悬痈者，患于肛门之前，阴囊之后是也，治之不早，鲜不伤生。凡觉肿痛，急用甘草节煎汤
服之，以缓其势，随以本方对证治之。
肿发热者，清肝解毒，小柴胡、制甘草之属。
肿痛甚者，解毒为主。（以制甘草是也。）不作脓，或不溃者，血虚也，八珍汤。
肿痛，小便赤涩者，肝经湿热也，宜分利清肝，龙胆泻肝汤是也。
一人谷道前患毒， 痛寒热，此肝经湿热所致，名曰悬痈，属阴虚。先以制甘草，二服
顿退，再以四物加
车前、青皮、甘草节、制黄柏、知母，四服而消。
一人患此， 痛发寒热，以小柴胡汤加制甘草，二剂少退，又制甘草四剂而消。
一人肿痛，小便赤涩，以加减龙胆泻肝汤，加制甘草，二剂少愈，以参、 、归、术、
黄柏、知母、制甘草，四剂而溃，更以四物加黄柏、知母、参、 、制甘草而愈。
一人脓熟不溃，胀痛，小便不利，急针之，尿脓皆利，以小柴胡加黄柏、白芷、金银花，
四剂痛止，以托里消毒散，数剂而愈。
一人悬痈已溃，但久不敛，脉大无力，以十全大补汤加五味、麦门冬，灸以豆豉饼，
月余而愈。
一人肿痛发热，以小柴胡加黄连、青皮，四剂少愈，更加以龙胆泻肝汤，数剂而消。
凡治悬痈，初起肿痛，或小便赤涩，先用制甘草一二剂，及蒜灸，更以龙胆泻肝汤。若发
热肿痛者，小柴胡汤加车前、黄柏、芎、归。脓已成，即针之。已溃，用八珍汤加制甘草、
柴胡梢、酒黄柏、知母。小便涩而脉有力者，仍用龙胆泻肝汤加制甘草。小便涩而脉无力者，
用清心莲子饮加制甘草。脓清不敛者，用大补剂，间以豆豉饼灸，或久而不敛者，亦用附子饼
灸，并效。
Xuan Yong (Hanging Abscess) refers to a carbuncle occurring anterior to the anus and posterior to the scrotum. If treatment is not initiated promptly, it rarely fails to endanger life. Whenever swelling and pain are felt, one should immediately decoct Gan Cao Jie (Catalpa Twig of Licorice Root) in water and drink it to alleviate the pathogenic force, followed by treating according to the specific syndrome using the formulas presented herein.
In cases with swelling and fever, the method is to clear the Liver and detoxify; Xiao Chai Hu Tang (Minor Bupleurum Decoction), Zhi Gan Cao (Prepared Licorice Root), and similar agents are used.
In cases with severe swelling and pain, detoxification is the primary approach (using Zhi Gan Cao).
If pus does not form or if the ulcer does not heal, it indicates Blood Deficiency; Ba Zhen Tang (Eight Treasures Decoction) is indicated.
In cases with swelling, pain, and dark, scanty, or painful urination, it is caused by Damp-Heat in the Liver Channel; the method should be to promote diuresis to drain dampness and clear the Liver heat; Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction) is appropriate.
One patient had a toxic lesion anterior to the anal opening, with pain and alternating chills and fever. This was caused by Damp-Heat in the Liver Channel and named Xuan Yong, belonging to Yin Deficiency. Initially, Zhi Gan Cao was administered; after two doses, symptoms receded rapidly. Then, Si Wu Tang (Four Substances Decoction) plus Che Qian Zi (Plantago Seed), Qing Pi (Aged Tangerine Peel), Gan Cao Jie (Catalpa Twig of Licorice Root), Zhi Huang Bo (Phellodendri Cortex Prepared with Bran), and Zhi Mu (Anemarrhenae Rhizoma) were given; after four doses, the condition resolved.
Another patient suffered from this condition, with pain accompanied by chills and fever. Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Zhi Gan Cao was used; after two doses, symptoms slightly subsided, and after four more doses of Zhi Gan Cao, the condition resolved.
Yet another patient presented with swelling, pain, and dark, scanty, or painful urination. Jian Di Long Dan Xie Gan Tang (Modified Gentian Liver-Draining Decoction) plus Zhi Gan Cao was administered; after two doses, symptoms slightly improved. Subsequently, Ren Shen (Ginseng Radix et Rhizoma), [missing character], Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), and Zhi Gan Cao were given; after four doses, the abscess ruptured. Finally, Si Wu Tang (Four Substances Decoction) plus Huang Bo, Zhi Mu, Ren Shen, [missing character], and Zhi Gan Cao led to recovery.
One patient had a mature abscess that had not ruptured, experiencing distending pain and difficulty in urination. Urgent acupuncture was performed to drain the pus; urine and pus flowed freely thereafter. Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Huang Bo, Bai Zhi (Angelicae Dahuricae Radix), and Jin Yin Hua (Lonicerae Japonicae Flos) were given; after four doses, pain ceased. Tuo Li Xiao Du San (Interior-Tonifying and Toxin-Expelling Powder) was then administered for several doses, resulting in recovery.
One patient’s Xuan Yong had already ruptured but failed to heal for a long time, with a large and powerless pulse. Shi Quan Da Bu Tang (Ten Great Tonics Decoction) plus Wu Wei Zi (Schisandrae Fructus) and Mai Men Dong (Ophiopogonis Radix) was prescribed, along with moxibustion using Dou Chi Bing (Fermented Soybean Cake); recovery occurred after more than a month.
One patient presented with swelling, pain, and fever. Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Huang Lian (Coptidis Rhizoma) and Qing Pi was given; after four doses, symptoms slightly improved. Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction) was then added; after several doses, the condition resolved.
Generally, for treating Xuan Yong, if there is initial swelling and pain, or dark, scanty, or painful urination, Zhi Gan Cao should be used for one or two doses first, combined with Suan Jiu (Garlic Moxibustion), followed by Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction). In cases with fever and swelling/pain, Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Che Qian Zi, Huang Bo, Xiong (Chuan Xiong, Ligusticum Chuanxiong Rhizome), and Dang Gui is used. Once pus has formed, immediate acupuncture drainage is required. After rupture, Ba Zhen Tang (Eight Treasures Decoction) plus Zhi Gan Cao, Chai Hu Shao (Bupleuri Radix Tip), Jiu Huang Bo (Wine-Processed Phellodendri Cortex), and Zhi Mu is employed. If urination is difficult and the pulse is forceful, Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction) plus Zhi Gan Cao is still used. If urination is difficult and the pulse is powerless, Qing Xin Lian Zi Yin (Heart-Clearing and Lotus Seed Decoction) plus Zhi Gan Cao is used. For clear pus that fails to heal, major tonifying formulas are used, interspersed with Dou Chi Bing moxibustion. For chronic non-healing ulcers, Fu Zi Bing moxibustion (Moxibustion with Aconite Cake) is also effective.