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At the initial stage, if there is pain in the lower abdomen, difficulty in urination, a slightly slow pulse in all six positions (radial arteries), and no aversion to cold or fever, the condition is mild. If the abscess has formed, with swelling and hardness in the lower abdomen, frequent but difficult urination, and a flooding and rapid pulse in all six positions, the condition is dangerous.

If the abscess has ruptured, with pus discharging intermittently, tenesmus (a feeling of incomplete defecation), occurring day and night without limit, and pain not diminishing, the condition is severe. If after rupture the pus is foul-smelling and turbid, or if it discharges as putrid, turbid blood stasis water, accompanied by increased deficiency-heat and loss of appetite, the prognosis is fatal.

At the initial stage, if there is pain in the lower abdomen that feels soft or hard upon palpation, and the pulse is hollow (Kou) and rapid, this indicates blood stasis; purgation is indicated. If there is pain in the lower abdomen with a palpable mass, constipation, and urinary symptoms resembling strangury, harmonization combined with purgation is indicated. If the abscess has ruptured, with intermittent pus discharge, unceasing abdominal pain, and loss of taste for food, tonification combined with expelling pus (Tuofa) is indicated. If a postpartum woman has lochia retention flowing into the small intestine causing pain with a rapid pulse, harmonization combined with guiding out stagnation is indicated. If abdominal distension persists for a long time, with the umbilicus protruding high, and a sound like water sloshing when turning the body, this indicates urgent accumulation of internal pus requiring needle drainage.

A male patient presented with distending pain in the lower abdomen, tenesmus, and intermittent pus discharge. The physician treated him as having dysentery, which worsened his condition. Upon examination, his pulse was hollow and rapid, indicating an abscess of the small intestine. After one dose of Yiyiren Tang (Coix Seed Decoction), he discharged about one sheng (approx. 200ml) of pus, and the sensation of heaviness ceased. He was then given Liu Mu Dan Pi San (Six Doses of Moutan Cortex Powder) and recovered.

A young girl, more than a month postpartum, developed gradual abdominal pain and swelling resembling Gu disease (parasitic or metabolic disorder). Internal physicians diagnosed it as Gu disease. A month later, she became heavy-limbed and confused, and her family had given up treatment. I happened to be consulted for pediatric sores and ulcers and heard this case, so I examined her. Although she was unconscious and confused, her pulse was fine, rapid, and forceful, indicating an internal abscess with pus formation, which did not necessarily preclude survival. Her family said, "There is no hope." I asked, "Let me press the swollen abdomen to determine life or death." Observing the skin over the swelling, it was tight, bright, and shiny, with intense heat below the umbilicus. This confirmed an internal abscess that was treatable, a case with virtually no risk. The family was delighted and prepared a clean chamber pot covered with half a bucket of boiling water for steam inhalation. First, I administered Yiyiren Tang with two qian (approx. 6g) of wine-fried Dahuang (Rhubarb Rhizome and Rhei Radix) slowly. When she felt abdominal pain, I helped her sit on the pot. The steam vaporized, and pus gushed out like a spring, mixing with the broth and filling the bucket. She immediately regained consciousness. Subsequently, she took Bazhen Tang (Eight Treasures Decoction) added with Mudanpi (Moutan Cortex) and Wuweizi (Schisandrae Fructus), and recovered after more than a month of regulation.

A female patient presented with swelling and pain in the lower abdomen and urinary symptoms resembling strangury. Her pulse was slow and hollow. This resulted from consuming raw and cold foods during menstruation, compounded by anger, leading to urgent Liver Fire clashing with blood stasis to form an internal abscess. Since the pus had not yet formed, I used Dahuang Tang (Rhubarb Decoction) to purge; after the blood stasis was completely expelled, she recovered.

A female patient who had a miscarriage retained blood stasis. Due to early physical exertion, she suffered from swelling and pain inside and outside the lower abdomen for over a month, accompanied by dry and hard stools, stagnant and difficult urination, dry mouth and throat, restlessness, and insomnia. Internal physicians' treatments aggravated the condition. Upon inquiry, I suspected an internal abscess. Her pulse was rapid, solid, and forceful, confirming that the intestinal abscess had formed. One dose of Yiyiren Tang with Dahuang discharged several bowls of pus, and the distending pain subsided instantly. However, the external swelling remained hard and painful, indicating the abscess was attempting to rupture and drain externally. I prescribed Shiquan Dabu Tang (Ten Significant Tonifying Decoction) for three doses until the pus and swelling subsided, followed by needle drainage. She then took Bazhen Tang added with Mudanpi and Wuweizi, and healed after more than a month.

A female patient presented with abdominal distension like a drum, the umbilicus protruding by more than one cun (approx. 3cm), stagnant and difficult urination, and a sloshing sound in the abdomen when turning. This indicated fully formed internal pus. I used a needle to puncture the highest point of the protrusion above the umbilicus, draining a basin full of pus. She took Mudan Pi San (Moutan Cortex Powder) for five or six doses, reducing the pus gradually. In the morning, she took Bawei Wan (Eight Flavor Pill), and in the evening, Bazhen Tang added with Zexie (Alisma Rhizome), Mudanpi, Huangqi (Astragali Radix), and Pugu Zhi (Psoraleae Fructus). She recovered after more than a month.