《华佗传》军吏李成若咳嗽,昼夜不寤,时吐脓血。以问佗,佗言君病肠痈,咳之所吐,非从肺
来也。与君散两钱,当吐二升余脓血,吐讫自养一月,可小起,好自将爱,一年便健。十八岁当一小
发,服此散亦行复瘥。若不得此药,故当死。复与两钱散,成得药去。五六岁,亲中人有疾如成者,
谓成曰∶卿今强健我欲死,何忍无急 药,(松之按∶古语以藏为 。)以待不祥?先持贷我,我瘥,
为卿从华佗更索。成与之。已故致谯,适佗见收,匆匆不忍从求。后阅十八年成病,竟发无药可服,
以至于死。(《三国志》)
薛立斋治金台院佥宪,年逾五十,腹内隐痛,小便如淋,皮肤错纵,而脉滑数,此肠痈也。脉滑
数则脓已成,遂以广东牛皮胶溶化,送太乙膏,下脓升许。更以排脓托里药及蜡矾丸而愈。
孙文垣治染匠妇,腹痛两年。或以为寒为热,为气为血,为虫为积,治不效。或与膏药大如斗,
贴之,痛益剧,欲去揭之,牢粘不可揭。卧舟中,数人扶之不起。往诊,见其面色苍黑,两手枯燥如
柴,六脉皆洪数。(腹痛脉洪数,内痈可知。其得生亦赖此。)问其痛之所在,解衣指示,(痛有定
处。)始知膏药牢粘。叩其不能起步之由,乃左脚不可动,动则痛应于心。察其色脉,皆非死候,此
必肠痈。左脚不能举动,是其征也。(俗名缩脚肠痈。)与荣卫反魂汤加金银花为君,四帖,酒水各
半煎服。一帖痛稍减,二帖下臭脓半桶,病全减,膏药亦不揭自落。四帖完,其妇与匠来谢,并求善
后之方。
龚子才治一妇人,腹痛如锥,每痛欲死,不可着手,六脉洪数,此肠痈也。用穿山甲炒、白芷、
贝母、僵蚕、大黄,合一大剂,水煎服,脓血从小便处出而愈。
李士材治吴光禄夫人,患腹满而痛,喘急异常,饮食不进。或用理气利水之剂,二十日不效。诊
之,脉大而数,右尺为甚。令人按腹,手不可近。曰∶此大肠痈也,脉数为脓已成。用黄 、角刺、
白芷之类,加葵根一两,煎一碗顿服之。未申痛甚,至夜半脓血大下,昏晕不支,即与独参汤稍安。
更与十全大补,两月而愈。
周汉卿治义乌陈氏子,腹有块,扪之如罂。汉卿曰∶此肠痈也。用大针灼而刺之,入三寸许,脓
随针迸出有声愈。(《明史》)
薛立斋诊秀水卜封君,善饮,腹痛便泻,服分利化痰等剂不应。其脉滑数,肤皮甲错,谓此酒毒,
致肠痈而溃败也,辞不治。仍服煎剂,果便脓而殁。
孙某治一女子腹痛,百方不效,脉滑数,时作热,腹微急。孙曰∶痛病脉当沉细,今滑数,肠痈
也。以云母膏一两,为丸如梧子大,以牛皮胶溶入酒中,并水吞之,饷时服尽,下脓血愈。(《外科
心法》)
薛立斋治通府张廷用患肠痈,两月余矣,时出白脓,体倦恶寒,此邪气去而中气虚也。用托里散
兼益气汤,徐徐呷之。又令以猪肚肺煮烂,取其汤调米粉煮,时呷半盏,后渐调理而痊。
一男子小腹痛而坚硬,小便数,汗时出,脉迟紧。以大黄汤一剂,下瘀合许,以薏苡仁汤四剂而
安。(苡仁、栝蒌各三钱,丹皮、桃仁各二钱。)
一男子患肠痈,脓已成。用云母膏一服,下脓升许,更以排脓托里药而愈。后因不守禁忌,以致
不救。
一人患肠痈,伛偻痛不能伸。有道人教以饮纯黄犬血二碗,和白酒服。其人遂饮至四碗,次日下
脓血尽而瘳。(《广笔记》)
《华佗传》记载:军吏李成患有咳嗽病,昼夜无法入睡,时常吐出脓血。李成因询问华佗,华佗说:“您的病是肠痈(肠道化脓性炎症),咳出的东西并非来自肺部。”于是给李成服用两钱药散,应当能吐出两升多脓血,吐完后静养一个月,可以稍微起身活动,好好调养爱护身体,一年后就能恢复健康。十八年后可能会有一次小发作,服用这种药散也能再次痊愈。如果得不到这种药,终究会死亡。华佗又给了李成两钱药散,李成拿着药离开。五六年后,李成的亲戚中有人得了像李成一样的病,对李成说:“你现在很健康,我却快要死了,怎么忍心没有急救的药,(松之按:古语中以“藏”为“待”。)来等待不祥之事发生?先借给我用吧,我好了,再向华佗那里为你索取。”李成就把药给了他。后来李成回到谯地,恰逢华佗被收捕,匆忙间不忍心再去求药。过了十八年,李成旧病复发,竟然没有药可服,最终导致死亡。(出自《三国志》)
薛立斋治疗金台院佥宪,年龄超过五十岁,腹部内部隐隐作痛,小便像淋病一样不畅,皮肤粗糙如鳞甲交错,脉象滑数,这是肠痈。脉象滑数说明脓液已经形成,于是用广东牛皮胶溶化后,送服太乙膏,排出脓液一升左右。随后使用排脓托里药物及蜡矾丸而痊愈。
孙文垣治疗一名染匠的妻子,腹痛两年。有人认为是寒证或热证,是气滞或血瘀,是有虫或有积滞,治疗均无效。有人给她贴了斗大的膏药,贴上后疼痛更加剧烈,想要揭掉,却粘得很牢揭不下来。躺在船中,几个人搀扶也起不来。孙文垣前去诊治,见其面色苍黑,两手干枯如柴,六脉皆洪数。(腹痛且脉象洪数,可知是内痈。她能存活也依赖于此。)询问她疼痛的具体部位,让她解开衣服指示,(疼痛有固定位置。)这才知道膏药粘得太牢。询问她不能起步的原因,原来是左脚不能动,一动就痛彻心胸。观察她的神色和脉象,都不是死症,这一定是肠痈。左脚不能举动,就是它的征象。(俗称缩脚肠痈。)给予荣卫反魂汤加金银花作为主药,共四帖,酒水各半煎服。服一帖后疼痛稍减,服二帖后排出臭脓半桶,病情大减,膏药也不需揭除自行脱落。四帖服完,这位妇女与工匠前来致谢,并请求善后调理的方子。
龚子才治疗一名妇人,腹痛如针刺,每次疼痛欲死,无法触碰,六脉洪数,这是肠痈。使用炒穿山甲、白芷、贝母、僵蚕、大黄,合为一剂,水煎服,脓血从小便处排出而痊愈。
