（附论）
大便痈者谬名也。乃男子血疝也。难素所不载。然而足厥阴肝之经络。是血流行之道路
也。冲脉、任脉、督脉。亦属肝经之旁络也。难经曰。男子七疝。血疝乃七疝之一也。治以
导水丸、桃仁承气汤。或抵当汤投之。若瘀血聚而不散。可以大作剂料。大泻一二十行。以
玉烛散和血通经之类是也。世人多用大黄、牡蛎。间有不愈者。是不知和血通经之道也。
方
七圣散 治便痈。
大黄 山栀 牡蛎（生） 栝蒌 金银花 皂角针（火烧出火气） 甘草（各等分） 上
为细
末。每服半两。生姜一大块。酒水各一盏。煎耗半。去滓空心服。以通利为度。却以药安于
肿处。仍用扯自身衣带。缚住脚大指。随病左右。
乳香定痛膏（出经验良方）治便痈先服复元通气散。黑神散打和。酒调服。以
药调涂。
南星 半夏 僵蚕（各半两） 柏霜叶（一两即芙蓉叶） 没药 乳香（各一两） 上
为末。
姜汁调涂。极能定痛消肿。及治肿毒。无名恶疮。
栝蒌散（出瑞竹堂）治便痈等恶疮。
栝蒌（一个去皮） 生姜（半两） 甘草（半两） 金银花（三钱） 牛蒡子（三钱微
炒） 上将
药不犯铜铁捶碎。用酒一大升。煎数沸。空心温服。微利为度。
便痈方（出神效方）便痈本名血疝。
牡蛎 大黄 甘草（各半两） 悬蒌（一个）
（案∶此方缺制法及服法）
三物汤 治便痈。
牡蛎 大黄 山栀子（各等分） 上为末。水酒一大盏。煎至七分。露一宿。温起空心
服。
治便痈。
朴硝末（三钱） 干姜末（一钱） 上作一服。用无灰好酒半碗。空心调下。
宣毒散 治便痈肿毒。
大黄（一两） 牡蛎（一两炒） 上为细末。每服三钱。酒二盏。煎至六分。和滓温服。
以
利为度。水调扫肿上即消。
治便痈（出神效方）
用冬葵子为末。酒调下三两服。
又方 治便痈俗名 。欲作未作之时。
用皂荚不蛀者烧过。阴干为末。酒调服之。皂角子七个。服之亦效。
胡桃酒方（出神效方）
用胡桃七个烧过。阴干为末。酒调服。不过三服。
生蜜粉方（出神效方）
用生蜜、米粉调服。休吃饭。利小便为度。
治便痈（出危氏方）
牛蒡子 破故纸 大黄 黑牵牛 上等分为细末。空心酒调下。一服即消。
神效桦皮散（出永类钤方）治便痈初发即用。
桦皮 杏仁 皂角刺 甜桃（十二枚） 山栀（五味各烧灰三钱） 穿山甲（黄土炒三
钱）
乳香 没药（各二钱） 酒浸别研。调和麝香少许。共九味。前六味并作末。却加下三味。
可
作六服。酒调。猛进二服即见效。经验只用猪牙皂角。煨令黄色作末。酒调效。
初发时服五香连翘散。吞皂角煎丸。用复元通气散不及此。淮人用蜀葵子七粒。皂角半
梃作末。以锻石同醋调。搽贴。独子肥皂荚同蒜捣贴。亦佳。身热脉实。先服败毒散数服住
。已溃者太乙膏贴。又四住散一两。十宣散二两。打和酒调。又擂葱根入蜜和匀。贴肿处。
用纸不令走气。内服桦皮通气等散。一云服桦皮散前。用胡桃煎于油中。却用酒空心嚼胡桃
。使大便稍利。却用桦皮散。一云穿山甲烧存性为末。酒服后。用土涂疮上。未成即消。已
成即溃。初作宜服复元通气散为先。
（附论）
大便痈这个名称是错误的叫法。它实际上是男子的血疝病。《难经》和《素问》中都没有记载这一病名。然而，足厥阴肝经的经络，是血液运行的道路。冲脉、任脉、督脉，也属于肝经的旁络分支。《难经》说：男子有七种疝气，血疝就是七种疝气中的一种。治疗可用导水丸、桃仁承气汤，或者投用抵当汤。如果瘀血积聚而不消散，可以使用大剂量的药物，使患者腹泻一二十次，像玉烛散那样调和血液、疏通经络。世人多用大黄、牡蛎，间或有治不好的，这是因为不懂得调和血液、疏通经络的方法。
方剂
七圣散 治疗大便痈。
大黄、山栀、牡蛎（生用）、栝蒌、金银花、皂角针（火烧以去除火气）、甘草（各等分）。以上药材研为细末。每次服用半两，生姜一大块，酒和水各一盏，煎煮至药液减半，去渣后空腹服用。以大便通畅为度。然后将药粉敷在肿胀处，并用扯下的自身衣带，绑住脚大拇指，根据病变在左侧或右侧进行对应绑扎。
乳香定痛膏（出自《经验良方》）治疗大便痈。先服用复元通气散，将黑神散捣碎混合，用酒调服。然后用药物调匀涂抹患处。
南星、半夏、僵蚕（各半两）、柏霜叶（一两，即芙蓉叶）、没药、乳香（各一两）。以上药材研为末。用姜汁调匀涂抹。极能止痛消肿，以及治疗肿毒、无名恶疮。
栝蒌散（出自《瑞竹堂》）治疗大便痈等恶疮。
栝蒌（一个，去皮）、生姜（半两）、甘草（半两）、金银花（三钱）、牛蒡子（三钱，微炒）。以上药材不要用铜铁器捶碎，用酒一大升，煎煮数沸。空腹温服。以轻微腹泻为度。
便痈方（出自《神效方》）大便痈本名叫血疝。
牡蛎、大黄、甘草（各半两）、悬蒌（一个）。
（按语：此方缺少制作方法和服用方法）
三物汤 治疗大便痈。
牡蛎、大黄、山栀子（各等分）。以上药材研为末。用水和酒一大盏，煎至七分，露天放置一夜。温起后空腹服用。
