人有腹痛口渴，左足屈而不伸，伸则痛甚，手按其痛处，更不可忍者，人以为腹中生痈也，谁知是小肠痈乎？
肠中生痈不同，有大小肠之分，屈右足者大肠生痈，屈左足者小肠生痈也。今屈而不伸者，既在左足，是痈生
于小肠，而非生于大肠矣。惟是大肠之痈易治，小肠之痈难医，以大肠可泄而小肠难泄也。若得其法，又何难
哉？盖大肠可泄其火，从糟粕而出；小肠可泄其火，从溲溺而泄也。方用泄毒至神汤∶
刘寄奴（三两） 车前子（三两） 金银花（三两） 泽泻（三两） 甘草（三两） 茯苓（一两）
玉米（一两） 肉桂（一分）
水煎服，一剂而水如注，二剂而痛顿止，三剂而症如失，不必四剂矣。此方皆利水之药，重用金银花为消
毒之品，何以建功之神如此？盖小肠之毒，必须内消，而内消之药舍金银花，实无他药可代。以他药消毒，均
能损伤正气，而小肠之气断不可损伤，故必须以金银花为君药。但金银花不能入于小肠之中，而佐以茯苓、车
前、泽泻、玉米之类，引入小肠，又加肉桂一分，得其气味，直入膀胱从溲溺而化其毒。若恐火毒太甚，诸药
不能迅速收功，更加寄奴之速祛，甘草之缓调，刚柔迟速，兼而行之，既无留滞之虞，又无峻烈之害，自然火
毒尽从小肠膀胱而出也。
秘诀∶
泄毒至神寄奴三，车银草泽重如前，
苓玉一两桂分入，三剂服后患可痊。
此症方用王公汤亦效∶
王不留（一两） 蒲公英（一两） 车前子（一两） 甘草（五钱） 金银花（三两）
水煎服，一剂效。
秘诀∶
王公汤治小肠痈，不留一两蒲公英，
车前一两五钱草，银花三两一剂从。
人有腹痛呼号不已，其痛却在左腹，按之痛不可忍，不许人按，人以为食积在大肠也，谁知是小肠之生痈
乎？夫肠痈必屈其足，而今不屈足，似非肠痈之病。然肠痈生于肠内，在大肠者屈右足而不伸，在小肠者屈左
足而不伸也。若痈生于肠外者，皆不屈足，痛在左则小肠生痈，痛在右则大肠生痈也。至于食积燥粪之痛，时
而痛，时而不痛，不若生痈之痛，有定而不移，常痛而无止息也。大小肠生痈于肠内，尚可破溃，而大小肠生
痈于肠外，断不可使之溃烂者，以肠外无可出之路，皆必死之症也。而小肠更甚，必须急治，以利水解毒为妙，
否则变生不测矣。方用利水解毒内消丹，亦可用王公汤，再加金银花三两可矣。
金银花（四两） 车前子（五钱） 薏苡仁（一两） 茯苓（一两） 当归（二两） 甘草（三钱）
水煎服，一剂而痛大减，二剂而痛又减，三剂而痛全止，四剂而痊愈矣。此方即前方（泄毒至神汤）之变
方也。但前方于利水之中而行其败毒之法，此方则于利水之
中而佐以补血败毒之味也。盖痈破尤宜利水，利水则毒随之而出，易于涤除。如痈未破，而不补血，徒事利水，
利水则水泄血虚，毒亦难于消化。同中之异，不可不知也。然此症须急早治之，否则痈虽愈而瘀血流于肠外，
必有终身腹痛之患矣。
秘诀∶
利水解毒内消丹，银花四两车五钱，
薏仁苓两归二两，甘草三钱一同煎。
人有腹痛骤甚，小便流血，左足不能伸者，人以为小肠生痈也，谁知是小肠之火太盛乎？夫小肠生痈，必
屈左足，今左足不伸，明是生痈之证，而余独谓是火盛者何也？盖生痈必有其征，岂有一旦骤生而流血者乎？
痈久而脓生，脓欲尽而血出，岂有不溃不烂而先出血者乎？然左足之屈，则又何也？盖小肠与大肠不同，小肠
细而大肠宽，宽者可以容邪，而细则难以容邪，此必然之理也。小肠受火煎熬，则肠中逼迫，不能舒畅，而左
足应之，故暂屈而不能伸，不若生痈者长屈而不能伸也。万不可因足之不伸，即信是痈，而妄用解毒之药，
其害大矣！然火毒与痈，从何而辨之？初病之时，辨其小便之有血无血耳。如初痛而足不伸，小便无血，乃是
生痈。初痛而足不伸，小便有血，乃是火痛，断不差也。治之法，泄其火邪不必化毒，则痛自止而足自伸矣。
方用加味小柴胡汤治之∶
柴胡（二钱） 黄芩（三钱） 人参（五钱） 茯苓（五钱） 半夏（一钱） 甘草（一钱） 生姜（三片）
大枣（三枚）
水煎服，一剂而足伸，二剂而血止，肠亦不痛矣。小柴胡汤非治小肠痈之药也，何以用之而效验之捷如此？
盖小肠之火盛者，起于肝木之郁也，木郁则火生，不敢犯心而犯小肠耳。夫火性炎上，今不上炎而反致下炽，
拂其火之性矣，此小肠所以受害而作痛也。至于血流于小便中者，又是何故？盖小肠之血，为火所逼，恐火烁
血干，故越出于小肠之外，直走膀胱，反使水道不行而流血也。小柴胡汤既舒其肝胆之气，则上炎之火气，其
