涌泉疽生尻骨前，形如伏鼠肿痛坚，督脉湿热溃破险，少壮易愈老弱难。
【注】此证生尻骨之前长强穴，属督脉经首穴，由湿热凝结而成。初肿坚硬疼痛，状
如伏鼠，十日可刺。得白脓者顺，溃迟青脓者险，紫黑水者逆。内治法同鹳口疽，外治
溃后，按痈疽溃疡门。少壮者得此易愈，老年气衰弱者，多成冷漏难痊。
\r涌泉疽图\p04-34a178.bmp\r
脏毒毒注在肛门，内外虚实各有因，醇酒浓味兼辛苦，外属阳分内属阴。
【注】此证有内外、阴阳之别。发于外者，由醇酒浓味，勤劳辛苦，蕴注于肛门，两旁
肿突，形如桃李，大便秘结，小水短赤，甚者肛门重坠紧闭，下气不通，刺痛如锥，脉
数有力，多实多热，属阳易治，宜服一煎散，能利二便，菩提露搽之；肿痛仍前，不全退
者，脓将成也，宜服托里透脓汤；脓胀痛针之；脓出之后，治同溃疡门。发于内者，兼
阴虚湿热，下注肛门，内结壅肿，刺痛如锥，大便虚闭，小水淋漓，寒热往来，遇夜尤甚，
脉数微细，为虚为湿，属阴难治，宜服五灰散，脓毒自然溃出；脓生迟者，服十全大补
汤托之，溃后按溃疡门。
\r脏毒图\p04-34a179.bmp\r
一煎散
当归尾 穿山甲（炙，研） 甘草（生） 桃仁泥 皂角刺（各二钱） 川黄连（一钱五分） 枳壳（麸炒）
槟榔 天花粉 乌药 赤芍 生地 白芷（各一钱） 元明粉 大黄（各三钱） 红花（五分）
水二盅，浸一宿，次早煎一滚，空心服，俟行三四次，以稀粥补之。
【方歌】一煎散消脏毒方，归甲甘连桃枳榔，天花皂刺红乌药，芍地元明芷大黄。
菩提露
熊胆（三分） 冰片（一分）
凉水十茶匙，调化开，搽于患处甚效。
【方歌】菩提露消积热痛，脏毒坚疼 肿增，水调熊胆加冰片，搽于患处毒渐轻。
五灰散
血管鹅毛 血余 蜈蚣 穿山甲 生鹿角（各烧存性）
各等分研细，共合匀。每服五钱，空心温黄酒调下。
【方歌】五灰散用鹅管毛，血余蜈甲鹿角烧，脏毒肿痛肛门内，每服五钱黄酒调。
托里透脓汤（见头部侵脑疽）
十全大补汤（见溃疡门）
涌泉疽生于尾骨前方，形状像趴着的鼠类，肿胀疼痛且质地坚硬。此病由督脉湿热蕴结所致，一旦溃破则病情危重；年轻力壮者容易痊愈，年老体弱者难以治愈。
【注】此证发生在尾骨前方的长强穴，属于督脉的首个穴位，是由湿热凝结而成的。初期肿块坚硬疼痛，形状像趴着的鼠类，十天左右可以针刺排脓。若流出白色脓液为顺证，若溃烂迟缓且流出青色脓液则为险证，若流出紫黑色水样物则为逆证。内治方法与鹳口疽相同，外治在溃破后，参照痈疽溃疡门的方法。年轻力壮的人得此病容易痊愈，老年人气血衰弱者，多形成冷性漏管，难以痊愈。
脏毒之毒积聚在肛门部位，有内发和外发的区别，虚实病因各不相同。多因饮用醇酒、食用浓味食物以及过度劳累辛苦所致，外发属阳分，内发属阴分。
【注】此证有内发和外发、属阴和属阳的区别。发于外部的，是由于醇酒厚味、勤劳辛苦，导致湿热蕴结注于肛门，两旁肿胀突起，形状像桃李，大便秘结，小便短赤，严重的肛门沉重坠胀紧闭，排气不通，刺痛如锥扎，脉搏数而有力，多为实证热证，属阳分，容易治疗，适宜服用一煎散，能通利大小便，用菩提露涂抹患处；如果肿痛依旧，没有完全消退，说明脓将要形成，适宜服用托里透脓汤；脓成胀痛时进行针刺；脓出之后，治疗方法同溃疡门。发于内部的，兼有阴虚湿热，下注于肛门，内部结聚壅肿，刺痛如锥扎，大便虚闭，小便淋漓不尽，寒热往来，夜间尤其严重，脉搏数而微细，属虚属湿，为阴分，难以治疗，适宜服用五灰散，脓毒自然溃破排出；若生脓迟缓，服用十全大补汤以托毒外出，溃破后参照溃疡门治疗。
一煎散
当归尾 穿山甲（炙，研末） 甘草（生用） 桃仁泥 皂角刺（各二钱） 川黄连（一钱五分） 枳壳（麸炒） 槟榔 天花粉 乌药 赤芍 生地 白芷（各一钱） 元明粉 大黄（各三钱） 红花（五分）
用水两盅，浸泡一夜，次日早晨煎煮至沸腾，空腹服用，待排便三四次后，用稀粥调养。
【方歌】一煎散消脏毒方，归甲甘连桃枳榔，天花皂刺红乌药，芍地元明芷大黄。
菩提露
熊胆（三分） 冰片（一分）
凉水十茶匙，调化开，涂抹于患处非常有效。
【方歌】菩提露消积热痛，脏毒坚疼 肿增，水调熊胆加冰片，搽于患处毒渐轻。
五灰散
血管鹅毛 血余 蜈蚣 穿山甲 生鹿角（各烧存性）
各等分研细，混合均匀。每次服用五钱，空腹用温黄酒送服。
Yongquan Ju (Abscess at Yongquan) arises anterior to the coccyx, resembling a crouching rat with swelling, pain, and hardness. It is caused by damp-heat in the Du Meridian (Governing Vessel); once ulcerated, it is dangerous. It heals easily in the young and vigorous but is difficult to cure in the old and weak.
