骑马痈、鱼口、血疝（名四，实一，）生于两腿合缝之间，属冲任为病，见于厥阴肝经之旁
络。皆郁怒蕴热，血聚成毒。有因劳役而致者；或不遂交感，精离不泄；或强固败精，留结而致
；或先下疳而继生，常有接发杨梅疮者。微觉，前羊酒方可用。初宜发散，即行疏利而兼解毒。
一服已泻，不必再服。次清湿热，疏肝火。如不散，先托里，次调养气血。
主方 大黄（三钱，虚人减用） 僵蚕（二钱） 当归尾 赤芍药 金银花 白芷梢（
各一钱） 芒硝（一钱） 木鳖子（三个） 穿山甲（三片，炒研） 天粉（一钱）上用好酒二
碗，煎至一碗，入大黄、芒硝滚一沸，连罐露一宿，五更温服， 浓盖卧出汗，通利一、二次愈。
治便毒∶山甲（三片，土炒） 木鳖（三个，切碎） 牡蛎（ ） 大黄（三分） 金银花
黄连 黄柏 黄芩 连翘（各一钱半） 黄蜡（二钱） 好酒煎，入蜡，空心服。
又方 便毒初起可消 大黄 皂角刺 金银花 防风 当归尾 甘草节 栝蒌仁（各等分）
上用水、酒各半煎，空心服。仍频提掣顶中发。
又方 三方皆可消散 僵蚕 槐花（各三钱）上为末，酒下。欲疏利，加大黄。
又方 龙胆草 大黄 栝蒌仁 桃仁（各一钱） 木鳖（三个）上用水酒浓煎，露一宿，温
服。
又方 代赭石（另研） 栀子 大黄（各一钱） 当归（五分）上用水煎，调乳香、没药末
各一钱服。
又方 毒将成脓 大黄 连翘（各五钱） 枳实（三钱） 浓朴 甘草（各二钱） 桃仁（
二十一粒）
上分三帖，酒煎服。
又方 劳役而成 射干（三寸），生姜（三片），水煎，空心服。未利，加大黄煎服。
灸法∶用核桃壳半个，以人粪填满，合毒上，壳外艾炷灸至消为度。
一人肿痛，服疏利药不消亦不溃，用人参、黄 、当归、白术、柴胡、白芷、甘草、皂角刺
，并八珍汤而愈。
一人溃而肿不消，脉浮涩，以豆豉饼灸，内服十全大补汤而愈。
Qima Yong (Horse-riding Carbuncle), Yukou (Fish-mouth Abscess), and Xieshan (Blood Hernia) [though named four, they are essentially one] arise between the junction of the two thighs. They belong to disorders of the Chong and Ren vessels, manifesting alongside the collateral channels of the Foot-Jueyin Liver Meridian. All result from pent-up anger and accumulated heat, where blood gathers to form toxicity. Some are caused by overexertion; some by unsatisfied sexual intercourse with semen failing to discharge; some by forcibly retaining stale semen, leading to stagnation and accumulation; or following chancre (Xia Gan), often associated with contact transmission of Yamei Chuang (Syphilis). In mild cases, the preceding Yangjiu Tang may be used. Initially, dispersing methods should be employed, followed immediately by purgative and detoxifying strategies. If diarrhea occurs after one dose, no further administration is needed. Subsequently, clear damp-heat and soothe Liver fire. If the swelling does not dissipate, first apply a supporting interior method, then nourish Qi and Blood.
Main Formula: Dahuang (Rhei Radix et Rhizoma, 3 qian, reduced for deficient persons), Jiangcan (Bombyx Batryticatus, 2 qian), Dangguiwei (Radix Angelicae Sinensis Cauda), Chishaoyao (Radix Paeoniae Rubra), Jinyinhua (Flos Lonicerae Japonicae), Baizhishao (Radix Angelicae Dahuricae Apicalis) [each 1 qian], Mangxiao (Natrii Sulfas, 1 qian), Mubiezi (Semen Momordicae, 3 pieces), Chuanshanjia (Squama Manis, 3 slices, stir-fried and ground), Tianfen (1 qian). Decoct the above herbs in 2 bowls of premium white wine until reduced to 1 bowl. Add Dahuang and Mangxiao, bring to a boil once. Leave the pot exposed overnight. Take warm at dawn (Wugeng). Cover thickly to induce sweating. Recovery occurs after 1-2 bowel movements.
