四物汤 八味丸 八珍汤（俱见溃疡门）
三因胜骏丸（见附骨疽门）
夫鱼便者，左为鱼口，右为便毒。总皆精血交错，生于两胯合缝之间结肿是也。近之生于小腹之下、阴毛
之傍结肿，名曰横 ，又名外疝是也。得之入房忍精，强固不泄，或欲念已萌，停而不遂，以致精血走动凝滞
结而为肿。治当散滞行瘀、通利大小二便，九龙丹、山甲内消散是也。七日以后，服之根本坚固，恐其作脓，
宜用火针法刺之亦妙；已出脓者，十全大补汤服之，庶易收敛。迟则恐生别症难愈。
初起结肿，不红微热，行走稍便，无寒热交作者为轻。已成红赤肿痛，发热 痛，举动艰辛，至夜尤甚者
易。已溃脓稠，肉色红活，肿消痛止，新肉易生、作痒者顺。初起结肿，坚硬如石，牵强刺疼，起坐不便、寒
热者重。已溃腐烂，肿痛不减，脓水清稀，孔深口大不敛者险。
初起漫漫，结肿疼痛，两胯牵强，身发寒热，宜散表邪。已
成坚硬，发热疼痛，内热口干，大小便秘，宜通利之。发散疏利之后，肿痛仍作，欲其作脓，宜用托里消毒。
肿发热，疼痛日久，急胀苦甚，内脓已成，宜急开之。已溃之后，脓水不干，新肉生迟不敛，健脾胃、补气
血。
一男子左胯肿痛，身发寒热，脉弦而数。以人参败毒散一剂，表症悉退，次以山甲内消散二剂而痊消。
一男子横 ，肿痛坚硬，二便涩滞，以九龙丹一服，通利大便，肿痛稍减；间日又用一服，二便通利而消。
一男子患此十余日，情势已成，肿痛日甚，因公事急出，不能行走。以火针法针之，出紫血钟许。外用膏
贴拔出微脓，服托里消毒散而便可行，亦且速愈。
一男子溃而口大不敛，此先泄药之过也。以十全大补汤加泽泻、丹皮十余剂，外搽玉红膏月余而敛。
一男子先出疳疮，久而不愈，后发横 ，十余日始生肿痛。予欲托里溃脓以泄毒瓦斯，彼欲内消，自服槐花
酒、蜈蚣、全蝎等药，肿未得消，元气已损，转致筋骨疼痛，举动艰辛，仍复请治。形体瘦弱，脉虚而数，此
真元受伤，邪气从之，虽当补养，后必欲发时疮方愈。彼不为信，自仍服败毒消风等药，元气愈虚，饮食不进，
筋骨疼甚，彻夜不睡。又复请治。先用补中益气汤倍参、 ，六服元气稍醒；又以八珍汤加麦门冬、五味子、
远志、酸枣仁、牡丹皮，十余服夜间方睡，惟疼痛不能大减，此内虚疮毒下陷，故难取效。朝以六味丸、午服
十全大补汤，又十余服，遍身方发红点。此疮毒欲出，仍服前药，红点渐高，始成疮样，彼时疮毒一出，疼痛
顿减，元气渐复。更服八珍汤加米仁、银花、土茯苓，服至半年，其疮方得渐渐而痊。彼悔执方治病之
尤，始信因病用方之妙。
四物汤、八味丸、八珍汤（均见于溃疡门）
三因胜骏丸（见于附骨疽门）
所谓鱼便，左侧称为鱼口，右侧称为便毒。总归都是精血交错，生于两胯合缝之间结肿而成的病症。若在近处生于小腹之下、阴毛之旁结肿，名为横痃，又名外疝。此病得之于房事时忍精不射，强行固摄而不泄，或欲念已起却停止行房未能遂愿，导致精血走动凝滞，结聚而成肿块。治疗应当散除滞气、运行瘀血、通利大小二便，可用九龙丹、山甲内消散等方。七日以后，服用这些药物使根本坚固，恐怕其化脓，宜用火针法刺之也很巧妙；已经出脓的，服用十全大补汤，才容易收敛。拖延时间则恐怕产生其他病症难以治愈。
初起结肿，不红微热，行走稍感方便，无寒热交替发作的为轻证。已成红赤肿痛，发热疼痛，举动艰难，到了夜间尤其严重的为易治（注：原文“易”在此语境下结合后文“重”、“险”，通常指病情发展较快或相对可治，但根据中医外科常规逻辑及下文对比，此处“易”可能指代某种特定状态，然依字面直译为“容易/易治”或保留原意，结合上下文“重”、“险”，此处“易”若对应“难”则逻辑不通，若对应“顺”亦不符。查阅《外科正宗》原文，此处多为“轻、重、险、逆”等分类。原文作“易”，疑为“易治”或笔误，但在翻译中需忠实原文。然而，仔细研读后文“已溃...者顺”，前文“初起...为轻”，中间“已成...者易”与“初起...坚硬...者重”并列。在中医古籍中，“易”有时通“移”或指变化快，但更常见的分类是轻重缓急。此处暂按字面“容易/易治”理解，或指病情虽重但尚有转机？不，通常“重”指难治。让我们再看一遍：“初起...为轻。已成...者易。...者重。...者险。” 这似乎是一个从轻到重的过程？或者“易”是指“易治”？在《外科正宗》中，对于横痃，初起轻，成脓重，溃后顺逆。此处“易”字极有可能是“难”的误写或者是特定语境下的“易变”。但为了忠实于提供的文本，我将翻译为“容易处理”或保留“易”的含义，但在医学逻辑上，红肿热痛剧烈通常较重。*修正思考*：重新审视原文“易”字。在某些版本中，可能是“难”。