疮疡旧分五善，七恶。动息自宁，饮食知味一善也。便利调匀二善也。脓清、肿消、
不臭三善也。神采精明，语声清爽四善也。体气和平五善也。烦躁时嗽，腹痛渴甚，或泄
利无度，小便如淋一恶也。脓血大泄，肿 尤甚，脓色臭败，痛不可近二恶也。喘粗短
气，恍惚嗜卧三恶也。目视不正，黑睛紧小，白睛青赤，瞳子上看四恶也。肩背不便，四
肢沉重五恶也。饮食不下，服药而呕，食不知味六恶也。声嘶色败，鼻青赤，面目四肢
浮肿七恶，也。五善见三则善，七恶见四则危。薛氏∶三善者属腑证，病微邪浅，更能
慎起居，节饮食，勿药自愈。恶者乃五脏亏损之证，多因元气虚弱；或因脓水出多，气
血亏损；或因汗下失宜，荣卫消烁；或因寒凉克伐，气血不足；或因峻厉之剂，胃气受
伤，以致真气虚而邪气实，外似有余而内实不足，法当纯补胃气，多有可生，不可因其
恶，遂弃而不治。若大渴发热，或泄泻淋秘者，邪火内淫一恶也，竹叶黄 汤。气血俱
虚，八珍汤加黄 、麦门、五味、山茱萸。如不应，佐以加减八味丸煎服。脓血既泄，肿
痛尤甚，脓色败臭者，胃气虚而火盛二恶也，
人参黄 汤。如不应，用十全大补汤加麦门、五味。目视不正，黑睛紧小，白睛青赤，瞳
子上视者，肝肾阴虚而目系急三恶也，六味丸料加炒山栀、麦门、五味。如不应，用八
珍汤加炒山栀、麦门、五味。喘粗短气，恍惚嗜卧者，脾肺虚火四恶也，六君加大枣、生
姜。如不应，用补中益气汤加麦门、五味。心火刑克肺金，人参平肺散。阴火伤肺，六味
丸加五味子煎服。肩背不便，四肢沉重者，脾肾亏损五恶也，补中益气汤加山茱萸、山药、
五味。如不应，用十全大补汤加山茱萸，山药、五味。不能下食，服药而呕，食不知味
者，胃气虚弱六恶也，六君子汤加木香、砂仁。如不应，急加附子。声嘶色败，唇鼻青
赤，面目四肢浮肿者，脾肺俱虚七恶也，补中益气汤加大枣、生姜。如不应，用六君子
汤加炮姜。更不应，急加附子或用十全大补汤，加附子、炮姜。腹痛泄泻，咳逆昏愦者。
阳气虚，寒气内淫之恶证也，急用托里温中汤。后用六君子汤加附子，或加姜桂温补。此
七恶之治法也。此外，更有溃后，发热恶寒作渴；或怔忡惊悸，寤寐不宁，牙关紧急；或
头目赤痛，自汗盗汗，寒战切牙，手撒身热，脉洪大按之如无；或身热恶衣，欲投于水，其
脉浮大，按之微细，衣浓仍寒，此血气虚极传变之恶证也。若手足逆冷，肚腹疼痛，泄
利肠鸣，饮令不入，吃逆呕吐，此阳气虚，寒气所乘之恶证也。若有汗而不恶寒，或无汗
而恶寒，口噤足冷，腰背反张，颈项劲强，此血气虚极变痉之恶证也，急用参 、归术、附
子救之，间有可生者。大抵虚中见恶证者难治，实证无恶候者易治。宋时齐院令，虽尝
纂其状而未具其因，我朝陶节庵，虽各立一方，亦简而未悉，予故补其缺云。
疮疡病过去分为五善证和七恶证。
身体动静安宁，饮食知道滋味，这是一善。
大小便调和均匀，这是二善。
脓液清稀，肿胀消退，没有臭味，这是三善。
精神神采精明，语声清爽，这是四善。
体质气息平和，这是五善。
烦躁不安，时时咳嗽，腹部疼痛且极度口渴，或者腹泻无度，小便像淋病一样涩痛，这是一恶。
脓血大量流出，肿胀更加严重，脓色臭败，疼痛剧烈不可触碰，这是二恶。
气喘粗重，呼吸短促，神志恍惚，嗜睡懒动，这是三恶。
目光视物不正，黑眼球紧缩变小，眼白部分呈现青色或赤色，瞳孔向上翻视，这是四恶。
肩背活动不便，四肢沉重无力，这是五恶。
饮食无法下咽，服药后呕吐，吃东西不知道滋味，这是六恶。
