人有腹痛口渴，左足屈而不伸，伸则痛甚，手按其痛处，更不可忍者，人以为腹中生痈也，谁知是小肠痈乎？
肠中生痈不同，有大小肠之分，屈右足者大肠生痈，屈左足者小肠生痈也。今屈而不伸者，既在左足，是痈生
于小肠，而非生于大肠矣。惟是大肠之痈易治，小肠之痈难医，以大肠可泄而小肠难泄也。若得其法，又何难
哉？盖大肠可泄其火，从糟粕而出；小肠可泄其火，从溲溺而泄也。方用泄毒至神汤∶
刘寄奴（三两） 车前子（三两） 金银花（三两） 泽泻（三两） 甘草（三两） 茯苓（一两）
玉米（一两） 肉桂（一分）
水煎服，一剂而水如注，二剂而痛顿止，三剂而症如失，不必四剂矣。此方皆利水之药，重用金银花为消
毒之品，何以建功之神如此？盖小肠之毒，必须内消，而内消之药舍金银花，实无他药可代。以他药消毒，均
能损伤正气，而小肠之气断不可损伤，故必须以金银花为君药。但金银花不能入于小肠之中，而佐以茯苓、车
前、泽泻、玉米之类，引入小肠，又加肉桂一分，得其气味，直入膀胱从溲溺而化其毒。若恐火毒太甚，诸药
不能迅速收功，更加寄奴之速祛，甘草之缓调，刚柔迟速，兼而行之，既无留滞之虞，又无峻烈之害，自然火
毒尽从小肠膀胱而出也。
秘诀∶
泄毒至神寄奴三，车银草泽重如前，
苓玉一两桂分入，三剂服后患可痊。
此症方用王公汤亦效∶
王不留（一两） 蒲公英（一两） 车前子（一两） 甘草（五钱） 金银花（三两）
水煎服，一剂效。
秘诀∶
王公汤治小肠痈，不留一两蒲公英，
车前一两五钱草，银花三两一剂从。
人有腹痛呼号不已，其痛却在左腹，按之痛不可忍，不许人按，人以为食积在大肠也，谁知是小肠之生痈
乎？夫肠痈必屈其足，而今不屈足，似非肠痈之病。然肠痈生于肠内，在大肠者屈右足而不伸，在小肠者屈左
足而不伸也。若痈生于肠外者，皆不屈足，痛在左则小肠生痈，痛在右则大肠生痈也。至于食积燥粪之痛，时
而痛，时而不痛，不若生痈之痛，有定而不移，常痛而无止息也。大小肠生痈于肠内，尚可破溃，而大小肠生
痈于肠外，断不可使之溃烂者，以肠外无可出之路，皆必死之症也。而小肠更甚，必须急治，以利水解毒为妙，
否则变生不测矣。方用利水解毒内消丹，亦可用王公汤，再加金银花三两可矣。
金银花（四两） 车前子（五钱） 薏苡仁（一两） 茯苓（一两） 当归（二两） 甘草（三钱）
水煎服，一剂而痛大减，二剂而痛又减，三剂而痛全止，四剂而痊愈矣。此方即前方（泄毒至神汤）之变
方也。但前方于利水之中而行其败毒之法，此方则于利水之
中而佐以补血败毒之味也。盖痈破尤宜利水，利水则毒随之而出，易于涤除。如痈未破，而不补血，徒事利水，
利水则水泄血虚，毒亦难于消化。同中之异，不可不知也。然此症须急早治之，否则痈虽愈而瘀血流于肠外，
必有终身腹痛之患矣。
秘诀∶
利水解毒内消丹，银花四两车五钱，
薏仁苓两归二两，甘草三钱一同煎。
人有腹痛骤甚，小便流血，左足不能伸者，人以为小肠生痈也，谁知是小肠之火太盛乎？夫小肠生痈，必
屈左足，今左足不伸，明是生痈之证，而余独谓是火盛者何也？盖生痈必有其征，岂有一旦骤生而流血者乎？
痈久而脓生，脓欲尽而血出，岂有不溃不烂而先出血者乎？然左足之屈，则又何也？盖小肠与大肠不同，小肠
细而大肠宽，宽者可以容邪，而细则难以容邪，此必然之理也。小肠受火煎熬，则肠中逼迫，不能舒畅，而左
足应之，故暂屈而不能伸，不若生痈者长屈而不能伸也。万不可因足之不伸，即信是痈，而妄用解毒之药，
其害大矣！然火毒与痈，从何而辨之？初病之时，辨其小便之有血无血耳。如初痛而足不伸，小便无血，乃是
生痈。初痛而足不伸，小便有血，乃是火痛，断不差也。治之法，泄其火邪不必化毒，则痛自止而足自伸矣。
方用加味小柴胡汤治之∶
柴胡（二钱） 黄芩（三钱） 人参（五钱） 茯苓（五钱） 半夏（一钱） 甘草（一钱） 生姜（三片）
大枣（三枚）
水煎服，一剂而足伸，二剂而血止，肠亦不痛矣。小柴胡汤非治小肠痈之药也，何以用之而效验之捷如此？
盖小肠之火盛者，起于肝木之郁也，木郁则火生，不敢犯心而犯小肠耳。夫火性炎上，今不上炎而反致下炽，
拂其火之性矣，此小肠所以受害而作痛也。至于血流于小便中者，又是何故？盖小肠之血，为火所逼，恐火烁
血干，故越出于小肠之外，直走膀胱，反使水道不行而流血也。小柴胡汤既舒其肝胆之气，则上炎之火气，其
