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】此证生于尻尾骨略上，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。
\r坐马痈图\p04-34a175.bmp\r
隔蒜灸法（见首卷灸法）
臀痈证属膀胱经，坚硬闷肿湿热凝，肉浓之处迟溃敛，最宜红活高肿疼。
【注】此证属膀胱经湿热凝结而成。生于臀肉浓处，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。
\r臀痈图\p04-34a176.bmp\r
隔蒜灸法（见首卷灸法）
仙方活命饮 透脓散俱见肿疡门\x
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 ，渐生 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。
\r上马痈下马痈图\p04-34a177.bmp\r
内托羌活汤
羌活 黄柏（酒炒，各二钱） 黄 （一钱五分）
当归尾 陈皮 本 连翘 苍术（炒） 甘草（炙） 防风（各一钱） 肉桂（三分）
水一盅，酒半盅，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， 本连翘苍桂风。
荆防败毒散（见项部脑疽）
托里透脓汤（见头部侵脑疽）
Zuoma Yong (Abscess at the Sitting-Horse Position) belongs to the Du Meridian. The pathology involves damp-heat coagulation slightly above the sacrococcygeal region. A high, swollen appearance with rapid ulceration and thick pus indicates a favorable prognosis; whereas a diffuse swelling with delayed ulceration and discharge of purple fluid indicates an ominous prognosis.
[Note] This condition arises slightly above the coccyx, belonging to the Du Meridian, caused by the coagulation of damp-heat. High swelling, rapid ulceration, and thick pus are signs of a favorable course; diffuse swelling, delayed ulceration, and discharge of purple fluid are dangerous signs. In patients with deficiency constitution, this condition easily progresses to fistula formation. Initially, moxibustion with garlic slices is appropriate to promote circulation and resolve stagnation, facilitating ulceration and healing. Internal medication should follow the protocol for Guankou Ju (Abscess at the Bird's Beak). After ulceration, internal and external treatments should refer to the section on Ulcerated Carbuncles and Sores.
Tun Yong (Gluteal Abscess) belongs to the Bladder Meridian. It presents as hard, stifling swelling due to damp-heat coagulation. When located in areas of thick muscle, ulceration and healing are slow. The most desirable presentation is high swelling, bright redness, and pain.
[Note] This condition is caused by damp-heat coagulation in the Bladder Meridian. Arising in the fleshy part of the buttocks, swelling, ulceration, and healing are all slow. Initially, moxibustion with garlic slices is recommended, along with administration of Xianfang Huoming Yin (Immortal Life Elixir Decoction) to dissipate the swelling; if ineffective, Tou Nong San (Pus-Penetrating Powder) should be taken, followed by incision when pus is ripe. After ulceration, internal and external treatments follow the protocols for Ulcerated Carbuncles and Sores.
Shangma Yong (Upper Horse Abscess) and Xiama Yong (Lower Horse Abscess) arise in the creases on the left and right sides, respectively. They are caused by damp-heat in the Bladder Meridian combined with emotional distress such as worry and indignation. Black depression indicates severe disease, while high swelling indicates mild disease.
[Note] This condition arises in the gluteal fold, involving damp-heat in the Bladder Meridian and qi stagnation due to emotional imbalance like worry and anger. Initially presenting like millet grains, it gradually develops into painful nodules accompanied by alternating chills and fever. High swelling and bright redness indicate a mild case; flat depression and black hardness indicate a severe case. Initially, Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Rescue from Toxicity) is administered to relieve chills and fever, followed by Neituo Qianghuo Tang (Internal Supportive Decoction with Notopterygium). As pus formation approaches completion, Tuoli Tou Nong Tang (Decoction for Internal Support and Pus Penetration) is given. All other internal and external treatments follow the protocols for Ulcerated Carbuncles and Sores.
Neituo Qianghuo Tang (Internal Supportive Decoction with Notopterygium)
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Huangbai (Phellodendri Cortex, stir-fried with wine, 2 qian each), Huangqi (Astragali Radix, 1.5 qian), Dangguiwei (Angelicae Sinensis Radix, tail portion), Chenpi (Citri Reticulatae Pericarpium), Bencao (Ligustici Chuanxiong Rhizoma), Lianqiao (Forsythiae Fructus), Cangzhu (Atractylodis Rhizoma, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Fangfeng (Saposhnikoviae Radix, 1 qian each), Rougui (Cinnamomi Cortex, 0.3 qian).
Preparation and Administration: Decoct with one cup of water and half a cup of wine until reduced to eight-tenths. Take before meals.
[Prescription Song]: Neituo Qianghuo resolves hardness, dries dampness and supports abscesses below the buttocks; Danggui, Huangqi, Chenpi, Huangbai, and Gancao together, Ligusticum, Forsythia, Atractylodes, Cinnamon, and Saposhnikovia.
Jingfang Baidu San (see Brain Ju at the Neck Region)
Tuoli Tou Nong Tang (see Qinnao Ju at the Head Region)