论曰∶肠痈由恚怒不节,忧思过甚,肠胃虚弱,寒温不调,邪热交攻,故营卫相干,血
为败浊,流渗入肠,不能传导,蓄结成痈,津液腐化,变为脓汁,其候少腹硬满,按之内痛,
小
或脓出脐中,或大便下脓血,宜急治之,不尔则邪毒内攻,腐烂肠胃,不可救矣,诊其脉洪
数者,脓已成,设脉迟紧虽脓未就,已有瘀血也。
治肠痈。少腹坚肿,大如掌而热,按之则痛,其上色或赤或白,小便稠数,汗出憎寒,
其脉迟紧者,未成脓,如脉数,则脓已成。大黄汤方
大黄(锉炒) 牡丹皮 硝石(研) 桃仁(汤浸去双仁皮尖炒) 芥子各半两
上五味,粗捣筛,每服五钱匕,水二盏,煎至一盏,去滓空心温服,以利下脓血为度,
未利再服。
治肠痈。木占斯散方
木占斯 浓朴(去粗皮生姜汁炙) 甘草(炙锉) 细辛(去苗叶) 栝蒌(去皮) 防
风(去
叉) 干姜(炮) 人参 桔梗(锉炒) 败酱(各一两)
上十味,捣罗为散,每服二钱匕,空心日晚,温酒调下。
治肠痈。牡丹汤方
牡丹皮(一两) 芍药 丹参 生干地黄(切焙各二两) 薏苡仁 桔梗(锉炒) 麦
门冬(
去心焙各一两半) 甘草(炙锉) 赤茯苓(去黑皮) 败酱(各一两)
上十味,粗捣筛,每服五钱匕,水二盏,入生姜五片,煎至一盏,去滓空心日晚温服。
治肠痈。犀角丸方
犀角屑(一两半) 巴豆(十粒去心皮炒研去油) 大黄(三分蒸三度锉) 蜀椒(去
目并闭
口者
芦(去芦
头)
上一十四味,捣罗为末,炼蜜丸如梧桐子大,每服三丸,空心米饮下,加至四五丸,利
下黄水为度。
治肠痈,里急隐痛,大便秘涩。梅仁汤方
梅核仁(四十九个去皮尖) 大黄(三两) 牡丹皮(一两三分) 冬瓜仁(四两) 犀
角(镑
一两半) 芒硝(二两半)
上六味, 咀如麻豆大,每服五钱匕,水二盏,煎至一盏,去滓温服,以下脓血三两行
为度。
治肠痈。附子汤方
附子(炮裂去皮脐) 败酱(各三分) 薏苡仁(一两半)
上三味, 咀如麻豆,每服三钱匕,水一盏,煎至六分,去滓空心日晚温服,下脓血即
瘥。
治肠痈。鸡毛散方
雄鸡项上毛(烧灰) 雄鸡屎(烧灰各一两)
上二味,细研为散,空心温酒二合,调下一钱匕,日晚再服。
又方
上截檐头尖少许,烧成灰,水调服,即穴出脓。
治肠痈,壮热恶寒,微汗气急,少腹痛,小便涩,或大便如刀锥刺痛,或有脓,腹中已
成脓。瓜子仁汁方
瓜子仁(三合与水陆协议研绞取汁) 当归(切焙一两捣末) 蛇蜕(一条烧灰研)
上三味,将二味末和匀,分作二服,用瓜子汁调下,空心日午服,下脓血即瘥。
治肠痈。大黄牡丹汤方
大黄(锉炒) 牡丹皮(各二两) 桃仁(汤浸去皮尖双仁炒半两) 芒硝(研一两) 冬
瓜仁
(三合)
上五味,粗捣筛,每服五钱匕,水一盏半,煎至八分,去滓空心温服,以利下脓血为度
治肠痈。薏苡仁汤方
薏苡仁(一两) 牡丹皮 桃仁(汤浸去皮尖双仁炒各一两半) 瓜子仁(半两)
上四味,粗捣筛,每服五钱匕,水一盏半,煎至七分,去滓空心日晚温服。
论述说:肠痈是由于愤怒没有节制,忧虑思虑过度,导致肠胃虚弱,寒热失调,邪热相互交攻,致使营卫之气相互干扰,血液败坏浑浊,流渗入肠道,不能正常传导,积聚凝结成痈肿,津液腐败化生,变成脓汁。其症状表现为少腹部坚硬胀满,按压时内部疼痛,有时脓液从脐中流出,有时大便排出脓血,应当紧急治疗,否则邪毒内攻,腐蚀肠胃,就无法挽救了。诊察其脉象洪大数急的,说明脓已经形成;如果脉象迟而紧,虽然脓尚未成熟,但已有瘀血存在。
治疗肠痈。少腹部坚硬肿胀,大如手掌且发热,按压则疼痛,面色或红或白,小便短赤频数,出汗且怕冷,脉象迟紧的,脓未形成;如果脉象数,则脓已形成。大黄汤方:大黄(切碎炒制)、牡丹皮、硝石(研细)、桃仁(热水浸泡去掉双仁和皮尖后炒制)、芥子各半两。以上五味药,粗捣筛过,每次服用五钱匕,加水二盏,煎煮至一盏,去渣,空腹温服,以排出脓血为度,若未通利再服用。
治疗肠痈。木占斯散方:木占斯、浓朴(去掉粗皮后用生姜汁炙烤)、甘草(炙后切碎)、细辛(去掉苗叶)、栝蒌(去掉皮)、防风(去掉叉枝)、干姜(炮制)、人参、桔梗(切碎炒制)、败酱草(各一两)。以上十味药,捣碎过罗成为散剂,每次服用二钱匕,空腹及晚间,用温酒调服。
治疗肠痈。牡丹汤方:牡丹皮(一两)、芍药、丹参、生干地黄(切片焙干各二两)、薏苡仁、桔梗(切碎炒制)、麦门冬(去掉心焙干各一两半)、甘草(炙后切碎)、赤茯苓(去掉黑皮)、败酱草(各一两)。以上十味药,粗捣筛过,每次服用五钱匕,加水二盏,放入生姜五片,煎煮至一盏,去渣,空腹及晚间温服。
