肠痈之脉滑而数，滑则为实，数则为热；滑则为营，数则为卫；卫数下降，营滑上升；营卫相干，血
为败浊。（《脉经》）关内逢芤肠里痈。（《脉诀》）
〔未脓〕桃仁承气汤 见一卷疫。
〔脓成〕大黄牡丹汤 大黄 芒硝（各一钱半） 栝蒌 丹皮 桃仁（各二钱半） 一方有冬瓜仁。服下有脓
即出，无即下血。
〔寒症〕牡丹皮散 参 苓 丹 薏 芷 归 芎 天麻 桃仁（各一钱） 官桂 甘草（各五分）
木香（三分）
〔寒症〕内托十宣散 参 归 芎 防 芷 桔 朴 桂 草 为末调，以酒下（三钱）。
〔未成〕通肠饮 忍冬藤 归尾 角刺 花粉 乳 没 芷 薏 草 或用黄占、矾为丸。
〔未成〕大黄煎 大黄 朴硝（各一钱） 丹皮 白芥子 桃仁（各二钱） 下后，以参 补托。
〔已成〕太乙膏 见六卷胃脘痛。
〔溃后〕排脓散 归 防 芷 蒌 翘 草 银花 甲片（各一钱）
〔脓滞〕薏苡仁汤 薏苡 蒌仁（各三钱） 丹皮 桃仁（各三钱）
〔血瘀〕四物延胡汤 当归 延胡（各一钱） 芎 芍 生地（各五分） 桃仁 红花 牛膝（各七分）
水煎。
〔峻补〕参 地黄汤 参 苓 地 丹 萸肉 山药 姜 枣
李氏 寒热脉数，少腹左偏痛引内 ，数日一更衣，左足不伸，此小肠痈也。盖小肠火腑，由气血壅滞
经隧，发为痈毒。宜先彻其在里瘀热，则痛势缓而痈内消。用大黄（三钱）、硝石（一钱）、归尾（钱半）、
赤芍（二钱）、桃仁（一钱）。数服痛减，次用乳香、甘草节、金银花、连翘、当归、木瓜、薏米、牛膝、
数服而消。
肠痈的脉象滑而数，滑脉主实证，数脉主热证；滑脉反映营气状态，数脉反映卫气状态；卫气之数下行，营气之滑上行；营卫之气相互干扰，导致血液腐败浑浊。（出自《脉经》）关部内侧出现芤脉，提示肠内发生痈肿。（出自《脉诀》）
【脓未形成时】使用桃仁承气汤（见第一卷疫病篇）。
【脓已形成时】使用大黄牡丹汤：大黄、芒硝（各一钱半）、栝蒌、丹皮、桃仁（各二钱半），另一版本方中有冬瓜仁。服药后若有脓则排出脓液，若无脓则排出瘀血。
【寒证】使用牡丹皮散：人参、茯苓、丹皮、薏苡仁、白芷、当归、川芎、天麻、桃仁（各一钱）、官桂、甘草（各五分）、木香（三分）。
【寒证】使用内托十宣散：人参、当归、川芎、防风、白芷、桔梗、厚朴、官桂、甘草，研为细末调服，用酒送下（三钱）。
【脓未形成】使用通肠饮：忍冬藤、当归尾、皂角刺、天花粉、乳香、没药、白芷、薏苡仁、甘草，或者用黄占、明矾制成丸剂。
【脓未形成】使用大黄煎：大黄、朴硝（各一钱）、丹皮、白芥子、桃仁（各二钱）。泻下之后，用人参等进行补益托毒治疗。
【脓已形成】使用太乙膏（见第六卷胃脘痛篇）。
【溃破之后】使用排脓散：当归、防风、白芷、栝蒌、连翘、甘草、金银花、穿山甲片（各一钱）。
【脓液滞留】使用薏苡仁汤：薏苡仁、栝蒌仁（各三钱）、丹皮、桃仁（各三钱）。
【血瘀】使用四物延胡汤：当归、延胡索（各一钱）、川芎、芍药、生地黄（各五分）、桃仁、红花、牛膝（各七分），水煎服。
【峻补】使用参地黄汤：人参、茯苓、地黄、丹皮、山茱萸、山药、生姜、大枣。
李氏患者，症见寒热往来、脉数，少腹左侧偏痛并牵引至内部，数日一次排便，左腿无法伸展，这是小肠痈。因为小肠属火腑，因气血壅滞于经络隧道，发为痈毒。应当先清除体内的瘀热，则疼痛缓解，痈肿内消。使用大黄（三钱）、硝石（一钱）、当归尾（一钱半）、赤芍（二钱）、桃仁（一钱）。服用数剂后疼痛减轻，随后使用乳香、甘草节、金银花、连翘、当归、木瓜、薏米、牛膝，服用数剂后痊愈。
The pulse of intestinal abscess is slippery and rapid; a slippery pulse indicates excess, while a rapid pulse indicates heat; a slippery pulse relates to Ying (Nutritive Qi), and a rapid pulse relates to Wei (Defensive Qi); the rapidity of Wei descends, and the slipperiness of Ying ascends; when Ying and Wei interfere with each other, the blood becomes corrupted and turbid. (*Mai Jing*) A Kou (cun-kou) pulse at the Guan position inside indicates an internal intestinal abscess. (*Mai Jue*)
[Before pus formation] Use Taoren Chengqi Tang (Peach Kernel Decoction to Order the Qi) (see Vol. 1 on Epidemic Diseases).
