保安万灵丹(见痈疽肿疽门)
十全大补汤(见溃疡门)
小柴胡汤(见瘰 门)
夫肠痈者,皆湿热、瘀血流入小肠而成也。又由来有三∶一、男子暴急奔走,以致肠胃传送不能舒利,败
血浊气壅遏而成者一也;二、妇人产后,体虚多卧,未经起坐,又或坐草艰难,用力太过,育后失逐败瘀,以
致败血停积,肠胃结滞而成者二也;三、饥饱劳伤,担负重物,致伤肠胃,又或醉饱、房劳过伤精
力,或生冷并进以致气血乖违,湿动痰生,多致肠胃痞塞,运化不通,气血凝滞而成者三也。总之,初起外症
发热恶寒,脉芤而数,皮毛错纵,腹急渐肿,按之急痛,大便坠重,小便涩滞若淋甚者,脐突腹胀,转侧水声,
此等并见则内痈已成也。初起未成时,小腹殷殷作痛,俨似奔豚,小便淋涩者,当大黄汤下之,瘀血去尽自安。
体虚脉细不敢下者,活血散瘀汤和利之。已成腹中疼痛,胀满不食,便淋刺痛者,薏苡仁汤主之。腹濡
而痛,小腹急胀,时时下脓者,毒未解也,用牡丹皮汤治之。如
脓从脐出,腹胀不除,饮食减少,面白神劳,此皆气血俱虚,宜八珍汤加牡丹皮、肉桂、黄 、五味子敛而补
之。如积袭日久,因循不识此症,误作胀病治之,以致毒攻五内,肠胃受伤;或致阴器攻烂,腐靥黑斑,色败
无脓,每流污水,腹连阴痛,烦躁不止,身热口干,衾帏多臭,卧房难进者,凡犯之俱为不治证。宜斟酌之。
保安万灵丹(参见痈疽肿疽门)
十全大补汤(参见溃疡门)
小柴胡汤(参见瘰疬门)
肠痈(肠道化脓性炎症),都是由湿热之邪和瘀血流入小肠而形成的。其成因主要有三种:一是男子突然急速奔跑,导致肠胃传导功能不畅,败血浊气壅滞阻塞而形成;二是妇女产后,身体虚弱多卧床,尚未起身活动,或者分娩时艰难用力过度,产后未能排出败血瘀滞,导致败血停积,肠胃结滞而形成;三是饥饱失常、劳累损伤,或背负重物,致使肠胃受伤,又或者醉酒后饱食、房事过度损伤精力,或生冷食物同食,导致气血失调,湿气内生,痰浊产生,多致肠胃痞塞,运化不通,气血凝滞而形成。总之,初起时的外部症状表现为发热恶寒,脉象芤而数,皮肤纹理粗糙交错,腹部紧急逐渐肿胀,按压时剧烈疼痛,大便有下坠沉重感,小便涩滞如同淋证,严重者脐部突出、腹胀,转动身体时有水声,这些症状并见,说明内痈已经形成。初起未成脓时,小腹隐隐作痛,好像奔豚病(一种气从少腹上冲心胸的病症),小便淋涩的,应当用大黄汤攻下,瘀血排尽自然安宁。身体虚弱、脉象细弱不敢攻下的,用活血散瘀汤调和利导。已成脓且腹中疼痛、胀满不能进食、大小便淋沥刺痛的,以薏苡仁汤为主治方。腹部柔软而疼痛,小腹急胀,时时排出脓液的,说明毒邪未解,用牡丹皮汤治疗。如果脓液从脐部流出,腹胀不消除,饮食减少,面色苍白、精神疲惫,这都是气血俱虚,宜用八珍汤加入牡丹皮、肉桂、黄芪、五味子收敛并补益。如果病程迁延日久,因循守旧不认识此症,误当作胀病治疗,以致毒邪攻犯五脏,肠胃受损;或者导致阴器溃烂,腐坏结痂出现黑斑,色泽败坏无脓,经常流出污水,腹部牵连阴部疼痛,烦躁不止,身体发热口干,被褥衣服多有臭味,难以进入卧室者,凡是出现这种情况的都属于不治之证。应当仔细斟酌判断。
Bao'an Wanling Dan (See Section on Carbuncles, Sores, and Swellings)
Shiquan Dabu Tang (Decoction for Perfect Tonification; See Section on Ulcers)
Xiao Chaihu Tang (Minor Bupleurum Decoction; See Section on Scrofula)
Changyong (Intestinal Abscess) is formed by the influx of damp-heat and blood stasis into the small intestine. Its etiology generally falls into three categories: First, in men, sudden and urgent running may impair the transportation and transformation functions of the intestines and stomach, causing turbid qi and failed blood to stagnate and obstruct, leading to the condition. Second, in women after childbirth, physical weakness leads to prolonged lying down without rising or sitting up; alternatively, difficult labor involving excessive exertion, combined with failure to expel failed blood and stasis postpartum, results in the accumulation of failed blood and obstruction of the intestines and stomach. Third, irregular eating habits, overwork, carrying heavy loads, or excessive indulgence in alcohol and full meals, along with excessive sexual activity damaging essence and vitality, or consuming raw and cold foods together, can cause disharmony of qi and blood. This generates internal dampness and phlegm, often resulting in intestinal blockage, impaired transport and transformation, and stagnation of qi and blood. In summary, early external symptoms include fever and aversion to cold, a floating and rapid pulse (Kou Mai), rough and interlaced skin texture, abdominal tightness and gradual swelling, severe pain upon pressure, a sensation of heaviness and bearing down during defecation, and dysuria resembling strangury. In severe cases, umbilical protrusion, abdominal distension, and splashing sounds when turning are observed. The simultaneous presence of these signs indicates that an internal abscess has formed. During the initial stage before suppuration, if there is dull pain in the lower abdomen resembling Ben Tun (Panic Disease characterized by Qi rushing upward from the lower abdomen) and dysuria, Da Huang Tang (Rhubarb Decoction) should be administered to purge; once the blood stasis is completely expelled, the patient will recover. For patients with weak constitutions and fine pulses who cannot tolerate purgation, Huoxue San Yu Tang (Blood-Activating and Stasis-Resolving Decoction) should be used to harmonize and promote circulation. If the abscess has formed, presenting with abdominal pain, distension, anorexia, and painful, dribbling urination, Yiyi Ren Tang (Coix Seed Decoction) is the primary treatment. If the abdomen is soft yet painful, with acute distension in the lower abdomen and intermittent discharge of pus, it indicates that the pathogenic toxin has not yet resolved; Mudan Pi Tang (Moutan Cortex Decoction) should be used. If pus discharges from the umbilicus, abdominal distension persists, food intake decreases, the complexion is pale, and spirit is fatigued, this signifies deficiency of both qi and blood. Bazen Tang (Eight-Treasure Decoction) supplemented with Mudan Pi (Moutan Cortex), Rou Gui (Cinnamon Bark), Huangqi (Astragalus Root), and Wuweizi (Schisandra Fruit) should be used to astringe and tonify. If the disease lingers for a long time due to neglect or misdiagnosis as simple distension, the toxin may attack the five zang organs and damage the intestines and stomach. Alternatively, it may cause ulceration of the genitalia, with rotting crusts and black spots, loss of luster, absence of pus, and continuous discharge of foul fluid. Accompanied by abdominal pain radiating to the yin region, incessant irritability, fever, dry mouth, and a strong offensive odor in bedding and clothing making the bedroom uninhabitable, such cases are considered incurable. Careful judgment is required.