〔《保》〕诸疮大痛，不辨肉色，漫肿光色，名附骨痈，如神三生散。
露蜂房 蛇蜕 头发（洗净，等分）
上烧灰存性，研细，酒下三钱。
〔丹〕附骨痈，热在血分之极。初发时，以青皮、甘草治之，破后当养血。
〔《素》〕肝满、肾满、肺满，皆实，即为肿。（王注云∶满谓脉气满实，肿谓痈肿。）肺之痈，
喘而两 满。（仲景云∶肺痈吐脓如米粥，咽燥振寒。）肝痈，两 满，卧则惊，不得小便。肾痈，
脚下至少腹满。（大奇论 林亿云∶脚下当作 下。《千金》云∶肠痈之为病，小腹肿强，按则痛，
便数似淋。仲景云∶肠痈小腹痞坚，盖小腹痛而痞坚者，肾痈也。小便数而似淋者，肠痈也。
即肺痈肝痈之属。）
胃脘痈，人迎脉逆而盛。（全文见后胃脘痈条。）
〔丹〕痈疽发于内者，肺痈、肝痈、肾痈、肠痈、囊内痈、附骨痈，惟肺痈须先解表，令表而出
之。
〔《千》〕咳唾脓血，其脉数实者，为肺痈。若口中咳即胸中隐痛，脉反滑数，此肺痈也。
问曰∶病者咳逆，何以知其肺痈？当有脓血，吐之则死，其脉何如？曰∶寸脉微而数。微
为风，数为热，微则汗出，数则恶寒，风中于卫，呼气不入，热逼于荣，吸气不出，风伤皮毛，热伤
血脉。风舍于卫，其人则咳，口干喘满，咽燥不渴，多吐浊沫，时时振寒。热之所过，血为凝滞，
蓄结痈脓，吐如米粥，始萌可救，脓成则死。问曰∶振寒发热，寸脉滑数，其人饮食起居如故，
此为痈肿。医反不知，以伤寒治之，不应，何以知有脓？脓之所在，何以别知其处？师曰∶假令脓
在胸中者，为肺痈，其脉数，咳吐有脓血。设脓未成，其脉自紧数，紧去但数，为脓已成也。
〔《要》〕小青龙汤（方见伤寒条。）
〔《要》〕葶苈大枣泻肺汤治肺痈，喘不得卧。
葶苈（炒黄，研细，丸如弹大） 大枣（十二枚）
水三升，入枣，先煮取二升，去枣，入葶苈，又煮一升，顿服之。又曰∶治肺痈胸满胀，
一身并面目浮肿，鼻塞清涕出，不知香臭酸辛，咳逆上气，喘鸣迫塞，用前方三日一剂，可至三四
剂，须先与小青龙汤一剂，乃与之。
〔《要》〕桔梗汤治咳而胸满，振寒脉数，咽干不渴，时出浊唾腥臭，久久吐脓如粥者，
肺痈也。
桔梗 甘草（炙。各一两）
水三升，煮取一升，去渣，分温再服，则吐脓血也。亦治喉痹。《三因》甘草倍之，每四钱，
名四圣散。《千金》亦名桔梗汤，用桔梗三两，甘草二两，服后，必吐脓血。
〔《要》〕苇茎汤治肺痈。又云∶一本治咳有微热，烦满，心胸甲错。
苇茎（三升，切） 薏苡仁（半升） 冬瓜仁（半升） 桃仁（五十枚，去皮）
水一斗，先煮苇茎得五升，去 ，入诸药，取二升，分温五服，当吐如粥。《千金》云∶
肺痈当吐脓血。（苇茎即汀洲间芦荻之粗种也。）
治吐脓血，如肺痈状，口臭，他方不应者，宜消风散。入男子发灰，研细入和之，清米饮下，
可除根，只两服。亦治吐血。（消风散方∶荆芥、川芎、羌活、人参、茯苓、僵蚕、防风、蝉蜕、
藿香各二钱，浓朴、陈皮各半两，为末是也。）
〔韦宙〕独行方治心胸甲错，为肺痈，黄昏汤主之。
用夜合皮掌大一枚，水三升，煮取二升，分再服。（夜合树，按本草即乌农树。）
上肺痈证治，《要略》以小青龙汤先与一剂，乃行气取脓之药，将以解表之风寒邪气，此治
肿疡之例也。
后以韦宙方终之者，将以补里之阴气，此治溃疡之例也。（以上六方皆丹溪所集。）
〔梅〕如圣丸治风热毒瓦斯上攻，咽喉痛痹，肿塞妨闷，及肺痈喘嗽，唾浓血，胸满振寒，咽干不
渴，时出浊沫，气臭腥，久久咯脓，状如米粥。
樟脑（另研） 牛黄（另研） 桔梗 甘草（生用。各一钱）
上为细末，炼蜜丸，每两作二十丸。每用一丸，噙化。
〔丹〕济生桔梗汤治肺痈，心胸气塞，咳嗽脓血，心神烦闷，咽干多渴，两足肿满，小便赤黄，大便多涩。
桔梗、贝母、川归、栝蒌仁、枳壳、薏苡仁、桑白皮、防风，以上各一两，生甘草、杏仁、
蒸百合各半两，黄 一两半。
上修事 咀，每服四钱，水一碗半，生姜五片，煎至八分，去渣服。若大便秘，加大黄。
小便秘，加木通。
〔仲〕桔梗白散治咳而胸满，振寒脉数，咽干不渴，时出浊唾腥臭，久久吐脓如米粥者，为肺
痈。
桔梗 贝母（各三分） 巴豆（一分，去皮，炒研如脂）
上三味，为散，强人饮服半钱匕，羸者减之。病在膈上者，吐脓血。膈下者，泻出。若下多
不止，饮冷水一碗则定。（此亦《要略》方，丹溪不删，采用之者，必有微意存焉。）
〔丹〕肺痈。《医垒元戎》搜风汤吐之。（搜风汤未考。）
〔《本》〕治肺痈，吐脓血，作臭气，胸乳皆痛，升麻汤。
川升麻 桔梗 薏苡仁 地榆 牡丹皮 芍药（各半两） 甘草（二分）
上锉粗末，每一两，水一升半，姜五片，煎去渣，日三服。
〔丹〕济生排脓汤治肺痈得吐脓后，以此排脓补肺。
生绵 二两，细末，每二钱，水一碗，煎一半服。
肺痈收敛疮口，止有合欢树皮，白蔹煎汤饮之。
肺痈已破，入风者不治。肠痈，《千金》谓妄治必杀人。肠痈为病，小腹重而强，按之则痛，
便数似淋，时时汗出，复恶寒，身皮甲错，腹皮急，如肿状，其脉数者，小有脓也。巢云∶洪数者，
已有脓，脉若迟紧者，未有脓。甚者腹胀大，转侧有水声，或绕脐生疮，或脓自脐出，或大便出
脓血。
〔《脉》〕问曰∶羽林妇病，何以知肠有脓？师曰∶脉滑而数，滑则为实，数则为热，滑则为
荣，数则为卫，卫数下降，荣滑上升，荣卫相干，血为败浊，小腹痞坚，小便或涩，或自汗出，或
复恶寒，脓为已成。设脉迟紧，则为瘀血，血下即安。
〔《要》〕薏苡附子败酱散治身甲错，腹皮急如腹胀，本无积聚，身热脉数者。
附子（炮，二分） 败酱（五分） 薏苡仁（一钱）
上为末，每服方寸匕，以水二合煎，顿服，小盒饭下。《三因》薏苡仁、附子同前，败酱用
一两一分，每四钱，水一盏半，煎七分，去渣空心服。
〔《千》〕大黄牡丹汤 治肠痈，小腹痞坚，或偏在膀胱左右，其色白坚大如掌热，小便自调，
时自汗出。脉迟坚者，未成脓，可下之，当有血。脉数脓成，不复可下。
大黄（四两） 牡丹皮（三两） 芒硝（二两） 冬瓜仁（一升） 桃仁（五十个）
