肿或发热者。清肝解毒。（小柴胡、制甘草。）
肿痛者。解毒为主。（制甘草。）不作脓或不溃者。气血虚也。（八珍汤。）肿痛小便赤滞
者。肝经湿热也。宜分利清肝。（龙胆泄肝汤。）
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（百二
服。顿退。再以四物加车前、青皮、甘草节、酒制黄柏、知母。数服而消。（此凭症也。）
一人年逾五十。患悬痈。脓清脉弱。此不慎酒色。湿热壅滞而然。脓清脉弱。老年值此
以收敛。况谷道前为任脉发原之地。肝经宗筋之所。予辞。果殁。治此痈惟涧水制甘草有效
。已破者。兼十全大补汤（十三）为要。
一人患此。 痛发寒热。以小柴胡汤加制甘草（百二七）二剂少退。又制甘草四剂而消。
（按小柴胡清肝。制甘草解毒。）
大抵此症属阴虚。故不足之人多患之。寒凉之剂。不可过用。恐伤胃气。惟制甘草一药
。不损气血。不动脏腑。其功甚捷。
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、
知母、制甘草。四剂（百二七）而溃。更以四物加黄柏、知母、参、 、制甘草而痊。（按
此先泻后补。当时以有所据。但不知其脉耳。）
一人肿痛未作脓。以加减龙胆泻肝汤二剂。少愈。再以四物加黄柏、知母、木通、四剂
消。（按此先治湿热后养血。）
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。
常见患者多不肯针。待其自破。殊不知紧要之地有脓。宜急针之。使毒外发。不致内溃
曰宜开户以逐之。凡疮若不针烙。毒瓦斯无从解。脓瘀无从泄。今之患者。反谓紧要之处。不
宜用针。何相违之远耶。
一人脓清不敛。内有一核。以十全大补汤加青皮、柴胡、制甘草。更以豆豉饼灸。核消
而敛。（此凭症也。）
一人久而不敛。脉大无力。以十全大补加五味、麦门。灸以豆豉饼。月余而愈。（此凭
症凭脉也。）
一老年余而不敛。诊脉尚有湿热。以龙胆泻肝汤（六七）二剂。湿退。以托里药及豆豉饼
灸而愈。（此凭症凭脉也。）
一人肿痛发热。以小柴胡加黄连、青皮（五）。四剂少愈。更以龙胆泻肝汤（六七）而消。
（此凭症也。）
一人脓熟不溃。脉数无力。此气血俱虚也。宜滋阴益气血之药。更针之。使脓毒外泄。彼反
用败毒药。致元气愈虚。疮势愈盛。后溃不敛。竟致不救。（按此不凭脉症而误治也。）
悬痈原系肝肾二经阴虚。须一于补。尤恐不治。况脓成而又克伐。不死何待。常治初起
肿痛。或小便赤涩。
先以制甘草一二剂。及蒜灸。更饮龙胆泻肝汤。若发热肿痛者。以小柴胡加车前、黄柏
、归。脓已成。即针之。已溃用八珍汤（十四）。加制甘草、柴胡稍、酒炒黄柏、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。
If swelling or fever occurs, clear the Liver and detoxify. (Use Xiaochaihu Tang [Minor Bupleurum Decoction], Zhi Gancao [Prepared Licorice Root].)
If swelling and pain occur, prioritize detoxification. (Use Zhi Gancao [Prepared Licorice Root].)
If suppuration does not form or ulceration does not occur, it is due to deficiency of Qi and Blood. (Use Bazhen Tang [Eight-Treasure Decoction].)
If there is swelling, pain, and red, stagnant urine, it is damp-heat in the Liver channel. One should promote diuresis to separate dampness and clear the Liver. (Use Longdan Xiegan Tang [Gentian Liver-Draining Decoction].)
