元戎云。凡人初觉发背欲结未结。赤热肿痛。先湿纸覆其上。立视候之。其纸先干处即
是结
灸至不痛。不痛灸至痛时方佳。最要早觉早灸为上。一日二日。十灸七活。三日四日。六七
活。五六日。三四活。过七日。则不可灸。若有十数头作一处生者。即用大蒜研成膏。作薄
饼铺
独蒜切去两头。取中间半寸浓。正安于疮上。着艾灸十四壮。多至四十九壮。又曰。灸而不
痛。痛而后止其灸。灸而不痛者。先及其 。所以不痛。而后及良肉。所以痛也。灸而痛。
不痛而后止其灸。灸而痛者。先及其未 。所以痛。次及将 。所以不痛也。刘氏曰。此谓
痈疽初发。宜灸之也。然诸疮患久成漏者。常有脓水不绝。其脓不臭。内无歹肉。尤宜用附
子浸透。切作大片。浓二三分。于疮上着艾灸之。仍服内托之药。隔三二日再灸之。不五七
次。自然肌肉长满矣。至有脓水恶物渐溃根深者。郭氏治用白面、硫黄、大蒜。三物一处捣
烂。着疮大小。捻作饼子。浓约三分。于疮上用艾炷灸二十一壮。一灸一易。后隔四五日。
方用翠霞锭子并信效锭子。互相用之。 入疮内歹肉尽处。好肉长平。然后外贴收敛之药。
内服应病之剂。调理即瘥矣。盖不止宜灸于疮之始发也。大抵始发宜灸。要汗下补养之药对
证。至灸冷疮。亦须内托之药切当。设有反逆。不唯不愈。恐致转生他病也。元好问记云。素
饮酒。于九月中。患脑之下。项之上。出小疮。后数日。脑项麻木。肿势外掀。疡医遂取五
香连翘。至八日不下。而云不可速疗。十八日得脓。俟脓出。用药或砭刺。三月乃可平。四
月如故。予记医经云。凡疮见脓九死一生。果如其言。则有束手待毙之悔矣。乃请东垣诊视
。且谓膏粱之变。不当投五香。五香已无及。当先用火攻之。然后用药。以大艾炷如两核许
者。攻之至百壮。乃觉痛。次为处方云。是足太阳膀胱之经其病逆。当急治以黄连消毒丸。
身面疣瘤。宝鉴云。艾炷灸十壮。即用醋摩雄黄涂纸上。剪如螺蛳靥大。贴灸处。用膏药重
贴。二日一易。候痒折出。纸如豆粉愈。
元戎说：大凡人们刚开始发觉发背（生于背部的痈疽）即将形成但尚未完全结聚时，局部出现发红、发热、肿胀和疼痛。此时先用湿纸覆盖在患处，立即观察等待。如果湿纸上先变干的地方，就是痈疽结聚的部位。对此处施灸，直到患者感觉不到疼痛为止；如果患者原本不痛，则灸到产生痛感时才停止，这样效果最好。最关键的是要尽早察觉并尽早施灸为上策。发病一两天内施灸，十个能救活七个；三到四天施灸，能救活六七个；五到六天施灸，能救活三四个；超过七天，就不宜再施灸了。如果有十几个疮头聚集在一起生长的，就用大蒜研成膏状，做成薄饼铺在患处。取独蒜，切去两头，取中间厚约半寸的一段，正放在疮口上，用艾炷灸十四壮，多至四十九壮。又说：如果施灸时患者不感到疼痛，应灸到产生痛感后再停止施灸。施灸时若不痛，是因为先灸到了病变部位（所以不痛），而后才灸到健康肌肉（所以痛）。如果施灸时患者感到疼痛，应在不痛之前停止施灸。施灸时若痛，是因为先灸到了未病变的部分（所以痛），随后才灸到将病变的部分（所以不痛）。刘氏说：这是指痈疽初发时，适宜施灸。然而，各种疮疡患病日久形成漏管（慢性窦道）的，常有脓水不断流出，脓液不臭，内部没有腐肉，尤其适宜用附子浸泡透后，切成大片，厚约二三分，放在疮口上施灸。同时服用内托药，每隔两三天再施灸一次，经过五七次治疗后，肌肉自然会长满愈合。至于那些脓水恶物逐渐溃烂、病根深重的，郭氏治疗时用白面、硫黄、大蒜三种药物一起捣烂，根据疮口大小，捏成饼状，厚度约三分，放在疮口上用艾炷灸二十一壮，每灸完一次更换一次新饼。之后每隔四五日，交替使用翠霞锭子和信效锭子，将其纳入疮口深处，直到腐肉排尽，好肉长平，然后在外贴收敛药物，内服对症药剂，调理后即可痊愈。这不仅仅是在疮疡初发时适宜施灸。大抵初发时适宜施灸，但要配合汗法、下法或补养药物对证使用。至于灸治阴寒之疮，也必须恰当使用内托药物。如果出现反常逆症，不仅不能治愈，恐怕还会导致转生其他疾病。元好问记载说：某人平时爱喝酒，在九月间，患于脑后下方、颈项上方，长出小疮。几天后，脑部和颈部麻木，肿势向外高突。疡医于是使用五香连翘汤，到了第八天脓仍未排出，并称不可快速治疗。第十八天才出脓，等待脓液排出后，用药或砭刺放血，三个月才能平复，四个月恢复如常。我记起医经上说：凡是疮疡见到化脓，十死一生。果真如此的话，那就只能束手待毙了。于是请李东垣诊治。李东垣说：这是由于饮食肥甘厚味引起的病变，不应当投用五香类药物。五香类药物已经来不及使用了，应当先用火攻疗法。用大艾炷，大小如两个核那样，施灸至一百壮，这时才感觉到疼痛。接着处方说：这是足太阳膀胱经的病气逆乱，应当紧急用黄连消毒丸治疗。身体面部的疣瘤，据《宝鉴》记载：用艾炷灸十壮，然后用醋研磨雄黄涂在纸上，剪成如螺蛳壳花纹大小的形状，贴在灸过的地方，再用膏药重重地贴上，两天更换一次，等到瘙痒且结痂脱落，纸屑像豆粉一样落下时就痊愈了。
Yuanyong stated: Generally, when a person first begins to feel that a back carbuncle (a severe abscess on the back) is about to form but has not yet fully consolidated, with local redness, heat, swelling, and pain, one should first cover the affected area with a wet paper and immediately observe it. The place where the wet paper dries out first indicates the site of consolidation. Moxibustion should be applied to this spot until the patient no longer feels pain; if the patient initially felt no pain, moxibustion should continue until pain arises, which is considered optimal. The most crucial aspect is early detection and early application of moxibustion. If treated within one or two days of onset, seven out of ten cases may survive; three to four days, six or seven out of ten; five to six days, three or four out of ten; after seven days, moxibustion is contraindicated. If multiple carbuncle heads grow clustered together, garlic should be ground into a paste, formed into a thin cake, and placed over the lesion. Take a single garlic clove, cut off both ends, retain the middle section approximately half an cun thick, place it directly on the sore, and apply fourteen moxa cones (Zhuang), up to forty-nine Zhuang. It is also said: If moxibustion causes no pain, continue until pain is felt before stopping. Lack of pain during moxibustion occurs because the healthy tissue is stimulated first (hence no pain), followed by the diseased tissue (which causes pain). Conversely, if pain is felt during moxibustion, stop before the pain subsides. Pain occurs because the unaffected tissue is stimulated first (causing pain), followed by the