典藏书目

[Background Information]
Book: Waike Jiyan Fang (Collected Effective Formulas for Surgery)
Author: Zhao Yizhen
Dynasty: Ming Dynasty, Hongwu Wuwu Year
Chapter: Lun Changyong Zhi (Discussion on Intestinal Carbuncle and Hemorrhoids)
Category: Formula

[Intestinal Carbuncle]

Intestinal carbuncle (nongpurulent inflammation of the intestine) arises from an imbalance of yin and yang, irregular emotions such as anger and joy, where pathogenic factors lie dormant within the zang-fu organs and accumulate inside the intestines and stomach. This leads to blood stasis and qi stagnation, disrupting normal circulation and causing accumulation that forms a carbuncle, resulting in swelling and pain. Sun Simiao stated that if one suddenly suffers from intestinal carbuncle without understanding its symptoms, and a mediocre physician treats it incorrectly, death may result. In the early stage of intestinal carbuncle, there is slight abdominal pain, swelling in the lower abdomen, and pain upon firm pressure. Urination is difficult and painful, resembling strangury. There is frequent sweating accompanied by aversion to cold. The skin becomes rough like scales, and the abdominal wall feels tense as if swollen, yet soft upon palpation. Alternatively, there may be fever without sweat, or chills and shivering. These are all characteristic signs. A surging and rapid pulse indicates the presence of pus, suggesting the use of purgative methods. A slow and tight pulse indicates that pus has not yet formed, and purgatives should not be used. In severe cases, the abdomen distends significantly, and water sounds can be heard when turning over. Sores may appear around the umbilicus, pus may discharge from the navel, or bloody pus may pass in the stool. All these constitute ominous signs.

Regarding gastric carbuncle (nongpurulent inflammation of the stomach), how can it be distinguished? The *Neijing* states: "When a person suffers from gastric carbuncle, the stomach pulse should be examined. If the pulse is deep and fine, it indicates rebellious qi. Rebellious qi causes the Renying pulse (carotid artery) to become excessively full. Heat gathers at the stomach opening but cannot circulate, thus forming a gastric carbuncle." The treatment method is similar to that of intestinal carbuncle. Initially, herbs that unblock and guide stagnation are used to clear obstructions. Subsequently, herbs that drain pus, detoxify, and support the interior are employed for regulation. This is the general principle.

[Hemorrhoids]

Hemorrhoidal disease differs from intestinal carbuncle. Its initial presentation occurs at the anal margin, appearing either like a mouse's teat or as small nodules, with itching, pain, and a sensation of heaviness and distress. Severe cases involve fever and aversion to cold. These conditions are caused by excesses in alcohol and sexual activity, long-term consumption of rich and sweet foods, intercourse while intoxicated or after heavy meals, which damage and disturb the blood vessels. Damp-heat leaks from the intestines and rushes downward, manifesting at the anal region, thereby forming hemorrhoids. There are five types: Pin-zhi (Yin Hemorrhoid), Mu-zhi (Yang Hemorrhoid), Qi-zhi (Qi Hemorrhoid), Xue-zhi (Blood Hemorrhoid), and Jiu-zhi (Alcohol Hemorrhoid). Other names include Changfeng-zhi (Wind-intestinal Hemorrhoid), Mai-zhi (Vessel Hemorrhoid), and Cixiong-zhi (Female-Male Hemorrhoid); these are all aliases for the five types. If left untreated for a long time, they may develop into fistulas or ulcers, becoming difficult to cure. Specific formulas are listed below; please examine them carefully before use.

[Dahuang Tang (Rhubarb Decoction)]
Treats intestinal carbuncle with hardness and swelling in the lower abdomen, large as a palm, hot to touch, painful upon pressure, with redness or pallor of the face, thick and frequent urination, sweating, and aversion to cold. A slow and tight pulse indicates unformed pus; a rapid pulse indicates formed pus.
Ingredients: Rhubarb (cut and stir-fried), Moutan Cortex (Peony Root Bark), Niter (ground), Mustard Seed, Peach Kernel (soaked in water, skin and tip removed, fried, each half tael).
Cut the ingredients finely. Take 5 qian per dose, decoct in two cups of water until one cup remains. Strain and take warm on an empty stomach. Continue until pus and blood are discharged. If not discharged, repeat the dose.

