疡之为病，必肿必痛。其故无他，气血壅滞，窒塞不能而已。所以消肿止痛，首推行血
行气为必要之法。惟行血不可太猛。破血逐瘀之品，非可轻率乱投，转滋流弊。而行气之药
，可以万全无害。抑且血之壅，即由于气之滞；苟得大气斡旋，则气行者血亦行，尤为一举
而两得。此则古人治疡，注重气分，洵分握要之图也。宋《李氏集验》背疽方有五香连翘汤
、内补十宣散，《窦氏疮疡经验》有许多流气饮，虽方药未免丛杂，而多用气分之药，最是
古人治疡正轨。寿颐谓气为血帅，血随气行，天地之大，必以空气营运化生万物。而人在气
交之中，动作行为，无一非此大气流行，为之鼓荡。所以凡治百病，必参以气分之药，而后
吹嘘运用，功效乃神。
古人补血之方，首推四物。地黄浓腻，非得归芎辛温运动之力，则呆滞有余，弊多利少
。制方精义，即在利用气药。而俗人昧焉，且谓当归、川芎即是补血之物，于古人用药真义
，未能体会，哪不可怪。况在疡患，明是气滞不行为病，苟不振动其气机，何能有济。此固
治疡者始终利赖之捷诀，而凡通达经隧，宣络脉之法，因无一不在行气二字之中者矣。
痰者，本非吾人体中应有之物质，而以观近人病状，则挟痰之证甚多。岂丹溪所谓东南
地土卑湿，由湿生热，湿热生痰，果得之于土薄水浅，而非人力之所能为耶。毋亦体质素弱
，脾运失司，大气之斡旋无权，饮食之消化不力，坐令水谷之精，不为津液，以洒陈于五脏
，和调于六腑，而徒酿为顽痰浊饮，有以助长病魔耳。古人恒谓肺为生痰之源、胃为贮痰之
器者，以肺为呼吸之道路，气机不利，则气化为水，而水饮停留；胃为水谷之渊薮，运化不
灵，则食即生痰，而浊涎盘踞。此痰饮之潜滋暗长于肺胃中者，尤其浅而易知，显而可据。
若夫经络肌肉之间，而亦多痰病，则非其肺胃之痰，可以随气血流行，以入经隧。盖亦其人
之营运不健，营卫周流，有时偶滞。遂令络脉中固有之津液，留顿于不知不觉之中。譬彼源
泉，本是澄清之故道，而下流既阻，污朽积焉；有如山蹊，初亦行人之快捷方式，而为闲不用，
茅草塞焉。此四肢百骸皮里膜外，所以停痰积饮之渊源；而外发痈疡，亦往往而多痰证。则
治疡者，可不于此加之意乎。惟痰能为疡，其基础则本于气机之阻滞，其成就亦别有感触之
原因。有因外风时热以激动其痰者，则风性升腾，上行而迅疾，其证多在颈项腮颐，如发颐
、腮、项前颌下诸痈，皆本于结痰，而动于外风，成于血热。则化痰也，而必泄热疏风。
有因肝胆内热以熬炼其痰者，则相火郁窒，入络而贯联，其证多在耳后项侧，如瘰 马刀连
络成串，皆本于木火而煎烁血液，驯致坚凝。则化痰也，而必舒肝清火。有胃络之结痰，则
乳房之结核是，宜兼泄胃家之实。若夫气液久虚，痰流经隧，历久始发之流痰，则非培补不
为功。而久郁之痰，有年痼疾，如石疽、乳岩者，则根深蒂固；且其人必满腹牢骚，又非药
力之可以抒愁解结者，夫岂“化痰”二字所能希冀百一。此虽同是痰病，而浅深大是不侔。
果能分别源流，投机处治，当亦可以十全八九。
又凡疡患之挟痰者，尚有部位可据，亦必见证分治。则项侧耳前后多风火，亦多肝火，
宜辨内外之因；胁肋 串有实火，亦有虚火，宜求铢两之称。若胸腹、肩背皆是流痰，而四
肢之部，则惟两臂间有流痰发生，而自股以下无之。学人慎弗以股胫之疡，误作挟痰论断，
而反以贻笑方家也。
外科疾病，必然出现肿胀和疼痛。其原因没有别的，就是气血壅滞，阻塞不通罢了。所以消除肿胀、缓解疼痛，首推行血和气的方法为必要之法。然而行血不可过于猛烈。破血逐瘀的药物，不可以轻率乱用，否则反而滋生弊端。而行气的药物，可以万全无害。况且血的壅滞，正是由于气的停滞；如果能使大气运转起来，那么气行则血亦行，这更是一举两得的好方法。这是古人治疗外科疾病，注重气分的原因，确实抓住了要领。宋代《李氏集验》中背疽的方剂有五香连翘汤（Wuxiang Lianqiao Tang）、内补十宣散（Neibu Shixuan San），《窦氏疮疡经验》中有许多流气饮（Liúqì Yǐn），虽然方药未免繁杂，但多用气分的药物，最符合古人治疗外科疾病的正轨。寿颐认为气为血之帅，血随气而行，天地之大，必以空气营运化生万物。而人在气交之中，动作行为，无一不是此大气流行，为之鼓荡。所以凡是治疗百病，必须参入气分的药物，而后吹嘘运用，功效才神奇。
古人补血方剂，首推四物汤（Sìwù Tāng）。地黄（Rehmanniae Radix）浓腻，如果不是得到当归（Angelicae Sinensis Radix）、川芎（Chuanxiong Rhizoma）辛温运动的力量，则呆滞有余，弊多利少。制方的精义，就在于利用气药。而世俗之人不明白这一点，甚至认为当归、川芎即是补血之物，对于古人用药的真义，未能体会，这难道不奇怪吗？何况在外科病患，明明是气滞不行为病，如果不振奋其气机，怎么能有济于事。这固然是治疗外科疾病者始终依赖的捷径，而凡是通达经隧、宣通络脉的方法，没有不在“行气”二字之中的了。
