经曰∶京门隐隐痛者肾疽，其上肉微起者肾痈。（京门穴，又名肾募，在身侧腰中监骨下肋间。）
《素问》曰∶肾痈脚下至小腹满。（大奇论曰∶脚下当作 下。）
张仲景曰∶小腹痛而痞坚者，肾痈也。小便数而似淋者，肠痈也。
王肯堂曰∶肾痈京门穴必隐痛微肿，令人寒热往来，面白不渴，少腹及肋下 胀
塞满。由肾虚不足之人，房劳太过，身形受寒，邪气自外乘之。初宜五积散加细辛；寒尽痛止，宜桂附地黄丸调理。
经曰∶中脘隐隐痛者胃疽，其上肉微起者胃痈。（中脘穴，又名胃募，在脐上四寸。）
又曰∶胃脘痈，人迎脉逆而盛。
《素问》∶帝曰∶人病胃脘痈者，诊当何如？岐伯曰∶诊此者当候胃脉，其脉当
沉细，沉细者气逆；（《甲乙经》沉细作沉涩。）逆者人迎甚盛，甚盛则热。人迎者胃脉也，逆
而盛则热聚于胃中而不行，故胃脘为痈也。（病能篇。）
《圣济录》云∶胃脘痈，由寒气隔阳，热聚胃口，寒热不调，故血肉腐坏。以气
逆于胃，故胃脉沉细。以阳气不得上升，故人迎热盛，令人寒热如疟，身皮甲错，或
咳嗽，或呕脓唾血。若脉洪数，脓成也，急
排之。脉迟紧，瘀血也，急下之，否则其毒内攻，腐烂肠胃矣。
李东垣曰∶脏腑肠胃内疮内疽，其疾隐而不见，目既不见，手不能近，所为至
难，可以诊其脉而辨之，亦可知矣。有胃脘痈者，当候胃脉，人迎者，胃脉也。其
脉沉细者气逆，逆则甚，甚则热聚胃口而不行，胃脘而为痈也。若其脉洪数者，脓
已成也；设脉迟紧，虽脓未就，已有瘀血也。宜急治之。不尔，则邪气内攻，腐烂肠胃，不可救也。（《十书》）
《百效全书》云∶胃脘居心穴之下，其生痈也，外证寒热如疟，胃浊则肺金失养，
或咳或呕，或唾脓血，皮肤错纵。多因饮食七情火郁，彼又外感寒气，使热浊之气
填塞胃脘，胃中清气下陷，故右关脉来沉细，胃中又为寒气所隔，故人迎脉来紧盛，
有此二脉，胃痈始成。宜大射干汤。如痰气上壅，甘桔汤；大便不利，太乙膏作丸
服之；小便赤涩，腹满不食，三仁汤；脓出食少，补中益气汤。
窦汉卿曰∶凡内痈，余尝以薏苡仁汤、牡丹皮散、太乙膏治之亦效。若吐脓血，饮
食少思，宜助胃壮气为主，而佐以前法，不可专治其疮。（《全书》）
朱丹溪曰∶内疽者，因饮食之毒，七情之火相郁而发，用射干汤主之。
冯鲁瞻曰∶胃痈者，胃为水谷之海，多气多血多热，若邪热内泊，则两热相合，故
结为痈。而胃脉必沉细，人迎必甚盛，盖胃脉见于右关，本宜洪大而反沉细者，足
见胃气之逆也。人迎者，胃经穴名，在结喉两旁，亦有动脉应于其间，见于左寸。今
若人迎甚盛，而右关沉细，则愈见热壅聚于胃口而不行，故不能充于脉耳。人见人
迎脉盛，误为伤寒，禁其饮食，则必死。（《锦囊》）
又曰∶胃脘痈者，何以别之？《内经》云∶人病胃脘痈者，当论脉沉细，沉细者
气逆，逆者人迎反甚，则热聚于胃口而不
行，故胃脘为痈也。治法与肠痈同，初以疏利之药导其滞，次用排脓消毒托里之药调之，此其大法也。
张仲景曰∶胃痈初起，中脘穴必隐痛微肿，寒热如疟，身皮甲错，并无咳嗽咯
吐脓血，由饮食之毒，七情之火，热聚胃口而成痈也。脉来沉数者，清胃射干汤下
之。若脉涩滞者，瘀血也，牡丹皮汤下之。脉洪数者，脓已成也，赤豆苡仁汤排之。体
倦气喘作渴，小水频数者，肺气虚也，补中益气汤加麦味补之。
《黄帝内经》说：京门穴处隐隐作痛的是肾疽，该处肌肉微微隆起的是肾痈。（京门穴，又称肾募穴，位于身体侧面腰部中监骨下方的肋间隙。）
《素问》说：肾痈的症状是从脚底到小腹部胀满。（《素问·大奇论》中指出，“脚下”应当作“髀下”，即大腿根部下方。）
张仲景说：小腹部疼痛且按之痞硬坚实的，是肾痈。小便频数且感觉像淋证一样的，是肠痈。
王肯堂说：肾痈患者京门穴必定隐痛微肿，使人出现寒热往来的症状，面色苍白且不口渴，少腹部及胁肋下方胀塞满闷。这是由于肾虚不足的人，房事过度，身体感受寒气，邪气从外部侵袭所致。初期适宜用五积散加细辛；待寒气尽除、疼痛停止后，适宜用桂附地黄丸进行调理。
《黄帝内经》说：中脘穴处隐隐作痛的是胃疽，该处肌肉微微隆起的是胃痈。（中脘穴，又称胃募穴，位于脐上四寸处。）
