自尾闾谷道起至臀股止，一切痔漏疮疽，皆汇于此部中，以便检阅参治。
《灵枢》曰∶发于尻名曰锐疽。其状赤坚大。急治之，不治，三十日死矣。
《鬼遗方》云∶涌泉疽，肿起发，太阴（太阴，尻尾前是也。）如伏鼠，二十日不穴死，十
日可刺，发清脓赤黑者死，白色可治。
陈实功曰∶此乃三阴亏损，督脉之经浊气湿痰流结而成。其患发在尾闾之穴高
骨尖上。初起形似鱼胞，久则突如鹳嘴，朝寒暮热，日轻夜重，溃后稀脓出而无禁，又
或鲜血出而不停。凡发此者，壮年犹可，老者可危。（《正宗》）
汪省之曰∶初起滋阴除湿，已成和气养荣，已溃滋肾保元。久而成漏，宜琥珀
蜡矾丸、先天大造丸兼服。（《理例》）
澄曰∶鹳口疽老弱难敛，易于成漏。
\r尾闾发\p04-a41a177.bmp\r
王肯堂曰∶尾闾发生于尾闾穴，乃督脉所主，最痛难忍，更难得脓。（《准绳》）
又曰∶病HT 生尾 骨处，结毒如桃李之大，红赤 痛，不能行动。
申斗垣曰∶得之奔走劳伤，或久坐血凝气滞者易治。得之酒色过度，忍精强战，
督脉亏损者，破必成漏，难以收功。（《启玄》）
\r臀痈\p04-a41a178.bmp\r
王肯堂曰∶肿高根浅为臀痈，肿平根深为臀疽，俱属足太阳膀胱经湿热所致。（《准绳》）
薛立斋曰∶臀乃膀胱经部分也，居小腹之后，此阴中之阴，其道远，其位僻，虽
太阳多血，气运难及，血亦罕到，中年后尤虑此患。治者毋伤脾胃，毋损气血，但当固根本为主。
陈实功曰∶臀痈生于小腹之后，位远僻奥，气亦罕到，血亦少来，凡生此者，湿
热流结凝滞而成。此证必须托毒外发，庶不内攻。初起毒从五脏蕴积者，患必有头，
红肿坠重如石，内必口干发热。治当通利积热，外以膏贴金黄散，敷四围，拔出瘀
脓血，内兼补托自愈；若误用败毒寒剂，外敷凉药，冰凝气血，毒瓦斯不得外泄，反致
内攻。如疮头软陷无脓，根脚平散不痛，口干烦躁谵语，痰喘气粗，恍惚不宁者，俱
为不治。但此证多从毒积五脏，自内至表者，十有八九；风寒暑热，自外至里者，百
中一二；尝既出而复入里者，终为死候。（《正宗》）
申斗垣曰∶臀疽乃太阳膀胱经多血少气，生于承扶穴最痛，宜托之。生于实处
者易治。近大小便处者，难治。（《启玄》）
冯鲁瞻曰∶痈发于臀，乃膀胱之湿毒蒸热，或禀赋阴虚，此地最难高耸溃脓。大宜托里为要。（《锦囊》）
朱丹溪曰∶臀痈生于臀上胯下近大腿处，由湿热相侵，气血凝聚郁毒而成。形
如大盘，肿阔盈尺，上覆其腰，下遮其胯，
此为阴中之阴，务须宣热拔毒，大补气血，培养肾胃，滋补根源。如此庶血易聚而脓
易作，毒易出而热可宣，不然经年累月，肿仍如故，疼痛日深。是以中年之后，犹虑
患此。一见虚弱便与滋补，可保终吉。若妄以清凉败毒内服外敷，则气血得寒益凝，多致不救。
从尾闾穴和肛门起，直到臀部和大腿止，这一区域内所有的痔疮、瘘管、疮疡和疽病，都汇集在此部分中，以便于查阅和参考治疗。
《灵枢》说：发于尻部的称为锐疽。其症状表现为局部红肿坚硬且大。必须紧急治疗，若不治疗，三十天后会死亡。
《鬼遗方》记载：涌泉疽，肿胀突起并破溃，太阴经（太阴经，指尻尾前方部位）的症状像潜伏的老鼠，二十天不切开排脓就会死亡；十天时可以针刺，若流出清澈的脓液或赤黑色脓液则预后不良，流出白色脓液则可治愈。
陈实功说：这是由于三阴经亏损，督脉中的浊气与湿痰流注凝结而成。病变发生在尾闾穴的高骨尖上。初起时形状像鱼泡，久了则突出如鹳鸟之嘴，早晨怕冷晚上发热，白天症状轻夜间重，溃破后稀脓流出不止，或者鲜血流出不停。凡是发生此病的人，壮年尚可救治，老年人则情况危急。（出自《外科正宗》）
汪省之说：初起时应滋阴除湿，已成脓时应调和气血、滋养荣卫，已溃破时应滋补肾精、保全元气。若久治不愈形成漏管，宜兼服琥珀蜡矾丸和先天大造丸。（出自《外科理例》）
尾闾发
王肯堂说：尾闾发发生于尾闾穴，由督脉所主，疼痛剧烈难以忍受，而且很难化脓。（出自《外科准绳》）
又说：病变生在尾骨处，结毒大小如桃李，红肿疼痛，导致无法行动。
申斗垣说：因奔走劳伤，或久坐导致血凝气滞者，容易治疗。因酒色过度、忍精强战导致督脉亏损者，破溃后必成漏管，难以收效。（出自《外科启玄》）