痰，本来不是人体中应有的物质，但观察近人的病症，挟痰的证候很多。难道是丹溪所说的东南地土卑湿，由湿生热，湿热生痰，果真是因为土薄水浅，而非人力所能改变的吗？恐怕也是体质素弱，脾运失司，大气的斡旋无权，饮食的消化不力，坐令水谷的精微，不能化为津液，以洒陈于五脏，和调于六腑，而徒然酿为顽痰浊饮，从而助长病魔罢了。古人常说肺为生痰之源、胃为贮痰之器，是因为肺为呼吸之道路，气机不利，则气化为水，而水饮停留；胃为水谷之渊薮，运化不灵，则食即生痰，而浊涎盘踞。这种痰饮潜滋暗长于肺胃中的情况，尤其浅而易知，显而可据。至于经络肌肉之间，也多痰病，则不是肺胃之痰，可以随气血流行，以入经隧。大概也是其人营运不健，营卫周流，有时偶有阻滞。遂令络脉中固有之津液，留顿于不知不觉之中。譬如源泉，本是澄清之故道，而下流既阻，污朽积焉；有如山蹊，初亦行人之快捷方式，而为闲不用，茅草塞焉。这就是四肢百骸皮里膜外停痰积饮的渊源；而外发痈疡，也往往多有痰证。那么治疗外科疾病的人，能不在此处加意吗？只是痰能导致疡，其基础本于气机之阻滞，其成就也有别感触的原因。有因外风时热以激动其痰者，则风性升腾，上行而迅疾，其证多在颈项腮颐，如发颐（Fāyí, 腮腺炎类疾病）、腮、项前颌下诸痈，皆本于结痰，而动于外风，成于血热。则化痰时，必须泄热疏风。有因肝胆内热以熬炼其痰者，则相火郁窒，入络而贯联，其证多在耳后项侧，如瘰疬（Luǒlì, 淋巴结结核）马刀连络成串，皆本于木火而煎烁血液，驯致坚凝。则化痰时，必须舒肝清火。有胃络之结痰，则乳房之结核是，宜兼泄胃家之实。若夫气液久虚，痰流经隧，历久始发之流痰（Liútán, 骨关节结核类疾病），则非培补不为功。而久郁之痰，有年痼疾，如石疽（Shíjū, 坚硬之疽）、乳岩（Rǔyán, 乳腺癌）者，则根深蒂固；且其人必满腹牢骚，又非药力之可以抒愁解结者，夫岂“化痰”二字所能希冀百一。这虽同是痰病，而浅深大是不侔。如果能分别源流，投机处治，当也可以十全八九。
另外，凡是外科病患挟痰的，尚有部位可据，也必见证分治。则项侧耳前后多风火，亦多肝火，宜辨内外之因；胁肋串有实火，亦有虚火，宜求铢两之称（权衡轻重）。若胸腹、肩背皆是流痰，而四肢之部，则惟两臂间有流痰发生，而自股以下无之。学人慎弗以股胫之疡，误作挟痰论断，而反以贻笑方家也。
Diseases of the surgical department (Yangke) invariably present with swelling and pain. The reason is none other than the stagnation and obstruction of Qi and Blood, leading to blockage. Therefore, to reduce swelling and relieve pain, promoting Blood circulation (Xingxue) and moving Qi (Xingqi) are essential methods. However, promoting Blood circulation should not be too aggressive. Substances that break Blood and drive out stasis (Poxue Zhuyu) should not be administered lightly or indiscriminately, as this may only exacerbate adverse effects. In contrast, Qi-moving herbs can be used safely without harm. Moreover, Blood stagnation arises from Qi stagnation; if the Great Qi is set in motion, then as Qi moves, Blood also moves, achieving two benefits with one action. This explains why ancient practitioners of surgical diseases emphasized the Qi aspect, which