（附论）
内经谓人病胃脘痈者。当候胃脉。其脉沉细者气逆。气逆者人迎甚盛。甚盛则热。人迎
者胃脉也。逆而盛。则热聚于胃口而不行。故胃脘为痈。夫阴阳升降。则营卫流通。气逆而
隔。则留结为痈。胃脘痈者。由寒气隔阳。热聚胃口。寒热不调。故血肉腐坏。以气逆于胃
。脉沉细。以阳气不得下通。故人迎甚盛。令人寒热如疟。皮甲错。或咳或呕。或唾脓血。
观伏梁之病。亦有挟胃脘痈者。以其里大脓血。居肠胃之外故也。
方
连翘升麻散（出圣惠方）治热聚胃脘。留结为痈。
连翘 升麻 射干（去尾） 独活（去芦头） 桑寄生 木通（锉各二两半） 大黄（锉
微炒
二两以上捣为粗末） 木香 沉香（镑） 薰陆香 丁香 麝香（各等分以上捣研为细末） 上
煎药五钱。水二盏。煎至一盏半。去滓。入后五香末二钱。再煎至一盏。温服。日三服。以
快利为度。
芍药汤（出圣济总录）治胃脘蓄热。结聚成脓。
赤芍药 犀角（镑） 木通（锉） 石膏（碎） 升麻（各二两） 甘草（锉） 朴硝 玄
参麦
门冬（去心各一两） 上粗捣筛。每服五钱。水一盏半。煎八分。去滓温服。不计时候。
麦门冬汤（出圣济总录）治热气留聚胃脘。内结成痈。
麦门冬（去心焙） 犀角（镑） 葳蕤 荠 赤芍药 石膏（各一两半） 甘草（炙
锉） 红
雪（各一两） 上粗捣筛。每服五钱。水一盏半。煎八分。去滓。入竹沥一合。再煎三二沸。
温服。
犀角汤（出圣济总录）治胃腑实热。留结为痈。阳气不得下。胃脉沉细者。
犀角（镑） 栀子仁 赤芍药 赤茯苓（去黑皮） 黄芩（去黑心） 射干（去毛） 大
黄（锉
炒各一两） 上粗捣。每服五钱。水一盏半。煎至一盏。滤去滓。入蜜一匙。搅匀。再煎一
两沸。食后温服。
射干汤（出圣济总录）治营卫不流。热聚胃口。血肉腐坏。胃脘成痈。
射干（去尾） 栀子仁 赤茯苓（去黑皮） 升麻（一两） 赤芍药 白术（各一两半）
上
咀麻豆大。每服五钱。水一盏半。煎至八分。去滓。入生地黄汁一合。蜜半合。再煎三沸。
温服。不拘时候。日二服。
（附论）
《内经》说，人患胃脘痈病时，应当诊察胃脉。如果脉象沉细，说明气机逆乱。气机逆乱会导致人迎脉非常盛大，人迎脉盛大则表现为热象。人迎脉属于胃经的脉象。气机逆乱且盛大，就会导致热邪聚集在胃口部位而不能运行，因此胃脘形成痈肿。阴阳之气升降正常，营卫之气就能流通；若气机逆乱而阻隔，就会停留结聚形成痈肿。胃脘痈，是由于寒气阻隔阳气，导致热邪聚集在胃口，寒热不调，致使血肉腐败坏死。因为气逆于胃，所以脉象沉细；因为阳气不能向下通达，所以人迎脉非常盛大。这会导致患者出现像疟疾一样的寒热症状，皮肤干枯如鳞甲交错，或者咳嗽、呕吐，或者吐出脓血。观察伏梁病，也有兼夹胃脘痈的情况，这是因为体内有大量的脓血，位于肠胃之外。
方剂
连翘升麻散（出自《圣惠方》），治疗热邪聚集于胃脘，留滞结聚形成痈肿。
药材：连翘、升麻、射干（去除尾部）、独活（去除芦头）、桑寄生、木通（锉碎，各二两半）、大黄（锉碎，微炒，二两以上，捣成粗末）、木香、沉香（镑片）、薰陆香、丁香、麝香（各等分，以上捣研成细末）。
用法：取上述煎药五钱，加水二盏，煎煮至一盏半，滤去药渣。加入后五种香料的细末二钱，再煎煮至一盏，温服。每日服用三次，以大便通畅为度。
芍药汤（出自《圣济总录》），治疗胃脘蓄积热邪，结聚化脓。
药材：赤芍药、犀角（镑片）、木通（锉碎）、石膏（打碎）、升麻（各二两）、甘草（锉碎）、朴硝、玄参、麦门冬（去心，各一两）。
用法：将药材粗捣筛过。每次服用五钱，加水一盏半，煎煮至八分满，滤去药渣，温服。不限定服药时间。
麦门冬汤（出自《圣济总录》），治疗热气留聚于胃脘，内部结聚形成痈肿。
药材：麦门冬（去心，焙干）、犀角（镑片）、葳蕤、荠苨、赤芍药、石膏（各一两半）、甘草（炙，锉碎）、红雪（各一两）。
用法：将药材粗捣筛过。每次服用五钱，加水一盏半，煎煮至八分满，滤去药渣。加入竹沥一合，再煎煮两三沸，温服。
犀角汤（出自《圣济总录》），治疗胃腑实热，留滞结聚形成痈肿。阳气不能下行，胃脉沉细者适用。
药材：犀角（镑片）、栀子仁、赤芍药、赤茯苓（去除黑皮）、黄芩（去除黑心）、射干（去除毛）、大黄（锉碎，炒，各一两）。
用法：将药材粗捣。每次服用五钱，加水一盏半，煎煮至一盏，过滤去渣。加入蜂蜜一匙，搅拌均匀，再煎煮一两沸，饭后温服。