治疗肠痈。犀角丸方:犀角屑(一两半)、巴豆(十粒去掉心皮炒研去油)、大黄(三分蒸三次后切碎)、蜀椒(去掉目并闭口者)、芦根(去掉芦头)……(原文此处有缺漏,依文意补全逻辑,但仅翻译可见部分)上一十四味药,捣碎过罗成为粉末,炼蜜制成梧桐子大小的丸剂,每次服用三丸,空腹米饮送下,可加至四五丸,以排出黄水为度。
治疗肠痈,伴有里急后重隐痛,大便秘结涩滞。梅仁汤方:梅核仁(四十九个去掉皮尖)、大黄(三两)、牡丹皮(一两三分)、冬瓜仁(四两)、犀角(镑片一两半)、芒硝(二两半)。以上六味药,切碎如麻豆大小,每次服用五钱匕,加水二盏,煎煮至一盏,去渣温服,以下排脓血二三行为度。
治疗肠痈。附子汤方:附子(炮裂去皮脐)、败酱草(各三分)、薏苡仁(一两半)。以上三味药,切碎如麻豆大小,每次服用三钱匕,加水一盏,煎煮至六分,去渣空腹及晚间温服,排出脓血即痊愈。
治疗肠痈。鸡毛散方:雄鸡项上的毛(烧成灰)、雄鸡屎(烧成灰各一两)。以上两味药,细研成为散剂,空腹用温酒二合调服一钱匕,晚间再服。
又一方:截取屋檐头尖端少许,烧成灰,用水调服,脓液即从穴位中排出。
治疗肠痈,壮热恶寒,微汗气急,少腹痛,小便涩滞,或大便如刀锥刺痛,或有脓,腹中已成脓。瓜子仁汁方:瓜子仁(三合与水一起研磨绞取汁液)、当归(切片焙干一两捣末)、蛇蜕(一条烧成灰研细)。以上三味药,将两种粉末混合均匀,分作两次服用,用瓜子汁调服,空腹及日午服用,排出脓血即痊愈。
治疗肠痈。大黄牡丹汤方:大黄(切碎炒制)、牡丹皮(各二两)、桃仁(热水浸泡去掉皮尖双仁炒制半两)、芒硝(研细一两)、冬瓜仁(三合)。以上五味药,粗捣筛过,每次服用五钱匕,加水一盏半,煎煮至八分,去渣空腹温服,以排出脓血为度。
治疗肠痈。薏苡仁汤方:薏苡仁(一两)、牡丹皮、桃仁(热水浸泡去掉皮尖双仁炒制各一两半)、瓜子仁(半两)。以上四味药,粗捣筛过,每次服用五钱匕,加水一盏半,煎煮至七分,去渣空腹及晚间温服。
Commentary states: Changyong (Intestinal Abscess) arises from uncontrolled anger, excessive worry and overthinking, leading to weakness of the intestines and stomach, disharmony of cold and heat, and mutual attack of pathogenic heat. This causes interference between Ying (Nutritive Qi) and Wei (Defensive Qi), resulting in blood becoming turbid and degenerated. The fluid flows into the intestines, fails to conduct normally, accumulates, condenses, and forms an abscess. Body fluids rot and transform into pus. The manifestations include hardness and fullness in the lower abdomen, internal pain upon pressure, sometimes pus discharging from the umbilicus, or pus and blood passing in the stool. It is imperative to treat it urgently; otherwise, pathogenic toxins will attack internally, corroding the intestines and stomach, rendering it incurable. Palpation reveals a洪数 (Hong-Shu, surging and rapid) pulse indicates that pus has already formed. If the pulse is迟紧 (Chi-Jin, slow and tight), although pus has not yet matured, blood stasis is already present.
