（一名便痈，一名便毒，一名 子，一名血疝，又俗名石米疮。左为鱼口，右为便毒，生于两
胯合缝之间。结肿名曰横 ，又名外疝。）
薛立斋治一妇人，拗中赤肿胀痛。此脓内作，用托里消毒散加柴胡，数剂溃而脓清。寒热，乃气
血复虚，用托里散而寒热止。用十全大补，百余剂而痊。
一妇人腹拗肿痛，小水不利，或时胸乳作痛，胁腹作胀。此肝火气滞，四物加柴胡、青皮、元胡
索、木香而愈。
一妇人拗中作痛，小腹痞闷，小便不利，内热体倦，饮食少思，此肝火内动，脾胃受伤也。用加
味归脾汤、柴胡清肝散而安。
一妇人拗中肿胀，小腹作痛，服下血之剂，其痛益甚，更吐泻少食。此肝脾复伤，用六君子汤加
升麻、柴胡而愈。
薛立斋治一妇人，两拗肿痛，腹内一块，不时上攻，月经不调，大便不利，此肝脾气滞而血伤。
以四君加芎、归、柴胡、山栀而愈。后因郁怒，前症复作，兼胸满腹胀盗汗，此肝木甚而伤脾土也。
用加味归脾汤，下芦荟丸而痊。
一妇人小腹内作痛，或痞闷，两拗肿痛，内热寒热，胸膈不利，饮食不甘，形体日瘦，此肝气滞
而气伤也。朝用补中益气汤，夕用芦荟丸渐愈，更用六味丸全愈。
一妇人两拗肿痛，小腹痞胀，白带时下，寒热往来，小水淋沥，此肝气滞而血病。用龙胆泻肝汤
渐愈，又用加味逍遥散、六味地黄丸全愈。
一妇人患前症，胸胁胀闷，或小水不利，或时腹痛，此肝火气病。先用龙胆泻肝汤，以清肝热，
又用加味逍遥散，以生肝血，六味地黄丸，以滋肾水而愈。
一妇人患前症，内热作渴，饮食不甘，肢体倦怠，阴中作梗，小便赤涩，此脾经郁结，肝经湿热。
用加味归脾汤而愈。后因怒气复作，小腹胀痛，用小柴胡加山栀、芎、归痛止，又用加味逍遥散而愈。
一妇人小腹痞闷，溺涩，内热，体倦懒食，此肝火动而脾血伤也。用八珍加柴胡、山栀、胆草而
安。
一妇人阴中如梗，两拗肿痛，寒热不食，小便频数，小腹重坠，此肝脾郁怒所致。先以补中益气
加茯苓、山栀、车前子、青皮以清肝火，升脾气，更以加味归脾汤，调理脾郁而愈。
一妇人小腹内如有所结，两拗并玉门俱肿，小便淋漓，经候不调，内热作渴，饮食少思，腹内如
鸡卵而渐大，脉洪数而虚，左关尤甚，属肝胆郁结之症也。用加味归脾汤，肝火退而脾土健。间以逍
遥散，下芦荟丸而愈。
一男子患便毒， 肿作痛，大小便秘，脉有力，以玉烛散二剂，顿退。更以龙胆泻肝汤，四剂而
愈。
一男子便毒已溃，而痛不止，小便秘涩，此肝火未解也。以小柴胡加黄柏、知母、芎、归，痛止
便利。更以托里当归汤而疮敛。若毒未解而痛不止者，须用活命饮。
春元凌待之，虚而服克伐药，几致危殆，用托里健脾药而愈。秀才王文远，因劳苦之后患此，服
小柴胡汤及表症散后，用托里药，脓成针之，而旬日愈。又胡判官脓清脉弱，以大补药已愈，因新婚
而复发，自用连翘清毒散，致泻利不止，竟至不救。可见此症属不足者多矣，非补不可。大凡便毒属
肝经，初起坚硬，肝主筋故也。五七日后赤软，脓成故也。若尚坚硬，乃元气不能腐化。往往人见坚
硬，只欲内消，反服攻散药，多致虚虚之祸。前此治者，即其验也。
魏玉横治宋复华兄，因劳顿患左拗肿硬，渐如鹅卵。或与发散，转甚。已半月，足冷过膝，面赤
手亦冷，恶寒夜热，口苦食懈，脉之弦数，曰∶此肝虚火甚也。与生地、杞子、沙参、麦冬、丹皮、
蒌仁、归身、红花，间入川楝、川连、羚羊、牛蒡，数剂寒热退。又十剂，其肿硬及诸症渐愈。惟余
小块如豆大未消，彼以要务奔走劳碌，复肿，数日大如李，其色赤而软，已成脓。再与前药，即自溃
而愈。此症俗名一石米疮，言百日后可愈也。即遇先辈如立斋，其治法或未能如是。余非能有过古人，
第知为肝肾病，则不杂入他药耳。
薛立斋治一妇人，素清苦，因郁怒患前症。或用散毒寒凉之药，反晡热内热，自汗盗汗，月经不
行，口干咽燥。此郁气伤脾，因药复损。先以当归汤数剂，后兼逍遥散五十余剂而愈。
陈自明治一男子，患便毒，坚硬，与神仙太乙丹一粒，即服之，去后二次，痛止，不日而消。（方
见虫门。）
薛立斋治一男子患此，未作脓，小便秘涩，以八珍三剂少愈。以小柴胡汤加泽泻、山栀、木通，
二剂而消。
一男子患此症，肿痛发寒热，以荆防败毒散二剂而止。以双解散二剂而愈。
一男子患此症，脓未成，觉大痛，服消毒托里内疏药不应。诊之脉洪大，毒尚在，以仙方活命饮，
一剂痛止，又一剂而消。
一男子患此症，肿痛，日晡发热，以小柴胡汤加青皮、花粉，四剂痛止热退。以神效栝蒌散，四
剂而消。
