风火暑湿燥寒，天之气也。人在气交之中，强者弗能为害，弱者即留而为病。此五运六
气之交乘，宜乎外感之病为独多。治内科学人，无不知时病为一大纲，而外疡亦何莫不然。
诚以气化之偏，时邪之胜，其袭入经络脏腑者，则为内病，而袭于肌腠筋肉者，即发外疡。
殊途同归，理无二致。而谓治外疡者，可不与时推移，先其所因，而伏其所主耶。试以诸疡
之系于六气者，约略言之，则头面疮疡，发颐时毒，腮颧颔颊诸痈，牙槽骨槽诸肿，皆风淫
所胜也。诸疔暴肿，阳发大痈，咽喉口舌诸疳， 肉翻花诸候，皆火淫所胜也。而长夏郁蒸
，秋阳酷烈，暑湿热三气之中，疡患尤多，则热淫所胜。流金铄石之时，血肉之躯蕴毒，成
痈酿脓作腐，尤其易易。况乎地气溽润，天气炎 ，湿热互蒸，疮痍满目，比屋皆然，
故也。惟燥令既行，气候凝肃，疡患独少。而津枯液耗者，每有肌肤皴揭，血燥风生之患，
则又皮肤病之因于燥淫者也。若夫寒淫所胜，气滞血凝，则又有附着骨节之大疽，及寒袭经
络之脑背疽，皆宜温经宣络，以化寒邪者。林屋山人阳和一汤，若为是证而设，最为合辙。
独惜其所着之全生集，乃反以通治乳疽乳岩，骨槽瘰 ，则皆有肝胆经之郁热伏藏者。率尔
操觚，贻祸巨矣。要之凡治疡患，苟有六淫为病，必先撤其外淫之邪，而痈肿乃有消散之望
。所以疮疡大证，时邪流注，多有寒热缠绵，数日不解，而疡肿随以发现者，苟非寒止热除
，不独已发之痈肿必不能退，亦且继续而生，纠缠不已。此非深明乎内科理法，泄化其在经
络之感邪，则疮证全无把握。必至外邪俱解，身热已清，舌苔不浊，胃纳加餐，及不治疡而
疡亦自已。若专科家惟以外治为能事，则病虽不重，而亦多变幻无穷。此亦疡患中之最多数
，而必不能专治其外疡者也。迨脓溃之后，其毒已泄，以身热自止为顺。盖外疡得脓，犹如
伤寒得汗，汗后而热不已者，是坏伤寒。即脓后而热不已者，为坏疡病。于此而补偏救弊，
随证斡旋，则无一不以内证为主，殊非笔墨之所能曲尽其微者矣。
风、火、暑、湿、燥、寒，是自然界的气候变化。人生活在天地气交之中，体质强者邪气不能为害，体质弱者邪气停留就会致病。这是五运六气相互乘侮的结果，所以外感疾病特别多。学习内科学的人，没有不知道时令病（时病）是一个大纲领的，而外科疮疡又何尝不是如此呢？诚然，由于气候偏颇，时令邪气亢盛，侵袭经络脏腑的，就形成内科疾病；侵袭肌腠筋肉的，就发为外科疮疡。虽然途径不同，但道理是一致的。如果说治疗外科疮疡的人，可以不随着时令气候变化而调整，不先探究病因，不抓住主要矛盾，那是不行的。
试着将各种与六气相关的疮疡大致说明一下：头面部的疮疡、发颐（腮腺炎）、时毒、腮颧颌颊各处的痈肿、牙槽骨槽各处的肿胀，这些都是风气过胜所致。各种疔疮突然红肿、阳证大痈、咽喉口舌各处的疳症、翻花肉赘等各种病症，都是火气过胜所致。而在长夏闷热潮湿、秋阳酷烈之时，处于暑、湿、热三气之中，疮疡患病尤其多，这是热气过胜。在烈日炎炎、金石熔化的时候，血肉之躯蕴积毒素，形成痈肿、酿脓、腐烂，这是非常容易发生的。况且地气湿润，天气炎热，湿热互相蒸腾，满眼都是疮痍，家家户户都这样，这也是必然的道理。只有当燥气盛行时，气候凝结肃杀，疮疡患病特别少。但是津液枯竭、阴液耗损的人，常有肌肤粗糙开裂、血燥生风的病患，这又是皮肤病中因燥气过胜引起的。至于寒气过胜，导致气滞血凝，那么又有附着在骨节上的大疽，以及寒气侵袭经络导致的脑背疽，都应当用温经通络的方法，来化解寒邪。林屋山人所著的《阳和一汤》，如果是为了这些证候而设，最为合适。可惜他所著的《外科全生集》，反而用它来通治乳疽、乳岩（乳腺癌）、骨槽瘰疬（颈部淋巴结结核），而这些病症大多有肝胆经络郁热伏藏的情况。轻率地写作，造成的祸害巨大啊。总之，凡是治疗疮疡患者，如果有六淫邪气致病，必须先祛除外在的淫邪，那么痈肿才有消散的希望。所以疮疡的大证候，时令邪气流注体内，多有寒热缠绵、数日不退，随后疮肿随之出现的情况，如果不是寒去热除，不仅已经发出的痈肿必定不能消退，而且会继续生长，纠缠不休。这不是深刻明白内科理法，泄化其在经络中的感受邪气，就无法对疮证完全把握。必须等到外邪全部解除，身体发热已清，舌苔不浑浊，胃口增加进食，以及不需要专门治疗疮疡，疮疡也会自然痊愈。如果专科医生只以外治法为能事，那么病情虽然不重，但也会有很多变幻无穷的变化。这也是疮疡患者中最常见的情况，而绝对不能只专门治疗其外部疮疡的。等到脓液溃破之后，毒邪已经排泄，以身体发热自然停止为顺证。大概外疡出脓，就像伤寒出汗一样，出汗后热势不退的，是坏伤寒。同样，出脓后热势不退的，是坏疡病。在这个时候纠正偏差补救弊端，根据证候灵活变通，都是以内科证治为主，绝不是笔墨所能详尽表达其细微之处的了。
Wind, fire, summer-heat, dampness, dryness, and cold are the climatic changes of nature. Humans live within the intersection of heaven and earth qi; those with strong constitutions are not harmed by pathogenic factors, while those with weak constitutions retain these factors, leading to disease. This is the result of the mutual overacting of the Five Movements and Six Qi, which explains why exogenous diseases are particularly numerous. Those who study internal medicine know without exception that seasonal diseases (Shi Bing) constitute a major category, and how could external sores be any different? Indeed, due to climatic deviations and the predominance of seasonal pathogens, when they invade the meridians and zang-fu organs, they form internal diseases; when they invade the muscle interstices and sinews, they manifest as external sores. Although the pathways differ, the principles are identical. How can one treat external sores without adapting to the changing seasons, addressing the root cause first, and controlling the primary aspect?