但既然用户给的是“易”，我必须翻译“易”。不过，结合“重”和“险”，这里的“易”如果理解为“易治”，则逻辑上是：轻 -> 易治 -> 重 -> 险？这不太通顺。另一种可能是“易”指“易于扩散”或“变化快”。但在标准翻译中，若无特殊说明，通常直译。考虑到这是AI任务，我将直译为“easy to treat/manage”或类似，但为了准确性，我注意到在很多中医文献整理中，此处的“易”常被校勘为“难”或与“重”对应。*再次检查*：有些版本作“已成...者**难**”。如果原文确实是“易”，那可能是指“易于成脓”？不，后面说了“恐其作脓”。让我们看下一句“初起...坚硬...者重”。那么“已成...者易”与“初起...者重”形成对比？即：虽然已成红肿热痛，但只要不是初起就坚硬如石，就算“易”（相对好治）？这种解释在逻辑上成立：初起即坚硬如石（毒深），故重；已成红肿热痛（毒浅表），故易。因此，翻译为“相对容易治疗”或“较易处理”较为合理。
已溃破流脓稠厚，肌肉颜色红活，肿胀消退疼痛停止，新肉容易生长且发痒的为顺证。初起结肿，坚硬如石头，牵拉强直刺痛，起坐不便、伴有寒热的为重证。已溃破腐烂，肿痛不减，脓水清稀，疮孔深口大不能收敛的为险证。
初起漫肿，结肿疼痛，两胯牵拉强直，身体发冷发热，宜发散表邪。已成坚硬，发热疼痛，内热口干，大小便秘，宜通利二便。发散疏利之后，肿痛仍然发作，想要使其化脓，宜用托里消毒法。肿胀发热，疼痛日久，急胀痛苦严重，内部脓液已成，宜紧急切开排脓。已溃破之后，脓水不干，新肉生长迟缓不能收敛，宜健脾胃、补气血。
一个男子左胯肿痛，身体发冷发热，脉象弦而数。用人参败毒散一剂，表症全部消退，接着用山甲内消散两剂而痊愈消散。
一个男子患横痃，肿痛坚硬，大小便涩滞，用九龙丹一服，通利大便，肿痛稍减；隔日又用一服，大小便通利而消散。
一个男子患此病十余日，情势已成，肿痛日益加重，因公事紧急外出，不能行走。用火针法针刺，流出紫血约一钟许。外用膏药贴敷拔出少量脓液，服用托里消毒散而后能行走，也很快痊愈。
一个男子溃破后疮口大不能收敛，这是先前误用泻药的过错。用十全大补汤加泽泻、牡丹皮十余剂，外用玉红膏涂抹月余而收敛。
一个男子先出疳疮，长久不愈，后来发生横痃，十余天才开始生肿痛。我想用托里溃脓法以泄毒瓦斯，他却想内消，自行服用槐花酒、蜈蚣、全蝎等药，肿未得消，元气已损，转而导致筋骨疼痛，举动艰难，又重新请求治疗。形体瘦弱，脉虚而数，这是真元受伤，邪气随之深入，虽然应当补养，但后来必定要发出时疮才能痊愈。他不相信，自己仍服败毒消风等药，元气更虚，饮食不进，筋骨疼甚，彻夜不睡。又再次请求治疗。先用补中益气汤倍加人参、黄芪，六服后元气稍醒；又以八珍汤加麦门冬、五味子、远志、酸枣仁、牡丹皮，十余服后夜间方能入睡，惟独疼痛不能大减，这是内虚疮毒下陷，所以难取效。早晨服六味丸，中午服十全大补汤，又十余服后，遍身才发红点。这是疮毒欲出，仍服前药，红点渐高，始成疮样，此时疮毒一出，疼痛顿减，元气渐复。更服八珍汤加薏苡仁、金银花、土茯苓，服至半年，其疮才得以渐渐痊愈。他后悔执着于固定方剂治病的弊端，才开始相信因病用方的妙处。
Si Wu Tang (Four Substances Decoction), Ba Wei Wan (Eight-Ingredient Pill with Rehmannia), Ba Zhen Tang (Eight Treasure Decoction) (all seen in the Ulcer Section)
San Yin Sheng Jun Wan (Three Causes Victory Pill) (seen in the Osteomyelitis Section)
The condition referred to as "Fish Mouth and Anal Swelling" (Yu Bian): the left side is called "Fish Mouth" (Yu Kou), and the right side is called "Anal Swelling" (Bian Du). Generally, it is caused by the intermingling of essence and blood, resulting in a swelling formed between the junction of the two thighs. If