一男子患此症，肿而不溃，以参、 、归、术、白芷、皂角刺、柴胡、甘草节，数服而溃。以八
珍汤加柴胡，数剂而愈。
一男子患此症，溃而肿不消，且不敛。诊之脉浮而涩，以豆豉饼灸之，更以十全大补汤，月余而
愈。
一男子患此症，溃而痛不止，诸药不应。诊之脉大，按之则数，乃毒未解也。以仙方活命饮而止，
又二剂而敛。
一男子患此症，服克伐之药，以求内消，致泻利不食。以二神丸先止其泻，以十全大补，倍加白
术、茯苓，数剂而消。大抵此症多患于劳役之人，亦有内蕴热毒而生者，须辨虚实及成脓否，不可妄
投药饵。常见治此症者，概用大黄之类，下之以求内消，或脓成令脓从大便出，鲜有见其痊也。人多
欲内消者，盖恐收口之难也。若补养血气，不旬日而收矣，何难之有？若脓既成，岂有可消之理？如
再用克伐之剂，反为难治。
一男子不慎房劳，患此肿痛。以双解散，一服通之，其痛即止。更以补中益气汤数剂而脓，针之。
以八珍汤加五味子、麦冬、柴胡，三十余剂而愈。大抵便痈者，血疝也，俗呼为便毒，言于不便处肿
毒，故为便痈也。乃足厥阴肝之经络，及冲任督脉，亦属肝之旁络，且气血流通之道。今壅而肿痛，
此则热毒所致，宜先疏导其滞，更以托里之剂。此临症制宜之法也。
一老妇患此症，肿痛，脓尚未成，小便涩，肝脉数，以加减龙胆泻肝汤加山栀、黄柏，四剂而消。
张德俊灸便毒，亲曾取效。云∶屡以灸他人皆验。以细草或软篦一茎，随所患左右手量中指，自
手掌尽处横纹量起，通三节，至指尽处为则，不量指甲集断。却将此草于手腕横纹量起，引草向臂，
当中草尽处即是穴。麦粒大灸三壮，肿散痛止，实时安。（《百乙方》）
缪仲淳亲试治便毒甚验。棉地榆四两，白酒三碗，煎一碗，空心服，虽肿者亦愈。加穿山甲同患
处者三片，土炒引经更妙。（《广笔记》）
又方∶棉地榆四两，粉甘草一两，金银花一两，白芷三钱，皂角刺二钱五分，水煎服。
黄履素曰∶余家有女流患便痈，两拗肿痛，不能起，疡医用败毒药十余帖，以围药逼之出脓，肿
痛愈甚。予查薛氏《外科枢要》，此症皆因郁怒伤肝得之，治用加味归脾汤、加味逍遥散间服。遂根据
用之，不三剂肿痛减半，六剂而起。
孙文垣治吴翁，年七十有三，偶坠马，左胁作痛，随治而愈。后半年，忽左胯肿痛，憎寒作热，
诸治罔效。或作疝气，投荔核、大小茴香、川楝、橘核之类，痛不可忍，至欲引绳自绝。诊之，六脉
浮而洪数，左尺尤甚。验痛处红肿如匏，按之烙手。此便毒也，非因近色而得。盖胯属厥阴肝经，肝
为血海，乃昔时坠马，恶血消之未尽，蓄于经络，化而为脓。年高气虚，又为香燥克伐，故痛且剧。
今其色青中隐黑，脓成久矣。乃令外科针之，出青黑脓五六碗。此俗名一石米疮也。乃用托里十宣散，
又加参、 每帖三钱，后加至五钱，一日两进，两月而愈。
（这种病又名便痈，又名便毒，又名子，又名血疝，民间俗称石米疮。左侧发病称为鱼口，右侧发病称为便毒，生于两胯合缝之间。结块肿胀称为横，又名外疝。）
薛立斋治疗一位妇人，阴中红肿疼痛。这是脓液在内部形成，使用托里消毒散加柴胡，服用数剂后溃破，脓液变清。出现寒热症状，是气血再次虚弱所致，使用托里散使寒热停止。随后使用十全大补汤，服用百余剂后痊愈。
另一位妇人腹股沟肿痛，小便不利，有时胸部和乳房作痛，胁肋腹部胀满。这是肝火气滞所致，用四物汤加柴胡、青皮、延胡索、木香而治愈。
又一位妇人腹股沟作痛，小腹胀闷，小便不利，体内发热身体疲倦，饮食减少思虑不足，这是肝火内动，脾胃受损所致。使用加味归脾汤、柴胡清肝散而安定病情。
又一位妇人腹股沟肿胀，小腹作痛，服用下血药物后，疼痛更加剧烈，并出现呕吐腹泻、食欲不振。这是肝脾再次受伤，使用六君子汤加升麻、柴胡而痊愈。
薛立斋治疗一位妇人，两侧腹股沟肿痛，腹内有肿块，不时向上攻冲，月经不调，大便不通利，这是肝脾气滞且血液受损。以四君子汤加川芎、当归、柴胡、山栀而治愈。后来因郁怒，前症复发，兼有胸满腹胀盗汗，这是肝木过盛损伤脾土所致。使用加味归脾汤，配合芦荟丸而痊愈。
又一位妇人小腹内部作痛，或感到痞闷，两侧腹股沟肿痛，体内发热伴有寒热往来，胸膈不畅，饮食不甘美，形体日渐消瘦，这是肝气滞涩且气机受损。早晨服用补中益气汤，晚上服用芦荟丸逐渐好转，再服用六味丸完全痊愈。
又一位妇人两侧腹股沟肿痛，小腹胀闷，白带时下，寒热往来，小便淋沥不尽，这是肝气滞涩且血分有病。使用龙胆泻肝汤逐渐好转，又使用加味逍遥散、六味地黄丸完全痊愈。
