陈良甫曰∶痈疽之毒有浅深，故收敛之功有迟速，断不可早用收口之药。恐毒瓦斯未尽，
后必复发，为患匪轻。若痈久不合，其肉白而脓少者，此气血俱虚，不能潮运，而疮口冷涩
也。每日用艾叶一把煎汤，避风热洗，及烧松香烟熏之，或用猪蹄汤洗之，更以神异膏贴之，
必须守禁调理，否则不效。又曰∶脉得寒则下陷，凝滞肌肉，故曰留连肉腠，是为冷漏。须
温补之。
丹溪曰∶诸经惟少阳厥阴之生痈者，宜须防之，以其多气少血也。血少则肌肉难长，故
疮久未合，必成败证。苟反用驱利毒药，以伐其阴分之血，祸不旋踵矣。
立斋曰∶肌肉者，脾胃之所主。收敛者，血气之所使，但当纯补脾胃，不宜泛敷生肌之
剂。夫疮不生肌，而色赤甚者，血热也，四物加山栀、连翘。色白而无神者，气虚也，四君
加当归、黄 。晡热内热，阴血虚也，四物加参术。脓水清稀者，气血虚也，十全大补汤。
食少体倦，脾气虚也，补中益气汤。烦热作渴，饮食如常，胃火也，竹叶黄 汤。不应，竹
叶石膏汤。热渴而小便频数，肾水虚也，用加减八味丸料煎服。若败肉去后，新肉微赤，四
沿白膜者，此胃中生气也，但用四君子汤，以培补之，则不日自敛。若妄用生肌之药，余毒
未尽，而反益甚耳。殊不知疮疡之作，由胃气不调，疮疡之溃，由胃气腐化，疮疡之敛，由
胃气荣养。东垣云∶胃乃发生之源，为人生之本。丹溪亦谓，治疮疡当助胃壮气，使根本坚
固。诚哉是言也，可不慎欤。
又曰∶若肌肉伤，而疮口不敛，用六君子汤以补脾胃。若气虚恶寒而疮口不敛，用补中
益气汤以补脾肺。若血虚发热而疮口不敛，用四物参术以滋肝脾。若脓多而疮口不敛，用八
珍汤，或十全大补汤，以养血气。如不应，但用四君归 以补脾胃。更不应，乃属命门火衰
，急用八味丸以壮火生土。若脉数发渴者，难治，以真气虚而邪气实也。
又曰∶生肌之法，当先理脾胃助气血为主。若气血俱虚不能生者，当用托里之剂。若
有风寒袭于疮所不能生者，宜用豆豉饼灸之。若流注顽疮内有脓管，或瘀血，或 核，须用
针头散腐之，锭子尤妙。如背疮、杖疮、汤火疮大溃，当用神效当归膏，则能去腐生新止痛，大有神效。
又曰∶痈疽溃后，毒尽则肉自生。常见世之治者，往往用龙骨血竭之属以求生肌，殊不
知余毒未尽，肌肉何以得生。气血既虚，龙竭岂能得效。设若脓毒未尽，就用生肌，则反增
溃烂。壮者轻者不过复溃，或迟敛而已。怯者重者必致内攻，或溃烂不敛，反致危矣。
又曰∶凡疮疡成漏，皆因元气不足，营气不从。阳气虚寒，则寒气逆于肉里，稽留血
脉，腐溃既久，即成是患。故凡治不足之证，于其初患，盒饭内用参 归术，温补脾胃，外
用桑枝葱熨，接补阳气，使自消散。若久而不能成脓，亦用前二法，补助以速之。若脓既成
而不溃，用艾于当头灸数炷而出之，却服十全大补汤。患者又当慎起居，节饮食，庶几收敛
。若用冷针开刺，久而内出清脓，外色黑黯。或误用生肌散，速其口敛，反束其邪，必成败证。
诸疮患久成漏，常有脓水不绝，其脓不臭，若无歹肉者，法用炮附子去皮尖，为细末，
以唾津和为饼，如三钱浓，安疮上，以艾炷灸之。漏大艾亦大，漏小艾亦小，但灸令微热，
不可令痛。干则易之，每灸一二十壮不论，灸后贴以膏药。隔二三日，又如前再灸，更服大
补气血之药，直至肉平为度。或用炮附子切片三分浓灸之亦可。或用江西淡豆豉为饼，多灸之亦效。
若疮久成漏，外有腐肉，内有脓管，不能收口者，以针头散和
作细条， 入口内，外用膏药贴之，待脓管尽去，自然渐平收口。或先用灸法，数日后用
此药亦可，仍内服十全大补等药。
郭氏灸法，疮疽久不收敛，及有脓水恶物，渐溃根深者，用白面、硫黄、大蒜三物，一
处捣烂，看疮大小捻作饼子，浓约三分，安于疮上，用艾炷灸二十一壮，一灸一易。后隔四
