《灵枢》云∶腋下其痈赤坚而不溃者，为马刀挟瘿，急治之。
汪省之曰∶马刀专属肝胆二经，其形颇长，坚硬如石，或在耳下至缺盆，或肩
上沿至胁下，甚至胸前累累，经年累月，有作疮而不破，有破烂而脓血不止者，其证
几危矣。（《理例》）
冯鲁瞻曰∶若在胸旁，或两胁结长核者，此名马刀。（《锦囊》）
周文采曰∶马刀疮生于项腋之间，有
类瘰 。但初起其状如马刀，赤色如火烧烙，极痛，此疮甚猛，宜急治之，不然多成危殆也。（《集验》）
胡公弼曰∶结于胸前及胸侧连胁者，名马刀。此足少阳胆经候也。初生小，后必
大。若疼痛破烂出脓，脓孔受风，决成漏证，断不易治；惟年壮气血盛者，治之易痊。（《青囊》）
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陈实功曰∶马刀疮形长如蛤者，是生于项侧耳下，肩上缺盆腋下。（《正宗》）
蒋示吉曰∶马刀结核，其硬如石，乃手足少阳经起。若失而不治，不守禁忌，渐
延至阳明，颊下颊车俱到，壮实者，溃坚汤；不足者，滋阴散坚汤主之。（《说约》）
澄曰∶马刀生于缺盆之上，由胸腋而至胁，本由痰核瘰 时，潮热时作，气血
已枯，精神短少，兼之医治不善，酿至脓血大溃，肿势日坚，更有溃流血水，毫无
脓汁，复有累如岩穴，胀而不痛，外撑车颊，内阻咽喉，饮食妨碍，筋脉拘挛，收
引疼痛，腿足牵扯，甚则怒火上冲，迫血从毛窍溢出，变而为马刀矣。马刀名之者，
何义？谓之马，其行疾。谓之刀，其器利。既疾且利，人将奚敌哉。故《灵枢经》云∶
马刀挟瘿，宜急治之。虽然人虽垂死，犹有可生之法，若坐视不救，岂仁者之心哉。
外宜艾灸，或可回生，如肩井、肺俞、膻中、风池、百劳、曲池穴，各灸三壮；内
服益气养荣汤，开郁清痰，和气消核之剂，首尾肝脾兼固，气血双扶，灸后用万灵膏
调理一年，恬淡静养，尚可保全性命。若妄治追蚀于外，攻伐于内，则死亡立待矣。
《灵枢》记载：腋下出现痈肿，颜色红赤、质地坚硬且不溃破的，称为马刀挟瘿，应当紧急治疗。
汪省之说：马刀病专门归属于肝胆二经，其形状较长，坚硬如石头，位置或在耳下至缺盆穴，或从肩上延伸至胁下，甚至在胸前成串出现，经过长年累月，有的形成疮口但不破裂，有的已经破烂且脓血不止，这种证候几乎危及生命。（出自《理例》）
冯鲁瞻说：如果在胸旁，或者两胁部结成长条状硬块的，这名叫马刀。（出自《锦囊》）
周文采说：马刀疮生于颈部和腋窝之间，类似瘰疬（淋巴结结核）。但初起时形状像马刀，颜色红赤如火烧灼，极度疼痛，这种疮非常猛烈，应当紧急治疗，否则多会发展成危重局面。（出自《集验》）
胡公弼说：结在胸前及胸侧连及胁部的，名叫马刀。这是足少阳胆经的病候。初生时较小，后来必定变大。如果疼痛破烂流出脓液，脓孔受风邪侵袭，必然形成漏证（慢性窦道），绝对不容易治愈；只有年轻力壮、气血旺盛的人，治疗才容易痊愈。（出自《青囊》）
陈实功说：马刀疮形状长得像蛤蜊的，是生在颈侧耳下、肩上、缺盆穴及腋下的部位。（出自《正宗》）
蒋示吉说：马刀结核，硬度像石头，起始于手足少阳经。如果延误不治疗，又不遵守禁忌，病情逐渐蔓延至阳明经，波及颊下和颊车穴。体质壮实的患者，用溃坚汤；体质虚弱的患者，用滋阴散坚汤主治。（出自《说约》）
我说：马刀生于缺盆穴之上，由胸腋部位延伸至胁部，原本是由于痰核和瘰疬日久，潮热时常发作，导致气血枯竭，精神短少，再加上医治不当，酿成脓血大溃，肿胀之势日益坚硬，更有甚者溃破流血水，毫无脓汁，还有肿块累累如同岩穴，胀满但不疼痛，向外撑开脸颊，向内阻塞咽喉，妨碍饮食，筋脉拘挛收缩疼痛，牵连腿足，甚至怒火上冲，迫使血液从毛孔溢出，最终变成为马刀。为什么叫马刀呢？称其为“马”，是因为它行动迅速；称其为“刀”，是因为它锋利无比。既迅速又锋利，人怎么能抵挡得住呢？所以《灵枢经》说：马刀挟瘿，应当紧急治疗。虽然如此，人即使濒临死亡，仍有可以救活的方法，如果坐视不管不施救，这难道是仁者的心肠吗？外治适宜采用艾灸，或许可以挽回生命，例如肩井穴、肺俞穴、膻中穴、风池穴、百劳穴、曲池穴，每个穴位各灸三壮；内服益气养荣汤，作为开郁清痰、调和气血消散结块的药剂，从头到尾兼顾肝脾，双补气血，艾灸之后使用万灵膏调理一年，保持心境恬淡安静休养，还可以保全性命。如果胡乱治疗，外用追蚀药物腐蚀，内用攻伐药物损伤正气，那么死亡就在眼前了。
The *Ling Shu* (Spiritual Pivot) states: When a carbuncle appears in the axilla, characterized by redness, hardness, and failure to suppurate, it is termed "Ma Dao Jia Ying" (Scrofula with Goiter), which requires urgent treatment.
