疮疡溃后，亦有偶尔见血之证，辨其形色，溯其源流，为因为果，有可得而言者。在刀
针初动之时，脓随血溢，血色鲜明，其血从皮肉之针口而来，非脓中之本兼有鲜血也（此惟
初
，血本易溢，而啼哭则火升气升，且挟心肝两经忿怒之火，故其血更多。凡暑天热疖，小儿
最多，用针必须俟其皮薄脓多为佳。早针则血多脓少，未必尽善。）有劳力伤经之疡，则其
络
溢，其血较多，是宜罨其针口以止之。盖本是络中流动之血，不宜听其横溢者也。亦有溃疡
太巨，并其大络化腐，则一经震动，鲜血直流。泄之不宜，止之不易。此宜令其安睡勿动，
而以手术其大络，则血能止。有溃后脓色不纯，与血混合，不白不赤，作桃花色者，则元气
不足，血随腐溢，最宜清养。若至元气已败，则溃后脓不成脓，血不成血，污浊垢腻，是败
浆之不可救药者也。别有血瘤，不宜妄针。若不知而误针之，其血不止，最易偾事。亦有溃
疡初本无血，忽然鲜血喷溢者，或则动作过度，震伤大络，苟能静摄，亦尚无伤。或则大怒
伤肝，血随气涌，凉血清肝，亦易有效。此外有血箭，有血痣，有肌衄，有大衄，皆血之无
故自溢者，虽非痈疽之类，而皆是外证，治疡者亦不可不知。要之无故血溢，皆由气火奔腾
，以致血络迸裂。是宜大剂清心肝之火，镇而抑之，庶几龙相安潜，而汹涌波涛，于以大定
。诚非杯水车薪，所能救此燎原之祸者也。
疮疡溃破之后，也有偶尔出现出血的证候。辨别其血色和形态，追溯其病因病机，是有规律可循、可以论述的。在刀针刚刺入的时候，脓液随着血液溢出，血色鲜明，这血是从皮肉间的针孔流出的，并非脓液中原本就混杂着鲜血（这种情况多见于初起阶段，因为此时血脉本就容易溢泄，加上小儿啼哭会导致火气上炎、气机上逆，且挟带心经和肝经因愤怒而生的火热之气，所以出血更多。凡是暑天发生的疖肿，小儿最为多见，用针必须等待皮薄脓多时进行才为适宜。过早针刺则血多脓少，未必是好事。）有因劳力损伤经络导致的疮疡，则络脉中的血液溢出，血量较多，这时应当敷盖针口以止血。因为这本是络脉中流动的血液，不应听任其横溢妄行。也有溃疡面过大，导致大络也发生腐败，只要一经震动，鲜血就会直流不止。此时不宜强行宣泄，也难以轻易止住。这种情况下应让患者安静睡眠不要活动，并通过手术处理受损的大络，血液才能停止。有的溃后脓色不纯，与血液混合，既不白也不红，呈现桃花色，这是元气不足，血液随着腐浊之物溢出，最宜采用清补滋养的方法。如果到了元气已经败坏的地步，那么溃后脓不成脓，血不成血，污浊垢腻，这就是败浆症，属于不可救药的状况。另有血瘤，不宜随意针刺。如果不知情而误刺，血液不止，最容易导致严重后果。也有溃疡起初并无出血，忽然鲜血喷涌而出的，或者是动作过度震伤了大络，如果能静养摄护，也尚且没有大碍；或者是大怒伤及肝脏，血液随气机冲涌而上，使用凉血清肝之法，也容易见效。此外还有血箭、血痣、肌衄、大衄等，都是血液无故自行溢出的情况，虽然不属于痈疽一类，但都属于外科病症，治疗外科疾病的医生也不可不知。总之，无故出血，都是因为气火奔腾，导致血络迸裂。此时宜用大剂量的药物清泻心肝之火，加以镇潜抑制，使龙雷之火相火得以安潜，汹涌的波涛才能平息。这确实不是杯水车薪所能挽救这种燎原之祸的。
After the ulceration of sores and carbuncles, there are occasional cases of bleeding. By distinguishing their color and form, and tracing their etiology and pathogenesis, patterns can be identified and discussed. At the initial moment when the knife or needle is applied, pus overflows with blood; the blood is bright red, originating from the puncture wound in the skin and flesh, rather than being inherently mixed within the pus (This occurs mainly in the early stage, as vessels are prone to leakage at this time. Crying causes fire to rise and qi to ascend, compounded by the anger-induced fire of the Heart and Liver meridians, leading to more profuse bleeding. For furuncles occurring in summer heat, which are most common in children, needling should only be performed when the skin is thin and pus is abundant. Early needling results in excessive blood and insufficient pus, which is not ideal.) In sores caused by labor injuring the collaterals, blood from the collaterals may overflow, resulting in a larger volume of blood; in such cases, the puncture site should be covered to stop the bleeding. This is because it is merely circulating blood within the collaterals that should not be allowed to spill recklessly. In cases where the ulcer is excessively large, causing the major collaterals to undergo putrefaction, any movement may trigger a continuous flow of fresh blood. It is difficult to treat by purging or to stop easily. The patient should be kept calm and still, and surgical intervention on the damaged major collateral is required to arrest the hemorrhage. If the post-ulceration discharge is impure, mixed with blood, appearing neither white nor red but resembling peach blossom color, it indicates deficiency of Yuan Qi (Original Qi), with blood overflowing along with putrid matter; this condition requires clearing and nourishing therapies. If Yuan Qi has already collapsed, the post-ulceration discharge fails to form proper pus or blood, becoming turbid and greasy; this represents "bai jiang" (decayed plasma), a hopeless condition. Hemangiomas (blood tumors) should not be pricked indiscriminately. If mistakenly punctured due to lack of knowledge, bleeding will not cease, potentially leading to disastrous consequences. There are also cases where an ulcer initially shows no bleeding but suddenly spurts fresh blood. This may result from excessive physical activity damaging major collaterals; if rest and care are observed, injury may be avoided. Alternatively, severe anger injuring the Liver may cause blood to surge with qi; cooling the blood and soothing the Liver is often effective. Additionally, conditions such as "xue jian" (blood arrow), "xue zhi" (blood mole), "ji nu" (muscle petechiae), and "da nu" (severe hemorrhage) involve spontaneous bleeding without obvious cause. Although these do not belong to the category of carbuncles and ulcers, they are external manifestations, and practitioners of surgery must be familiar with them. In summary, spontaneous bleeding without apparent cause is due to surging qi and fire, causing blood collaterals to rupture. Large doses of herbs to clear Heart and Liver fire and suppress it with sedating agents are indicated, allowing the Dragon Fire and Ministerial Fire to settle, thereby calming the turbulent waves. Such severe hemorrhage cannot be remedied by meager efforts like pouring a cup of water on a burning cartload of straw.