【方歌】坐马痈属督脉经，尻尾略上湿热凝，高肿速溃稠脓顺，
漫肿溃迟紫水凶。
【注】此证生于尻尾略上，属督脉经，由湿热凝结而成。高肿
溃速脓稠者顺；若漫肿溃迟出紫水者险。虚人患此，易
于成漏。初宜艾壮隔蒜片灸之，以宣通结滞，令其易溃
易敛，内服之药，与鹳口疽同。溃后内外俱按痈疽溃疡
门。
又方：隔蒜灸法（见首卷灸法）
【方歌】肾痈证属膀肪经，坚硬闷肿湿热凝，肉厚之处迟溃敛，
最宜红活高肿疼。
【注】此证属膀胱经湿热凝结而成。生于臀肉厚处，肿、溃、
敛俱迟慢。初宜隔蒜片艾灸，服仙方活命饮消之；不应
者，即服透脓散，脓熟针之。溃后，内外治法俱按痈疽
溃疡门。
方剂：隔蒜灸法（见首卷灸法）
仙方活命饮、透脓散（俱见肿疡门）
【方歌】上马痈与下马痈，上左下右折纹生，膀胱湿热忧愤起，
黑陷属重高肿轻。
【注】此证生于臀肉之下折纹中，属膀胱经湿热，又兼七情不
和，忧愤凝滞而成。初起如粟，黄脓小疱，渐生焮痛，
寒热往来，高肿红亮为轻，平陷黑硬为重。初服荆防败
毒散以退寒热，次服内托羌活汤；脓势将成，服托里透
脓汤。其余内外治法，俱按痈疽溃疡门。
方剂：内托羌活汤
组成：羌活 黄柏（酒炒，各二钱）
黄耆（一钱五分） 当归尾
陈皮 〔高〕本
连翘 苍术（炒）
甘草（炙） 防风（各一钱）
肉桂（三分）
水一钟，酒半钟，煎八分，食前服。
【方歌】内托羌活宣坚硬，燥湿能托臀下痈，归黄陈柏同甘草，
蒿本连翘苍桂风。
又方：荆防败毒散（见项部脑疽）
托里透脓汤（见头部侵脑疽）
[Formula Song] Zuo Ma Yong (Sitting Horse Carbuncle) belongs to the Du Mai (Governor Vessel), where damp-heat condenses slightly above the coccyx. High swelling with rapid ulceration and thick pus indicates a favorable prognosis; diffuse swelling with delayed ulceration and purple fluid discharge indicates a ominous prognosis.
[Annotation] This condition arises slightly above the coccyx, belonging to the Du Mai (Governor Vessel), formed by the condensation of damp-heat. High swelling, rapid ulceration, and thick pus are signs of a favorable course; if there is diffuse swelling, delayed ulceration, and discharge of purple fluid, it is dangerous. In patients with deficiency constitution, this condition easily progresses to fistula formation. Initially, moxibustion with garlic slices should be applied to promote circulation and resolve stagnation, facilitating ulceration and healing. Internal medication is the same as that for Guan Kou Ju (Stork's Mouth Carbuncle). After ulceration, internal and external treatments follow the methods in the "Carbuncle and Ulcer" section.
Another method: Garlic-slice Moxibustion (see Volume One, Moxibustion Methods)
[Formula Song] Shen Yong (Kidney Carbuncle) syndrome belongs to the Bladder Meridian, characterized by hardness, stifling swelling, and condensation of damp-heat. Arising in areas of thick gluteal muscle, swelling, ulceration, and healing are all slow. The most desirable presentation is redness, liveliness, high swelling, and pain.
[Annotation] This condition is caused by the condensation of damp-heat in the Bladder Meridian. It occurs in the thick muscular area of the buttocks, where swelling, ulceration, and healing are all slow. Initially, moxibustion with garlic slices is suitable, along with administering Xian Fang Huo Ming Yin (Immortal Life-Elixir Powder) to dissipate the swelling; if ineffective, Tou Nong San (Pus-Penetrating Powder) should be taken, and once the pus matures, it should be punctured. After ulceration, internal and external treatments follow the "Carbuncle and Ulcer" section.
Formulas: Garlic-slice Moxibustion (see Volume One, Moxibustion Methods); Xian Fang Huo Ming Yin (Immortal Life-Elixir Powder), Tou Nong San (Pus-Penetrating Powder) (both see Swollen Ulcer Section).
[Formula Song] Shang Ma Yong (Ascending Horse Carbuncle) and Xia Ma Yong (Descending Horse Carbuncle) arise in the gluteal creases, left on top and right on bottom. They originate from damp-heat in the Bladder Meridian combined with emotional distress and indignation causing stagnation. Black depression indicates severe condition; high swelling indicates mild condition.
[Annotation] This condition arises in the crease below the gluteal muscles, belonging to damp-heat in the Bladder Meridian, compounded by disharmony of the Seven Emotions (Seven Affects), where grief and indignation cause Qi stagnation. Initially, it appears like millet grains or small yellow pustules, gradually developing into redness, swelling, heat, and pain, accompanied by alternating chills and fever. High swelling with bright red color indicates a mild condition; flat depression with black hardness indicates a severe condition. Initially, Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxins) is taken to relieve chills and fever, followed by Nei Tuo Qiang Huo Tang (Internal Supportive Decoction with Notopterygium). When pus formation is imminent, Tuo Li Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction) is administered. All other internal and external treatments follow the "Carbuncle and Ulcer" section.
Formula: Nei Tuo Qiang Huo Tang (Internal Supportive Decoction with Notopterygium)
Composition: Qiang Huo (Rhizoma et Radix Notopterygii), Huang Bo (Cortex Phellodendri, wine-fried), each 2 qian; Huang Qi (Radix Astragali), 1.5 qian; Dang Gui Wei (Radix Angelicae Sinensis caudex); Chen Pi (Pericarpium Citri Reticulatae); Gao Ben (Rhizoma Ligustici Chuanxiong); Lian Qiao (Fructus Forsythiae); Cang Zhu (Rhizoma Atractylodis Chinensis, fried); Gan Cao (Radix Glycyrrhizae, honey-fried); Fang Feng (Radix Saposhnikoviae), each 1 qian; Rou Gui (Cortex Cinnamomi), 3 fen.
Decoct one zhong of water and half a zhong of wine until eight parts remain; take before meals.
[Formula Song] Nei Tuo Qiang Huo disperses hardness, dries dampness, and supports the expulsion of carbuncles under the buttocks; Dang Gui, Huang Qi, Chen Pi, Huang Ba together with Gan Cao, Gao Ben, Lian Qiao, Cang Zhu, Rou Gui, and Fang Feng.
Another formula: Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxins) (see Occipital Brain Carbuncle); Tuo Li Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction) (see Head Invasion Brain Carbuncle).