腹痈者，患于脐下或傍二寸许属脾经，近胁属胆经。盖因脾经阴虚，气滞血凝，或因脾虚，饮食积热所患。若 肿
作痛者，泻黄散。坚硬肿痛者，清胃散。肿痛便秘者，清凉饮。如此而仍痛者，瘀血凝滞也，活命饮。既用此药而不消，
则内欲作脓也，用托里消毒散。若脓出而痛不减者，毒未解也，亦用前药。若脓出而反加痛，及脓水清稀者，气血虚也，
用参 托里散。若食少体倦者，脾气虚也，用五味异功散加当归、柴胡、升麻。哺热内热者，脾血虚也，用四君、当归、
丹皮。如有他症，当随症治之。
一小儿患此，漫肿微痛，肉色不变，面色痿黄，饮食少
思，此脾气虚而食积内热也。用五味异功散加升麻、当归，及如圣饼，其肿渐消；又用托里散而愈。
一小儿患此，肿痛寒热，活命饮未二服肿痛顿止，用托里散、如圣饼，而肿渐消，又用神效散及托里消毒散，数剂
而痊。
一小儿患之，内溃作渴，饮食少思，属元气虚弱，先用托里消毒散，四剂脓溃，而发热恶寒，肢体倦怠，此邪气去
而真气虚也。用八珍、升麻补之稍愈，又用托里散、异功散，间服而痊。
一小儿腹疮，大便秘结，发热饮冷，此热蓄于里也，用内疏黄连汤一剂，大便通而痛止；又用清热消毒散，内热退
而疮愈。
一小儿腹患疮，敷寒凉之药，其肿益甚，腹中阴痛，手足并冷，此阳气虚寒之症也，余用回阳汤、抑阴散，而肿渐
消，毒渐散；又用托里散而敛。
一小儿患此，脓成不溃，面色黄白，恶心少食，发热恶寒，大便不实，此脾胃虚弱也，先用六君、升麻、柴胡，诸
症渐退，饮食渐进；又朝用益气汤，夕用异功散而溃，又用八珍汤而愈。
一小儿腹中作痛，肉色不变三月矣，诊其脉滑数而有力，此腹痈内溃也，用托里散，大便出脓甚多，乃用薏苡仁汤
及托里散而愈。
一小儿小腹赤肿，服流气败毒等药，肉色如故，食少体倦，余谓此肝脾气血虚而药伤之也，用六君、肉桂，及葱熨
之法，饮食渐进，其肿渐消，又佐以八珍汤而愈。
一小儿患此而溃，肿不消，恪服败毒之药，饮食少思，脓清发热，余谓脾胃之气复伤，不信，仍行气清热，肿痛益
甚，服消导化痰之药，腹胀作泻，余先用异功散加升麻、柴胡、木香，佐以二神丸，二十余剂，诸症渐愈；乃用异功散
加当归、黄 ，元气渐复；却用八珍汤，内芍药炒黄数剂，改用托里散而愈。次年，因劳心发热作渴，用当归补血汤而
安。毕姻后，寒热往来，患处作痒，用十全大补汤、六味地黄丸而愈。
四君子汤（加陈皮、半夏，即六君子汤） 治脾胃虚弱，或因寒凉伤胃，致肿不能消，或溃而不能敛者，但以
此药温补脾胃，诸症自退。如误用攻伐，则七恶随至矣。若脾胃气虚，疮口出血，或吐血便血，则加当归，脾胃充健，
则血自归经。若脾虚血弱不生肌，或晡热内热者，更加熟地黄，不可投四物沉阴之剂，能伤脾胃也。若胃气虚弱，克伐
伤脾，饮食少思，或食而难化，若作呕作泄者，尤宜用之。如兼痰嗽气逆，肢体倦怠，面目浮肿者，亦因脾虚不能生肺
而然也，最宜用之。
人参 白术（炒） 茯苓 甘草（各等分）
上每服二钱，姜枣水煎
清胃散 治脾胃有热生疮，或胃火牙痛，或连头面。
升麻（五分） 生地黄 牡丹皮 黄连（炒） 当归（各三分）
上水煎服，加柴胡、山栀即加味清胃散。
六君子汤 治疮疡，脾胃虚弱，肿痛不消，或不溃敛，宜用此药，以壮营气，诸症自愈。即四君加半夏、陈皮。
清凉饮 治疮疡，脾胃实热，烦躁饮食， 痛脉实，大便秘结，小便赤涩。
赤芍药 当归 甘草 大黄（各等分）
上每服一钱，水煎。
当归补血汤 治疮疡，肌热面赤烦渴，脉洪大而虚，重按全无，此血虚脉也。误服白虎汤必死。（方见发热不止）
益气养荣汤 治气血损伤，四肢颈项等处患肿，不问坚软赤白痛否，日晡发热，或溃而不敛者。（方见鹤膝风）
十全大补汤 治诸疮，血气虚不能溃腐收敛；或脓出，发热恶寒，汗出烦眩，口眼歪斜；或肌瘦少食，发热口
干等症，须多服之为善。（方见便痈）
参 托里散（方见痘痈）
补中益气汤（方见肌肉不止）
托里消毒散
托里散（二方见热毒疮疡）
五味异功散（方见用败毒之药）
如圣饼（方见流注）
神效散（方见胎毒发丹）
八珍汤（方见发热不止）
腹痈，是指发生在脐下或旁开约二寸处，归属于脾经；若靠近胁肋部，则归属于胆经。这通常是因为脾经阴虚，导致气机阻滞、血液凝滞，或者因脾气虚弱，饮食积滞化热所致。如果局部肿胀且疼痛，使用泻黄散。如果肿块坚硬、肿胀且疼痛，使用清胃散。如果肿胀疼痛且大便秘结，使用清凉饮。如果经过上述治疗仍然疼痛，说明是瘀血凝滞，使用活命饮。如果使用了这些药物后肿块仍未消退，说明内部即将化脓，应使用托里消毒散。如果脓液排出后疼痛不减，说明毒邪未解，也继续使用前面的药物。如果脓液排出后疼痛反而加重，以及脓水清稀，说明气血虚弱，使用参 托里散。如果食欲减退、身体疲倦，说明脾气虚弱，使用五味异功散加当归、柴胡、升麻。如果傍晚发热、体内自觉发热，说明脾血虚弱，使用四君子汤、当归、丹皮。如果有其他症状，应当根据具体症状进行治疗。