tissue about to become diseased (which ceases to cause pain). Liu stated: This refers to the initial stage of carbuncles and sores, where moxibustion is appropriate. However, for chronic ulcers that have persisted for a long time and developed sinuses (chronic fistulas), characterized by continuous non-odorous pus discharge without internal necrotic tissue, it is particularly suitable to soak Radix Aconiti Lateralis Preparata (Fuzi, Prepared Lateral Root of Aconite) thoroughly, slice it into large pieces approximately two to three fen thick, place it on the ulcer, and apply moxibustion. Simultaneously administer internal supportive herbs (Neituo, Internal Supportive Therapy), and repeat moxibustion every two to three days. After five to seven sessions, the flesh will naturally regenerate and fill the wound. For cases with deep-rooted infection and gradual溃烂 (ulceration) of foul pus, Guo's treatment method involves pounding together white flour, Realgar (Liu Huang, Arsenic Sulfide), and garlic into a paste. Form this into a cake approximately three fen thick, sized to the ulcer, place it on the lesion, and apply twenty-one moxa cones. Replace the cake after each session. Subsequently, every four to five days, alternate using Cuixia Dingzi (Cuixia Pill) and Xinxiao Dingzi (Xinxiao Pill), inserting them deep into the ulcer until all necrotic tissue is expelled and healthy granulation tissue levels out. Then apply external astringent medicines and internal disease-specific formulas; regulation will lead to recovery. This indicates that moxibustion is not only suitable for the initial stage of sores. Generally, early-stage sores are suitable for moxibustion, provided it is combined with diaphoretic, purgative, or tonic therapies according to syndrome differentiation. For treating cold-type ulcers, appropriate internal supportive therapy is also essential. If adverse reactions occur, not only will the condition fail to heal, but other diseases may arise. Yuan Haowen recorded: An individual who habitually drank wine developed a small sore below the occiput and above the neck in the ninth month. Several days later, numbness spread to the head and neck, with swelling protruding outward. The surgeon prescribed Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction). By the eighth day, pus had not drained, and the surgeon claimed rapid cure was impossible. Pus finally drained on the eighteenth day. After drainage, medication or bloodletting with a stone needle (Bianci, Stone Needle Therapy) was used. It took three months to flatten and four months to return to normal. I recalled from medical classics: "When a sore suppurates, nine die and one survives." If this were true, one would merely wait for death with hands bound. Thus, Li Dongyuan was consulted. He stated: This is a disorder caused by rich food and drink, and Wuxiang (Five-Aromatic) herbs are inappropriate. Since Wuxiang herbs are ineffective at this stage, fire therapy (Huogong, Fire Attack Therapy) should be employed first. Use large moxa cones, size of two kernels, applying up to one hundred Zhuang until pain is perceived. Then, he prescribed: This is a reversal of Qi in the Foot-Taiyang Bladder Meridian (Zu Taiyang Pangguang Jing); urgently treat with Huanglian Xiaodu Wan (Coptis Detoxification Pill). Regarding warts and tumors on the body and face, Baojian records: Apply ten moxa cones, then grind Realgar with vinegar, paint it on paper, cut into shapes resembling snail shells, and apply to the moxibusted area. Cover with a plaster, changing every two days. Wait for itching and scabbing to fall off like bean powder, indicating healing.