吕沧洲治一小儿。十二岁。患内痈。腹胀脐凸而颇锐。医欲刺脐出脓。其母不许。请吕
视之。见一僧拥炉炽炭。燃铜筋一枚烈火中。瞪目视翁曰。此儿病痈发小肠。苟舍刺脐。无
他法。吕谕之曰。脐神阙也。针刺所当禁。矧痈舍于内。惟当以汤丸攻之。苟如而言。必杀
是子矣。僧怒趋而出。吕投透脓散一匙。明日。脓自气合溃。继以十奇汤下万应膏丸。而瘥
立斋治给事钱南郭。腹内患痈。已成而不见。欲用托里之药发之。彼用行气破血以图内
消。形体甚倦。饮食益少。患处顿陷。色黯坚硬。按之不痛。仍用大补之剂。色赤肿起。脓
熟针之。再用托里。肿溃渐愈而消。
一男子腹内作痛。腹外微肿。或欲药汗之。薛曰。肉色如故。脉数无力。此元气虚损。
毒不能外发。遂与参、 、归、术之类数剂。渐发于外。又数剂。脓成而欲针之。彼惑于人
言。用大黄、白芷、穿山甲之类。引脓从便出。以致水泻不止。患处平陷。自汗盗汗。热渴
不食。仍用前剂加半夏、陈皮、姜、桂。四剂。形气渐复。又数剂。针去其脓。仍用补剂。
幸幼未婚。故得痊也。
鸿胪苏龙溪。小腹内肿胀作痛。大小便秘结。作渴欲饮冷。脉洪数而实。用黄连解毒散
二剂热痛顿止。二便调和。用活命饮而愈。
大司马李梧山。腹痛而势已成。用活命饮一剂。痛即退。用托里消毒散。肿顿起。此脓
将成。用托里散补其元气。自溃而愈。
锦衣掌堂刘廷器。仲夏腹患痈。溃而脓水清稀。发热作渴。腹胀作呕。饮食不入。诸医
以为热毒内攻。皆用芩、连、大黄之剂。病加剧。邀薛诊。投以参、 、姜、附等药。一剂
呕止食进而安。再用托里补剂而疮愈。
进士边云庄。腹痛恶寒。作湿痰食积治之。益甚。脉浮数。薛曰。浮数之脉更恶寒。疽
疮之证也。彼不信。旬余复请视之。左尺洪数。知内有脓矣。仍不信。至小腹肿胀。连及两
臀。始悟。薛曰。脓溃臀矣。气血俱虚。何以收敛。服活命饮一钟。臀溃一孔。出脓斗许。
气息奄奄。势成可畏。用大补药一剂。神思方醒。每去后。粪从疮出。且出血甚多。痛不可
忍。欲求死而不得。小腹间若觉有物上拄。即发痉。牙关紧。不省人事。发热烦躁。此时脉
洪大。举按皆实。苏而诊之。脉仍洪大。按之如无。此气血虚极。以十全大补汤用参 至四
斤余。加附子二枚而痉止。共享此方五十余剂而疮敛。
吕沧洲治疗一名十二岁的儿童。患儿患有内痈，腹部胀大，肚脐突出且形状尖锐。医生打算针刺肚脐排脓，但患儿的母亲不同意，便请吕沧洲诊治。吕沧洲见到一位僧人正拥炉烧炭，将一根铜筋在烈火中燃烧，僧人瞪着眼睛对吕翁说：“这个孩子的病是肠痈发作于小肠，如果放弃针刺肚脐，就没有其他办法了。”吕沧洲告诫他说：“脐部即神阙穴，是针刺所禁忌的部位。况且痈毒生于体内，只应当用汤药或丸药攻治。如果按照你所说的方法，一定会害死这个孩子。”僧人愤怒地快步离开。吕沧洲给患儿喂服透脓散一匙。第二天，脓液自然从气海、关元穴处溃破流出。随后继以十奇汤服用，并配合万应膏丸，病情随即痊愈。
立斋治疗给事中钱南郭，其腹内患痈，已经形成但未见明显外象。立斋打算使用托里透脓的药物促使它发出来，但患者自行使用行气破血的方法企图使痈肿内消。导致患者形体非常疲倦，饮食日益减少，患处突然凹陷，颜色暗红坚硬，按压时不痛。立斋仍使用大补的药剂，患处颜色变红肿胀隆起，脓液成熟后针刺排脓，再使用托里药物，肿块溃破后逐渐愈合消退。
有一名男子腹内疼痛，腹外轻微肿胀。有人想用发汗药物治疗。薛己说：“肌肉颜色如常，脉象数而无力，这是元气虚损，毒邪不能向外发散。”于是给予人参、白术、当归、黄芪等类药物数剂，毒邪逐渐发于体表。又服数剂，脓液形成后想要针刺排脓。患者听信他人言语，使用大黄、白芷、穿山甲等药物，试图引导脓液从大便排出，导致水泻不止，患处平陷，出现自汗和盗汗，发热口渴，无法进食。薛己仍使用前方的药剂，加入半夏、陈皮、生姜、肉桂。服用四剂后，患者的形体和气息逐渐恢复。又服数剂，针刺排出脓液，继续使用补益药剂。幸好患者年幼未婚，所以得以痊愈。
鸿胪寺卿苏龙溪，小腹内部肿胀疼痛，大小便秘结，口干想喝冷水，脉象洪数而实。使用黄连解毒散两剂，热痛顿时停止，二便调和。随后使用仙方活命饮而痊愈。
大司马李梧山，腹痛且病势已成。使用仙方活命饮一剂，疼痛立即减退。接着使用托里消毒散，肿块顿时隆起，这是脓液即将形成的征兆。使用托里散补益元气，脓肿自然溃破而痊愈。
锦衣卫掌堂刘廷器，仲夏时节腹部患痈，溃破后脓水清稀，伴有发热口渴，腹部胀满作呕，饮食无法进入。众医认为是热毒内攻，都使用黄芩、黄连、大黄等寒凉药剂，导致病情加重。邀请薛己诊治，投以人参、干姜、附子等温补药物。一剂后呕吐停止，饮食进进而病情安定。再用托里补益药剂，疮口愈合。
