中脘疽由胃火生，脐上四寸隐隐疼，坚硬漫肿无红热，不食呕哕毒内攻。
【注】此证一名胃疽，发于心胸之下，脐上四寸，任脉经中脘穴。隐痛日久，向外生
疽，坚硬漫肿，皮色无红无热，由过食炙爆，以致胃腑火毒而成。人迎脉盛，是毒瓦斯攻里，
作呕不食，咳嗽脓痰者逆。初宜服仙方活命饮，色紫坚硬，宜服山甲内消散。脓势将成，
内外治法，俱按痈疽肿疡、溃疡门。若起长脓迟，或疮不 痛者，急用艾壮隔独头蒜片，
置患上灸之回阳。
\r中脘疽图\p04-34a123.bmp\r
山甲内消散
穿山甲（炒，三大片） 当归尾 大黄 甘草
节（各三钱） 土木鳖（三个） 黑牵牛 僵蚕（炒，各一钱）
酒、水各一盅，煎八分，空心服，渣再煎服。大便行三四次，方食稀粥淡味调理。
【方歌】山甲内消火毒积，色紫坚疼中脘疽，归尾大黄僵草节，木鳖牵牛加酒宜。
仙方活命饮（见肿疡门）
吓痈七情郁火成，脐上三寸粟微红，暴肿 痛二七溃，顶陷色黑溃迟凶。
【注】此证由七情郁火凝结而成。生脐上三寸，属任脉经建里穴。初如粟米，痒痛相
兼，其肿迅速，寒热往来，甚则呕哕，牵引脐痛。初肿微红，顶尖根束，渐透赤色，时
痛时止，十四日溃脓者顺；若顶陷紫黑，根脚漫肿，面赤大渴，脉见浮数而散大者逆。内
治与幽痈参考，外治法按痈疽肿疡、溃疡门。
\r吓痈图\p04-34a124.bmp\r
中脘疽由胃火引起，疼痛位于脐上四寸处，呈隐隐作痛之状，肿块坚硬且漫肿，皮肤颜色不红、无发热感，患者食欲不振并伴有呕吐呃逆，此为毒邪内攻之象。
【注】此证又名胃疽，发病部位在心胸之下、脐上四寸处，属于任脉经的中脘穴。隐痛日久，向外生出疽疮，表现为坚硬漫肿，皮色既不红也不热，这是由于过食煎炸烧烤食物，导致胃腑火毒积聚而成。若人迎脉搏动盛大，说明毒瓦斯攻入体内，出现呕吐、不能进食、咳嗽且有脓痰者，属逆证（预后不良）。初期适宜服用仙方活命饮；若疮色紫暗坚硬，适宜服用山甲内消散。当脓势即将形成时，内外治法均参照痈疽肿疡、溃疡章节的方法处理。如果起发长脓迟缓，或者疮口不痛者，急需用艾炷隔着独头蒜片置于患处进行艾灸，以回阳救逆。
[中脘疽图]
山甲内消散
穿山甲（炒制，三大片） 当归尾 大黄 甘草节（各三钱） 土木鳖（三个） 黑牵牛 僵蚕（炒制，各一钱）
用酒和水各一盅，煎至八分满，空腹服用，药渣再次煎煮后服用。待大便排出三四次后，方可食用稀粥及清淡饮食进行调理。
【方歌】山甲内消解火毒积滞，针对色紫坚疼之中脘疽，方中含归尾、大黄、僵蚕、甘草节，加木鳖子、牵牛子并用酒水煎服为宜。
仙方活命饮（见肿疡门）
吓痈由七情郁结化火而成，发病部位在脐上三寸，初起如粟米般微红，肿胀迅速，疼痛剧烈，约十四日溃破，若疮顶凹陷、色黑且溃破迟缓者，预后凶险。
【注】此证由七情郁结化火凝结而成。生于脐上三寸处，属于任脉经的建里穴。初起如同粟米大小，瘙痒与疼痛并存，肿胀发展迅速，伴有寒热往来，严重时出现呕吐呃逆，牵引脐部疼痛。初期肿胀微红，疮顶高突根部收束，逐渐透出赤色，时痛时止，十四日溃脓者为顺证（预后良好）；若疮顶凹陷、色紫黑，根部漫肿无边，面部潮红、大渴，脉象浮数而散大者，属逆证。内治法可参考幽痈，外治法按痈疽肿疡、溃疡章节处理。
[吓痈图]
Zhongwan Ju (Abscess at Zhongwan) arises from Stomach Fire. The pain is located four cun above the umbilicus, presenting as a dull ache. The swelling is hard and diffuse, with no redness or heat on the skin. The patient suffers from anorexia, vomiting, and hiccups, indicating internal attack by toxic pathogens.
