Library

Chengxin abscess (Abscess at the Xinggu point) arises in the depression below the xiphoid process. The swelling is firm and white in color, the pulse is hollow and weak (Kou pulse), accompanied by lower back pain, yellowish skin, and facial edema. Etiology may involve mid-body injury due to excessive labor, or disharmony of Ying and Wei (Nutritive and Defensive Qi) following trauma; it may also result from liver qi stagnation damaging the liver, with liver pathogenic factors invading the spleen, causing spleen qi to fail in its transporting function, leading to qi and blood stasis; or it may occur after illness when zang-fu qi declines, preventing the smooth regulation of Ying and Wei. Treatment should focus on harmonizing Ying blood and unblocking collaterals, nourishing and regulating qi and blood, allowing the swelling to gradually resolve internally. If it progresses to suppuration, it often develops into consumptive weakness (Xian Que), making recovery difficult.

Tan abscess (Phlegm Abscess) arises below the Zhongwan point (CV12), either on the left or right side. Initially presenting as a nodule that gradually enlarges, becoming hard and white. Its etiology, pulse, and symptoms are similar to Chengxin abscess, and the treatment method is also the same. This condition requires prompt treatment; if it reaches the stage of suppuration and pus is vomited out, it is considered incurable.

Weiwuan abscess (Gastric Epigastric Abscess) arises at the Zhongwan point (also known as the Front-Mu point of the Stomach, located three finger-widths below the xiphoid process, four cun above the umbilicus). It is divided into external and internal abscesses. The external abscess lies between the skin and fascia, initially presenting as diffuse swelling that gradually turns red and suppurates. This is caused by habitual consumption of rich wine and heavy flavors, leading to accumulation of damp-heat, failure of Spleen Yang to transport, and stagnation of qi and blood; or it may result from Shanghan (Cold Damage) Jie Xiong (Chest Binding), where although fu organ qi is unblocked, Spleen and Lung qi deficiency leads to failed ascending and descending functions, causing damp-turbidity to mix and stagnate, resulting in disharmony of Ying and Wei. Treatment should promote the draining of damp-heat, raise Lung qi, support the Spleen and Stomach, clear heat and detoxify the Ying level, so that resolution may be achieved. If pus has formed, incision and drainage should be performed to expel pathogens, followed by tonification and expulsion therapies to conclude treatment. As for the internal abscess, commonly called "Wei Yong" (Stomach Abscess), it arises within the stomach. Initially, there is dull pain and slight swelling at the Zhongwan point, hardness upon palpation, rough skin texture (lack of luster), and alternating chills and fever resembling malaria. Etiology often involves alcohol consumption, roasted foods, emotional stagnation transforming into fire, combined with external cold obstructing yang, causing hot turbid qi to fill the epigastrium, sinking of clear stomach qi, and obstruction of Ying qi flow. The Right Guan pulse will necessarily appear deep and fine; since the Stomach pulse manifests at the Right Guan position, which should normally be洪大 (Huge and Large), a deep and fine pulse indicates rebellious Stomach qi. The Renying point (ST9, located on both sides of the carotid artery) pulse will be very vigorous because heat gathers at the stomach opening but fails to disperse. With these two pulses, the abscess is confirmed. At this time, Shaoyin jue-ni (Jueyin/Shao Yin reversal/cold extremities) may occur, joint movement becomes difficult, chest and diaphragm feel stifled and blocked, and abdominal pain radiates to the heart. If the pulse is洪数 (Huge and Rapid), pus has formed, and urgent drainage is required; Chidou Yiren Tang (Red Bean and Coix Seed Decoction) is the primary formula, and Daye Gan Tang (Large Belamcanda Decoction) may also be used. If the pulse is迟紧 (Slow and Tight), although pus has not yet formed, blood stasis exists, requiring urgent purgation; Mudan Pi San (Moutan Bark Powder) is the primary formula. For phlegm-qi rebellion upward, Ganjie Tang (Licorice and Platycodon Decoction) is used; for constipation, Taiyi Gao pills are taken; for dark, scanty urine, abdominal fullness, and anorexia, Sanren Tang (Three Seeds Decoction) is used; for fatigue, asthma, thirst, and frequent urination, indicating Lung qi deficiency, Buzhong Yiqi Tang (Middle-Boosting Qi-Supplementing Decoction) with Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Fruit) is used for supplementation. If pus is vomited spontaneously from the mouth in this condition, toxic vapors will spread, rotting the intestines and stomach, spleen qi will decline daily, food intake will decrease, physical and mental exhaustion will set in, and death will ensue from depletion of essence and exhaustion of qi.