（男妇同用）
臀，膀胱经部分也。居小腹之后，此阴中之阴。其道远，其位僻，虽太阳多血，气运难
及，血亦罕到，中年后，尤虑此患。治者毋伤脾胃，毋损气血，但当固根本为主。若肿硬作痛者
，形气虚而邪气实也，用托里消毒散主之。微肿微痛者，形气病气俱虚也，用托里散补之。
欲作脓，用托里羌活汤。若痛甚，用仙方活命饮。大势既退，亦用托里消毒散。若脾虚不能
消散，或不溃不敛者，六君子加芎、归、黄 。若阴虚不能消散，或作渴便淋者，六味丸加
五味子。若阳虚不能溃，或脓清不能敛者，用补中益气汤。气血俱虚者，十全大补汤。若肿
硬未成脓者，用隔蒜灸、活命饮。溃后豆豉饼，补中益气、十全大补二汤。若灸后大势已退
，余毒未消，频用葱熨，以补其气，以消余毒。为善！
治验
巡抚陈和峰，脾胃不健，常服消导之剂，左腿股及臀患肿。余曰∶此脾气虚而下注，非
疮毒
甚，体益倦。余用白术一味，煎饮而消。
儒者杨启元，左臀患此，敷贴凉药，肿彻内股，服连翘消毒散，左体皆痛。余以为足三
阴亏损
而疮口敛。
一儒者肿 痛甚，此邪毒壅滞，用活命饮、隔蒜灸而消。后因饮食劳倦，肿痛仍作，寒
热头疼，此元气虚而未能复也。与补中益气汤，频用葱熨法，两月而愈。
一男子漫肿，而色不变，脉滑数而无力，脓将成矣。余用托里而欲针，彼畏针而欲内消
。
昆庠吴辅之父患此，内溃肿胀，发热口干，饮食少思，此脾胃虚弱也。先用六君加芎、
归、 ，数剂而溃，又用十全大补汤倍加参、 ，五十余剂而愈。
南濠沈克章子，年三十。脉如屋漏雀啄，肿硬色赤，脓水清稀，误服败毒之药。余曰∶
此足
气复而疮愈。
一男子硬痛发热，此膀胱气虚，而湿热壅滞。用内托羌活汤二剂，热痛悉退；后用托里
消毒散而溃；又用托里散四十余剂而敛。
平湖袁上舍患痔，外敷寒凉，内服消毒，攻溃于臀，脓水清稀，脉洪大而数，寒热作渴
。余辞不治，后果殁。此足三阴亏损之症，失滋化源，以致真气益虚，邪气愈甚矣。不死何俟！
（男女通用）
臀部，是足太阳膀胱经循行分布的区域。位于小腹后方，属于阴中之阴的部位。其经络路径深远，位置偏僻，虽然太阳经多血，但气机运行难以到达，血液也很少流注至此，因此中年以后，尤其要警惕此处的疾患。治疗时不要损伤脾胃，不要耗损气血，只应当以固护根本为主。如果局部肿胀坚硬且疼痛，这是形体正气虚弱而邪气实盛的表现，主用托里消毒散。如果轻微肿胀和疼痛，这是形体、正气和病气都虚弱的表现，用托里散来补益。如果即将化脓，用托里羌活汤。如果疼痛剧烈，用仙方活命饮。当大势退去后，也使用托里消毒散。如果因脾虚导致无法消散，或者溃破后不愈合的，用六君子汤加川芎、当归、黄芪。如果因阴虚导致无法消散，或者出现口渴、小便淋涩的，用六味丸加五味子。如果因阳虚导致不能溃破，或者脓液清稀不能收敛的，用补中益气汤。气血俱虚的，用十全大补汤。如果肿胀坚硬但未成脓的，用隔蒜灸配合仙方活命饮。溃破后用豆豉饼敷贴，并服用补中益气汤或十全大补汤。如果艾灸后大势已退，但余毒未消，频繁使用葱熨法，以补益其气，消除余毒，这是很好的方法！
治验记录：
巡抚陈和峰，脾胃功能不强健，经常服用消食导滞的药物，左腿大腿及臀部发生肿胀。我说：这是脾气虚弱导致湿浊下注，并非疮毒严重，身体更加疲倦。我单用白术一味药煎水饮用，肿胀便消除了。
儒生杨启元，左侧臀部患此病，敷贴凉性药物，肿胀蔓延至内侧大腿，服用连翘消毒散后，左侧身体全部疼痛。我认为这是足三阴经亏损所致，应当滋补足三阴经。
一位儒生臀部肿胀疼痛剧烈，这是邪毒壅滞，我用仙方活命饮配合隔蒜灸使肿痛消除。后来因为饮食不节和劳累，肿痛再次发作，伴有寒热、头痛，这是元气虚弱未能恢复的表现。给予补中益气汤，并频繁使用葱熨法，两个月后痊愈。
一名男子臀部漫肿，肤色没有改变，脉象滑数但无力，脓液将要形成。我想用托里法并准备针刺排脓，但他害怕针刺，想要通过内服药物消散。
昆山学校吴辅的父亲患此病，内部溃破肿胀，发热口干，饮食减少思虑不足，这是脾胃虚弱的表现。先用六君子汤加川芎、当归、黄芪，几剂药后溃破，又用十全大补汤加倍人参、黄芪，五十多剂药后痊愈。
南濠沈克章的儿子，三十岁。脉象如屋漏、雀啄（危重脉象），肿胀坚硬色赤，脓水清稀，误服了败毒的药物。我说：这是足三阴经亏损，应当滋补足三阴经，待正气恢复后疮疡才能痊愈。
一名男子臀部硬痛发热，这是膀胱气虚，湿热壅滞。用内托羌活汤两剂，热痛全部消退；后用托里消毒散使疮疡溃破；又用托里散四十多剂后疮口收敛。
平湖袁上舍患有痔疮，外敷寒凉药物，内服解毒药物，攻伐导致臀部溃破，脓水清稀，脉象洪大而数，伴有寒热、口渴。我推辞不治，后来果然去世。这是足三阴经亏损的病症，失去了滋生化之源，导致真气更加虚弱，邪气更加旺盛。不死还等什么！
(For both men and women)
The buttocks are the area distributed by the Foot-Taiyang Bladder Meridian. Located behind the lower abdomen, this is a region of "Yin within Yin." Its pathway is distant, and its position is secluded. Although the Taiyang meridian is rich in blood, Qi circulation rarely reaches it, and Blood flow is also scarce. Therefore, after middle age, one must be particularly vigilant against ailments here. In treatment, do not damage the Spleen and Stomach, nor deplete Qi and Blood; instead, focus primarily on consolidating the root (Ben). If there is swelling, hardness, and pain, this indicates that the physical constitution (Xing) and Zheng Qi are deficient while Xie Qi is excess. The primary formula is Tuoli Xiaodu San (Support the Interior and Detoxify Powder). If there is slight swelling and pain, this indicates deficiency in physical constitution, Zheng Qi, and pathogenic factors. Use Tuoli San (Support the Interior Powder) to tonify. If suppuration is imminent, use Tuoli Qianghuo Tang (Support the Interior and Notopterygium Decoction). If the pain is severe, use Xianfang Huoming Yin (Immortal Life Elixir Decoction). After the major symptoms have subsided, Tuoli Xiaodu San should still be used. If the Spleen is deficient and unable to resolve the swelling, or if the ulcer fails to heal, use Liujunzi Tang (Six Gentlemen Decoction) added with Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Astragali Radix (Huangqi). If Yin deficiency prevents resolution, or if thirst and dysuria occur, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) added with Schisandrae Fructus (Wuweizi). If Yang deficiency prevents suppuration, or if the pus is clear and fails to contract, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For simultaneous deficiency of Qi and Blood, use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction). If there is swelling and hardness but no suppuration, apply Garlic-Separator Moxibustion combined with Xianfang Huoming Yin. After suppuration, apply Fermented Soybean Cake (Douchi Bing) and administer either Buzhong Yiqi Tang or Shiquan Dabu Tang. If after moxibustion the major pathogenic factors have receded but residual toxins remain, frequently apply Scallion-Ironing (Congyi) to tonify Qi and eliminate residual toxins. This is excellent!