性即顺而不逆也，又得茯苓以分消其水气，则水顺流而不横，其血归经而不逆，自然气舒血和，而消毒矣，此
方之所以奇耳。
秘诀∶
加味小柴治肠毒，黄芩三钱参苓五，
夏草一钱加姜枣，二剂血止肠痈主。
此症用车苓连甘汤亦效∶
车前子（五钱） 茯苓（一两） 黄连（三钱） 甘草（三钱）
水煎服。
秘诀∶
又有车苓连甘汤，车前五钱苓两襄，
甘连三钱同煎服，止血通和此方良。
有人出现腹痛、口渴，左腿弯曲无法伸直，若强行伸直则疼痛加剧，用手按压疼痛部位更是难以忍受。人们通常认为是腹中生了痈疽，但谁能想到这是小肠痈呢？
肠道生痈的情况各不相同，有区分大肠和小肠的不同表现：屈曲右腿的是大肠生痈，屈曲左腿的是小肠生痈。现在患者左腿弯曲无法伸直，既然病位在左侧，说明痈生于小肠，而非大肠。只是大肠的痈容易治疗，小肠的痈难治，因为大肠可以通过排泄糟粕来泄热，而小肠难以通过这种方式泄热。如果掌握了正确的方法，又有什么困难呢？大概大肠的火毒可以从粪便中排出；小肠的火毒则必须从小便中排出。方剂使用泄毒至神汤：
刘寄奴（三两） 车前子（三两） 金银花（三两） 泽泻（三两） 甘草（三两） 茯苓（一两）
玉米（一两） 肉桂（一分）
用水煎服，服用一剂后小便如水注般通畅，服用两剂后疼痛立刻停止，服用三剂后症状完全消失，不需要服用第四剂了。这个方子全是利水药物，重用金银花作为解毒之品，为何能取得如此神奇的功效？大概小肠的毒邪，必须从内部消散，而在内消的药物中，除了金银花，实在没有别的药可以替代。用其他药物解毒，都会损伤正气，而小肠的气机绝对不可损伤，所以必须以金银花为君药。但是金银花不能直接进入小肠，所以辅以茯苓、车前子、泽泻、玉米等药物，将其引入小肠，再加入一分肉桂，借其气味，直接入膀胱，从小便中化解毒邪。如果担心火毒太盛，诸药不能迅速见效，再加上刘寄奴的快速祛除作用，甘草的缓和调理作用，刚柔并济，快慢兼施，既没有留滞的担忧，也没有峻烈药物的危害，自然火毒全部从小肠和膀胱排出。
秘诀：
泄毒至神寄奴三，车银草泽重如前，
苓玉一两桂分入，三剂服后患可痊。
此症也可使用王公汤，同样有效：
王不留行（一两） 蒲公英（一两） 车前子（一两） 甘草（五钱） 金银花（三两）
用水煎服，服用一剂即见效。
秘诀：
王公汤治小肠痈，不留一两蒲公英，
车前一两五钱草，银花三两一剂从。
有人腹痛呼叫不止，疼痛在左侧腹部，按压时疼痛难以忍受，不允许别人按压。人们以为是食积在大肠，但谁能想到是小肠生痈呢？凡是肠痈必定会屈曲双腿，而现在不屈曲双腿，似乎不是肠痈的病证。然而肠痈生于肠内，在大肠者屈右腿而不伸，在小肠者屈左腿而不伸。如果痈生于肠外，都不会屈曲双腿，疼痛在左侧则是小肠生痈，疼痛在右侧则是大肠生痈。至于食积或燥粪引起的疼痛，时而痛，时而又不痛，不像生痈的疼痛那样固定不移，常痛且无休止。大小肠生痈在肠内，尚可破溃排脓，而大小肠生痈在肠外，绝对不能使其溃烂，因为肠外没有排出的通路，都是必死的病症。其中小肠更为严重，必须紧急治疗，以利水解毒为妙，否则会发生不可测的变化。方剂使用利水解毒内消丹，也可以使用王公汤，再加金银花三两即可。
金银花（四两） 车前子（五钱） 薏苡仁（一两） 茯苓（一两） 当归（二两） 甘草（三钱）
用水煎服，服用一剂后疼痛大减，服用两剂后疼痛又减轻，服用三剂后疼痛完全停止，服用四剂后痊愈。这个方子就是前方（泄毒至神汤）的变方。只是前方是在利水中配合败毒之法，此方则是在利水中辅以补血败毒的药物。大概痈破溃后更宜利水，利水则毒邪随之而出，易于清除。如果痈未破溃，而不补血，只从事利水，利水会导致水泄血虚，毒邪也难以消化。同中之异，不可不知道。然而此症必须及早治疗，否则虽然痈愈，但瘀血流于肠外，必然会有终身腹痛的隐患。
秘诀：
利水解毒内消丹，银花四两车五钱，
薏仁苓两归二两，甘草三钱一同煎。