射干汤（出自《圣济总录》），治疗营卫之气不流通，热邪聚集在胃口，血肉腐败坏死，胃脘形成痈肿。
药材：射干（去除尾部）、栀子仁、赤茯苓（去除黑皮）、升麻（一两）、赤芍药、白术（各一两半）。
用法：将药材切碎如麻豆大小。每次服用五钱，加水一盏半，煎煮至八分满，滤去药渣。加入生地黄汁一合，蜂蜜半合，再煎煮三沸，温服。不限定服药时间，每日服用两次。
(Attached Discussion)
The *Neijing* (Classic of Internal Medicine) states that when a person suffers from epigastric carbuncle (epigastric abscess), one should examine the stomach pulse. If the pulse is deep and fine, it indicates rebellious Qi. Rebellious Qi causes the Renying (ST9) pulse to be extremely full. An extremely full Renying pulse manifests as heat. The Renying pulse belongs to the Stomach meridian. When Qi is rebellious and full, heat accumulates at the gastric opening without circulating, thus forming an abscess in the epigastrium. When Yin and Yang ascend and descend normally, Ying (Nutritive) and Wei (Defensive) Qi circulate freely; if Qi is rebellious and obstructed, it stagnates and knots to form an abscess. Epigastric carbuncle arises because cold Qi blocks Yang Qi, causing heat to accumulate at the gastric opening. The disharmony of cold and heat leads to the putrefaction of flesh and blood. Because Qi rebels in the Stomach, the pulse is deep and fine; because Yang Qi cannot descend and communicate, the Renying pulse becomes extremely full. This causes symptoms such as chills and fever resembling malaria, skin dryness with scaling (skin turning into armor-like scales), coughing or vomiting, or expectoration of pus and blood. Observing the disease Fuliang (Abdominal Mass), there are cases complicated by epigastric carbuncle, because large amounts of pus and blood reside outside the intestines and stomach.
Formulas
Lianqiao Shengma San (Forsythia and Cimicifuga Powder) [from *Shenghui Fang*]: Treats heat accumulating in the epigastrium, stagnating and knotting to form an abscess.