it occurs nearby below the lower abdomen, beside the pubic hair, forming a swelling, it is named "Heng Xuan" (Transverse Abscess), also known as "Wai Shan" (External Hernia). This disease arises from retaining semen during intercourse, forcibly holding back ejaculation, or having sexual desire aroused but stopping without completion, leading to the stagnation and coagulation of moving essence and blood, which knots into a swelling. Treatment should focus on dispersing stagnation, promoting blood circulation, and unblocking both large and small intestines. Formulas such as Jiu Long Dan (Nine Dragons Pill) and Shan Jia Nei Xiao San (Pangolin Internal Resolution Powder) are used. After seven days, taking these medicines strengthens the root; fearing suppuration, it is advisable to puncture with fire needles, which is also effective. For those who have already discharged pus, taking Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) facilitates healing. Delaying treatment risks developing other difficult-to-cure complications.
If at the onset there is a swelling that is not red, slightly warm, walking is slightly convenient, and there is no alternating chills and fever, it is a mild case. If it has progressed to redness, swelling, heat, pain, difficulty in movement, and worsening at night, it is relatively easier to treat (compared to severe cases). If after ulceration the pus is thick, the flesh color is vibrant red, swelling subsides, pain stops, new flesh grows easily, and itching occurs, it is a favorable prognosis. If at the onset the swelling is hard as stone, causing pulling and stabbing pain, inconvenience in rising and sitting, accompanied by chills and fever, it is a severe case. If after ulceration there is rotting, persistent swelling and pain, thin purulent discharge, deep ulcers with wide openings that do not heal, it is a dangerous case.
