【方歌】大小肠痈因湿热，气滞瘀血注肠中，初服大黄行瘀滞，
脓成薏苡牡丹平。
【注】此二证俱由湿热气滞，凝结而成。或努力瘀血，或产后
败瘀蓄积，流注于大肠、小肠之中。初起发热恶风自汗
，身皮甲错，关元、天枢二穴隐痛微肿，按之腹内急痛
，大肠痈多大便坠肿，小肠痈多小水涩滞，脉俱迟紧，
此时痈脓未成，宜大黄汤下之；瘀血利尽，若小水闭涩
，仍宜大黄汤加琥珀末、木通利之自效，若痈成日久不
溃，身皮甲错，内无积聚，腹急腹痛，身无热而脉数者
，系肠内阴冷，不能为脓，宜薏苡附子散主之；若脉见
洪数，肚脐高突，腹痛胀满不食，动转侧身则有水声，
便淋刺痛者，痈脓已成，宜薏苡汤主之；腹濡而痛，少
腹急胀，时时下脓者，毒未解也，宜丹皮汤治之；如脓
从脐出，腹胀不除，饮食减少，面白神劳，此属气血俱
虚，宜八珍汤加牡丹皮、肉桂、黄耆、五味子敛而补之
。患者转身动作，宜徐缓而勿惊，慎之。如耽延日久，
因循失治，以致毒攻内藏，腹痛牵阴，肠胃受伤，或致
阴器紫黑腐烂，色败无脓，每流污水，衾帏多臭，烦躁
不止，身热缢干，俱属逆证。
关元穴又名小肠募，在脐下三寸。天枢穴又名大肠募，
在脐旁开二寸。
方剂：大黄汤
组成：大黄（锉，炒） 牡丹皮
硝皮（研） 芥子
桃仁（炒，先以汤去皮、尖，双仁勿用）
上各等分，共锉碎，每用五钱。水二钟，煎至一钟
，去渣，空心温服。以利下脓血为度，未利再服。
【方歌】大黄汤善治肠痈，少腹坚痛脓未成，牡丹皮与大黄妙，
芥子桃仁硝石灵。
又方：薏苡附子散
组成：附子（炮，二分） 败酱（五分）
薏苡仁（炒，一钱）
上为末，每服方寸匕，以水二合煎，顿服，小水当
下。《三因》云：薏苡、附子同前，败酱用一两一分，
每四钱水盏半，煎七分，去渣，空心服。
【方歌】薏苡附子散甲错，肠痈腹胀痛脉数，附子败酱薏苡仁，
为末水煎空心服。
又方：薏苡汤
组成：薏苡仁 栝蒌仁（各三钱）
牡丹皮 桃仁（泥，各二钱）
水二钟，煎至一钟，不拘时服。
【方歌】薏苡汤治腹水声，肠痈便淋刺痛疼，牡丹皮栝括蒌子，
还有桃仁薏苡仁。
又方：丹皮汤
组成：丹皮 栝蒌仁（各一钱）
桃仁（泥） 朴硝（各二钱）
大黄（五钱）
水二钟，煎一钟，去渣入硝，再煎数滚，不拘时服
。
【方歌】丹皮汤疗肠痈证，腹濡而痛时下脓，硝黄丹蒌桃仁共，
水煎服之有奇功。
又方：八珍汤（见溃疡门）
【方歌】大小肠痈由湿热引起，气机阻滞、瘀血注入肠道。初期服用大黄汤以行散瘀滞；脓液形成后，用薏苡仁、牡丹皮等药来平复病情。
【注】这两种证候都是由湿热气滞，凝结而成。或者是用力过度导致瘀血，或者是产后败血蓄积，流注于大肠、小肠之中。初起时发热、恶风、自汗，皮肤干枯如鳞甲交错（身皮甲错），关元穴、天枢穴两处隐隐作痛且微肿，按压时腹部内部急痛。大肠痈多表现为大便坠胀感，小肠痈多表现为小便涩滞不畅，脉象均为迟紧。此时痈脓尚未形成，适宜用大黄汤攻下；若瘀血排尽后，小便仍闭涩不通，仍宜在大黄汤中加入琥珀末、木通以利小便，自然见效。如果痈脓形成日久不溃破，身体皮肤干枯如鳞甲交错，体内无积聚物，腹部拘急疼痛，身体无发热而脉数，这是肠内阴寒凝滞，不能化脓，适宜用薏苡附子散主治；如果脉象见洪数，肚脐高突，腹痛胀满不能进食，转动侧身时有水声，小便淋沥刺痛，这是痈脓已成，适宜用薏苡汤主治；腹部柔软而痛，少腹拘急胀满，时常排出脓液，这是毒邪未解，适宜用丹皮汤治疗；如果脓液从脐部流出，腹胀不消除，饮食减少，面色苍白，精神疲惫，这属于气血俱虚，适宜用八珍汤加入牡丹皮、肉桂、黄芪、五味子收敛并补益。患者转身动作，应当缓慢而不要惊扰，务必谨慎。如果拖延日久，因循守旧失治，导致毒邪攻入内脏，腹痛牵引至阴部，肠胃受伤，或者导致阴器紫黑腐烂，色泽败坏无脓，经常流出污水，被褥衣服多有臭味，烦躁不止，身体发热消瘦干枯，都属于逆证（预后不良）。
关元穴又名小肠募穴，位于脐下三寸。天枢穴又名大肠募穴，位于脐旁开二寸。
方剂：大黄汤
组成：大黄（锉碎，炒） 牡丹皮
硝皮（研细） 芥子
桃仁（炒，先用水煮去皮、尖，双仁勿用）
以上各等分，共锉碎，每次用五钱。水两钟，煎至一钟，去渣，空腹温服。以大便通畅排出脓血为度，未通再服。
【方歌】大黄汤善于治疗肠痈，少腹坚硬疼痛且脓未成，牡丹皮与大黄巧妙配合，芥子桃仁硝石灵验。
又方：薏苡附子散
组成：附子（炮制，二分） 败酱草（五分）
薏苡仁（炒，一钱）
以上研为末，每次服用方寸匕，用水二合煎煮，一次性服下，小便应当下行。《三因方》记载：薏苡、附子同前法，败酱草用一两一分，每次四钱，水一盏半，煎至七分，去渣，空腹服。
【方歌】薏苡附子散治疗皮肤甲错，肠痈腹胀痛脉数，附子败酱薏苡仁，研为末用水煎空腹服。
又方：薏苡汤
组成：薏苡仁 栝蒌仁（各三钱）
牡丹皮 桃仁（捣泥，各二钱）
水两钟，煎至一钟，不拘时候服用。
【方歌】薏苡汤治疗腹中有水声，肠痈小便淋沥刺痛疼，牡丹皮栝楼蒌子，还有桃仁薏苡仁。
又方：丹皮汤
组成：丹皮 栝蒌仁（各一钱）
桃仁（捣泥） 朴硝（各二钱）
大黄（五钱）
水两钟，煎成一钟，去渣加入硝石，再煎几次沸腾，不拘时候服用。
[Formula Song] Large and small intestine abscesses are caused by damp-heat; qi stagnation and blood stasis pour into the intestines. In the early stage, Dahuang Tang (Rhubarb Decoction) is taken to move blood stasis; once pus is formed, Yiyi Ren (Coix Seed) and Mudan Pi (Moutan Cortex) are used to calm the condition.
