盖肛门为足太阳膀胱经所主（足太阳会阳穴在肛门之旁），是经为湿热所聚之腑，此处生
痈，每由于酒色中伤，湿浊不化，气不流行者多。其始发也，恶寒身热，绕肛而痛， 红漫
肿，大便坚结不通，小便亦艰。初宜清泄肺胃，如鲜地、杏仁、槐米、地榆、芩、连、枳壳
、芦根、蔗汁等类。若大便再不通行，即用凉膈散通腑，得大便一行，其湿毒随便而泄，或
亦有不成脓者。如便通后其肿痛仍然不减，绕肛成脓者，为脏头毒；或左或右成脓者，为偷
粪鼠；在两边出脓者，为肛门痈。投药宜用归尾、萆 、槐米、苡仁、丹皮、山栀等，清理
下焦湿热。此证溃脓后，自热退身凉痛止，倘或肝肾充足，气血和谐，即可于十日之内收口
矣。如延久不敛，每多成漏，总以升药条提之。此疡虽有三名，其实总归湿热下注而结。用
药治法俱同，故并而论之。
按∶治漏管，又有挂割之法，最能败事，但增痛损神，漏终不去。盖肉理阻隔而成管。
若不渐渐入药，腐脱拔去，焉能肌理沦浃？如近时诸葛静山治法最妙，惜其人已故，其法失
传。
臀痈生于臀上胯下近大腿处，由太阳膀胱湿热流结，气血凝聚而成。形大如盘，肿阔盈
尺，上覆其腰，下遮其胯。此为阴中之阴，务须宣热拔毒，大补气血，培养肾胃，滋补根源
。如此，庶血易聚而脓易作，毒易出而热可宣。不然，经时累月，肿仍如故，疼痛日深。是
以中年之后，犹虑患此。唯一见虚弱，即与滋补，可保终吉。若妄以清凉败毒，内服外敷，
则气血得寒益凝，毒瓦斯不得外发，反致内攻，多致不救。治法∶如初起患上有头，红热坠重
如石，口干发热者，此毒从五脏蕴积，宜内消沃雪汤通利积热，外敷如意金黄散，拔出瘀脓紫
血，内兼托药自愈；如漫肿色白，脉虚弱者，此寒凝湿滞，气血两虚，宜与桂枝和营汤，兼
服万灵丹发汗；溃后，服八珍、十全收口。
骑马痈，亦名骗马坠，生于肾囊之旁，大腿根里侧，股缝夹空中。由肝肾湿火结滞而成
。此处乃至阴之下，医治不可过用寒凉之剂，又不可用刀针，如用只可针一、二分，慎之慎
之！初起，以七味圣神汤治之甚妙。盖此毒乃乘虚而入，必大补其血，而佐以逐邪之品，则
病去如失矣。余法与前同。
附∶上马痈，生于左臀之下褶纹中；下马痈，生于右臀之下褶纹中；坐马痈，生于尻骨
略上。总由湿热凝结而成。
肛门由足太阳膀胱经所主管（足太阳膀胱经的会阳穴位于肛门旁边），这条经脉是湿热邪气聚集的场所。此处发生痈肿，大多是由于酒色过度损伤身体，导致湿浊之气无法运化，气机运行不畅所致。疾病初起时，表现为恶寒发热，疼痛环绕肛门，局部红肿弥漫，大便干结不通，小便也排尿困难。初期治疗应当清泄肺胃之热，可选用鲜地黄、杏仁、槐米、地榆、黄芩、黄连、枳壳、芦根、甘蔗汁等药物。如果大便仍然不通畅，就使用凉膈散来通导腑实，一旦大便通畅，湿毒便随粪便排出，有时甚至不会化脓。如果大便通畅后，肿痛依然不减，且环绕肛门化脓，这称为脏头毒；如果在左侧或右侧化脓，称为偷粪鼠；如果在两侧出脓，称为肛门痈。用药宜选用当归尾、萆薢、槐米、薏苡仁、牡丹皮、山栀等，以清理下焦的湿热。此证溃破流脓后，自然热退身凉疼痛停止，倘若肝肾精气充足，气血调和，就可以在十日内伤口愈合。如果拖延日久不收敛，往往容易形成瘘管，总要用升药条进行提脓祛腐。虽然这种疮疡有三个名称，但其实质都是湿热下注凝结而成。用药治法都相同，所以合并论述。
按语：治疗瘘管，还有挂线切割的方法，这种方法最容易坏事，只会增加痛苦损耗精神，而瘘管始终不能去除。这是因为肌肉纹理阻隔形成了管道。如果不逐渐用药，使腐肉脱落拔除，怎么能令肌肉纹理彻底修复？如近代诸葛静山的治法最为精妙，可惜此人已经去世，其方法失传了。
臀痈生于臀部上方、胯部下方靠近大腿处，是由足太阳膀胱经的湿热流注凝结，导致气血凝聚而成。肿块大如盘子，肿胀宽阔满一尺，向上覆盖腰部，向下遮盖胯部。这属于阴中之阴，务必宣散热毒，大补气血，培养肾胃，滋补根本。这样，血液才容易汇聚，脓液才容易生成，毒邪才容易排出，热势才可宣散。否则，经过数月时间，肿胀依然如故，疼痛日益加深。因此中年之后，还要担心患此病。只要一见虚弱表现，立即给予滋补，就可以保证最终痊愈。如果错误地使用清凉败毒的药物，内服外敷，那么气血遇到寒凉会更加凝滞，毒邪不得向外发散，反而向内攻陷，多导致无法救治。治疗方法：如果初起患处有头，红肿热痛沉重如石头，口干发热，这是毒邪从五脏蕴积而来，适宜内服沃雪汤通利积热，外敷如意金黄散，拔出瘀脓紫血，同时兼用托毒透脓的药物即可自愈；如果漫肿颜色发白，脉象虚弱，这是寒凝湿滞，气血两虚，适宜服用桂枝和营汤，兼服万灵丹发汗；溃破后，服用八珍汤或十全大补汤促进收口。
骑马痈，又名骗马坠，生于肾囊旁边，大腿根部内侧，股缝夹空之处。是由肝肾湿火结滞而成。此处是至阴之下位，医治不可过度使用寒凉药剂，也不可用刀针，如果必须用针，只可针刺一两分深，务必谨慎！初起时，用七味圣神汤治疗非常有效。因为这种毒邪是乘虚而入，必须大补其血，并辅以驱邪的药物，病邪就会像失去依托一样迅速消除。其他治法与前文相同。
