一人年逾三十。腹患痈肿。脉数喜冷。齐氏曰。疮疡肿起。坚硬者实也。河间曰。肿硬
。烦躁饮冷。邪在内也。用清凉饮（十二）倍大黄三剂。稍缓。次以四物汤加芩、连、山栀、
木通四剂而溃。更以十宣散（四）去参、 、桂。加金银花、天花粉。彼欲速效。自服温补药
。肚腹遂肿小便不利。仍用清凉饮。脓溃数碗。再以托里药治之而愈。（此因症因脉处治
一人腹痈 痛。烦躁作呕。脉实。河间曰。疮疡属火。须分内外以治其本。又云呕哕心
肿硬瞀闷。或皮肉不变。脉沉而实。毒在内也。当疏其内以绝其源。用内疏黄连汤。（三）利
二三行。诸症悉去。更以连翘消毒散而愈。（此据脉症而治。）
一人腹痈。脓熟开迟。脉微细。脓出后。疮口微脓如蟹吐沫。此内溃透膜也。疮疡透膜
。十无一生。虽用大补。亦不能救。此可为待脓自出之戒也。（此据症也。）
一恭人腹内一块。不时作痛。痛则不知人事。良久方苏。诸药不应。其脉沉细。非疮也
间云。失笑散（百九）治疝气及妇人血气痛欲死。并效。与一服。痛去六七。再服而平。此药
治产后心腹绞痛及儿枕痛。尤妙。（按此凭脉处治。）
一儿十岁。腹胀痛。服消导药不应。彼以为毒。其脉右关沉伏。此食积也。河间云。食
吐。胃脘痈也。更兼身体痛难移。腹胀善噫。舌本强。得后与气快然衰。皆脾病也。审之。
因食粽得此。以白酒曲热酒服而愈。（按此凭脉凭症而治也。）
一人素嗜酒色。小腹患毒。脉弱微痛。欲求内消。予谓当助胃壮气。兼行经活血佐之可消
欲速效。自用败毒等药。势果盛。疮不溃脓。饮食少思。两月余复请诊。脉愈弱。盗汗不止。
聚肿不溃。肌寒肉冷。自汗色脱。此气血俱虚。故不能发肿成脓。以十全大补汤（十三）三十
余剂。脓成针之。反加烦躁。脉大。此亡阳也。以圣愈汤（十七）二剂。仍以前汤百剂而愈。
（此凭脉症处治。）
有一位三十多岁的人，腹部患痈肿。脉象数，喜欢冷饮。齐氏说：疮疡肿起，质地坚硬的属于实证。河间（刘完素）说：肿胀坚硬、烦躁、想喝冷水，说明邪气在体内。使用清凉饮（十二）并加倍大黄，服用三剂后症状稍缓解。接着用四物汤加黄芩、黄连、山栀、木通，服用四剂后脓液溃破。再用十宣散（四），去掉人参、[原文缺字]、桂枝，加入金银花、天花粉。患者想要快速见效，自行服用温补药，导致肚腹更加肿胀，小便不通利。仍然使用清凉饮，脓液排出数碗，再用托里药治疗而痊愈。（这是根据症状和脉象进行治疗的案例。）
另有一人患腹痈，疼痛，烦躁作呕，脉象实。河间说：疮疡属于火证，必须区分内外以治其根本。又说：呕吐呃逆、心部肿硬、神志昏闷，或者皮肤肌肉颜色不变，脉象沉而实，说明毒气在体内。应当疏通内部以断绝病源。使用内疏黄连汤。（三）利下二三行，所有症状全部消除。再用连翘消毒散治疗而痊愈。（这是依据脉症进行治疗的。）
还有一人患腹痈，脓已成熟但迟迟不溃破，脉象微细。脓液流出后，疮口微有脓液，状如螃蟹吐沫。这是内部溃破穿透腹膜了。疮疡穿透腹膜，十个人中没有能活下来的一个，即使使用大补药物，也不能挽救。这可以作为等待脓液自然排出的警戒案例。（这是根据症状判断的。）
一位恭人的腹内有肿块，不时疼痛，痛时不知人事，很久才苏醒。各种药物都不见效。她的脉象沉细。这不是疮疡。有人提到失笑散（百九）治疗疝气及妇人血气痛欲死，都有效。给她服一剂，疼痛减轻六七成，再服后平复。此药治疗产后心腹绞痛及儿枕痛，尤其奇妙。（按此是凭脉象进行治疗的。）
有一个十岁的孩子，腹胀痛，服用消导药无效。他认为是有毒邪。他的右关脉沉伏。这是食积。河间说：饮食停滞呕吐，是胃脘痈。再加上身体疼痛难以移动，腹胀善于打嗝，舌根强硬，大便通畅或排气后感觉轻松舒适，这些都是脾病。仔细审察，是因为吃了粽子导致此病，用白酒曲泡热酒服用而痊愈。（按此是凭脉象和症状进行治疗的。）
有一人平时嗜好酒色，小腹患毒，脉弱微痛，想要通过内服药物消散。我认为应当扶助胃气、壮大气血，兼以行经活血的药物辅助，可以消散。但他想要快速见效，自行服用败毒等药，病情果然加重，疮疡不溃脓，饮食减少思虑。两个多月后再次请诊，脉象更弱，盗汗不止，聚集肿胀不溃破，肌肉寒冷，自汗，面色脱失。这是气血俱虚，所以不能发肿成脓。使用十全大补汤（十三）三十多剂，脓液形成后针刺排脓，反而增加烦躁，脉象变大，这是亡阳。使用圣愈汤（十七）两剂，仍以前方（十全大补汤）一百剂而痊愈。（这是凭脉症进行治疗的。）
A man over thirty years old suffered from an abdominal carbuncle. His pulse was rapid, and he desired cold drinks. Qi Shi stated: When a sore or ulcer swells and is hard, it indicates excess [Shi]. He Jian (Liu Wansu) stated: Swelling and hardness accompanied by irritability and a desire for cold drinks indicate that the pathogenic factor is inside the body. Qingliang Yin (Cooling Drink) with doubled Da Huang (Rhubarb Radix et Rhizoma) was administered for three doses, after which symptoms slightly alleviated. Subsequently, Siwu Tang (Four Substance Decoction) modified with Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Shan Zhi (Gardenia Fruit), and Mu Tong (Akebia Stem) was given for four doses, leading to suppuration. Then, Shixuan San (Ten Acupoints Powder) was used, removing Ren Shen (Ginseng Root), [character missing in original], and Gui Zhi (Cinnamon Twig), and adding Jin Yin Hua (Honeysuckle Flower) and Tian Hua Fen (Trichosanthes Root). The patient, desiring a rapid effect, self-administered warming and tonifying medicines, resulting in further abdominal swelling and difficulty in urination. Qingliang Yin was employed again, and after several bowls of pus were discharged, Tuoli Yao (Supporting Interior Medicines) were used to achieve recovery. (This case was treated based on symptoms and pulse.)