上 咀，水五升煮一升，顿服，当下脓血。《删繁》用芒硝半合，瓜子五合。刘涓子用硝石
三合，《肘后》同，名瓜子汤。《三因》用大黄、桃仁各二分，瓜子三分，牡丹皮一钱，硝二钱，
锉散作一帖，水三盏，煎至八分，去渣，入硝再煎沸，顿服无时。
〔无〕薏苡汤治肠痈，腹中痛，烦躁不安，或胀满不食，小便涩。妇人产后虚热，多有此病，
纵非痈，但疑是者，便可与。或有差，亦无妨。
薏苡仁五两，牡丹皮、桃仁各三两，瓜子仁四两。
锉散，每四大钱，水盏半，煎七分服。姚氏去桃仁，用杏仁。崔氏加芒硝二两。《千金》方同。
医案曰∶女子腹痛，百方不治，脉滑数，时作热，腹微急。孙诊曰∶腹痛脉当沉细，今脉滑数，
此肠痈也。以云母膏一两，作丸如桐子大。以牛皮胶烊，温酒调胶水，下丸子药。晌时服尽膏，
下脓血一盆而安。
〔《千》〕灸法，屈两肘正肘头锐骨是穴，灸百壮，下脓血而安。
王氏《余话》有妇人肠中痛不可忍，大便自小便出。李生诊之曰∶芤脉见于阳部，此肠痈也。
乃出云母膏，作百十丸，煎黄 汤吞下，利脓血数升而安。李曰∶寸芤积血在胸，关芤为肠生痈也。
李乃杨吉老之婿，弃举业习医，官取医博士。内疽者，皆因饮食之火，挟七情之火，相郁而发。
饮食者阴受之，七情者脏腑受之，宜其发在腔子而向里，非干肠胃肓膜也。谓之内者，以其视之不
见故名焉。
上肠痈五方，丹溪先生所集也。前三方内，其《要略》一方，元本虽云内有痈脓，然先生
不言之，而又连《千金》、《三因》二方置于篇首者，盖亦肿疡泻利例也。后二方用胶烊黄 煎
汤。吞药者，盖亦溃疡补例也。
〔《素》〕帝曰∶人病胃脘痈者，诊当何如？岐伯曰∶诊此者，当候胃脉，其脉当沉细，沉细者
气逆，（《甲乙经》“沉细”作“沉涩”。）逆者人迎甚盛，甚盛则热。人迎者胃脉也，逆而盛
则热聚于胃中而不行，故胃脘为痈也。（病能篇）
〔河〕射干汤治胃脘痈，人迎脉逆而盛，嗽脓血，荣卫不流，热聚胃口成痈。
射干（去毛） 栀仁 赤茯苓（去皮） 升麻（各一两） 赤芍药（一两半） 白术（半两）
上为末，每服五钱，水二盏，煎至一盏，去渣，入地黄汁一合，蜜半合，再煎温服，不计时
候。
〔《要》〕复元通气散治诸气涩，耳聋，腹痈，便痈，疮疽无头，止痛消肿。
青皮 陈皮（各四两） 甘草（三寸，生熟各半） 穿山甲（炮） 栝蒌根（各二两） 金银花（一两）
连翘（一两）
上为细末，热酒调下。
〔丹〕肠痈，大肠有热积，死血流注，桃仁承气汤加连翘、秦艽。近肛门破，入风者，难治，用
防风之类。大凡破伤风，在头面则以白芷为君，防风头佐之，盖去头面皮肤之风故也。在身体及四
肢则以防风为君，随身梢用，下部则以独活佐之。肺痈吐脓后，其脉短而涩者，自痊；浮大者，难
治。其面色白而反赤者，此火之克金，皆不可治。
《金匮方论》曰∶热在上焦者，因咳为肺痿。肺痿之病，何从得之？或从汗出，或从呕吐，或
从消渴小便利数，或从便难又被快药下利，重亡津液。故寸口脉数，其人咳，口中反有浊唾涎沫者，
为肺痿之病。若口中辟辟燥，咳即胸中隐隐痛，脉反滑数，此为肺痈。咳唾脓血，脉数虚者，为肺
痿；数实者，为肺痈。
按此言肺痿属热，如咳久肺伤，声哑声嘶咯血，此属阴虚火热甚是也。本论治肺痿吐涎沫而不
咳者，其人不渴，必遗尿，小便数，以上虚不能制下故也。此为肺中冷，必眩，多涎唾，用炙甘草、
干姜，此属寒也。肺痿吐涎多，心中温液者，用炙廿草汤，此补虚劳也。亦与补阴虚火热不同，是
皆宜分治之。故肺痿又有寒热之异也。
〔《精》〕劳伤血气，腠理虚而风邪乘之，内盛于肺也。则汗出恶风，咳嗽短气，鼻塞项强，胸
胁胀满，久久不瘥，已成肺痿也。
〔《保》〕肺痈者，由食啖辛热炙爆，或酣饮热酒，燥热伤肺所致，治之宜早。
【《保命集》】各种疮疡疼痛剧烈，无法分辨肌肉颜色，肿胀弥漫且表面光亮，称为附骨痈，可用如神三生散治疗。
露蜂房、蛇蜕、头发（洗净，等量）
以上药物烧成灰但保留药性，研成细末，用酒送服三钱。
【朱丹溪】附骨痈，是热邪深入血分的极致表现。初发时，用青皮、甘草治疗；破溃后应当养血。
【《黄帝内经·素问》】肝脉满实、肾脉满实、肺脉满实，都属于实证，就会形成肿疡。（王冰注解说：满是指脉气满实，肿是指痈肿。）肺的痈病，表现为喘息且两胁胀满。（张仲景说：肺痈咳吐脓液像米粥一样，咽喉干燥并伴有寒战。）肝的痈病，两胁胀满，睡觉时易惊，小便不通。肾的痈病，从脚底到小腹部胀满。（《大奇论》林亿注说：“脚下”应当作“髀下”。《千金方》说：肠痈这种病，小腹胀硬强直，按压则疼痛，小便频数类似淋病。张仲景说：肠痈小腹痞硬坚实，大概小腹痛而痞硬坚实的，是肾痈。小便频数而类似淋病的，是肠痈。这属于肺痈、肝痈之类。）
胃脘痈，人迎脉逆行且盛大。（全文见后文胃脘痈条。）
【朱丹溪】痈疽发生在体内的，有肺痈、肝痈、肾痈、肠痈、囊内痈、附骨痈，只有肺痈需要先解表，使邪气从体表排出。
【《千金方》】咳嗽吐脓血，脉象数而实的，是肺痈。如果口中一咳就胸中隐痛，脉象反而滑数，这是肺痈。
问：病人咳嗽气逆，怎么知道是肺痈？应当有脓血，如果吐出脓血就会死，它的脉象怎么样？答：寸脉微而数。微代表风，数代表热，微则汗出，数则恶寒，风邪伤及卫分，呼气不能入内，热邪逼迫营分，吸气不能外出，风邪损伤皮毛，热邪损伤血脉。风邪停留于卫分，人就会咳嗽，口干气喘胀满，咽喉干燥但不渴，多吐浑浊泡沫，时常寒战。热邪经过的地方，血液凝滞，蓄积结聚成痈脓，咳出像米粥一样的东西，刚开始萌芽时可救治，脓已成则难治。问：寒战发热，寸脉滑数，这个人饮食起居如常，这是痈肿。医生反而不知道，按伤寒治疗，无效，怎么知道有脓？脓在什么位置，怎么辨别它的位置？老师说：假如脓在胸中，就是肺痈，其脉数，咳嗽吐有脓血。假设脓未形成，脉自紧数，紧象消失只余数象，说明脓已形成了。
【《太平惠民和剂局方》】小青龙汤（方剂见伤寒条）。
【《太平惠民和剂局方》】葶苈大枣泻肺汤治疗肺痈，喘息不能平卧。
葶苈子（炒黄，研细，做成弹子大小的丸） 大枣（十二枚）
