张仲景云∶肠痈之症，因饮食积热，或母食辛热之物所致，小腹按之则痛，小便数似淋，腹急恶寒，身皮甲错，或
自汗恶寒。若脉迟紧未有脓者，用仙方活命饮，以解其毒。脉洪数已有脓者，服太乙膏，以下其脓。小腹疼痛，小便不
利者，脓壅滞也，牡丹皮散主之。窃谓∶经云∶肠痈为病不可惊，惊则肠断而死。故坐卧转侧之间，须令徐缓，时少饮
薄粥，及用八珍汤，固其元气，静养调理，庶可保也。
一小儿小腹作痛，小便如淋，身皮甲错，此肠痈也，脓已成，用薏苡仁汤、排脓散而痊。
一小儿腹中作痛，时或汗出，身皮甲错，小便如淋，脉滑数，脓已成也，用大黄汤一剂，下脓甚多，又用薏苡仁汤
而痊。
一小儿小腹胀痛，脉浮数，按之迟紧，不时畏寒，大便或欲去而不去，小便频而短，此为肠痈，但脓未成耳。不信，
或作痢症，恪用清热分利之剂，诸症蜂起而殁。
一小儿停食腹胀痛，二便不利，服草果、良姜之类，更加发热作渴，脉洪大而数。余曰∶此饮食滞而蕴热，将成脓
矣，前药非其治也。不信，仍服之，腹发赤晕，大便下脓而殁。
一小儿患肠痈，先用太乙膏，后服牡丹皮散下脓而愈。后因跌，腹内作痛，遍身皆赤，良久身黯而殁，盖肠断故也。
大黄汤 治肠痈，小腹坚肿，按之则痛，肉色如常。或 赤微肿，小便频数，汗出憎寒，脉迟紧，脓未成也，
急服之。
大黄（炒） 朴硝（各二钱） 牡丹皮 栝蒌仁 桃仁（去皮尖。各二钱）
上每服二三钱，水煎。
薏苡仁汤 治肠痈，腹中痛，烦躁不安，或胀满不食，小便涩滞。
薏苡仁 牡丹皮 桃仁（各三两） 栝蒌仁（四两）
上每服四钱，水煎。
桃仁汤 治肠痈，腹中痛，烦躁不安，壅痛，大便闭涩。亦有绕脐生疮者，但用此药无妨。
桃仁 大黄（炒） 牡丹皮 芒硝 犀角（镑） 冬瓜仁（研。各二钱）
上水煎，入犀角末服。
牡丹皮散 治肠痈，腹濡而痛，时下脓汁或下血。
牡丹皮 人参 天麻 白茯苓 黄 （炒） 薏苡仁 桃仁 白芷（炒） 当归 川芎 官桂 甘草（各五分） 木
香（二分）
上每服三五钱。
仙方活命饮（方见热毒疮疡）
太乙膏（方见跌扑外伤）
八珍汤（方见发热不止）
Zhang Zhongjing stated: The condition of Changyong (Intestinal Abscess) is caused by food stagnation transforming into heat, or by the mother consuming spicy and hot foods. Symptoms include pain upon pressing the lower abdomen, frequent urination resembling Lin syndrome (dysuria), abdominal tension with aversion to cold, skin dryness resembling scales (Ji Fu Jia Cuo), or spontaneous sweating with aversion to cold. If the pulse is slow and tight, indicating that pus has not yet formed, Xianfang Huoming Yin (Immortal Life Elixir) should be used to resolve toxicity. If the pulse is surging and rapid, indicating that pus has already formed, Taiyi Gao (Great One Ointment) should be taken to drain the pus. If there is lower abdominal pain accompanied by difficulty in urination, this indicates obstruction by pus, and Mudanpi San (Moutan Powder) is the primary prescription. I hold that: The classics state, "In cases of Intestinal Abscess, one must avoid fright; if frightened, the intestines may rupture leading to death." Therefore, during sitting, lying, turning, and moving, actions must be slow and gentle. One should occasionally drink thin rice gruel and take Bazhen Tang (Eight Treasures Decoction) to consolidate the Yuan Qi (Original Qi). With quiet rest and regulation, life can be preserved.
A child presented with pain in the lower abdomen, urinary frequency resembling Lin syndrome, and skin dryness resembling scales. This was diagnosed as Intestinal Abscess with pus already formed. Treatment with Yiyiren Tang (Coix Seed Decoction) and Paimon San (Pus-Draining Powder) resulted in recovery.