又一位妇人患前述病症，胸胁胀闷，或小便不利，有时腹痛，这是肝火气病。先用龙胆泻肝汤以清肝热，又用加味逍遥散以生肝血，六味地黄丸以滋肾水而痊愈。
又一位妇人患前述病症，体内发热口渴，饮食不甘美，肢体倦怠，阴中有梗塞感，小便赤涩，这是脾经郁结，肝经湿热。使用加味归脾汤而痊愈。后来因怒气复发，小腹胀痛，用小柴胡汤加山栀、川芎、当归，疼痛停止，又用加味逍遥散而痊愈。
又一位妇人小腹胀闷，尿涩，体内发热，身体疲倦懒于进食，这是肝火动而脾血受损。使用八珍汤加柴胡、山栀、龙胆草而安定病情。
又一位妇人阴中有梗塞感，两侧腹股沟肿痛，寒热不食，小便频数，小腹重坠，这是肝脾郁怒所致。先用补中益气汤加茯苓、山栀、车前子、青皮以清肝火，升脾气，再用加味归脾汤，调理脾郁而痊愈。
又一位妇人小腹内感觉有结块，两侧腹股沟及阴门均肿胀，小便淋漓，月经不调，体内发热口渴，饮食少思，腹内如鸡卵般逐渐增大，脉象洪数而虚，左关脉尤为明显，属于肝胆郁结之症。使用加味归脾汤，肝火退去而脾土健运。间服逍遥散，配合芦荟丸而痊愈。
一名男子患便毒，肿胀作痛，大小便秘结，脉象有力，用玉烛散二剂，顿时消退。再用龙胆泻肝汤，四剂而痊愈。
一名男子便毒已溃破，但疼痛不止，小便秘涩，这是肝火未解。用小柴胡汤加黄柏、知母、川芎、当归，疼痛停止，大小便利。再用托里当归汤使疮口收敛。如果毒邪未解而疼痛不止者，必须使用仙方活命饮。
春元凌待之，体质虚弱却服用克伐药物，几乎导致危殆，用托里健脾药而痊愈。秀才王文远，因劳苦之后患此病，服用小柴胡汤及表症散后，用托里药，脓成后针刺，十日痊愈。又有胡判官脓液清稀脉象微弱，用大补药已愈，因新婚而复发，自用连翘清毒散，导致泻利不止，最终不治身亡。可见此症属虚损者居多，非补益不可。大凡便毒属于肝经，初起坚硬，因为肝主筋的缘故。五七日后变红软，是因为脓成的缘故。如果仍然坚硬，是元气不能腐化脓液。往往人们见其坚硬，只想使其内消，反而服用攻散药物，多导致虚上加虚的祸害。之前的治疗者，就是验证了这一点。
魏玉横治疗宋复华的兄长，因劳累患左侧腹股沟肿硬，逐渐如鹅卵大小。有人给予发散药物，病情反而加重。已经半个月，脚冷过膝，面赤手也冷，恶寒夜热，口苦食欲懈怠，诊脉弦数，说：这是肝虚火旺。给予生地、枸杞、沙参、麦冬、丹皮、瓜蒌仁、当归身、红花，间入川楝子、黄连、羚羊角、牛蒡子，数剂后寒热退去。又十剂，其肿硬及诸症逐渐痊愈。只余小块如豆大未消，他因要务奔走劳碌，再次肿胀，数日大如李子，颜色赤而软，已成脓。再给与前药，即自行溃破而愈。此症俗名一石米疮，言百日后可愈。即使遇到前辈如薛立斋，其治法或许未能如此。我并非能超越古人，只是知道这是肝肾之病，就不杂入其他药物罢了。
薛立斋治疗一位妇人，平素清苦，因郁怒患前述病症。或用散毒寒凉药物，反而出现傍晚发热、体内发热、自汗盗汗，月经不行，口干咽燥。这是郁气伤脾，因用药再次损伤。先用当归汤数剂，后兼用逍遥散五十余剂而痊愈。
陈自明治疗一名男子，患便毒，坚硬，给予神仙太乙丹一粒，立即服用，排便两次后，疼痛停止，不久消散。（方剂见虫门。）
薛立斋治疗一名男子患此病，未成脓，小便秘涩，用八珍汤三剂稍好。用小柴胡汤加泽泻、山栀、木通，二剂而消散。
一名男子患此症，肿痛发寒热，用荆防败毒散二剂而止。用双解散二剂而痊愈。
一名男子患此症，脓未成，感觉剧痛，服用消毒托里内疏药物无效。诊脉洪大，毒邪尚在，用仙方活命饮，一剂疼痛停止，又一剂而消散。
一名男子患此症，肿痛，傍晚发热，用小柴胡汤加青皮、天花粉，四剂疼痛停止热退。用神效栝蒌散，四剂而消散。
一名男子患此症，肿而不溃，用人参、黄芪、当归、白术、白芷、皂角刺、柴胡、甘草节，数次服用后溃破。用八珍汤加柴胡，数剂而痊愈。
一名男子患此症，溃破后肿不消，且不收敛。诊脉浮而涩，用豆豉饼灸之，再用十全大补汤，月余而痊愈。
一名男子患此症，溃破后疼痛不止，诸药无效。诊脉大，按之则数，是毒邪未解。用仙方活命饮而止痛，又二剂而收敛。
一名男子患此症，服用克伐药物，以求内消，导致泻利不食。用二神丸先止其泻，用十全大补汤，倍加白术、茯苓，数剂而消散。大抵此症多患于劳役之人，也有内蕴热毒而生者，须辨别虚实及是否成脓，不可妄投药饵。常见治疗此症者，概用大黄之类，泻下以求内消，或脓成令脓从大便出，鲜少见其痊愈。人多想内消，大概是担心收口困难。如果补养血气，不到十天即可收口，有何难处？如果脓既已成，岂有可消的道理？如果再用克伐之剂，反而难以治疗。