Wang Shengzhi stated: Ma Dao is exclusively related to the Liver and Gallbladder meridians. Its shape is rather long and hard as stone. It may occur from below the ear to the Quepen point (ST12), or extend from the shoulder along to the hypochondrium, even appearing in clusters on the chest. After years, some form sores that do not break, while others break open with continuous discharge of pus and blood; this condition is nearly critical. (*Li Li*)
Feng Luzhan stated: If there are elongated nodules结 (knots) beside the chest or in both hypochondriac regions, this is named Ma Dao. (*Jin Nang*)
Zhou Wencai stated: Ma Dao sores arise between the neck and axilla, resembling Scrofula (Luo Li). However, at the initial stage, they resemble a horse knife, are red like fire burns, and extremely painful. This sore is very fierce; it should be treated urgently, otherwise, it often becomes critical. (*Ji Yan*)
Hu Gongbi stated: Nodules located on the chest and extending laterally to the hypochondrium are named Ma Dao. This is a manifestation of the Foot-Shaoyang Gallbladder Meridian. Initially small, they will inevitably grow larger. If they become painful, break open, and discharge pus, exposure to wind through the pus hole will certainly lead to a Fistula syndrome (Lou Zheng), which is extremely difficult to cure; only those who are young, strong, and have abundant Qi and Blood can be easily cured. (*Qing Nang*)
Chen Shigong stated: Ma Dao sores, shaped long like clams, arise on the side of the neck, below the ear, on the shoulder, at the Quepen point, and in the axilla. (*Zheng Zong*)
Jiang Shiji stated: Ma Dao tubercles are hard as stone and originate from the Hand-Shaoyang and Foot-Shaoyang meridians. If neglected and untreated, and if dietary/lifestyle taboos are not observed, the condition gradually extends to the Yangming meridian, reaching the submandibular area and Jiache point. For robust patients, Kui Jian Tang (Hardness-Dispersing Decoction) is used; for deficient patients, Zi Yin San Jian Tang (Nourishing Yin and Dispersing Hardness Decoction) is the primary prescription. (*Shuo Yue*)
I state: Ma Dao arises above the Quepen point, extending from the chest and axilla to the hypochondrium. It originally stems from Phlegm Nodules and Scrofula persisting over time, accompanied by tidal fevers, leading to exhaustion of Qi and Blood and diminished spirit. Compounded by improper medical treatment, it酿 (brews) into massive ulceration of pus and blood. The swelling becomes increasingly hard daily. In severe cases, it ulcerates leaking blood and serum without pus, or forms clusters like rock caves—swollen but painless—pushing outwards against the cheeks and obstructing the throat internally, hindering eating and drinking. Tendons and vessels become contracted and painful, pulling on the legs and feet. Even worse, anger rises upward, forcing blood to overflow from hair follicles, eventually transforming into Ma Dao. Why is it called Ma Dao? "Ma" (Horse) implies swiftness; "Dao" (Knife) implies sharpness. Being both swift and sharp, how can one resist it? Thus, the *Ling Shu Jing* states: "Ma Dao Jia Ying should be treated urgently." Nevertheless, even when a person is near death, there are methods to save them. To sit idly by and not rescue them is contrary to the heart of a benevolent person. Externally, moxibustion is suitable and may restore life; for example, apply three moxa cones each to the Jianjing (GB21), Feishu (BL13), Danzhong (CV17), Fengchi (GB20), Bailao (EX-HN5), and Quchi (LI11) acupoints. Internally, administer Yi Qi Yang Rong Tang (Qi-Nourishing and Blood-Sustaining Decoction), a formula that opens depression, clears phlegm, harmonizes Qi, and dissipates nodules, simultaneously supporting the Liver and Spleen throughout the treatment course and doubly supporting Qi and Blood. After moxibustion, use Wan Ling Gao (Myriad Spirits Ointment) for conditioning for one year, maintaining a tranquil and calm lifestyle, which can still preserve life. If treated recklessly, using cauterizing agents externally and attacking/purgative drugs internally, death will follow immediately.