Ingredients: Lianqiao (Forsythiae Fructum), Shengma (Cimicifugae Rhizoma), Shegan (Belamcandae Rhizoma, remove tail), Duhuo (Angelicae Pubescentis Radix, remove radicle), Sangjisheng (Taxilli Caulis), Mutong (Akebiae Caulis, crushed, each 2.5 liang), Dahuang (Rhei Radix et Rhizoma, crushed, slightly stir-fried, over 2 liang, pounded into coarse powder), Muxiang (Aucklandiae Radix), Chenxiang (Aquilariae Lignum Resinatum, shaved), Xunluxiang (Boswelliae Resina), Dingxiang (Syzygii Flos), Shexiang (Moschus, equal parts, above pounded and ground into fine powder).
Usage: Take 5 qian of the decoction ingredients, add 2 zhan of water, decoct until 1.5 zhan remains. Strain the dregs. Add 2 qian of the five-fragrance fine powder. Decoct again until 1 zhan remains. Take warm. Three doses per day. Stop when bowel movement is unobstructed.
Shaoyao Tang (Peony Decoction) [from *Shengji Zonglu*]: Treats heat accumulation in the epigastrium, knotting and purulating.
Ingredients: Chishaoyao (Paeoniae Radix Rubra), Xijiao (Rhinocerotis Cornu), Mutong (Akebiae Caulis, crushed), Shigao (Gypsum Fibrosum, crushed), Shengma (Cimicifugae Rhizoma, each 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma, crushed), Poxiao (Natrii Sulfas), Xuanshen (Scrophulariae Radix), Maidong (Ophiopogonis Radix, remove heart, each 1 liang).
Usage: Coarsely pound and sieve the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct until 0.8 zhan remains. Strain and take warm. No specific timing for administration.
Maidong Tang (Ophiopogon Decoction) [from *Shengji Zonglu*]: Treats heat qi lingering and accumulating in the epigastrium, internally knotting to form an abscess.
Ingredients: Maidong (Ophiopogonis Radix, remove heart, bake), Xijiao (Rhinocerotis Cornu, shaved), Weirui (Polygonati Odorati Rhizoma), Qini (Adenophorae Radix), Chishaoyao (Paeoniae Radix Rubra), Shigao (Gypsum Fibrosum, each 1.5 liang), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, crushed), Hongxue (Red Snow, each 1 liang).
Usage: Coarsely pound and sieve the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct until 0.8 zhan remains. Strain. Add 1 he of Zhuli (Bamboo Sap). Decoct for two or three boils. Take warm.
Xijiao Tang (Rhinoceros Horn Decoction) [from *Shengji Zonglu*]: Treats excess heat in the Stomach organ, lingering and knotting to form an abscess. Applicable when Yang Qi cannot descend and the stomach pulse is deep and fine.
Ingredients: Xijiao (Rhinocerotis Cornu, shaved), Zhizi Ren (Gardeniae Semen), Chishaoyao (Paeoniae Radix Rubra), Chifuling (Poria Cocos with Red Skin, remove black skin), Huangqin (Scutellariae Radix, remove black heart), Shegan (Belamcandae Rhizoma, remove hairs), Dahuang (Rhei Radix et Rhizoma, crushed, fried, each 1 liang).
Usage: Coarsely pound the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct until 1 zhan remains. Filter and remove dregs. Add one spoonful of honey, stir evenly. Decoct for one or two boils. Take warm after meals.
Shegan Tang (Belamcanda Decoction) [from *Shengji Zonglu*]: Treats non-circulation of Ying and Defensive Qi, heat accumulating at the gastric opening, putrefaction of flesh and blood, forming an abscess in the epigastrium.
Ingredients: Shegan (Belamcandae Rhizoma, remove tail), Zhizi Ren (Gardeniae Semen), Chifuling (Poria Cocos with Red Skin, remove black skin), Shengma (Cimicifugae Rhizoma, 1 liang), Chishaoyao (Paeoniae Radix Rubra), Baizhu (Atractylodis Macrocephalae Rhizoma, each 1.5 liang).
Usage: Cut the herbs into pieces the size of hemp seeds. Take 5 qian per dose, add 1.5 zhan of water, decoct until 0.8 zhan remains. Strain. Add 1 he of Shengdihuang juice (Rehmanniae Radix Juice) and half a he of honey. Decoct for three boils. Take warm. No specific timing. Two doses per day.