一名男子不慎房事，患此肿痛。用双解散，一服通畅，疼痛即止。再用补中益气汤数剂促使脓成，针刺。用八珍汤加五味子、麦冬、柴胡，三十余剂而痊愈。大抵便痈，即是血疝，俗呼为便毒，言于不便之处肿毒，故为便痈。乃足厥阴肝之经络，及冲任督脉，亦属肝之旁络，且为气血流通之道。今壅滞而肿痛，此为热毒所致，宜先疏导其滞，再以托里之剂。这是临症制宜的方法。
一位老妇患此症，肿痛，脓尚未成，小便涩，肝脉数，用加减龙胆泻肝汤加山栀、黄柏，四剂而消散。
张德俊灸治便毒，亲自曾取效。说：屡次灸他人皆有效验。用细草或软篦一根，随所患左右手量中指，自手掌尽处横纹量起，通三节，至指尽处为标准，不量指甲截断处。却将此草于手腕横纹量起，引草向臂，当中草尽处即是穴位。麦粒大灸三壮，肿散痛止，即时安宁。（《百乙方》）
缪仲淳亲自试验治疗便毒非常有效。棉地榆四两，白酒三碗，煎成一碗，空腹服用，即使肿胀者也能痊愈。加穿山甲同患处三片，土炒引经更妙。（《广笔记》）
又一方：棉地榆四两，粉甘草一两，金银花一两，白芷三钱，皂角刺二钱五分，水煎服。
黄履素说：我家有女子患便痈，两侧腹股沟肿痛，不能起床，疡医用败毒药十余帖，用围药逼之出脓，肿痛更甚。我查阅薛氏《外科枢要》，此症皆因郁怒伤肝得之，治用加味归脾汤、加味逍遥散间服。于是照此使用，不到三剂肿痛减半，六剂而起。
孙文垣治疗吴翁，年七十有三，偶然坠马，左胁作痛，随即治愈。后半年，忽左胯肿痛，憎寒作热，各种治疗无效。有人当作疝气，投荔核、大小茴香、川楝、橘核之类，痛不可忍，甚至想引绳自尽。诊脉，六脉浮而洪数，左尺尤甚。检验痛处红肿如匏瓜，按之烫手。这是便毒，不是因近色欲而得。盖胯属厥阴肝经，肝为血海，乃是昔日坠马，恶血消之未尽，蓄于经络，化而为脓。年高气虚，又为香燥克伐，故痛且剧烈。现在其色青中隐黑，脓成已久。于是令外科医生针刺，流出青黑脓五六碗。此俗名一石米疮。于是用托里十宣散，又加人参、黄芪每帖三钱，后加至五钱，一日两进，两月而痊愈。
(This condition is also known as Bian Yong (Perineal Abscess), Bian Du (Genital Swelling), Zi (Tumor), Xue Shan (Blood Hernia), and commonly referred to as Shi Mi Chuang (Stone Rice Sore). When occurring on the left, it is called Yu Kou (Fish Mouth); when on the right, it is called Bian Du. It arises in the crease between the two thighs. A nodular swelling is called Heng (Horizontal), also known as Wai Shan (External Hernia).)
Xue Lizhai treated a woman with redness, swelling, and pain in the genital region. This indicated pus forming internally. He used Tuoli Xiaodu San (Supporting Interior and Detoxifying Powder) added with Chai Hu (Bupleurum Root). After several doses, it ulcerated, and the pus became clear. The appearance of chills and fever indicated a recurrence of Qi and Blood deficiency. He used Tuoli San (Supporting Interior Powder), which stopped the chills and fever. Subsequently, he used Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction). After more than a hundred doses, she recovered.