性即顺而不逆也，又得茯苓以分消其水气，则水顺流而不横，其血归经而不逆，自然气舒血和，而消毒矣，此
方之所以奇耳。
秘诀∶
加味小柴治肠毒，黄芩三钱参苓五，
夏草一钱加姜枣，二剂血止肠痈主。
此症用车苓连甘汤亦效∶
车前子（五钱） 茯苓（一两） 黄连（三钱） 甘草（三钱）
水煎服。
秘诀∶
又有车苓连甘汤，车前五钱苓两襄，
甘连三钱同煎服，止血通和此方良。
A person presents with abdominal pain and thirst, the left leg is flexed and cannot be extended; extension exacerbates the pain. Palpation of the painful area is unbearable. People assume it is an abscess in the abdomen, but who would know that it is actually an Intestinal Abscess (Chang Yong) of the Small Intestine?
The formation of abscesses in the intestines varies, distinguished by involvement of the Large Intestine or Small Intestine: flexion of the right leg indicates a Large Intestine abscess, while flexion of the left leg indicates a Small Intestine abscess. Since the current case involves flexion of the left leg without extension, the abscess is located in the Small Intestine, not the Large Intestine. However, abscesses of the Large Intestine are easier to treat, whereas those of the Small Intestine are difficult to cure, because the Large Intestine can drain heat through fecal excretion, while the Small Intestine cannot easily do so. If the correct method is mastered, what difficulty remains? Generally, fire-toxin in the Large Intestine can be drained via feces; fire-toxin in the Small Intestine must be drained via urine. The prescription used is Xi Du Zhi Shen Tang (Toxin-Draining Supreme Divine Decoction):
Liu Ji Nu (Sanliao, Herba Siegesbeckiae) (3 liang), Che Qian Zi (Sanliao, Semen Plantaginis) (3 liang), Jin Yin Hua (Sanliao, Flos Lonicerae Japonicae) (3 liang), Ze Xie (Sanliao, Rhizoma Alismatis) (3 liang), Gan Cao (Sanliao, Radix Glycyrrhizae Uralensis) (3 liang), Fu Ling (1 liang, Poria) (1 liang), Yu Mi (1 liang, Frumentis Indici Cornucopia) (1 liang), Rou Gui (1 fen, Cortex Cinnamomi Cassiae) (1 fen).