《素问》记载：黄帝问：人患胃脘痈病，诊察时应该怎样？岐伯回答：诊察此病应当候察胃脉，其脉象应当沉细，脉沉细说明气机逆乱；（《甲乙经》中“沉细”写作“沉涩”。）气机逆乱则人迎脉非常旺盛，非常旺盛则表示有热。人迎脉属于胃经的脉象，脉气逆乱而旺盛，则热气聚集在胃中而不能运行，所以胃脘发生痈肿。（出自《素问·病能篇》。）
《圣济总录》说：胃脘痈，是由于寒气阻隔阳气，热气聚集在胃口，寒热不调，导致血肉腐败坏死。因为气机逆乱于胃，所以胃脉呈现沉细。因为阳气不能上升，所以人迎脉热盛，使人出现寒热如疟疾般的症状，皮肤干枯粗糙如鳞甲交错，或者咳嗽，或者呕吐脓血唾沫。如果脉象洪大数急，说明脓已形成，应立即排脓。如果脉象迟而紧，说明有瘀血，应立即攻下瘀血，否则毒气内攻，会腐烂肠胃。
李东垣说：脏腑肠胃内部的疮疡和疽，病情隐蔽而外表看不出，眼睛看不见，手也不能靠近，诊治极为困难，可以通过诊察脉象来辨别，也就知道了。患有胃脘痈的，应当候察胃脉，人迎脉就是胃脉。脉象沉细说明气机逆乱，逆乱严重，严重时热气聚集在胃口而不能运行，导致胃脘发生痈肿。如果脉象洪大数急，说明脓已经形成；假如脉象迟而紧，虽然脓未形成，但已有瘀血。应当紧急治疗。如果不这样，邪气就会内攻，腐烂肠胃，就无法救治了。（出自《十书》。）
《百效全书》说：胃脘位于心俞穴之下，它发生痈肿时，外证表现为寒热如疟疾，胃中浊气会导致肺金失去滋养，或者咳嗽或呕吐，或者吐出脓血，皮肤纵横交错粗糙。多因饮食不当和七情之火郁结，又外感寒气，使热浊之气填塞胃脘，胃中清气下陷，所以右关脉呈现沉细，胃中又被寒气阻隔，所以人迎脉呈现紧盛，具备这两种脉象，胃痈才形成。适宜用大射干汤。如果痰气上壅，用甘桔汤；大便不通利，用太乙膏制成丸剂服用；小便赤红涩痛，腹部胀满不想进食，用三仁汤；脓出后食欲减少，用补中益气汤。
窦汉卿说：凡是内痈，我曾用薏苡仁汤、牡丹皮散、太乙膏治疗也有效。如果呕吐脓血，饮食减少思虑，应当以助胃壮气为主，并辅助以前面的方法，不可专门治疗疮疡。（出自《全书》。）
朱丹溪说：内疽，是因为饮食之毒与七情之火相互郁结而发作，用射干汤为主方治疗。
冯鲁瞻说：胃痈，胃是水谷汇聚的海，多气、多血、多热，如果邪热内停，则两热相合，所以结成痈肿。而胃脉必然沉细，人迎脉必然非常旺盛，盖因胃脉显现于右关部，本应当洪大而反而沉细，足见胃气之逆乱。人迎穴是胃经的穴位名，位于结喉两旁，此处也有动脉搏动应于其中，脉象反映在左寸部。现在如果人迎脉非常旺盛，而右关脉沉细，就更显见热邪壅聚在胃口而不能运行，所以不能充盈于脉管中。人们看到人迎脉盛，误认为是伤寒，禁止其饮食，则必然死亡。（出自《锦囊》。）
又说：如何辨别胃脘痈？《内经》说：人患胃脘痈病，应当论述脉象沉细，脉沉细说明气机逆乱，气机逆乱则人迎脉反而旺盛，那么热气聚集在胃口而不能运行，所以胃脘发生痈肿。治疗方法与肠痈相同，初期用疏利药物引导滞气，随后用排脓、消毒、托里的药物调理，这是基本大法。
张仲景说：胃痈初起时，中脘穴必定隐痛微肿，寒热如疟疾，身体皮肤干枯粗糙如鳞甲交错，并没有咳嗽咯吐脓血，这是由于饮食之毒和七情之火，热气聚集在胃口而成痈。脉象沉数的，用清胃射干汤攻下。如果脉象涩滞，是瘀血，用牡丹皮汤攻下。脉象洪大的，说明脓已形成，用赤豆苡仁汤排脓。身体疲倦气喘口渴，小便频数的，是肺气虚，用补中益气汤加麦冬、五味子补益。
The *Classic of Medicine* (Huangdi Neijing) states: If there is a dull pain at the Jingmen point, it is Kidney Ju (Kidney Carbuncle); if the flesh above slightly protrudes, it is Kidong Yong (Kidney Abscess). (Jingmen point, also known as the Front-Mu point of the Kidney, is located in the middle of the waist on the side, between the ribs below the Jian bone.)
