柴胡清肝汤 加味逍遥散（见瘰 门） 补中益气汤 八味汤 六君子汤 托里消毒散 贵金丸 灸法（俱见首卷）
鹳口疽 生于尻尾高骨尖处。一名锐疽。灵枢云。发于尻。初如鱼肫。久若鹳嘴。由督脉经湿痰流结所
致。朝寒暮热。夜重日轻。溃出稀脓。或流鲜血。少壮尤可。老弱难医。
滋阴除湿汤 初起者宜此和之。
川芎 当归 白芍 熟地（各一钱） 柴胡 黄芩 陈皮 知母 贝母（各八分） 泽泻 地骨皮
甘草（各五分）
水二钟。姜三片。煎八分。食前服。
和气养荣汤 已成不得内消者。宜此托之。
人参 陈皮 白术 黄 茯苓 丹皮 当归 熟地（各一钱） 沉香 甘草（各五分）
水二钟。煎八分。食前服。
滋肾保元汤 气血虚弱。溃而不敛者。宜此补之。
人参 黄 白术 茯苓 归身 杜仲 山萸肉 丹皮 熟地（各一钱） 肉桂 大附子 甘草（各五分）
水二钟。姜三片。枣二枚。莲肉七个。食前煎服。
上症失治。久而成漏者。宜服先天大造丸。（见流注门）兼服琥珀蜡矾丸。（见肿疡门）久之自能收敛。
坐马痈 生于尻尾略上些。初起。灸膝下外 横骨尽处。治同鹳口疽。
臀痈 生于臀之中。居小腹之后。为阴中之阴。其道远。其位僻。虽属足太阳膀胱经多血。奈气运不到。
血亦罕来。最难收敛。由湿痰凝结而成。
初起有头。红热重坠。发热口干者。用贵金丸利之。绀珠膏贴之。初起无头漫肿。皮色不变者。用绀珠
丹托之。隔蒜灸之。如大势已退。余肿未消者。频煮热葱熨之。除湿二陈汤调之。已成欲作脓者。托里
羌活汤。痛甚者神授卫生散。大势已退。托里消毒散。不消及不溃不敛者。脾虚也。六君子汤加
川芎、当归、黄 。脾虚下注者。只白术一味。煎饮自消。毋以能溃脓为惑。不消作渴便淋者。阴虚
也。六味地黄丸加五味子。溃而不敛者。用生姜煎汤洗之。久者以豆豉饼灸之。
此症。自里至表者十有八九。从六淫外感入里者百中一二。故治宜外发。庶免内攻。其有软陷无脓。
根脚平散而不痛者。甚则口干。烦躁谵语。痰喘气粗者。由误服寒凉。失于滋补所致也。不治。书云。若
无补养之功。其祸多在结痂之后。是知疡科以培补元气为首务也。
有因患痔。敷服寒凉。致令攻溃于臀者。其脉大而数。症则寒热作渴。疮则脓水清稀。些三阴经亏损
之症也不治。
柴胡清肝汤、加味逍遥散（见瘰疬门）、补中益气汤、八味汤、六君子汤、托里消毒散、贵金丸、灸法（均见于首卷）。
鹳口疽，生于尻尾高骨尖处。又名锐疽。《灵枢》记载：发于尻部，初起时像鱼肚，日久则形如鹳嘴。此病由督脉经湿痰流注结聚所致。症状表现为早晨怕冷傍晚发热，夜间加重白天减轻。溃破后流出稀薄脓液，或流出鲜血。青壮年患者尚可治疗，年老体弱者难以医治。
对于初起阶段的患者，适宜使用滋阴除湿汤调和。
药材组成：川芎、当归、白芍、熟地黄（各一钱），柴胡、黄芩、陈皮、知母、贝母（各八分），泽泻、地骨皮、甘草（各五分）。
煎服法：用水二钟，生姜三片，煎至八分，饭前服用。
和气养荣汤，适用于疮疡已成但无法内消的情况，适宜用此方托毒外出。
药材组成：人参、陈皮、白术、黄芪、茯苓、牡丹皮、当归、熟地黄（各一钱），沉香、甘草（各五分）。
煎服法：用水二钟，煎至八分，饭前服用。
滋肾保元汤，适用于气血虚弱，疮口溃破后不能愈合的情况，适宜用此方补益。
药材组成：人参、黄芪、白术、茯苓、当归身、杜仲、山茱萸肉、牡丹皮、熟地黄（各一钱），肉桂、大附子、甘草（各五分）。
煎服法：用水二钟，生姜三片，大枣二枚，莲子肉七个，饭前煎服。
上述病症若失治，日久形成漏管者，适宜服用先天大造丸（见流注门），兼服琥珀蜡矾丸（见肿疡门）。日久自然能够收敛。
坐马痈，生于尻尾略上方一些。初起时，灸膝下外侧横骨尽处。治疗方法同鹳口疽。
臀痈，生于臀部中间，位于小腹之后，属于阴中之阴。其病位深远，位置偏僻，虽然属于足太阳膀胱经多血之经，奈何气运不到，血液也罕至，最难收敛。此病由湿痰凝结而成。
初起有头，红肿热痛且沉重坠胀，伴有发热口干者，用贵金丸通利，外贴绀珠膏。初起无头漫肿，皮色不变者，用绀珠丹托毒，隔蒜灸之。如果大势已退，余肿未消者，频繁煮热葱熨烫患处，并用除湿二陈汤调服。疮疡已成欲作脓者，用托里羌活汤；疼痛剧烈者，用神授卫生散。大势已退后，用托里消毒散。若不消散及不溃破不愈合者，属脾虚，用六君子汤加川芎、当归、黄芪。脾虚下注者，单用白术一味，煎水饮用自能消散，不要以能否溃脓为困惑。若不消散且口渴小便淋涩者，属阴虚，用六味地黄丸加五味子。溃破后不愈合者，用生姜煎汤清洗患处；病程久者，用豆豉饼灸之。
此症，由里出表的占十之八九，从六淫外感入里的仅占百中一二。因此治疗宜向外发散，以免邪气内攻。若有软陷无脓，根脚平散且不痛者，甚至出现口干、烦躁谵语、痰喘气粗者，这是由于误服寒凉药物，失去滋补所致。这种情况难以治愈。书中说：如果没有补养的功夫，祸患多在结痂之后。由此可知，外科以培补元气为首要任务。
有因患痔疮，敷服寒凉药物，导致攻溃于臀部者。其脉象大而数，症状表现为寒热交替、口渴，疮口脓水清稀。这是三阴经亏损的病症，难以治愈。