indeed grasped the key essence. In Song Dynasty's *Li Shi Ji Yan*, formulas for back carbuncles include Wuxiang Lianqiao Decoction (Five-Aromatic Forsythia Decoction) and Neibu Shixuan Powder (Internal-Nourishing Ten-Point Dispersion). *Dou Shi Chuangyang Jingyan* contains many Liúqì Infusions (Flowing-Qi Decoctions). Although these formulas may seem somewhat complex, their frequent use of Qi-regulating substances aligns best with the orthodox approach of ancient surgical treatments. Shouyi posits that Qi is the commander of Blood, and Blood follows Qi. In the vastness of heaven and earth, all things are generated and transformed through the operation of air. Humans exist within the intersection of Qi; every movement and action is driven by the circulation of this Great Qi. Thus, in treating various diseases, incorporating Qi-regulating substances is necessary so that, through their gentle stimulation and operation, efficacy becomes miraculous.
Among ancient formulas for nourishing Blood, Sìwù Decoction (Four-Substance Decoction) is paramount. Dihuang (Rehmanniae Radix) is thick and cloying; without the acrid-warm and mobilizing power of Danggui (Angelicae Sinensis Radix) and Chuanxiong (Chuanxiong Rhizoma), it remains stagnant, causing more harm than good. The refined essence of formula preparation lies in utilizing Qi-moving herbs. Yet laypeople fail to understand this, mistakenly believing that Danggui and Chuanxiong alone constitute blood-nourishing agents, failing to grasp the true intent of ancient medicinal usage—is this not strange? Furthermore, in surgical conditions, the pathology is clearly due to Qi stagnation and failure of movement. If the Qi mechanism is not invigorated, how can there be any benefit? This is undoubtedly a shortcut relied upon throughout by those treating surgical diseases, and all methods for unblocking meridians and collaterals fall under the umbrella of "moving Qi."