李士材治疗吴光禄夫人,患腹部胀满且疼痛,喘息急促异常,饮食不进。有人使用理气利水的药剂,二十天无效。诊察发现,脉象大而数,右尺部尤为明显。让人按压腹部,手不敢靠近。说:“这是大肠痈,脉数说明脓液已形成。”使用黄芪、皂角刺、白芷之类,加上葵根一两,煎成一碗顿服。未时到申时疼痛加剧,到了半夜脓血大量排出,出现昏晕支撑不住的情况,立即给予独参汤稍作安定。随后给予十全大补汤,两个月后痊愈。
周汉卿治疗义乌陈氏的儿子,腹部有肿块,摸起来像酒坛。周汉卿说:“这是肠痈。”用大针烧红后刺入,约三寸深,脓液随着针迸出并发出声音,病愈。(出自《明史》)
薛立斋诊视秀水卜封君,此人喜欢饮酒,腹痛伴腹泻,服用分利化痰等药剂无效。其脉象滑数,皮肤粗糙如鳞甲交错,说是酒毒导致肠痈并溃败,推辞不治。病人仍服用煎剂,果然排出脓血而死。
孙某治疗一名女子腹痛,百方治疗无效,脉象滑数,时常发热,腹部微急。孙某说:“痛病的脉象应当沉细,现在却是滑数,这是肠痈。”用云母膏一两,制成梧桐子大小的丸药,用牛皮胶溶化在酒中,连同水一起吞服,一顿饭的时间服完,排出脓血而痊愈。(出自《外科心法》)
薛立斋治疗通府张廷用患肠痈,两个多月了,时常流出白色脓液,身体疲倦怕冷,这是邪气已去但中气虚弱所致。使用托里散兼益气汤,慢慢呷服。又让他用猪肚肺煮烂,取其汤汁调米粉煮食,时时呷饮半盏,后来逐渐调理而痊愈。
一男子小腹部疼痛且坚硬,小便频数,时常出汗,脉象迟紧。服用大黄汤一剂,排出瘀血一升左右,再服用薏苡仁汤四剂而安宁。(薏苡仁、栝蒌各三钱,丹皮、桃仁各二钱。)
一男子患肠痈,脓液已形成。服用一剂云母膏,排出脓液一升左右,随后使用排脓托里药物而痊愈。后来因为不遵守禁忌,导致救治无效。
一人患肠痈,弯腰驼背疼痛无法伸直。有道教人士教他饮用纯黄狗血两碗,混合白酒服用。那人于是喝到四碗,第二天脓血排尽而病愈。(出自《广笔记》)
*Hua Tuo's Biography* records: Li Cheng, a military officer, suffered from coughing, unable to sleep day or night, and frequently expectorated pus and blood. He inquired of Hua Tuo, who said, "Your disease is Chang Yong (intestinal abscess); what you cough up does not originate from the lungs." He then gave Li Cheng two qian of medicinal powder, stating that he should expectorate more than two sheng of pus and blood. After expectoration, he should rest for one month, then could rise slightly, taking good care of himself; within a year, he would recover health. Eighteen years later, there might be a minor recurrence, which could also be cured by taking this powder. If this medicine is not obtained, death will inevitably ensue. Hua Tuo gave Li Cheng another two qian of powder, and Li Cheng departed with the medicine. Five or six years later, a relative of Li Cheng fell ill with symptoms similar to Li Cheng's, and said to him, "You are now strong and healthy, while I am dying. How can I bear to have no emergency medicine [Song Zhi notes: In ancient language, 'cang' (store) implies 'dai' (wait)] to await misfortune? Lend it to me first; when I recover, I will obtain more from Hua Tuo for you." Li Cheng gave it to him. Later, Li Cheng returned to Qiao, but found Hua Tuo had been arrested, and in his haste, could not bring himself to seek more medicine. Eighteen years later, Li Cheng's old illness recurred, and having no medicine available, he eventually died. (From *Records of the Three Kingdoms*)
