胁痈,又名穿胁痈,或发于左胁,或发于右胁。人之两胁乃足厥阴肝经气分出入之道路
,一有阻滞,不得疏通,郁而为痛,故血亦为之凝聚矣。是以胁之上下发毒,皆属肝经。此
证多因郁怒肝火而发,或因肝胆之气不平,而风火内搏,营逆血热结聚而发。惟虚怯人生之
;若肥胖内实者,鲜此证也。初起,宜栀子清肝汤解郁泻火;已成,四妙汤加青皮、香附;
脓成者,即针之,勿伤内膜;溃后,宜八珍汤加山萸肉、牡丹皮、泽泻,兼滋肾水。但气虚
胃弱之人,亦不可过与补阳之药,恐内受热剂,则虚热愈盛,盛则透伤内膜,切宜慎之。又
病因虚劳所得,如破流臭败,脓水清稀,补托不应者,是死证也。
肋痈生于肋条骨间,又名侠荧痈,亦由肝火郁怒结聚而成。初起骨间隐痛,渐渐肿起,
后或大如杯碗,色或赤或白,疼痛难忍,内肠绞刺。患在左,痛牵右肋;患在右,痛牵左肋
。体虚之人,难以胜受。惟此处痈疽,多是内毒却入攻而死者多。人染此患,急宜用针刺
出脓血,防其内攻。若至二候,溃出稠脓为吉,溃出清水为凶。治法与前证参用。
腹痈者,亦名腹皮痈,生于腹之皮里膜外。乃脾经之毒,因食煎 油腻,酒醉太过
入房,以致毒不流通而结,无论左右,隐痛日久,后发痈肿于皮外;右关脉见沉数而腹痛甚
者,是其候也。不可过服克伐之药,若希图消散,过伤胃气,则肿不能溃,溃不能敛,难致
收功矣。初,宜服活命饮,或化毒除湿汤;溃后,服托里消毒汤。
脐痈生于脐中,由心经积热流于小肠经,毒聚而成(心与小肠为表里,心移热于小肠,
故发是毒)。肿大如瓜,高突若铃,或红或白。但脐为任脉神阙穴,禁针之所,宜早消散,
否则恐其内溃。若有脓,即穿破出外为吉。初宜多服蜡矾丸,汤剂则用黄连解毒合五苓散
治之,或导赤散加归尾、赤芍、银花亦可。
漏脐疮,或因肾虚火亢而发;或因恼怒气郁而发。宜服补剂,外以生肌散敷之。又小儿
脐中撒尿,因肝肾亏乏,气不宣化,是童痨败证,不治。
Xie Yong (Abscess of the Hypochondrium), also known as Chuan Xie Yong, may occur in the left or right hypochondrium. The bilateral hypochondrium of the human body is the pathway for the Qi of the Foot Jueyin Liver Meridian to enter and exit. Once obstructed and unable to be unblocked, stagnation leads to pain, causing blood to coagulate accordingly. Therefore, sores and toxins occurring above and below the hypochondrium all belong to the Liver Meridian. This condition often arises due to depression and anger leading to Liver Fire, or due to disharmony of Liver and Gallbladder Qi, with Wind and Fire battling internally, causing counterflow of Ying Qi, heat in the Blood, and aggregation. It is mostly seen in individuals with deficiency and frailty; those who are obese and have internal excess rarely suffer from this condition. In the early stage, Zhi Zi Qing Gan Tang (Gardenia Decoction to Clear the Liver) should be used to resolve stagnation and drain fire; when the abscess has formed but not yet ruptured, Si Miao Tang (Four Marvels Decoction) added with Qing Pi (Green Tangerine Peel) and Xiang Fu (Cyperus Rhizome) is indicated; when pus has matured, it should be lanced immediately, taking care not to damage the inner membrane; after rupture, Ba Zhen Tang (Eight Treasures Decoction) added with Shan Yu Rou (Cornus Fruit), Mu Dan Pi (Moutan Cortex), and Ze Xie (Alisma Rhizome) should be used to nourish Kidney Water. However, for those with Qi deficiency and weak Stomach function, one must not excessively administer Yang-tonifying herbs, lest the intake of hot-natured formulas exacerbate deficient heat, which could penetrate and damage the inner membrane; caution is essential. Furthermore, if the etiology is due to consumptive disease, such as a ruptured sore discharging foul-smelling putrid matter with thin, clear pus, and tonifying and supporting methods fail to respond, it is a fatal syndrome.
Lei Yong (Abscess of the Ribs), located between the ribs, is also known as Xia Ying Yong. It is also caused by the aggregation of Liver Fire, depression, and anger. Initially, there is a dull pain in the bone, gradually swelling up, later becoming large like a cup or bowl, with color either red or white, unbearable pain, and a sensation of internal intestines being twisted and pierced. If affected on the left, pain radiates to the right hypochondrium; if on the right, pain radiates to the left hypochondrium. Individuals with weak constitution find it difficult to endure. For abscesses and carbuncles in this area, death often results from internal attack by toxins. Upon contracting this affliction, urgent needle drainage of pus and blood is required to prevent internal invasion. If, by the second phase (approximately two weeks), thick pus drains upon rupture, it is auspicious; if clear water drains, it is ominous. Treatment methods refer to those for the preceding syndrome.
Fu Yong (Abdominal Abscess), also named Fu Pi Yong, occurs between the abdominal skin and fascia. It is toxin of the Spleen Meridian, resulting from consuming fried and greasy foods, excessive alcohol intake, or excessive sexual activity, leading to stagnation and aggregation of toxins. Regardless of side, there is long-standing dull pain, followed by the emergence of an abscess on the exterior of the skin; if the pulse at the Right Guan position is deep and rapid with severe abdominal pain, these are its signs. One must not overdose on purgative or attacking drugs; attempting to dissipate the swelling while excessively damaging Stomach Qi will result in the inability of the swelling to suppurate or heal, making recovery difficult. In the initial stage, Huo Ming Yin (Life-Saving Decoction) or Hua Du Chu Shi Tang (Toxin-Transforming and Dampness-Draining Decoction) is suitable; after rupture, Tuo Li Xiao Du Tang (Interior-Supporting and Toxin-Expelling Decoction) should be taken.
Qi Yong (Umbilical Abscess) occurs in the umbilicus, caused by accumulated heat in the Heart Meridian flowing into the Small Intestine Meridian, with toxin aggregation (The Heart and Small Intestine are interior-exteriorly related; heart heat transferred to the small intestine causes this toxicity). The swelling is large like a melon, protruding high like a bell, colored either red or white. However, the umbilicus is Shen Que (Conscious Pupil), an acupoint of the Ren Mai (Conception Vessel), where acupuncture is prohibited. Early dissipation is advisable; otherwise, internal ulceration is feared. If pus forms and breaks outward, it is auspicious. Initially, La Fan Wan (Beeswax and Alum Pill) should be taken frequently; for decoctions, Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity) combined with Wu Ling San (Five Ingredient Powder with Poria) is used, or Dao Chi San (Guide Out the Red Powder) added with Gui Wei (Tail of Angelica Root), Chi Shao (Red Peony Root), and Yin Hua (Chrysanthemum Flos) is also acceptable.
Lou Qi Chuang (Leaking Umbilicus Ulcer) may arise from Kidney deficiency with hyperactive fire, or from annoyance and Qi stagnation. Tonifying agents should be administered, and external application of Sheng Ji San (Flesh-Generating Powder) is recommended. Additionally, if infants urinate in the umbilicus due to deficiency of Liver and Kidney and failure of Qi to circulate and transform, it constitutes a pediatric consumptive failure syndrome, which is incurable.