有一个小孩患此病，漫肿微痛，肤色不变，面色萎黄，饮食减少，这是脾气虚弱兼有食积内热。使用五味异功散加升麻、当归，以及如圣饼，肿块逐渐消退；后又使用托里散而痊愈。
另一个小孩患此病，肿痛伴有寒热往来，服用活命饮不到两剂，肿痛立刻停止，使用托里散、如圣饼，肿块逐渐消退，又使用神效散及托里消毒散，数剂后痊愈。
还有一个小孩患病，内部溃破并感到口渴，饮食减少，属于元气虚弱。先用托里消毒散，四剂后脓液溃出，但出现发热恶寒、肢体倦怠，这是邪气已去而真气虚弱。使用八珍汤加升麻补益，稍见好转，又交替使用托里散、异功散，最终痊愈。
一个小孩腹部生疮，大便秘结，发热想喝冷水，这是热邪蓄积在体内。使用内疏黄连汤一剂，大便通畅后疼痛停止；又使用清热消毒散，内热退去后疮口愈合。
一个小孩腹部患疮，敷用寒凉药物，导致肿块更加严重，腹部隐痛，手足发冷，这是阳气虚寒的症状。我使用回阳汤、抑阴散，肿块逐渐消退，毒邪逐渐消散；又使用托里散使疮口收敛。
一个小孩患此病，脓成但未溃破，面色黄白，恶心、进食少，发热恶寒，大便不成形，这是脾胃虚弱。先用六君子汤加升麻、柴胡，诸症逐渐消退，饮食逐渐增加；又早晨服用益气汤，晚上服用异功散，促使溃破，又使用八珍汤而痊愈。
一个小孩腹部疼痛，肤色不变已有三个月，诊察其脉象滑数而有力，这是腹痈内部溃破。使用托里散，大便排出大量脓液，随后使用薏苡仁汤及托里散而痊愈。
一个小孩小腹红肿，服用流气败毒等药物，肤色如常，饮食少、身体疲倦。我认为这是肝脾气血虚弱且被药物所伤，使用六君子汤加肉桂，以及葱熨法，饮食逐渐增加，肿块逐渐消退，又辅以八珍汤而痊愈。
一个小孩患此病已溃破，肿块不消，严格服用败毒药物，饮食减少，脓液清稀且发热。我认为脾胃之气再次受损，患者不信，仍行气清热，导致肿痛更甚，服用消导化痰药物后，腹胀腹泻。我先使用异功散加升麻、柴胡、木香，佐以二神丸，二十余剂后诸症渐愈；然后使用异功散加当归、黄芪，元气逐渐恢复；接着使用八珍汤，其中芍药炒黄，数剂后改用托里散而痊愈。次年，因劳心导致发热口渴，使用当归补血汤而安定。结婚后，出现寒热往来，患处瘙痒，使用十全大补汤、六味地黄丸而痊愈。
四君子汤（加入陈皮、半夏，即为六君子汤）：治疗脾胃虚弱，或因寒凉损伤胃气，导致肿胀不能消退，或溃破后不能收敛的情况。只要以此药温补脾胃，诸症自然消退。如果误用攻伐药物，则七恶证候随之而来。如果脾胃气虚，疮口出血，或吐血、便血，则加入当归，脾胃充健，则血液自然回归经脉。如果脾虚血弱不能生肌，或傍晚发热、体内自觉发热者，再加熟地黄，不可投用四物汤这种沉阴的药剂，因为它会损伤脾胃。如果胃气虚弱，克伐伤脾，饮食减少，或进食后难以消化，甚至呕吐腹泻者，尤其适宜使用。如果兼有痰嗽气逆、肢体倦怠、面目浮肿者，也是因为脾虚不能生肺所致，最适宜使用此方。
人参、白术（炒）、茯苓、甘草（各等分）。
以上每服二钱，姜枣水煎服。
清胃散：治疗脾胃有热生疮，或胃火牙痛，或连及头面部。
升麻（五分）、生地黄、牡丹皮、黄连（炒）、当归（各三分）。
以上水煎服，加入柴胡、山栀即为加味清胃散。
六君子汤：治疗疮疡，脾胃虚弱，肿痛不消，或不溃破不收敛，宜用此药，以壮营气，诸症自愈。即四君子汤加半夏、陈皮。
清凉饮：治疗疮疡，脾胃实热，烦躁多饮，疼痛脉实，大便秘结，小便赤涩。
赤芍药、当归、甘草、大黄（各等分）。
以上每服一钱，水煎。
当归补血汤：治疗疮疡，肌肤发热、面赤烦渴，脉洪大而虚，重按全无，这是血虚脉象。误服白虎汤必死。（方剂见发热不止条下）
益气养荣汤：治疗气血损伤，四肢颈项等处患肿，不问坚硬柔软、红白、疼痛与否，日晡时发热，或溃破后不收敛者。（方剂见鹤膝风条下）
十全大补汤：治疗各种疮疡，血气虚弱不能溃腐收敛；或脓液排出，发热恶寒，出汗烦眩，口眼歪斜；或肌肉消瘦、饮食少、发热口干等症状，须多服用为好。（方剂见便痈条下）
补中益气汤（方剂见肌肉不止条下）
托里散（这两个方剂见热毒疮疡条下）
五味异功散（方剂见用败毒之药条下）