Treatment for Biandu (Groin Abscess): Chuanshanjia (Squama Manis, 3 slices, soil-stir-fried), Mubie (Semen Momordicae, 3 pieces, chopped), Muli (Concha Ostreae, dosage unspecified), Dahuang (Rhei Radix et Rhizoma, 3 fen), Jinyinhua (Flos Lonicerae Japonicae), Huanglian (Rhizoma Coptidis), Huangbai (Cortex Phellodendri), Huangqin (Radix Scutellariae), Lianqiao (Fructus Forsythiae) [each 1.5 qian], Huangla (Beeswax, 2 qian). Decoct in good wine, add beeswax, take on an empty stomach.
Another Prescription: For early-stage Biandu that can be resolved. Dahuang (Rhei Radix et Rhizoma), Zaojiaoci (Gleditsiae Sinensis Spina), Jinyinhua (Flos Lonicerae Japonicae), Fangfeng (Radix Saposhnikoviae), Dangguiwei (Radix Angelicae Sinensis Cauda), Gancaojie (Radix Glycyrrhizae Uralensis Joint), Gualouren (Semen Benincasae) [equal parts]. Decoct in half water and half wine, take on an empty stomach. Simultaneously, frequently pull the hair at the vertex of the head.
Another Prescription: The aforementioned three formulas can all resolve the condition. Jiangcan (Bombyx Batryticatus), Huaihua (Flos Sophorae) [each 3 qian]. Grind into powder, take with wine. To enhance purgative action, add Dahuang.
Another Prescription: Longdancao (Radix Gentianae), Dahuang (Rhei Radix et Rhizoma), Gualouren (Semen Benincasae), Taoren (Semen Persicae) [each 1 qian], Mubie (Semen Momordicae, 3 pieces). Decoct strongly in water and wine mixture, leave exposed overnight, take warm.
Another Prescription: Daizheshi (Haematitum, separately ground), Zhizi (Fructus Gardeniae), Dahuang (Rhei Radix et Rhizoma) [each 1 qian], Danggui (Radix Angelicae Sinensis, 0.5 qian). Decoct in water, mix with粉末 of Rushxiang (Olibanum) and Moyao (Myrrha) [each 1 qian], take orally.
Another Prescription: When toxin is about to suppurate. Dahuang (Rhei Radix et Rhizoma), Lianqiao (Fructus Forsythiae) [each 5 qian], Zhishi (Fructus Aurantii Immaturus, 3 qian), Houpo (Cortex Magnoliae Officinalis), Gancao (Radix Glycyrrhizae Uralensis) [each 2 qian], Taoren (Semen Persicae, 21 grains). Divide into three doses, decoct in wine, take orally.
Another Prescription: Caused by overexertion. Shegan (Rhizoma Belamcandae, 3 cun), Shengjiang (Rhizoma Zingiberis Recens, 3 slices). Decoct in water, take on an empty stomach. If no purgation occurs, add Dahuang and decoct.
Moxibustion Method: Use half a walnut shell, fill it with human feces, place it over the abscess. Apply moxa cones on the outside of the shell until the swelling dissipates.
Case 1: A patient had painful swelling. After taking purgative medicines, neither resolution nor suppuration occurred. Treated with Renshen (Radix Ginseng), Huangqi (Radix Astragali Membranacei), Danggui (Radix Angelicae Sinensis), Baizhu (Rhizoma Atractylodis Macrocephalae), Chaihu (Radix Bupleuri), Baizhi (Radix Angelicae Dahuricae), Gancao (Radix Glycyrrhizae Uralensis), Zaojiaoci (Gleditsiae Sinensis Spina), combined with Bazhen Tang (Eight-Treasure Decoction), resulting in recovery.
Case 2: A patient had suppuration but swelling persisted. Pulse was floating and choppy. Treated with Douchi Bing Moxibustion (Moxibustion using fermented soybean cake) internally supplemented with Shiquan Dabu Tang (Ten-Agent Great Tonifying Decoction), resulting in recovery.