[Sisheng San (Four Sages Powder)]
(Also known as Shenxiao Gualou San)
Treats intestinal carbuncles and sores occurring on the head, beard area, back, axilla, and breasts, as well as inguinal abscesses. It is highly effective.
Ingredients: Fresh Trichosanthes Fruit (one piece, peeled), Licorice Root (ground, 4 qian), Myrrh (ground, 3 qian), Frankincense (ground, 1 qian).
Decoct in two large bowls of high-quality red wine over low heat until one bowl remains. Divide into two doses and finish within two days. Passage of foul matter via stool is desirable. If dried Trichosanthes is used, use two pieces. For upper body ailments, take after meals; for lower body ailments, take before meals. If pus has formed, it will liquefy; if not formed, it will exit via urine. For severe cases, prepare another batch to continue treatment until symptoms subside.

[Mudan San (Moutan Powder)]
Treats cold-type intestinal carbuncle with soft abdomen, pain, and frequent discharge of pus.
Ingredients: Moutan Cortex, Ginseng Root, Gastrodia Tuber, Poria, Astragalus Root, Costus Root, Angelica Sinensis, Ligusticum Chuanxiong, Cinnamon Twig, Peach Kernel (skin and tip removed, each 3 fen), Angelica Dahurica, Coix Seed, Licorice Root (roasted, each 2 fen).
Grind into fine powder. Take 3 qian per dose, decoct in one cup of water until 0.7 cup remains. Take warm before meals.

[Meiren Tang (Plum Kernel Decoction)]
Treats intestinal carbuncle with tenesmus, dull pain, and constipation.
Ingredients: Plum Kernels (49 pieces, skin and tip removed), Rhubarb (3 liang), Moutan Cortex (1.3 liang), Winter Melon Seeds (4 liang), Mirabilite (2.5 liang), Rhino Horn (shaved, 1.5 liang).
Cut into sizes similar to hemp seeds. Take 5 qian per dose, decoct in two cups of water until one cup remains. Strain and take warm. Continue until 2-3 passages of pus and blood occur.

[Shenxian Lafan Wan (Immortal Wax and Alum Pills)]
Treats intestinal carbuncle with internal expulsion effects. Suitable for all ages, universally effective. Best for stopping pain without damaging the zang-fu organs.
Ingredients: Yellow Beeswax (half tael, yellow variety preferred, alternative recipe uses 7 qian), White Alum (1 tael, transparent variety, finely ground).
Melt the beeswax and mix with alum to form pills the size of paulownia seeds. Take 20 pills initially, gradually increasing to 30 pills. Take with warm plain water far from meals.

[Yiyi Ren Tang (Coix Seed Decoction)]
Treats intestinal carbuncle with abdominal colic, restlessness, bloating, loss of appetite, and difficult urination. Common in postpartum women with deficiency-heat. Can be taken even if the diagnosis is uncertain.
Ingredients: Coix Seed, Trichosanthes Kernel (each 3 qian), Moutan Cortex, Peach Kernel (each 2 qian).
Take as one dose, decoct in two cups of water until one cup remains. Take at any time.

[Qinjiao Baizhu Wan (Gentian and Atractylodes Macrocephala Pills)]
Treats hemorrhoids with pus and blood, dry and hard stools causing unbearable pain.
Ingredients: Gentiana Scabra (rhizome removed), Peach Kernel (skin and tip removed, separately ground), Gleditsia Sinensis Pod (charred, each 1 liang), Immature Bitter Orange (bran-fried), Angelica Sinensis Tail (wine-processed), Alisma, Atractylodes Macrocephala (each half tael), Sanguisorba Officinalis (3 qian).
Grind into fine powder, mix with peach kernel paste, and bind with cooked flour paste to form pills the size of paulownia seeds. Dry thoroughly. Take 100 pills on an empty stomach with white water. Follow with a light meal. Avoid raw, cold, hard foods, cold water vegetables, damp noodles, alcohol, and pungent/spicy/hot spices. Failure to observe these restrictions renders the medicine ineffective. Cure usually occurs after several doses.