[Annotation] These two conditions are both formed by the coagulation of damp-heat and qi stagnation. It may be due to blood stasis from excessive exertion, or retained lochia after childbirth flowing into the large and small intestines. Initially, there is fever, aversion to wind, and spontaneous sweating; the skin is dry and scaly like fish scales (shen pi jia cuo); there is dull pain and slight swelling at the Guanyuan (CV4) and Tianshu (ST25) acupoints; pressing causes acute abdominal pain. Large intestine abscesses often present with a sensation of rectal tenesmus and swelling; small intestine abscesses often present with dysuria. The pulse is uniformly slow and tight. At this time, the abscess pus has not yet formed, and it is appropriate to use Dahuang Tang (Rhubarb Decoction) to purge; if the water passage remains blocked after the blood stasis is cleared, it is still appropriate to add Hupo (Amber) powder and Mutong (Akebia Caulis) to Dahuang Tang (Rhubarb Decoction) to promote urination, which will be effective. If the abscess has been formed for a long time without ulcerating, the body skin is dry and scaly, there is no accumulation inside, the abdomen is tense and painful, the body has no fever but the pulse is rapid, this indicates cold-yin in the intestines that cannot transform into pus, and Yiyi Fuzi San (Coix and Aconite Powder) should be primarily used. If the pulse is surging and rapid, the umbilicus protrudes, there is abdominal pain, distension, fullness, and an inability to eat, and there is a splashing sound when turning or changing position, along with dysuria and stabbing pain, the abscess pus has already formed, and Yiyi Tang (Coix Decoction) should be used. If the abdomen is soft but painful, the lower abdomen is tense and distended, and pus is discharged frequently, the pathogenic toxin has not been resolved, and Danpi Tang (Moutan Decoction) should be used for treatment. If pus flows from the umbilicus, abdominal distension is not relieved, food intake decreases, the complexion is pale, and spirit is fatigued, this belongs to deficiency of both qi and blood, and Bazhen Tang (Eight Treasures Decoction) added with Mudan Pi (Moutan Cortex), Rougui (Cinnamon Bark), Huangqi (Astragalus Root), and Wuweizi (Schisandra Fruit) should be used to astringe and tonify. Patients should turn and move slowly and avoid startling themselves; this must be handled with caution. If delayed for a long time, neglected due to inertia, leading to the toxin attacking the internal organs, abdominal pain radiating to the yin region, and injury to the stomach and intestines, it may result in the genitalia becoming purple-black and rotting, loss of luster with no pus, frequent discharge of turbid water, foul odor on bedding and clothes, incessant irritability, fever, and emaciation; all these belong to adverse syndromes (poor prognosis).