有人腹痛突然剧烈，小便流血，左腿不能伸直，人们认为是小肠生痈，但谁能想到这是小肠火气太盛呢？凡小肠生痈，必定屈曲左腿，现在左腿不伸，明显是生痈的证候，但我唯独说是火盛的原因是什么呢？大概生痈必有其征兆，岂有一旦突然生成就流血的吗？痈久才会化脓，脓液将尽时血液才流出，岂有不溃烂而先出血的吗？那么左腿弯曲又是为什么呢？大概小肠与大肠不同，小肠细而大肠宽，宽大的可以容纳邪气，而细小的难以容纳邪气，这是必然的道理。小肠受火邪煎熬，则肠中逼迫，不能舒畅，从而反映在左腿上，所以暂时弯曲而不能伸直，不像生痈那样长期弯曲而不能伸直。万不可因为腿不伸直，就相信是痈，而妄用解毒药物，危害很大！然而火毒与痈，如何辨别呢？在初病之时，辨别小便中有血还是无血罢了。如果初起疼痛且腿不伸，小便无血，乃是生痈。如果初起疼痛且腿不伸，小便有血，乃是火痛，绝不会差。治疗方法，泄其火邪不必化毒，则疼痛自止而腿自伸了。方剂使用加味小柴胡汤治疗：
柴胡（二钱） 黄芩（三钱） 人参（五钱） 茯苓（五钱） 半夏（一钱） 甘草（一钱） 生姜（三片）
大枣（三枚）
用水煎服，服用一剂后腿伸直，服用两剂后血止，肠也不再疼痛。小柴胡汤并非治疗小肠痈的药物，为何使用它却见效如此快捷？大概小肠火盛，起因于肝木郁结，木郁则生火，不敢侵犯心脏而侵犯小肠罢了。火性炎上，现在不上炎反而在下部炽盛，违背了火的本性，这就是小肠受害而作痛的原因。至于血液流入小便中，又是什么原因呢？大概小肠的血，被火邪逼迫，恐怕火邪烧干血液，所以溢出小肠之外，直走膀胱，反而导致水道不通而流血。小柴胡汤既能疏解肝胆之气，则上炎的火气，其性质就会顺遂而不逆乱，再加上茯苓以分消水气，则水流顺畅而不横溢，血液回归经脉而不逆乱，自然气舒血和，从而达到消毒的效果，这就是此方奇妙的地方。
秘诀：
加味小柴治肠毒，黄芩三钱参苓五，
夏草一钱加姜枣，二剂血止肠痈主。
此症用车苓连甘汤也有效：
车前子（五钱） 茯苓（一两） 黄连（三钱） 甘草（三钱）
用水煎服。
秘诀：
又有车苓连甘汤，车前五钱苓两襄，
甘连三钱同煎服，止血通和此方良。
A person presents with abdominal pain and thirst, the left leg is flexed and cannot be extended; extension exacerbates the pain. Palpation of the painful area is unbearable. People assume it is an abscess in the abdomen, but who would know that it is actually an Intestinal Abscess (Chang Yong) of the Small Intestine?
The formation of abscesses in the intestines varies, distinguished by involvement of the Large Intestine or Small Intestine: flexion of the right leg indicates a Large Intestine abscess, while flexion of the left leg indicates a Small Intestine abscess. Since the current case involves flexion of the left leg without extension, the abscess is located in the Small Intestine, not the Large Intestine. However, abscesses of the Large Intestine are easier to treat, whereas those of the Small Intestine are difficult to cure, because the Large Intestine can drain heat through fecal excretion, while the Small Intestine cannot easily do so. If the correct method is mastered, what difficulty remains? Generally, fire-toxin in the Large Intestine can be drained via feces; fire-toxin in the Small Intestine must be drained via urine. The prescription used is Xi Du Zhi Shen Tang (Toxin-Draining Supreme Divine Decoction):