The *Suwen* (Basic Questions) states: The symptoms of Kidney Yong include fullness from the soles of the feet to the lower abdomen. (In the *Daqi Lun* chapter of the *Suwen*, "soles of the feet" should be read as "below the thighs".)
Zhang Zhongjing stated: Lower abdominal pain with hardness and obstruction upon palpation indicates Kidney Yong. Frequent urination with a sensation resembling strangury indicates Intestinal Yong.
Wang Kentang stated: In Kidney Yong, the Jingmen point will definitely have dull pain and slight swelling, causing alternating chills and fever, a pale complexion without thirst, and distension and fullness in the lower abdomen and hypochondrium. This arises in individuals with Kidney deficiency who have overindulged in sexual activity, allowed their bodies to be chilled by cold, and thereby invited pathogenic factors from the exterior. Initially, Wuji San (Five Accumulations Powder) with Xixin (Asarum) is suitable; once the cold has dissipated and pain ceased, Guifu Dihuang Wan (Cinnamon Twig and Aconite Pill of the Eight Ingredients) is suitable for regulation.
The *Classic of Medicine* states: If there is a dull pain at the Zhongwan point, it is Stomach Ju; if the flesh above slightly protrudes, it is Stomach Yong. (Zhongwan point, also known as the Front-Mu point of the Stomach, is located four cun above the umbilicus.)
It further states: In Stomach Wan Yong (Epigastric Abscess), the Renying pulse appears rebellious and vigorous.
The *Suwen* records: The Yellow Emperor asked: When a person suffers from Stomach Wan Yong, how should the diagnosis be conducted? Qibo replied: To diagnose this condition, one must observe the Stomach pulse; the pulse should be deep and fine. A deep and fine pulse indicates rebellious Qi. (The *Jiayi Jing* writes "deep and fine" as "deep and choppy".) Rebellious Qi causes the Renying pulse to become very vigorous; when very vigorous, it indicates heat. The Renying pulse belongs to the Stomach meridian. When the pulse is rebellious and vigorous, heat accumulates in the Stomach and fails to circulate, thus causing an abscess in the epigastrium. (From the *Bingneng Pian* chapter.)
The *Shengji Zonglu* states: Stomach Wan Yong occurs due to cold qi blocking yang qi, causing heat to accumulate at the stomach opening. The disharmony of cold and heat leads to the corruption of flesh and blood. Because Qi rebels in the Stomach, the Stomach pulse becomes deep and fine. Because Yang Qi cannot ascend, the Renying pulse becomes hot and vigorous, causing symptoms such as alternating chills and fever resembling malaria, skin that is rough and scaly like fish scales, coughing, or vomiting pus and blood. If the pulse is surging and rapid, pus has formed, and immediate drainage is required. If the pulse is slow and tight, it indicates blood stasis, which requires immediate purgation; otherwise, the toxin will attack internally, rotting the intestines and stomach.