Xue Lizhai treated the Jiantian of Jintai Yuan, a man over fifty years old, who suffered from dull pain inside the abdomen, urination resembling strangury (lin syndrome), and skin rough as fish scales (cu zong). His pulse was slippery and rapid, indicating Chang Yong (intestinal abscess). A slippery and rapid pulse suggests that pus has already formed. Therefore, Xue dissolved Guangdong ox-hide glue and administered Taiyi Gao (Great Emperor Plaster), resulting in the discharge of about one sheng of pus. Subsequently, he used pus-draining and qi-supporting medicines along with La Fan Wan (Wax and Alum Pill) to effect a cure.
Sun Wenyuan treated the wife of a dyer, who had suffered from abdominal pain for two years. Some attributed it to cold or heat, qi stagnation or blood stasis, parasites or food accumulation, but treatments were ineffective. Someone applied a plaster as large as a bushel to her abdomen, which intensified the pain. She wished to remove it, but it adhered so firmly that it could not be peeled off. Lying in a boat, she could not be lifted even with the help of several people. Sun Wenyuan went to examine her and observed a dark complexion and hands dry as firewood, with all six pulses being flooding and rapid. (Abdominal pain with flooding and rapid pulses indicates internal abscess. Her survival relied on this.) Upon asking where the pain was located and having her expose her chest to indicate the site (pain with a fixed location), he realized the plaster was stuck too firmly. Asking why she could not walk, he learned her left leg could not move; movement caused pain radiating to the heart. Observing her color and pulse, neither indicated a fatal prognosis; this must be Chang Yong (intestinal abscess). The inability to move the left leg is its sign. (Commonly known as "Shrink-leg Intestinal Abscess"). He prescribed Rong Wei Fan Hun Tang (Nutritive and Defensive Soul-Returning Decoction) with Jin Yin Hua (Honeysuckle Flower) as the chief herb, four doses, decocted with half wine and half water. After one dose, pain decreased slightly; after two doses, half a bucket of foul-smelling pus was discharged, and the illness greatly subsided; the plaster fell off spontaneously without needing removal. After completing four doses, the woman and the dyer came to express gratitude and requested a formula for convalescence.