Phlegm (Tan) is not originally a substance that should exist in the human body. However, observing contemporary cases, syndromes involving Phlegm are numerous. Is it truly because, as Danxi stated, the low and damp terrain of the southeast generates Heat from Dampness, and Phlegm from Damp-Heat, resulting from thin soil and shallow water beyond human control? Or is it rather that individuals have inherently weak constitutions, with Spleen transport and transformation failing, lacking the authority of Great Qi rotation, and having poor digestion of food and fluids. Consequently, the essence of grain and water fails to transform into Body Fluids (Jinye) to moisten the Five Zang organs and harmonize the Six Fu organs, instead brewing stubborn Phlegm and turbid fluid retention, thereby aiding the pathogenic factors. Ancient texts often state that the Lung is the source of Phlegm production and the Stomach is the vessel storing Phlegm. This is because the Lung serves as the pathway for respiration; when Qi mechanism is unfavorable, Qi transforms into Water, leading to fluid retention. The Stomach is the reservoir of food and drink; when transportation and transformation are inefficient, food generates Phlegm, and turbid saliva accumulates. This latent growth of Phlegm-fluid in the Lung and Stomach is particularly shallow and easy to know, obvious and verifiable. As for Phlegm diseases in the meridians and muscles, these are not Phlegm from the Lung and Stomach circulating with Qi and Blood into the meridians. Rather, it is due to poor physiological operation, where the Zhouliu (circulation) of Ying and Wei occasionally stagnates. This causes the inherent fluids in the collaterals to remain stagnant unknowingly. Like a spring source, originally clear but blocked downstream, accumulating filth; or like a mountain path, initially a shortcut for pedestrians, but unused and overgrown with weeds. This is the origin of retained Phlegm and accumulated fluid in the skin, membranes, and limbs. External carbuncles and sores often involve Phlegm syndromes. Should those treating surgical diseases not pay attention to this? However, while Phlegm can lead to sores, its foundation lies in Qi mechanism obstruction, and its manifestation has other triggering causes. Some are triggered by external Wind and seasonal Heat agitating the Phlegm; since Wind nature is ascending and rapid, symptoms often appear on the neck, cheeks, and jaw, such as Fāyí (Mumps-like disease), cheek abscesses, and submandibular abscesses. These originate from condensed Phlegm, activated by external Wind, and formed by Blood-Heat. Treatment requires resolving Phlegm while clearing Heat and dispersing Wind. Others are caused by internal Heat of the Liver and Gallbladder refining the Phlegm; when Minister Fire is depressed and obstructed, entering collaterals and connecting, symptoms often appear behind the ears and on the sides of the neck, such as Luǒlì (Scrofula/Lymphatic Tuberculosis) forming chains. These originate from Wood-Fire burning Blood, leading to hardening. Treatment requires resolving Phlegm while soothing the Liver and clearing Fire. Phlegm condensing in the Stomach collaterals manifests as breast nodules, requiring simultaneous purging of Stomach excess. If Qi and Fluids have been deficient for a long time, and Phlegm travels through meridians, manifesting late as Liútán (Tuberculous Abscess/Bone TB), tonification is required for efficacy. For long-depressed Phlegm becoming chronic diseases, such as Shíjū (Hard Carbuncle) or Rǔyán (Breast Cancer), the root is deep and solid; moreover, the patient is full of resentment, which cannot be resolved by medication alone. How can "resolving Phlegm" alone hope to achieve even partial success? Although these are all Phlegm diseases, their depth and severity differ greatly. If one can distinguish the source and flow, and treat according to the specific situation, eight or nine out of ten recoveries can be expected.
Furthermore, for surgical patients with Phlegm, there are specific locations to rely on, and treatment must be differentiated based on manifestations. Symptoms around the sides of the neck and in front/behind the ears often involve Wind-Fire and Liver-Fire, requiring differentiation of internal and external causes. Symptoms in the hypochondrium may involve Excess Fire or Deficient Fire, requiring careful weighing of severity. If Phlegm occurs in the chest, abdomen, shoulders, and back, in the limbs, Phlegm typically occurs only in the arms, not below the thighs. Students must not mistake sores on the thighs and shins as Phlegm-involved syndromes, lest they be laughed at by experts.