（论三首 方二十九首灸法二首）
论曰∶卒得肠痈而不晓其病候，愚医治之错则杀人。肠痈之为病，小腹重而强，抑之则
痛，小便数似淋，时时汗出，复恶寒，其身皮皆甲错，腹皮急，如肿状，其脉数者，小有脓
也。（《巢氏病源》云∶洪数者，已有脓也。）其脉迟紧者，未有脓也。甚则腹胀大，转侧闻
水声，或绕脐生疮，或脓从脐中出，或小便出脓血。
问曰∶宫羽林妇病，医脉之，何以知妇人肠中有脓，为下之即愈。师曰∶寸口脉滑而数
，滑则为实，数则为热。滑则为荣。数则为卫。卫数下降，荣滑上升，荣卫相干，血为浊败，
小
大黄（四两） 牡丹（三两） 芒硝（二两） 瓜子（一升） 桃仁（五十粒）
上五味， 咀，以水五升煮取一升，顿服，当下脓血。（《金匮》方用牡丹一两，瓜子
半升，芒硝二合。《删繁》方用瓜子半升，芒硝半合。刘涓子用硝石三合，云∶肠痈之病，
小腹痞坚，或在膀胱左右，其色或白，坚大如掌热，小便欲调时自汗出，其脉迟坚者，未成
脓，可下之，当有血。脉数脓成不复，可下。《肘后》名瓜子汤。）
牡丹 甘草 败酱 生姜 茯苓（各二两） 桔梗 薏苡仁 麦门冬（各三两） 丹参 芍
药（各四两） 生地黄（五两）
上十一味， 咀，以水一斗，煮取三升，分三服，日三。
又方 薏苡仁一升 牡丹 桃仁（各三两） 瓜瓣（二升）
上四味， 咀，以水六升，煮取二升，分二服。（姚氏不用桃仁，用李仁。崔氏有芒硝
二两，云∶腹中 痛，烦满不安，或胀满不下饮食，小便涩。此病多是肠痈，人多不识。妇
人产
凡肠痈，其状两耳叶纹理甲错，初患腹中苦痛，或绕脐有疮如粟皮热，便脓血出似赤白
下，不治必死方∶
以马蹄灰，鸡子白和涂，即拔毒瓦斯，不过，再涂瘥。
又方 以瓜子三升捣末，水三升，煮取一升半，分三服。
又方 以马牙烧灰，鸡子和涂，干即易。
灸肠痈方∶
屈两肘，正灸肘头锐骨各百壮，则下脓血，即瘥。
论曰∶产后宜勤挤乳，不宜令汁蓄积，蓄积不去，便结不复出，恶汁于内，引热温壮结
坚牵掣痛，大渴引饮，乳急痛，手不得近，成妒乳，非痈也。急灸两手鱼际各二十七壮，断
痈脉也。不复恶手近乳，汁亦自出，便可手助迮捋之，则乳汁大出，皆如脓状。内服连翘汤，
外
动经年月名为妒乳。妇人饮儿者，乳皆欲断，世谓苟抄乳是也，宜以赤龙皮汤及天麻汤洗之，
敷二物飞乌膏，及飞乌散佳。若始作者，可敷黄芩漏芦散，及黄连胡粉散并佳。
（论述三篇，方剂二十九首，灸法二首）
论述说：突然患上肠痈而不了解其病症表现，愚笨的医生治疗错误就会致人死亡。肠痈这种病，小腹部沉重且僵硬，按压时疼痛，小便频数像淋病一样，经常出汗，又怕冷，皮肤粗糙如鳞甲交错，腹壁紧绷，像肿胀的样子，脉象数的，说明脓液少量形成。（《巢氏病源》说：脉象洪大的，说明已经有脓了。）脉象迟而紧的，说明还没有形成脓液。病情严重的则腹部胀大，翻身转动时可听到水声，或者肚脐周围生疮，或者脓液从脐中流出，或者小便排出脓血。
问：宫羽林家的妇女患病，医生诊脉后，怎么知道妇人肠中有脓，通过泻下就能痊愈？老师说：寸口脉滑而数，滑脉主实邪，数脉主热。滑脉反映营气，数脉反映卫气。卫气因热而下陷，营气因实而上逆，营卫相互干扰，血液变得浑浊败坏，小腹……
大黄（四两） 牡丹皮（三两） 芒硝（二两） 瓜子（一升） 桃仁（五十粒）
以上五味药，切碎，用水五升煮取一升，一次性服用，应当排出脓血。（《金匮要略》方用牡丹一两，瓜子半升，芒硝二合。《删繁》方用瓜子半升，芒硝半合。刘涓子用硝石三合，说：肠痈的病，小腹部痞塞坚硬，或在膀胱左右，颜色或白，坚硬大如手掌且发热，小便正常时自汗出，脉象迟而坚的，脓未形成，可泻下，应当有瘀血排出。脉数者脓已成，也可泻下。《肘后备急方》名为瓜子汤。）
牡丹皮 甘草 败酱草 生姜 茯苓（各二两） 桔梗 薏苡仁 麦门冬（各三两） 丹参 芍药（各四两） 生地黄（五两）
以上十一味药，切碎，用水一斗，煮取三升，分三次服用，每天三次。
又一方：薏苡仁一升 牡丹皮 桃仁（各三两） 瓜瓣（二升）
以上四味药，切碎，用水六升，煮取二升，分两次服用。（姚氏不用桃仁，用李仁。崔氏加芒硝二两，说：腹中疼痛，烦闷胀满不安，或者胀满不能进食，小便涩滞。这病多是肠痈，人们大多不认识。妇人产后……）
凡是肠痈，症状是两耳叶纹理粗糙如鳞甲交错，初起时腹中剧烈疼痛，或者肚脐周围有疮疡如粟米皮般发热，排出脓血类似赤白痢疾，不治疗必定死亡。方剂：
用马蹄灰，与鸡蛋清调和涂抹，即可拔出毒气，不超过两次涂抹即愈。
又一方：用瓜子三升捣成末，水三升，煮取一升半，分三次服用。
