丹溪曰。臀痈者。臀居小腹之后。在下。此阴中之阴。道远位僻。虽曰太阳多血气。气
运不
到。血亦罕来。中年后尤虑患此。才有肿痛。参之脉症。但见虚弱。便与滋补血气。可保终
吉。若无滋补之功。其祸多在结痂之后。或半年以来乃病多致失手。慎之慎之。
一论足太阳经中。左右尺脉俱紧。按之无力。屁臀生痈。坚硬肿痛大作。
内托羌活汤
羌活 黄柏（酒炒） 防风 本 归尾（各二钱） 黄 （一钱五分） 苍术（米泔浸） 连
翘陈皮 甘草（炙各五分） 肉桂（三分）
上锉一剂。酒水同煎。空心温服。以衣覆盖患处。使药力常行。不可去衣。
丹溪曰。肠痈常作湿热。积久入风。难治。
千金谓肠痈妄治必杀人。其病小腹重强。按之则痛。小便如淋。时时汗出。复恶寒。身
皮甲错。肚腹紧急。如肿之状。脉数者。微有脓也。巢云。洪数
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
便脓血。急服蜡矾丸。酒下。兼进后方。
一论肠痈便毒痈疽。初起即消。已肿即溃。血随大便中出。宜用千金内托散。（方见痈
疽即加减真人活命饮）
一论肚内生痈。及痈疽恶毒。宜用
内消沃雪汤
当归身 白芍 黄 甘草节 射干 连翘 香白芷 贝母 陈皮 皂角刺 乳香 没
药穿山甲 天花粉 金银花 木香 青皮 甚者。加大黄。
上锉。酒水煎服。秘方是世所奇。投之如神。
一论肠痈胀痛不安。或腹满不食。小便赤。妇人产后虚热。多有此疾。但疑惑间便不服
服亦无害。视其右关脉芤者是也。
薏苡仁（二两） 牡丹皮（一两） 栝蒌仁（一两）
上锉一两。水煎。一方。加川芎、桃仁。
一妇人腹痛如锥刺。每痛至死。不敢着手。六脉洪数。此肠痈毒也。用
穿山甲（炒） 白芷 贝母 僵蚕 大黄
上锉一大剂。水煎服。打下脓血。自小便中出。即愈。后再无患。宜少食煎炒热物。
一治肠痈日久。溃烂出脓。腹内刺痛不可忍者。
用铁打一尺长三棱针。将鸭肠一条。贯针在内。将鸭肠曲转。轻轻送入粪门内。送到痛
处。方是疮痈之处。即将鸭肠扯动。针尖出。刺破其毒。脓随针而出。用手重按痛处。脓出
尽而愈。此秘法也。
丹溪说：臀痈，是指发生在臀部后方的痈肿。臀部位于小腹之后，位置在下，属于阴中之阴。此处经络遥远、部位偏僻，虽然足太阳膀胱经多血多气，但气血运行难以到达，血液也很少流经此处。因此，人到中年以后尤其要警惕患此病。一旦出现肿痛，结合脉象和症状判断，只要见到虚弱的征象，就应当给予滋补气血的治疗，这样可以保全性命，获得吉祥的结果。如果缺乏滋补的功效，祸患往往出现在结痂之后，或者经过半年左右的时间才发病，这大多会导致治疗失误。务必谨慎，务必谨慎。
另一篇论述足太阳经病变中提到：左右尺部脉象都紧，重按无力，臀部生痈，局部坚硬、肿痛剧烈。
内托羌活汤
组成：羌活、黄柏（酒炒）、防风、藁本、当归尾（各二钱），黄芪（一钱五分），苍术（米泔水浸泡）、连翘、陈皮、甘草（炙，各五分），肉桂（三分）。
用法：以上药材锉碎为一剂，用酒和水共同煎煮，空腹温服。服药后用衣物覆盖患处，使药力持续发挥作用，不可去掉覆盖物。
丹溪说：肠痈常由湿热引起，日久入风，难以治愈。
千金方认为，肠痈若误治必致人死亡。其症状表现为小腹部沉重僵硬，按压则疼痛，小便像淋证一样不畅，时常出汗，又恶寒，皮肤粗糙如鳞甲交错，肚腹紧急，像肿胀的样子。脉数者，说明微有脓液；巢元方说，脉洪数者，说明已有脓液；脉若迟紧者，说明还没有脓液。病情严重者，腹部胀大，转动身体时有水声，或者脐周生疮，或者脓液从脐部流出，或者大便排出脓血。此时应急服蜡矾丸，用酒送下，并兼服后方。
另一篇论述肠痈、便毒及痈疽初起时即消散，已肿胀时即溃破，血液随大便排出。适宜使用千金内托散。（该方见“痈疽”章节，即加减真人活命饮）
另一篇论述体内生痈，以及痈疽恶毒，适宜使用内消沃雪汤。
组成：当归身、白芍、黄芪、甘草节、射干、连翘、香白芷、贝母、陈皮、皂角刺、乳香、没药、穿山甲、天花粉、金银花、木香、青皮。病情严重者，加大黄。
用法：以上药材锉碎，用酒和水煎服。此秘方世人罕见，投药如神效。
另一篇论述肠痈胀痛不安，或腹部胀满不能进食，小便色赤。妇人产后虚热，多有此疾。但在疑惑之间不要服用，即使服用也无害。可以通过观察右关脉芤象来确诊。
组成：薏苡仁（二两），牡丹皮（一两），栝蒌仁（一两）。
用法：以上药材锉碎一两，用水煎服。另一版本方剂，加入川芎、桃仁。
有一位妇人腹痛如锥刺，每次痛至濒死，不敢让人触碰。六脉洪数，这是肠痈毒邪所致。使用以下药物：
穿山甲（炒）、白芷、贝母、僵蚕、大黄。
用法：以上药材锉碎一大剂，用水煎服。排出脓血，从小便中排出，即可痊愈，此后不再患病。宜少吃煎炒燥热之物。
另一法治疗肠痈日久，溃烂出脓，腹内刺痛不可忍受。
使用铁制的一尺长三棱针，将一条鸭肠贯穿在针上，把鸭肠弯曲，轻轻送入肛门内，送到疼痛处，那里才是疮痈所在之处。然后将鸭肠抽动，使针尖露出，刺破毒邪，脓液随针而出。用手用力按压疼痛处，待脓液排尽而痊愈。这是秘法。