水三升，放入枣，先煮取二升，去掉枣，放入葶苈子，再煮取一升，一次性服用。又说：治疗肺痈胸满胀，全身及面目浮肿，鼻塞流清涕，不知香臭酸辛，咳嗽气逆上冲，喘鸣气塞，用前方，三天一剂，可服至三四剂，必须先给一小青龙汤一剂，然后再给此方。
【《太平惠民和剂局方》】桔梗汤治疗咳嗽且胸满，寒战脉数，咽干不渴，时常吐出浑浊唾沫腥臭，久久咳吐脓液像粥一样的，是肺痈。
桔梗 甘草（炙。各一两）
水三升，煮取一升，去渣，分两次温服，则会吐出脓血。也治疗喉痹。《三因极一病证方论》中甘草加倍，每服四钱，名叫四圣散。《千金方》也叫桔梗汤，用桔梗三两，甘草二两，服后，必定吐出脓血。
【《太平惠民和剂局方》】苇茎汤治疗肺痈。又说：另一版本治疗咳嗽有微热，烦闷，心胸皮肤粗糙如鳞甲。
苇茎（三升，切碎） 薏苡仁（半升） 冬瓜仁（半升） 桃仁（五十枚，去皮）
水一斗，先煮苇茎得五升，去掉渣滓，放入其他药物，取二升，分五次温服，应当咳出像粥一样的东西。《千金方》说：肺痈应当咳出脓血。（苇茎即汀洲间芦荻的粗种。）
治疗吐脓血，像肺痈症状，口臭，其他方剂无效的，宜用消风散。加入男子头发灰，研细调和，用清米饮送下，可除根，只需两服。也治疗吐血。（消风散方：荆芥、川芎、羌活、人参、茯苓、僵蚕、防风、蝉蜕、藿香各二钱，厚朴、陈皮各半两，研为末即可。）
【韦宙】独行方治疗心胸皮肤粗糙如鳞甲，属肺痈，用黄昏汤主治。
用夜合树皮掌大一枚，水三升，煮取二升，分两次服用。（夜合树，据本草记载即乌农树。）
以上肺痈的证治，《金匮要略》先用小青龙汤一剂，然后行气排脓的药物，用来解除体表的风寒邪气，这是治疗肿疡的法则。
后用韦宙方结束的，用来补益里阴之气，这是治疗溃疡的法则。（以上六方都是丹溪先生所收集。）
【梅师】如圣丸治疗风热毒瓦斯上攻，咽喉痛痹，肿塞妨闷，以及肺痈喘嗽，吐浓血，胸满寒战，咽干不渴，时常吐出浊沫，气臭腥，久久咯脓，状如米粥。
樟脑（另研） 牛黄（另研） 桔梗 甘草（生用。各一钱）
以上为细末，炼蜜为丸，每两作二十丸。每次用一丸，含化。
【朱丹溪】济生桔梗汤治疗肺痈，心胸气塞，咳嗽脓血，心神烦闷，咽干多渴，两足肿满，小便赤黄，大便多涩。
桔梗、贝母、当归、栝蒌仁、枳壳、薏苡仁、桑白皮、防风，以上各一两，生甘草、杏仁、蒸百合各半两，黄芪一两半。
以上处理干净切碎，每服四钱，水一碗半，生姜五片，煎至八分，去渣服用。如果大便秘结，加大黄。
小便不利，加木通。
【张仲景】桔梗白散治疗咳嗽且胸满，寒战脉数，咽干不渴，时常吐出浑浊唾沫腥臭，久久咳吐脓液像米粥一样的，为肺痈。
桔梗 贝母（各三分） 巴豆（一分，去皮，炒研如脂）
以上三味，研为散，体质强者饮服半钱匕，体弱者减量。病在膈上的，吐出脓血。病在膈下的，泻出脓血。如果泻下过多不止，饮一碗冷水则可止住。（这也是《金匮要略》的方子，丹溪没有删减，采用它，必定有深意存在。）
【朱丹溪】肺痈。《医垒元戎》用搜风汤吐之。（搜风汤未考证。）
【《神农本草经》】治疗肺痈，吐脓血，发出臭气，胸乳皆痛，用升麻汤。
川升麻 桔梗 薏苡仁 地榆 牡丹皮 芍药（各半两） 甘草（二分）
以上锉成粗末，每一两，水一升半，姜五片，煎去渣，日服三次。
【朱丹溪】济生排脓汤治疗肺痈咳吐脓后，以此排脓补肺。
生绵黄芪二两，细末，每二钱，水一碗，煎一半服用。
肺痈收敛疮口，只有合欢树皮，白蔹煎汤饮用。
肺痈已破，侵入风邪的不治。肠痈，《千金方》说误治必杀人。肠痈这种病，小腹重而强直，按压则痛，小便频数类似淋病，时常汗出，又恶寒，身体皮肤粗糙如鳞甲，腹皮紧急，像肿胀的样子，其脉数的，是有少量脓。巢元方说：脉洪数的，已有脓，脉若迟紧的，未有脓。严重的腹胀大，转动侧身有水声，或绕脐生疮，或脓自脐出，或大便出脓血。
【《脉经》】问：羽林妇生病，怎么知道肠中有脓？老师说：脉滑而数，滑则为实，数则为热，滑则为营，数为卫，卫数下降，营滑上升，营卫相搏，血化为败浊，小腹痞硬，小便或涩，或自汗出，或复恶寒，脓为已成。假设脉迟紧，则为瘀血，血下即安。
【《太平惠民和剂局方》】薏苡附子败酱散治疗身体皮肤粗糙如鳞甲，腹皮紧急像腹胀，本无积聚，身热脉数的。
附子（炮，二分） 败酱（五分） 薏苡仁（一钱）
以上为末，每服方寸匕，以水二合煎，顿服，小盒饭送下。《三因极一病证方论》薏苡仁、附子同前，败酱用一两一分，每四钱，水一盏半，煎七分，去渣空心服。
【《千金方》】大黄牡丹汤 治疗肠痈，小腹痞硬坚实，或偏在膀胱左右，其色白坚大如手掌热，小便自调，时自汗出。脉迟坚者，未成脓，可下之，当有血。脉数脓成，不复可下。
大黄（四两） 牡丹皮（三两） 芒硝（二两） 冬瓜仁（一升） 桃仁（五十个）
以上切碎，水五升煮取一升，顿服，当下脓血。《删繁》用芒硝半合，瓜子五合。刘涓子用硝石三合，《肘后备急方》相同，名叫瓜子汤。《三因极一病证方论》用大黄、桃仁各二分，瓜子三分，牡丹皮一钱，硝二钱，锉散作一帖，水三盏，煎至八分，去渣，入硝再煎沸，顿服无时。
【无名氏】薏苡汤治疗肠痈，腹中痛，烦躁不安，或胀满不食，小便涩。妇人产后虚热，多有此病，纵非痈，但疑是者，便可与。或有差，亦无妨。
薏苡仁五两，牡丹皮、桃仁各三两，瓜子仁四两。
锉散，每四大钱，水盏半，煎七分服。姚氏去桃仁，用杏仁。崔氏加芒硝二两。《千金方》同。
医案说：女子腹痛，百方不治，脉滑数，时常发热，腹微急。孙思邈诊察说：腹痛脉当沉细，今脉滑数，这是肠痈。用云母膏一两，做成梧桐子大的丸。用牛皮胶溶化，温酒调胶水，送下丸子药。晌时服尽膏，下脓血一盆而安。
【《千金方》】灸法，屈两肘正对肘头锐骨是穴，灸百壮，下脓血而安。
王氏《余话》有妇人肠中痛不可忍，大便自小便出。李生诊察说：芤脉见于阳部，这是肠痈。于是拿出云母膏，做百十丸，煎黄芪汤吞下，利脓血数升而安。李生说：寸芤积血在胸，关芤为肠生痈也。李生乃杨吉老之婿，弃举业习医，官授医博士。内疽者，皆因饮食之火，挟七情之火，相郁而发。饮食者阴受之，七情者脏腑受之，宜其发在腔子而向里，非干肠胃肓膜也。谓之内者，以其视而不见故名焉。
