凡揩脓水垢纸，必须入一竹篮中，挂透风处，但腐肉瘀脓，皆人之气血所变者，
日中晒之，则疮口痛，放在湿处，则脓水不干，待平愈之后，用干柴一束烧之。
澄曰∶初起肿疡者，乃痈疽恶毒，始发壅肿，七日之内，未成脓者，目曰肿疡，
施治之早，仅可内消十之六七，纵不能全消，亦可移深居浅，转重就轻。但不可骤
用寒凉敷药，冰凝肌肉，更勿轻投苦寒丸剂，凝滞气血，遏郁毒瓦斯，便难消散。若
已八九朝，内脓已成，治无消法，若勉强消之，不独不能消散，反致气血受亏，根
脚散漫，内脓不能外泄，脓汁清稀。所以消肿疡之法，贵乎早也。
王肯堂曰∶痈疽之证，发无定处，欲令内消于初起红肿结聚之际，施行气活血、
解毒消肿之药是也。当审浅深大小，经络处所，形脉虚实。如发于脑、背、腰、项、
臀、 者，乃太阳经也，宜黄连、羌活。背连胁处，为近少阳，宜柴胡，并宜败毒散、
仙方活命饮。形实脉实者，宜漏芦汤、内疏黄连汤、追毒丸疏利之。气虚者，参
为主，血虚者，归芎为主，佐以消毒之药，随分野以引经药行至病所。六经分野，上
有痈疽，其五经各随本经标本寒温，气血多少，以行补泻。惟少阳一经，虽曰气多
血少，而气血皆不足也，治与气虚血虚同法。凡栝蒌、射干、穿山甲、金银花、夏
枯草、蟾酥、连翘、地丁、鼠粘子、木鳖子之类，为内消之药。仙方活命饮、内消
丸、柞木饮子、牛胶饮子、车辙散、返魂
丹、消毒饮，为内消之方，众皆知之。殊不知补泻虚实，平治寒温，使气血各得其
常，则可内消也。其外用紫葛汤淋洗，及用散涂膏贴者，亦使气血和平，而肿消热退也。
李东垣曰∶夫痈疽丹肿之生，皆由阴阳不调，营卫凝涩，气血不流之所生也。古
人有言曰∶阳滞于阴则生疮，阴滞于阳则生疽。疮疽之生，有内有外，内生于脏腑
胸腹之中，外生于肤肉筋骨之表，发无定处。夫郁滞之本，则因气血不流，蒸气不
能外达，留滞而成内热，疮疽所生焉。若初觉气血郁滞，皮肉结聚，肿而不溃时，可
疏涤风热，通利脏腑，一二行后，徐次用诸汤 渍，即得内消矣。不然，则治之稍
慢，毒热不散，反攻其内，致令脓血之聚也。《内经》谓∶治病必求于本。盖疮疽本
乎中热之郁结不通也，其风邪寒气所聚也，治之宜温热之剂和血令内消也。辨之有法，
须认风寒则肿硬色白，热毒则 肿色赤，以为异也。如有气已结聚，不可用内消之法，
宜用排脓托毒之药，此皆先后之次也。
又曰∶消者，灭也，灭其形证也。经曰∶诸痛痒疮疡，皆属心火。火者，离卦
也。离者，外阳而内阴，内阴壅滞，必然外攻，治当内消，使绝其源而清其内，不
令外发，故云内消。乃初起微觉之时，即以汤液丸散，内服外敷，疏其源，绝其毒，
实时消散，如形证已成，不用此法也。
程山龄曰∶内消者，肿毒初起，即用药消散也。凡病痈疽、发背、对口、疔毒，
其初起憎寒壮热，有似伤寒，而痛偏着一处，饮食如常者，蓄积有脓也。当初起时，
脓尚未成，不过气血乖违，逆于肉理耳。外敷远志膏，或金黄如意散、铁箍散，或贴
普救万全膏；内服银花甘草汤，或内消散，实时消散。若系疔疮，即宜刺破，或艾灸
肿处，上搽蟾酥饼，贴以万全膏，内服菊花甘草汤，随即平伏。菊花连根带叶，皆
治疔疮之圣药也。其中亦有挟风寒而发者，又宜先用荆防散，或芎芷香苏饮，冬月万
灵丹以散之。随服银花、菊花等药，即可内消，务须及早下手，不可迟滞。（《十法》）
凡是擦拭脓水、污垢的纸张，必须放入一个竹篮中，悬挂在通风透气的地方。因为腐肉和瘀积的脓液，都是人体气血变化而成的产物。如果在正午阳光下暴晒，会导致疮口疼痛；如果放置在潮湿处，则脓水无法干燥。待患者完全平复痊愈之后，再用一束干柴将其焚烧处理。
顾世澄说：初起阶段的肿疡，是指痈疽恶毒刚开始发作，出现壅塞肿胀。在七天之内，尚未化脓的，称为“肿疡”。此时施治越早，仅靠内消法就能消除六七成的病情。即使不能完全消除，也能使病位由深变浅，病情由重转轻。但是，不可突然使用寒凉的外敷药物，以免导致肌肉冰凝；也不要轻易投用苦寒的内服丸剂，以免凝滞气血，遏制郁结的毒气，从而导致难以消散。如果已经过了八九天，内部脓液已经形成，治疗就不适用内消法了。如果勉强使用内消法，不仅不能消散，反而会导致气血亏损，疮根散漫，内部脓液无法向外排泄，脓汁变得清稀。所以，治疗消肿疡的方法，贵在早期干预。
