汤，先调滞气，更以养
血之药。若因忧思致小便白浊者，用此汤吞青州白丸子，屡效。
一老人，伤寒表邪未尽，股内患肿发热，以人参败毒散二剂热止。灸以香附饼，又小柴
胡汤加二陈、羌活、川芎、归、术、枳壳，数剂而散。
一男了，退患溃而不敛，用人参养营汤及附子饼，更以补剂煎膏贴之，两月余而愈。
一男子，腿患肿，肉色不变，不痛，脉浮而滑，以补中益气汤加半夏、茯苓、枳壳、木
香饮之，以香附饼熨之。彼谓气无补法，乃服方脉流气饮，虚愈甚。复求治，以六君了汤加
芎归数剂，饮食少进。再用补剂，月余而消。夫气无补法，俗论也。以其为病痞塞，似难于补
，殊不知卫气虚而不能营运，则邪气滞而为病。经云∶壮者气行则愈，怯者弱者则着而为病
。苟不用补法，元气何由而行乎。
一妇人，腿患筋挛骨痛，诸药不应，脉迟紧，用大防风汤，二剂顿退，又二剂而安。又
一妇人亦然，先用前汤二服，更服黑丸子而痊。此二患若失治，必溃成败证。
一男子，肩胛患之，微肿，形劳气弱，以益气养营汤服黑丸子，以及木香生地黄作饼，
覆患处熨之，月余脓成。针之，仍服前药而愈。
一男子，臂肿，筋挛骨痛，年余方溃，不敛，诊其脉更虚，以内塞散一料少愈，以十全
大补汤，及附子饼灸之而愈。《精要》云∶留积经久，极阴生阳，寒化为热。以此溃多成痿
，宜早服内塞散排之。
一男子，臂患出腐骨三块，尚不敛，发热作渴，脉浮大而涩，乃气血俱损，须多服生血
气之药，庶可保全。彼惑于火尚未尽，仍用凉药内服外敷，几危，求治。其形甚瘁，其脉愈
虚，先以六君子汤加芎归，月余饮食渐进。以八珍汤加肉桂三十余剂，疮色乃赤。更以十全
大补汤，外以附子饼灸之，仅年而瘥。（薛按）
薛己说：流注这种病证，多因情绪郁结，或突然暴怒，或脾气虚弱导致湿气逆乱于肌肉纹理之间，或腠理（皮肤毛孔及肌肉间隙）不致密，寒邪客居于经络之中，或有湿痰阻滞，或因闪挫扑跌损伤，或产后瘀血流入注于关节，或伤寒病后余邪未尽而引发祸患。这些情况都是因为人体真气不足，邪气得以乘虚而入，从而导致气滞血凝而成病。然而对于此证，无论病变发生在四肢关节，还是胸腹腰臀部位；无论是结成肿块，还是漫肿无头；无论是疼痛还是不痛，都适宜使用葱熨法（用热葱包敷患处），以及益气养营汤来固护元气，那么未成脓的自会消散，已成脓的自会溃破，可以完全痊愈。如果不补益气血，且不节制饮食、谨慎起居、戒除七情（喜、怒、忧、思、悲、恐、惊）的刺激，而专门使用寒凉克伐的药物，则都无法治愈。
另外，《治法》中说：经常治疗此证，凡是因暴怒所致，出现胸膈部气机不畅的，以调理气机为主。因抑郁所致且不痛的，适宜调理经脉，补益气血。肿胀坚硬且作痛的，行气和血。溃破后不能收敛的，以补益气血为主。伤寒余邪未尽的，调和并解散邪气。脾气虚弱，湿热凝滞于肌肉纹理的，以健脾除湿为主。闪挫跌打，瘀血凝滞致病的，调和气血，疏通经络。受寒邪侵袭，筋脉拘挛骨痛，或全身疼痛的，适宜温通经络，养血气。如果日久不愈合，疮口呈现“无阳”（阳气衰微）状态的，适宜用豆豉饼或附子饼进行灸治，以祛散寒邪，接续补益阳气。或者外用琥珀膏贴敷。如果内部有脓管，或长出瘀肉，而不能愈合的，用针头散去除腐肉，即可自愈，锭子药效果更佳。
《医林集要》说：骨疽是流注恶化后的败坏证候。如果使用凉药，则会内伤脾胃，外冰凝血液。脾主肌肉，脾气受伤，饮食必然减少，肌肉无法生长。血由脉络运行，受寒冰凝则气血不旺盛，因而更加停滞。适宜使用调理脾胃的方法，脾健运则血自生，气自然营运。又有白虎飞尸之邪，留连一个周期，或辗转数年，待冷毒朽骨排尽后自愈。如果是附骨腐烂的可以痊愈，如果是正骨腐烂则为终身废疾。如果有毒邪从手足或头面肿起，或兼有疼痛，向上蔓延至颈项骨节去处，像疡珠串联一样，这是风湿流气之证，适宜用小续命汤加减，以及独活寄生汤治疗。如果两膝肿痛发作，或至全身骨节疼痛的，这是风湿痹，又名历节风，适宜用附子八物汤治疗。又有结核在颈部腋下，或两乳旁，或两胯软肉处，名叫石痈，属于冷证。又有小儿宿痰失道，导致结核在颈项臀膊胸背之处，也是石痈之证，都适宜用热药敷贴。以上诸证，都是由于肾引起的。肾主骨，肾虚则骨冷，从而致病。所谓骨疽，都起于肾，也是因为根源在此，所以用大附子来补肾气，肾气充实则骨有生气，疽就不会附着于骨了。
有一个男子，臀部肿一块微痛，脉象弦紧，用疮科流气饮，服四剂后消散。
有一个妇人，因暴怒，腰部肿一块，胸膈气机不利，有时气走窜作痛，用方脉流气饮，数剂后停止，再配合小柴胡汤合四物汤加香附、贝母，月余后痊愈。
有一个妇人，体质弱性格急躁，胁肋手臂肿痛，胸膈痞闷，服用流气败毒药反而发热，用四七汤数剂，胸宽气利。再用小柴胡汤合四物汤加陈皮、香附，肿痛也消退。大抵妇人性情执着，不能宽解，多被七情所伤，遂致全身疼痛。或肢节肿痛，或气填胸满，或感觉如梅核塞喉咽吐不出，或痰涎壅盛，上气喘急，或呕逆恶心，严重的渴闷欲绝。产妇多有此证。适宜服用四七汤，先调滞气，再以养血药物调理。如果因忧思导致小便白浊的，用此汤吞服青州白丸子，屡见疗效。