Abdominal carbuncle (Fu Yong) refers to a condition occurring below the umbilicus or approximately two cun lateral to it, belonging to the Spleen Meridian of Foot-Taiyin; if located near the hypochondrium, it belongs to the Gallbladder Meridian of Foot-Shaoyang. This is generally caused by Yin deficiency of the Spleen Meridian, leading to Qi stagnation and Blood coagulation, or due to Spleen Qi deficiency with food accumulation transforming into heat. If there is swelling and pain, apply Xiehuang San (Drain the Yellow Powder). If the mass is hard, swollen, and painful, apply Qingwei San (Clear the Stomach Powder). If there is swelling, pain, and constipation, apply Qingliang Yin (Cooling Drink). If pain persists despite these treatments, it indicates Blood stasis and stagnation, so apply Mianing Yin (Life-Saving Drink). If the swelling does not subside after using these medicines, it suggests that suppuration is forming internally, so apply Tuoli Xiaodu San (Support the Interior and Eliminate Toxin Powder). If pain remains unchanged after pus discharge, the pathogenic toxin has not been resolved, so continue using the previous formulas. If pain increases after pus discharge, and the pus is thin and clear, it indicates Qi and Blood deficiency, so apply Shenqi Tuoli San (Ginseng Qi Supporting Interior Powder). If appetite is poor and the body feels fatigued, it indicates Spleen Qi deficiency, so apply Wuyi Yigong San (Five-Ingredient Extraordinary Efficacy Powder) added with Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), and Shengma (Cimicifugae Rhizoma). If there is afternoon fever and internal heat sensation, it indicates Spleen Blood deficiency, so apply Sijun Tang (Four Gentlemen Decoction), Danggui (Angelicae Sinensis Radix), and Danpi (Moutan Cortex). If other symptoms are present, treat according to the specific manifestations.