Another patient suffered from an abdominal carbuncle with pain, irritability, vomiting, and a solid pulse. He Jian stated: Carbuncles belong to fire syndromes; one must distinguish between interior and exterior to treat the root cause. He also stated: Vomiting, hiccuping, heart swelling and hardness, mental confusion, or unchanged skin and flesh color with a deep and solid pulse indicate that toxicity is inside the body. One should unblock the interior to cut off the source. Neishu Huanglian Tang (Interior-Draining Coptis Decoction) was prescribed. After two or three bowel movements, all symptoms disappeared. The patient recovered after taking Liaoqiao Xiaodu San (Forsythia Detoxification Powder). (This was treated based on pulse and symptoms.)
A third patient had an abdominal carbuncle where the pus had matured but failed to rupture spontaneously, with a faint and thin pulse. After pus discharge, the wound exuded a small amount of pus resembling crab bubbles. This indicated internal rupture penetrating the peritoneum. Carbuncles penetrating the peritoneum are fatal in ten out of ten cases; even with strong tonification, rescue is impossible. This serves as a warning against waiting for spontaneous rupture. (This judgment was based on symptoms.)
A noblewoman had a mass inside her abdomen causing intermittent pain. During pain episodes, she lost consciousness and only regained awareness after a long time. Various medicines were ineffective. Her pulse was deep and fine. This was not a carbuncle. It was mentioned that Shixiao San (Pain-Dispersing Powder) is effective for hernia and severe blood-stasis pain in women. One dose was given, reducing pain by sixty to seventy percent; a second dose brought relief. This medicine is particularly excellent for postpartum colic and "child pillow" pain. (This was treated based on pulse.)
A ten-year-old boy suffered from abdominal distension and pain. Digestive-promoting medicines were ineffective. He believed it was due to toxicity. His right Guan position pulse was deep and hidden. This was food stagnation. He Jian stated: Food retention with vomiting indicates stomach carbuncle. Additionally, body pain preventing movement, abdominal distension with frequent belching, stiffness of the tongue base, and relief after defecation or passing gas are all signs of Spleen disease. Upon careful examination, it was determined that eating zongzi (sticky rice dumplings) caused this condition. The boy recovered after taking Baijiu Qu (White Wine Qu) brewed in hot wine. (This was treated based on pulse and symptoms.)
A person who habitually indulged in alcohol and sexual activity developed a toxic lesion in the lower abdomen with a weak pulse and slight pain. He sought internal resolution. I advised supporting the Stomach Qi and strengthening Qi and Blood, assisted by herbs that promote circulation and resolve stasis, which could lead to resolution. However, desiring a quick effect, he self-administered detoxifying medicines. Consequently, the condition worsened; the sore did not suppurate, appetite decreased, and thinking became scarce. Two months later, upon re-examination, the pulse was weaker, night sweats persisted, swelling remained without rupture, muscles felt cold, spontaneous sweating occurred, and the complexion was pale. This indicated deficiency of both Qi and Blood, preventing the formation of swelling and pus. Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) was administered for over thirty doses. Once pus formed, it was lanced. However, irritability increased, and the pulse became large, indicating Yang collapse. Shengyu Tang (Sage's Life-Sustaining Decoction) was given for two doses, followed by another hundred doses of the previous decoction, leading to recovery. (This was treated based on pulse and symptoms.)