臀痈
王肯堂说：肿势高突、根基浅表的是臀痈；肿势平坦、根基深固的是臀疽，二者都属于足太阳膀胱经湿热所致。（出自《外科准绳》）
薛立斋说：臀部是足太阳膀胱经分布的区域，位于小腹之后，属于阴中之阴，经络遥远，位置偏僻，虽然太阳经多血，但气运难以到达，血液也很少流经此处，中年以后尤其要警惕此患。治疗者不要损伤脾胃，不要损耗气血，只应当以巩固根本为主。
陈实功说：臀痈生于小腹之后，位置遥远偏僻，气也难以到达，血也很少来此。凡是发生此病，都是湿热流注凝结停滞而成。此证必须托毒外出，才不会内攻脏腑。初起时毒邪从五脏蕴积而来，患处必有头，红肿沉重如石头，内部必然口干发热。治疗应当通利积热，外部用金黄散膏贴敷四周，拔出瘀脓血，内部兼用补托之法即可自愈；如果误用败毒寒凉药物，外部敷用凉药，会导致气血冰凝，毒邪不得外泄，反而导致内攻。如果疮头软陷无脓，根脚平散不痛，伴有口干烦躁谵语、痰喘气粗、神志恍惚不安等症状，都属于不治之症。但这种病大多是从毒积五脏，自内向外发的，十有八九；风寒暑热自外向内的，百中仅一二；曾经发出又复陷入里的，最终都是死候。（出自《外科正宗》）
申斗垣说：臀疽属于太阳膀胱经多血少气，生于承扶穴处最痛，宜用托法治疗。生于坚实肌肉处的容易治疗。靠近大小便处的，难治。（出自《外科启玄》）
冯鲁瞻说：痈发于臀部，是膀胱的湿毒蒸腾发热，或者是禀赋阴虚，此地最难高耸溃脓。特别适宜以托里透脓为关键。（出自《外科锦囊》）
朱丹溪说：臀痈生于臀部上方、胯下靠近大腿处，由湿热相侵，气血凝聚郁结毒邪而成。形状像大盘子，肿胀宽阔达一尺以上，向上覆盖腰部，向下遮盖胯部，这属于阴中之阴，务必宣散热邪、拔除毒邪，大补气血，培养肾胃，滋补根源。这样才容易聚血生脓，毒邪容易排出，热邪可以宣散，否则经年累月，肿胀依然如故，疼痛日益加深。因此中年之后，还要忧虑患上此病。一见虚弱就给予滋补，可保最终吉祥。如果妄用清凉败毒药物内服外敷，则气血遇寒更加凝滞，多导致无法救治。
From the Weili (Tailbone) point and the anus to the buttocks and thighs, all hemorrhoids, fistulas, sores, and carbuncles in this region are compiled here for easy reference and treatment.
The *Ling Shu* states: A lesion occurring on the sacrum is called Rui Ju (Sharp Carbuncle). Its presentation features redness, hardness, and swelling. It requires urgent treatment; if untreated, death will occur within thirty days.
The *Gui Yi Fang* records: Yongquan Ju (Carbuncle at Yongquan), characterized by swelling and rupture, involves the Tai Yin meridian (referring to the area anterior to the sacrum and tail). If it resembles a lurking mouse and is not punctured within twenty days, death ensues. Puncture may be performed after ten days. Prognosis is poor if clear or dark red/black pus is discharged, but favorable if white pus appears.