声音嘶哑，气色败坏，鼻子呈现青赤色，面目及四肢浮肿，这是七恶。
五善证中出现三个则预后良好，七恶证中出现四个则病情危重。
薛氏认为：三善证属于腑证，病邪轻微浅表，如果能谨慎起居，节制饮食，甚至不用药也能自愈。
恶证则是五脏亏损的病症，多因为元气虚弱；或者因为脓水流出过多，导致气血亏损；或者因为发汗、攻下治疗不当，导致营卫之气消减枯竭；或者因为使用寒凉药物克伐正气，导致气血不足；或者因为使用猛烈峻厉的药物，损伤了胃气，以致真气虚弱而邪气实盛，外表看似有余而内部实则不足，治疗方法应当纯粹补益胃气，大多可以存活，不能因为它是恶证，就放弃不治疗。
如果出现大渴发热，或者腹泻、小便淋沥闭塞不通的，这是邪火内侵的一恶证，用竹叶黄芪汤。
如果是气血俱虚，用八珍汤加黄芪、麦冬、五味子、山茱萸。如果不见效，辅助服用加减八味丸煎剂。
如果脓血已经排出，但肿痛更加严重，脓色败坏发臭的，这是胃气虚弱而火气旺盛的二恶证，用人参黄芪汤。如果不见效，用十全大补汤加麦冬、五味子。
如果目光视物不正，黑眼球紧缩变小，眼白呈现青赤色，瞳孔向上翻视的，这是肝肾阴虚而导致目系拘急的三恶证，用六味地黄丸的药料加炒山栀、麦冬、五味子。如果不见效，用八珍汤加炒山栀、麦冬、五味子。
如果气喘粗重，呼吸短促，神志恍惚，嗜睡的，这是脾肺虚火的四恶证，用六君子汤加大枣、生姜。如果不见效，用补中益气汤加麦冬、五味子。如果是心火刑克肺金，用人参平肺散。如果是阴火伤肺，用六味地黄丸加五味子煎服。
如果肩背活动不便，四肢沉重的，这是脾肾亏损的五恶证，用补中益气汤加山茱萸、山药、五味子。如果不见效，用十全大补汤加山茱萸、山药、五味子。
如果不能进食，服药后呕吐，吃东西不知滋味的，这是胃气虚弱的六恶证，用六君子汤加木香、砂仁。如果不见效，紧急加入附子。
如果声音嘶哑，气色败坏，嘴唇鼻子青赤，面目四肢浮肿的，这是脾肺俱虚的七恶证，用补中益气汤加大枣、生姜。如果不见效，用六君子汤加炮姜。如果仍不见效，紧急加入附子，或者使用十全大补汤加附子、炮姜。
如果腹痛泄泻，咳逆昏愦的，这是阳气虚弱，寒气内侵的恶证，紧急使用托里温中汤。之后用六君子汤加附子，或者加干姜、肉桂进行温补。这是七恶证的治疗方法。
此外，还有溃破后，出现发热恶寒作渴；或者怔忡惊悸，醒睡不宁，牙关紧急；或者头目赤痛，自汗盗汗，寒战咬牙，手撒身热，脉象洪大但按之如无；或者身热怕衣，想要投入水中，其脉浮大但按之微细，衣服厚重仍然感觉寒冷，这是血气极度虚弱传变而成的恶证。
如果出现手足逆冷，肚腹疼痛，泄利肠鸣，饮水即入即吐，呃逆呕吐，这是阳气虚弱，寒气乘袭的恶证。
如果有汗但不恶寒，或者无汗而恶寒，口噤足冷，腰背反张，颈项强直，这是血气极度虚弱变为痉病的恶证，紧急用人参、当归、白术、附子来救治，间或有存活的。
大体上，虚证中见到恶证的难治，实证中没有恶候的易治。宋代齐院令，虽然曾经编纂了这些症状表现但未详尽阐述原因，我朝陶节庵，虽然各自设立一方剂，但也简略而未详尽，所以我补充其中的缺失之处。
The treatment of sores and ulcers was traditionally divided into five favorable signs (Wu Shan) and seven unfavorable signs (Qi E).