又一方：用马牙烧成灰，与鸡子调和涂抹，干了就更换。
灸治肠痈方：
弯曲两肘，正对肘头锐骨处各灸一百壮，即可排出脓血，随即痊愈。
论述说：产后应该勤于挤奶，不要让乳汁积聚，积聚不去，就会凝结不再流出，恶汁在体内，引动热邪温壮凝结坚硬牵掣疼痛，极度口渴想喝水，乳房急痛，手不能触碰，形成妒乳，这不是痈。紧急灸两手鱼际穴各二十七壮，以断绝痈脉。不再厌恶手靠近乳房，乳汁也会自然流出，就可以用手帮助挤压捋顺，则乳汁大量流出，都像脓状。内服连翘汤，外……
持续经年月的称为妒乳。哺乳妇人的乳汁都想要断绝，世人称为苟抄乳，适宜用赤龙皮汤及天麻汤清洗，敷涂二物飞乌膏，以及飞乌散较好。如果是刚开始发作的，可以敷涂黄芩漏芦散，以及黄连胡粉散也都很好。
(Three discourses, twenty-nine prescriptions, two moxibustion methods)
The discourse states: Suddenly contracting intestinal abscess (intestinal carbuncle) without understanding its clinical manifestations, a foolish doctor treating it incorrectly may cause death. The disease of intestinal abscess is characterized by heaviness and stiffness in the lower abdomen, pain upon pressing, frequent urination resembling strangury (dysuria), occasional sweating, aversion to cold, skin roughness resembling scales, abdominal wall tension resembling swelling, and a rapid pulse indicating small amounts of pus formation. (According to *Chao Shi Bing Yuan*: a surging and rapid pulse indicates that pus has already formed.) A slow and tight pulse indicates that pus has not yet formed. In severe cases, the abdomen becomes distended, water sounds can be heard when turning over, sores may appear around the umbilicus, pus may discharge from the umbilicus, or pus and blood may be passed in urine.
Question: Regarding the woman from the Gongyulin family who was ill, how did the physician determine through pulse diagnosis that there was pus in her intestines and that purgation would lead to recovery? The Master said: The pulse at the Cun Kou position is slippery and rapid. Slippery indicates excess pathogenic factors; rapid indicates heat. Slippery reflects Ying (Nutritive) Qi; rapid reflects Wei (Defensive) Qi. Wei Qi descends due to heat, while Ying Qi rises due to excess. Ying and Wei interfere with each other, causing blood to become turbid and degenerated, leading to...