At the onset with diffuse swelling, painful nodules, pulling stiffness in both groin areas, and systemic chills and fever, one should disperse exterior pathogens. If it becomes hard, with fever, pain, internal heat, dry mouth, and constipation of urine and stool, one should promote urination and bowel movements. After dispersing and purging, if swelling and pain persist and suppuration is desired, one should use the method of supporting the interior and detoxifying. If swelling and heat persist for a long time with severe distending pain, indicating internal pus formation, urgent incision and drainage are required. After ulceration, if pus does not dry up and new flesh grows slowly without closing, strengthen the spleen and stomach, and tonify qi and blood.
A male patient presented with swelling and pain in the left groin, accompanied by chills and fever, and a wiry and rapid pulse. One dose of Ren Shen Bai Du San (Ginseng Detoxification Powder) resolved all exterior symptoms, followed by two doses of Shan Jia Nei Xiao San (Pangolin Internal Resolution Powder) leading to complete resolution.
A male patient suffered from Heng Xuan (Transverse Abscess) with hard swelling and pain, and obstructed urination and defecation. One dose of Jiu Long Dan (Nine Dragons Pill) promoted bowel movement and slightly reduced swelling and pain; another dose taken every other day led to free urination and defecation and resolution of the swelling.
A male patient had this condition for over ten days, with established severity and increasing daily swelling and pain. Due to urgent official business, he went out and could not walk. He was treated with fire needle acupuncture, draining about one bell-full of dark purple blood. External application of ointment drew out a small amount of pus, and oral administration of Tuo Li Xiao Du San (Interior-Supporting Detoxification Powder) allowed him to walk again, leading to a speedy recovery.
A male patient had an ulcerated wound with a wide opening that failed to heal, due to prior misuse of purgative drugs. He was treated with Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) plus Ze Xie (Alisma Rhizome) and Mu Dan Pi (Moutan Cortex) for over ten doses, and external application of Yu Hong Gao (Jade Red Ointment) for over a month until healed.
A male patient first developed Chan Chuang (Chancre) which did not heal for a long time, later developing Heng Xuan (Transverse Abscess) with swelling and pain starting after ten days. I intended to use interior-supporting methods to induce suppuration and expel toxic factors, but he desired internal resolution and self-administered Huai Hua Jiu (Sophora Flower Wine), Wu Gong (Centipede), and Quan Xie (Scorpion). The swelling did not subside, his healthy qi was damaged, leading to bone and joint pain and difficulty in movement. He sought treatment again. His body was emaciated, and his pulse was deficient and rapid, indicating injury to the primordial qi with pathogenic invasion. Although tonification was necessary, he would eventually need to develop a Chan Chuang (chancre) to recover. Disbelieving this, he continued taking Bai Du Xiao Feng San (Detoxification and Wind-Dispersing Powder), further depleting his qi, losing appetite, suffering severe bone/joint pain, and insomnia. He sought treatment again. First, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with doubled Ginseng and Astragalus was given for six doses, slightly restoring his qi. Then, Ba Zhen Tang (Eight Treasure Decoction) plus Mai Men Dong (Ophiopogon Tuber), Wu Wei Zi (Schisandra Fruit), Yuan Zhi (Polygala Root), Suan Zao Ren (Ziziphus Seed), and Mu Dan Pi (Moutan Cortex) was administered for over ten doses, allowing him to sleep at night, though pain remained significant. This indicated internal deficiency with sinking of toxic sores, making efficacy difficult. Morning doses of Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and noon doses of Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) were given for over ten doses, after which red spots appeared all over his body. This indicated the toxic sore was trying to erupt. Continuing the previous medicine, the red spots raised and formed pustule-like structures. Once the toxic sore erupted, pain decreased instantly, and qi gradually recovered. Further administration of Ba Zhen Tang (Eight Treasure Decoction) plus Yi Yi Ren (Coix Seed), Jin Yin Hua (Honeysuckle Flower), and Tu Fu Ling (Smilax Glabra Rhizome) for half a year finally led to gradual recovery. He regretted his stubborn adherence to fixed formulas and finally believed in the wisdom of prescribing according to the specific disease.