治疗大便痈。
朴硝末（三钱）、干姜末（一钱）。以上作为一服的量。用好酒半碗，空腹调服。
宣毒散 治疗大便痈肿毒。
大黄（一两）、牡蛎（一两，炒过）。以上研为细末。每次服用三钱，用酒二盏，煎至六分，连同药渣一起温服。以利下为度。用水调匀扫涂在肿胀处即可消退。
又一方 治疗大便痈俗名[此处原文缺失字，推测为“肾痈”或类似俗称]。欲发未发之时。
用不蛀的皂荚烧过，阴干研为末，用酒调服。皂角子七个，服用也有效。
胡桃酒方（出自《神效方》）
用胡桃七个烧过，阴干研为末，用酒调服。不超过三服。
生蜜粉方（出自《神效方》）
用生蜜、米粉调服。不要吃饭。以利小便为度。
治疗大便痈（出自《危氏方》）
牛蒡子、破故纸、大黄、黑牵牛。上等分为细末，空腹用酒调服。一服即消。
神效桦皮散（出自《永类钤方》）治疗大便痈初发时即用。
桦皮、杏仁、皂角刺、甜桃（十二枚）、山栀（五味，各烧灰三钱）、穿山甲（黄土炒三钱）、乳香、没药（各二钱）。酒浸后分别研磨，调和少许麝香。共九味药。前六味药一并研为末，再加入后三味药。可制成六服。用酒调服，猛进两服即可见效。经验只用猪牙皂角，煨至黄色研为末，酒调服有效。
初发时服用五香连翘散，吞服皂角煎丸。用复元通气散不如这个方法好。淮地人用蜀葵子七粒、皂角半梃研为末，用锻石同醋调匀，搽贴。独子肥皂荚同蒜捣烂贴敷，也很好。身体发热、脉象实者，先服用败毒散数服止住。已经溃破的用太乙膏贴敷。又取四住散一两、十宣散二两，捣碎混合用酒调服。又擂碎葱根加入蜂蜜和匀，贴敷在肿胀处。用纸包裹不让漏气。内服桦皮通气等散。一说在服用桦皮散前，先用胡桃在油中煎炸，然后空腹嚼食胡桃。使大便稍微通畅，再用桦皮散。一说将穿山甲烧存性研为末，用酒送服后，用土涂在疮上。未成脓的即消退，已成脓的即溃破。初起时宜先服用复元通气散。
(Attached Discussion)
"Da Bian Yong" (Perineal Abscess) is a misnomer. It is actually "Xue Shan" (Blood Hernia) in men. This condition is not recorded in the *Nan Jing* (Classic of Difficult Issues) or the *Su Wen* (Basic Questions). However, the meridians and collaterals of the Foot Jueyin Liver Meridian are the pathways where blood flows. The Chong Mai (Penetrating Vessel), Ren Mai (Conception Vessel), and Du Mai (Governor Vessel) also belong to the collateral branches of the Liver Meridian. The *Nan Jing* states: "Men have seven types of hernias," and "Xue Shan" (Blood Hernia) is one of them. Treatment involves using Dao Shui Wan (Water-Guiding Pill), Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi), or Di Dang Tang (Stagnation-Resisting Decoction). If blood stasis accumulates and does not dissipate, large doses can be administered to induce diarrhea twenty times or so, similar to the method of Yu Zhu San (Jade Candle Powder) which harmonizes blood and unblocks the meridians. People often use Da Huang (Rhubarb Rhizome) and Mu Li (Oyster Shell); occasionally, cases remain uncured because they do not understand the principle of harmonizing blood and unblocking the meridians.