A patient suffered from a toxic lesion anterior to the anus, with pain, aversion to cold, and fever. This was caused by damp-heat in the Liver channel, named Xuanyong [Hanging Abscess], belonging to Yin deficiency. First, use Zhi Gancao [Prepared Licorice Root] (120 doses), which rapidly reduced symptoms. Then, use Siwu Tang [Four-Substance Decoction] added with Cheqianzi [Plantago Seed], Qingpi [Aged Tangerine Peel], Gancao Jie [Licorice Joint], Jiuhuangbai [Wine-processed Phellodendron Bark], and Zhimu [Anemarrhena Rhizome]; after several doses, it resolved. (This case relies on symptom differentiation.)
A patient over fifty years old suffered from Xuanyong [Hanging Abscess] with thin pus and a weak pulse. This resulted from imprudence in alcohol and sexual activity, leading to stagnation of damp-heat. With thin pus and a weak pulse, for an elderly person, one should employ astringent methods. Moreover, the area anterior to the anus is the origin of the Ren Mai [Conception Vessel] and the site where the Liver channel gathers the sinews. I declined treatment, and the patient indeed died. In treating this type of abscess, only Jian Shui Zhi Gancao [Jianshui-processed Prepared Licorice Root] is effective. For those already ulcerated, combining with Shiquan Dabu Tang [Complete Great Tonifying Decoction] (13) is essential.
A patient suffered from this condition; upon onset of pain accompanied by aversion to cold and fever, Xiaochaihu Tang [Minor Bupleurum Decoction] added with Zhi Gancao [Prepared Licorice Root] was used. After two doses, symptoms slightly subsided; after four more doses of Zhi Gancao [Prepared Licorice Root], it resolved. (Note: Xiaochaihu Tang [Minor Bupleurum Decoction] clears the Liver; Zhi Gancao [Prepared Licorice Root] detoxifies.)
Generally, this condition belongs to Yin deficiency, so individuals with insufficiency are prone to it. Cold-natured medicines should not be overused, lest they damage Stomach Qi. Only Zhi Gancao [Prepared Licorice Root] does not damage Qi and Blood nor disturb the Zang-Fu organs, and its efficacy is very rapid.
A patient presented with swelling, pain, and red, astringent urine. Ji Jian Longdan Xiegan Tang [Modified Gentian Liver-Draining Decoction] added with Zhi Gancao [Prepared Licorice Root] was used; after two doses, slight improvement occurred. Then, Renshen [Ginseng Root], [missing herb], Danggui [Angelica Sinensis Root], Baizhu [Atractylodes Macrocephala Rhizome], Zhimu [Anemarrhena Rhizome], and Zhi Gancao [Prepared Licorice Root] were administered for four doses (127?), leading to ulceration. Subsequently, Siwu Tang [Four-Substance Decoction] added with Huangbai [Phellodendron Bark], Zhimu [Anemarrhena Rhizome], Renshen [Ginseng Root], [missing herb], and Zhi Gancao [Prepared Licorice Root] led to recovery. (Note: This case employed purging first, then tonifying, which had basis at the time, but the pulse was unknown.)
A patient had swelling and pain without suppuration. Ji Jian Longdan Xiegan Tang [Modified Gentian Liver-Draining Decoction] was used for two doses, resulting in slight improvement. Then, Siwu Tang [Four-Substance Decoction] added with Huangbai [Phellodendron Bark], Zhimu [Anemarrhena Rhizome], and Mutong [Akebia Caulis] was used for four doses, leading to resolution. (Note: This case treated damp-heat first, then nourished Blood.)
A patient had mature pus that did not ulcerate, accompanied by distending pain and difficult urination. Urgent acupuncture was performed; both urine and pus flowed freely. Xiaochaihu Tang [Minor Bupleurum Decoction] added with Huangbai [Phellodendron Bark], Baizhi [Angelica Dahurica Root], and Jinyinhua [Lonicerae Japonicae Flos] was used for four doses, stopping the pain. Tuoli Xiaodu San [Interior-Supporting Detoxification Powder] was used for several doses, leading to recovery.
It is common for patients to refuse acupuncture, waiting for spontaneous rupture. However, when pus accumulates in critical areas, urgent acupuncture is necessary to allow the toxin to discharge externally, preventing internal collapse. As stated, "open the door to drive out the pathogen." If sores are not punctured or cauterized, toxins cannot be resolved, and pus/stasis cannot drain. Modern patients wrongly believe that critical areas should not be needled, which is far removed from medical principles.