有一个老人，伤寒表邪未尽，大腿内侧患肿发热，用人参败毒散二剂热止。用香附饼灸治，又用小柴胡汤加二陈汤、羌活、川芎、当归、白术、枳壳，数剂后消散。
有一个男子，腿患溃破后不收敛，用人参养营汤及附子饼，再用补剂煎膏贴敷，两月余后痊愈。
有一个男子，腿部患肿，肉色不变，不痛，脉浮而滑，用补中益气汤加半夏、茯苓、枳壳、木香饮用，并用香附饼熨敷。那人认为气病没有补法，于是服用方脉流气饮，虚损更严重。再次求治，用六君子汤加川芎、当归数剂，饮食稍进。再用补剂，月余后消散。所谓气无补法，是世俗的论调。因为此病表现为痞塞，似乎难以补益，殊不知卫气虚弱而不能营运，则邪气滞留而为病。经书说：壮年人气行则愈，怯弱者气弱则留着而为病。如果不使用补法，元气从哪里运行呢？
有一个妇人，腿部患筋挛骨痛，诸药无效，脉迟紧，用大防风汤，二剂后顿退，又二剂后安宁。另一个妇人也是如此，先用前汤服两剂，再服黑丸子而痊愈。这两个病患如果失治，必定溃破成为败证。
有一个男子，肩胛部患病，微肿，形体劳累气弱，用益气养营汤服黑丸子，以及木香生地黄作饼，覆盖患处熨敷，月余后脓成。针刺排脓，仍服前药而愈。
有一个男子，手臂肿，筋挛骨痛，一年多才溃破，不收敛，诊其脉更虚，用内塞散一料稍好，用十全大补汤，及附子饼灸治而愈。《精要》说：留积经久，极阴生阳，寒化为热。因此溃破多成痿证，宜早服内塞散排出。
有一个男子，手臂患出腐骨三块，尚不收敛，发热作渴，脉浮大而涩，乃气血俱损，须多服生血气的药物，才可以保全。他惑于火毒尚未尽，仍用凉药内服外敷，几乎危殆，求治。其形甚憔悴，其脉更虚，先用六君子汤加川芎、当归，月余饮食渐进。用八珍汤加肉桂三十余剂，疮色乃变红。再用十全大补汤，外用附子饼灸治，仅一年而痊愈。（薛己按语）
Xue Ji stated: The syndrome of Liuzhu (flowing obstruction) is mostly caused by emotional depression, sudden rage, or spleen qi deficiency leading to the reversal of dampness in the muscle tissue. It may also result from loose interstices (skin pores and muscle gaps) allowing cold pathogens to lodge in the meridians, presence of damp-phlegm, sprains or falls, postpartum blood stasis flowing into joints, or residual pathogens from Shanghan (cold damage disease) not yet cleared. All these occur because of a deficiency in true qi, allowing pathogens to take advantage, resulting in qi stagnation and blood coagulation. However, for this syndrome, whether it arises in the limbs and joints, or in the chest, abdomen, waist, and buttocks; whether it forms a lump or diffuse swelling; whether it is painful or painless, one should appropriately use the Congyi method (applying hot scallion packs to the affected area) and Qiyi Yangying Tang (Qi-Nourishing Decoction) to consolidate the original qi. Thus, unformed abscesses will dissipate on their own, and formed ones will suppurate and heal, leading to complete recovery. If one does not tonify qi and blood, nor regulate diet, be cautious with daily life, and guard against the Seven Emotions (joy, anger, worry, thought, sadness, fear, fright), but instead exclusively uses cold and purgative drugs, it cannot be cured.