The anus is governed by the Foot-Taiyang Bladder Meridian (the Huiyang [BL35] acupoint of this meridian is located beside the anus). This meridian is a site where damp-heat pathogens accumulate. Abscesses occurring here are mostly due to injuries from excessive alcohol and sexual activity, leading to the failure of turbid dampness to transform and the stagnation of Qi movement. Initially, it presents with aversion to cold and fever, pain encircling the anus, diffuse redness and swelling, hard and constipated stools, and difficult urination. In the early stage, treatment should focus on clearing and draining heat from the Lung and Stomach, using herbs such as fresh Rhizoma Dioscoreae Hypoglaucae (Xian Di), Semen Armeniacae Amarum (Xing Ren), Flos Sophorae (Huai Mi), Radix Sanguisorbae (Di Yu), Radix Scutellariae (Qin), Fructus Gardeniae (Lian - *Note: Context implies Huanglian/Coptis*, but text says Lian, usually refers to Coptis or Gardenia in combination, here likely Coptis for clearing heat), Fructus Aurantii (Zhi Qiao), Rhizoma Phragmitis (Lu Gen), and juice of Sugarcane (Zhe Zhi) etc. If stool remains unpassed, Liangge San (Cool the Middle Palace Powder) should be used to unblock the Fu organs. Once stool is passed, the damp-toxin is discharged with the feces, and sometimes pus may not form at all. If after stool passage the swelling and pain remain unchanged and pus forms around the anus, it is called Zang Tou Du (Visceral Head Toxin); if pus forms on the left or right side, it is called Tou Fen Shu (Stealing Feces Rat); if pus discharges from both sides, it is called Gang Men Yong (Anal Abscess). Medications should include Radix Angelicae Sinensis Caulis (Gui Wei), Rhizoma Anemarrhenae (Bi Xie), Flos Sophorae (Huai Mi), Semen Coicis (Yi Yi Ren), Cortex Moutan (Dan Pi), and Fructus Gardeniae (Shan Zhi) to clear and drain damp-heat from the Lower Jiao. After this condition ulcerates and discharges pus, the fever naturally subsides, the body cools, and pain stops. If the Liver and Kidney essence are sufficient and Qi and Blood are harmonious, the wound will heal within ten days. If it lingers without healing, it often becomes a fistula; generally, Sheng Yao Tiao (Elevating Medicine Strips) should be used to promote pus discharge and remove necrotic tissue. Although this sore has three names, its essence is always the downward pouring and knotting of damp-heat. The medication and treatment methods are identical, so they are discussed together.
