Rhubarb and Moutan Bark Decoction

金匱要略

-- For intestinal abscess, there is swelling and a mass in the lower abdomen; when pressed, it is painful like strangury, but urination is normal. There is frequent fever, spontaneous sweating, and further aversion to cold. If the pulse is slow and tight, the pus has not formed and it can be purged downward; there should be blood. If the pulse is surging and rapid, the pus has already formed and it must not be purged downward. Dahuang Mudan Decoction governs it. (Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet))

Dahuang 4 liang, Mudan 1 liang, Taoren 50 pieces, Guazi (winter melon seed) half sheng, Mangxiao 3 ge. The above five ingredients: use 6 sheng of water, decoct to obtain 1 sheng, remove the dregs, add Mangxiao, decoct again to a boil, and take all at once. If there is pus, it should be purged downward; if there is no pus, it should purge downward blood. (Shanghan Zabing Lun)

Use 6 sheng of water, decoct to obtain 1 sheng, remove the dregs, add Mangxiao, decoct again to a boil, and take all at once. (Modern usage: decoct in water and take orally.)

湯劑

Drain heat and break blood stasis, dissipate masses and reduce swelling.

At the initial onset of intestinal abscess (chang yong), there is pain in the right lower abdomen that is tender to pressure; in severe cases there is local swelling and a mass, with intense pain on pressure; urination is frequent like strangury, or the right leg is flexed and cannot be extended; there may be intermittent fever, spontaneous sweating, and then aversion to cold. If the pulse is slow and tight, the pus has not yet formed and purgation may be used, and there should be blood; if the pulse is large and rapid, the pus has already formed and purgation may also be used.

If there is yang deficiency, with a pale, enlarged, tender tongue with tooth marks and slippery watery coating: add Prepared Aconite (Pao Fu Zi): 10. -- If heat toxin is relatively severe: add Dandelion (Pu Gong Ying): 15, Patrinia (Bai Jiang Cao): 30. -- If Blood stasis is relatively severe: add Red Peony (Chi Shao): 10.

In all cases after intestinal abscess has ruptured, as well as in the elderly, pregnant women, postpartum women, or those with excessively weak constitution, it should be used with caution or contraindicated.