A child suffered from this condition with diffuse swelling and slight pain, unchanged skin color, sallow complexion, and reduced appetite. This indicated Spleen Qi deficiency with food accumulation and internal heat. Wuyi Yigong San was administered with additions of Shengma (Cimicifugae Rhizoma) and Danggui (Angelicae Sinensis Radix), along with Rusheng Bing (Rusheng Cake), resulting in gradual reduction of the swelling; subsequently, Tuoli San was used for complete recovery.
Another child presented with swelling, pain, and alternating chills and fever. After taking Huoming Yin (Life-Saving Drink) for less than two doses, the swelling and pain ceased immediately. Tuoli San and Rusheng Bing were then used to gradually reduce the swelling, followed by Shenshao San (Miraculous Effect Powder) and Tuoli Xiaodu San, leading to recovery after several doses.
A third child developed an internal ulcer with thirst and reduced appetite, indicating Yuan Qi (Original Qi) deficiency. Tuoli Xiaodu San was initially administered; after four doses, pus discharged. However, fever, aversion to cold, and limb fatigue ensued, indicating that the pathogenic factor had departed while the True Qi (Zhen Qi) was deficient. Bazhen Tang (Eight Treasures Decoction) with Shengma (Cimicifugae Rhizoma) was used to tonify, showing slight improvement. Alternating use of Tuoli San and Yigong San led to full recovery.
A child with an abdominal sore presented with constipation, fever, and a desire to drink cold water, indicating heat accumulation in the interior. Neishu Huanglian Tang (Internal Purging Coptis Decoction) was given for one dose; upon bowel movement, pain stopped. Qingre Xiaodu San (Clear Heat and Eliminate Toxin Powder) was then used to resolve internal heat and heal the sore.
A child with an abdominal sore applied cold-natured external medications, causing increased swelling, dull abdominal pain, and cold extremities. This indicated Yang Qi deficiency and cold. Huiyang Tang (Restore Yang Decoction) and Yiyin San (Suppress Yin Powder) were used to gradually reduce swelling and dissipate toxin; Tuoli San was then used to promote healing.
A child with this condition had formed pus but not yet ruptured, presenting with sallow-white complexion, nausea, poor appetite, fever, aversion to cold, and loose stools, indicating Spleen and Stomach weakness. Liu Jun Zi Tang (Six Gentlemen Decoction) with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) was used first, leading to gradual resolution of symptoms and improved diet. Qiyi Tang (Benefit Qi Decoction) was taken in the morning and Yigong San in the evening to induce rupture, followed by Bazhen Tang for complete recovery.
A child complained of abdominal pain for three months with unchanged skin color. The pulse was slippery, rapid, and forceful, indicating internal rupture of an abdominal carbuncle. Tuoli San was administered, resulting in the passage of large amounts of pus via stool. Yiyiren Tang (Coix Seed Decoction) and Tuoli San were then used for recovery.
A child presented with redness and swelling of the lower abdomen. After taking Liufei Baidu drugs (Flowing Qi and Resolving Toxin preparations), the skin color remained normal, but appetite was poor and fatigue was present. It was determined that Liver and Spleen Qi and Blood were deficient and injured by medication. Liu Jun Zi Tang with Rougui (Cinnamon Bark) and Congyun method (Scallion moxibustion) were used to improve diet and reduce swelling, assisted by Bazhen Tang for recovery.
A child with an ruptured carbuncle had persistent swelling despite strict use of detoxifying drugs, presenting with poor appetite, thin pus, and fever. It was judged that Spleen and Stomach Qi was re-injured. The patient did not believe this and continued with Qi-moving and heat-clearing methods, worsening swelling and pain. Digestive-promoting and phlegm-resolving drugs caused abdominal distension and diarrhea. Initially, Yigong San with Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), and Muxiang (Aucklandiae Radix), assisted by Ershen Wan (Two Spirits Pill), was used for over twenty doses to resolve symptoms. Then, Yigong San with Danggui (Angelicae Sinensis Radix) and Huangqi (Astragali Radix) was used to restore Yuan Qi. Subsequently, Bazhen Tang with fried Shaoyao (Paeoniae Radix Alba) was used for several doses, followed by Tuoli San for recovery. The following year, mental exertion caused fever and thirst, treated with Danggui Buxue Tang (Danggui Tonifies Blood Decoction) for stability. After marriage, alternating chills and fever and itching at the lesion site occurred, treated with Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) for recovery.