[Qinjiao Fangfeng Tang (Gentian and Saposhnikovia Decoction)]
Treats hemorrhoids causing pain during daily bowel movements. If there is no pain, it is not hemorrhoids.
Ingredients: Gentiana Scabra, Saposhnikovia Root, Angelica Sinensis, Atractylodes Macrocephala (each 1.5 qian), Phellodendron Bark, Tangerine Peel, Bupleurum, Rhubarb (stir-baked), Alisma (each 1 qian), Safflower, Peach Kernel, Cimicifuga Rhizome (each 5 fen), Licorice Root (roasted, 6 fen).
Take as one dose, decoct in two cups of water until one cup remains. Take on an empty stomach. Avoid wind and cold, sexual activity, alcohol, damp noodles, and spicy/hot foods.

[Diyu San (Sanguisorba Powder)]
Treats hemorrhoidal swelling and pain.
Ingredients: Sanguisorba Officinalis, Astragalus Root, Immature Bitter Orange, Areca Seed, Ligusticum Chuanxiong, Scutellaria Baicalensis, Sophora Flower, Red Peony Root, Notopterygium Root, Ampelopsis Radix, Honeycomb (fried until charred), Licorice Root (roasted, each 5 fen).
Take as one dose, decoct in two cups of water until one cup remains. Take before meals.

[Huaijiao Wan (Sophora Fruit Pills)]
Treats various hemorrhoids, intestinal wind with bleeding, and rectal prolapse.
Ingredients: Sophora Fruit (stalks removed, 1 liang), Saposhnikovia Root, Sanguisorba Officinalis, Immature Bitter Orange (bran-fried), Angelica Sinensis, Scutellaria Baicalensis (each half tael).
Grind into fine powder, bind with wine paste to form pills the size of paulownia seeds. Take 50 pills on an empty stomach with rice drink.

[Diaochang Wan (Hooking Intestine Pills)]
Treats chronic and acute hemorrhoids, swelling and pain at the anal margin, or intermittent itching with pus and blood.
Ingredients: Trichosanthes Fruit (two pieces, charred), Thistle Bark (two pieces, charred), White Alum (appropriate amount), Green Vitriol (appropriate amount), Baeckea Frutescens (raw), Arisaema Cum Bile, Celosia Cristata (cut and fried), Pinellia Ternata (each 5 liang), Walnut Kernel (15 pieces, charred), Immature Bitter Orange (fried), Aconitum Carmichaelii (processed, skin and navel removed), Chebula Terminalia (pitted, each 2 liang).
Grind into fine powder, bind with vinegar paste to form pills the size of paulownia seeds. Take 30-50 pills before bed with warm wine. Ten days of use shows effect for long-standing cases; long-term use eliminates the root cause.

[Zaojiao Jian Wan (Gleditsia Decoction Pills)]
Treats internal hemorrhoids, nodules inside the anal canal, alternating chills and fever.
Ingredients: Gleditsia Sinensis Pod (full foot-length, three stalks, strings and seeds removed, vinegar-roasted), White Alum (appropriate amount), Thistle Bark (roasted yellow), Coix Seed, Angelica Dahurica (each 1 liang), Peach Kernel (skin removed, fried), Descurainia Sophia Seed (fried), Ligusticum Chuanxiong, Platycodon Grandiflorus (each half tael), Pig Hind Hoof Nail (ten pieces, charred).
Grind into fine powder, bind with refined honey to form pills the size of paulownia seeds. Take 50 pills on an empty stomach with decoction of Mulberry Root Bark.

