薛立斋曰∶凡疠疡，当知有变有类之不同，而治法有汗有下，有砭刺攻补之不一。盖兼
证当审轻重，变证当察先后，类证当详真伪，而汗、下、砭刺、攻补之法，又当量其人之虚
实，究其病之原委而施治之。盖虚者，形气虚也；实者，病气实而形气未必实也。
一、疠疡砭刺之法，子和张先生谓∶一汗抵千针。盖以砭血不如发汗之周遍也。然发汗
即出血，出血即发汗，二者一律。若恶血凝滞在肌表经络者，宜刺宜汗，取委中出血则效。
若恶毒蕴结于脏腑，非荡涤其内则不能痊。若毒在外者，非砭刺遍身患处及两臂腿腕，两手
足指缝各出血，其毒必不能散。若表里俱受毒者，非外砭内泄，其毒决不能退。若上体多，
宜用醉仙散，取其内蓄恶血从齿缝中出，乃刺手指缝并臂腕，以去肌表毒血。若下体多，宜
用再造散，令恶血陈虫从谷道中出，仍针指足缝并腿腕，隔一二日更刺之，以血赤为度。如
有寒热头痛等证，当大补气血为主。
一、疠疡服轻粉之剂，若腹痛去后，兼有脓秽之物，不可用药止之。若口舌肿痛，秽水
时流，作渴、发热喜冷。此为上焦热毒，宜用泻黄散。若寒热往来，宜用小柴胡汤加知母。
若口齿缝出血，发热而大便秘结，此为热毒内淫，宜用黄连解毒汤。若大便调和，用《局方
》犀角地黄汤。若秽水虽尽，口舌不愈，或发热作渴而不饮冷，此虚热也，宜七味白术散。
一、疠疡手足腿臂或各指拳挛者，由阴火炽盛，亏损气血，当用加味逍遥散加生地黄，
及换肌散兼服。
一、疠疡生虫者，以五方风邪翕合，相火制金，金衰不能平木，所以化虫。内食五脏，
而证则见于外也。宜用升麻汤送泻清丸，或桦皮散以清肺肝之邪。外灸承浆，以疏阳明、任
脉，则风热息而虫不生矣。若肝经虚热者，佐以加味逍遥散、六味地黄丸。
徐东皋曰∶经云∶汗之则疮已。况癞之为风，尤疮之最恶者。故曰∶疠风诸疮热久，热
则生风，且疠风尤染肃杀之气而成者，若非汗法，何以去其毒风？所以汗之一法，乃治疠之
最要者。其余诸方，次第用之可也。凡患人身上痒甚，盖以风邪气郁，血不荣敷而然，宜四
物汤加黄芩、白芷调浮萍末服，发汗而愈。
一、疠风灸法，先服桦皮散，自少至多，服五七日，灸承浆穴七壮。灸疮愈后，再灸之
。凡三灸之后，服二圣散泄热，祛血中之风邪，时更以升麻汤送下泻清丸为佳。倘年深日久
，即以愈风丹、换骨丹等方，详而用之。
一、凡大风初起，头面搔痒，更有红紫疹块起者，即可服防风通圣散加苦参、天麻、蝉
蜕数十帖，外用七珍汤浴洗，发汗则易愈。大忌五辛荤腥浓味半年，必不再发。
薛立斋说：凡是治疗疠疡（麻风及严重皮肤疮疡），应当知道病情有变化与相似的不同，治疗方法包括发汗、攻下、砭刺、攻邪和补益等，各不相同。对于兼夹证候应当审察其轻重，对于变证应当观察其先后顺序，对于类似证候应当详细辨别真伪；而发汗、攻下、砭刺、攻邪和补益的方法，又应当根据患者的虚实情况，探究疾病的根源来实施治疗。所谓“虚”，是指形体和气机虚弱；所谓“实”，是指病邪气盛，但形体和气机未必强实。
一、治疗疠疡使用砭刺法，子和张先生认为：一次发汗的效果抵得上千次针刺。这是因为放出瘀血不如发汗那样周身遍达。然而发汗即相当于出血，出血即相当于发汗，两者原理一致。如果恶血凝滞停留在肌表和经络中，适宜采用针刺或发汗法，取委中穴放血则有效。如果恶毒蕴结在脏腑内部，不荡涤清除内脏毒素就不能痊愈。如果毒邪在体表，不通过砭刺遍身患处以及双臂、双腿手腕、双手足指缝各处放血，毒邪必然不能消散。如果表里都受毒邪侵袭，不通过外部砭刺和内部泄毒，毒邪决不能消退。如果上部症状多，适宜使用醉仙散，取其让体内蓄积的恶血从齿缝中排出，同时针刺手指缝和手臂手腕，以去除肌表的毒血。如果下部症状多，适宜使用再造散，令恶血和陈旧的虫体从肛门排出，仍然针刺手指、足趾缝隙以及腿部手腕，隔一二日再次针刺，直到血液颜色由暗红转为鲜红为止。如果有寒热、头痛等症状，应当以大补气血为主。