王肯堂说：痈疽这类病症，发病没有固定的位置。想要在其初起红肿结聚之时实现内消，应当施行行气活血、解毒消肿的药物。此时应当审察病位的深浅、大小以及所在的经络部位，辨别形证和脉象的虚实。例如，发于脑、背、腰、项、臀、腿部的，属于太阳经病变，适宜使用黄连、羌活。背部连接胁肋处的，靠近少阳经，适宜使用柴胡，并配合使用败毒散、仙方活命饮。形体壮实、脉象有力的，适宜使用漏芦汤、内疏黄连汤、追毒丸来疏通利导。气虚的，以人参为主药；血虚的，以当归、川芎为主药，佐以消毒的药物，根据经络分野选用引经药引导药力到达病所。六经的分野规律是：上部发生痈疽，其余五经各自跟随本经标本的寒热属性，以及气血的多少，来进行补泻治疗。只有少阳一经，虽然说是气多血少，但实际上气血都不足，治疗方法与气虚血虚相同。凡是栝蒌、射干、穿山甲、金银花、夏枯草、蟾酥、连翘、地丁、鼠粘子（牛蒡子）、木鳖子之类的，作为内消的药物。仙方活命饮、内消丸、柞木饮子、牛胶饮子、车辙散、返魂丹、消毒饮，作为内消的方剂，众人都知道。却不知道补泻虚实、平治寒温，使气血各得其常，才能实现内消。其外用紫葛汤淋洗，以及使用散剂涂抹、膏药贴敷的，也是为了使气血平和，从而消肿退热。
李东垣说：痈疽丹肿的产生，都是由阴阳不调、营卫凝涩、气血不流通所造成的。古人有话说：阳气阻滞于阴分则生疮，阴气阻滞于阳分则生疽。疮和疽的产生，有在内和在外的区别，内生在于脏腑胸腹之中，外生于皮肤肌肉筋骨之表，发病没有固定位置。这种郁滞的根本原因，是因为气血不流通，蒸腾之气不能向外达出，留滞而成内热，从而产生疮疽。如果刚感觉到气血郁滞，皮肉结聚，肿胀但未溃破时，可以疏涤风热，通利脏腑，经过一两次治疗后，再慢慢使用各种汤剂浸泡，即可实现内消。否则，如果治疗稍慢，毒热不散，反而攻入体内，导致脓血积聚。《内经》说：治病必求于本。大概疮疽的本源是中焦热毒的郁结不通，以及风邪寒气的聚集，治疗宜用温热性质的药物调和气血，使其内消。辨别的方法是有规律的，必须认清：风寒所致则肿胀坚硬、颜色发白；热毒所致则肿胀、颜色发红，以此作为区别。如果有气机已经结聚，不可再用内消法，适宜使用排脓托毒的药物，这是治疗的先后次序。
又说：所谓“消”，就是消灭，消灭其形态和症状。经书说：所有的痛、痒、疮疡，都属于心火。火，对应八卦中的离卦。离卦的特点是外阳而内阴，内部阴气壅滞，必然向外攻冲，治疗应当内消，切断其源头并清解内部，不让其向外发散，所以叫作内消。这是在初起微觉不适的时候，立即以汤液、丸、散内服，配合外敷，疏通源头，断绝毒气，实时消散。如果形态症状已经形成，就不再用这种方法了。
程山龄说：内消，是指肿毒初起时，立即用药使其消散。凡是患有痈疽、发背、对口疔、疔毒的，初起时憎寒壮热，症状类似伤寒，但疼痛偏着于一处，饮食如常的，说明蓄积已有脓液。但在初起阶段，脓尚未形成，不过是气血乖违，逆乱于肌肉纹理之间罢了。外敷远志膏，或金黄如意散、铁箍散，或贴普救万全膏；内服银花甘草汤，或内消散，即可实时消散。如果是疔疮，就应当刺破，或者艾灸肿胀处，上搽蟾酥饼，贴以万全膏，内服菊花甘草汤，随即平伏。菊花连根带叶，都是治疗疔疮的圣药。其中也有夹杂风寒而发的，又适宜先用荆防散，或芎芷香苏饮，冬季可用万灵丹来疏散。随后服用金银花、菊花等药物，即可内消，务必及早下手，不可迟滞。（出自《十法》）
Whenever wiping pus and soiled paper, it is necessary to place them in a bamboo basket and hang them in a well-ventilated area. This is because necrotic flesh and stagnant pus are all transformations of the body's Qi and Blood. If exposed to the sun at noon, it will cause pain in the wound; if placed in a damp area, the pus will not dry up. After the patient has completely recovered, burn them with a bundle of dry firewood.