Guanyuan (CV4) acupoint is also known as the Front-Mu point of the Small Intestine, located three cun below the umbilicus. Tianshu (ST25) acupoint is also known as the Front-Mu point of the Large Intestine, located two cun lateral to the umbilicus.
Formula: Dahuang Tang (Rhubarb Decoction)
Composition: Dahuang (Rhei Radix et Rhizoma, crushed, stir-fried) Mudan Pi (Moutan Cortex) Xiaopi (Natrii Sulfas, ground) Jiezi (Sinapis Semen) Taoren (Persicae Semen, stir-fried, skin and tip removed by boiling first, double-kernel seeds not used)
All ingredients in equal proportions, crushed together. Use five qian each time. Add two zhong of water, decoct until one zhong remains, remove dregs, and take warm on an empty stomach. Stop when stool passes with pus and blood; if not passed, take again.
[Formula Song] Dahuang Tang (Rhubarb Decoction) effectively treats intestinal abscess, with hard pain in the lower abdomen before pus formation; Mudan Pi (Moutan Cortex) and Dahuang (Rhubarb) work wonderfully, while Jiezi (Mustard Seed), Taoren (Peach Kernel), and Xiaoshi (Niter) are efficacious.
Another Formula: Yiyi Fuzi San (Coix and Aconite Powder)
Composition: Fuzi (Prepared Aconiti Lateralis Radix, two fen) Baijiangcao (Patriniae Herba, five fen) Yiyiren (Coicis Semen, stir-fried, one qian)
Grind into powder. Take one fangcun bi each time, decoct with two he of water, and take in one dose. Urination should follow. *San Yin Fang* states: Coix seed and Aconite as above, use one liang and one fen of Patriniae Herba. For every four qian, add half a cup of water, decoct to seven parts, remove dregs, and take on an empty stomach.
[Formula Song] Yiyi Fuzi San (Coix and Aconite Powder) treats skin scaling, intestinal abscess with abdominal distension, pain, and rapid pulse; Aconite, Patriniae Herba, and Coix seed are ground into powder and decocted in water for empty-stomach consumption.
Another Formula: Yiyi Tang (Coix Decoction)
Composition: Yiyiren (Coicis Semen) Gualouren (Trichosanthis Semen, three qian each) Mudan Pi (Moutan Cortex) Taoren (Persicae Semen, pounded into paste, two qian each)
Add two zhong of water, decoct until one zhong remains, take at any time.
[Formula Song] Yiyi Tang (Coix Decoction) treats splashing sounds in the abdomen, intestinal abscess with dysuria and stabbing pain; Moutan Cortex, Trichosanthis Seed, and Persicae Seed combined with Coix Seed are effective.
Another Formula: Danpi Tang (Moutan Decoction)
Composition: Danpi (Moutan Cortex, one qian) Gualouren (Trichosanthis Semen, one qian) Taoren (Persicae Semen, pounded into paste, two qian) Puxiao (Mirabilitum, two qian) Dahuang (Rhei Radix et Rhizoma, five qian)
Add two zhong of water, decoct until one zhong remains, remove dregs, add Mirabilitum, boil a few more times, and take at any time.
[Formula Song] Danpi Tang (Moutan Decoction) treats intestinal abscess syndrome, with soft abdomen, pain, and frequent pus discharge; Niter, Rhubarb, Moutan, Trichosanthis Seed, and Persicae Seed together, decocted in water, yield miraculous results.
Another Formula: Bazhen Tang (Eight Treasures Decoction) (See Ulcer Section)