〔薛〕腹痈者，患于脐下或傍二寸许，属脾经。近胁、属胆经。盖因脾经阴虚气
滞血凝，或因脾虚饮食积热所患，若 肿作痛者，泻黄散。坚硬肿痛者，清胃散。
肿痛便秘者，清凉饮。如此而仍痛者，瘀血凝滞也，活命饮。既用此药而不消，则内
欲作脓也，用托里消毒散。若脓出而痛不减者，毒未解也，亦用前药。若脓出而反
加痛，及脓水清稀者，气血虚也，用参 托里散。若食少体倦者，脾气虚也，用五
味异功散加当归、柴胡、升麻。晡热内热者，脾血虚也，用四君、当归、丹皮。如
有他证，当随证治之。
〔薛〕臀痈属膀胱经湿热，或禀赋阴虚。若肿硬作痛，用内托羌活汤。微肿微痛，
用托里消毒散。若初起大痛，或五日之间，似消不消，似溃不溃者，先用仙方活命
饮，后用托里消毒散。若已溃食少体倦，疮不生肌，脾胃虚弱者，用五味异功散加
柴胡、升麻。禀赋阴虚，小便数而不敛者，加减八味丸。气虚久不生肌收口，用豆
豉饼及补中益气汤培养元气。若用解热攻毒，及敷围寒凉之剂，则气血受伤，必成
败证矣。
内托羌活汤 治尻肾生痈，坚硬肿痛。
羌活 黄柏（酒制。各一钱） 防风 本 当归尾（各五分） 肉桂 连翘 甘草（炙） 苍术
陈皮（各三分） 黄 （八分）
上，作二剂，水一钟，入酒一杯煎，空心服。
【薛己】腹痈，发病部位在脐下或旁边约两寸处，归属于脾经。若靠近胁肋部，则归属于胆经。这通常是因为脾经阴虚导致气机阻滞、血液凝滞，或者因脾气虚弱、饮食积滞化热所致。如果局部肿胀且疼痛，使用泻黄散。如果肿块坚硬、肿胀且疼痛，使用清胃散。如果肿胀疼痛伴有大便便秘，使用清凉饮。如果经过上述治疗仍然疼痛，说明是瘀血凝滞，使用活命饮（即仙方活命饮）。如果使用了这些药物后肿块仍未消散，说明内部即将化脓，应使用托里消毒散。如果脓液排出但疼痛不减，说明毒邪未解，也继续使用前面的药物。如果脓液排出后疼痛反而加剧，以及脓水清稀，说明气血虚弱，使用参托里散（即人参托里散）。如果食欲不振、身体疲倦，说明脾气虚弱，使用五味异功散加入当归、柴胡、升麻。下午发热、自觉体内发热，说明脾血虚弱，使用四君子汤、当归、丹皮。如果有其他证候，应当根据具体症状进行治疗。
【薛己】臀痈归属于膀胱经湿热，或者是先天禀赋阴虚。如果肿块坚硬且疼痛，使用内托羌活汤。如果轻微肿胀和轻微疼痛，使用托里消毒散。如果初起时剧烈疼痛，或在五天内，看起来似消未消、似溃未溃，先用仙方活命饮，后用托里消毒散。如果已经溃破，出现食欲减退、身体疲倦，疮口不长新肉，属于脾胃虚弱，使用五味异功散加入柴胡、升麻。如果是先天禀赋阴虚，小便频数且不能收敛的，使用加减八味丸。如果是气虚导致长期不长肉、不收敛伤口，使用豆豉饼外敷及补中益气汤来培养元气。如果使用清热解毒攻毒的药物，以及外敷寒凉性质的围药，就会损伤气血，必然会导致败证（难治之症）。
内托羌活汤：治疗尾骶部和肾脏区域生痈，表现为肿块坚硬、肿胀且疼痛。
药材组成：羌活、黄柏（酒制，各一钱）、防风、藁本、当归尾（各五分）、肉桂、连翘、甘草（炙）、苍术、陈皮（各三分）、黄芪（八分）。
用法：以上药材分为两剂，用水一钟，加入一杯酒煎煮，空腹服用。
[Xue] Abdominal carbuncle occurs below the umbilicus or approximately two cun to the side, belonging to the Spleen Meridian. If it is near the hypochondrium, it belongs to the Gallbladder Meridian. This is generally caused by Yin deficiency of the Spleen Meridian leading to Qi stagnation and Blood stasis, or due to Spleen Qi deficiency with dietary accumulation transforming into heat. If swelling and pain occur, use Xiehuang San (Drain Yellow Powder). If the mass is hard, swollen, and painful, use Qingwei San (Clear Stomach Powder). If there is swelling, pain, and constipation, use Qingliang Yin (Cooling Drink). If pain persists despite such treatment, it indicates Blood stasis and stagnation; use Huoming Yin (Life-Saving Decoction, i.e., Xianfang Huoming Yin). If the lesion does not resolve after using these medicines, it suggests that suppuration is forming internally; use Tuoli Xiaodu San (Support the Interior and Eliminate Toxin Powder). If pus is discharged but pain does not decrease, the pathogenic toxin has not been resolved; continue using the aforementioned medicines. If pain increases after pus discharge, and the pus is thin and clear, it indicates Qi and Blood deficiency; use Shentuo Li San (Ginseng Supporting the Interior Powder). If appetite is poor and the body feels