汪省之曰∶夫肌肉，脾之主也，溃后收敛迟速者，乃气血盛衰使然。世人但知
生肌用龙、竭，止痛用乳、没，余谓不然。生肌之法，当先理脾胃，助气血为主，则
肌肉自生，岂假龙、竭之属！设若脓未尽，就用生肌，反生溃烂。壮者、轻者，不
过复溃，或迟敛而已；怯者、重者，必致内攻，或溃烂不敛者多矣。至于止痛之法，
热者清之，寒者温之，实者泻之，虚者补之，脓郁不出者开之，恶肉侵蚀者去之。如
是则痛自止，岂在乳、没然后痛止乎。（《理例》）
薛立斋曰∶夫肌者，脾胃之所主，收敛者，气血之所使，但当纯补脾胃，不宜
泛敷生肌之剂。夫疮不生肌而肿赤甚者，血热也，四物加山栀、连翘；色白而无神者，
气虚也，四君加归 ；晡热，阴血虚也，四物加参术；脓水稀者，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。若败血
去后，新肉微赤，四沿白膜者，此胃中生气也，用四君子汤以培补之，则不日而敛，
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。东垣曰∶胃乃生发之源，为人身之本。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！（《经验全书》）
冯鲁瞻曰∶凡肌肉伤而疮口不敛者，用六君子汤以补脾胃为主；或气虚恶寒而疮
口不敛者，用补中益气汤以补脾肺；若血虚发热而疮口不敛者，用四物参 以滋肝
脾∶若脓多而疮口不敛者，八珍汤或十全大补汤以养血气。经曰∶脾主肌肉，如前
药未应，但用四君、归、 以补脾胃；若更不应，乃下元阳虚，急用八味丸以壮火
生土；若脉数发渴者，难治，此真气虚而邪气实也。（《锦囊》）
又曰∶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，则不日而敛，盖疮疡之作，由胃气不调，疮疡之溃，由胃气腐化，疮疡之
敛，由胃气荣养。
汪省之说：肌肉，是脾脏所主管的器官，溃疡后伤口收敛速度的快慢，是由气血的盛衰决定的。世人只知道生肌（促进肉芽生长）使用血竭和儿茶，止痛使用乳香和没药，我认为不是这样。生肌的方法，应当先调理脾胃，以扶助气血为主，那么肌肉自然就会生长，哪里需要借助血竭、儿茶这类药物呢！如果脓液没有排尽，就使用生肌药物，反而会导致溃烂加重。体质强壮、病情轻浅的人，不过是再次溃破，或者收敛迟缓罢了；体质虚弱、病情深重的人，必然导致毒邪内攻，出现溃烂不愈合的情况非常多。至于止痛的方法，热证用清热法，寒证用温里法，实证用泻下法，虚证用补益法，脓液郁结不能排出者予以引流，腐肉侵蚀者予以清除。像这样疼痛自然停止，哪里在于非要用乳香、没药才能止痛呢。（出自《理例》）
薛立斋说：肌肤，由脾胃所主管，伤口收敛，是由气血的作用所致，只应当纯粹地补益脾胃，不宜广泛外敷生肌的药物。疮疡不长新肉且红肿严重的，是血热所致，用四物汤加入山栀、连翘；颜色苍白而无神气的，是气虚所致，用四君子汤加入当归；午后发热，是阴血虚所致，用四物汤加入人参、白术；脓水稀薄，是气血两虚所致，用十全大补汤；饮食减少、身体疲倦，是脾气虚所致，用补中益气汤；烦躁发热、口渴，但饮食正常，是胃火所致，用竹叶石膏汤，若无效，再用竹叶石膏汤（注：原文此处重复提及或指代不同侧重，依文意译为相应方剂）；发热口渴且小便频数，是肾水虚所致，用加减八味丸煎服。如果败血去除后，新长出的肉微微发红，四周有白色薄膜，这是胃中生发的正气，用四君子汤来培补它，那么不久就能愈合，如果妄用生肌的药物，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；疮疡的愈合，是由于胃气的荣养作用。李东垣说：胃是生发之源，是人身的根本。朱丹溪也说：治疗疮疡应当助胃壮气，使根本坚固，这话确实正确啊，能不谨慎吗！（出自《经验全书》）
冯鲁瞻说：凡是肌肉受伤而疮口不愈合的，用六君子汤以补益脾胃为主；如果是气虚恶寒而疮口不愈合的，用补中益气汤以补益脾肺；如果是血虚发热而疮口不愈合的，用四物汤加人参以滋养肝脾；如果脓多而疮口不愈合的，用八珍汤或十全大补汤以养血益气。经书说：脾主肌肉，如果前面的药物没有效果，只用四君子汤、当归、黄芪来补益脾胃；如果仍然没有效果，那是下元阳虚，急用八味丸以壮火生土（温补肾阳以健脾）；如果脉象数动且口渴，属于难治之症，这是真气虚而邪气实。（出自《锦囊》）
又说：如果腐肉去除后，新长出的肉微微发红，四周有白色薄膜，这是胃中生发的正气，只用四君子汤来培补它，那么不久就能愈合。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；疮疡的愈合，是由于胃气的荣养作用。
Wang Shengzhi stated: Flesh is governed by the Spleen. The speed of wound contraction after ulceration depends on the abundance or deficiency of Qi and Blood. People generally believe that using Dragon's Blood (Xuejie) and Catechu (Elaeocarpus) promotes flesh growth, while using Frankincense (Ruxiang) and Myrrh (Moyao) relieves pain. I disagree. The method for promoting flesh growth should first regulate the Spleen and Stomach and assist Qi and Blood as the primary approach; then flesh will grow naturally. Why rely on substances like Dragon's Blood and Catechu? If pus has not been fully discharged and astringent/flesh-promoting agents are applied prematurely, it may instead cause further ulceration. For those with strong constitutions or mild conditions, it may merely result in re-ulceration or delayed healing; for those with weak constitutions or severe conditions, it inevitably leads to internal invasion of pathogens, resulting in many cases of non-healing ulcers. Regarding pain relief, heat patterns require clearing heat, cold patterns require warming interior, excess patterns require purging, and deficiency patterns require tonifying. If pus is stagnated and cannot exit, it should be drained; if necrotic tissue is eroding, it should be removed. In this manner, pain will cease naturally. Does pain relief depend solely on Frankincense and Myrrh? (From *Li Li*)