Chaihu Qinggan Tang (Bupleurum Decoction to Clear the Liver), Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) (see Scrofula Section), Buzhong Yiqi Tang (Decoction to Tonify the Middle and Augment the Qi), Bawei Tang (Eight-Ingredient Decoction), Liujunzi Tang (Six-Gentleman Decoction), Tuoli Xiaodu San (Decoction to Support the Interior and Eliminate Toxins), Guijin Wan (Precious Metal Pill), Moxibustion methods (all see Volume 1).
Guankou Ju (Stork-Mouth Carbuncle) arises at the apex of the high bone of the sacrococcygeal region. It is also known as Rui Ju (Sharp Carbuncle). The *Ling Shu* states: arising in the sacral region, initially resembling a fish's ventriculus, and over time taking the shape of a stork's beak. This condition is caused by the accumulation and binding of damp-phlegm flowing through the Du Meridian (Governing Vessel). Symptoms include morning chills and evening fevers, worsening at night and improving during the day. Upon ulceration, thin pus or fresh blood may flow. It is treatable in young and strong individuals but difficult to cure in the elderly and weak.
For early-stage cases, Ziyin Chushi Tang (Nourish Yin and Dampness-Draining Decoction) is suitable for harmonization.
Ingredients: Chuanxiong Rhizome (Chuanxiong Radix), Danggui Radix (Angelicae Sinensis Radix), Baishao Radix (Paeoniae Radix Alba), Shudihuang (Prepared Rehmanniae Radix) (each 1 qian); Chaihu Radix (Bupleuri Radix), Huangqin Cortex (Scutellariae Radix), Chenpi (Citri Reticulatae Pericarpium), Zhimu Rhizoma (Anemarrhenae Rhizoma), Beimu Bulbus (Fritillariae Thunbergii Bulbus) (each 8 fen); Zexia Herba (Alismatis Rhizoma), Digupi Cortex (Lycii Cortex), Gancao Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma) (each 5 fen).
Preparation: Use two zhong of water and three slices of ginger. Decoct until eight fen remains. Take before meals.
Heqi Yangrong Tang (Harmonize Qi and Nourish Ying Decoction) is indicated when the abscess has formed but cannot resolve internally; it is suitable for supporting the interior to expel toxins.