Gu Shicheng said: Swollen ulcers (Zhongyang) in the initial stage refer to carbuncles and malignant sores that have just started to develop, presenting with congestion and swelling. Within seven days, before suppuration occurs, they are called "Swollen Ulcers" (Zhongyang). Early treatment allows for internal resolution (Neixiao) of 60-70% of the condition. Even if complete resolution is not achieved, it can shift the pathology from deep to superficial and from severe to mild. However, one must not suddenly use cold-natured external compresses, which would cause ice-like coagulation of the muscle tissue; nor should bitter-cold pills be lightly administered, as this would stagnate Qi and Blood and suppress the郁结 toxic vapors, making resolution difficult. If eight or nine days have passed and internal pus has formed, the method of internal resolution is no longer applicable. Forcing internal resolution at this stage will not only fail to resolve the condition but also deplete Qi and Blood, causing the root of the sore to scatter and the internal pus to fail to drain externally, resulting in thin and clear pus. Therefore, the key to treating swollen ulcers lies in early intervention.
Wang Kentang said: The manifestations of carbuncles and malignant sores appear without fixed locations. To achieve internal resolution during the initial stage of redness, swelling, and aggregation, one should administer herbs that promote Qi circulation and blood activation, detoxify, and reduce swelling. One must examine the depth, size, and meridian location, as well as assess the excess or deficiency in the physical constitution and pulse. For instance, lesions on the head, back, waist, neck, buttocks, and thighs belong to the Taiyang Meridian and are suitable for Huanglian (Coptis Rhizome) and Qianghuo (Notopterygium Rhizome). Lesions on the back extending to the hypochondrium are close to the Shaoyang Meridian and are suitable for Chaihu (Bupleurum Root), along with Baidu San (Detoxification Powder) and Xianfang Huoming Yin (Immortal Life Decoction). In cases of robust physique and excess pulse, Loulu Tang (Arnebia Decoction), Neishu Huanglian Tang (Internal Draining Coptis Decoction), and Zhuodu Wan (Toxin-Chasing Pill) are suitable for unblocking and draining. For Qi deficiency, Renshen (Ginseng Radix et Rhizoma) is the primary herb; for Blood deficiency, Danggui (Angelica Sinensis Radix) and Chuanxiong (Ligusticum Chuanxiong Rhizoma) are primary, assisted by detoxifying herbs. According to the meridian distribution, select guiding herbs to lead the medicinal power to the disease site. Regarding the six meridians: when carbuncles occur in the upper body, the other five meridians follow their respective meridian characteristics of cold/heat and the abundance/scarcity of Qi and Blood for tonification or purgation. Only the Shaoyang Meridian, although described as having abundant Qi and scarce Blood, actually suffers from insufficiency of both Qi and Blood; its treatment follows the same principles as Qi and Blood deficiency. Herbs such as Gualou (Trichosanthes Fruit), Shegan (Belamcanda Rhizome), Chuanshanjia (Pangolin Scales), Jinyinhua (Lonicerae Flos), Xiakucao (Prunellae Spica), Chansu (Toad Venom), Lianqiao (Forsythiae Fructus), Diding (Violae Herba), Niuzi (Arctii Fructus), and Muguaizi (Strychni Semen) serve as internal resolution agents. Formulas such as Xianfang Huoming Yin (Immortal Life Decoction), Neixiao Wan (Internal Resolution Pill), Zhamu Yinzi (Zelkova Decoction), Niujiao Yinzi (Ox Horn Decoction), Cheche San (Cart Track Powder), Fanhun Dan (Soul-Returning Elixir), and Xiaodu Yin (Detoxification Decoction) are known internal resolution formulas. However, one must understand that balancing tonification/purgation and excess/deficiency, and regulating cold/heat to restore Qi and Blood to their normal state, is what enables internal resolution. External applications such as washing with Zigey Tang (Polygonum Vine Decoction) and applying powders or plasters also aim to harmonize Qi and Blood, thereby reducing swelling and clearing heat.