Liu Ji Nu (Sanliao, Herba Siegesbeckiae) (3 liang), Che Qian Zi (Sanliao, Semen Plantaginis) (3 liang), Jin Yin Hua (Sanliao, Flos Lonicerae Japonicae) (3 liang), Ze Xie (Sanliao, Rhizoma Alismatis) (3 liang), Gan Cao (Sanliao, Radix Glycyrrhizae Uralensis) (3 liang), Fu Ling (1 liang, Poria) (1 liang), Yu Mi (1 liang, Frumentis Indici Cornucopia) (1 liang), Rou Gui (1 fen, Cortex Cinnamomi Cassiae) (1 fen).
Decoct in water and take orally. After one dose, urination becomes profuse like flowing water; after two doses, pain ceases abruptly; after three doses, symptoms disappear completely, and a fourth dose is unnecessary. This formula consists entirely of diuretic herbs, with heavy use of Jin Yin Hua as an anti-toxic agent. Why does it achieve such miraculous results? Toxin in the Small Intestine must be resolved internally, and among internal-resolving herbs, Jin Yin Hua has no substitute. Other anti-toxic herbs tend to damage healthy Qi, which must not be damaged in the Small Intestine; thus, Jin Yin Hua serves as the Sovereign herb. However, Jin Yin Hua cannot enter the Small Intestine directly, so it is assisted by Fu Ling, Che Qian Zi, Ze Xie, and Yu Mi to guide it into the Small Intestine. Additionally, a small amount of Rou Gui is added to carry the aroma directly into the Bladder, resolving toxin via urine. If concerned that the fire-toxin is too severe for these herbs to act quickly, Liu Ji Nu is added for rapid expulsion, and Gan Cao for gentle regulation. Combining firm and soft, slow and fast actions avoids stagnation and harsh side effects, ensuring fire-toxin exits naturally from the Small Intestine and Bladder.