Danxi stated: "Buttock carbuncle" (Tun Yong, a carbuncle located on the buttock) refers to a carbuncle occurring posterior to the lower abdomen. The buttocks are located below and belong to "Yin within Yin". The meridians are distant and the location is remote. Although the Foot-Taiyang Bladder Meridian (Zu Tai Yang Pang Guang Jing) is rich in blood and Qi, the movement of Qi fails to reach here, and blood rarely flows through it. Therefore, after middle age, one should be particularly vigilant against contracting this disease. Once swelling and pain appear, by correlating pulse and symptoms, if deficiency signs are observed, tonifying Blood and Qi should be administered immediately to ensure safety and auspicious outcomes. If such tonification is lacking, disaster often occurs after the scab forms, or the disease manifests after half a year, frequently leading to treatment failure. Exercise utmost caution.
Another discussion regarding the Foot-Taiyang Meridian states: When both left and right Chi pulses (Chi Mai, pulse position at the wrist corresponding to the Kidneys/Lower Jiao) are tight and weak upon deep pressure, accompanied by a carbuncle on the buttock that is hard, swollen, and severely painful, use Neituo Qianghuo Tang (Internal Supportive Decoction of Notopterygium).
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Huangbai (Phellodendri Cortex, stir-fried with wine), Fangfeng (Saposhnikoviae Radix), Bencao (Ligustici Rhizoma et Radix), Guiwei (Radix Angelicae Sinensis, tail end) (each 2 qian); Huangqi (Astragali Radix) (1.5 qian); Cangzhu (Atractylodis Rhizoma, soaked in rice water), Lianqiao (Forsythiae Fructus), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 0.5 qian); Rougui (Cinnamomi Cortex) (0.3 qian).
Preparation: Coarsely powder the ingredients for one dose. Decoct with a mixture of wine and water. Take warm on an empty stomach. Cover the affected area with clothing to maintain constant medicinal action; do not remove the covering.
Danxi stated: "Intestinal carbuncle" (Chang Yong, a carbuncle of the intestine) is often caused by Damp-Heat accumulating over time and transforming into Wind, making it difficult to treat.