Formulas
Qi Sheng San (Seven-Sage Powder) treats Perineal Abscess.
Da Huang (Rhubarb Rhizome), Zhi Zi (Gardenia Fruit), Mu Li (Oyster Shell, raw), Gua Lou (Trichosanthes Fruit), Jin Yin Hua (Honeysuckle Flower), Zao Jiao Zhen (Gleditsia Sinensis Thorn, fire-roasted to remove fire toxicity), Gan Cao (Licorice Root) [equal parts]. Grind the above into fine powder. Take half liang per dose with one large piece of fresh ginger, one cup of wine, and one cup of water. Decoct until the liquid reduces by half, strain, and take on an empty stomach. Continue until bowel movements become free. Then apply the powder to the swollen area. Use a strip of one's own clothing belt to bind the big toe, corresponding to the left or right side of the disease.
Ru Xiang Ding Tong Gao (Frankincense Pain-Calming Ointment) (from *Jing Yan Liang Fang*) treats Perineal Abscess. First take Fu Yuan Tong Qi San (Restoring Original Qi-Unblocking Powder), mix Hei Shen San (Black Divine Powder), and take with wine. Then apply the medicated paste topically.
Tian Nan Xing (Arisaema Rhizome), Ban Xia (Pinellia Tuber), Jiang Can (Bombyx Batryticatus) [half liang each], Bai Shuang Ye (Cercidiphyllum Leaf, one liang, i.e., Fu Rong Ye/Hibiscus Mutabilis Leaf), Mo Yao (Myrrh), Ru Xiang (Frankincense) [one liang each]. Grind into powder. Mix with Ginger Juice (Sheng Jiang Zhi) for topical application. It effectively calms pain and reduces swelling, and also treats swellings/toxins and nameless malignant ulcers.
Gua Lou San (Trichosanthes Powder) (from *Rui Zhu Tang*) treats Perineal Abscess and other malignant ulcers.
Gua Lou (Trichosanthes Fruit, one, peeled), Sheng Jiang (Fresh Ginger, half liang), Gan Cao (Licorice Root, half liang), Jin Yin Hua (Honeysuckle Flower, three qian), Niu Bang Zi (Arctium Seed, three qian, lightly stir-fried). Do not crush the herbs with copper or iron vessels. Use one sheng of wine, boil several times. Take warm on an empty stomach. Stop when mild laxation occurs.
Bian Yong Fang (Perineal Abscess Formula) (from *Shen Xiao Fang*). Perineal Abscess was originally named Blood Hernia.
Mu Li (Oyster Shell), Da Huang (Rhubarb Rhizome), Gan Cao (Licorice Root) [half liang each], Xuan Lou (Trichosanthes Fruit, one).
(Note: This formula lacks preparation and administration instructions.)
San Wu Tang (Three-Ingredient Decoction) treats Perineal Abscess.
Mu Li (Oyster Shell), Da Huang (Rhubarb Rhizome), Shan Zhi Zi (Gardenia Fruit) [equal parts]. Grind into powder. Use one cup of water and wine, decoct to seventy percent. Leave exposed overnight. Take warm on an empty stomach.
Treatment for Perineal Abscess.
