牡丹皮汤 治肠痈冷症。腹濡而痛。重按则止。时时下脓者。
牡丹皮 桃仁泥 薏苡仁 白芷 人参 黄 茯苓 当归 川芎 白芍(各一钱) 官桂 甘草(各五分)
木香(三分)
水二钟。煎八分。温服。
加味地黄汤 治肠痈溃后。淋漓不已。或精神减少。饮食无味。自汗盗汗等症。
熟地 山药 山茱萸 白茯苓 丹皮 人参(等分) 黄 (倍之)
用煨姜三片。大胶枣二个。水二钟。煎一钟。空心服。
梅豆汤 治肠痈下后。脓多者。
薏苡仁(二合) 黑豆(百粒) 乌梅(一个)
水煎熟取汤一大钟。入阿胶一钱。生蒲黄一钱。再煎服。
天丁散 治肠痈内痈。已有脓者。
皂角刺(一两)
酒水煎服则脓下。
薏苡仁汤(见前内痈) 十全大补汤
大肠痈之发。必先天枢穴隐痛不已。(穴在脐旁二寸)右边痛甚。脉则右寸洪数。治与内痈及小肠痈同法。
胃痈之发。必先中脘穴隐痛不已。(穴在脐上四寸)令人咳吐脓血。寒热如疟。由寒气隔阳。热聚胃口所致。以寒
气逆于胃。故胃脉沉细。以阳气不得上升。故人迎紧盛。
脉迟芤涩者瘀血也。牡丹皮汤下之。脉洪数者脓成也。赤豆薏苡仁汤排之。
膏粱之人初起者。宜清胃射干汤。体倦。气喘作渴。小便频数者。肺气虚也。补中益气汤。加山茱萸、山药、
五味子、麦门冬。或兼加减八味丸。再夏月以生脉散。代茶饮之。是症以壮气助胃为主。佐以前药。不可
专攻其毒。
牡丹皮汤:治疗肠痈的寒证。表现为腹部柔软且疼痛,重按时疼痛停止,时常排出脓液。
处方组成:牡丹皮、桃仁泥、薏苡仁、白芷、人参、黄芪、茯苓、当归、川芎、白芍(各一钱),官桂、甘草(各五分),木香(三分)。
煎服法:用水两钟,煎至八分,温服。
加味地黄汤:治疗肠痈溃破后,脓液淋漓不尽,或精神萎靡,饮食无味,自汗、盗汗等症状。
处方组成:熟地黄、山药、山茱萸、白茯苓、牡丹皮、人参(等量),黄芪(用量加倍)。
煎服法:用煨姜三片,大胶枣二个,水两钟,煎至一钟,空腹服用。
梅豆汤:治疗肠痈经泻下治疗后,脓液仍多的情况。
处方组成:薏苡仁(二合)、黑豆(一百粒)、乌梅(一个)。
煎服法:用水煎熟取汤一大钟,加入阿胶一钱、生蒲黄一钱,再煎煮后服用。
天丁散:治疗肠痈及内痈,体内已有脓液的情况。
处方组成:皂角刺(一两)。
煎服法:用酒和水煎服,则脓液可下行排出。
大肠痈发作时,必然先在天枢穴处隐痛不止。(该穴位在肚脐旁开二寸)右侧疼痛剧烈,脉象表现为右寸部洪大而数。治疗方法与内痈及小肠痈相同。
胃痈发作时,必然先在中脘穴处隐痛不止。(该穴位在肚脐上四寸)导致人咳嗽并吐出脓血,出现如疟疾般的寒热症状。这是由于寒气阻隔阳气,热气聚集于胃口所致。因寒气逆乱于胃,所以胃脉沉细;因阳气不能上升,所以人迎脉紧盛。
若脉象迟、芤、涩,说明有瘀血,用牡丹皮汤攻下;若脉象洪数,说明脓已成,用赤豆薏苡仁汤排脓。
对于平时饮食肥甘厚味之人,初起发病时,宜用清胃射干汤。若出现身体疲倦、气喘、口渴、小便频数等症状,属于肺气虚,用补中益气汤,加山茱萸、山药、五味子、麦门冬。或者兼用加减八味丸。夏季则以生脉散代茶饮用。此病的治疗以壮气助胃为主,辅以上述药物,不可专门攻伐毒邪。
Mudan Pi Decoction: Treats cold-type intestinal abscess. Symptoms include a soft abdomen with pain that ceases upon heavy pressure, and frequent discharge of pus.