Li Dongyuan said: The generation of carbuncles, malignant sores, and erysipelas arises from disharmony of Yin and Yang, stagnation of Ying and Wei, and lack of flow in Qi and Blood. The ancients said: When Yang stagnates in Yin, sores arise; when Yin stagnates in Yang, malignant sores arise. Sores and malignant sores can originate internally or externally. Internal ones arise within the Zang-Fu organs and chest/abdomen; external ones arise on the surface of skin, flesh, sinews, and bones, appearing without fixed locations. The root of this stagnation is the lack of Qi and Blood flow, preventing steaming Qi from reaching the exterior, leading to retention and internal heat, thus generating sores and malignant sores. If one initially feels Qi and Blood stagnation, with skin and flesh aggregation, swelling but no ulceration, one can dispel wind-heat and unblock the Zang-Fu organs. After one or two treatments, slowly using various decoctions for soaking can achieve internal resolution. Otherwise, if treatment is delayed, toxic heat will not dissipate but instead attack inward, leading to the accumulation of pus and blood. The *Neijing* states: "In treating diseases, one must seek the root." The root of sores and malignant sores lies in the郁结 obstruction of middle-jiao heat and the aggregation of wind-cold pathogens. Treatment should employ warm-natured herbs to harmonize Qi and Blood for internal resolution. Differentiation requires recognizing that wind-cold causes hard, white swelling, while toxic heat causes red, swollen areas. If Qi has already aggregated, the method of internal resolution should not be used; instead, herbs for expelling pus and supporting toxicity expulsion should be employed. This represents the sequence of treatment.
He further stated: "Xiao" (Resolution) means destruction, destroying the morphological signs. The classics say: "All pain, itching, sores, and ulcers belong to Heart Fire." Fire corresponds to the Li Trigram in the Eight Trigrams. Li is outwardly Yang and inwardly Yin. Internal Yin stagnation inevitably attacks outwardly. Treatment should focus on internal resolution to cut off the source and clear the interior, preventing outward eruption, hence termed "Internal Resolution." This applies when symptoms are just beginning to manifest; immediately administering decoctions, pills, or powns orally, combined with external application, unblocks the source and cuts off the toxin, allowing for immediate resolution. If the morphological signs are fully established, this method is no longer used.
Cheng Shanling said: Internal resolution refers to using medication to dissipate swelling and toxins at the very onset. For conditions like carbuncles, back abscesses, opposite-mouth sores, and ding-toxic sores, the initial stage presents with aversion to cold and high fever, resembling Taiyang disease, with pain localized to one area and normal appetite, indicating accumulated pus. However, at the initial stage, pus has not yet formed; it is merely a deviation of Qi and Blood, reversing into the muscle tissues. External application of Yuanzhi Gao (Polygalae Plaster), Jinhuang Ruyi San (Golden Yellow Ruyi Powder), Tiegu San (Iron Hoop Powder), or Pujiu Wanchuan Gao (Universal Salvation Plaster); oral administration of Yinhua Gancao Tang (Honeysuckle and Licorice Decoction) or Neixiao San (Internal Resolution Powder) can achieve immediate resolution. If it is a Ding sore (hard chancre), it should be pricked open, or moxa applied to the swollen area, with Chansu Bing (Toad Venom Cake) applied topically and Wanchuan Gao pasted over it, accompanied by oral Ju Hua Gancao Tang (Chrysanthemum and Licorice Decoction), leading to rapid subsidence. Chrysanthemum, including roots and leaves, is a sacred herb for treating Ding sores. Some cases involve concurrent wind-cold, requiring prior use of Jingfang San (Aster and Saposhnikovia Powder) or Xiongzhi Xiangsu Yin (Ligusticum, Angelica, Perilla, and Platycodon Decoction), or Wanling Dan (Ten Thousand Spirits Elixir) in winter to disperse. Subsequently taking Jinyinhua (Honeysuckle) and Ju Hua (Chrysanthemum) allows for internal resolution. It is crucial to act early and not delay. (From *Ten Methods*)