The *Qianjin Fang* (Prescriptions Worth a Thousand Gold) warns that mismanagement of intestinal carbuncle will surely kill the patient. Symptoms include heaviness and stiffness in the lower abdomen, pain upon palpation, urinary difficulty resembling strangury (Lin syndrome), frequent sweating, aversion to cold, skin roughness resembling fish scales, abdominal tension resembling swelling. A rapid pulse indicates slight pus formation. Chao Yuanyuan stated: A flooding and rapid pulse indicates established pus; a slow and tight pulse indicates no pus yet. In severe cases, the abdomen becomes distended with fluid sounds upon turning, ulcers may form around the umbilicus, pus may discharge from the umbilicus, or stool may contain pus and blood. Immediately administer Lafan Wan (Wax and Alum Pill) taken with wine, and concurrently use the following formula.
Another discussion on intestinal carbuncle, perineal toxin, and sores/ulcers states that if treated early, they dissipate; if already swollen, they suppurate. Blood discharges with the stool. Use Qianjin Neituo San (Thousand-Gold Internal-Supporting Powder). (See formula under "Sores and Ulcers", which is Ji Jian Zhenren Huoming Yin [Modified Real Person's Life-Preserving Decoction]).
Another discussion on internal abdominal carbuncles and malignant sores/ulcers suggests using Neixiao Woxue Tang (Internal-Dissolving Snow-Melting Decoction).
Ingredients: Dangguishen (Radix Angelicae Sinensis, body), Baishao (Paeoniae Radix Alba), Huangqi (Astragali Radix), Gancaojie (Glycyrrhizae Radix et Rhizoma, joint section), Shegan (Belamcandae Rhizoma), Lianqiao (Forsythiae Fructus), Xiangbaizhi (Angelicae Dahuricae Radix), Beimu (Fritillariae Bulbus), Chenpi (Citri Reticulatae Pericarpium), Saojiaoci (Gleditsiae Spina), Ruxiang (Olibanum), Moyao (Myrrha), Chuanshanjia (Manis Squama), Tianhuafen (Trichosanthis Radix), Jinyinhua (Lonicerae Japonicae Flos), Muxiang (Aucklandiae Radix), Qingpi (Citri Reticulatae Pericarpium Viride). For severe cases, add Dahuang (Rhei Radix et Rhizoma).
Preparation: Coarsely powder. Decoct with wine and water. This secret recipe is rare in the world and acts miraculously.
Another discussion on intestinal carbuncle causing restless pain or abdominal fullness with anorexia, and red urine. Women with postpartum deficient heat often suffer from this condition. Hesitation in diagnosis may lead to non-treatment, but even if treated incorrectly, it causes no harm. Diagnosis can be confirmed by observing a hollow pulse (Kou Mai) at the right Guan position.
Ingredients: Yiyiren (Coicis Semen) (2 liang), Mudanpi (Moutan Cortex) (1 liang), Gualouren (Trichosanthis Semen) (1 liang).
Preparation: Coarsely powder 1 liang. Decoct with water. Another variation adds Chuanxiong (Ligustici Chuanxiong Rhizoma) and Taoren (Persicae Semen).
A woman suffered abdominal pain like needle stabs, reaching near-death intensity, unable to bear touch. Her six pulses were flooding and rapid, indicating intestinal carbuncle toxicity. Use:
Chuanshanjia (Manis Squama, stir-fried), Baizhi (Angelicae Dahuricae Radix), Beimu (Fritillariae Bulbus), Jiangcan (Bombyx Batryticatus), Dahuang (Rhei Radix et Rhizoma).
Preparation: Coarsely powder a large dose. Decoct with water. After taking, pus and blood will be discharged via urination, leading to cure and no recurrence. Avoid fried and hot-natured foods.
Another method for long-standing intestinal carbuncle with ulceration, pus discharge, and unbearable stabbing abdominal pain:
Use a one-chi long iron three-edged needle. Thread a duck intestine through the needle. Curve the intestine and gently insert it into the anus until it reaches the painful area, which marks the location of the carbuncle. Then pull the duck intestine back slightly to expose the needle tip, piercing the toxicity. Pus will discharge with the needle. Press the painful area firmly with hand until all pus is expelled, resulting in cure. This is a secret method.