Another woman presented with groin swelling and pain, difficult urination, occasional chest and breast pain, and distension in the hypochondrium and abdomen. This was due to Liver Fire and Qi stagnation. She was cured using Si Wu Tang (Four Substance Decoction) added with Chai Hu, Qing Pi (Aged Tangerine Peel), Yuan Hu Suo (Corydalis Rhizome), and Mu Xiang (Aucklandia Root).
Another woman had pain in the groin, abdominal fullness and stuffiness, difficult urination, internal heat, fatigue, and poor appetite. This was caused by internal stirring of Liver Fire damaging the Spleen and Stomach. She was stabilized using Jiawei Guipi Tang (Modified Restore the Spleen Decoction) and Chaihu Qinggan San (Bupleurum Clearing Liver Powder).
Another woman had groin swelling and lower abdominal pain. After taking blood-draining medications, her pain worsened, accompanied by vomiting, diarrhea, and loss of appetite. This indicated further injury to the Liver and Spleen. She was cured using Liujunzi Tang (Six Gentlemen Decoction) added with Sheng Ma (Cimicifuga Rhizome) and Chai Hu.
Xue Lizhai treated a woman with bilateral groin swelling and pain, an abdominal mass that occasionally attacked upward, irregular menstruation, and difficult defecation. This was due to Liver and Spleen Qi stagnation and Blood injury. She was cured using Sijunzi Tang (Four Gentlemen Decoction) added with Xiong (Ligusticum Rhizome), Gui (Angelica Sinensis Root), Chai Hu, and Shan Zhi (Gardenia Fruit). Later, due to depression and anger, the previous symptoms recurred, accompanied by chest fullness, abdominal distension, and night sweats. This indicated excessive Liver Wood injuring Spleen Earth. She was cured using Jiawei Guipi Tang combined with Lushui Wan (Aloe Pill).