二、治疗疠疡服用含有轻粉的药物后，如果出现腹痛并伴有脓液污秽之物排出，不可用药止泻。如果口舌肿痛，秽水时常流出，口渴、发热且喜冷饮，这是上焦热毒，适宜使用泻黄散。如果寒热往来，适宜使用小柴胡汤加知母。如果口齿缝出血，发热且大便秘结，这是热毒内侵，适宜使用黄连解毒汤。如果大便调和，使用《局方》中的犀角地黄汤。如果秽水排尽后，口舌仍未愈合，或者发热口渴但不喜冷饮，这是虚热，适宜使用七味白术散。
三、疠疡患者手足、腿臂或各个手指出现拳挛拘急，是由于阴火炽盛，亏损了气血，应当使用加味逍遥散加生地黄，以及换肌散配合服用。
四、疠疡生出虫体，是因为五方风邪聚合，相火克制肺金，导致金气衰弱不能平抑肝木，所以化生虫体。虫体在内侵蚀五脏，而症状则表现在外。适宜使用升麻汤送服泻清丸，或者使用桦皮散以清除肺肝之邪。外部艾灸承浆穴，以疏通阳明经和任脉，这样风热平息而虫体不生。如果是肝经虚热，辅助使用加味逍遥散、六味地黄丸。
徐东皋说：医经云：“发汗则疮愈。”何况癞病属于风邪所致，更是疮疡中最恶劣的一种。所以说：疠风诸疮日久发热，热极生风，且疠风尤其容易沾染肃杀之气而成，如果不是用发汗法，怎么能去除其中的毒风？所以发汗这一方法，是治疗疠风最重要的手段。其余各种方剂，按次序使用即可。凡是患病者身上瘙痒严重，这是由于风邪气机郁滞，血液不能濡养肌肤所致，适宜使用四物汤加黄芩、白芷调服浮萍末，发汗后即可痊愈。
一、治疗疠风的灸法，先服用桦皮散，剂量由少逐渐增多，服用五到七天，然后艾灸承浆穴七壮。灸疮愈合后，再行艾灸。经过三次艾灸之后，服用二圣散以泄热，祛除血中的风邪，期间更适宜用升麻汤送服泻清丸。如果病程长久，就详细使用愈风丹、换骨丹等方剂。
一、凡是大风初起，头面部搔痒，更有红紫色疹块出现的，就可以服用防风通圣散加苦参、天麻、蝉蜕数十帖，外用七珍汤洗浴，发汗则容易痊愈。严格忌食五辛、荤腥及浓味食物半年，必定不再复发。
Xue Lizhai stated: In the treatment of li yang (leprosy and severe skin ulcers), one must understand that there are differences between variations and similar presentations, and treatment methods vary among diaphoresis (sweating method), purgation, bloodletting with stone needles, attacking pathogens, and tonification. For concurrent syndromes, one must assess their severity; for transformed syndromes, one must observe their sequence; for similar syndromes, one must carefully distinguish truth from falsehood. Furthermore, the methods of diaphoresis, purgation, bloodletting, attacking, and tonifying must be applied according to the patient's deficiency or excess, investigating the root cause of the disease. "Deficiency" refers to weakness in form and Qi; "excess" refers to an abundance of pathogenic Qi, though the form and Qi may not necessarily be robust.