fatigued, it indicates Spleen Qi deficiency; use Wuyi Yigong San (Five-Ingredient Formula for Enhancing Function) added with Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), and Shengma (Cimicifugae Rhizoma). If there is afternoon fever and internal heat, it indicates Spleen Blood deficiency; use Sijunzi Tang (Four Gentlemen Decoction), Danggui (Angelicae Sinensis Radix), and Danpi (Moutan Cortex). If other syndromes are present, treat according to the specific symptoms.
[Xue] Gluteal carbuncle belongs to Damp-Heat in the Bladder Meridian, or congenital Yin deficiency. If the swelling is hard and painful, use Neituo Qianghuo Tang (Internal Support Qianghuo Decoction). If the swelling and pain are mild, use Tuoli Xiaodu San (Support the Interior and Eliminate Toxin Powder). If severe pain occurs at the onset, or within five days, where the condition seems neither resolving nor ulcerating, first use Xianfang Huoming Yin (Prescribed Life-Saving Decoction), followed by Tuoli Xiaodu San (Support the Interior and Eliminate Toxin Powder). If already ulcerated with poor appetite and fatigue, and the wound fails to generate flesh, indicating Spleen and Stomach weakness, use Wuyi Yigong San (Five-Ingredient Formula for Enhancing Function) added with Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma). For congenital Yin deficiency with frequent urination and lack of astringency, use Jiaban Bawei Wan (Modified Eight-Ingredient Pill). For Qi deficiency causing prolonged failure of tissue regeneration and wound closure, use Douchi Bing (Fermented Soybean Cake) applied externally and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to cultivate Yuan Qi (Original Qi). If heat-clearing, detoxifying, and attacking agents are used, along with cold-natured topical compresses, Qi and Blood will be injured, inevitably leading to Bai Zheng (defeat syndrome/incurable stage).
Neituo Qianghuo Tang: Treats carbuncles arising in the sacral and renal regions, characterized by hard, swollen, and painful masses.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Huangbai (Phellodendri Cortex, wine-processed, each 1 qian), Fangfeng (Saposhnikoviae Radix), Bencao (Ligustici Rhizoma et Radix), Dangguiwei (Angelicae Sinensis Radix, tail portion, each 5 fen), Rougui (Cinnamomi Cortex), Lianqiao (Forsythiae Fructus), Gancao (Licorice Root, honey-fried), Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium, each 3 fen), Huangqi (Astragali Radix, 8 fen).
Preparation: Divide into two doses. Boil with one zhong of water and one cup of wine. Take on an empty stomach.