【方歌】涌泉疽生尻骨前，形如伏鼠肿痛坚，督脉湿热溃破险，
少壮易愈老弱难。
【注】此证生尻骨之前长强穴，属督脉经首穴，由湿热凝结而
成。初肿坚硬疼痛，状如伏鼠，十日可刺。得白脓者顺
，溃迟青脓者险，紫黑水者逆。内治法同鹳口疽，外治
溃后，按痈疽溃疡门。少壮者得此易愈，老年气衰弱者
，多成冷漏难痊。
【方歌】脏毒毒注在肛门，内外虚实各有因，醇酒厚味兼辛苦，
外属阳分内属阴。
【注】此证有内外、阴阳之别。发于外者，由醇酒厚味，勤劳
辛苦，蕴注于肛门，两旁肿突，形如桃李，大便秘结，
小水短赤，甚者肛门重坠紧闭，下气不通，刺痛如锥，
脉数有力，多实多热，属阳易治，宜服一煎散，通利二
便，菩提露搽之；肿痛仍前，不全退者，脓将成也，宜
服托里透脓汤；脓胀痛针之；脓出之后，治同溃疡门。
发于内者，兼阴虚湿热，下注肛门，内结壅肿，刺痛如
锥，大便虚闭，小水淋漓，寒热往来，遇夜尤甚，脉数
微细，为虚为湿，属阴难治，宜服五灰散，脓毒自然溃
出；脓生迟者，服十全大补汤托之，溃后按溃疡门。
方剂：一煎散
组成：当归尾 穿山甲（炙，研）
甘草（生） 桃仁泥
皂角刺（各二钱） 川黄连（一钱五分）
枳壳（麸炒） 槟榔
天花粉 乌药
赤芍 生地
白芷（各一钱） 元明粉
大黄（各三钱） 红花（五分）
水二钟，浸一宿，次早煎一滚，空心服，俟行三、
四次，以稀粥补之。
【方歌】一煎散消脏毒方，归甲甘连桃枳榔，天花皂刺红乌药，
芍地元明芷大黄。
又方：菩提露
组成：熊胆（三分） 冰片（一分）
凉水一茶匙，调化开，搽于患处甚效。
【方歌】菩提露消积热痛，脏毒坚疼焮肿增，水调熊胆加冰片，
搽于患处毒渐轻。
又方：五灰散
组成：血管鹅毛 血余
蜈蚣 穿山甲
生鹿角（各烧存性）
各等分研细，共合匀，每服五钱，空心温黄酒调下
。
【方歌】五灰散用鹅管毛，血余蜈甲鹿角烧，脏毒肿痛肛门内，
每服五钱黄酒调。
又方：托里透脓汤（见头部侵脑疽）
十全大补汤（见溃疡门）
【方歌】涌泉疽生于尾骨前方，形状像趴着的鼠类，肿痛且坚硬，因督脉湿热所致，一旦溃破则病情危重，年轻力壮者容易痊愈，年老体弱者难以治愈。
【注】此证发生在尾骨前方的长强穴，属于督脉经的首个穴位，由湿热凝结而成。初期肿胀坚硬疼痛，形状像趴着的鼠类，十日后可以针刺排脓。若流出白色脓液为顺证，溃破延迟且流出青色脓液为险证，流出紫黑色水样物为逆证。内治方法与鹳口疽相同，外治方面，溃破后参照痈疽溃疡门处理。年轻力壮者患此病容易痊愈，老年人气血衰弱者，多形成冷性漏管，难以痊愈。
【方歌】脏毒之毒注于肛门，有内发和外发、虚证和实证的不同成因，多因嗜食醇酒厚味及辛勤劳作所致，外发属阳分，内发属阴分。
【注】此证有内外、阴阳的区别。发于外部的，是由于嗜食醇酒厚味，加上辛勤劳作，湿热蕴结注于肛门，导致肛门两旁肿胀突起，形状像桃李，大便秘结，小便短赤，严重的肛门沉重坠胀紧闭，排气不通，刺痛如锥扎，脉象数而有力，多为实证、热证，属阳证，容易治疗，适宜服用一煎散，通利大小便，并用菩提露涂抹患处；如果肿痛依旧，不能完全消退，说明脓液即将形成，适宜服用托里透脓汤；脓液胀痛时进行针刺；脓液排出之后，治疗方法同溃疡门。发于内部的，兼有阴虚湿热，下注于肛门，内部结聚壅肿，刺痛如锥扎，大便虚闭（排便无力），小便淋漓不尽，寒热往来，夜间症状尤其严重，脉象数而微细，为虚证、湿证，属阴证，难以治疗，适宜服用五灰散，使脓毒自然溃破排出；若脓液生成迟缓，服用十全大补汤以托毒外出，溃破后参照溃疡门处理。
方剂：一煎散
组成：当归尾、穿山甲（炙后研末）、甘草（生用）、桃仁泥、皂角刺（各二钱）、川黄连（一钱五分）、枳壳（麸炒）、槟榔、天花粉、乌药、赤芍、生地、白芷（各一钱）、元明粉、大黄（各三钱）、红花（五分）。
用法：用水两钟，浸泡一整夜，次日清晨煎煮至沸腾，空腹服用，待排便三至四次后，用稀粥调养。
【方歌】一煎散是消除脏毒的方剂，包含归尾、穿山甲、甘草、黄连、桃仁、枳壳、槟榔、天花粉、皂角刺、红花、乌药、赤芍、生地、元明粉、白芷、大黄。
又一方：菩提露
组成：熊胆（三分）、冰片（一分）。
用法：凉水一茶匙，调化开后，涂抹于患处，效果显著。
【方歌】菩提露消除积热疼痛，脏毒坚硬疼痛红肿加剧，用水调化熊胆加冰片，涂抹于患处，毒邪逐渐减轻。
又一方：五灰散
组成：血管鹅毛、血余、蜈蚣、穿山甲、生鹿角（各烧存性）。
用法：各等分研成细末，混合均匀，每次服用五钱，空腹用温黄酒送服。
[Formula Song] Yongquan abscess arises anterior to the coccyx, resembling a crouching rat with swelling, pain, and hardness; caused by damp-heat in the Du Meridian (Governing Vessel), rupture is dangerous. It heals easily in the young and strong, but is difficult to cure in the old and weak.