Another child presented with abdominal pain, occasional sweating, skin dryness resembling scales, urinary frequency resembling Lin syndrome, and a slippery and rapid pulse. This indicated that pus had already formed. One dose of Dahuang Tang (Rhubarb Decoction) was administered, resulting in the discharge of a large amount of pus. Subsequent treatment with Yiyiren Tang led to recovery.
A third child presented with distending pain in the lower abdomen, a floating and rapid pulse that became slow and tight upon deep pressure, intermittent aversion to cold, difficulty in defecation despite the urge, and frequent but scanty urination. This was Intestinal Abscess, but pus had not yet formed. The family did not believe this diagnosis and treated it as Li disease (Dysentery), strictly using formulas for clearing heat and promoting diuresis. Consequently, various symptoms arose simultaneously, and the child died.
A fourth child presented with abdominal distension and pain due to food stagnation, and obstruction of both stool and urine. After taking Caoguo (Tsaoko Fruit) and Liangjiang (Galangal Rhizome), the fever and thirst worsened, and the pulse became surging and rapid. I stated, "This is heat accumulating from food stagnation, approaching pus formation. The previous medications are inappropriate." The family did not believe this and continued the medication. Red halos appeared on the abdomen, pus was passed in the stool, and the child died.
A fifth child suffered from Intestinal Abscess. Initially, Taiyi Gao was applied, followed by Mudanpi San to drain pus, resulting in recovery. Later, due to a fall, the child experienced internal abdominal pain, reddening of the entire body, followed by darkening of the complexion and death. This was due to intestinal rupture.
Dahuang Tang: Treats Intestinal Abscess characterized by hardness and swelling of the lower abdomen, pain upon pressure, normal muscle color, or slight redness and swelling, frequent urination, sweating with aversion to cold, and a slow, tight pulse. This indicates pus has not yet formed; administer urgently.
Da Huang (Stir-fried Rhubarb Radix et Rhizoma) 2 qian, Po Xiao (Mirabilite Natrii Sulfatis) 2 qian, Mudan Pi (Moutan Cortex) 2 qian, Gualou Ren (Trichosanthis Semen) 2 qian, Tao Ren (Persicae Semen, peeled and core removed) 2 qian.
Take 2-3 qian per dose, decoct in water.
Yiyiren Tang: Treats Intestinal Abscess characterized by abdominal pain, restlessness, abdominal distension with anorexia, and difficult, stagnant urination.
Yiyi Ren (Coicis Semen) 3 liang, Mudan Pi 3 liang, Tao Ren 3 liang, Gualou Ren 4 liang.
Take 4 qian per dose, decoct in water.
Taoren Tang: Treats Intestinal Abscess characterized by abdominal pain, restlessness, obstructive pain, and constipation. It may also be used for ulcers around the umbilicus without harm.
Tao Ren 2 qian, Da Huang (Stir-fried) 2 qian, Mudan Pi 2 qian, Mang Xiao (Natrii Sulfatis) 2 qian, Xi Jiao (Rhinocerotis Cornu, sliced) 2 qian, Donggua Ren (Benincasae Semen) 2 qian (ground).
Decoct in water, add Xi Jiao powder before ingestion.
Mudanpi San: Treats Intestinal Abscess characterized by soft abdomen with pain, periodic discharge of pus or blood.
Mudan Pi 5 fen, Renshen (Ginseng Radix et Rhizoma) 5 fen, Tianma (Gastrodiae Rhizoma) 5 fen, Bai Fuling (Poria) 5 fen, Huangqi (Astragali Radix, stir-fried) 5 fen, Yiyi Ren 5 fen, Tao Ren 5 fen, Baizhi (Angelicae Dahuricae Radix, stir-fried) 5 fen, Danggui (Angelicae Sinensis Radix) 5 fen, Chuanxiong (Chuanxiong Rhizoma) 5 fen, Guanzi Gui (Cinnamomi Cortex) 5 fen, Gancao (Glycyrrhizae Radix et Rhizoma) 5 fen, Muxiang (Aucklandiae Radix) 2 fen.
Take 3-5 qian per dose.
Xianfang Huoming Yin (See formula under "Heat-Toxic Carbuncles")
Taiyi Gao (See formula under "Traumatic Injuries")
Bazhen Tang (See formula under "Persistent Fever")