指患疔麻痒，寒热恶心，左半体皆麻，脉数不时见。曰∶凡疮不宜不痛，不可大痛，烦
闷者不治，今作麻痒，尤其恶也。用夺命丹二服，不应。又用解毒之剂，麻痒始去，乃
作肿痛，薛曰∶势虽危所喜作痛，但毒瓦斯无从而泄，乃针之，诸证顿退，又用解毒之剂
而瘥。苏痒，盛原博，掌后患疔，红丝至腕，恶寒发热，势属表证，与夺命丹一服，红丝
顿消，又用和解之剂，大势已退。彼又服败毒药，发渴发热，红丝仍见，脉浮大而虚，此
气血受伤而然，以补中益气汤主之而愈。盖夺命既服，疮邪已散。而复用败毒之剂，是
诛伐无过，失《内经》之旨矣。一儒者患疔，元气素弱。薛补其气血，出脓而愈。后因劳
役疮痕作痒，乃别服败毒散一剂，以致口噤舌强，手足搐揉，痰涎上涌，自汗不止，此
气血复伤而复痉也。用十全大补，加附子一钱，灌服而苏。一男子患疔，服夺命汤汗不
止，疮不痛，热不止，便不利，此汗多亡阳而真气伤矣。用参 、归术、芍防、五味二
剂，诸证悉退，惟以小便不利为忧。薛曰∶汗出不利小便，汗止则阳气复而自利矣，仍用
前药，去防风，加麦冬，倍用黄芩、当归，四剂而便行，疮溃而愈。表甥居富，右手小指
患疔色紫。或云∶小疮针刺出血，敷以凉药，掌指肿三四倍，黯而不痛，神思昏愦，烦躁
不宁，此真气夺而邪气实也，先以夺命丹一服，活命饮二剂稍可，薛因他往，或遍刺其
手，出鲜血碗许，肿延臂腕， 大如瓠，手指肿数倍，不能溃。薛用大剂参 、归术之
类，及频灸遍手而肿渐消，但大便不实，时当泄气，此元气下陷，以补中益气加骨脂、肉
蔻、吴茱、五味，大便实而气不泄，又日以人参五钱，麦冬三钱，五味二钱，水煎代茶
饮之，又用大补药五十余剂而渐愈。此证初若不用解毒之剂，后不用大补之药，欲生也
难矣。一人年二十，唇患疔四日矣，有紫脉自疮延至口内，将及于喉。薛曰∶此真气虚
而邪气实也。若紫脉过喉则难治矣，须针紫脉，并疮头出恶血，以泄其毒则可。乃别用
解毒之剂，头面俱肿，求治甚笃。薛曰∶先日之言不诬矣。诊其脉洪数，按之如无，口
内肿胀，针不能入，为砭面与唇出黑血碗许，势虽少退，略进汤，终至不起。都宪张恒山，
左足指患之，痛不可忍，急隔蒜灸三十余壮，即能行步。欲速愈，或用凉药敷贴，遂致血
凝肉死，毒瓦斯复炽。再灸百壮，服活命饮，出紫血毒，才得解，脚底通溃，腐筋烂肉甚多。
将愈，误用生肌药，反助其毒，元气亏损而不能愈。薛治以托里药，喜其禀实，客处三
月余方愈。大凡疔患于肢节，灸法有回生之功，设投以凉剂收敛，腠理隧道壅塞，邪气
愈甚，多致不起。若毒未尽，骤用生肌，轻者反增溃烂，重者必致危亡。一男子足指患
疔，肿 痛赤，用隔蒜灸、人参败毒散加金银花、白芷、大黄，二剂痛止。又用十宣散
加天花粉、金银花，去桂，数剂而愈。濮阳传云∶万历丁亥，金台有妇人，以羊毛遍鬻
于市，忽不见。继而都人身生泡瘤渐大，痛死者甚众，瘤内惟有羊毛。道人传一方，以
黑豆、荞麦为粉，涂擦，毛落而愈。名羊毛疔。
荆芥败毒散（方见肿疡。）加菊花叶妙，鲜者捣汁，入药尤良。
治疔疮
黄连 羌活 青皮 白僵蚕 防风 独活 蝉蜕 细辛 赤芍药 甘草节 独脚茅
（各等分）
上 咀。每服五钱，先将一服，入泽兰叶少许，姜十钱重同擂烂，热酒和服。然后
用酒、水各半盏，姜三片煎服。病势退减后，再加大黄少许煎服，略下一二行，荡去余毒。
更用白梅、苍耳子，研烂贴疮上，拔去根脚。