Treatment for Changyong (Intestinal Abscess). Lower abdomen is hard and swollen, size like a palm, hot to touch, painful upon pressure. Complexion may be red or white. Urine is scanty, thick, and frequent. Sweating with aversion to cold. A 迟紧 (Chi-Jin, slow and tight) pulse indicates pus has not formed; a 数 (Shu, rapid) pulse indicates pus has formed. Dahuang Tang (Rhubarb Decoction) Formula: Rhizoma et Radix Rhei (Dahuang, 大黄) [crushed and stir-fried], Cortex Moutan (Mudanpi, 牡丹皮), Natrii Nitras (Xiaoshi, 硝石) [ground], Semen Persicae (Taoren, 桃仁) [soaked in water, removed double kernels, skin, and tips, then stir-fried], Semen Sinapis Albae (Jiezi, 芥子) each half liang. The above five herbs are coarsely crushed and sifted. Each dose consists of 5 qianbi, boiled in 2 zhan of water until 1 zhan remains. Strain and take warm on an empty stomach. Stop when pus and blood are discharged; if not discharged, administer again.
Treatment for Changyong (Intestinal Abscess).muzhansi San (Wood Saponin Powder) Formula: Herba Siegesbeckiae (Muzhansi, 木占斯), Cortex Magnoliae Officinalis (Noupu, 浓朴) [coarse bark removed, stir-baked with ginger juice], Radix Glycyrrhizae Preparata (Gancao, 甘草) [stir-baked and crushed], Radix et Rhizoma Asari (Xixin, 细辛) [seeds and leaves removed], Fructus Trichosanthis (Gualou, 栝蒌) [skin removed], Radix Saposhnikoviae (Fangfeng, 防风) [forks removed], Rhizoma Zingiberis Preparatum (Ganjiang, 干姜) [pao-processed], Radix Ginseng (Renshen, 人参), Radix Platycodonis (Jiegeng, 桔梗) [crushed and stir-fried], Herba Patriniae (Baijiang, 败酱) each 1 liang. The above ten herbs are crushed, sieved into powder. Each dose is 2 qianbi, taken warm with wine on an empty stomach and in the evening.
Treatment for Changyong (Intestinal Abscess). Mudan Tang (Peony Decoction) Formula: Cortex Moutan (Mudanpi, 牡丹皮) [1 liang], Radix Paeoniae Albae (Shaoyao, 芍药), Radix Salviae Miltiorrhizae (Danshen, 丹参), Radix Rehmanniae Preparata (Sheng Gan Dihuang, 生干地黄) [sliced and baked, each 2 liang], Semen Coicis (Yiyiren, 薏苡仁), Radix Platycodonis (Jiegeng, 桔梗) [crushed and stir-fried], Radix Ophiopogonis (Mendong, 麦门冬) [heart removed, baked, each 1.5 liang], Radix Glycyrrhizae Preparata (Gancao, 甘草) [stir-baked and crushed], Poria Cocos cum Ligno Rubra (Chifuling, 赤茯苓) [black skin removed], Herba Patriniae (Baijiang, 败酱) each 1 liang. The above ten herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled in 2 zhan of water with 5 slices of fresh Ginger (Shengjiang, 生姜) until 1 zhan remains. Strain and take warm on an empty stomach and in the evening.
Treatment for Changyong (Intestinal Abscess). Xijiao Wan (Rhino Horn Pill) Formula: Cornu Rinocerotis (Xijiao, 犀角) [shavings, 1.5 liang], Fructus Crotonis Tiglii (Badou, 巴豆) [10 grains, heart and skin removed, stir-fried, ground, oil removed], Rhizoma et Radix Rhei (Dahuang, 大黄) [3 fen, steamed three times, crushed], Fructus Schisandrae Chinensis (Shujiao, 蜀椒) [eyes and closed-mouth ones removed], Rhizoma Imperatae (Baiguilu, 芦) [tips removed]... (Note: Original text has gaps here, translating visible parts). The above fourteen ingredients are ground into fine powder. Honey pills are made the size of Sophora japonica seeds. Each dose is 3 pills, taken with rice water on an empty stomach. Dosage can be increased to 4-5 pills. Stop when yellow fluid is discharged.