Chen Shigong states: This condition arises from the deficiency of the Three Yin meridians, with turbid qi and damp-phlegm flowing and knotting in the Du Mai (Governing Vessel). The lesion occurs at the high bone tip above the Weili point. Initially, it resembles a fish bladder; later, it protrudes like an ibis's beak. Patients experience chills in the morning and fever in the evening, with symptoms lighter during the day and heavier at night. After ulceration, thin pus flows uncontrollably, or fresh blood bleeds incessantly. While young adults may recover, the prognosis for the elderly is critical. (*Waike Zhengzong*)
Wang Shengzhi states: In the initial stage, nourish Yin and drain Dampness. Once abscessed, harmonize Qi and nourish Ying. After ulceration, nourish Kidney Jing and preserve Yuan Qi. If it persists into a fistula, administer Hupo La Wan (Amber Wax Pill) and Xiantian Da Zao Wan (Pre-heaven Great Creation Pill) concurrently. (*Waike Lili*)
Gu Shicheng states: Guan Kou Ju (Ibis Mouth Carbuncle) is difficult to heal in the elderly and weak, prone to forming fistulas.
Weili Fa (Eruption at Weili)
Wang Kentang states: Weili Fa occurs at the Weili point, governed by the Du Mai. It is extremely painful and difficult to suppurate. (*Waike Zhunsheng*)
He also states: When the disease occurs at the coccyx, toxic nodules form the size of plums or peaches, presenting with redness, swelling, and pain, rendering movement impossible.
Shen Douyuan states: Cases resulting from exertion or prolonged sitting causing blood stasis and Qi stagnation are easier to treat. Cases resulting from excessive sexual activity or holding back ejaculation, leading to Du Mai deficiency, will likely become fistulas upon rupture and are difficult to cure. (*Waike Qixuan*)
Tun Yong (Buttock Abscess)
Wang Kentang states: High swelling with a shallow root is Tun Yong; flat swelling with a deep root is Tun Ju. Both are caused by Damp-Heat in the Foot-Taiyang Bladder Meridian. (*Waike Zhunsheng*)
Xue Lizhai states: The buttock is the domain of the Foot-Taiyang Bladder Meridian, located posterior to the lower abdomen. It is "Yin within Yin," distant in pathway and remote in location. Although the Taiyang meridian is rich in blood, Qi circulation rarely reaches it, and blood flow is scarce. Thus, individuals past middle age should particularly guard against this affliction. Treatment should avoid damaging the Spleen and Stomach or depleting Qi and Blood, focusing instead on consolidating the Root.
Chen Shigong states: Tun Yong arises posterior to the lower abdomen, in a remote and obscure location where Qi rarely reaches and blood seldom arrives. It results from the accumulation and stagnation of Damp-Heat. This condition must be treated by expelling toxins outward to prevent internal invasion. If the toxin originates from internal organ accumulation, the lesion will have a head, appearing red, swollen, heavy, and stone-hard, accompanied by internal dry mouth and fever. Treatment should promote the clearance of accumulated heat externally using Jin Huang San (Golden Yellow Powder) paste applied around the periphery to draw out stagnant pus and blood, combined internally with tonifying and expelling methods for self-healing. Misuse of cold-natured detoxifying herbs or external cooling applications causes Qi and Blood to congeal like ice, trapping toxins and forcing them inward. If the sore head becomes soft and sunken without pus, the base spreads flatly without pain, and symptoms include dry mouth, irritability, delirium, phlegm-wheezing, coarse breathing, and mental restlessness, these are untreatable. Most cases (80-90%) arise from internal toxin accumulation spreading outward; only 1-2% result from external Wind-Cold, Summer-Heat, or Heat invading inward. Recurrence with internal penetration indicates a fatal outcome. (*Waike Zhengzong*)
Shen Douyuan states: Tun Ju belongs to the Foot-Taiyang Bladder Meridian, which is rich in blood but deficient in Qi. Lesions at the Chengfu point are most painful and require expulsion therapy. Those arising in solid muscle tissue are easier to treat; those near the urethra or anus are difficult to treat. (*Waike Qixuan*)
Feng Luzhan states: Sores erupting on the buttocks are caused by Damp-Toxin steaming and heating in the Bladder, or by congenital Yin deficiency. This area is least likely to rise high and suppurate effectively. Therefore, interior-tonifying and suppuration-promoting methods are essential. (*Waike Jinnang*)
Zhu Danxi states: Tun Yong occurs on the upper buttocks near the thigh, caused by Damp-Heat invasion and the coagulation of Qi and Blood into郁毒 (stagnant toxin). The shape resembles a large plate, with broad swelling extending over a chi, covering the waist upward and obscuring the crotch downward. This is "Yin within Yin." One must vigorously dissipate Heat, extract Toxins, greatly tonify Qi and Blood, cultivate the Kidneys and Stomach, and nourish the roots. Only then can blood gather easily, pus form readily, toxins exit smoothly, and Heat dissipate. Otherwise, swelling persists for years, and pain deepens daily. Hence, those past middle age must beware. Upon seeing weakness, immediate tonification ensures good outcomes. Misuse of cooling and detoxifying agents internally and externally causes Qi and Blood to congeal further due to cold, often leading to untreatable conditions.