以上肠痈五方，丹溪先生所收集。前三方内，其《金匮要略》一方，原本虽云内有痈脓，然先生不言，而又连《千金》、《三因》二方置于篇首者，盖亦肿疡泻利例也。后二方用胶烊黄芪煎汤吞药者，盖亦溃疡补例也。
【《黄帝内经·素问》】黄帝问：人患胃脘痈的病，诊察应当如何？岐伯说：诊察这个病，应当候胃脉，其脉应当沉细，沉细则气逆，（《甲乙经》“沉细”作“沉涩”。）逆者人迎脉甚盛，甚盛则热。人迎脉是胃脉，逆而盛则热聚于胃中而不行，故胃脘为痈也。（病能篇）
【李东垣】射干汤治疗胃脘痈，人迎脉逆而盛，嗽脓血，营卫不流，热聚胃口成痈。
射干（去毛） 栀仁 赤茯苓（去皮） 升麻（各一两） 赤芍药（一两半） 白术（半两）
以上为末，每服五钱，水二盏，煎至一盏，去渣，入地黄汁一合，蜜半合，再煎温服，不计时侯。
【《太平惠民和剂局方》】复元通气散治疗诸气涩，耳聋，腹痈，便痈，疮疽无头，止痛消肿。
青皮 陈皮（各四两） 甘草（三寸，生熟各半） 穿山甲（炮） 栝蒌根（各二两） 金银花（一两） 连翘（一两）
以上为细末，热酒调下。
【朱丹溪】肠痈，大肠有热积，死血流注，桃仁承气汤加连翘、秦艽。近肛门破，入风邪者，难治，用防风之类。大凡破伤风，在头面则以白芷为君，防风为臣佐，盖去头面皮肤之风故也。在身体及四肢则以防风为君，随身梢用，下部则以独活为臣佐。肺痈吐脓后，其脉短而涩者，自愈；浮大者，难治。其面色白而反赤者，此火克金，皆不可治。
《金匮方论》说：热在上焦者，因咳为肺痿。肺痿的病，从何得来？或从汗出，或从呕吐，或从消渴小便利数，或从便难又被快药下利，重亡津液。故寸口脉数，其人咳，口中反有浊唾涎沫者，为肺痿的病。若口中辟辟燥，咳即胸中隐隐痛，脉反滑数，此为肺痈。咳唾脓血，脉数虚者，为肺痿；数实者，为肺痈。
按：此言肺痿属热，如咳久肺伤，声哑声嘶咯血，此属阴虚火热甚是也。本论治肺痿吐涎沫而不咳者，其人不渴，必遗尿，小便数，以上虚不能制下故也。此为肺中冷，必眩，多涎唾，用炙甘草、干姜，此属寒也。肺痿吐涎多，心中温液者，用炙甘草汤，此补虚劳也。亦与补阴虚火热不同，是皆宜分治之。故肺痿又有寒热之异也。
[From *Baoming Ji*] Various sores with severe pain, where the flesh color cannot be distinguished, presenting as diffuse swelling with a shiny surface, are named *Fugu Yong* (Periosteal Abscess). Use Rusheng Sansan (Miraculous Three-Life Powder).
Rhododendri Melli Fermentatum (Lufengfang), Ophichthidis Cutis (Shetui), Human Hair (cleaned, equal parts).
Burn the above to ash while preserving their medicinal properties, grind into fine powder, and take three qian with wine.
[Zhu Danxi] *Fugu Yong* (Periosteal Abscess) represents extreme heat in the Blood level. At the initial stage, treat with Qingpi (Green Tangerine Peel) and Gancao (Licorice Root); after ulceration, nourish the Blood.
[From *Huangdi Neijing Suwen*] Fullness and excess in the Liver, Kidney, and Lung pulses all constitute Excess patterns, resulting in swelling. (Wang Bing’s commentary states: "Fullness" refers to pulse qi being full and excess; "Swelling" refers to carbuncles and sores.) Lung abscess manifests as wheezing and distension of both hypochondria. (Zhang Zhongjing says: Lung abscess expectorates pus like rice porridge, with dry throat and chills.) Liver abscess presents with distension of both hypochondria, fright during sleep, and inability to urinate. Kidney abscess presents with fullness from the sole of the foot to the lower abdomen. (Lin Yi’s commentary on *Daqi Lun* states: "Sole of the foot" should be read as "below the thigh". *Qianjin Fang* states: The disease of intestinal