小肠痈之发。必先关元穴隐痛不已。（穴在脐下三寸）初起发热恶风。脉芤而数。腹急肿痛。大便
坠。小便涩。久则腹胀下淋。转侧有水声者。内痈成也。
由饱食负重。或醉饱入房。或产难弩力。或暴急奔走。致令气血壅遏。周旋失度。凝滞而成。如失治则流
注关节。变为败症矣。
初起小腹殷痛。俨似奔豚。小便淋涩者。薏苡仁汤加大黄下之。如已成。腹痛胀满不食。小便淋者。薏苡
仁汤主之。如腹痛重按则止。时时下脓者。毒未解也。牡丹皮汤并太乙膏主之。如下后脓多者。梅豆汤
和之。如面白食少。气血虚也。加减地黄汤。十全大补汤加丹皮、五味子补之。
肠痈宜灸两肘尖各百壮。艾如绿豆大。则大便下脓血。立愈。肠痈为病不可惊。惊则肠断。凡坐卧转侧。
俱宜徐缓。饮食宜少宜软烂。大宜滋补。固其元气。
脉则左寸洪数。又云。跗阳脉滑而数。知当屎脓。古为脓从脐出者不治。惟大补之亦有效者。
一人肠痈误治。腹胀如鼓。诊其脉细数而有力。视其腹。脐下一块光亮大热。腹内不时肠鸣。知为痈也。
令备净桶一个入滚水半桶。盖之听用。随以薏苡仁汤加酒大黄三钱。徐徐服之。待腹觉痛。扶坐桶上。
脓下如涌。其痛立减。随大补之而愈。
一人误作胀治。致毒内攻。腹痛连阴。阴器腐烂。色败无脓。水流臭秽。燥热口干。不治。果殁。
一妇腹如怀孕。疼痛不止。余用川芎、当归、炒蒲黄、炒吴茱萸、炒五灵脂、红花。水煎服。下血块斗许而愈。
Jiaban Bawei Wan (Modified Eight-Ingredient Pill), Shenqi Wan (Kidney Qi Pill) (both seen in the first volume), Jinye Wutu Dan (Golden Fluid Earth Earth Pill) (seen in the section on Gangrene of the Toes).
When Xiao Chang Yong (Small Intestine Abscess) occurs, there must first be persistent dull pain at the Guanyuan acupoint. (The acupoint is located three cun below the umbilicus.) In the initial stage, there is fever and aversion to wind, the pulse is Kou (hollow) and rapid, the abdomen is tense, swollen, and painful, there is a sensation of bearing down during defecation, and urination is difficult and涩 (astringent/stagnant). After a long time, abdominal distension and dribbling urination occur, and a sound of water can be heard when turning the body; this indicates the formation of an internal abscess.
This is caused by carrying heavy loads after full meals, sexual intercourse after drunkenness or overeating, straining during difficult childbirth, or sudden rapid running, leading to stagnation and obstruction of Qi and Blood, loss of normal circulation, and coagulation and stasis. If untreated, the pathogenic factors flow into the joints, transforming into a fatal condition.
In the initial stage, if there is severe pain in the lower abdomen resembling Ben Tun (Running Piglet disease), accompanied by difficult and burning urination, use Yiyi Ren Tang (Coix Seed Decoction) with Dahuang (Rhubarb) to purge. If the abscess has formed, presenting with abdominal pain, distension, anorexia, and difficult urination, treat primarily with Yiyi Ren Tang (Cois Seed Decoction). If abdominal pain is relieved upon deep pressure, and pus is discharged intermittently, it indicates that the toxin has not been resolved; treat with Mudanpi Tang (Moutan Cortex Decoction) and apply Taiyi Gao externally. If copious pus is discharged after purgation, harmonize with Meidou Tang. If the complexion is pale and food intake is poor, it indicates deficiency of Qi and Blood; tonify with Jiaban Dihuang Tang (Modified Rehmannia Pill) or Shiquan Dabu Tang (Ten Complete Tonifying Decoction) added with Mudanpi (Moutan Cortex) and Wuweizi (Schisandra Fruit).
For Chang Yong (Intestinal Abscess), moxibustion is suitable on both elbow tips, one hundred moxa cones each, with moxa cones the size of a mung bean; this will cause pus and blood to be passed through the bowels, resulting in immediate recovery. Patients with Chang Yong must not be startled, as startling may cause intestinal rupture. Sitting, lying down, and turning should all be done slowly. Diet should be small in quantity and soft in texture. Extensive tonification is highly recommended to consolidate Yuan Qi (Original Qi).
The pulse presents as Hong (surging) and Shu (rapid) at the Left Cun position. Another view states that if the Fuyang pulse is Hua (slippery) and Shu (rapid), it indicates that feces and pus will be discharged. Ancient texts consider abscesses discharging pus from the umbilicus as incurable, though cases exist where only extensive tonification was effective.
One patient with intestinal abscess was mis-treated, resulting in abdominal distension like a drum. The pulse was Xi (fine) and Shu (rapid) yet forceful. Observation of the abdomen revealed a bright, hot, and large mass below the umbilicus, with frequent borborygmus inside, indicating an abscess. A clean bucket was prepared with half a bucket of boiling water and covered for use. Then, Yiyi Ren Tang (Coix Seed Decoction) with three qian of Jiuhuang (Wine-processed Rhubarb) was administered slowly. When abdominal pain arose, the patient was supported to sit on the bucket, and pus gushed out, immediately relieving the pain. Subsequent extensive tonification led to recovery.
Another patient was mis-treated for abdominal distension, causing toxins to attack internally. Abdominal pain radiated to the yin region, the external genitalia became necrotic and foul-smelling with no pus, only foul fluid exuding, accompanied by dry heat and thirst. This was incurable, and the patient indeed died.
A female patient had an abdomen distended like pregnancy with unceasing pain. I used Chuanxiong (Ligusticum Chuanxiong Rhizome), Danggui (Angelica Sinensis Root), Chao Puhuang (Fried Pollen Typhae), Chao Wuzhuyu (Fried Evodiae Fructus), Chao Wulingzhi (Fried Trogopteri Dung), and Honghua (Carthamus Tinctorius Flower), decocted in water and administered orally. After passing approximately one dou of blood clots, she recovered.