手指患疔疮，出现麻木瘙痒，伴有寒热往来、恶心呕吐，左侧半身皆感麻木，脉象数急且不时显现。薛己说：凡是疮疡，不应该完全不痛，也不宜剧烈疼痛；若患者感到烦闷不安的，属于难治之症。如今出现麻木瘙痒，更是病情恶化的表现。使用夺命丹服用两剂，未见疗效。又改用解毒类药物，麻木瘙痒才消除，但随后转为肿痛。薛己说：虽然病势危急，但可喜的是出现了疼痛，这说明毒邪有外泄之机，然而目前毒邪仍无出路，于是用针刺破患处，各种症状顿时消退，再服用解毒药物而痊愈。
苏痒，字原博，手掌后部患疔疮，红色血丝延伸至手腕，伴有恶寒发热，病势属于表证。给予夺命丹一服，红丝顿时消散，再用和解类药物治疗，大势已退。他又自行服用败毒药物，导致口渴发热，红丝再次出现，脉象浮大而虚，这是气血受损所致。以补中益气汤为主治疗而痊愈。这是因为夺命丹服用后，疮毒邪气已经疏散，如果此时再使用败毒药物，就是诛伐无辜（损伤正气），违背了《内经》的宗旨。
一位儒者患疔疮，元气素来虚弱。薛己为他补益气血，排出脓液后痊愈。后来因劳累导致疮口疤痕处瘙痒，便另外服用败毒散一剂，以致出现牙关紧闭、舌体僵硬、手足抽搐揉动、痰涎上涌、自汗不止等症状，这是气血再次受损而引发的痉病。使用十全大补汤，加入附子一钱，灌服后苏醒。
一名男子患疔疮，服用夺命汤后汗出不止，疮口不痛，发热不退，小便不通利，这是汗出过多导致亡阳而真气受损。使用人参、当归、白术、芍药、防风、五味子等药二剂，各种症状全部消退，只是为小便不通利而担忧。薛己说：出汗多则小便不利，汗止则阳气恢复，小便自然通利。仍然使用前面的药物，去掉防风，加入麦冬，加倍使用黄芩和当归，四剂后大便通畅，疮口溃破而愈。
表甥居富，右手小指患疔疮，颜色紫暗。有人说：用小疮针刺出血，敷以凉药，结果掌指肿胀三四倍，颜色黯黑且不痛，神志昏沉烦躁不安，这是真气被剥夺而邪气实盛的表现。先服用夺命丹一服，活命饮二剂，症状稍有好转。薛己因事外出，有人遍刺其手部，流出鲜血约一碗，肿胀蔓延至手臂手腕，肿得大如葫芦，手指肿胀数倍，不能溃破。薛己使用大剂量的人参、当归、白术之类药物，并频繁艾灸全手，肿胀逐渐消退。但大便不成形，时常排气，这是元气下陷所致，使用补中益气汤加补骨脂、肉豆蔻、吴茱萸、五味子，使大便成形且气不泄。又每天用人参五钱、麦冬三钱、五味子二钱，水煎代茶饮用，再用大补药物五十余剂，逐渐痊愈。这个病症，起初如果不使用解毒药物，后期不使用大补药物，想要存活是很难的。
一人二十岁，嘴唇患疔疮四天，有紫色脉络从疮口延伸至口腔内部，即将到达咽喉。薛己说：这是真气虚弱而邪气实盛。如果紫脉越过咽喉，就难以治疗了，必须针刺紫脉，并刺破疮头放出恶血，以泄其毒，才可以。然而另用解毒药物，导致头面部都肿胀，求治心切。薛己说：我前日的话没有错。诊察其脉象洪数，重按却感觉无力，口腔内肿胀严重，针无法刺入，于是用砭石刮面与唇部，放出黑血约一碗，病势稍微减退，勉强进些汤水，最终未能挽回生命。
都宪张恒山，左脚趾患此病，疼痛难忍，急忙隔蒜灸三十多壮，就能行走。想要快速痊愈，有人用凉药敷贴，导致血液凝滞、肌肉坏死，毒邪更加炽盛。再次灸一百壮，服用活命饮，排出紫黑色毒血，才得以缓解，脚底完全溃烂，腐筋烂肉很多。快要痊愈时，误用生肌药物，反而助长毒邪，元气亏损而不能痊愈。薛己用托里药物治理，庆幸他体质结实，客居他乡三个多月才痊愈。大凡疔疮生在肢节部位，灸法有起死回生的功效，如果投用凉剂收敛，导致腠理隧道壅塞，邪气更甚，大多导致死亡。如果毒邪未尽，骤然使用生肌药物，轻者反而增加溃烂，重者必定导致危亡。