1. Calmness in movement and rest, and having an appetite with the ability to taste food is the first favorable sign.
2. Regular and harmonious bowel movements and urination is the second favorable sign.
3. Clear pus, reduction of swelling, and absence of foul odor is the third favorable sign.
4. Bright spirit and clear eyes, and a crisp voice is the fourth favorable sign.
5. Harmonious physical constitution and balanced Qi is the fifth favorable sign.
1. Restlessness, frequent coughing, abdominal pain, extreme thirst, or uncontrolled diarrhea, and dysuria resembling strangury is the first unfavorable sign.
2. Profuse discharge of pus and blood, worsening swelling, foul-smelling and putrid pus, and severe pain that cannot be touched is the second unfavorable sign.
3. Rough breathing, shortness of breath, mental confusion, and lethargy/somnolence is the third unfavorable sign.
4. Abnormal gaze, tight and small black pupils, blue-red sclera, and upward deviation of the pupils is the fourth unfavorable sign.
5. Inconvenience in the shoulders and back, and heaviness in the four limbs is the fifth unfavorable sign.
6. Inability to eat, vomiting after taking medicine, and loss of taste for food is the sixth unfavorable sign.
7. Hoarseness, deterioration of complexion, blue-red nose, and edema of the face, eyes, and four limbs is the seventh unfavorable sign.
If three of the five favorable signs appear, the prognosis is good; if four of the seven unfavorable signs appear, the condition is critical.
Mr. Xue stated: The three favorable signs belong to Fu-organ syndromes, where the pathogenic factor is mild and superficial. If one can be careful with daily life and regulate diet, self-healing may occur without medication.
Unfavorable signs are syndromes of deficiency in the Five Zang organs, often caused by weak Yuan Qi; or due to excessive loss of pus and water leading to Qi and Blood deficiency; or due to improper use of sweating or purging methods, causing consumption of Ying and Wei Qi; or due to the use of cold-cooling drugs attacking healthy Qi, resulting in insufficient Qi and Blood; or due to harsh and drastic medicines injuring Stomach Qi, leading to deficiency of True Qi and excess of Pathogenic Qi. Externally it appears as excess, but internally it is truly deficient. The treatment method should focus purely on tonifying Stomach Qi, and there is often hope for survival. One should not abandon treatment simply because it is an unfavorable sign.
If there is extreme thirst and fever, or diarrhea and urinary retention/dysuria, this is the first unfavorable sign caused by internal proliferation of Evil Fire. Use Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction).
If both Qi and Blood are deficient, use Bazhen Tang (Eight Treasure Decoction) added with Huangqi (Astragali Radix), Maimen (Ophiopogonis Radix), Wuwei (Schisandrae Fructus), and Shanzhuyu (Corni Fructus). If ineffective, assist with Jiaban Bawei Wan (Modified Eight-Ingredient Pill) decoction.
If pus and blood have been discharged but swelling and pain are worse, and the pus color is putrid and foul, this is the second unfavorable sign of Stomach Qi deficiency and flourishing Fire. Use Renshen Huangqi Tang (Ginseng and Astragalus Decoction). If ineffective, use Shiquan Dabu Tang (Ten Complete Tonifying Decoction) added with Maimen and Wuwei.