五日，用药锭针头散等药， 入疮内，歹肉尽去，好肉长平，然后贴收敛之药，内服应病
之剂，调理即瘥矣。
一男子，年逾二十，禀弱，左腿外侧患毒三月方溃，脓水清稀，肌肉不生，以十全大补
汤加牛膝，二十余剂渐愈。更以豆豉饼灸之，月余而痊。
一妇人，左臂结核，年余方溃，脓清不敛，一男子患贴骨痈，腿细短软，疮口不合，俱
用十全大补汤，外以附子饼及贴补药膏，调护得宜，百剂而愈。大凡不足证，宜大补之剂，
兼灸以补接阳气，祛散寒邪为上。
京师董赐，年逾四十，胸患疮成漏，日出脓碗许，喜饮食如常，以十全大补汤加贝母、
远志、白蔹、续断，灸以附子饼，脓渐少，谨调护岁余而愈。（薛按）
陈良甫说：痈疽的毒邪有浅有深，所以收敛愈合的速度有快有慢，绝对不可以过早使用收口药物。担心毒气未尽，日后必然复发，造成的祸患非常严重。如果痈疽久不愈合，疮肉苍白且脓液稀少，这是气血两虚，无法推动气血运行，导致疮口寒冷涩滞。每天用一把艾叶煎汤，避开风热清洗，并用烧松木产生的烟熏烤，或者用猪蹄汤清洗，再用神异膏贴敷，必须严格遵守禁忌进行调理，否则无效。他又说：脉象遇寒则下陷，凝滞在肌肉中，所以称为留连在肌肉腠理之间，这叫冷漏。需要用温补的方法治疗。
丹溪说：各条经络中只有少阳经和厥阴经发生痈疽时，需要特别防范，因为这两条经多气少血。血少则肌肉难以生长，所以疮口久久不能愈合，必定会演变成败证（危重证候）。如果反而使用攻逐泻利的毒药，来损伤阴分的血液，灾祸很快就会降临。
立斋说：肌肉由脾胃所主管。收敛功能是由气血所驱动的，只应当纯粹地补益脾胃，不宜广泛涂抹生肌的药物。如果疮口不生肌肉，且颜色赤红严重的，是血热，用四物汤加山栀、连翘。颜色苍白且无神色的，是气虚，用四君子汤加当归、黄芪。傍晚发热或内部发热，是阴血虚，用四物汤加人参、白术。脓水清稀，是气血虚，用十全大补汤。饮食减少、身体疲倦，是脾气虚，用补中益气汤。烦躁发热、口渴，但饮食正常，是胃火，用竹叶石膏汤（注：原文“竹叶黄”应为竹叶石膏汤之误或简写，此处依语境及后文“竹叶石膏汤”推断为清热剂，若严格按字面可译为Zhu Ye Huang Qi Tang，但中医常识多为竹叶石膏汤，此处保留原意并修正为常见方名以符合学术规范，或直译竹叶黄芪汤？原文后半段有“竹叶石膏汤”，前半段“竹叶黄”极可能是“竹叶石膏汤”的脱漏或“竹叶黄芪汤”。鉴于后文有明确“竹叶石膏汤”，前文“竹叶黄”结合“胃火”症状，通常指竹叶石膏汤或竹叶黄芪汤。此处按原文字面“竹叶黄”处理，但在英文中需准确对应。考虑到“胃火”且“饮食如常”，竹叶石膏汤更对症。但为了忠实原文，我将译为 Zhu Ye Huang (Bamboo Leaf and Huangqi) Decoction 或指出可能为 Zhu Ye Shi Gao Tang。根据上下文“不应，竹叶石膏汤”，说明前面那个不是竹叶石膏汤。前面是“竹叶黄”，可能是竹叶黄芪汤。暂译为 Zhu Ye Huang Decoction）。如果服用无效，改用竹叶石膏汤。发热口渴且小便频数，是肾水虚，用加减八味丸料煎服。如果腐肉去除后，新肉微红，四周有白色薄膜，这是胃中生发的正气，只需使用四君子汤来培补，那么不久自然就会收敛。如果胡乱使用生肌的药物，余毒未尽，反而会加重病情。殊不知疮疡的发生，是由于胃气不调；疮疡的溃破，是由于胃气的腐化作用；疮疡的收敛，是由于胃气的荣养作用。东垣说：胃是发生之源，是人生的根本。丹溪也说，治疗疮疡应当助胃壮气，使根本坚固。这话确实正确，能不谨慎吗？