Xue Lizhai stated: Skin and muscle are governed by the Spleen and Stomach, and wound contraction is driven by Qi and Blood. One should purely tonify the Spleen and Stomach and avoid indiscriminately applying topical flesh-promoting agents. If an ulcer fails to generate new tissue and presents with severe redness and swelling, it indicates Blood Heat; treat with Si Wu Tang (Four Substances Decoction) added with Gardenia (Zhizi) and Forsythia (Lianqiao). If the color is pale and lacks luster, it indicates Qi Deficiency; treat with Si Jun Zi Tang (Four Gentlemen Decoction) added with Angelica Sinensis (Danggui). Afternoon fever indicates Yin-Blood Deficiency; treat with Si Wu Tang added with Ginseng (Renshen) and Atractylodes (Baizhu). Thin pus indicates Qi and Blood Deficiency; treat with Shi Quan Da Bu Tang (Great Tonification Decoction). Poor appetite and fatigue indicate Spleen Qi Deficiency; treat with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Irritability, fever, and thirst with normal appetite indicate Stomach Fire; treat with Zhu Ye Huang Qin Tang (Bamboo Leaf and Scutellaria Decoction), or if ineffective, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction). Fever, thirst, and frequent urination indicate Kidney Water Deficiency; treat with Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill). Once necrotic blood is cleared and new flesh appears slightly red with a white membrane around the edges, this signifies the vital Qi of the Stomach. Use Si Jun Zi Tang (Four Gentlemen Decoction) to nourish and tonify it, and healing will occur within days. If one recklessly uses flesh-promoting drugs while residual toxins remain, the condition will worsen. It is unknown that the occurrence of sores and ulcers stems from disharmony of Stomach Qi; their ulceration results from the rotting action of Stomach Qi; and their healing results from the nourishing action of Stomach Qi. Li Dongyuan said: The Stomach is the source of generation and the root of the human body. Zhu Danxi also stated: When treating sores and ulcers, one must support the Stomach and strengthen Qi to solidify the root. This is indeed true; can one not be cautious? (From *Jing Yan Quan Shu*)
Feng Luzhan stated: For wounds where muscles are injured and the sore does not heal, use Liu Jun Zi Tang (Six Gentlemen Decoction) primarily to tonify the Spleen and Stomach. If Qi Deficiency causes aversion to cold and non-healing, use Bu Zhong Yi Qi Tang to tonify the Spleen and Lung. If Blood Deficiency causes fever and non-healing, use Si Wu Tang (Four Substances Decoction) added with Ginseng to nourish the Liver and Spleen. If there is excessive pus and non-healing, use Ba Zhen Tang (Eight Treasures Decoction) or Shi Quan Da Bu Tang to nourish Blood and Qi. The Classics state: The Spleen governs the flesh. If previous treatments fail, simply use Si Jun Zi Tang, Dang Gui, and Huang Qi to tonify the Spleen and Stomach. If there is still no response, it indicates Yang Deficiency in the Lower Yuan; urgently use Ba Wei Wan (Eight-Ingredient Pill) to strengthen Fire to generate Earth. If the pulse is rapid and there is thirst, it is difficult to treat, indicating True Qi Deficiency and Pathogenic Excess. (From *Jin Nang*)
He also stated: After necrotic tissue is removed, if new flesh is slightly red with a white membrane around the edges, this represents the vital Qi of the Stomach. Simply use Si Jun Zi Tang (Four Gentlemen Decoction) to nourish and tonify it, and healing will occur quickly. The occurrence of sores and ulcers is due to disharmony of Stomach Qi; their ulceration is due to the rotting action of Stomach Qi; and their healing is due to the nourishing action of Stomach Qi.