一名男子脚趾患疔疮，肿胀疼痛发红，使用隔蒜灸、人参败毒散加金银花、白芷、大黄，二剂后疼痛停止。又用十宣散加天花粉、金银花，去掉桂枝，数剂后痊愈。
濮阳传记载：万历丁亥年，金台有一位妇人，将羊毛遍撒于集市，忽然消失。接着都城人身生泡瘤，逐渐变大，痛苦死亡的很多人，瘤内只有羊毛。道人传授一方，用黑豆、荞麦磨成粉，涂擦，毛落而愈。名为羊毛疔。
荆芥败毒散（方剂见肿疡篇）。加入菊花叶效果奇妙，新鲜的捣汁入药尤其好。
治疗疔疮方：
黄连、羌活、青皮、白僵蚕、防风、独活、蝉蜕、细辛、赤芍药、甘草节、独脚茅（各等分）。
以上药材切碎。每服五钱，先将一服药，加入少许泽兰叶、十钱重的生姜同捣烂，用热酒调和服用。然后用酒、水各半盏，生姜三片煎服。病势退减后，再加入少许大黄煎服，略微通下大便一二行，以荡除余毒。再用白梅、苍耳子研烂贴在疮上，拔去根脚。
Fingers suffering from Ding sores (hard, deep-rooted boils) present with numbness and itching, accompanied by alternating chills and fever, nausea, and vomiting. The entire left side of the body feels numb, and the pulse is rapid and intermittently visible. Xue Ji stated: Generally, sores should not be completely painless, nor should they cause severe pain; if the patient experiences irritability and oppression, it is untreatable. The current presentation of numbness and itching indicates a particularly malignant progression. Administration of Duoming Dan (Life-Rescuing Pill) for two doses yielded no effect. Subsequently, detoxifying agents were used, after which the numbness and itching subsided, but swelling and pain ensued. Xue Ji remarked: Although the condition is critical, the emergence of pain is auspicious as it suggests the potential for toxin discharge; however, the toxic factors currently have no outlet. Therefore, acupuncture was employed to puncture the lesion, causing all symptoms to recede abruptly. Further administration of detoxifying agents led to recovery.