Another woman had internal lower abdominal pain or fullness, bilateral groin swelling and pain, internal heat with alternating chills and fever, chest diaphragm discomfort, poor taste in food, and gradual emaciation. This was due to Liver Qi stagnation and Qi injury. In the morning, she took Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); in the evening, she took Lushui Wan. She gradually improved and was fully cured after taking Liuwei Wan (Six-Ingredient Pill with Rehmannia).
Another woman had bilateral groin swelling and pain, lower abdominal fullness and distension, intermittent leukorrhea, alternating chills and fever, and dribbling urination. This was due to Liver Qi stagnation and Blood pathology. She gradually improved using Longdan Xiegan Tang (Gentian Draining the Liver Decoction), then was fully cured using Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia).
Another woman suffering from the aforementioned symptoms had chest and hypochondriac distension and stuffiness, or difficult urination, or occasional abdominal pain. This was a Liver Fire Qi disorder. First, she used Longdan Xiegan Tang to clear Liver Heat; then Jiawei Xiaoyao San to generate Liver Blood; and Liuwei Dihuang Wan to nourish Kidney Water, leading to recovery.
Another woman with the aforementioned symptoms had internal heat with thirst, poor taste in food, limb fatigue, a sensation of obstruction in the yin, and red, scanty, painful urination. This was due to Spleen Meridian constraint and Liver Meridian Damp-Heat. She was cured using Jiawei Guipi Tang. Later, due to anger, the condition recurred with lower abdominal distension and pain. She used Xiao Chaihu Tang added with Shan Zhi, Xiong, and Gui. The pain stopped, and she was subsequently cured using Jiawei Xiaoyao San.
Another woman had lower abdominal fullness and stuffiness, astringent urination, internal heat, and fatigue with reluctance to eat. This was due to Liver Fire stirring and Spleen Blood injury. She was stabilized using Bazhen Tang (Eight Treasures Decoction) added with Chai Hu, Shan Zhi, and Dan Cao (Gentian Root).
Another woman had a sensation of obstruction in the yin, bilateral groin swelling and pain, chills, fever, anorexia, frequent urination, and heavy bearing down in the lower abdomen. This was caused by Liver and Spleen depression and anger. First, she used Buzhong Yiqi Tang added with Fu Ling (Poria), Shan Zhi, Che Qian Zi (Plantago Seed), and Qing Pi to clear Liver Fire and raise Spleen Qi. Then, she used Jiawei Guipi Tang to regulate Spleen depression, resulting in recovery.
Another woman felt a knot in the lower abdomen, with swelling of both groins and the vulva, dribbling urination, irregular menstruation, internal heat with thirst, poor appetite, and an abdominal mass growing like a chicken egg. Her pulse was surging, rapid, and deficient, especially at the Left Guan position. This belonged to Liver and Gallbladder depression and constraint. She used Jiawei Guipi Tang; as Liver Fire retreated, Spleen Earth became robust. Intermittently, she took Xiaoyao San and Lushui Wan, leading to recovery.
A man suffered from Bian Du (Genital Swelling), with swelling and pain, constipation of both stool and urine, and a forceful pulse. He used Yuzhu San (Jade Candle Powder) for two doses, causing immediate reduction. He then used Longdan Xiegan Tang for four doses, leading to recovery.
A man whose Bian Du had ulcerated still experienced pain, with difficult urination. This indicated unresolved Liver Fire. He used Xiao Chaihu Tang added with Huang Bo (Phellodendron Bark), Zhi Mu (Anemarrhena Rhizome), Xiong, and Gui. The pain stopped, and bowel/urinary functions normalized. He then used Tuoli Danggui Tang (Supporting Interior Angelica Decoction) for wound contraction. If the toxin remains unresolved and pain persists, Xianfang Huoming Yin (Immortal Formula for Preserving Life) must be used.
Chun Yuanling Daizhi was weak but took attacking/draining medicines, nearly reaching a critical state. He was cured using Supporting Interior and Strengthening Spleen medicines. Scholar Wang Wenyuan contracted this illness after labor and hardship. After taking Xiao Chaihu Tang and Biaozheng San (Exterior Syndrome Powder), he used Supporting Interior medicines. Once pus formed, it was lanced, and he recovered in ten days. Another case, Judge Hu, had clear pus and a weak pulse. He recovered with major tonifying medicines but relapsed after a new marriage. Using self-prescribed Lianqiao Qingdu San (Forsythia Clearing Toxin Powder) caused incessant diarrhea, leading to death. This shows that this condition is mostly deficiency-type and requires tonification. Generally, Bian Du belongs to the Liver Meridian. Initially hard because the Liver governs sinews. After five to seven days, it becomes red and soft as pus forms. If it remains hard, it is because Yuan Qi cannot transform it into pus. Often, people see hardness and desire internal resolution, taking attacking/dispersing medicines, often causing harm of deficiency upon deficiency. Previous treatments serve as proof.