Secret Formula:
Xi Du Zhi Shen uses Sanliang Liu Ji Nu,
Che Qian, Jin Yin, Gan Cao, Ze Xie also Sanliang.
Fu Ling and Yu Mi at One Liang, Rou Gui One Fen,
After three doses, the affliction is cured.
For this condition, Wang Gong Tang is also effective:
Wang Bu Liu Xing (1 liang, Semen Viciae Arvensis) (1 liang), Pu Gong Ying (1 liang, Herba Taraxaci) (1 liang), Che Qian Zi (1 liang, Semen Plantaginis) (1 liang), Gan Cao (5 qian, Radix Glycyrrhizae Uralensis) (5 qian), Jin Yin Hua (3 liang, Flos Lonicerae Japonicae) (3 liang).
Decoct in water and take orally. Effective after one dose.
Secret Formula:
Wang Gong Tang treats Small Intestine Abscess,
Wang Bu Liu Xing One Liang, Pu Gong Ying One Liang,
Che Qian Zi One Liang, Gan Cao Five Qian,
Jin Yin Hua Three Liang, cured in one dose.
A person suffers from severe abdominal pain, crying out incessantly. The pain is in the left abdomen, unbearable upon palpation, and the patient forbids touching. People assume it is food retention in the Large Intestine, but who would know it is an abscess in the Small Intestine? Intestinal abscesses invariably involve leg flexion. The current lack of flexion might suggest it is not an intestinal abscess. However, if the abscess is inside the intestine, Large Intestine cases involve right leg flexion, and Small Intestine cases involve left leg flexion. If the abscess is outside the intestine, legs are not flexed; pain on the left indicates Small Intestine abscess, pain on the right indicates Large Intestine abscess. Pain from food retention or dry stool comes and goes, unlike abscess pain, which is fixed, constant, and unceasing. Abscesses inside the Large or Small Intestine can rupture and drain, but those outside cannot be allowed to ulcerate, as there is no exit path externally, leading to certain death. Small Intestine abscesses are even more critical and require urgent treatment using diuresis and detoxification; otherwise, unpredictable complications may arise. Use Li Shui Jie Du Nei Xiao Dan (Water-Draining Toxin-Resolving Internal-Dissolving Pill), or Wang Gong Tang with an additional 3 liang of Jin Yin Hua.
Jin Yin Hua (4 liang, Flos Lonicerae Japonicae) (4 liang), Che Qian Zi (5 qian, Semen Plantaginis) (5 qian), Yi Yi Ren (1 liang, Semen Coicis) (1 liang), Fu Ling (1 liang, Poria) (1 liang), Dang Gui (2 liang, Radix Angelicae Sinensis) (2 liang), Gan Cao (3 qian, Radix Glycyrrhizae Uralensis) (3 qian).
Decoct in water and take orally. After one dose, pain decreases significantly; after two doses, pain lessens further; after three doses, pain stops completely; after four doses, recovery is achieved. This formula is a variation of the previous one (Xi Du Zhi Shen Tang). The former promotes toxin resolution within diuresis, while this one supplements blood-nourishing and toxin-resolving properties within diuresis. When an abscess ruptures, diuresis is especially suitable to flush out toxin. If unruptured, failing to nourish blood while only promoting diuresis leads to fluid loss and blood deficiency, making toxin resolution difficult. These nuances must be understood. This condition requires early treatment; otherwise, even if the abscess heals, blood stasis flowing outside the intestine will cause lifelong abdominal pain.