Su Yang, courtesy name Yuanbo, suffered from a Ding sore on the posterior aspect of his palm, with red streaks extending to the wrist, accompanied by chills and fever. The pathology belonged to the exterior syndrome. One dose of Duoming Dan caused the red streaks to vanish immediately. A harmonizing formula was then administered, significantly reducing the severity of the illness. He subsequently self-administered purgative-toxin-resolving drugs, resulting in thirst, fever, and the reappearance of red streaks. The pulse was floating, large, and deficient, indicating injury to Qi and Blood. Treatment with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) resulted in recovery. This was because, after taking Duoming Dan, the pathogenic factors of the sore had already dispersed. Re-administering purgative-toxin-resolving agents at this stage would constitute an unjust attack on healthy tissue, violating the principles of the *Neijing* (Inner Canon).
A scholar suffered from a Ding sore; his primordial Qi was inherently weak. Xue Ji tonified his Qi and Blood, leading to suppuration and recovery. Later, due to overexertion, the scar tissue of the healed sore became itchy. He separately took one dose of Baidu San (Detoxification Powder), which resulted in trismus (lockjaw), tongue stiffness, convulsions of the hands and feet, surging phlegm-saliva, and incessant spontaneous sweating. This indicated that Qi and Blood had been injured again, leading to wind-stroke-like spasms. Shiquan Dabu Tang (Complete Great Tonifying Decoction) with one qian of Fuzi (Prepared Aconite Root) was administered via gavage, restoring consciousness.
A man suffered from a Ding sore. After taking Dueming Tang (Life-Rescuing Decoction), he experienced profuse sweating, absence of pain in the sore, persistent fever, and urinary retention. This indicated yang collapse due to excessive sweating and injury to true Qi. Two doses of Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Bai Shao (White Peony Root), Fang Feng (Saposhnikovia Root), and Wu Wei Zi (Schisandra Fruit) resolved all symptoms. However, he remained concerned about urinary difficulty. Xue Ji stated: Excessive sweating leads to urinary difficulty; once sweating ceases, yang qi will recover, and urination will normalize naturally. The previous prescription was continued, excluding Fang Feng, adding Mai Dong (Ophiopogon Tuber), and doubling the dosage of Huang Qin (Scutellaria Root) and Dang Gui. After four doses, bowel movements normalized, the sore ulcerated, and he recovered.
My cousin-in-law, Ju Fu, suffered from a Ding sore on the little finger of the right hand, appearing purple. Some suggested pricking the small sore to bleed and applying cooling medicines. Consequently, the palm and fingers swelled three to four times their normal size, becoming dark and painless, with mental confusion and restlessness. This indicated depletion of true Qi and excess of pathogenic factors. Initially, one dose of Duoming Dan and two doses of Huoming Yin (Living Life Decoction) provided slight relief. While Xue Ji was away, others pricked his hand extensively, releasing approximately one bowl of fresh blood. Swelling extended to the arm and wrist, becoming as large as a gourd, with fingers swollen several times their normal size, unable to ulcerate. Xue Ji prescribed a large dose of Ren Shen, Dang Gui, Bai Zhu, etc., and frequently moxibusted the entire hand, gradually reducing the swelling. However, loose stools and frequent flatus occurred, indicating sinking of primordial Qi. Buzhong Yiqi Tang plus Gub Zhi (Psoralea Fruit), Rou Dou Kou (Nutmeg), Wu Zhu Yu (Evodia Fruit), and Wu Wei Zi were used to firm the stool and prevent qi leakage. Additionally, daily tea made from 5 qian of Ren Shen, 3 qian of Mai Dong, and 2 qian of Wu Wei Zi was consumed. Over fifty doses of major tonifying formulas were taken before gradual recovery. In this case, if detoxifying agents had not been used initially, and major tonics had not been used later, survival would have been difficult.