abscess involves a swollen and hard lower abdomen, pain upon pressure, and frequent urination resembling strangury. Zhang Zhongjing says: Lower abdominal stuffiness and hardness characterizes intestinal abscess; generally, lower abdominal pain with stuffiness and hardness is Kidney abscess. Frequent urination resembling strangury is Intestinal abscess. These belong to the category of Lung and Liver abscesses.)
Stomach abscess is characterized by a reversed and vigorous Renying pulse. (The full text is found in the section on Stomach Abscess below.)
[Zhu Danxi] For internal carbuncles and sores, including Lung abscess, Liver abscess, Kidney abscess, Intestinal abscess, Scrotal internal abscess, and Periosteal abscess, only Lung abscess requires first resolving the exterior to expel pathogens from the body surface.
[From *Qianjin Fang*] Coughing up pus and blood with a rapid and solid pulse indicates Lung abscess. If coughing causes hidden pain in the chest and the pulse is slippery and rapid, this is Lung abscess.
Question: A patient has coughing and rebellious Qi; how do we know it is Lung abscess? There should be pus and blood; if vomited, death ensues. What is the pulse? Answer: The Cun position pulse is faint and rapid. Faint indicates Wind, Rapid indicates Heat. Faint implies sweating, Rapid implies aversion to cold. Wind attacks the Defensive level, preventing exhalation from entering; Heat forces the Nutritive level, preventing inhalation from exiting. Wind damages the skin and hair; Heat damages the blood vessels. Wind lodging in the Defensive level causes cough, dry mouth, wheezing, and distension, dry throat without thirst, copious secretion of turbid foam, and intermittent chills. Wherever Heat passes, blood coagulates and stagnates, accumulating to form pus and abscess. Expectoration resembles rice porridge. In the early stage, it can be saved; once pus is formed, it is difficult to treat. Question: Chills and fever, slippery and rapid Cun pulse, yet diet and daily life remain normal—this is a carbuncle. The physician fails to recognize this and treats it as Cold Damage, yielding no effect. How do we know pus exists? How do we locate the pus? The Master says: If pus is in the chest, it is Lung abscess; the pulse is rapid, and coughing produces pus and blood. Assuming pus is not yet formed, the pulse is tight and rapid; when the tightness disappears leaving only rapidity, the pus has formed.