Commentary: For treating fistulas, there is also the method of ligature and cutting, which is most detrimental, only increasing pain and damaging the spirit, while the fistula ultimately does not resolve. This is because muscle fibers obstruct and form a tube. Without gradually applying medicine to cause necrotic tissue to fall off and be removed, how can the muscle texture be thoroughly repaired? The treatment method of Zhuge Jing Shan in recent times was excellent, but unfortunately, he has passed away, and his method has been lost.
Tun Yong (Buttock Abscess) occurs above the buttocks, below the hip joint, near the thigh. It is formed by the flow and accumulation of damp-heat in the Foot-Taiyang Bladder Meridian, causing Qi and Blood to condense. The mass is large like a plate, swollen and broad reaching one chi, covering the waist above and hiding the hip below. This belongs to Yin within Yin. It is essential to vent heat and extract toxins, greatly tonify Qi and Blood, nourish the Kidneys and Stomach, and supplement the root. Only then can blood easily gather, pus easily form, toxins easily exit, and heat be dispersed. Otherwise, after months, the swelling remains as before, and pain deepens daily. Therefore, even after middle age, one must fear contracting this disease. As soon as weakness is observed, immediate tonification ensures ultimate auspiciousness. If mistakenly treated with cooling and detoxifying agents, taken internally and applied externally, Qi and Blood will become more stagnant due to cold, and toxic vapors will fail to emerge outward, instead attacking inward, often leading to untreatable conditions. Treatment method: If initially the affected area has a head, with redness, heat, heaviness, and hardness like stone, accompanied by dry mouth and fever, this indicates toxin accumulated from the Five Zang organs. It is appropriate to internally use Wo Xue Tang (Snow-Melting Decoction) to unblock accumulated heat, externally apply Ru Yi Jin Huang San (Ruyi Golden Yellow Powder) to draw out stasis, pus, and purple blood, and simultaneously use supporting/tonifying drugs for self-healing; if there is diffuse swelling with white color and a weak pulse, this indicates cold coagulation and damp stagnation with deficiency of both Qi and Blood. It is appropriate to take Guizhi Heying Tang (Cinnamon Twig Decoction to Harmonize the Ying Level) and concurrently take Wan Ling Dan (Ten Thousand Spirits Pill) to induce sweating; after ulceration, take Bazhen Tang (Eight Treasure Decoction) or Shiquan Dabu Tang (Complete Great Tonifying Decoction) to promote healing.
Qima Yong (Horse-Riding Abscess), also known as Pian Ma Zhui, occurs beside the scrotum, on the inner side of the root of the thigh, in the cleft between the thighs. It is formed by the knotting and stagnation of damp-fire in the Liver and Kidneys. This location is the lowest part of extreme Yin. Medical treatment must not overuse cold-cooling agents, nor should scalpels or needles be used. If needles must be used, depth should be limited to one or two fen; caution is paramount! At the onset, treating with Qiwei Shenshen Tang (Seven-Ingredient Divine Spirit Decoction) is very effective. Since this toxin enters via deficiency, it is necessary to greatly tonify Blood and assist with anti-pathogenic herbs, so that the disease will depart as if lost. Other methods are the same as previously described.
Appendix: Shangma Yong (Upper Horse Abscess) occurs in the fold below the left buttock; Xia Ma Yong (Lower Horse Abscess) occurs in the fold below the right buttock; Zuoma Yong (Sitting Horse Abscess) occurs slightly above the coccyx. All are caused by the concretion of damp-heat.