他又说：如果肌肉受伤，而疮口不收敛，用六君子汤来补益脾胃。如果气虚恶寒而疮口不收敛，用补中益气汤来补益脾肺。如果血虚发热而疮口不收敛，用四物汤加人参、白术来滋养肝脾。如果脓多而疮口不收敛，用八珍汤，或十全大补汤，来养血益气。如果无效，只用四君子汤加当归、黄芪来补益脾胃。如果再无效，就属于命门火衰，急需使用八味丸来壮火生土。如果脉数且口渴，难治，因为真气虚而邪气实。
他又说：生肌的方法，应当先调理脾胃、辅助气血为主。如果气血俱虚不能生肌的，应当使用托里透脓的药剂。如果有风寒侵袭疮口不能生肌的，宜用豆豉饼灸法。如果有流注顽疮，内有脓管，或有瘀血，或有结核，须用针头散腐蚀腐肉，锭子效果尤其好。如果是背疮、杖疮、汤火疮大面积溃烂，应当使用神效当归膏，能够去腐生新止痛，大有神效。
他又说：痈疽溃破后，毒尽则肉自生。常见世上的医生，往往使用龙骨、血竭之类的药物以求生肌，却不知道余毒未尽，肌肉怎么能生长。气血既然已经虚弱，龙骨、血竭怎么能见效。假如脓毒未尽，就用生肌药，反而会增加溃烂。体质强壮、病情轻的，不过是再次溃破，或者延迟收敛而已。体质虚弱、病情重的，必定导致内攻，或者溃烂不收敛，反而导致危险。
他又说：凡是疮疡形成瘘管，都是因为元气不足，营气运行不畅。阳气虚寒，寒气逆犯肌肉深处，稽留在血脉中，腐烂溃破时间长久，就形成这种病患。所以凡是治疗不足的证候，在初患病时，应当内服人参、当归、白术，温补脾胃，外用桑枝葱熨法，接补阳气，使其自然消散。如果久了不能成脓，也用前两种方法，补助以加速成脓。如果脓已成但不溃破，用艾炷在患处正中心灸几壮使其排出脓液，然后服用十全大补汤。患者又应当谨慎起居，节制饮食，差不多就能收敛。如果用冷针穿刺，时间久了会从内部流出清脓，外部颜色黑黯。或者误用生肌散，加速疮口收敛，反而束缚了邪气，必定演变成败证。
各种疮患久成瘘管，常有脓水不绝，其脓不臭，如果没有坏肉的，用法是将炮附子去皮尖，研为细末，用唾液调和做成饼，厚约三分，放在疮上，用艾炷灸之。瘘管大艾炷也大，瘘管小艾炷也小，只要灸到微微发热，不可令疼痛。干了就更换，每次灸一二十壮不限次数，灸后贴上膏药。隔二三天，再像之前那样灸，同时服用大补气血的药物，直到肌肉平整为止。或者将炮附子切成三分厚的片来灸也可以。或者用江西淡豆豉做成饼，多灸几次也有效。
如果疮久成瘘，外有腐肉，内有脓管，不能收口的，用针头散和作细条，插入疮口内，外用膏药贴敷，待脓管完全去除，自然逐渐平整收口。或者先用灸法，数日后用此药也可以，仍然内服十全大补等药物。
郭氏灸法：疮疽久不收敛，且有脓水恶物，逐渐溃烂根深的，用白面、硫黄、大蒜三物，一处捣烂，看疮的大小捏成饼子，厚约三分，安放在疮上，用艾炷灸二十一壮，灸一次换一次。之后隔四五天，用药锭、针头散等药，插入疮内，坏肉尽去，好肉长平，然后贴收敛的药，内服应病的药剂，调理即可痊愈。
一个男子，年龄超过二十岁，体质虚弱，左腿外侧患毒三个月才溃破，脓水清稀，肌肉不生，用十全大补汤加牛膝，二十多剂后逐渐痊愈。再用豆豉饼灸法，一个多月后康复。
一个妇人，左臂有结核，一年多才溃破，脓清不收敛；一个男子患贴骨痈，腿细短软，疮口不合，都使用十全大补汤，外用附子饼及贴补药膏，调护得当，一百剂后痊愈。大凡不足的证候，宜用大补的药剂，兼用灸法来补接阳气，祛散寒邪为上策。
京城的董赐，年龄超过四十岁，胸部患疮形成瘘管，每天流出脓液约一碗，喜欢饮食如常，用十全大补汤加贝母、远志、白蔹、续断，用附子饼灸法，脓液逐渐减少，谨慎调护一年多的时间而痊愈。（薛己按语）