Clinical Cases:
Chen Hefeng, Censor-in-Chief, had weak Spleen and Stomach function and frequently took digestive aids. He developed swelling in his left thigh and buttock. I stated: "This is due to Spleen Qi deficiency causing dampness to sink downward, not severe toxin accumulation. His body is increasingly fatigued." I prescribed a decoction of single herb Atractylodis Macrocephalae Rhizoma (Baizhu), which resolved the swelling.
Yang Qiyuan, a scholar, suffered from this condition in his left buttock. After applying cooling plasters and taking Liaoqiao Xiaodu San (Forsythia Detoxifying Powder), he experienced pain throughout his left side. I diagnosed this as a deficiency of the Three Foot-Yin meridians and treated accordingly to tonify them.
A scholar presented with severe swelling and pain in the buttock, caused by stagnation of pathogenic toxins. I used Xianfang Huoming Yin combined with Garlic-Separator Moxibustion, which resolved the condition. Later, due to dietary irregularities and overexertion, the swelling and pain returned, accompanied by aversion to cold, fever, and headache. This indicated that Yuan Qi was deficient and had not recovered. I administered Buzhong Yiqi Tang and frequently applied the Scallion-Ironing method. He recovered after two months.
A man presented with diffuse swelling without color change, and a slippery, rapid yet forceless pulse, indicating impending suppuration. I intended to use a supporting method and prepare for needle drainage, but he feared needles and desired internal resolution.
The father of Wu Fu from Kunshan School suffered from internal suppuration and swelling, fever, dry mouth, and poor appetite. This was diagnosed as Spleen and Stomach weakness. Initially, I prescribed Liujunzi Tang added with Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Astragali Radix (Huangqi). After several doses, it suppurated. Subsequently, I used Shiquan Dabu Tang with doubled Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi). After more than fifty doses, he recovered.
Shen Kezhang’s son from Nanhao, aged thirty, presented with a pulse resembling dripping water or pecking sparrow (ominous pulses), hard red swelling, and thin pus. He had mistakenly taken detoxifying drugs. I stated: "This is a deficiency of the Three Foot-Yin meridians. It requires tonification of these meridians; only when Qi recovers will the sore heal."
A man presented with hard, painful, and hot buttocks. This was due to Bladder Qi deficiency and stagnation of Damp-Heat. Two doses of Neituo Qianghuo Tang (Internal Support and Notopterygium Decoction) completely relieved the heat and pain. Thereafter, Tuoli Xiaodu San was used to induce suppuration, followed by Tuoli San for over forty doses to promote healing.
Yuan Shangshe from Pinghu suffered from hemorrhoids. He applied cold herbs externally and took detoxifying herbs internally, which attacked the body and caused an ulcer in the buttock. The pus was thin, the pulse was large, rapid, and forceful, and he experienced chills, fever, and thirst. I declined treatment. He subsequently died. This was a syndrome of deficiency in the Three Foot-Yin meridians, where the source of transformation and nourishment was lost, leading to further depletion of True Qi and exacerbation of pathogenic factors. Death was inevitable!