Furthermore, "Treatment Methods" states: In frequently treating this syndrome, if caused by sudden rage with chest and diaphragm discomfort, regulation of qi is primary. If caused by depression without pain, regulating the meridians and tonifying qi and blood are appropriate. For swollen, hard, and painful areas, moving qi and harmonizing blood is indicated. For ulcers that fail to heal, tonifying qi and blood is primary. For residual pathogens from Shanghan, harmonizing and resolving them is suitable. For spleen qi deficiency with damp-heat stagnating in muscle tissue, strengthening the spleen and removing dampness is primary. For injuries from sprains and falls with blood stasis stagnation, harmonizing qi and blood and regulating meridians is appropriate. For attacks by cold pathogens causing tendon spasms, bone pain, or generalized body pain, warming the meridians and nourishing qi and blood is indicated. If the condition persists without healing and the ulcer shows signs of "Yang deficiency" (lack of yang energy), moxibustion with fermented soybean cakes or aconite cakes is suitable to dispel cold pathogens and restore yang qi. Alternatively, Hupo Gao (Amber Plaster) can be applied externally. If there are internal sinus tracts or overgrown granulation tissue preventing healing, Zhitou San (Needle Head Powder) should be used to remove necrotic tissue for self-healing; Dingzi (pill-shaped medicine) is particularly effective.
"Yilin Jiyao" (Essentials of the Medical Forest) states: Guju (bone carbuncle) is a deteriorated stage of Liuzhu. If cooling medicines are used, they will internally injure the spleen and externally freeze the blood. The spleen governs muscles; when spleen qi is injured, appetite decreases, and muscles do not grow. Blood flows through vessels; when frozen, qi and blood become weak and stagnate further. It is appropriate to regulate the spleen; when the spleen is healthy, blood generates naturally, and qi circulates smoothly. There is also the pathogen known as Baihu Feishi (White Tiger Flying Corpse), which lingers for cycles or years until cold toxins and necrotic bones are expelled, after which it heals spontaneously. If the flesh attached to the bone rots, it can be cured; if the bone itself rots, it results in lifelong disability. If toxic swelling arises from the hands, feet, or head and face, accompanied by pain, spreading upwards to the neck and joints like linked beads, this is a Wind-Dampness Flowing Qi syndrome, treatable with Jiajian Xiaoyuming Tang (Modified Minor Rescue Decoction) and Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction). If both knees swell and hurt, or general joint pain occurs, this is Wind-Dampness Bi Syndrome, also known as Lijie Feng (Traveling Joint Wind), treatable with Fuzi Bawu Tang (Aconite Eight Substances Decoction). There are also nodules in the neck, armpits, beside the breasts, or soft flesh of the groin, called Shiyong (Stone Carbuncle), belonging to Cold Syndromes. In children, retained phlegm deviating from its path can cause nodules in the neck, buttocks, arms, chest, and back, also constituting Shiyong, all of which should be treated with warm compresses. All the above syndromes originate from the Kidney. The Kidney governs bones; Kidney deficiency leads to cold bones, causing disease. So-called Guju all arise from the Kidney, hence the root lies here. Therefore, large doses of Fuzi (Prepared Aconite Root) are used to tonify Kidney qi; when the Kidney is solid, bones have vital energy, and the carbuncle does not adhere to the bone.
A male patient had a slightly painful swelling on his buttock with a wiry-tight pulse. He was treated with Chuangke Liuqi Yin (Wound Specialist Flowing Qi Decoction) for four doses, and it resolved.
A female patient suffered from a swollen mass on her waist due to sudden rage, with chest diaphragm discomfort and intermittent wandering pain. She was treated with Fangmai Liuqi Yin (Pulse Diagnosis Flowing Qi Decoction) for several doses to stop the symptoms, followed by Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Siwu Tang (Four Substances Decoction) plus Xiangfu (Cyperus Rhizome) and Beimu (Fritillaria Bulb). She recovered after more than a month.