Secret Formula:
Li Shui Jie Du Nei Xiao Dan contains Four Liang Jin Yin Hua,
Five Qian Che Qian Zi, One Liang Yi Yi Ren and Fu Ling,
Two Liang Dang Gui, Three Qian Gan Cao, decoct together.
A person experiences sudden severe abdominal pain, hematuria, and inability to extend the left leg. People attribute this to a Small Intestine abscess, but who would know it is due to excessive Fire in the Small Intestine? Small Intestine abscesses always involve left leg flexion. The current inability to extend the left leg clearly suggests an abscess, yet I attribute it to excess Fire. Why? Abscesses have specific signs; they do not appear suddenly with bleeding. Pus forms over time and bleeds only when nearly exhausted. How to explain the leg flexion? The Small Intestine is narrow, while the Large Intestine is wide. Wide spaces accommodate pathogens; narrow ones do not. When the Small Intestine is scorched by Fire, internal pressure prevents smooth flow, causing reflexive flexion of the left leg temporarily, unlike the chronic flexion seen in abscesses. Do not mistake leg non-extension for an abscess and recklessly use detoxifying herbs, as this causes great harm! How to distinguish Fire-Toxin from Abscess? Observe urine at onset. Initial pain with non-extension and no blood indicates Abscess. Initial pain with non-extension and blood indicates Fire-Pain. Treatment involves draining Fire-evil without focusing on toxin resolution; pain will cease and leg extension will return. Use Jia Wei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction):
Chai Hu (2 qian, Radix Bupleuri) (2 qian), Huang Qin (3 qian, Radix Scutellariae Baicalensis) (3 qian), Ren Shen (5 qian, Radix Ginseng) (5 qian), Fu Ling (5 qian, Poria) (5 qian), Ban Xia (1 qian, Rhizoma Pinelliae Ternatae) (1 qian), Gan Cao (1 qian, Radix Glycyrrhizae Uralensis) (1 qian), Sheng Jiang (3 slices, Rhizoma Zingiberis Recens) (3 slices), Da Zao (3 pieces, Fructus Jujubae) (3 pieces).
Decoct in water and take orally. After one dose, leg extends; after two doses, bleeding stops, and intestinal pain ceases. Xiao Chai Hu Tang is not typically for Small Intestine Abscess, yet why is it so effective? Excess Fire in the Small Intestine originates from Liver Wood Stagnation. Wood stagnation generates Fire, which attacks the Small Intestine rather than the Heart. Fire normally flares upward; here it burns downward, violating its nature, causing Small Intestine pain. Blood in urine occurs because Fire forces blood out of the Small Intestine into the Bladder, obstructing water passages and causing bleeding. Xiao Chai Hu Tang soothes Liver and Gallbladder Qi, allowing Fire to rise smoothly. Fu Ling drains dampness, ensuring water flows normally and blood returns to vessels. Thus, Qi flows freely, Blood harmonizes, and toxin resolves. This is the miracle of this formula.
Secret Formula:
Jia Wei Xiao Chai Hu treats Intestinal Toxin,
Huang Qin Three Qian, Ren Shen and Fu Ling Five Qian each,
Ban Xia and Gan Cao One Qian, add Sheng Jiang and Da Zao,
Two doses stop bleeding, main treatment for Intestinal Abscess.
Che Ling Lian Gan Tang is also effective for this condition:
Che Qian Zi (5 qian, Semen Plantaginis) (5 qian), Fu Ling (1 liang, Poria) (1 liang), Huang Lian (3 qian, Rhizoma Coptidis) (3 qian), Gan Cao (3 qian, Radix Glycyrrhizae Uralensis) (3 qian).
Decoct in water and take orally.
Secret Formula:
There is also Che Ling Lian Gan Tang,
Che Qian Zi Five Qian, Fu Ling One Liang,
Gan Cao and Huang Lian Three Qian each, decoct together,
Excellent for stopping bleeding and harmonizing.