Wei Yuheng treated Song Fuhua's brother, who developed a hard left groin swelling due to exhaustion, gradually enlarging like a goose egg. Given dispersing medicines, it worsened. After half a month, his feet were cold above the knees, face red, hands cold, aversion to cold, night fever, bitter taste, and sluggish appetite. Pulse was wiry and rapid. Wei said: "This is Liver deficiency with excessive fire." He prescribed Sheng Di (Rehmannia Root), Gou Qi (Goji Berry), Sha Shen (Glehnia Root), Mai Dong (Ophiopogon Tuber), Dan Pi (Moutan Cortex), Gua Lou Ren (Trichosanthes Seed), Dang Gui Shen (Angelica Sinensis Root Heart), and Hong Hua (Safflower). Intermittently adding Chuan Lian Zi (Szechwan Chinaberry Seed), Chuan Lian (Corydalis Rhizome - *Note: likely referring to Yan Hu Suo or similar, text says Chuan Lian*), Ling Yang Jiao (Antelope Horn), and Niu Bang Zi (Arctium Fruit). After several doses, chills and fever subsided. After ten more doses, the swelling/hardness and other symptoms gradually improved. Only a small bean-sized lump remained. Due to business travel and exertion, it swelled again, becoming plum-sized, red and soft, indicating pus formation. Giving the previous medicine again led to spontaneous rupture and recovery. This condition is commonly called Yi Shi Mi Chuang (One Stone Rice Sore), saying it heals in a hundred days. Even predecessors like Lizhai might not have treated it thus. I do not claim to surpass ancients; I simply know it is a Liver/Kidney disease and avoid mixing other herbs.
Xue Lizhai treated a woman who was ascetic and suffered from the aforementioned condition due to depression and anger. Using detoxifying/cold medicines caused afternoon/internal fever, spontaneous and night sweats, amenorrhea, dry mouth, and throat. This was Qi constraint injuring the Spleen, compounded by medication damage. She first took Dang Gui Tang (Angelica Decoction) for several doses, then combined with Xiaoyao San for over fifty doses, leading to recovery.
Chen Ziming treated a man with Bian Du, hard and swollen. He gave one pill of Shenxian Taiyi Dan (Immortal Supreme Great Elixir Pill). After two bowel movements, pain stopped, and it resolved in a few days. (Formula seen in Worm section.)
Xue Lizhai treated a man with this condition, no pus yet, difficult urination. He used Bazhen Tang for three doses, slightly better. Then Xiao Chaihu Tang added with Ze Xie (Alisma Rhizome), Shan Zhi, and Mu Tong (Akebia Stem), resolving in two doses.
A man with this condition had swelling, pain, chills, and fever. Jing Fang Baidu San (Schizonepeta and Saposhnikovia Decoction to Rescue from Toxicity) for two doses stopped the symptoms. Shuangjie San (Double Release Powder) for two doses cured him.
A man with this condition had no pus yet but severe pain. Medicines for detoxification, supporting interior, and internal draining failed. Pulse was surging and large; toxin remained. Xianfang Huoming Yin (Immortal Formula for Preserving Life) stopped pain in one dose and resolved it in another.
A man with this condition had swelling, pain, and afternoon fever. Xiao Chaihu Tang added with Qing Pi and Hua Fen (Trichosanthes Root) stopped pain and fever in four doses. Shenxiao Gualou San (Miraculous Effective Trichosanthes Powder) resolved it in four doses.
A man with this condition had swelling without ulceration. Ren Shen (Ginseng), Huang Qi (Astragalus Root), Dang Gui, Bai Zhu (Atractylodes Macrocephala Rhizome), Bai Zhi (Angelica Dahurica Root), Zao Jiao Ci (Gleditsia Spine), Chai Hu, and Gan Cao Jie (Licorice Joint) were taken several times until ulceration. Bazhen Tang added with Chai Hu cured him in several doses.
A man with this condition ulcerated, but swelling persisted and did not contract. Pulse was floating and choppy. Moxibustion with Dou Chi Bing (Fermented Soybean Cake) was applied, followed by Shiquan Dabu Tang. He recovered in over a month.
A man with this condition ulcerated, but pain persisted despite various medicines. Pulse was large, rapid upon pressure. Toxin remained. Xianfang Huoming Yin stopped pain, and contraction occurred in two more doses.