Decoct in water and take orally. After one dose, urination becomes profuse like flowing water; after two doses, pain ceases abruptly; after three doses, symptoms disappear completely, and a fourth dose is unnecessary. This formula consists entirely of diuretic herbs, with heavy use of Jin Yin Hua as an anti-toxic agent. Why does it achieve such miraculous results? Toxin in the Small Intestine must be resolved internally, and among internal-resolving herbs, Jin Yin Hua has no substitute. Other anti-toxic herbs tend to damage healthy Qi, which must not be damaged in the Small Intestine; thus, Jin Yin Hua serves as the Sovereign herb. However, Jin Yin Hua cannot enter the Small Intestine directly, so it is assisted by Fu Ling, Che Qian Zi, Ze Xie, and Yu Mi to guide it into the Small Intestine. Additionally, a small amount of Rou Gui is added to carry the aroma directly into the Bladder, resolving toxin via urine. If concerned that the fire-toxin is too severe for these herbs to act quickly, Liu Ji Nu is added for rapid expulsion, and Gan Cao for gentle regulation. Combining firm and soft, slow and fast actions avoids stagnation and harsh side effects, ensuring fire-toxin exits naturally from the Small Intestine and Bladder.
Secret Formula:
Xi Du Zhi Shen uses Sanliang Liu Ji Nu,
Che Qian, Jin Yin, Gan Cao, Ze Xie also Sanliang.
Fu Ling and Yu Mi at One Liang, Rou Gui One Fen,
After three doses, the affliction is cured.
For this condition, Wang Gong Tang is also effective:
Wang Bu Liu Xing (1 liang, Semen Viciae Arvensis) (1 liang), Pu Gong Ying (1 liang, Herba Taraxaci) (1 liang), Che Qian Zi (1 liang, Semen Plantaginis) (1 liang), Gan Cao (5 qian, Radix Glycyrrhizae Uralensis) (5 qian), Jin Yin Hua (3 liang, Flos Lonicerae Japonicae) (3 liang).
Decoct in water and take orally. Effective after one dose.
Secret Formula:
Wang Gong Tang treats Small Intestine Abscess,
Wang Bu Liu Xing One Liang, Pu Gong Ying One Liang,
Che Qian Zi One Liang, Gan Cao Five Qian,
Jin Yin Hua Three Liang, cured in one dose.
A person suffers from severe abdominal pain, crying out incessantly. The pain is in the left abdomen, unbearable upon palpation, and the patient forbids touching. People assume it is food retention in the Large Intestine, but who would know it is an abscess in the Small Intestine? Intestinal abscesses invariably involve leg flexion. The current lack of flexion might suggest it is not an intestinal abscess. However, if the abscess is inside the intestine, Large Intestine cases involve right leg flexion, and Small Intestine cases involve left leg flexion. If the abscess is outside the intestine, legs are not flexed; pain on the left indicates Small Intestine abscess, pain on the right indicates Large Intestine abscess. Pain from food retention or dry stool comes and goes, unlike abscess pain, which is fixed, constant, and unceasing. Abscesses inside the Large or Small Intestine can rupture and drain, but those outside cannot be allowed to ulcerate, as there is no exit path externally, leading to certain death. Small Intestine abscesses are even more critical and require urgent treatment using diuresis and detoxification; otherwise, unpredictable complications may arise. Use Li Shui Jie Du Nei Xiao Dan (Water-Draining Toxin-Resolving Internal-Dissolving Pill), or Wang Gong Tang with an additional 3 liang of Jin Yin Hua.
Jin Yin Hua (4 liang, Flos Lonicerae Japonicae) (4 liang), Che Qian Zi (5 qian, Semen Plantaginis) (5 qian), Yi Yi Ren (1 liang, Semen Coicis) (1 liang), Fu Ling (1 liang, Poria) (1 liang), Dang Gui (2 liang, Radix Angelicae Sinensis) (2 liang), Gan Cao (3 qian, Radix Glycyrrhizae Uralensis) (3 qian).
Decoct in water and take orally. After one dose, pain decreases significantly; after two doses, pain lessens further; after three doses, pain stops completely; after four doses, recovery is achieved. This formula is a variation of the previous one (Xi Du Zhi Shen Tang). The former promotes toxin resolution within diuresis, while this one supplements blood-nourishing and toxin-resolving properties within diuresis. When an abscess ruptures, diuresis is especially suitable to flush out toxin. If unruptured, failing to nourish blood while only promoting diuresis leads to fluid loss and blood deficiency, making toxin resolution difficult. These nuances must be understood. This condition requires early treatment; otherwise, even if the abscess heals, blood stasis flowing outside the intestine will cause lifelong abdominal pain.