[From *Tai Ping Hui Min He Ji Ju Fang*] Xiao Qinglong Tang (Formula see Cold Damage section).
[From *Tai Ping Hui Min He Ji Ju Fang*] Tingli Dazao Xiefei Tang treats Lung abscess with wheezing and inability to lie flat.
Xing Semen Lepidii (Tinglizi) (stir-fried yellow, ground fine, made into pills the size of a bullet) Jujubae Fructus (Dazao) (12 fruits).
Add water 3 sheng, boil with Jujube until 2 sheng remain, remove Jujubes, add Xing Semen Lepidii, boil until 1 sheng remains, take in one dose. It is also said: To treat Lung abscess with chest fullness and distension, edema of the whole body and face, nasal congestion with clear discharge, loss of smell for sweet, foul, sour, or pungent tastes, coughing and rebellious Qi, wheezing and airway obstruction, use the above formula, one dose every three days, up to three or four doses. First administer one dose of Xiao Qinglong Tang, then give this formula.
[From *Tai Ping Hui Min He Ji Ju Fang*] Jiegeng Tang treats cough with chest fullness, chills, rapid pulse, dry throat without thirst, occasional expulsion of turbid sputum with a fishy odor, and long-term expectoration of pus like porridge, indicating Lung abscess.
Scutellariae Radix (Jiegeng) Glycyrrhizae Radix et Rhizoma (Gancao) (roasted. Each 1 liang).
Add water 3 sheng, boil to 1 sheng, remove dregs, divide into two warm doses. Pus and blood will be expelled. Also treats throat bi. In *San Yin Ji Yi Bing Zheng Fang Lun*, Gancao is doubled, each dose 4 qian, named Sisheng San. *Qianjin Fang* also calls it Jiegeng Tang, using 3 liang Jiegeng and 2 liang Gancao; after taking, pus and blood must be expelled.
[From *Tai Ping Hui Min He Ji Ju Fang*] Weijing Tang treats Lung abscess. It is also said: Another version treats cough with slight fever, vexation and fullness, and rough skin on the chest and heart.
Phragmitis Rhizoma (Weijing) (3 sheng, cut) Coicis Semen (Yiyiren) (0.5 sheng) Benincasae Semen (Dongguaren) (0.5 sheng) Persicae Semen (Taoren) (50 kernels, peeled).
Add water 1 dou, first boil Phragmis Rhizoma to obtain 5 sheng, remove dregs, add other herbs, boil to 2 sheng, divide into five warm doses. One should expectorate like porridge. *Qianjin Fang* says: Lung abscess should expectorate pus and blood. (Weijing is the coarse variety of reeds found in tidal areas.)
For expectoration of pus and blood resembling Lung abscess, bad breath, and unresponsive to other formulas, use Xiaofeng San. Add Ash of Human Hair, grind fine and mix, take with clear rice drink to eradicate the root,仅需 two doses. Also treats hematemesis. (Xiaofeng San formula: Schizonepetae Herba, Ligustici Chuanxiong Rhizoma, Notopterygii Rhizoma et Radix, Ginseng Radix, Poria, Bombyx Batryticatus, Saposhnikoviae Radix, Cicadae Periostracum, Pogostemonis Herba each 2 qian; Magnoliae Cortex, Citri Reticulatae Pericarpium each 0.5 liang, ground into powder.)
[Wei Zhou] Duxing Fang treats rough skin on the chest and heart, belonging to Lung abscess, using Huanghun Tang as the main treatment.
Use Albiziae Cortex (Yehe Pi) the size of a palm, add water 3 sheng, boil to 2 sheng, divide into two doses. (Albizia tree, according to Materia Medica, is Wunong tree.)
Regarding the above syndromes and treatments for Lung abscess, *Jingui Yaolue* first uses one dose of Xiao Qinglong Tang to resolve exterior Wind-Cold pathogens, which is the example for treating swelling-stage sores.
The subsequent use of Wei Zhou’s formula aims to tonify interior Yin Qi, which is the example for treating ulcerated sores. (The above six formulas were collected by Mr. Danxi.)
[Meishi] Rusheng Wan treats Wind-Heat toxic vapors attacking upward, causing sore throat bi, swelling and obstruction, as well as Lung abscess with wheezing and cough, thick bloody sputum, chest fullness and chills, dry throat without thirst, occasional turbid foam, foul-smelling sputum, long-term expectoration of pus resembling rice porridge.
Borneolum Syntheticum (Zhangnao) (separately ground) Calculus Bovis (Niuhuang) (separately ground) Scutellariae Radix Glycyrrhizae Radix et Rhizoma (raw. Each 1 qian).
Grind into fine powder, refine honey to make pills, each liang makes twenty pills. Take one pill at a time, hold in mouth to dissolve.
[Zhu Danxi] Jisheng Jiegeng Tang treats Lung abscess with chest and heart Qi obstruction, coughing pus and blood, mental restlessness, dry throat with excessive thirst, swelling and fullness of both feet, red and yellow urine, and constipation.
Scutellariae Radix, Fritillariae Bulbus, Angelicae Sinensis Radix, Trichosanthis Fructus Semen, Aurantii Fructus, Coicis Semen, Mori Cortex, Saposhnikoviae Radix, each 1 liang; raw Glycyrrhizae Radix et Rhizoma, Pruni Semen, steamed Lilii Bulbus each 0.5 liang; Astragali Radix 1.5 liang.
Process and chop finely, each dose 4 qian, add water 1.5 bowls and 5 slices of fresh ginger, decoct to 0.8 bowl, remove dregs and take. If stool is dry, add Rheum Palmatum Radix et Rhizoma. If urine is scanty, add Akebiae Caulis.