Gong Zicai treated a woman suffering from stabbing abdominal pain, so severe she felt like dying, and the abdomen was untouchable. Her six pulses were flooding and rapid, indicating Chang Yong (intestinal abscess). He used Chao Shan Jia (Stir-fried Pangolin Scale), Bai Zhi (Angelica Dahurica), Bei Mu (Fritillaria Bulb), Jiang Can (Bombyx Batryticatus), and Da Huang (Rhubarb Rhizome), combined into one large dose, decocted in water and taken orally. Pus and blood were discharged via the urethra, and she recovered.
Li Shicai treated the wife of Wuguanglu, who suffered from abdominal fullness and pain, extreme panting, and inability to eat. Treatments using qi-regulating and diuretic agents were ineffective for twenty days. Examination revealed a large and rapid pulse, particularly pronounced at the right chi position. Pressing the abdomen was intolerable to the touch. Li stated, "This is Da Chang Yong (large intestine abscess); the rapid pulse indicates pus formation." He used Huang Qi (Astragalus Root), Jiao Ci (Gleditsia Sinensis Spine), Bai Zhi (Angelica Dahurica), etc., plus one liang of Kui Gen (Malva Root), decocted in one bowl and taken in one dose. Pain intensified during the Wei and Shen hours; by midnight, pus and blood were discharged profusely, leading to fainting and collapse. Immediately, Du Shen Tang (Single Ginseng Decoction) was given to stabilize her condition. Subsequently, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) was administered, and she recovered after two months.
Zhou Hanqing treated the son of the Chen family from Yiwu, who had a mass in the abdomen, feeling like a jar upon palpation. Zhou Hanqing said, "This is Chang Yong (intestinal abscess)." He used a large needle heated red-hot to puncture the area, inserting it about three cun deep. Pus spurted out with sound upon insertion, and the patient recovered. (From *History of Ming*)
Xue Lizhai examined Bu Fengjun of Xiushui, a man fond of drinking alcohol, who suffered from abdominal pain and diarrhea. Treatments using draining and phlegm-resolving agents were ineffective. His pulse was slippery and rapid, and his skin was rough as fish scales. Xue diagnosed this as alcohol toxicity causing Chang Yong (intestinal abscess) that had ulcerated and collapsed, and declined treatment. The patient continued taking decoctions and indeed passed pus and blood before dying.
Dr. Sun treated a young woman with abdominal pain, unresponsive to hundreds of remedies. Her pulse was slippery and rapid, with intermittent fever and slight abdominal tension. Dr. Sun said, "Painful diseases typically present with sinking and fine pulses; the current slippery and rapid pulse indicates Chang Yong (intestinal abscess)." He prepared Yun Mu Gao (Mica Plaster) one liang into pills the size of Chinese wolfberries, dissolved in ox-hide glue mixed with wine, and swallowed with water. Taken within the time of a meal, pus and blood were discharged, and she recovered. (From *External Medicine Core Methods*)
Xue Lizhai treated Zhang Tingyong, Prefectural Administrator, who had suffered from Chang Yong (intestinal abscess) for over two months, occasionally discharging white pus, fatigue, and aversion to cold. This indicated that pathogenic factors had retreated but middle qi was deficient. He prescribed Tuo Li San (Support Interior Powder) combined with Yi Qi Tang (Benefit Qi Decoction), taken slowly sip by sip. He also instructed the patient to boil pig stomach and lungs until soft, use the broth to cook rice flour, and sip half a cup occasionally. Gradual调理 (conditioning) led to recovery.
A male patient suffered from lower abdominal pain and hardness, frequent urination, and occasional sweating. His pulse was slow and tight. One dose of Da Huang Tang (Rhubarb Decoction) was administered, resulting in the discharge of about one sheng of blood stasis. Four doses of Yi Yi Ren Tang (Coix Seed Decoction) brought peace. (Yi Yi Ren [Coix Seed] and Gua Lou [Trichosanthes Fruit] 3 qian each; Dan Pi [Moutan Bark] and Tao Ren [Peach Kernel] 2 qian each.)
A male patient suffered from Chang Yong (intestinal abscess) with pus already formed. One dose of Yun Mu Gao (Mica Plaster) was administered, discharging about one sheng of pus. Subsequent treatment with pus-draining and qi-supporting medicines led to recovery. However, due to failure to observe dietary and lifestyle taboos, he ultimately died despite rescue efforts.
One person suffered from Chang Yong (intestinal abscess), stooping in pain and unable to straighten up. A Daoist priest advised drinking two bowls of pure yellow dog blood mixed with white wine. The patient drank four bowls in total. The next day, pus and blood were completely discharged, and he recovered. (From *Guang Biji*)