Chen Liangfu stated: The toxicity of carbuncles and sores varies in depth; therefore, the speed of healing and closure varies. It is absolutely inadvisable to use astringent agents for wound closure too early. One must fear that if the toxic pathogens are not fully expelled, they will inevitably recur later, causing severe harm. If a sore fails to heal for a long time, with pale flesh and scanty pus, this indicates deficiency of both Qi and Blood, failing to circulate and nourish, resulting in a cold and stagnant wound opening. Daily, boil a handful of Artemisia argyi Folium (Ai Ye, Mugwort Leaf) in water, wash the area while avoiding wind and heat, fumigate it with smoke from burning pine wood, or wash it with broth made from pig trotters. Then apply Shenyi Gao (Miraculous Ointment). Strict adherence to dietary and lifestyle taboos is required during recovery; otherwise, the treatment will be ineffective. He further stated: When the pulse sinks due to cold, stagnation occurs in the muscles, lingering in the muscle layers and interstices, termed "Cold Fistula" (Leng Lou). This requires warming and tonifying treatments.
Danxi stated: Among the meridians, only the Shaoyang (Lesser Yang) and Jueyin (Terminal Yin) meridians are prone to carbuncles and require special caution, as they are characterized by abundant Qi and scarce Blood. Scarce Blood makes muscle growth difficult; thus, if a wound fails to close for a long time, it will inevitably degenerate into a critical condition (Bai Zheng). If one mistakenly uses purgative or toxic drugs to attack the Blood of the Yin aspect, disaster will follow swiftly.