[Zhang Zhongjing] Jiegeng Bai San treats cough with chest fullness, chills, rapid pulse, dry throat without thirst, occasional expulsion of turbid sputum with a fishy odor, and long-term expectoration of pus like rice porridge, indicating Lung abscess.
Scutellariae Radix Fritillariae Bulbus (each 3 fen) Croci Fructus (Badou) (1 fen, peeled, stir-fried and ground to paste).
The above three ingredients, make into powder. For strong individuals, take half a qianbi with water; reduce dose for weak individuals. Pathogens above the diaphragm cause vomiting of pus and blood; below the diaphragm cause purgation. If diarrhea is excessive and uncontrolled, drink one bowl of cold water to stop it. (This is also a formula from *Jingui Yaolue*; Danxi did not delete it, adopting it implies there must be subtle meaning.)
[Zhu Danxi] Lung abscess. *Yilei Yuanrong* uses Soufeng Tang to induce vomiting. (Soufeng Tang could not be verified.)
[From *Shennong Bencao Jing*] To treat Lung abscess with expectoration of pus and blood, foul odor, and pain in chest and breasts, use Shengma Tang.
Cimicifugae Rhizoma, Scutellariae Radix, Coicis Semen, Sanguisorbae Radix, Moutan Cortex, Paeoniae Radix Rubra (each 0.5 liang) Glycyrrhizae Radix et Rhizoma (2 fen).
Chop into coarse pieces, each 1 liang, add water 1.5 sheng and 5 slices of ginger, decoct, remove dregs, take three times a day.
[Zhu Danxi] Jisheng Painong Tang treats Lung abscess after expectorating pus, used here to drain pus and tonify the Lung.
Raw Astragali Radix 2 liang, ground fine, each 2 qian, add water 1 bowl, decoct to half, take.
To close the wound of Lung abscess, only Albiziae Cortex and Ampelopsis Radix decocted in water for drinking are effective.
If Lung abscess has ruptured and Wind enters, it is untreatable. Intestinal abscess, *Qianjin Fang* states that mistaken treatment will surely kill. Intestinal abscess presents with heavy and hard lower abdomen, pain upon pressure, frequent urination resembling strangury, intermittent sweating, aversion to cold, rough skin like scales, tense abdominal wall resembling swelling, and rapid pulse indicating small amount of pus. Chao Yuanyuan says: Surging and rapid pulse indicates pus has formed; slow and tight pulse indicates no pus yet. Severe cases present with abdominal distension, sound of water when turning, ulcers around the navel, pus discharging from the navel, or pus and blood in stool.
[From *Mai Jing*] Question: A woman of the Yulin guard is ill; how do we know there is pus in the intestines? The Master says: Pulse is slippery and rapid. Slippery indicates Excess, Rapid indicates Heat. Slippery indicates Nutritive, Rapid indicates Defensive. Defensive Rapid descends, Nutritive Slippery ascends. Nutritive and Defensive interfere with each other, blood becomes turbid and ruined, lower abdomen is stuffy and hard, urination may be obstructed, or spontaneous sweating occurs, or aversion to cold returns, indicating pus has formed. If the pulse is slow and tight, it is blood stasis; once blood is discharged, peace ensues.
[From *Tai Ping Hui Min He Ji Ju Fang*] Yiyi Fuzi Baijiang San treats rough skin like scales, tense abdominal wall resembling distension, no accumulation, fever, and rapid pulse.
Aconiti Lateralis Radix Praeparata (Pao) (2 fen) Patriniae Radix (Baijiang) (5 fen) Coicis Semen (1 qian).
Make into powder, each dose 1 fangcunbi, decoct in 2 he of water, take in one dose, swallow with small box meal. *San Yin Ji Yi Bing Zheng Fang Lun*: Yiyiren and Fuzi same as above, Baijiang 1 liang 1 fen, each 4 qian, water 1.5 zhan, decoct to 0.7, remove dregs, take on empty stomach.
[From *Qianjin Fang*] Dahuang Mudan Tang treats Intestinal abscess with stuffy and hard lower abdomen, or偏 located left or right of the bladder, white and hard large like a palm, hot, normal urination, intermittent sweating. Slow and hard pulse indicates pus not yet formed, purgation is indicated, blood should appear. Rapid pulse indicates pus formed, purgation is no longer indicated.
Rhei Radix et Rhizoma (4 liang) Moutan Cortex (3 liang) Natrii Sulfas (Mangxiao) (2 liang) Benincasae Semen (1 sheng) Persicae Semen (50 kernels).
Chop finely, add water 5 sheng, boil to 1 sheng, take in one dose, pus and blood should be purged. *Shanfan* uses 0.5 he Mangxiao and 0.5 he melon seeds. Liu Juanzi uses 3 he nitre, same as *Zhouhou*, named Guazi Tang. *San Yin Ji Yi Bing Zheng Fang Lun* uses Dahuang and Taoren each 2 fen, Guazi 3 fen, Mudanpi 1 qian, Xiao 2 qian, chop into powder for one packet, water 3 zhan, decoct to 0.8, remove dregs, add Xiao, boil again, take in one dose at any time.
[Anonymous] Yiyi Tang treats Intestinal abscess with abdominal pain, restlessness, or distension and anorexia, and scanty urination. Postpartum deficiency heat in women often has this disease; even if not an abscess, if suspected, it can be given. Even if mistaken, it does no harm.
Coicis Semen 5 liang, Moutan Cortex and Persicae Semen each 3 liang, Melon Seed Kernel 4 liang.
Chop into powder, each 4 daqian, water 1.5 zhan, decoct to 0.7, take. Yao Shi removes Taoren, uses Apricot Seed. Cui Shi adds 2 liang Mangxiao. Same as *Qianjin Fang*.
Medical case: A woman had abdominal pain, unresponsive to hundred prescriptions, pulse slippery and rapid, intermittent fever, slight abdominal tension. Sun Si miao diagnosed: Abdominal pain pulse should be deep and fine, now slippery and rapid, this is Intestinal abscess. Use Yunmu Gao 1 liang, made into pills the size of tung seeds. Dissolve Niupijiao, mix with warm wine, take the pills. Finished the ointment by noon, discharged a basin of pus and blood and was relieved.