Treatment for Changyong (Intestinal Abscess) with tenesmus and dull pain, constipation and dryness. Meiren Tang (Plum Kernel Decoction) Formula: Fructus Pruni Armeniacae (Meihe Ren, 梅核仁) [49 grains, skin and tips removed], Rhizoma et Radix Rhei (Dahuang, 大黄) [3 liang], Cortex Moutan (Mudanpi, 牡丹皮) [1.3 liang], Semen Benincasae (Dongguaren, 冬瓜仁) [4 liang], Cornu Rinocerotis (Xijiao, 犀角) [shaved, 1.5 liang], Natrii Sulfas (Mangxiao, 芒硝) [2.5 liang]. The above six herbs are chopped like hemp seeds. Each dose is 5 qianbi, boiled in 2 zhan of water until 1 zhan remains. Strain and take warm. Stop when 2-3 passages of pus and blood are discharged.
Treatment for Changyong (Intestinal Abscess). Fuzi Tang (Aconite Decoction) Formula: Radix Aconiti Lateralis Preparata (Fuzi, 附子) [pao-processed, skin and navel removed], Herba Patriniae (Baijiang, 败酱) each 3 fen, Semen Coicis (Yiyiren, 薏苡仁) [1.5 liang]. The above three herbs are chopped like hemp seeds. Each dose is 3 qianbi, boiled in 1 zhan of water until 0.6 zhan remains. Strain and take warm on an empty stomach and in the evening. Recovery occurs when pus and blood are discharged.
Treatment for Changyong (Intestinal Abscess). Jimao San (Chicken Feather Powder) Formula: Pluma Colli Galli Masculini (Xiongji Xiangshang Mao, 雄鸡项上毛) [burnt to ash], Excrementum Galli Masculini (Xiongji Shi, 雄鸡屎) [burnt to ash, each 1 liang]. The above two ingredients are finely ground into powder. Take 1 qianbi mixed with 2 he of warm wine on an empty stomach, and repeat in the evening.
Another prescription: Cut a small amount from the tip of the eaves, burn to ash, mix with water and take orally. Pus will discharge from the acupoint.
Treatment for Changyong (Intestinal Abscess) with high fever and aversion to cold, slight sweating, shortness of breath, lower abdominal pain, dysuria, or stabbing pain in the stool like knife cones, or presence of pus indicating mature abscess in the abdomen. Guazi Ren Zhi Fang (Melon Seed Juice Formula): Semen Cucurbitae (Guazi Ren, 瓜子仁) [3 he, ground with water, juice extracted], Radix Angelicae Sinensis (Danggui, 当归) [sliced, baked, 1 liang, ground to powder], Cuticula Serpentis (Shetui, 蛇蜕) [one strip, burnt to ash, ground]. The above three ingredients: Mix the two powders evenly, divide into two doses. Take with melon seed juice on an empty stomach and at noon. Recovery occurs when pus and blood are discharged.
Treatment for Changyong (Intestinal Abscess). Dahuang Mudan Tang (Rhubarb and Peony Decoction) Formula: Rhizoma et Radix Rhei (Dahuang, 大黄) [crushed and stir-fried], Cortex Moutan (Mudanpi, 牡丹皮) each 2 liang, Semen Persicae (Taoren, 桃仁) [soaked, skin and tips removed, double kernels removed, stir-fried, 0.5 liang], Natrii Sulfas (Mangxiao, 芒硝) [ground, 1 liang], Semen Benincasae (Dongguaren, 冬瓜仁) [3 he]. The above five herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled in 1.5 zhan of water until 0.8 zhan remains. Strain and take warm on an empty stomach. Stop when pus and blood are discharged.
Treatment for Changyong (Intestinal Abscess). Yiyiren Tang (Coix Seed Decoction) Formula: Semen Coicis (Yiyiren, 薏苡仁) [1 liang], Cortex Moutan (Mudanpi, 牡丹皮), Semen Persicae (Taoren, 桃仁) [soaked, skin and tips removed, double kernels removed, stir-fried, each 1.5 liang], Semen Cucurbitae (Guazi Ren, 瓜子仁) [0.5 liang]. The above four herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled in 1.5 zhan of water until 0.7 zhan remains. Strain and take warm on an empty stomach and in the evening.