小腹痈,生于小腹皮里膜外。或因膏粱浓味,或因七情火郁,以致脾虚气滞而成,小儿
乃惊积亏损所致。初起漫肿坚硬,肉色不变。数日后,有热渐红者,属阳,易治;无热不红
者,属阴,难治。此证不问初起未溃已溃,俱宜助胃壮气,而以行经活血之药佐之,如四君
子汤加川芎、当归、白芷、枳壳之类。如误用克伐攻利凉药,败证必出。若其纯阴无阳者,
宜十全大补加参、 、姜、附以温发之。又有肿高 赤作痛者,此属湿火,先用仙方活命饮
,或化毒除湿汤;成脓后脉洪数者,用托里消毒散。
缓疽,生于少腹之旁,乃脾经气滞寒积而成。坚硬,不红不热,痛引腰腿,有数月不溃
者。若寒热间作,饮食减少,渐致羸瘦,此属败证。治宜补养气血、温通经络,理中汤合四
物汤主之。
肾俞发者,即腰疽,生于两腰内肾陷肉之间,或生两腰中间,最为险候。盖肾为性命根
本,藏精藏气藏神;又乃受命先天,育女育男育寿。此必房劳过度,气竭精伤,欲火销阴,
外阳煽动,以致真阴从此而耗,既耗之后,其脏必虚,所以诸火诸邪,乘虚而入。其证初起
令人口干,寒热大作,百节俱痛。如本脏稍有真阴制火,疮形自可高肿红活为脓。治以人参
养营汤加山萸肉、北五味、知母、黄柏,及加减八味丸,以救其源。若疮形紫黑干枯,坚硬
不作脓者,为真阴内败,再无可生之理,死在十五日前后。
鹳口疽,发于尾闾穴之高骨尖上,亦名尾闾发,《灵枢》名锐疽。此由三阴亏损,督脉
之经浊气湿痰流结而成。初起形似鱼肫,久则突如鹳嘴,朝寒暮热,日轻夜重,溃后稀脓出
而无禁,又或鲜血出而不停。凡发此者,壮年犹可,老者可危。初宜滋阴除湿汤和之;已成
未溃者,和气养营汤托之;溃而不敛者,滋肾保元汤补之;久而成漏者,琥珀蜡矾丸、先天
大造丸,兼服甚妙。
Xiao Fu Yong (Abscess of the Lower Abdomen) arises in the space between the skin and fascia of the lower abdomen. It may be caused by a diet rich in rich, greasy, and sweet foods, or by emotional disturbances leading to the stagnation of fire, resulting in Spleen Qi deficiency and Qi stagnation; in children, it is caused by fright and accumulation leading to depletion. Initially, there is diffuse swelling that is hard, with unchanged skin color. After several days, if heat gradually appears and redness develops, it belongs to the Yang pattern and is easy to treat; if there is no heat and no redness, it belongs to the Yin pattern and is difficult to treat. For this condition, regardless of whether it is in the initial stage, un-ulcerated, or ulcerated, it is appropriate to use herbs that tonify Stomach Qi and strengthen healthy Qi, assisted by herbs that promote circulation through the meridians and invigorate blood, such as Sizijunzi Tang (Four Gentlemen Decoction) added with Chuanxiong Rhizoma (Chuanxiong), Danggui Radix (Danggui), Baizhis Fructus (Baizhi), and Zhike Pericarpium Citri Reticulatae (Zhike). If harsh purgatives, draining agents, or cooling medicines are mistakenly used, a collapse syndrome will inevitably occur. In cases of pure Yin without Yang, Shiquan Dabu Tang (Ten Significant Tonifying Decoction) added with Renshen Radix Ginseng (Renshen), Rouguici Cortex Cinnamomi Cassiae (Rougui), Ganjiangis Rhizoma (Ganjiang), and Fuzii Radix Preparata (Fuzi) should be used to warm and disperse. If the swelling is high, red, and painful, this belongs to Damp-Fire; Xianfang Huoming Yin (Immortal Formula for Saving Lives Infusion) or Huadu Chushi Tang (Toxin-Transforming and Dampness-Removing Decoction) should be used first; after suppuration occurs and the pulse is surging and rapid, Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) is used.
Huan Ju (Slow Carbuncle) arises on the side of the lower abdomen, formed by Qi stagnation and cold accumulation in the Spleen Meridian. The mass is hard, not red, not hot, with pain radiating to the waist and legs, sometimes failing to ulcerate for months. If alternating chills and fever occur, food intake decreases, and emaciation gradually ensues, this belongs to a collapse syndrome. Treatment should focus on tonifying Qi and Blood and warming and unblocking the meridians, primarily using Lizhong Tang (Regulate the Middle Decoction) combined with Siwu Tang (Four Substances Decoction).
Shensu Fa (Eruption at Shensu Point), also known as Yao Ju (Lumbar Carbuncle), arises between the muscles in the depression of the kidneys on both sides of the waist, or in the middle of both waists, representing a most critical condition. The Kidney is the root of life and nature, storing Essence, Qi, and Spirit; it is the organ receiving destiny from the Pre-heaven, governing reproduction of males and females, and longevity. This condition must result from excessive sexual activity, leading to exhaustion of Qi and injury of Essence, where desire-fire consumes True Yin, and external Yang flares up, causing True Yin to be depleted. Once depleted, the Zang organ becomes deficient, allowing various fires and pathogens to enter due to deficiency. Symptoms initially include dry mouth, severe alternating chills and fever, and pain in all joints. If the Zang organ retains some True Yin to control fire, the lesion will naturally become high, swollen, red, and active, forming pus. Treatment uses Renshen Yangying Tang (Ginseng Nourishing Ying Decoction) added with Shanzhuyu Fructus Corni Officinalis (Shanzhuyu), Beiwuzizi Fructus Schisandrae Chinensis (Bei Wuzi), Zhimu Rhizoma Anemarrhenae (Zhimu), and Huangbai Cortex Phellodendri (Huangbai), along with Jiaban Bawei Wan (Modified Eight-Ingredient Pill), to rescue the source. If the lesion is purple-black, dry, hard, and does not form pus, this indicates internal failure of True Yin, with no possibility of survival, and death will occur around fifteen days later.
Guankou Ju (Stork-Mouth Carbuncle) erupts on the sharp bone tip of the Weilu point, also called Weilü Fa (Eruption at Weilu), named Ruiju (Sharp Carbuncle) in Ling Shu. This is caused by deficiency of the Three Yin (Liver, Spleen, Kidney), with turbid Qi and damp-phlegm from the Du Mai (Governor Vessel) flowing and condensing. Initially, the shape resembles a fish stomach; over time, it protrudes like a stork's beak, with morning chills and evening fever, lighter during the day and heavier at night. After ulceration, thin pus flows out uncontrollably, or fresh blood flows continuously. Those who develop this in their prime years can still be saved, but it is dangerous for the elderly. Initially, Ziyin Chushi Tang (Yin-Nourishing and Dampness-Removing Decoction) should be used to harmonize; if formed but not yet ulcerated, Heqi Yangying Tang (Harmonizing Qi and Nourishing Ying Decoction) should be used to support expulsion; if ulcerated but not healing, Zishen Baoyuan Tang (Kidney-Nourishing and Yuan-Qi-Supporting Decoction) should be used to tonify; if it persists and forms a fistula, Hupo Lafan Wan (Amber and Wax-Alum Pill) and Xiandian Dazao Wan (Pre-heaven Great Creation Pill) taken together are very effective.