薛立斋曰∶凡疮疡有脓之际，乃肉腐而为脓，是毒瓦斯侵蚀而溃也，若不速去之，
恐毒瓦斯蓄而侵溃好肉，如肘膝枢纽关节之所，筋骨坏，废疾成也。有等畏针之徒，多
致不救，或密针之，或以赛针散，即透出脓极妙。
汪省之曰∶夫痈疽疮疖，皆由气血壅滞而生，当推虚实表里，而早治之，可以
内消。此内消之法，宜早治也。若毒瓦斯已结者，勿泥内消之法，当辨脓之有无深浅，
急宜酌量刺之，缓而不刺，毒则内攻，穿通脏腑，腐烂筋骨，可不慎哉。若脉紧为
脓未成，紧去但数，为脓已成；以手按之热者有脓，不热无脓；按之牢硬未有脓，按
之半软半硬已有脓；大软方是脓成，若大按之痛者，脓深，按之不甚痛者，脓未成；
按之即复痛者，为有脓，不复痛者，无脓；薄皮剥起者，脓浅，皮色不变不高阜者，脓
深。浅者宜砭，深者宜针，手足指梢及乳，必候脓大软，方可开放。若夫麻痘之后，余
毒未尽，肢节有痈，稍觉有脓，便用决破，迟则成挛曲之疾矣。（《理例》）
汪省之曰∶凡痈疽或已成，气血虚者，邪气深者，邪气散漫不能突起，亦难溃脓，
或破后脓少，或脓清稀，或坚硬不软，或虽得脓而根脚红肿开大，皆气血虚，邪气
盛，兼以六淫之邪变生诸证，必用内托，令其毒热出于肌表，则易愈也。内托以补药
为主，活血驱邪之药为臣，或以芳香之药，行其郁滞，或以温热之药，御其风寒。（《理例》）
周文采曰∶夫托者，起也，上也。痈毒之法，外之内者，邪必攻内，自然之理，
当用托里汤液加升麻、银花，使荣卫通行，
血脉调和，疮毒消散。故云疮家无一日不托里也。（《启玄》）
王肯堂曰∶痈疽已成，大抵托里消毒散、托里散、小托里散、十宣散皆为要药，
但用随时加减耳。如冬月并气滞之人，五香连翘汤，虚弱人去大黄；素不宜寒药者，
小五香汤；形脉实，脓色稠，不可用补药者，忍冬丸之类。大脓出，败肉去，红肿
消，当用人参、黄 、当归、白术大剂补之，令气血滋茂，新肉易生也。（《准绳》）
薛新甫曰∶有随证加减用药，例以托里消毒为主，诚内托之良法。
薛立斋说：凡是疮疡化脓的时候，是肌肉腐败化为脓液，这是毒气侵蚀导致溃破。如果不迅速去除它，恐怕毒气蓄积并侵蚀周围健康的肌肉，特别是在肘部、膝部等关节枢纽部位，会导致筋骨损坏，形成残疾。有些畏惧针刺的人，往往导致无法救治；或者用细针穿刺，或者使用赛针散（一种外用拔毒药物），让脓液透出，效果极好。
汪省之说：痈疽疮疖，都是由气血壅滞而生成的，应当推究虚实表里的情况，尽早治疗，可以使疮疡在内部消散。这种内消的方法，宜于早期治疗。如果毒气已经结聚，不要拘泥于内消的方法，应当辨别脓液的有无和深浅，急忙斟酌进行刺破排脓；拖延不刺，毒气就会向内攻伐，穿透脏腑，腐烂筋骨，怎么可以不谨慎呢？如果脉象紧，说明脓未形成；紧象消失但脉数，说明脓已形成；用手按压患处感觉发热的有脓，不发热的无脓；按压时坚硬牢固的没有脓，按压时半软半硬的已有脓；非常柔软才是脓成，如果重按才痛的是脓深，轻按不太痛的是脓未成；按压后疼痛立即复现的是有脓，不复现的是无脓；表皮薄而剥起的是脓浅，皮色不变且不高起的脓深。脓浅的用砭石法，脓深的用针法，手足指梢及乳房部位，必须等到脓液大而柔软，才可以开放引流。如果是麻疹、天花之后，余毒未尽，肢体关节出现痈肿，稍微觉得有脓，就立刻决破，拖延则会形成肢体挛曲残疾。（《理例》）
汪省之说：凡是痈疽，或者已经形成，气血虚弱的人，邪气深入的人，邪气散漫不能突起，也难以溃脓；或者破溃后脓液少，或者脓液清稀，或者坚硬不软，或者虽然得到脓液但根部红肿范围扩大，这些都是气血虚弱、邪气盛实，兼受六淫邪气变化产生各种证候，必须使用内托法，使毒热从肌表排出，这样容易痊愈。内托法以补益药为主，活血驱邪的药为辅助，或者用芳香的药物，疏通郁滞，或者用温热的药物，抵御风寒。（《理例》）
周文采说：所谓“托”，就是提起、上升的意思。治疗痈毒的方法，病邪由外向内的，邪气必然攻伐内脏，这是自然之理，应当使用托里汤液加入升麻、金银花，使营卫之气通行，血脉调和，疮毒消散。所以说治疮的人没有一天不运用托里法的。（《启玄》）
王肯堂说：痈疽已经形成，大抵上托里消毒散、托里散、小托里散、十宣散都是重要药物，只是根据时机随时加减罢了。比如冬季以及气机阻滞的人，用五香连翘汤，体虚的人去掉大黄；平时不宜用寒凉药的人，用小五香汤；形体脉象实证，脓液稠厚，不可用补药的人，用忍冬丸之类。脓液大量排出，败坏的肉去除，红肿消退，当用人参、黄芪、当归、白术大剂量补益，使气血滋长茂盛，新肉容易生长。（《准绳》）
Xue Lizhai stated: Whenever a sore or ulcer reaches the stage of suppuration, it is due to the corruption of flesh into pus, which is the result of toxic qi eroding and causing rupture. If this is not removed promptly, there is a risk that the toxic qi will accumulate and invade healthy tissue. In areas such as the elbows and knees, which are joint pivots, this can lead to damage of tendons and bones, resulting in disability. Some individuals who fear acupuncture often reach an incurable state; alternatively, using fine needles or applying Sai Zhen San (a topical drug for drawing out toxins) to allow pus to drain is extremely effective.