[Pus formed] Use Dahuang Mudan Tang (Rhubarb and Moutan Decoction): Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas) (each 1.5 qian); Gualou (Trichosanthis Fructus), Danpi (Moutan Cortex), Taoren (Persicae Semen) (each 2.5 qian). Another prescription includes Dongguaren (Benincasae Semen). After taking the medicine, if pus exists, it will be discharged; if not, blood will be discharged.
[Cold syndrome] Use Mudan Pi San (Moutan Bark Powder): Shen (Ginseng Radix), Ling (Poria), Dan (Moutan Cortex), Yi (Coicis Semen), Zhi (Angelicae Dahuricae Radix), Gui (Angelicae Sinensis Radix), Xiong (Ligustici Chuanxiong Rhizoma), Tianma (Gastrodiae Rhizoma), Taoren (Persicae Semen) (each 1 qian); Guigui (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 qian); Muxiang (Aucklandiae Radix) (0.3 qian).
[Cold syndrome] Use Neituo Shixuan San (Internal Support Ten-Aperture Powder): Shen (Ginseng Radix), Gui (Angelicae Sinensis Radix), Xiong (Ligustici Chuanxiong Rhizoma), Fang (Saposhnikoviae Radix), Zhi (Angelicae Dahuricae Radix), Jie (Bupleuri Radix or Platycodonis Radix - context implies Platycodon for abscess), Pu (Magnoliae Officinalis Cortex), Gui (Cinnamomi Ramulus), Cao (Glycyrrhizae Radix et Rhizoma), ground into powder and taken with wine (3 qian).
[Not yet formed] Use Tongchang Yin (Intestine-Opening Decoction): Rendongteng (Lonicerae Japonicae Caulis), Guiwei (Angelicae Sinensis Radix tail), Jiaoci (Gleditsiae Spina), Huafen (Trichosanthis Radix), Ru (Olibanum), Mo (Myrrha), Zhi (Angelicae Dahuricae Radix), Yi (Coicis Semen), Cao (Glycyrrhizae Radix et Rhizoma). Alternatively, use Huangzhan (Yellow Wax) and Fan (Alumen) as pills.
[Not yet formed] Use Dahuang Jian (Rhubarb Decoction): Dahuang (Rhei Radix et Rhizoma), Puxiao (Natrii Sulfas) (each 1 qian); Danpi (Moutan Cortex), Baijiezi (Sinapis Semen), Taoren (Persicae Semen) (each 2 qian). After purgation, use Shen (Ginseng Radix) to tonify and support.
[Already formed] Use Taiyi Gao (Taiyi Plaster) (see Vol. 6 on Epigastric Pain).
[After ulceration] Use Painong San (Discharge Pus Powder): Gui (Angelicae Sinensis Radix), Fang (Saposhnikoviae Radix), Zhi (Angelicae Dahuricae Radix), Lou (Trichosanthis Fructus), Qiao (Forsythiae Fructus), Cao (Glycyrrhizae Radix et Rhizoma), Yinhua (Lonicerae Japonicae Flos), Jiapian (Testudinis Carapax et Plastrum) (each 1 qian).
[Pus stagnation] Use Yiyiren Tang (Coix Seed Decoction): Yiyi (Coicis Semen), Louren (Trichosanthis Semen) (each 3 qian); Danpi (Moutan Cortex), Taoren (Persicae Semen) (each 3 qian).
[Blood stasis] Use Siwu Yanhu Tang (Four Substances and Corydalis Decoction): Danggui (Angelicae Sinensis Radix), Yanhu (Corydzidis Rhizoma) (each 1 qian); Xiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix), Shengdi (Rehmanniae Radix) (each 0.5 qian); Taoren (Persicae Semen), Honghua (Carthami Flos), Niuxi (Achyranthis Bidentatae Radix) (each 0.7 qian). Decoct in water.
[Strong Tonification] Use Shen Dihuang Tang (Ginseng and Rehmannia Decoction): Shen (Ginseng Radix), Ling (Poria), Di (Rehmanniae Radix), Dan (Moutan Cortex), Yurou (Corni Fructus), Shanyao (Dioscoreae Rhizoma), Jiang (Zingiberis Rhizoma), Zao (Jujubae Fructus).
Patient Li presented with alternating chills and fever, a rapid pulse, pain in the left lower abdomen radiating inward, defecation once every few days, and inability to extend the left leg. This is an abscess of the small intestine. The small intestine is a Fire Fu Organ; due to qi and blood congestion in the meridians and collaterals, it develops into toxic abscesses. It is appropriate to first eliminate the interior blood stasis and heat, so that the pain subsides and the abscess resolves internally. Prescribe Dahuang (Rhei Radix et Rhizoma) (3 qian), Xiaoshi (Nitrums) (1 qian), Guiwei (Angelicae Sinensis Radix tail) (1.5 qian), Chishao (Paeoniae Radix Rubra) (2 qian), Taoren (Persicae Semen) (1 qian). After several doses, the pain decreased. Subsequently, use Ruxiang (Olibanum), Gancaojie (Glycyrrhizae Radix et Rhizoma joint), Jinyinhua (Lonicerae Japonicae Flos), Lianqiao (Forsythiae Fructus), Danggui (Angelicae Sinensis Radix), Mugua (Chaenomelis Fructus), Yimi (Coicis Semen), Niuxi (Achyranthis Bidentatae Radix). After several doses, the condition resolved.