【方歌】幽痈脐上七寸生，初小渐大肿硬疼，忧思厚味火毒发，
咬牙寒战毒陷攻。
【注】此证生脐上七寸，初起如粟，渐增漫肿疼痛，形如鹅卵
，甚则坚硬，痛牵胸肋。由过食膏梁厚味，忧思气结，
肠胃不通，火郁成毒，自内而外发也。初起肿痛，皮色
未红，时若心烦呕哕，脉沈实者，当疏火毒，以绝其源
，宜内疏黄连汤服之。焮肿痛甚邪气实也，宜服托里散
，外用艾壮隔蒜片灸之。脉见沈迟，其脓未成，用补中
益气汤托之；脉见洪数，其脓已成，用托里透脓汤。脓
熟胀痛不溃，系气血虚也，急用十全大补汤温补之，外
兼用卧针开，卧针者，斜入斜出，防伤内膜也。或误行
汗下，或误敷寒凉，以致肿而不溃，溃而不敛者，急用
十全大补汤，加干姜、附子以救之。已溃朝寒暮热者，
气血虚也；食少作泻，脾胃虚也；胸痞痰涌，脾肺虚也
，俱服六君子汤，服后诸证悉退，换十全大补汤调理即
愈。外治之法，按痈疽肿疡、溃疡门。无论已溃未溃，
忽咬牙寒战，系气虚不能胜毒，毒陷攻里之兆；或溃后
脓水忽多忽少，疮口如蟹吐沫者，系内膜已透，俱为逆
证。
方剂：托里散
组成：皂刺 金银花
黄芩 牡蛎（〔火段〕）
当归 赤芍
朴硝 大黄
花粉 连翘（去心，各等分）
共研粗末，每用五钱，酒、水各一钟，煎八分，去
渣服。
【方歌】托里散医诸疮毒，肿甚焮疼煎服消，皂刺银花芩牡蛎，
归芍硝黄花粉翘。
又方：内疏黄连汤（见肿疡门）
隔蒜炙法（见首部灸法）
托里透脓汤（见头部侵脑疽）
补中益气汤、十全大补汤、六君子汤（即香砂六君子汤
减去藿香、砂仁。俱见溃疡门）
[Prescription Verse] Youyong (Deep Abscess) arises seven cun above the umbilicus; initially small, it gradually enlarges with swelling, induration, and pain. Caused by excessive worry and rich/fatty foods leading to fire-toxin eruption, symptoms include teeth grinding and chills indicating toxin sinking inward.
[Annotation] This condition occurs seven cun above the umbilicus. Initially resembling a millet grain, it gradually increases into diffuse swelling and pain, shaped like a goose egg. In severe cases, it becomes hard, with pain radiating to the chest and hypochondrium. It results from overconsumption of rich and greasy foods, emotional stress causing Qi stagnation, and intestinal obstruction, where fire郁 (stagnation) transforms into toxin, erupting from the interior to the exterior. At the onset of swelling and pain, if the skin color is not red, but accompanied by mental restlessness, vomiting, and belching, with a deep and solid pulse, one should vent fire-toxin to cut off its source, suitable for taking Neishu Huanglian Tang (Internal Draining Coptis Decoction). If redness, swelling, heat, and pain are severe with excess pathogenic factors, Tuoli San (Support Interior Powder) should be taken, combined externally with moxibustion using mugwort cones separated by garlic slices. If the pulse is deep and slow, indicating pus has not yet formed, Buyi Yiqi Tang (Tonify Middle and Augment Qi Decoction) should be used to support the expulsion of toxins; if the pulse is surging and rapid, indicating pus has formed, Tuoli Tou Nong Tang (Support Interior and Perforate Pus Decoction) is indicated. If the pus is ripe with distending pain but does not ulcerate, it is due to Qi and Blood deficiency; urgently use Shiquan Dabu Tang (Ten Complete Tonifying Decoction) for warming and tonification. Externally, combine with "lying needle" incision; "lying needle" refers to inserting and withdrawing obliquely to prevent damage to the inner membrane. If mistakenly treated with sweating or purging methods, or incorrectly applied cold-cooling ointments, resulting in swelling without ulceration or ulceration without healing, urgently use Shiquan Dabu Tang added with Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite Root) to rescue the condition. After ulceration, morning chills and evening fever indicate Qi and Blood deficiency; reduced appetite and diarrhea indicate Spleen and Stomach deficiency; chest fullness and profuse phlegm indicate Spleen and Lung deficiency. All these should take Liujunzi Tang (Six Gentlemen Decoction); after symptoms subside, switch to Shiquan Dabu Tang for regulation and recovery. For external treatment, refer to the chapters on Ulcerative Sores and Ulcerated Lesions. Regardless of whether ulcerated or not, sudden teeth grinding and chills indicate Qi deficiency failing to overcome toxins, a sign of toxin sinking inward; or if after ulceration, pus flow fluctuates significantly and the wound resembles crab spitting foam, it indicates penetration of the inner membrane. Both are adverse signs.
Formula: Tuoli San (Support Interior Powder)
Composition: Gleditsiae Spina (Zaoci), Lonicerae Japonicae Flos (Jinyinhua), Scutellariae Radix (Huangqin), Ostreae Concha (Muli) [calcined], Angelicae Sinensis Radix (Danggui), Paeoniae Rubra Radix (Chishao), Natrii Sulfas (Puxiao), Rheii Radix et Rhizoma (Dahuang), Trichosanthis Radix (Huafen), Forsythiae Fructus (Lianqiao) [heart removed, equal parts].
Grind into coarse powder. Each dose uses 5 qian, decocted with one zhong of wine and one zhong of water until reduced to 8 fen. Strain and take.
[Prescription Verse] Tuoli San treats various sores and toxins; decoct and take to reduce severe swelling and burning pain. Ingredients: Zaoci, Jinyinhua, Huangqin, Muli, Danggui, Chishao, Puxiao, Dahuang, Huafen, Lianqiao.
Another Formula: Neishu Huanglian Tang (See Chapter on Ulcerative Sores)
Garlic-Separated Moxibustion Method (See Front Section on Moxibustion Methods)
Tuoli Tou Nong Tang (See Head Section on Brain-Penetrating Carbuncle)
Buyi Yiqi Tang, Shiquan Dabu Tang, Liujunzi Tang (i.e., Xiangsha Liujunzi Tang minus Huoxiang and Sharen. All see Chapter on Ulcerated Lesions)