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(For both men and women)
The buttocks are the area distributed by the Foot-Taiyang Bladder Meridian. Located behind the lower abdomen, this is a region of "Yin within Yin." Its pathway is distant, and its position is secluded. Although the Taiyang meridian is rich in blood, Qi circulation rarely reaches it, and Blood flow is also scarce. Therefore, after middle age, one must be particularly vigilant against ailments here. In treatment, do not damage the Spleen and Stomach, nor deplete Qi and Blood; instead, focus primarily on consolidating the root (Ben). If there is swelling, hardness, and pain, this indicates that the physical constitution (Xing) and Zheng Qi are deficient while Xie Qi is excess. The primary formula is Tuoli Xiaodu San (Support the Interior and Detoxify Powder). If there is slight swelling and pain, this indicates deficiency in physical constitution, Zheng Qi, and pathogenic factors. Use Tuoli San (Support the Interior Powder) to tonify. If suppuration is imminent, use Tuoli Qianghuo Tang (Support the Interior and Notopterygium Decoction). If the pain is severe, use Xianfang Huoming Yin (Immortal Life Elixir Decoction). After the major symptoms have subsided, Tuoli Xiaodu San should still be used. If the Spleen is deficient and unable to resolve the swelling, or if the ulcer fails to heal, use Liujunzi Tang (Six Gentlemen Decoction) added with Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Astragali Radix (Huangqi). If Yin deficiency prevents resolution, or if thirst and dysuria occur, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) added with Schisandrae Fructus (Wuweizi). If Yang deficiency prevents suppuration, or if the pus is clear and fails to contract, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For simultaneous deficiency of Qi and Blood, use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction). If there is swelling and hardness but no suppuration, apply Garlic-Separator Moxibustion combined with Xianfang Huoming Yin. After suppuration, apply Fermented Soybean Cake (Douchi Bing) and administer either Buzhong Yiqi Tang or Shiquan Dabu Tang. If after moxibustion the major pathogenic factors have receded but residual toxins remain, frequently apply Scallion-Ironing (Congyi) to tonify Qi and eliminate residual toxins. This is excellent!

Clinical Cases:
Chen Hefeng, Censor-in-Chief, had weak Spleen and Stomach function and frequently took digestive aids. He developed swelling in his left thigh and buttock. I stated: "This is due to Spleen Qi deficiency causing dampness to sink downward, not severe toxin accumulation. His body is increasingly fatigued." I prescribed a decoction of single herb Atractylodis Macrocephalae Rhizoma (Baizhu), which resolved the swelling.

Yang Qiyuan, a scholar, suffered from this condition in his left buttock. After applying cooling plasters and taking Liaoqiao Xiaodu San (Forsythia Detoxifying Powder), he experienced pain throughout his left side. I diagnosed this as a deficiency of the Three Foot-Yin meridians and treated accordingly to tonify them.

A scholar presented with severe swelling and pain in the buttock, caused by stagnation of pathogenic toxins. I used Xianfang Huoming Yin combined with Garlic-Separator Moxibustion, which resolved the condition. Later, due to dietary irregularities and overexertion, the swelling and pain returned, accompanied by aversion to cold, fever, and headache. This indicated that Yuan Qi was deficient and had not recovered. I administered Buzhong Yiqi Tang and frequently applied the Scallion-Ironing method. He recovered after two months.

A man presented with diffuse swelling without color change, and a slippery, rapid yet forceless pulse, indicating impending suppuration. I intended to use a supporting method and prepare for needle drainage, but he feared needles and desired internal resolution.

The father of Wu Fu from Kunshan School suffered from internal suppuration and swelling, fever, dry mouth, and poor appetite. This was diagnosed as Spleen and Stomach weakness. Initially, I prescribed Liujunzi Tang added with Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Astragali Radix (Huangqi). After several doses, it suppurated. Subsequently, I used Shiquan Dabu Tang with doubled Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi). After more than fifty doses, he recovered.

Shen Kezhang’s son from Nanhao, aged thirty, presented with a pulse resembling dripping water or pecking sparrow (ominous pulses), hard red swelling, and thin pus. He had mistakenly taken detoxifying drugs. I stated: "This is a deficiency of the Three Foot-Yin meridians. It requires tonification of these meridians; only when Qi recovers will the sore heal."

A man presented with hard, painful, and hot buttocks. This was due to Bladder Qi deficiency and stagnation of Damp-Heat. Two doses of Neituo Qianghuo Tang (Internal Support and Notopterygium Decoction) completely relieved the heat and pain. Thereafter, Tuoli Xiaodu San was used to induce suppuration, followed by Tuoli San for over forty doses to promote healing.

Yuan Shangshe from Pinghu suffered from hemorrhoids. He applied cold herbs externally and took detoxifying herbs internally, which attacked the body and caused an ulcer in the buttock. The pus was thin, the pulse was large, rapid, and forceful, and he experienced chills, fever, and thirst. I declined treatment. He subsequently died. This was a syndrome of deficiency in the Three Foot-Yin meridians, where the source of transformation and nourishment was lost, leading to further depletion of True Qi and exacerbation of pathogenic factors. Death was inevitable!