[Shenxiao San (Miraculous Powder)]
For washing hemorrhoids. Often caused by excessive desires, alcohol, and sexual indulgence among the wealthy, along with emotional instability. Symptoms include nodules like beads, swelling of the anus/intestine, pus leakage, bleeding, and excruciating pain. Effective for all swellings, sores, hemorrhoids, and intestinal wind with leakage.
Ingredients: Sophora Root, Sichuan Pepper, Bitter Gourd, Coriander Seed, Sophora Flower, Immature Bitter Orange, Schizonepeta, Honeysuckle, Angelica Dahurica, Forsythia, Angelica Pubescens, Fennel, Ephedra, Oyster Shell (appropriate amount), Clematis Root, Chinese Toon Bark (each 2 liang).
Chop the herbs. Use 5 qian per dose with 6-7 bowls of water and two stalks of green onion. Boil for 5-7 boils. Strain. Sit in a basin over the steam, then wash. Very effective. Adding two old yellow eggplants is especially good.

[Woniu Gao (Snail Ointment)]
Highly effective for applying to hemorrhoids.
Ingredients: Snail (one piece), Borneol, Musk (small amounts).
Grind together until smooth. Store in a porcelain box. Apply the juice to the sore the next morning.

[Badu San (Detoxifying Powder)]
Apply to swollen and toxic hemorrhoidal areas.
Ingredients: Rhubarb, Phellodendron Bark, Bletilla Striata, Gypsum Fibrosum, Scutellaria Baicalensis, Coptis Chinensis, Ampelopsis Radix, Gardenia Jasminoides, Glauber Salt (equal parts).
Grind into powder. Mix with well water and apply.

[Jifeng Wujin San (Jifeng Black Gold Powder)]
Treats hemorrhoids.
Ingredients: Yellow Ox Horn Heart, Pig Tooth Gleditsia, Thistle Bark, Pangolin Scales (all stir-fried until black), Gleditsia Spine, Sophora Seed, Immature Bitter Orange, Cyathula Root, Donkey-hide Gelatin (fried, equal parts).
Grind into fine powder. Take 1.5 qian per dose. Mix with crushed walnut meat and wine. Take before meals. For heat in the large intestine, take with Schizonepeta tea. For persistent bleeding, take with Angelica Sinensis decoction.

[Zhiqiao San (Immature Bitter Orange Powder)]
For fumigation and washing of hemorrhoids.
Ingredients: Immature Bitter Orange, Cyathula Root (each 2 liang), Schizonepeta, Large Phellodendron Bark (each 1 liang), Coptis Chinensis, Cnidium Monierii, Dogwood Root Bark, Hematite, Ginger (processed, each half tael), Xanthium Root, Ilex Aquifolium Leaf, Shallot, Cypress Branch (each one handful), Black Soybean (half sheng).
Chop the herbs. Use one large measure per dose with three large bowls of water. Decoct until two bowls remain. Fumigate first, then wash. Do this 3-5 times daily.

[Jieyin Dan (Binding Yin Pellets)]
Treats intestinal wind and visceral toxin with blood in the stool.
Ingredients: Immature Bitter Orange (pulp removed, bran-fried), Clematis Root, Polygonum Multiflorum, Chinese Toon Root Bark, Tangerine Peel (white part removed), Schizonepeta Spike, Astragalus Root (equal parts).
Grind into fine powder. Bind with wine-cooked paste and a little honey to form pills the size of paulownia seeds. Take 50-70 pills before meals with rice drink. Alternative: omit honey, use a little vinegar with aged rice drink decoction.

[Zhu Zang Wan (Pig Intestine Pills)]
Treats prolonged blood in stool in adults and children, increased appetite with easy hunger, no abdominal pain, and no tenesmus. First, roast Cuttlefish Bone until yellow, remove skin, grind to white powder, and take with Equisetum Decoction. Effect seen after three days.
Ingredients: Coptis Chinensis (2 liang, chopped), Tender Pig Intestine (2 chi, fat removed).
Stuff the Coptis into the pig intestine, tie both ends, and boil until very soft. Grind finely, add cake paste, and form pills the size of paulownia seeds. Take 30-50 pills with rice...