Lizhai stated: Muscles are governed by the Spleen and Stomach. Closure is driven by Qi and Blood. Therefore, one should purely tonify the Spleen and Stomach rather than indiscriminately applying topical agents for muscle regeneration. If a wound fails to regenerate flesh and appears intensely red, it is due to Blood Heat; treat with Siwu Tang (Four Substances Decoction) plus Gardeniae Fructus (Shanzhi) and Forsythiae Fructus (Lianqiao). If the color is pale and lacks luster, it is due to Qi Deficiency; treat with Sijunzi Tang (Four Gentlemen Decoction) plus Angelicae Sinensis Radix (Danggui) and Astragali Radix (Huangqi). Afternoon fever or internal heat indicates Yin Blood Deficiency; treat with Siwu Tang plus Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu). Clear and thin pus indicates Qi and Blood Deficiency; treat with Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction). Reduced appetite and physical fatigue indicate Spleen Qi Deficiency; treat with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Irritability, fever, and thirst with normal appetite indicate Stomach Fire; treat with Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction - *Note: Text says 'Zhuye Huang', likely referring to a variation or typo for Zhuye Shigao Tang, but translated literally here based on context of Stomach Fire*). If there is no response, switch to Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Fever, thirst, and frequent urination indicate Kidney Water Deficiency; treat with Jiaban Bawei Wan (Modified Eight-Ingredient Pill) decocted and taken orally. After necrotic tissue is removed, if new flesh is slightly red with a white membrane around the edges, this represents the generating Qi of the Stomach. Simply use Sijunzi Tang (Four Gentlemen Decoction) to cultivate and tonify, and the wound will naturally close within days. If one recklessly uses muscle-regenerating drugs while residual toxins remain, the condition will worsen. It is unknown that the occurrence of sores stems from disharmony of Stomach Qi; their ulceration results from the rotting action of Stomach Qi; and their healing results from the nourishing power of Stomach Qi. Dongyuan said: The Stomach is the source of generation and the root of life. Danxi also stated that treating sores requires supporting Stomach Qi and strengthening the body to ensure a solid foundation. These words are indeed true; can one not be cautious?
He further stated: If muscles are injured and the wound does not close, use Liujunzi Tang (Six Gentlemen Decoction) to tonify the Spleen and Stomach. If Qi Deficiency causes aversion to cold and the wound does not close, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to tonify the Spleen and Lungs. If Blood Deficiency causes fever and the wound does not close, use Siwu Tang (Four Substances Decoction) plus Renshen (Ginseng) and Baizhu (Atractylodes) to nourish the Liver and Spleen. If there is excessive pus and the wound does not close, use Bazhen Tang (Eight Treasures Decoction) or Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction) to nourish Blood and tonify Qi. If there is no response, use Sijunzi Tang (Four Gentlemen Decoction) plus Danggui (Angelica) and Huangqi (Astragalus) to tonify the Spleen and Stomach. If still ineffective, it belongs to Decline of Mingmen Fire (Gate of Life Fire); urgently use Bawei Wan (Eight-Ingredient Pill) to strengthen Fire to generate Earth. If the pulse is rapid and there is thirst, the prognosis is poor because True Qi is deficient while Pathogenic Qi is excess.
He further stated: The method of regenerating muscle should primarily focus on regulating the Spleen and Stomach and assisting Qi and Blood. If Qi and Blood are both deficient and unable to generate flesh, use formulas for supporting the interior and expelling toxins. If Wind-Cold invades the wound preventing regeneration, use Moxibustion with Fermented Soybean Cake (Dou Chi Bing). If there are stubborn sores with flowing abscesses containing sinus tracts, blood stasis, or nodules, use Zhitou San (Needle Head Powder) to cauterize necrotic tissue; using pills (Dingzi) is especially effective. For large ulcers such as back sores, cane beat injuries, or scalds/burns, use Shenxiao Danggui Gao (Miraculous Angelica Ointment), which removes necrotic tissue, generates new flesh, and relieves pain, showing great efficacy.
He further stated: After a carbuncle or sore ulcerates, once the toxin is exhausted, flesh regenerates naturally. Often, physicians use substances like Dragon Bone (Long Gu) and Dragon's Blood (Xuexie) seeking to promote healing, unaware that if residual toxins remain, flesh cannot grow. Since Qi and Blood are already deficient, how can Long Gu and Xuexie be effective? If pus and toxins are not fully cleared and astringents are applied, it will instead increase ulceration. In strong patients with mild conditions, it may merely cause re-ulceration or delayed healing. In weak patients with severe conditions, it will certainly lead to internal invasion, or persistent ulceration without healing, leading to danger.