Wang Shengzhi stated: Carbuncles, ulcers, sores, and boils all arise from the stagnation of Qi and Blood. One should assess deficiency and excess, exterior and interior conditions, and treat them early to achieve internal resolution. This method of internal resolution is best applied early. However, if toxic qi has already condensed, one should not rigidly adhere to internal resolution methods. Instead, one must distinguish the presence and depth of pus and promptly decide on puncturing. Delaying puncture allows toxic qi to attack inward, penetrating viscera and rotting tendons and bones; how can one be careless? A tight pulse indicates that pus has not yet formed; when the tightness disappears but the pulse becomes rapid, it indicates that pus has formed. Pressing the area with heat suggests the presence of pus, while lack of heat suggests its absence. Firm hardness upon pressing indicates no pus, whereas semi-softness indicates pus is present. Extreme softness signifies mature pus. Severe pain only upon deep pressure indicates deep-seated pus, while mild pain upon light pressure indicates immature pus. Pain that returns immediately after releasing pressure indicates pus, whereas pain that does not return indicates no pus. Thin, peeling skin indicates superficial pus, while unchanged skin color and lack of elevation indicate deep pus. Superficial pus is treated with Bian stone therapy, while deep pus requires needle drainage. For fingertips, toes, and breasts, one must wait until the pus is abundant and soft before opening for drainage. Following smallpox or measles, if residual toxicity remains and carbuncles appear in the limbs and joints, once slight suppuration is felt, immediate incision is necessary; otherwise, it may lead to contracture deformities. (From *Li Li*)
Wang Shengzhi further stated: Regarding carbuncles and ulcers that have already formed, in cases of Qi and Blood deficiency, deep pathogenic factors, or diffuse pathogens that fail to protrude and are difficult to suppurate, or where post-incision pus is scanty, thin, or the area remains hard without softening, or where the base of the ulcer is red, swollen, and expanding despite suppuration, these are signs of Qi and Blood deficiency combined with excessive pathogenic factors and transformations caused by the Six Exogenous Pathogens. In such cases, Internal Support (Nei Tuo) therapy must be used to expel toxic heat through the muscle layer, facilitating recovery. Internal Support therapy primarily uses tonifying herbs, with blood-invigorating and pathogen-expelling herbs as adjuncts. Alternatively, aromatic herbs may be used to resolve stagnation, or warm herbs to ward off wind and cold. (From *Li Li*)
Zhou Wencai stated: The term "Tuo" (Support/Prop up) implies lifting and raising. When treating carbuncle toxicity, if the pathogen moves from the exterior to the interior, the pathogen naturally attacks the interior. This is a natural principle. Therefore, one should use Toli Decoction (Interior-Supporting Liquid) supplemented with Rhizoma Cimicifugae (Shengma) and Flos Lonicerae Japonicae (Yinhua) to promote the circulation of Ying and Wei, harmonize the blood vessels, and dissipate carbuncle toxicity. Thus, it is said that those treating sores must employ Interior Support daily. (From *Qi Xuan*)
Wang Kentang stated: Once carbuncles and ulcers have formed, formulas such as Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder), Tuoli San (Interior-Supporting Powder), Xiao Tuoli San (Minor Interior-Supporting Powder), and Shixuan San (Ten-Accumulations Powder) are essential medications, subject to modification based on timing and condition. For instance, in winter or for patients with Qi stagnation, Wuxiang Lianqiao Tang (Five-Aromatic and Forsythia Decoction) is suitable; for weak patients, remove Rhizoma et Radix Rhei (Dahuang); for those generally intolerant to cold-natured drugs, use Xiao Wuxiang Tang (Minor Five-Aromatic Decoction); for patients with substantial form and pulse, thick pus, and contraindications for tonification, use pills such as Rendong Wan (Honeysuckle Pill). Once large amounts of pus are discharged, necrotic tissue is removed, and redness and swelling subside, large doses of Radix Ginseng (Renshen), Radix Astragali Membranacei (Huangqi), Radix Angelicae Sinensis (Danggui), and Rhizoma Atractylodis Macrocephalae (Baizhu) should be administered to tonify vigorously, ensuring the abundance of Qi and Blood to facilitate the growth of new tissue. (From *Zhun Sheng*)
Xue Xinpu stated: There are modifications of prescriptions according to symptoms, generally centering on Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder), which is indeed an excellent method of Internal Support.