[Note] This condition is also known as Wei Ju (Stomach Abscess). It occurs below the heart and chest, four cun above the umbilicus, at the Zhongwan acupoint of the Ren Mai (Conception Vessel). After a long period of dull pain, an abscess develops outwardly, characterized by hardness and diffuse swelling without redness or heat. This is caused by excessive consumption of fried and roasted foods, leading to the accumulation of fire-toxin in the Stomach organ. If the Renying pulse is vigorous, it indicates that toxic vapors are attacking the interior; symptoms such as vomiting, inability to eat, coughing with purulent sputum constitute a "Ni" (adverse/rebellious) prognosis. Initially, Xian Fang Huo Ming Yin should be administered. If the lesion is purple and hard, Shan Jia Nei Xiao San is indicated. When pus formation is imminent, both internal and external treatments should follow the protocols for Tumors and Ulcers sections. If pus formation is delayed or the sore is painless, urgent moxibustion using moxa cones placed over slices of single-clove garlic on the affected area should be applied to restore Yang energy.
[Image: Zhongwan Ju]
Shan Jia Nei Xiao San
Chuan Shan Jia (Pangolin Scales, stir-fried, three large pieces) Dang Gui Wei (Tail of Angelica Sinensis) Da Huang (Rhubarb Root) Gan Cao Jie (Licorice Root segments) [each 3 qian] Tu Mu Bie (Earth Spiny Fruit) Hei Qian Niu (Black Morning Glory Seeds) Jiang Can (Silkworm, stir-fried) [each 1 qian]
Decoct with one cup of wine and one cup of water until reduced to 80%. Take on an empty stomach. Decoct the dregs again and take. After three to four bowel movements, resume diet with thin rice porridge and bland flavors.
[Prescription Verse] Shan Jia Nei Xiao dissipates accumulated fire-toxin, treating Zhongwan Ju with purple color, hardness, and pain. It contains Dang Gui Wei, Da Huang, Jiang Can, and Gan Cao Jie, best taken with Mu Bie and Qian Niu decocted in wine and water.
Xian Fang Huo Ming Yin (See Tumors Section)
Xia Yong (Fright-Induced Carbuncle) results from Qi stagnation transforming into fire. It appears three cun above the umbilicus, initially resembling a millet seed with slight redness. Swelling is rapid, accompanied by severe pain. It typically ulcerates after fourteen days. If the apex is depressed, black, and ulceration is delayed, the prognosis is ominous.
[Note] This condition is formed by the coagulation of fire due to emotional stagnation. It arises at Jianli acupoint, three cun above the umbilicus, belonging to the Ren Mai. Initially, it resembles a millet grain, with simultaneous itching and pain. Swelling progresses rapidly, accompanied by alternating chills and fever. In severe cases, vomiting and hiccups occur, radiating pain to the umbilicus. Early swelling is slightly red, with a high apex and constricted base, gradually turning crimson. Pain comes and goes. Ulceration with pus discharge after fourteen days is considered "Shun" (favorable). If the apex is depressed, purple-black, the base is diffuse, the face is flushed, there is extreme thirst, and the pulse is floating, rapid, and scattered/large, it is considered "Ni" (adverse). Internal treatment refers to You Yong; external treatment follows the Tumors and Ulcers sections.
[Image: Xia Yong]