Ingredients: Cortex Moutan (Danpi), Semen Persicae (Taoren) prepared as paste, Coicis Semen (Yiyiren), Radix Angelikae Dahuricae (Baizhi), Radix Ginseng (Renshen), Radix Astragali (Huangqi), Poria (Fuling), Radix Angelicae Sinensis (Danggui), Radix Chuanxiong (Chuanxiong), Radix Paeoniae Alba (Baishao) (each 1 qian), Cinnamomi Ramulus (Guangui), Radix Glycyrrhizae (Gancao) (each 0.5 qian), Fructus Tsaoko (Muxiang) (0.3 qian).
Preparation and Administration: Decoct with two zhong of water until reduced to eight fen. Take warm.
Jiawei Dihuang Tang: Treats post-ulceration of intestinal abscess, characterized by continuous dripping of pus, or symptoms such as diminished spirit, loss of taste in food, spontaneous sweating, and night sweats.
Ingredients: Rehmanniae Radix Preparata (Shudi), Dioscoreae Rhizoma (Shanyao), Corni Fructus (Shanzhuyu), Poria (Baifuling), Cortex Moutan (Danpi), Radix Ginseng (Renshen) (equal parts), Radix Astragali (Huangqi) (double the amount).
Preparation and Administration: Use three slices of roasted ginger and two large jujubes. Decoct with two zhong of water until reduced to one zhong. Take on an empty stomach.
Meidou Tang: Treats intestinal abscess after purgation, where pus volume remains high.
Ingredients: Coicis Semen (Yiyiren) (2 he), Sojae Semen Nigrum (Heidou) (100 grains), Vitis Conyfoliae Fructus (Wumei) (one fruit).
Preparation and Administration: Decoct with water until cooked, obtain a large zhong of decoction. Add one qian of Ecliptae Herba (Ejiao - note: typically Ejiao is Colla Corii Asini, here interpreted as阿胶 which is Colla Corii Asini/Donkey-hide Gelatin) and one qian of Sparganii Pulvis (Puhuang). Re-decoct and take.
Tianding San: Treats intestinal abscess and internal abscess where pus has already formed.
Ingredients: Gleditsiae Sinensis Spina (Zaocia Spina/Saojiaoci) (1 liang).
Preparation and Administration: Decoct with wine and water; this facilitates the downward discharge of pus.
Yiyiren Tang (see previous section on Internal Abscess), Shiquan Dabu Tang.
Onset of Large Intestine Abscess: There must be persistent dull pain at the Tianshu acupoint first. (The acupoint is located 2 cun lateral to the umbilicus). Pain is severe on the right side. The pulse presents as flooding and rapid at the Right Cun position. The treatment method is the same as for internal abscesses and Small Intestine Abscess.
Onset of Stomach Abscess: There must be persistent dull pain at the Zhongwan acupoint first. (The acupoint is located 4 cun above the umbilicus). This causes coughing up of pus and blood, and chills and fever resembling malaria. This is caused by cold qi blocking yang qi, leading to heat accumulation in the stomach region. Because cold qi rebels in the stomach, the stomach pulse is deep and fine. Because yang qi cannot ascend, the Renying pulse is tight and full.
If the pulse is slow, knotted, thready, and choppy, it indicates blood stasis; treat with Mudan Pi Decoction to purge. If the pulse is flooding and rapid, it indicates pus formation; treat with Chidou Yiyiren Tang to drain pus.
For individuals accustomed to rich and sweet foods, if treated at the initial stage, Qingwei Shegan Tang is appropriate. If symptoms include fatigue, asthma/dyspnea, thirst, and frequent urination, this indicates Lung Qi deficiency; treat with Buzhong Yiqi Tang, adding Corni Fructus (Shanzhuyu), Dioscoreae Rhizoma (Shanyao), Schisandrae Fructus (Wuweizi), and Ophiopogonis Radix (Maidong). Alternatively, use Jiawei Bawei Wan. In summer, Shengmai San can be used as tea substitute. The main principle for treating this condition is to strengthen qi and assist the stomach, supplemented by the aforementioned herbs. Do not solely focus on attacking the toxin.