1. Regarding the use of bloodletting with stone needles for li yang, Zhang Hezi stated: One instance of diaphoresis is equivalent to a thousand needle pricks. This is because releasing blood is less comprehensive than inducing sweating. However, diaphoresis is akin to bleeding, and bleeding is akin to diaphoresis; they are essentially the same principle. If evil blood stagnates in the muscle layers and meridians, both needling and diaphoresis are suitable; taking blood from Weizhong (BL40) yields effective results. If toxic heat accumulates within the Zang-Fu organs, internal purification is required for recovery. If toxins reside on the exterior, blood must be released from all affected areas on the body, as well as the wrists of both arms, ankles of both legs, and the spaces between fingers and toes; otherwise, the toxin will not dissipate. If both interior and exterior are affected by toxins, external bloodletting combined with internal purgation is necessary to eliminate the toxin. If symptoms predominate in the upper body, Zuixian San (Intoxicating Immortal Powder) should be used to allow accumulated evil blood to exit through the gum margins, while simultaneously pricking the finger webs and arm wrists to remove superficial toxic blood. If symptoms predominate in the lower body, Zaizao San (Reconstruction Powder) should be used to expel evil blood and old worms via the anus, while still pricking the finger/toe webs and leg/ankle wrists; repeat pricking every one to two days until the blood turns bright red. If accompanied by aversion to cold, fever, headache, etc., primary treatment should focus on greatly tonifying Qi and Blood.
2. After administering medicines containing calomel (light powder) for li yang, if abdominal pain occurs followed by the discharge of pus and foul matter, do not use medication to stop the diarrhea. If there is swelling and pain in the mouth and tongue, continuous flow of foul saliva, thirst, fever, and a preference for cold drinks, this indicates toxic heat in the Upper Jiao; Xiehuang San (Drain Yellow Powder) is appropriate. If there is alternating chills and fever, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Zhimu (Anemarrhena Rhizome) is appropriate. If bleeding occurs from the gum margins, accompanied by fever and constipation, this indicates internal invasion of toxic heat; Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) is appropriate. If bowel movements are normal, Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) from the *Ju Fang* is appropriate. If the foul discharge has ceased but the mouth and tongue remain unhealed, or if there is fever and thirst without a desire for cold drinks, this is deficient heat; Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) is appropriate.
3. When li yang patients experience spasms and curling of the hands, feet, legs, arms, or individual fingers, it is due to blazing Yin fire damaging Qi and Blood. Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) added with Shengdihuang (Rehmanniae Radix Recens) should be taken, along with Huanji San (Muscle-Replacing Powder).
4. The emergence of worms in li yang results from the convergence of wind pathogens from the five directions, where Ministerial Fire suppresses Lung Metal. As Metal becomes deficient, it fails to control Liver Wood, leading to the generation of worms. These worms internally damage the Zang organs, while manifestations appear externally. Shengma Tang (Cimicifuga Decoction) should be used to administer Xieqing Wan (Clearing Down Pills), or Huapi San (Birch Bark Powder) should be used to clear pathogens from the Lungs and Liver. External moxibustion at Chengjiang (CV24) helps unblock the Yangming and Ren Mai meridians, causing wind-heat to subside and worms to cease growing. For Liver channel deficient heat, add Jiawei Xiaoyao San and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia).
Xu Donggao stated: The classics say, "Diaphoresis cures sores." Moreover, leprosy is caused by wind and is the most malignant of sores. Thus, it is said: Long-standing heat in leprosy sores generates wind, and leprosy is particularly formed by inhaling killing autumnal qi. Without the diaphoretic method, how can toxic wind be expelled? Therefore, diaphoresis is the most crucial method for treating leprosy. Other formulas should be used sequentially. Severe itching on the body of patients is due to wind pathogen stagnation and blood failing to nourish the skin. Siwu Tang (Four Substances Decoction) added with Huangqin (Scutellaria Root) and Baizhi (Angelica Dahurica) should be taken with Fuping (Duckweed) powder to induce sweating and achieve cure.
1. For moxibustion therapy in leprosy, first take Huapi San, gradually increasing the dose over five to seven days. Then apply moxibustion to Chengjiang (CV24) with seven moxa cones. After the moxa blisters heal, repeat the moxibustion. After three rounds of moxibustion, take Ersheng San (Two Sages Powder) to drain heat and expel wind pathogens from the blood; during this time, it is best to take Xieqing Wan using Shengma Tang as a vehicle. If the disease has persisted for many years, detailed use of Yufeng Dan (Wind-Dispelling Pill) and Huangu Dan (Bone-Changing Pill) is recommended.
1. When Da Feng (Great Wind/Leprosy) first begins, with itching on the head and face and the appearance of red-purple rash patches, Fangfeng Tongsheng San (Saposhnikovia Decoction for Unblocking and Generating) added with Kushen (Sophora Root), Tianma (Gastrodia Rhizome), and Chantui (Cicada Slough) should be taken for dozens of doses. Externally, wash with Qizhen Tang (Seven Treasures Decoction). Inducing sweating facilitates easier recovery. Strictly avoid pungent spices, meat, fish, and strong flavors for half a year to prevent recurrence.