一人年逾三十。腹患痈肿。脉数喜冷。齐氏曰。疮疡肿起。坚硬者实也。河间曰。肿硬
。烦躁饮冷。邪在内也。用清凉饮（十二）倍大黄三剂。稍缓。次以四物汤加芩、连、山栀、
木通四剂而溃。更以十宣散（四）去参、 、桂。加金银花、天花粉。彼欲速效。自服温补药
。肚腹遂肿小便不利。仍用清凉饮。脓溃数碗。再以托里药治之而愈。（此因症因脉处治
一人腹痈 痛。烦躁作呕。脉实。河间曰。疮疡属火。须分内外以治其本。又云呕哕心
肿硬瞀闷。或皮肉不变。脉沉而实。毒在内也。当疏其内以绝其源。用内疏黄连汤。（三）利
二三行。诸症悉去。更以连翘消毒散而愈。（此据脉症而治。）
一人腹痈。脓熟开迟。脉微细。脓出后。疮口微脓如蟹吐沫。此内溃透膜也。疮疡透膜
。十无一生。虽用大补。亦不能救。此可为待脓自出之戒也。（此据症也。）
一恭人腹内一块。不时作痛。痛则不知人事。良久方苏。诸药不应。其脉沉细。非疮也
间云。失笑散（百九）治疝气及妇人血气痛欲死。并效。与一服。痛去六七。再服而平。此药
治产后心腹绞痛及儿枕痛。尤妙。（按此凭脉处治。）
一儿十岁。腹胀痛。服消导药不应。彼以为毒。其脉右关沉伏。此食积也。河间云。食
吐。胃脘痈也。更兼身体痛难移。腹胀善噫。舌本强。得后与气快然衰。皆脾病也。审之。
因食粽得此。以白酒曲热酒服而愈。（按此凭脉凭症而治也。）
一人素嗜酒色。小腹患毒。脉弱微痛。欲求内消。予谓当助胃壮气。兼行经活血佐之可消
欲速效。自用败毒等药。势果盛。疮不溃脓。饮食少思。两月余复请诊。脉愈弱。盗汗不止。
聚肿不溃。肌寒肉冷。自汗色脱。此气血俱虚。故不能发肿成脓。以十全大补汤（十三）三十
余剂。脓成针之。反加烦躁。脉大。此亡阳也。以圣愈汤（十七）二剂。仍以前汤百剂而愈。
（此凭脉症处治。）
A man over thirty years old suffered from an abdominal carbuncle. His pulse was rapid, and he desired cold drinks. Qi Shi stated: When a sore or ulcer swells and is hard, it indicates excess [Shi]. He Jian (Liu Wansu) stated: Swelling and hardness accompanied by irritability and a desire for cold drinks indicate that the pathogenic factor is inside the body. Qingliang Yin (Cooling Drink) with doubled Da Huang (Rhubarb Radix et Rhizoma) was administered for three doses, after which symptoms slightly alleviated. Subsequently, Siwu Tang (Four Substance Decoction) modified with Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Shan Zhi (Gardenia Fruit), and Mu Tong (Akebia Stem) was given for four doses, leading to suppuration. Then, Shixuan San (Ten Acupoints Powder) was used, removing Ren Shen (Ginseng Root), [character missing in original], and Gui Zhi (Cinnamon Twig), and adding Jin Yin Hua (Honeysuckle Flower) and Tian Hua Fen (Trichosanthes Root). The patient, desiring a rapid effect, self-administered warming and tonifying medicines, resulting in further abdominal swelling and difficulty in urination. Qingliang Yin was employed again, and after several bowls of pus were discharged, Tuoli Yao (Supporting Interior Medicines) were used to achieve recovery. (This case was treated based on symptoms and pulse.)
Another patient suffered from an abdominal carbuncle with pain, irritability, vomiting, and a solid pulse. He Jian stated: Carbuncles belong to fire syndromes; one must distinguish between interior and exterior to treat the root cause. He also stated: Vomiting, hiccuping, heart swelling and hardness, mental confusion, or unchanged skin and flesh color with a deep and solid pulse indicate that toxicity is inside the body. One should unblock the interior to cut off the source. Neishu Huanglian Tang (Interior-Draining Coptis Decoction) was prescribed. After two or three bowel movements, all symptoms disappeared. The patient recovered after taking Liaoqiao Xiaodu San (Forsythia Detoxification Powder). (This was treated based on pulse and symptoms.)
A third patient had an abdominal carbuncle where the pus had matured but failed to rupture spontaneously, with a faint and thin pulse. After pus discharge, the wound exuded a small amount of pus resembling crab bubbles. This indicated internal rupture penetrating the peritoneum. Carbuncles penetrating the peritoneum are fatal in ten out of ten cases; even with strong tonification, rescue is impossible. This serves as a warning against waiting for spontaneous rupture. (This judgment was based on symptoms.)
A noblewoman had a mass inside her abdomen causing intermittent pain. During pain episodes, she lost consciousness and only regained awareness after a long time. Various medicines were ineffective. Her pulse was deep and fine. This was not a carbuncle. It was mentioned that Shixiao San (Pain-Dispersing Powder) is effective for hernia and severe blood-stasis pain in women. One dose was given, reducing pain by sixty to seventy percent; a second dose brought relief. This medicine is particularly excellent for postpartum colic and "child pillow" pain. (This was treated based on pulse.)
A ten-year-old boy suffered from abdominal distension and pain. Digestive-promoting medicines were ineffective. He believed it was due to toxicity. His right Guan position pulse was deep and hidden. This was food stagnation. He Jian stated: Food retention with vomiting indicates stomach carbuncle. Additionally, body pain preventing movement, abdominal distension with frequent belching, stiffness of the tongue base, and relief after defecation or passing gas are all signs of Spleen disease. Upon careful examination, it was determined that eating zongzi (sticky rice dumplings) caused this condition. The boy recovered after taking Baijiu Qu (White Wine Qu) brewed in hot wine. (This was treated based on pulse and symptoms.)
A person who habitually indulged in alcohol and sexual activity developed a toxic lesion in the lower abdomen with a weak pulse and slight pain. He sought internal resolution. I advised supporting the Stomach Qi and strengthening Qi and Blood, assisted by herbs that promote circulation and resolve stasis, which could lead to resolution. However, desiring a quick effect, he self-administered detoxifying medicines. Consequently, the condition worsened; the sore did not suppurate, appetite decreased, and thinking became scarce. Two months later, upon re-examination, the pulse was weaker, night sweats persisted, swelling remained without rupture, muscles felt cold, spontaneous sweating occurred, and the complexion was pale. This indicated deficiency of both Qi and Blood, preventing the formation of swelling and pus. Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) was administered for over thirty doses. Once pus formed, it was lanced. However, irritability increased, and the pulse became large, indicating Yang collapse. Shengyu Tang (Sage's Life-Sustaining Decoction) was given for two doses, followed by another hundred doses of the previous decoction, leading to recovery. (This was treated based on pulse and symptoms.)