Secret Formula:
Li Shui Jie Du Nei Xiao Dan contains Four Liang Jin Yin Hua,
Five Qian Che Qian Zi, One Liang Yi Yi Ren and Fu Ling,
Two Liang Dang Gui, Three Qian Gan Cao, decoct together.
A person experiences sudden severe abdominal pain, hematuria, and inability to extend the left leg. People attribute this to a Small Intestine abscess, but who would know it is due to excessive Fire in the Small Intestine? Small Intestine abscesses always involve left leg flexion. The current inability to extend the left leg clearly suggests an abscess, yet I attribute it to excess Fire. Why? Abscesses have specific signs; they do not appear suddenly with bleeding. Pus forms over time and bleeds only when nearly exhausted. How to explain the leg flexion? The Small Intestine is narrow, while the Large Intestine is wide. Wide spaces accommodate pathogens; narrow ones do not. When the Small Intestine is scorched by Fire, internal pressure prevents smooth flow, causing reflexive flexion of the left leg temporarily, unlike the chronic flexion seen in abscesses. Do not mistake leg non-extension for an abscess and recklessly use detoxifying herbs, as this causes great harm! How to distinguish Fire-Toxin from Abscess? Observe urine at onset. Initial pain with non-extension and no blood indicates Abscess. Initial pain with non-extension and blood indicates Fire-Pain. Treatment involves draining Fire-evil without focusing on toxin resolution; pain will cease and leg extension will return. Use Jia Wei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction):
Chai Hu (2 qian, Radix Bupleuri) (2 qian), Huang Qin (3 qian, Radix Scutellariae Baicalensis) (3 qian), Ren Shen (5 qian, Radix Ginseng) (5 qian), Fu Ling (5 qian, Poria) (5 qian), Ban Xia (1 qian, Rhizoma Pinelliae Ternatae) (1 qian), Gan Cao (1 qian, Radix Glycyrrhizae Uralensis) (1 qian), Sheng Jiang (3 slices, Rhizoma Zingiberis Recens) (3 slices), Da Zao (3 pieces, Fructus Jujubae) (3 pieces).
Decoct in water and take orally. After one dose, leg extends; after two doses, bleeding stops, and intestinal pain ceases. Xiao Chai Hu Tang is not typically for Small Intestine Abscess, yet why is it so effective? Excess Fire in the Small Intestine originates from Liver Wood Stagnation. Wood stagnation generates Fire, which attacks the Small Intestine rather than the Heart. Fire normally flares upward; here it burns downward, violating its nature, causing Small Intestine pain. Blood in urine occurs because Fire forces blood out of the Small Intestine into the Bladder, obstructing water passages and causing bleeding. Xiao Chai Hu Tang soothes Liver and Gallbladder Qi, allowing Fire to rise smoothly. Fu Ling drains dampness, ensuring water flows normally and blood returns to vessels. Thus, Qi flows freely, Blood harmonizes, and toxin resolves. This is the miracle of this formula.
Secret Formula:
Jia Wei Xiao Chai Hu treats Intestinal Toxin,
Huang Qin Three Qian, Ren Shen and Fu Ling Five Qian each,
Ban Xia and Gan Cao One Qian, add Sheng Jiang and Da Zao,
Two doses stop bleeding, main treatment for Intestinal Abscess.
Che Ling Lian Gan Tang is also effective for this condition:
Che Qian Zi (5 qian, Semen Plantaginis) (5 qian), Fu Ling (1 liang, Poria) (1 liang), Huang Lian (3 qian, Rhizoma Coptidis) (3 qian), Gan Cao (3 qian, Radix Glycyrrhizae Uralensis) (3 qian).
Decoct in water and take orally.
Secret Formula:
There is also Che Ling Lian Gan Tang,
Che Qian Zi Five Qian, Fu Ling One Liang,
Gan Cao and Huang Lian Three Qian each, decoct together,
Excellent for stopping bleeding and harmonizing.