Sijun Zi Tang (Four Gentlemen Decoction) (when Chenpi (Citri Reticulatae Pericarpium) and Banxia (Pinelliae Rhizoma) are added, it becomes Liu Jun Zi Tang): Treats Spleen and Stomach weakness, or swelling that cannot resolve or ulcers that cannot heal due to cold-damaging the Stomach. By warming and tonifying the Spleen and Stomach with this formula, symptoms will naturally recede. Misuse of purgatives will lead to the appearance of Seven Evil syndromes. If Spleen and Stomach Qi deficiency causes bleeding from the ulcer, hematemesis, or hematochezia, add Danggui (Angelicae Sinensis Radix); when Spleen and Stomach become robust, blood will return to its vessels. If Spleen deficiency and Blood weakness fail to generate flesh, or if there is afternoon/internal heat, add Shudihuang (Rehmanniae Radix Praeparata). Do not administer Siwu Tang (Four Substance Decoction), as its heavy and yin nature damages the Spleen and Stomach. If Stomach Qi is weak, damaging the Spleen through harsh purging, leading to poor appetite or difficulty digesting food, vomiting, or diarrhea, this formula is especially suitable. For cases complicated by phlegm-cough, rebellious Qi, limb fatigue, and facial/ocular edema—caused by Spleen deficiency failing to generate Lung Qi—this formula is most appropriate.
Ren Shen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) (stir-fried), Fuling (Poria), Gancao (Licorice Root) (equal parts).
Take two qian per dose, decoct with Ginger and Jujube in water.
Qingwei San (Clear the Stomach Powder): Treats sores caused by heat in the Spleen and Stomach, toothache due to Stomach fire, or swelling involving the head and face.
Shengma (Cimicifugae Rhizoma) (5 fen), Shengdi Huang (Rehmanniae Radix), Mudan Pi (Moutan Cortex), Huanglian (Coptidis Rhizoma) (stir-fried), Danggui (Angelicae Sinensis Radix) (3 fen each).
Decoct in water and take orally. Adding Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) creates Jiawei Qingwei San (Modified Clear the Stomach Powder).
Liu Jun Zi Tang (Six Gentlemen Decoction): Treats sores with Spleen and Stomach weakness, where swelling and pain do not subside, or ulcers do not rupture or heal. Use this to strengthen Ying Qi (Nutritive Qi), allowing symptoms to resolve spontaneously. It is Sijun Zi Tang plus Banxia (Pinelliae Rhizoma) and Chenpi (Citri Reticulatae Pericarpium).
Qingliang Yin (Cooling Drink): Treats sores with excess heat in the Spleen and Stomach, irritability, excessive drinking, painful conditions with a solid pulse, constipation, and dark, scanty urination.
Chishaoyao (Paeoniae Radix Rubra), Danggui (Angelicae Sinensis Radix), Gancao (Licorice Root), Dahuang (Rhei Radix et Rhizoma) (equal parts).
Take one qian per dose, decoct in water.
Danggui Buxue Tang (Danggui Tonifies Blood Decoction): Treats sores with skin heat, red face, irritability, and thirst, with a flooding and empty pulse that vanishes under heavy pressure, indicating Blood deficiency. Misuse of Baihu Tang (White Tiger Decoction) will be fatal. (See "Unceasing Fever" for the formula).
Yiqi Yangrong Tang (Benefit Qi and Nourish Ying Decoction): Treats Qi and Blood injury, swelling in limbs, neck, etc., regardless of hardness, softness, color, or pain; afternoon fever; or ulcers that do not heal after rupture. (See "Crane Knee Wind" for the formula).
Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction): Treats various sores where Qi and Blood deficiency prevents rupture and healing; or after pus discharge, presents with fever, aversion to cold, sweating, dizziness, facial paralysis; or emaciation, poor appetite, fever, and dry mouth. Long-term administration is beneficial. (See "Perineal Carbuncle" for the formula).
Shenqi Tuoli San (Ginseng Qi Supporting Interior Powder) (See "Smallpox Carbuncle" for the formula).
Buzhong Yiqi Tang (Tonify the Middle and Benefit Qi Decoction) (See "Unceasing Muscle Bleeding" for the formula).
Tuoli Xiaodu San (Support the Interior and Eliminate Toxin Powder)
Tuoli San (Support the Interior Powder) (Both formulas see "Heat-Toxic Sores").
Wuyi Yigong San (Five-Ingredient Extraordinary Efficacy Powder) (See "Use of Detoxifying Drugs" for the formula).
Rusheng Bing (Rusheng Cake) (See "Liuzhu" for the formula).
Shenshao San (Miraculous Effect Powder) (See "Fetal Toxin Erysipelas" for the formula).
Bazhen Tang (Eight Treasures Decoction) (See "Unceasing Fever" for the formula).