张仲景云∶肠痈之证,因饮食积热,或母食辛热之物所致。小腹按之则痛,小
便数似淋,腹急,恶寒,身皮甲错,或自汗恶寒,若脉迟紧,未有脓者,用仙方活
命饮以解其毒。脉洪数,已有脓者,服太乙膏以下其脓。小腹疼痛,小便不利者,
脓壅滞也,牡丹皮散主之。
窃谓、经云∶肠痈为病,不可惊,惊则肠断而死。故坐卧转侧之间,须令徐
缓,时少饮薄粥,及用八珍汤固其元气,静养调理,庶可保也。
大黄汤 治肠痈,小腹坚肿,按之则痛,肉色如常,或 赤微肿,小便频数,汗出
憎寒,脉紧,脓未成也,急服之。
大黄(炒) 朴硝(各一钱) 牡丹皮 栝蒌仁 桃仁(去皮尖,各二钱)
每服二三钱,水煎。
薏苡仁汤 治肠痈腹中痛烦躁不安,或胀满不食,小便涩滞。
薏苡仁 牡丹皮 桃仁(各三两) 栝蒌仁(四两)
上,每服四钱,水煎。
桃仁汤 治肠痈腹中痛,烦躁不安,壅痛,大便闭涩。亦有绕脐生疮者,但用此药
无妨。
桃仁 大黄(炒) 牡丹皮 芒硝 犀角(镑) 冬瓜仁(研。各二钱)
上,水煎,入犀角末服。
牡丹皮散 治肠痈腹濡而痛,时下脓汁,或下血。
牡丹皮 人参 天麻 白茯苓 黄 (炒) 薏苡仁 桃仁 白芷(炒) 当归 川芎
官桂 甘草(各五分) 木香(二分)
上,每服三五钱,水煎。
张仲景说:肠痈(肠道化脓性炎症)这一病证,是由于饮食积滞生热,或者母亲食用辛辣温热食物所致。小腹按压时感到疼痛,小便频数类似淋证,腹部拘急,恶寒,皮肤粗糙如鳞甲,或者自汗且恶寒。如果脉象迟而紧,说明尚未成脓,使用仙方活命饮来解毒。如果脉象洪大而数,说明已经成脓,服用太乙膏以排出脓液。如果小腹疼痛且小便不利,这是脓液壅滞的表现,用牡丹皮散主治。
我认为:经典医籍记载:患肠痈病,不可受惊,受惊则会导致肠断而死。所以在坐卧、转身侧身之间,必须动作缓慢,偶尔少量饮用稀薄的米粥,并使用八珍汤巩固元气,安静休养调理,才可以保全生命。
大黄汤:治疗肠痈,小腹坚硬肿胀,按压则痛,肌肉颜色如常,或微红微肿,小便频数,出汗且憎恶寒冷,脉象紧,脓液尚未形成,应紧急服用此药。
大黄(炒制) 朴硝(各一钱) 牡丹皮 栝蒌仁 桃仁(去皮尖,各二钱)
每次服用二三钱,用水煎煮。
薏苡仁汤:治疗肠痈腹中疼痛烦躁不安,或腹胀满不能进食,小便涩滞不畅。
薏苡仁 牡丹皮 桃仁(各三两) 栝蒌仁(四两)
以上药材,每次服用四钱,用水煎煮。
桃仁汤:治疗肠痈腹中疼痛,烦躁不安,壅塞疼痛,大便闭结不通。也有脐周生疮的情况,只要使用此药无妨。
桃仁 大黄(炒制) 牡丹皮 芒硝 犀角(镑片) 冬瓜仁(研碎。各二钱)
以上药材,用水煎煮,加入犀角末服用。
牡丹皮散:治疗肠痈腹部柔软但疼痛,时下脓汁,或下血。
牡丹皮 人参 天麻 白茯苓 黄芪(炒制) 薏苡仁 桃仁 白芷(炒制) 当归 川芎 官桂 甘草(各五分) 木香(二分)
以上药材,每次服用三五钱,用水煎煮。
Zhang Zhongjing stated: The syndrome of Changyong (intestinal abscess) is caused by food stagnation generating heat, or by the mother consuming spicy and hot foods. There is pain upon pressing the lower abdomen; urination is frequent, resembling Lin syndrome (dysuria); the abdomen feels tense; there is aversion to cold; the skin is rough like scales; or there is spontaneous sweating with aversion to cold. If the pulse is slow and tight, indicating that pus has not yet formed, Xianfang Huoming Yin (Immortal Life Elixir Decoction) should be used to resolve toxicity. If the pulse is surging and rapid, indicating that pus has already formed, Taiyi Gao (Great One Plaster) should be taken to drain the pus. If there is pain in the lower abdomen and difficulty in urination, this indicates obstruction by pus, which is primarily treated with Mudanpi San (Moutan Powder).
I hold that: The classics state: "In cases of Changyong, one must not be startled; being startled leads to intestinal rupture and death." Therefore, during sitting, lying down, turning, or shifting positions, movements must be slow and gentle. One should occasionally drink thin congee and use Bazhen Tang (Eight Treasures Decoction) to consolidate Yuan Qi (primordial Qi), resting quietly and regulating the condition, so as to preserve life.
Dahuang Tang (Rhubarb Decoction): Treats Changyong characterized by hardness and swelling in the lower abdomen, pain upon pressure, normal muscle color or slight redness and swelling, frequent urination, sweating with aversion to cold, and a tight pulse, indicating that pus has not yet formed. It should be taken urgently.
Chao Dahuang (Stir-fried Rhizoma Rhei Preparata), Puxiao (Natrii Sulfas) (each 1 qian); Mudanpi (Cortex Moutan Radicis), Gualou Ren (Semen Benincasae), Tao Ren (Semen Persicae, peeled and removed of kernels) (each 2 qian).
Take 2-3 qian per dose, decoct in water.
Yiyiren Tang (Coix Seed Decoction): Treats Changyong with abdominal pain, restlessness, or abdominal distension and fullness with loss of appetite, and astringent/difficult urination.
Yiyiren (Semen Coicis), Mudanpi (Cortex Moutan Radicis), Tao Ren (Semen Persicae) (each 3 liang); Gualou Ren (Semen Benincasae) (4 liang).
Decoct the above ingredients; take 4 qian per dose in water.
Tao Ren Decoction: Treats Changyong with abdominal pain, restlessness, obstructive pain, and constipation. In cases where sores appear around the umbilicus, using this medicine is also safe.
Tao Ren (Semen Persicae), Chao Dahuang (Stir-fried Rhizoma Rhei Preparata), Mudanpi (Cortex Moutan Radicis), Mangxiao (Natrii Sulfas), Xijiao (Cornu Rhinocerotis, shaved), Dongguaren (Semen Citruli, crushed) (each 2 qian).
Decoct in water, and take with powdered Xijiao.
Mudanpi San (Moutan Powder): Treats Changyong with a soft but painful abdomen, discharge of pus or blood.
Mudanpi (Cortex Moutan Radicis), Renshen (Radix Ginseng), Tianma (Rhizoma Gastrodiae), Baifuling (Poria), Chao Huangqi (Stir-fried Radix Astragali Preparata), Yiyiren (Semen Coicis), Tao Ren (Semen Persicae), Chao Baizhi (Stir-fried Radix Angelicae Dahuricae), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Guangui (Cortex Cinnamomi), Gancao (Radix Glycyrrhizae) (each 5 fen); Muxiang (Radix Aucklandiae) (2 fen).
Take 3-5 qian per dose, decoct in water.