进士边云庄，腹痛恶寒，被当作湿痰食积治疗，病情反而加重。脉象浮数。薛己说：“浮数的脉象加上恶寒，是疽疮的证候。”患者不相信。十多天后再次请薛己诊治，左尺脉洪数，薛己知道体内已有脓液。患者仍不信。直到小腹肿胀，牵连到两侧臀部，才醒悟。薛己说：“脓液已在臀部溃破。”此时气血俱虚，如何收敛？服用仙方活命饮一钟（量词），臀部溃破一个孔洞，流出脓液约斗许。患者气息微弱，形势危急可畏。使用大补药剂一剂，神志才清醒。每次排便后，粪便从疮口流出，且出血很多，疼痛难以忍受，想求死却不得解脱。小腹间若感觉有物向上顶撞，就会引发痉挛，牙关紧闭，不省人事，发热烦躁。此时脉象洪大，轻取重按皆实。苏醒后诊脉，脉象仍洪大，但重按若无。这是气血极度虚弱。使用十全大补汤，用人参至四斤有余，加入附子两枚，痉挛停止。共用此方五十余剂，疮口收敛愈合。
Lu Cangzhou treated a twelve-year-old child suffering from an internal carbuncle (Nei Yong). The abdomen was distended, and the umbilicus protruded sharply. A physician wished to puncture the umbilicus to drain the pus, but the mother refused and requested Lu’s consultation. Lu observed a monk fanning a furnace with hot coals, heating a copper rod in the fire. The monk stared at Lu and said, “This child suffers from an intestinal carbuncle originating in the small intestine. If you abandon puncturing the umbilicus, there is no other method.” Lu admonished him, stating, “The umbilicus is Shenque (Shenque acupoint), which is contraindicated for needle insertion. Moreover, since the carbuncle is located internally, it should be treated only with decoctions or pills. Following your advice would certainly kill the child.” The monk left angrily. Lu administered one spoonful of Tou Nong San (Perforating Pus Powder) to the child. The following day, the pus naturally drained from the area of Qihai and Guanyuan acupoints. Subsequently, the patient took Shi Qi Tang (Ten Miracles Decoction) and Wan Ying Gao Wan (Myriad Answers Ointment Pills), leading to a complete recovery.
Lizhai treated Qian Nanguo, a Censor, who suffered from an abdominal internal carbuncle that had formed but showed no external signs. Lizhai intended to use Tuo Li (Supporting the Interior) herbs to promote its emergence, but the patient used Qi-moving and Blood-breaking methods attempting to resolve it internally. This resulted in severe fatigue, decreased appetite, sudden depression of the affected area, dark and hard texture, and painlessness upon pressure. Lizhai continued with strong tonifying formulas. The area became red, swollen, and raised; once the pus matured, it was lanced. Further Tuo Li treatment led to gradual healing and resolution.