A patient had thin pus that failed to heal, with a nodule inside. Shiquan Dabu Tang [Complete Great Tonifying Decoction] added with Qingpi [Aged Tangerine Peel], Chaihu [Bupleuri Radix], and Zhi Gancao [Prepared Licorice Root] was used, along with Douchi Bing Moxibustion [Fermented Soybean Cake Moxibustion]; the nodule dissipated, and healing occurred. (This case relies on symptom differentiation.)
A patient had prolonged non-healing with a large but forceless pulse. Shiquan Dabu Tang [Complete Great Tonifying Decoction] added with Wuweizi [Schisandra Fruit] and Maidong [Ophiopogon Tuber] was used, along with Douchi Bing Moxibustion [Fermented Soybean Cake Moxibustion]; recovery occurred after more than a month. (This case relies on symptom and pulse differentiation.)
An elderly patient had residual issues with non-healing. Pulse diagnosis indicated remaining damp-heat. Longdan Xiegan Tang [Gentian Liver-Draining Decoction] (67?) was used for two doses to reduce dampness; then interior-supporting medicines and Douchi Bing Moxibustion [Fermented Soybean Cake Moxibustion] were used for recovery. (This case relies on symptom and pulse differentiation.)
A patient had swelling, pain, and fever. Xiaochaihu Tang [Minor Bupleurum Decoction] added with Huanglian [Coptidis Rhizoma] and Qingpi [Aged Tangerine Peel] (5) was used for four doses, yielding slight improvement. Longdan Xiegan Tang [Gentian Liver-Draining Decoction] (67?) was then used for resolution. (This case relies on symptom differentiation.)
A patient had mature pus that did not ulcerate, with a rapid but forceless pulse, indicating deficiency of both Qi and Blood. Medicines to nourish Yin and benefit Qi and Blood should be used, combined with acupuncture to drain pus/toxins externally. The patient instead used destructive drugs, causing further depletion of Yuan Qi [Original Qi] and worsening the sore. Eventually, it ulcerated and failed to heal, leading to death. (Note: This was misdiagnosis and mistreatment ignoring pulse and symptoms.)
Xuanyong [Hanging Abscess] originates from Yin deficiency in the Liver and Kidney channels. Treatment must focus on tonification, especially since it is difficult to cure. How much more so if purgatives are used after suppuration forms? Death would be inevitable. Generally, for initial swelling/pain or red/astringent urine, use Zhi Gancao [Prepared Licorice Root] for 1-2 doses, along with Suan Moxibustion [Garlic Moxibustion], and drink Longdan Xiegan Tang [Gentian Liver-Draining Decoction]. If fever and swelling/pain occur, use Xiaochaihu Tang [Minor Bupleurum Decoction] added with Cheqianzi [Plantago Seed], Huangbai [Phellodendron Bark], and Danggui [Angelica Sinensis Root]. Once pus is formed, perform acupuncture. For ulcerated cases, use Bazhen Tang [Eight-Treasure Decoction] (14), added with Zhi Gancao [Prepared Licorice Root], Chaihu Shao [Bupleuri Radix Tip], Jiuhuangbai [Wine-processed Phellodendron Bark], and Zhimu [Anemarrhena Rhizome]. If urine is astringent and the pulse is forceful, continue using Longdan Xiegan Tang [Gentian Liver-Draining Decoction] added with Zhi Gancao [Prepared Licorice Root]. If urine is astringent and the pulse is forceless, use Qingxin Lianzi Yin [Heart-Clearing Lotus Seed Decoction] added with Zhi Gancao [Prepared Licorice Root]. For thin pus failing to heal, use major tonifying agents, interspersed with Douchi Bing Moxibustion [Fermented Soybean Cake Moxibustion]. For prolonged non-healing, use Fuzi Bing Moxibustion [Aconite Cake Moxibustion]; both are effective.