[Note] This condition occurs at the Changqiang (GV1) acupoint anterior to the coccyx, which is the first acupoint of the Du Meridian (Governing Vessel), formed by the coagulation of damp-heat. Initially, the swelling is hard and painful, resembling a crouching rat; it can be punctured after ten days. The discharge of white pus indicates a favorable prognosis (Shun), while delayed ulceration with green pus indicates a critical condition (Xian), and the discharge of purple-black fluid indicates an adverse prognosis (Ni). Internal treatment is the same as for Guankou Ju (Abscess at Guankou). For external treatment after ulceration, refer to the Ulcerative Sores section. The young and vigorous heal easily, whereas the elderly with deficient Qi and blood often develop cold fistulas that are difficult to cure.
Zangdu (Visceral Toxin) involves toxin accumulation in the anus, with internal and external manifestations having different causes. It results from consuming rich wine and heavy flavors, combined with overwork and hardship. External manifestation belongs to the Yang aspect, while internal manifestation belongs to the Yin aspect.
[Note] This condition has distinctions between internal/external and Yin/Yang. When manifesting externally, it is due to rich wine and heavy flavors, along with labor and hardship, causing damp-heat to accumulate and pour into the anus. Swelling protrudes on both sides, resembling plums or peaches. There is constipation and short, red urine. In severe cases, the anus feels heavy and drops, closes tightly, gas cannot pass, and there is stabbing pain like a needle. The pulse is rapid and forceful, indicating excess and heat (Yang), which is easy to treat. One should take Yi Jian San (One-Boil Powder) to promote urination and defecation, and apply Puti Lu (Bodhi Dew) topically. If swelling and pain persist without complete resolution, pus is forming; one should take Tuoli Tou Nong Tang (Support Interior and Perforate Pus Decoction). Once pus forms and causes distending pain, it should be lanced. After pus discharge, treatment follows the Ulcerative Sores section. When manifesting internally, it involves Yin deficiency with damp-heat pouring down into the anus, causing internal congestion and swelling, stabbing pain like a needle, false constipation, dribbling urine, alternating chills and fever (especially worse at night), and a rapid, fine pulse. This indicates deficiency and dampness (Yin), which is difficult to treat. One should take Wu Hui San (Five Ashes Powder) to allow pus and toxin to naturally discharge. If pus formation is slow, take Shiquan Dabu Tang (Ten Complete Tonifying Decoction) to support the interior and expel pus. After ulceration, follow the Ulcerative Sores section.
Yi Jian San (One-Boil Powder)
Dangguiwei (Tail of Angelica Sinensis Root), Chanshijia (Pangolin Scales, roasted and powdered), Gancao (Licorice Root, raw), Taoren (Peach Kernel, mashed), Zaojiaoci (Gleditsia Sinensis Thorn) [2 qian each]; Chuanhuanglian (Coptis Rhizome) [1.5 qian]; Zhike (Aurantium Fructus, bran-fried), Binglang (Areca Seed), Tianhuafen (Trichosanthes Root), Wuyao (Lindera Root), Chishao (Red Peony Root), Shengdi (Rehmannia Root), Baizhi (Angelica Dahurica Root) [1 qian each]; Yuanmingfen (Mirabilite), Dahuang (Rhubarb Root) [3 qian each]; Honghua (Safflower) [0.5 fen].
Soak in two sheng of water overnight. Boil thoroughly the next morning. Take on an empty stomach. Wait for three to four bowel movements, then nourish with thin rice gruel.
[Fangge - Prescription Song] Yi Jian San eliminates visceral toxin: Danggui, Jia, Gan, Lian, Tao, Zhike, Binglang. Tianhua, Zaoji, Hong, Wuyao, Shaoyao, Di, Yuanming, Baizhi, Dahuang.
Puti Lu (Bodhi Dew)
Xiongdan (Bear Bile) [3 fen], Bingpian (Borneol) [1 fen].
Mix with ten teaspoons of cool water until dissolved. Apply to the affected area; very effective.
[Fangge - Prescription Song] Puti Lu clears accumulated heat and pain; for hard pain and swelling of visceral toxin. Mix Xiongdan and Bingpian with water, apply to the site, and the toxin gradually lightens.
Wu Hui San (Five Ashes Powder)
Xueguan Emao (Blood-vessel Goose Feather), Xueyu (Scorched Hair), Wugong (Centipede), Chanshijia (Pangolin Scales), Shenglujiao (Fresh Deer Antler) [all burned to retain their properties].
Grind equal parts into fine powder and mix well. Take 5 qian per dose, mixed with warm yellow wine on an empty stomach.
[Fangge - Prescription Song] Wu Hui San uses goose feather quills, scorched hair, centipedes, scales, and deer antlers. For internal anal swelling and pain of visceral toxin, take 5 qian mixed with yellow wine.
Tuoli Tou Nong Tang (Support Interior and Perforate Pus Decoction) (See Head Section: Qinaojv Abscess)
Shiquan Dabu Tang (Ten Complete Tonifying Decoction) (See Ulcerative Sores Section)