Li Dongyuan stated: Internal ulcers and carbuncles within the zang-fu organs and intestines are hidden and invisible externally. Since they cannot be seen by eyes or touched by hands, diagnosis is extremely difficult. However, by observing the pulse, one can distinguish them and understand the condition. For those suffering from Stomach Wan Yong, one should observe the Stomach pulse; the Renying pulse is the Stomach pulse. A deep and fine pulse indicates rebellious Qi. Severe rebellion leads to heat accumulating at the stomach opening and failing to circulate, resulting in an abscess in the epigastrium. If the pulse is surging and rapid, pus has formed; if the pulse is slow and tight, although pus has not yet formed, blood stasis exists. Urgent treatment is necessary. Otherwise, pathogenic factors will attack internally, rotting the intestines and stomach, making the condition incurable. (From the *Ten Books*.)
The *Baixiao Quanshu* states: The Stomach Wan is located below the Xinshu point. When an abscess forms here, external symptoms include alternating chills and fever resembling malaria. Stomach turbidity causes Lung Metal to lose nourishment, leading to coughing or vomiting, spitting up pus and blood, and rough, crisscrossed skin. This is often caused by dietary toxins and emotional fire郁结 (stagnation), combined with external cold invasion, causing hot and turbid qi to fill the epigastrium. Clear Qi in the Stomach sinks downward, so the Right Guan pulse appears deep and fine. The Stomach is blocked by cold qi, so the Renying pulse appears tight and vigorous. With these two pulses present, Stomach Yong is formed. Dasye Gan Tang (Major Belamcanda Decoction) is suitable. If phlegm and Qi obstruct upward, Ganjie Tang (Licorice and Platycodon Decoction) is used; if bowel movements are difficult, Taiyi Gao (Great One Ointment) made into pills is taken; if urine is red and scanty with abdominal fullness and loss of appetite, Saren Tang (Three Seeds Decoction) is used; if pus has drained but appetite remains poor, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is used.
Dou Hanqing said: Regarding all internal abscesses, I have treated them effectively using Yiyiren Tang (Coix Seed Decoction), Mudanpi San (Moutan Bark Powder), and Taiyi Gao. If pus and blood are vomited, and food intake is low with little desire to eat, the primary approach should be to strengthen the Stomach and boost Qi, assisted by the aforementioned methods, rather than treating the ulcer exclusively. (From the *Complete Book*.)
Zhu Danxi stated: Internal carbuncles arise from the stagnation of dietary toxins and emotional fire. Shegan Tang (Belamcanda Decoction) is the main formula for treatment.
Feng Luzhan stated: In Stomach Yong, the Stomach is the sea of water and grain, possessing abundant Qi, Blood, and Heat. If pathogenic heat lodges internally, the two heats combine, forming an abscess. Consequently, the Stomach pulse must be deep and fine, and the Renying pulse must be very vigorous. The Stomach pulse manifests at the Right Guan position, where it should naturally be surging and large; the fact that it is instead deep and fine demonstrates the rebellion of Stomach Qi. The Renying point is a name for a point on the Stomach meridian, located on both sides of the laryngeal prominence, where arterial pulsation can be felt, and its pulse reflection appears at the Left Cun position. Now, if the Renying pulse is very vigorous while the Right Guan pulse is deep and fine, it further confirms that heat is congested and stagnant at the stomach opening and cannot circulate, thus failing to fill the pulse vessel. People often mistake a vigorous Renying pulse for Cold Damage (Shanghan) and prohibit food intake, which inevitably leads to death. (From the *Brocade Pouch*.)
He further stated: How to distinguish Stomach Wan Yong? The *Neijing* says: When a person suffers from Stomach Wan Yong, one should discuss the deep and fine pulse. A deep and fine pulse indicates rebellious Qi; rebellion causes the Renying pulse to become contrary and vigorous. Thus, heat accumulates at the stomach opening and fails to circulate, resulting in an abscess in the epigastrium. The treatment method is the same as for Intestinal Yong: initially use dispersing and draining herbs to guide away stagnation, then use herbs to drain pus, detoxify, and support the interior for regulation. This is the general principle.
Zhang Zhongjing stated: At the onset of Stomach Yong, the Zhongwan point will definitely have dull pain and slight swelling, accompanied by alternating chills and fever resembling malaria, and skin that is rough and scaly like fish scales, without coughing or expectorating pus and blood. This is caused by dietary toxins and emotional fire, with heat accumulating at the stomach opening to form an abscess. If the pulse is deep and rapid, Qingwei Shegan Tang (Clear Stomach Belamcanda Decoction) should be administered to purge. If the pulse is choppy and sluggish, it indicates blood stasis, and Mudanpi Tang (Moutan Bark Decoction) should be administered to purge. If the pulse is surging and rapid, pus has formed, and Chidou Yiren Tang (Red Bean and Coix Seed Decoction) should be used to drain pus. If the body is fatigued, short of breath, thirsty, and urinating frequently, it indicates Lung Qi deficiency; Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Berry) should be used to tonify.