He further stated: All chronic sores becoming fistulas are due to insufficiency of Yuan Qi (Original Qi) and disordered Ying Qi (Nutritive Qi). Yang Qi deficiency and cold cause Cold Qi to rebel into the muscle layers, stagnating in the blood vessels. Prolonged rotting and ulceration result in this condition. Therefore, when treating deficiency syndromes, at the initial stage, internally administer Renshen (Ginseng), Danggui (Angelica), and Baizhu (Atractylodes) to warm and tonify the Spleen and Stomach; externally apply Sangzhi Congyi (Moxibustion with Mulberry Branch and Scallion) to connect and supplement Yang Qi, allowing natural resolution. If suppuration fails to occur after a long time, use the aforementioned two methods to assist and accelerate the process. If pus has formed but not drained, apply moxa directly over the center of the lesion for several cones to drain it, then administer Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction). The patient must also be careful with daily routine and diet moderation to facilitate healing. If punctured with a cold needle, clear pus may emerge from inside after a long time, with dark black discoloration outside. Or if Mistakenly using astringent powders to accelerate closure, the pathogen is trapped, inevitably leading to a critical condition.
For various sores that have become chronic fistulas with continuous non-foul-smelling pus and no necrotic tissue, the method is to take processed Aconiti Lateralis Radix Praeparata (Pao Fuzi, Prepared Lateral Root of Aconite), remove skin and tips, grind into fine powder, mix with saliva to form a cake about 0.1 cm thick, place on the wound, and moxibustion. Larger fistulas require larger moxa cones; smaller ones require smaller cones. Moxa until slightly warm, not painful. Replace when dry. Moxa 10-20 cones per session without limit, then apply ointment. Repeat every 2-3 days, concurrently administering Great Tonifying Qi and Blood medicines until the flesh is level. Alternatively, slice processed Aconite to 0.1 cm thickness for moxibustion. Or use Jiangxi Dan Dou Chi (Light Fermented Soybean) cakes for frequent moxibustion, which is also effective.
If a chronic fistula has external necrotic tissue and internal sinus tracts preventing closure, mix Zhitou San (Needle Head Powder) into thin strips, insert into the wound, and cover with ointment externally. Wait until sinus tracts are completely removed, and the wound will gradually flatten and close. Alternatively, use moxibustion first, then this medicine after a few days, while continuing internal administration of Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction) and similar formulas.
Guoshi Moxibustion Method: For carbuncles and sores that fail to heal for a long time, with foul pus and deep-rooted ulceration, mix Bai Mian (White Flour), Liu Huang (Sulfur), and Da Suan (Garlic), pound into a paste. Shape into a cake according to the size of the sore, about 0.1 cm thick, place on the sore, and apply 21 moxa cones, replacing each time. After 4-5 days, insert medicinal pills or Zhitou San (Needle Head Powder) into the sore. Once necrotic tissue is gone and healthy flesh is level, apply astringent ointments and administer internal medicine corresponding to the disease. Recovery will follow with proper regulation.
A man, over twenty years old, with a weak constitution, developed a toxic swelling on the lateral aspect of his left leg, which ulcerated after three months. The pus was clear and thin, and flesh did not regenerate. He was treated with Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction) plus Achyranthis Bidentatae Radix (Niuxi) for more than twenty doses, gradually improving. He was then treated with moxibustion using Fermented Soybean Cake (Dou Chi Bing) and recovered in over a month.
A woman had a nodule on her left arm that ulcerated after more than a year, with clear pus and failure to heal. A man suffered from a deep-seated carbuncle on his leg, with a thin, short, and soft limb, and a wound that would not close. Both were treated with Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction), externally applied with Processed Aconite Cakes (Fuzi Bing) and tonifying plasters. With proper care, they healed after one hundred doses. Generally, for deficiency syndromes, Great Tonifying formulas combined with moxibustion to supplement Yang Qi and dispel Cold Evil are the best approach.
Dong Ci from Beijing, over forty years old, developed a fistula on his chest, draining about a bowl of pus daily. His appetite remained normal. He was treated with Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction) plus Fritillariae Bulbus (Beimu), Polygalae Radix (Yuanzhi), Ampelopsis Radix (Bailian), and Dipsaci Radix (Xuduan), along with moxibustion using Processed Aconite Cakes (Fuzi Bing). Pus gradually decreased, and he recovered after more than a year of careful regulation. (Commentary by Xue Ji)