Another female patient, constitutionally weak and irritable, experienced swelling and pain in her hypochondrium and arm, with chest fullness. After taking Liuqi Baidu Yao (Flowing Qi Detoxifying Medicine), she developed fever. She was treated with Siqu Tang (Seven Four Decoction) for several doses, relieving chest fullness and promoting qi flow. Then, Xiaochaihu Tang combined with Siwu Tang plus Chenpi (Tangerine Peel) and Xiangfu reduced the swelling and pain. Generally, women tend to be emotionally fixed and unable to relax, making them susceptible to injury by the Seven Emotions, leading to generalized pain, joint swelling, chest oppression, globus sensation (feeling of a plum pit in the throat), excessive phlegm, shortness of breath, nausea, or severe thirst and distress. Postpartum women often suffer from this. It is appropriate to take Siqu Tang first to regulate stagnant qi, followed by blood-nourishing herbs. If urinary turbidity is caused by worry and overthinking, swallowing Qingzhou Baiwanzi (Qingzhou White Pills) with this decoction has proven effective repeatedly.
An elderly patient had residual exterior pathogens from Shanghan, presenting with swelling and fever in the inner thigh. Renshen Baidou San (Ginseng and Imperata Powder) for two doses stopped the fever. Moxibustion with Xiangfu cakes was applied, followed by Xiaochaihu Tang combined with Erchen Tang (Two Aged Things Decoction), Qianghuo (Notopterygium Rhizome), Chuanxiong (Ligusticum Rhizome), Danggui (Angelica Sinensis), Baizhu (Atractylodes Macrocephala Rhizome), and Zhike (Bitter Orange Fruit). It resolved after several doses.
A male patient had an ulcerated leg wound that failed to heal. He was treated with Renshen Yangying Tang (Ginseng Nourishing Qi and Blood Decoction) and Aconite Cakes, along with topical application of tonic paste. He healed after more than two months.
A male patient had a leg swelling with unchanged skin color and no pain, with a floating-slippery pulse. He was given Buzhong Yiqi Tang (Central-Boosting and Qi-Supplementing Decoction) added with Banxia (Pinellia Tuber), Fuling (Poria), Zhike, and Muxiang (Aucklandia Root), and the area was moxa-warmed with Xiangfu cakes. He believed that qi disorders should not be treated with tonification, so he took Fangmai Liuqi Yin, worsening his deficiency. Upon seeking further treatment, Liujunzi Tang (Six Gentlemen Decoction) added with Chuanxiong and Danggui for several doses improved his appetite. Continued tonification led to resolution after a month. The saying "qi disorders cannot be treated with tonification" is a vulgar theory. Although the disease presents as blockage, seemingly difficult to tonify, it is unknown that when defensive qi is deficient and fails to circulate, pathogens stagnate and cause disease. The Classics state: Those who are strong recover as qi moves; those who are weak suffer lingering disease. Without tonification, how can original qi move?
A female patient suffered from leg tendon spasms and bone pain, unresponsive to various medicines, with a slow-tight pulse. Dafangfeng Tang (Major防风 Decoction) for two doses rapidly alleviated symptoms, and she stabilized after another two doses. Another female patient with similar symptoms took two doses of the previous decoction, followed by Hei Wanzi (Black Pills), and recovered. If these cases were mismanaged, they would likely suppurate and become incurable.
A male patient had slight swelling on his shoulder blade, with physical exhaustion and weak qi. He took Qiyi Yangying Tang and Hei Wanzi, and applied Muxiang Shengdihuang Bing (Aucklandia and Rehmannia Cake) to the area with heat compression. Pus formed after a month. Incision and drainage were performed, and he continued the previous medication to heal.
A male patient had arm swelling, tendon spasms, and bone pain, which only suppurated after more than a year and failed to heal. His pulse was even weaker. One dose of Neisai San (Internal Obstruction Powder) brought slight improvement. He was then treated with Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) and moxibustion with Aconite Cakes, leading to recovery. "Jingyao" states: Long-standing accumulation generates yang from extreme yin, and cold transforms into heat. Thus, ulcers often become atrophic; early administration of Neisai San is recommended to expel pathogens.
A male patient expelled three pieces of necrotic bone from his arm wound, which still did not heal, accompanied by fever, thirst, and a large-slippery-pulse. This indicated dual deficiency of qi and blood, requiring abundant intake of qi- and blood-generating herbs for preservation. Confused by the belief that fire toxins were not fully cleared, he continued using cooling medicines internally and externally, nearly dying before seeking help. His appearance was emaciated, and his pulse extremely weak. First, Liujunzi Tang added with Chuanxiong and Danggui was given for a month, gradually improving his diet. Bazhen Tang (Eight Treasures Decoction) added with Rougui (Cinnamon Bark) for more than thirty doses turned the wound red. Finally, Shiquan Dabu Tang was taken, with external moxibustion using Aconite Cakes, leading to recovery within a year. (Note by Xue Ji)