[From *Qianjin Fang*] Moxibustion method: Bend elbows, the point directly opposite the sharp bone of the elbow tip is the acupoint. Moxa 100 zhuang, discharges pus and blood and brings relief.
Wang Shi’s *Yu Hua* records a woman with unbearable intestinal pain, feces passing through urine. Li Sheng diagnosed: Kou pulse appears in Yang positions, this is Intestinal abscess. Then produced Yunmu Gao, made into 100+ pills, decocted Huangqi Tang to swallow, discharged several sheng of pus and blood and was relieved. Li said: Cun Kou indicates blood accumulation in chest, Guan Kou indicates intestinal abscess. Li was the son-in-law of Yang Jilao, abandoned civil service exams to study medicine, appointed Medical Doctor. Internal carbuncles arise from Fire of Diet combined with Fire of Seven Emotions, stagnating and erupting. Diet affects Yin, Seven Emotions affect Zang-Fu, thus they erupt inward in the cavity, not affecting the intestines, stomach, or membrane. Called "internal" because they cannot be seen.
The above five formulas for Intestinal abscess were collected by Mr. Danxi. Among the first three, the *Jingui Yaolue* formula originally mentions internal pus, but Mr. Danxi does not mention it, and places *Qianjin* and *San Yin* formulas at the beginning, likely following the example of purgation for swelling-stage sores. The latter two formulas use dissolved gelatin and Huangqi decoction to swallow medicine, likely following the example of tonification for ulcerated sores.
[From *Huangdi Neijing Suwen*] The Yellow Emperor asked: For people suffering from Stomach abscess, how should diagnosis be conducted? Qibo answered: Diagnose this by observing the Stomach pulse; the pulse should be deep and fine. Deep and fine indicates rebellious Qi. (In *Jiayi Jing*, "deep and fine" is written as "deep and choppy"). Rebellious Qi causes the Renying pulse to be very vigorous; very vigorous means Heat. Renying is the Stomach pulse; rebellion and vigor mean Heat gathers in the Stomach and cannot circulate, thus forming a Stomach abscess. (Chapter Bingneng)
[Li Dongyuan] Shegan Tang treats Stomach abscess with rebellious and vigorous Renying pulse, coughing pus and blood, stagnant Ying and Wei, Heat gathering at the stomach opening forming an abscess.
Belamcandae Rhizoma (Shegan) (remove hairs) Gardeniae Fructus (Zhiren) (remove peel) Alismatis Rhizoma (Chifuling) (remove peel) Cimicifugae Rhizoma (each 1 liang) Paeoniae Radix Rubra (1.5 liang) Atractylodis Macrocephalae Rhizoma (0.5 liang).
Make into powder, each dose 5 qian, water 2 zhan, decoct to 1 zhan, remove dregs, add 1 he Rehmanniae Juice and 0.5 he honey, decoct again and take warm, at any time.
[From *Tai Ping Hui Min He Ji Ju Fang*] Fuyuan Tongqi San treats Qi stagnation, deafness, abdominal abscess, anal abscess, non-suppurating carbuncles and sores, relieving pain and reducing swelling.
Citri Reticulatae Viride Pericarpium (Qingpi) Citri Reticulatae Pericarpium (Chenpi) (each 4 liang) Glycyrrhizae Radix et Rhizoma (3 cun, half raw half roasted) Manis Squama (Pao) Trichosanthis Radix (each 2 liang) Lonicerae Japonicae Flos (1 liang) Forsythiae Fructus (1 liang).
Make into fine powder, take with hot wine.
[Zhu Danxi] Intestinal abscess, caused by Heat accumulation in Large Intestine and stagnation of dead blood, use Taochengqi Tang plus Jinnyinhua and Qinjiao. If near the anus and ruptured with Wind entry, difficult to treat, use Fangfeng and similar herbs. Generally, for traumatic wind, if on head and face, Baizhi is sovereign, Fangfeng is minister-assistant, to remove Wind from head and face skin. If on body and limbs, Fangfeng is sovereign, use tail end, for lower part use Duohuo as minister-assistant. After Lung abscess expectorates pus, if pulse is short and choppy, self-healing; if floating and large, difficult to treat. If complexion is white but turns red, this is Fire overcoming Metal, all untreatable.
*Jingui Fanglun* says: Heat in Upper Jiao causes cough leading to Lung Flaccidity. How does Lung Flaccidity arise? From sweating, vomiting, Xiao Ke with frequent urination, or difficulty defecating treated with harsh purgatives, causing severe loss of fluids. Thus Cun Kou pulse is rapid, person coughs, mouth has turbid saliva and foam, this is Lung Flaccidity. If mouth is parched, cough causes hidden chest pain, pulse is slippery and rapid, this is Lung Abscess. Coughing pus and blood, rapid and deficient pulse is Lung Flaccidity; rapid and excess pulse is Lung Abscess.
Note: This states Lung Flaccidity belongs to Heat. Long-term cough damaging Lung, hoarse voice and hemoptysis belong to Yin Deficiency with Fire. The original text treats Lung Flaccidity with salivation but no cough, no thirst, enuresis, frequent urination, due to Upper Deficiency failing to control Lower. This is Cold in Lung, causing dizziness and copious saliva, use Roasted Gancao and Ganjiang, belonging to Cold. Lung Flaccidity with copious saliva and warm fluid in heart uses Roasted Gancao Tang, tonifying deficiency and fatigue. This differs from tonifying Yin Deficiency Fire, so they should be treated separately. Thus Lung Flaccidity has Cold and Heat distinctions.
[From *Jingyi*] Labor injuring Qi and Blood, pores deficient allowing Wind pathogen to invade, flourishing internally in Lung. Sweating, aversion to wind, cough, shortness of breath, nasal congestion, stiff neck, chest and hypochondriac distension, long-term non-healing, becoming Lung Flaccidity.
[From *Baoming Ji*] Lung abscess is caused by eating spicy, hot, fried foods, or drinking hot wine excessively, damaging Lung with dryness and heat. Treatment should be early.