Ingredients: Renshen Radix (Ginseng Radix), Chenpi (Citri Reticulatae Pericarpium), Baizhu Rhizoma (Atractylodis Macrocephalae Rhizoma), Huangqi Radix (Astragali Radix), Poria (Poria Cocos), Mudanpi Cortex (Moutan Cortex), Danggui Radix (Angelicae Sinensis Radix), Shudihuang (Prepared Rehmanniae Radix) (each 1 qian); Chenxiang Lignum (Aquilariae Lignum Resinatum), Gancao Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma) (each 5 fen).
Preparation: Use two zhong of water. Decoct until eight fen remains. Take before meals.
Zishen Baoyuan Tang (Nourish Kidney and Protect Yuan Decoction) is indicated for deficiency of qi and blood with ulcers that fail to heal; it is suitable for tonification.
Ingredients: Renshen Radix (Ginseng Radix), Huangqi Radix (Astragali Radix), Baizhu Rhizoma (Atractylodis Macrocephalae Rhizoma), Poria (Poria Cocos), Danggui Radix (Angelicae Sinensis Radix - specifically the body), Duzhus Cortex (Eucommiae Cortex), Shanyurou Fructus (Corni Fructus), Mudanpi Cortex (Moutan Cortex), Shudihuang (Prepared Rehmanniae Radix) (each 1 qian); Rougui Cortex (Cinnamomi Cortex), Da Fuzizi (Aconiti Lateralis Radix Praeparata), Gancao Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma) (each 5 fen).
Preparation: Use two zhong of water, three slices of ginger, two dates, and seven lotus seeds. Decoct and take before meals.
If the above conditions are neglected and develop into fistulas over time, Xiantian Dazao Wan (Primordial Great Creation Pill) (see Flowing-Note Section) should be taken, along with Hupo Lafan Wan (Amber Wax Alum Pill) (see Ulcerated Swelling Section). Over time, they will naturally converge and heal.
Zuama Yong (Sitting-Horse Abscess) arises slightly above the sacrococcygeal region. At the onset, moxa should be applied to the lateral end of the transverse bone below the knee. Treatment is the same as for Guankou Ju.
Tun Yong (Gluteal Abscess) arises in the center of the buttocks, located behind the lower abdomen. It belongs to yin within yin. Its location is distant and remote. Although it belongs to the Foot-Taiyang Bladder Meridian, which is rich in blood, qi circulation rarely reaches it, and blood flow is scarce, making healing most difficult. This condition is caused by the coagulation of damp-phlegm.
In the early stage, if there is a head, with redness, heat, heavy dragging sensation, fever, and dry mouth, use Guijin Wan to promote drainage and apply Ganzhu Gao externally. If there is no head and swelling is diffuse with unchanged skin color, use Ganzhu Dan to support the interior, and apply moxibustion with garlic slices. If the major symptoms have subsided but residual swelling remains, frequently apply hot scallion compresses and regulate with Chushi Erchen Tang. When the abscess is mature and suppuration is imminent, use Tuoli Qianghuo Tang. For severe pain, use Shenshou Weisheng San. After the major symptoms subside, use Tuoli Xiaodu San. If it does not resolve, nor suppurate nor heal, it indicates Spleen deficiency; use Liujunzi Tang plus Chuanxiong Rhizome (Chuanxiong Radix), Danggui Radix (Angelicae Sinensis Radix), and Huangqi Radix (Astragali Radix). If due to Spleen deficiency with downward pouring, simply decoct Baizhu Rhizoma (Atractylodis Macrocephalae Rhizoma) alone and drink it to resolve spontaneously; do not be confused by whether pus can be expelled. If it does not resolve, accompanied by thirst and dysuria, it indicates Yin deficiency; use Liuwei Dihuang Wan plus Wuweizi Fructus. For ulcers that fail to heal, wash with ginger decoction; for chronic cases, apply moxibustion with fermented soybean cakes.
This condition emerges from the interior to the exterior in eight or nine out of ten cases, while entering from the exterior via the six excess pathogens occurs only one or two times in a hundred. Therefore, treatment should focus on dispersing outward to prevent internal attack. Cases presenting with soft depression without pus, flat and scattered roots without pain, or even dry mouth, irritability, delirium, phlegm-wheezing, and coarse breathing, are caused by the mistaken use of cold-cooling herbs and lack of tonification. These are incurable. The text states: "Without the merit of nourishment and tonification, disaster often follows after scabbing." Thus, it is known that in surgery, cultivating and supplementing Yuan Qi (Original Qi) is the primary task.
There are cases where hemorrhoids were treated with cold-cooling applications and ingestions, leading to ulceration in the gluteal region. The pulse is large and rapid; symptoms include alternating chills and fever, thirst; the wound discharges clear and thin pus. These are signs of deficiency in the Three Yin Meridians and are incurable.