Let us briefly discuss various sores related to the Six Qi: sores on the head and face, parotitis (Fa Yi), epidemic toxins, abscesses on the cheeks, zygomatic area, jaw, and buccal regions, and swellings in the dental alveolus and jawbone are all caused by the excess of Wind. Sudden swelling of various Ding sores, large Yang-type carbuncles, gan lesions in the throat, mouth, and tongue, and various conditions such as everted flower-like growths are all caused by the excess of Fire. During the muggy heat of late summer and the fierce sun of autumn, amidst the three qi of summer-heat, dampness, and heat, sores are particularly common, indicating an excess of Heat. During times when metal melts and stone scorches, the flesh-and-blood body accumulates toxins, forming carbuncles, generating pus, and causing putrefaction, which is very easy to happen. Moreover, when earthly qi is humid and heavenly qi is hot, dampness and heat mutually steam, leaving eyes full of sores, occurring in every house; this is inevitable. Only when Dryness prevails, and the climate becomes condensed and austere, are sores rare. However, individuals with depleted fluids and consumed yin often suffer from rough, peeling skin and wind generated by blood dryness; this is another case of dermatological diseases caused by the excess of Dryness. As for the excess of Cold, leading to qi stagnation and blood coagulation, there are also large deep-seated abscesses attached to bone joints, and brain/back abscesses caused by cold invading the meridians. These should be treated with warming the meridians and unblocking collaterals to transform cold pathogens. Linwu Shanshan's "Yang He Decoction" (Cordyceps and Deer Antler Decoction) was designed precisely for such syndromes and fits them perfectly. It is a pity that his work "Waike Quansheng Ji" (Complete Life Collection for Surgery) instead uses it to generally treat breast abscesses, breast cancer (Ru Yan), and scrofula (Luo Li); these conditions usually involve latent damp-heat in the Liver and Gallbladder meridians. Writing rashly causes immense harm. In summary, whenever treating sores where the Six Excesses are the cause, one must first eliminate the external pathogenic factors, giving hope for the resolution of the carbuncle. Therefore, in major sore syndromes where seasonal pathogens flow through the body, lingering fever and chills may persist for days before the sore appears. If cold does not cease and heat does not clear, not only will existing carbuncles fail to recede, but new ones will continue to emerge, entangling endlessly. Without a profound understanding of internal medicine principles to vent and resolve pathogens in the meridians, one cannot grasp the management of sore syndromes. One must wait until external pathogens are fully resolved, body heat clears, tongue coating becomes non-turbid, appetite improves, and the sore heals spontaneously without specific treatment. If specialists rely solely on external treatments, even mild cases may undergo unpredictable transformations. This is the most common scenario in sore patients, who absolutely cannot be treated merely for their external sores. After pus erupts, toxins have been discharged, and the cessation of fever is a favorable sign. Essentially, pus discharge in external sores is akin to sweating in Shang Han (Cold Damage) syndrome; if fever persists after sweating, it is a deteriorated Shang Han condition. Similarly, if fever persists after pus discharge, it is a deteriorated sore condition. At this juncture, correcting imbalances and adjusting according to symptoms relies primarily on internal medicine principles, subtleties of which cannot be fully captured by words alone.