Da Huang (Rhei Radix et Rhizoma, 4 liang) Mudan Pi (Moutan Cortex, 3 liang) Mang Xiao (Natrii Sulfas, 2 liang) Gua Zi (Benincasa Semen, 1 sheng) Tao Ren (Persicae Semen, 50 grains)
The above five herbs are cut into pieces, boiled in five sheng of water to obtain one sheng, taken at once. Pus and blood should be discharged. (In *Jin Gui Yao Lue*, Mudan is used in 1 liang, Gua Zi in half sheng, Mang Xiao in 2 he. In *Shan Fan*, Gua Zi is used in half sheng, Mang Xiao in half he. Liu Juanzi uses Nuxiao (Saltpeter) in 3 he, stating: For intestinal abscess, the lower abdomen feels obstructed and hard, either left or right of the bladder, color may be white, hardness large as a palm and hot, spontaneous sweating occurs when urination is normal, a slow and firm pulse indicates unformed pus, which can be treated with purgation, expecting blood discharge. A rapid pulse indicates formed pus, which can also be treated with purgation. *Zhou Hou Bei Ji Fang* names this Guazi Tang.)
Mudan Pi (Moutan Cortex) Gan Cao (Glycyrrhizae Radix et Rhizoma) Bai Jiang Cao (Patriniae Herba) Sheng Jiang (Zingiberis Rhizoma Recens) Fu Ling (Poria, each 2 liang) Jie Geng (Platycodonis Radix) Yi Yi Ren (Coicis Semen) Mai Men Dong (Ophiopogonis Radix, each 3 liang) Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma) Shao Yao (Paeoniae Radix, each 4 liang) Sheng Di Huang (Rehmanniae Radix, 5 liang)
The above eleven herbs are cut into pieces, boiled in ten dou of water to obtain three sheng, divided into three doses, taken three times a day.
Another prescription: Yi Yi Ren (Coicis Semen, 1 sheng) Mudan Pi (Moutan Cortex) Tao Ren (Persicae Semen, each 3 liang) Gua Ban (Cucurbitae Semen, 2 sheng)
The above four herbs are cut into pieces, boiled in six sheng of water to obtain two sheng, divided into two doses. (Yao's method does not use Tao Ren, but Li Ren. Cui's method adds Mang Xiao 2 liang, stating: Abdominal pain, restlessness and fullness, or distension preventing food intake, difficult urination. This disease is mostly intestinal abscess, which people often fail to recognize. Postpartum women...)
Generally, for intestinal abscess, the signs include rough texture on the earlobes resembling scales. Initially, there is severe abdominal pain, or sores around the umbilicus feeling hot like millet husks, discharging pus and blood similar to bloody dysentery. Without treatment, it will inevitably lead to death. Prescription:
Use Ma Ti Hui (Ash of Horse Hoof) mixed with Ji Zi Bai (Egg White) for external application. It draws out toxic qi. Applying no more than twice leads to recovery.
Another prescription: Use Gua Zi (Benincasa Semen) 3 sheng, pounded into powder, boiled in three sheng of water to obtain one and a half sheng, divided into three doses.
Another prescription: Burn Ma Ya (Horse Tooth) to ash, mix with Ji Zi (Egg) for external application. Change when dry.
Moxibustion prescription for intestinal abscess:
Flex both elbows, apply moxa directly to the sharp bone at the tip of each elbow for one hundred moxa cones. Pus and blood will discharge, and recovery will follow immediately.
The discourse states: After childbirth, milk should be frequently expressed. It is inadvisable to let milk accumulate. If accumulated and not expelled, it coagulates and cannot flow out. Bad fluids remain inside, attracting heat and warmth, leading to hard, knotted masses causing pulling pain, extreme thirst requiring drinking, breast urgency and pain where the hand cannot touch, forming Du Ru (jealous breast), which is not an abscess. Urgently apply moxa to Yu Ji (Lung 10) on both hands, twenty-seven cones each, to cut off the abscess pulse. The aversion to hand touching the breast ceases, milk flows naturally, and manual expression can assist, resulting in large amounts of milk discharge resembling pus. Internally take Lian Qiao Tang (Forsythia Decoction), externally...
If lasting for months or years, it is called Du Ru. For nursing mothers whose milk needs to be dried up, known in the world as Gou Chao Ru, it is suitable to wash with Chi Long Pi Tang (Red Dragon Bark Decoction) and Tian Ma Tang (Gastrodia Decoction), then apply Er Wu Fei Wu Gao (Two-Ingredient Flying Bird Ointment) and Fei Wu San (Flying Bird Powder). If just beginning, applying Huang Qin Lu Lu San (Scutellaria and Euphorbia Powder) and Huang Lian Hu Fen San (Coptis and Lead Powder) is also excellent.