A twenty-year-old man suffered from a Ding sore on the lip for four days. Purple veins extended from the sore into the oral cavity, approaching the throat. Xue Ji stated: This is deficiency of true Qi and excess of pathogenic factors. If the purple veins cross the throat, it becomes difficult to treat. It is necessary to prick the purple veins and the head of the sore to release foul blood and drain the toxicity. However, other practitioners used detoxifying agents, causing swelling of the head and face. Seeking treatment urgently, Xue Ji said: My previous words were correct. The pulse was flooding and rapid, but empty upon deep pressure. Oral swelling was severe, preventing needle insertion. Bian stone therapy was applied to the face and lips, releasing about one bowl of black blood. The condition slightly improved, and some liquid food was taken, but he ultimately died.
Zhang Hengshan, a Censor, suffered from this condition on the toe of the left foot. The pain was unbearable. Immediate moxibustion through garlic for over thirty cones allowed him to walk. Desiring a quick cure, cool medicines were applied externally, causing blood coagulation and muscle necrosis, with toxins flaring up again. Moxibustion was performed for one hundred cones, and Huoming Yin was taken, discharging purple-black toxic blood, providing relief. The sole of the foot completely ulcerated with extensive rotting of tendons and flesh. Near recovery, mistaken use of skin-regenerating medicines aggravated the toxins. Due to primordial Qi depletion, healing stalled. Xue Ji treated with interior-supporting medicines. Fortunately, his constitution was robust, and he recovered after residing away from home for over three months. Generally, when Ding sores occur on limbs and joints, moxibustion has life-saving effects. If cooling agents are used to consolidate, blocking the pores and collaterals, the pathogenic factors intensify, often leading to death. If toxins are not fully cleared and skin-regenerating medicines are used prematurely, mild cases may worsen with increased ulceration, and severe cases may become fatal.
A man suffered from a Ding sore on his toe, presenting with swelling, pain, and redness. Moxibustion through garlic and Renshen Baidu San (Ginseng Detoxification Powder) added with Jin Yin Hua (Honeysuckle Flower), Bai Zhi (Angelica Dahurica Root), and Da Huang (Rhubarb Root) stopped the pain after two doses. Shixuan San (Ten Acupoints Powder) added with Tian Hua Fen (Trichosanthes Root) and Jin Yin Hua, excluding Gui Zhi (Cinnamon Twig), cured the condition after several doses.
Puyang Chuan recorded: In the Dinghai year of the Wanli era, a woman in Jintai scattered wool throughout the market and then disappeared. Subsequently, people in the capital developed blistering tumors that grew larger, causing painful deaths in many cases. Inside the tumors, only wool was found. A Daoist priest transmitted a formula using black beans and buckwheat ground into powder, applied topically. When the hair fell out, the patient recovered. This is named Yangmao Ding (Wool Ding Sore).
Jingjie Baidu San (Detoxification Powder with Schizonepeta) (Formula seen in the chapter on Swollen Ulcers). Adding Chrysanthemum leaves is excellent; fresh ones crushed for juice are especially effective in medication.
Treatment for Ding Sores:
Huang Lian (Coptis Rhizome), Qiang Huo (Notopterygium Rhizome), Qing Pi (Citrus Unripe Peel), Bai Jiang Can (Bombyx Batryticatus), Fang Feng (Saposhnikovia Root), Du Huo (Angelica Pubescens Root), Chan Tui (Cicada Slough), Xi Xin (Asarum Root), Chi Shao Yao (Red Peony Root), Gan Cao Jie (Licorice Knot), Du Jiao Mao (Single-Foot Grass) (Equal parts).
The above herbs are coarsely crushed. For each dose of five qian, first take one portion, add a small amount of Ze Lan Ye (Lycopus Leaf) and ginger weighing ten qian, pound them together until paste-like, and take with hot wine. Then, decoct with half a cup of wine and half a cup of water, along with three slices of ginger, and drink. After the disease severity subsides, add a small amount of Da Huang and decoct again, allowing for one or two bowel movements to sweep away residual toxins. Finally, apply a paste of Bai Mei (White Plum) and Cang Er Zi (Xanthium Fruit) to the sore to extract the root.