Pu Xiao Mo (Mirabilite Powder, three qian), Gan Jiang (Dried Ginger Powder, one qian). Prepare as one dose. Mix with half a bowl of good non-grain alcohol and take on an empty stomach.
Xuan Du San (Toxin-Releasing Powder) treats Perineal Abscess swelling and toxin.
Da Huang (Rhubarb Rhizome, one liang), Mu Li (Oyster Shell, one liang, stir-fried). Grind into fine powder. Take three qian per dose with two cups of wine, decoct to sixty percent. Take warm with the dregs. Continue until purgation occurs. Mix with water and sweep/apply onto the swelling to reduce it.
Treatment for Perineal Abscess (from *Shen Xiao Fang*)
Use Dong Kui Zi (Malva Seed) ground into powder, taken with wine, three liang per dose.
Another Formula: Treats Perineal Abscess (commonly known as [missing character]). When it is about to appear but has not yet formed.
Use non-worm-eaten Zao Jiao (Gleditsia Sinensis Fruit), roast it, dry in shade, and grind into powder. Take with wine. Seven Zao Jiao Zi (Gleditsia Seeds) are also effective when taken.
Hu Tao Jiu Fang (Walnut Wine Formula) (from *Shen Xiao Fang*)
Roast seven Hu Tao (Walnuts), dry in shade, grind into powder, and take with wine. Not exceeding three doses.
Sheng Mi Fen Fang (Raw Honey Flour Formula) (from *Shen Xiao Fang*)
Mix raw honey and rice flour, take orally. Abstain from eating solid food. Continue until urination increases.
Treatment for Perineal Abscess (from *Wei Shi Fang*)
Niu Bang Zi (Arctium Seed), Po Gu Zhi (Astragalus Complanatus Fruit), Da Huang (Rhubarb Rhizome), Hei Qian Niu (Black Morning Glory Seed). Grind into fine powder. Take on an empty stomach mixed with wine. One dose eliminates the condition.
Shen Xiao Hua Pi San (Divine-Efficacy Birch Bark Powder) (from *Yong Lei Qian Fang*) treats early-stage Perineal Abscess.
Hua Pi (Birch Bark), Xing Ren (Apricot Seed), Zao Jiao Ci (Gleditsia Thorn), Tian Tao (Sweet Peach, twelve pieces), Shan Zhi Zi (Gardenia Fruit, five flavors, each roasted to ash, three qian), Chuan Shan Jia (Pangolin Scale, stir-fried with yellow earth, three qian), Ru Xiang (Frankincense), Mo Yao (Myrrh) [two qian each]. Soak in wine and grind separately. Mix with a small amount of She Xiang (Musk). Total nine ingredients. The first six are ground into powder, then add the last three. Prepare for six doses. Take with wine. Taking two doses vigorously yields visible results. Empirical experience uses only Zhu Ya Zao Jiao (Pig-Tooth Gleditsia), baked until yellow, ground, and taken with wine.
At the initial stage, take Wu Xiang Lian Qiao San (Five-Spice Forsythia Powder) and swallow Zao Jiao Jian Wan (Gleditsia Decoction Pills). Using Fu Yuan Tong Qi San is inferior to this method. People in Huai region use seven Shu Kui Zi (Malva Seeds) and half a stick of Zao Jiao (Gleditsia Fruit) ground into powder, mixed with Duan Shi (Calcined Alum) and vinegar for topical application. Single-seed Soap Pods (Du Zi Fei Zao Jia) mashed with garlic and applied is also good. For those with body heat and excess pulse, first take Bai Du San (Toxin-Resisting Powder) for several doses to stop symptoms. For already ulcerated cases, apply Tai Yi Gao (Great Unity Ointment). Also mix Si Zhu San (Four-Stay Powder, one liang) and Shi Xuan San (Ten-Auspicious Powder, two liang), take mixed with wine. Also mash Cong Gen (Scallion Root), mix with honey, and apply to the swollen area. Cover with paper to prevent evaporation. Internally take Hua Pi Tong Qi etc. powders. One method says before taking Hua Pi San, fry Walnuts in oil, then chew walnuts on an empty stomach with wine to slightly loosen bowels, then take Hua Pi San. Another method says after taking Chuan Shan Jia (Pangolin Scale) powder with wine, apply earth to the sore. If not formed, it resolves; if formed, it ulcerates. At the beginning, it is suitable to first take Fu Yuan Tong Qi San.