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The *Neijing* (Classic of Internal Medicine) in the chapter "Bing Neng Lun" states: When a person suffers from stomach epigastrium abscess (a purulent inflammation of the stomach), one should examine the stomach pulse. The pulse should be deep and fine. A deep and fine pulse indicates rebellious Qi. Rebellious Qi causes the Renying pulse (the artery of the Foot-Yangming Stomach Meridian located at the neck) to become extremely full. An extremely full pulse indicates heat. The Renying pulse reflects the condition of the Stomach Meridian. If the pulse is rebellious and full, heat gathers at the gastric opening but cannot circulate, thus causing an abscess in the stomach epigastrium.

Ma Zhonghua said: The Stomach is the sea of water and grain; its meridian is abundant in Qi and Blood. The pulse appearing at the Right Guan position (the Guan position of the radial artery on the right wrist, corresponding to the Spleen and Stomach) should originally be surging and full. Now that it is instead deep and fine, this indicates that Stomach Qi has already become rebellious. The Renying acupoint is named after the Stomach Meridian, located on both sides of the laryngeal prominence, where the arterial pulsation can be felt. Its pulse manifestation is typically seen on the left hand (referring to the palpable pulsation of the Renying point itself, contrasting with the Cunkou). Now, the Right Guan pulse is deep and fine, while the Renying pulse is extremely full; this shows that heat is gathering at the gastric opening and failing to circulate. The *Lingshu: Jingmai* chapter states: If the Renying pulse is three times larger than the Cunkou pulse, it indicates excess in the Stomach Meridian. Verifying this, one can know the pulse characteristics of stomach epigastrium abscess.

Zhang Zhongjing said: For patients vomiting pus from an abscess, one must not treat the vomiting directly; once the pus is exhausted, the patient will heal spontaneously. Here, the location of the abscess is not explicitly stated, but the mention of vomiting pus implies that since the patient vomits without coughing, it is known not to be lung abscess, but clearly stomach epigastrium abscess. The *Neijing* says: Heat gathers at the gastric opening and fails to circulate, leading to an abscess in the stomach epigastrium. The stomach epigastrium belongs to the Yangming channel; due to the rebellious Qi of Yangming, the pus cannot be expectorated through coughing but is expelled via vomiting. The nature of the pus is not like that of lung abscess, which resembles congee; rather, because the pus originates from the stomach epigastrium, it transforms from dampness and coagulates into pus, sometimes forming phlegm clots resembling clam meat. The statement "do not treat the vomiting" means one must not use acrid-aromatic warming Stomach anti-emetic agents. This is because the turbid stasis of the pus steams the谷物 Qi, causing vomiting. Once the pus is discharged, the vomiting will cease naturally. If the abscess is located in the upper part of the stomach epigastrium, this is indeed the case. However, if the abscess extends beyond the middle, below the diaphragm, the pus will exit through the feces. For mild cases, select Paishang Tang (Drain Pus Decoction) from the *Jinkui Yaolue*; for severe cases, select Dahuang Mudan Tang (Rhubarb and Moutan Decoction) or Liangge San (Cool the Diaphragm Powder). If the pus is vomited from above, for mild cases, select Paishang San (Drain Pus Powder) from the *Jinkui Yaolue*; for severe cases, select Shegan Tang (Belamcanda Decoction), or Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) added with Honeysuckle Stem (Jinyinhua) and Forsythia Fruit (Lianqiao). These are all methods of guiding the pathogen according to its tendency. When the pus becomes thin and vomiting stops, subsequently administer Taiyi Gao (Great Efficacy Ointment) made into pills. For deficient individuals, use Bazhen Tang (Eight Treasures Decoction) added with Astragalus Root (Huangqi), Honeysuckle Stem (Jinyinhua), and Forsythia Fruit (Lianqiao) for regulation and tonification. Whenever the tongue coating persists for a long time, is black and greasy, the mouth feels sweet, and the breath is foul and turbid, these are signs of stomach epigastrium abscess formation. Astute physicians should distinguish them early, lest they wait until the abscess is established and incurable.

Shi Wan treated Tan Zhongan. He was obese and fond of drinking alcohol. In early summer, he suffered from high fever, vomiting, and rebellious Qi, with dull pain on the left side of the chest and diaphragm, intolerant to touch, scanty and frequent urination, slippery tongue coating, vomiting thick phlegm after eating accompanied by pain, gradually presenting blood-tinged fluid, and a choppy and irregular pulse. He was prescribed Liangge San (Cool the Diaphragm Powder) added with Dendrobium Stem (Shihu) and Forsythia Fruit (Lianqiao). After administration, a large amount of thick and greasy material was discharged. Initially, a surgeon treated him as having lung abscess without effect. I said, "Lung abscess must present with coughing and expectoration of foul-smelling sputum. This patient only vomits without coughing; it is undoubtedly a Stomach disease." After purgation, four or five days later, vomiting recurred as before. He was treated again with small doses for regulation. After three purgations, the pathological trend finally subsided. Subsequently, he was regulated with Baoyuan Tang (Preserve the Origin Decoction), Poria (Fuling), and Tangerine Peel (Chenpi) for twenty days until recovery. Previously, a Mr. Li suffered from this disease, focusing exclusively on clearing heat, resolving phlegm, and detoxifying. Until the diaphragmatic margin ulcerated and腐rosion occurred, with pus and water dripping continuously, he lingered for a month and died. This was truly due to delayed recognition, waiting until the condition deteriorated irreversibly, making regret futile.