A man with this condition took attacking/draining medicines seeking internal resolution, causing diarrhea and anorexia. Ershen Wan (Two Spirits Pill) stopped diarrhea first. Shiquan Dabu Tang with doubled Bai Zhu and Fu Ling resolved it in several doses. Generally, this condition affects those engaged in physical labor, or arises from internal accumulated heat-toxin. One must distinguish deficiency/excess and whether pus has formed; do not prescribe recklessly. Common practitioners use Da Huang (Rhubarb Root) to purge for internal resolution, or let pus exit via stool if formed. Rarely do they recover. People desire internal resolution fearing difficult wound closure. If Qi and Blood are tonified, closure occurs in less than ten days; what difficulty is there? If pus is already formed, how can it dissolve? Using attacking medicines makes it harder to treat.
A man neglected sexual activity, contracting this with swelling and pain. Shuangjie San (Double Release Powder) once promoted flow, stopping pain immediately. Buzhong Yiqi Tang for several doses promoted pus formation, which was then lanced. Bazhen Tang added with Wu Wei Zi (Schisandra Berry), Mai Dong, and Chai Hu cured him in over thirty doses. Generally, Bian Yong is Xue Shan (Blood Hernia), commonly called Bian Du, meaning swelling/toxin in an inconvenient place. It involves the Foot Jueyin Liver Meridian, and the Chong, Ren, and Du vessels, which are also collateral branches of the Liver and pathways for Qi/Blood circulation. Now obstructed and swollen/painful, this is caused by Heat-Toxin. One should first guide/dredge the stagnation, then use Supporting Interior agents. This is the method of adapting to clinical situations.
An elderly woman with this condition had swelling, pain, no pus yet, astringent urination, and a rapid Liver pulse. Ji Jian Longdan Xiegan Tang (Modified Gentian Draining Liver Decoction) added with Shan Zhi and Huang Bo resolved it in four doses.
Zhang Dejun moxa-treated Bian Du, achieving personal success. He claimed repeated successes on others. Use a thin grass or soft comb stem. Measure the middle finger of the affected side's hand: from the distal palmar crease across three segments to the fingertip (excluding nail). Use this length to measure from the wrist crease up the arm. The point where the grass ends is the acupoint. Moxa three grains-sized cones. Swelling dissipates, pain stops, immediate relief. (*Baibai Fang*)
Miao Zhongchun personally tested treating Bian Du with great efficacy. Mian Di Yu (Hemp-root Peony Root) 4 liang, White Wine 3 bowls. Decoct to 1 bowl. Take on an empty stomach. Even if swollen, it cures. Add 3 slices of Chuan Shan Jia (Pangolin Scale) fried in earth to guide the meridian for better effect. (*Guang Biji*)
Another formula: Mian Di Yu 4 liang, Fen Gan Cao (Powdered Licorice) 1 liang, Jin Yin Hua (Honeysuckle Flower) 1 liang, Bai Zhi 3 qian, Zao Jiao Ci 2.5 qian. Decoct in water and take.
Huang Lvsu said: My family had a daughter with Bian Yong, bilateral groin swelling/pain, unable to rise. Surgeons used toxic drugs for over ten prescriptions and encircling medicines to force pus, worsening swelling/pain. I consulted Xue's *Waike Shuyao* (General Principles of Surgery), which states this condition arises from depression/anger injuring the Liver. Treatment uses Jiawei Guipi Tang and Jiawei Xiaoyao San alternately. I followed this usage. In less than three doses, swelling/pain halved; in six doses, she could rise.
Sun Wen yuan treated Old Man Wu, aged 73. He accidentally fell from a horse, hurting his left hypochondrium, which healed quickly. Half a year later, sudden left hip swelling/pain, aversion to cold with fever. Various treatments failed. Some diagnosed as Hernia Qi, prescribing Li He (Lychee Seed), Xiao/Hui Xiang (Fennel/Star Anise), Chuan Lian, Ju He (Tangerine Seed). Pain was unbearable, almost leading to suicide. Pulse: Floating, surging, rapid on all positions, especially Left Chi. Examining the painful area: red/swollen like a gourd, hot to touch. This is Bian Du, not acquired from sexual excess. The hip belongs to the Jueyin Liver Meridian; Liver is the Sea of Blood. Residual evil blood from the past fall remained unabsorbed, accumulating in meridians, transforming into pus. Advanced age and Qi deficiency, plus harsh/aromatic/draining medicines, made pain severe. Color is green-black, indicating long-standing pus. Ordered surgery to lance, draining 5-6 bowls of green-black pus. This is commonly called Yi Shi Mi Chuang. Used Tuoli Shixuan San (Supporting Interior Ten-Auspicious Powder) added with Ren Shen (Ginseng) and Huang Qi (Astragalus Root), starting at 3 qian per prescription, increasing to 5 qian. Taken twice daily, recovered in two months.