[Note] This condition occurs at the Changqiang (DU1) acupoint anterior to the coccyx, which is the first acupoint of the Du Meridian (Governing Vessel). It is formed by the concretion of damp-heat. Initially, there is hard swelling and pain, resembling a crouching rat; puncture can be performed after ten days. The discharge of white pus indicates a favorable prognosis (Shun); delayed rupture with green pus indicates a critical situation (Xian); discharge of purple-black fluid indicates an adverse prognosis (Ni). Internal treatment is the same as for Guankou abscess. For external treatment after rupture, refer to the Ulcerative Sores section. The young and strong heal easily; the elderly with Qi and Blood deficiency often develop cold fistulas that are difficult to cure.
[Formula Song] Zangdu (Visceral Toxin) toxin settles in the anus; it has internal and external origins, and excess and deficiency patterns. It results from rich food, alcohol, and hard labor; externally it belongs to the Yang aspect, internally to the Yin aspect.
[Note] This condition distinguishes between internal and external, and Yin and Yang. When manifesting externally, it is caused by rich food, alcohol, and hard labor, leading to the accumulation and settling of damp-heat in the anus. Swelling protrudes on both sides of the anus, resembling plums or peaches. There is constipation and short, red urine. In severe cases, the anus feels heavy and tight, with no passage of gas, and stabbing pain like a needle. The pulse is rapid and forceful, indicating Excess and Heat, belonging to Yang. It is easy to treat. One should take Yi Jian San to unblock the bowels and promote urination, and apply Bodhi Dew to the affected area. If swelling and pain persist without subsiding, pus is forming; one should take Tuoli Tou Nong Tang (Support Interior and Perforate Pus Decoction). Puncture when there is painful distension due to pus. After pus discharge, treatment follows the Ulcerative Sores section. When manifesting internally, it involves Yin deficiency with damp-heat sinking to the anus, causing internal congestion and swelling, stabbing pain like a needle, false constipation (inability to defecate due to weakness), dribbling urine, alternating chills and fever (worse at night), and a rapid, thready pulse. This indicates Deficiency and Dampness, belonging to Yin. It is difficult to treat. One should take Wu Hui San to allow natural rupture of pus and toxin. If pus formation is slow, take Shiquan Dabu Tang to support the body and expel pus. After rupture, follow the Ulcerative Sores section.
Formula: Yi Jian San (One-Boil Decoction)
Composition: Radix Angelicae Sinensis Cauda (Danggui Wei), Scales Pangolin (Shanjiazhu, stir-baked and ground), Raw Radix Glycyrrhizae Uralensis (Gancao), Persicaria Semen (Taoren, mashed), Spina Gleditsiae Sinensis (Zaogao Ci) (2 qian each), Rhizoma Coptidis Chinesis (Chuan Huanglian) (1.5 qian), Fructus Aurantii (Zhike, bran-fried), Areca Seed (Binglang), Radix Bupleuri (Tianhuafen - *Note: Tianhuafen is Trichosanthes Root, Bupleuri is Chaihu. Text says Tianhuafen*), Radix Akebiae (Wuyao), Radix Paeoniae Rubra (Chishao), Radix Rehmanniae Preparata/Shengdi (Shengdi), Radix Angelicae Dahuricae (Baizhi) (1 qian each), Natrii Sulfas (Yuanmingfen), Radix et Rhizoma Rhei (Dahuang) (3 qian each), Flos Carthami Tinctorii (Honghua) (0.5 fen).
Usage: Soak in 2 zhong of water overnight. Boil once the next morning. Take on an empty stomach. Wait until bowel movements occur three to four times, then nourish with thin porridge.
[Formula Song] Yi Jian San eliminates Zangdu; contains Danggui, Shanjiagwu, Gancao, Huanglian, Taoren, Zhike, Binglang, Tianhuafen, Zaogao Ci, Honghua, Wuyao, Chishao, Shengdi, Yuanmingfen, Baizhi, Dahuang.
Another Formula: Bodhi Dew
Composition: Bear Gallbladder (Xiongdan) (3 fen), Borax (Bingpian) (1 fen).
Usage: Dissolve in one teaspoon of cool water and apply to the affected area; highly effective.
[Formula Song] Bodhi Dew clears accumulated heat and pain; for Zangdu with hard pain and burning swelling, mix Xiongdan and Bingpian with water and apply to the site to gradually reduce toxicity.
Another Formula: Wu Hui San (Five Ashes Powder)
Composition: Vascular Goose Feather (Xueguan Emanao), Human Hair (Xueyu), Centipede (Wugong), Scales Pangolin (Shanjiazhu), Fresh Deer Antler (Sheng Lujiao). All calcined to retain their properties (shao cun xing).
Usage: Grind equal parts into fine powder, mix well. Take 5 qian per dose, mixed with warm yellow wine on an empty stomach.
[Formula Song] Wu Hui San uses goose feather, hair, centipede, pangolin scales, and deer antler calcined; for Zangdu pain and swelling inside the anus, take 5 qian mixed with yellow wine.
Another Formula: Tuoli Tou Nong Tang (See Head Section: Qinao Ju)
Shiquan Dabu Tang (See Ulcerative Sores Section)