A male patient experienced internal abdominal pain with slight external swelling. Someone suggested treating him with diaphoresis (sweating therapy). Xue Ji stated, “The skin color remains unchanged, and the pulse is rapid yet forceless. This indicates deficiency of Yuan Qi (Primal Qi), preventing the pathogenic toxin from expressing outwardly.” He prescribed several doses of Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), Dang Gui (Angelica Sinensis Root), and Huang Qi (Astragalus Root). Gradually, the condition expressed externally. After more doses, pus formed, and needle drainage was planned. However, influenced by others, the patient used Da Huang (Rhubarb Root), Bai Zhi (Angelica Dahurica Root), and Shan Jia Jia (Pangolin Scales) to induce drainage via the bowels, causing persistent watery diarrhea. The lesion flattened, accompanied by spontaneous sweating, night sweats, fever, thirst, and anorexia. Xue Ji repeated the previous formula, adding Ban Xia (Pinellia Tuber), Chen Pi (Citrus Peel), Sheng Jiang (Fresh Ginger), and Rou Gui (Cinnamon Bark). After four doses, the patient’s constitution and Qi recovered. Following several more doses, the pus was drained via needle, and tonic formulas were continued. Fortunately, the patient was young and unmarried, allowing for full recovery.
Su Longxi, Minister of Ceremonies, suffered from swelling and pain in the lower abdomen, constipation of both stool and urine, thirst for cold drinks, and a surging, rapid, and excess pulse. Two doses of Huang Lian Jie Du San (Coptis Decoction for Resolving Toxins) stopped the heat and pain immediately, regulating bowel and bladder functions. He was then cured using Xian Fang Huo Ming Yin (Immortal Life Preserving Powder).
Li Wushan, Grand Commandant, suffered from abdominal pain where the condition had progressed significantly. One dose of Xian Fang Huo Ming Yin relieved the pain immediately. He then took Tuo Li Xiao Du San (Interior-Supporting and Toxin-Resolving Powder), causing the swelling to rise sharply, indicating impending pus formation. Using Tuo Li San (Interior-Supporting Powder) to tonify Yuan Qi, the abscess ruptured spontaneously, leading to recovery.
Liu Tingqi, Director of the Embroidered Uniform Guard, developed an abdominal carbuncle in midsummer. It ulcerated with thin, clear pus, accompanied by fever, thirst, abdominal distension, vomiting, and inability to eat. Other physicians attributed this to internal attack by heat-toxin and prescribed cooling herbs such as Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), and Da Huang. The condition worsened. Xue Ji was invited to consult and prescribed Ren Shen, Gan Jiang (Dried Ginger), and Fu Zi (Aconite Lateral Root). After one dose, vomiting ceased, appetite returned, and the patient stabilized. Further Tuo Li tonics healed the wound.
Bian Yunzhuang, Jinshi degree holder, suffered from abdominal pain and aversion to cold. He was treated for damp-phlegm and food stagnation, which aggravated his condition. His pulse was floating and rapid. Xue Ji stated, “A floating and rapid pulse combined with aversion to cold indicates a Ju (deep-seated abscess/ulcer).” The patient did not believe this. Ten days later, upon re-examination, the Left Chi pulse was surging and rapid, indicating internal pus. The patient remained skeptical until the lower abdomen swelled, extending to both buttocks. Xue Ji noted, “The pus has ruptured in the buttocks. With both Qi and Blood deficient, how can healing occur?” He administered one measure of Xian Fang Huo Ming Yin. A hole opened in the buttock, discharging approximately a dou (unit of volume) of pus. The patient’s breath was faint, and the situation was critical. One dose of strong tonifying medicine restored consciousness. Subsequently, feces exited through the wound along with significant bleeding, causing unbearable pain. The patient felt a sensation of something pushing upward in the lower abdomen, triggering spasms, lockjaw, unconsciousness, fever, and irritability. At this time, the pulse was surging and large, feeling solid on both light and heavy pressure. Upon waking, the pulse remained surging and large but felt empty upon deep pressure, indicating extreme deficiency of Qi and Blood. He was treated with Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction), using over four jin (approx. 2kg) of Ren Shen and two pieces of Fu Zi. The spasms ceased. After fifty-plus doses of this formula, the wound closed.