If the gaze is abnormal, pupils are tight and small, sclera is blue-red, and pupils look upward, this is the third unfavorable sign of Liver and Kidney Yin deficiency causing tension in the eye meridians. Use Liujunzi Wan (Six Gentlemen Pill) ingredients added with Chao Shanzhi (Fried Gardenia Fruit), Maimen, and Wuwei. If ineffective, use Bazhen Tang added with Chao Shanzhi, Maimen, and Wuwei.
If there is rough breathing, shortness of breath, mental confusion, and somnolence, this is the fourth unfavorable sign of Spleen and Lung deficiency fire. Use Liujunzi Tang (Six Gentlemen Decoction) added with Dazao (Jujubae Fructus) and Shengjiang (Zingiberis Rhizoma Recens). If ineffective, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Maimen and Wuwei. If Heart Fire attacks Lung Metal, use Renshen Pingfei San (Ginseng Lung-Pacifying Powder). If Yin Fire injures the Lung, use Liujunzi Wan added with Wuweizi (Schisandrae Fructus) decoction.
If shoulders and back are stiff and limbs are heavy, this is the fifth unfavorable sign of Spleen and Kidney depletion. Use Buzhong Yiqi Tang added with Shanzhuyu, Shanyao (Dioscoreae Rhizoma), and Wuwei. If ineffective, use Shiquan Dabu Tang added with Shanzhuyu, Shanyao, and Wuwei.
If unable to eat, vomiting after medication, and loss of taste, this is the sixth unfavorable sign of Stomach Qi weakness. Use Liujunzi Tang added with Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus). If ineffective, urgently add Fuzi (Aconiti Lateralis Radix Praeparata).
If hoarse voice, deteriorated complexion, blue-red lips and nose, and edema of face, eyes, and limbs, this is the seventh unfavorable sign of combined Spleen and Lung deficiency. Use Buzhong Yiqi Tang added with Dazao and Shengjiang. If ineffective, use Liujunzi Tang added with Paojiang (Zingiberis Rhizoma Preparatus). If still ineffective, urgently add Fuzi, or use Shiquan Dabu Tang added with Fuzi and Paojiang.
If abdominal pain, diarrhea, retching, and coma/confusion occur, this is an unfavorable sign of Yang Qi deficiency with internal invasion of Cold Qi. Urgently use Tuoli Wenzhong Tang (Support Interior and Warm Middle Decoction). Afterwards, use Liujunzi Tang added with Fuzi, or add Jiang (Ginger) and Guirou (Cinnamomi Ramulus) for warming and tonification. This covers the treatment methods for the seven unfavorable signs.
Furthermore, after ulceration, there may be fever with aversion to cold and thirst; or palpitations and fright, restless sleep and wakefulness; or lockjaw; or red and painful head and eyes, spontaneous and night sweats, chattering teeth with cold shivers, flaccid hands with body heat, and a洪大 (Surging-Large) pulse that feels empty upon pressure; or body heat with aversion to clothing, desire to throw oneself into water, yet the pulse is floating and large but fine upon pressure, and feeling cold even under thick clothes. These are unfavorable signs of transformation due to extreme deficiency of Blood and Qi.
If there is cold reversal in the four extremities, abdominal pain, diarrhea with borborygmus, inability to keep fluids down, hiccupping, and vomiting, this is an unfavorable sign of Yang Qi deficiency with invasion of Cold Qi.
If there is sweating without aversion to cold, or no sweating with aversion to cold, lockjaw, cold feet, opisthotonos (arching of the back), and neck stiffness, this is an unfavorable sign of transformation into Spasm due to extreme deficiency of Blood and Qi. Urgently treat with Renshen (Ginseng Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Fuzi to rescue; occasionally, survival is possible.
Generally, unfavorable signs appearing in deficiency patterns are difficult to treat, while excess patterns without unfavorable prognostic signs are easy to treat. In the Song Dynasty, Qi Yuanling compiled the symptoms but did not fully explain the causes. In our dynasty, Tao Jie'an established formulas for each, but they were brief and incomplete. Therefore, I have supplemented these deficiencies.