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Welling-abscess (yōng) of the intestine; attributed to congealing blood that stems from damp-heat or from general qì and blood stagnation.

Biomedical correspondence: appendicitis, periappendicular abscess.

Intestinal welling-abscess was first mentioned in Plain Questions (素问 sù wèn), which attributed it to lesser yáng (shào yáng) reverse flow and claimed it to be uncurable and fatal. Zhāng Jī (2nd–3rd centuries CE), in On Cold Damage and Miscellaneous Diseases (伤寒杂病论 shāng hán zá bìng lùn), described the presuppurative and suppurative stages in detail and prescribed treatments. Essential Prescriptions of the Golden Cabinet (金匮要略 jīn guì yào lüè) gives his description as follows:

Intestinal welling-abscess [is marked by] swollen glomus in the lesser abdomen that is painful when pressed and like strangury although though urine is normal, and [by] periodic heat effusion and spontaneous sweating followed by aversion to cold. If the pulse is slow and tight, pus has not yet formed, and it can be treated by precipitation, which should be manifest in blood [in the stool]. If the pulse is surging and rapid, pus has formed; precipitation cannot be administered. Rhubarb and Moutan Decoction (大黄牡丹皮汤 dà huáng mǔ dān pí tāng) is the main treatment.

Distinction is made between large intestine welling-abscess and small intestine welling-abscess on the basis of the location of pain. If the pain is in the vicinity of ST-25 (Celestial Pivot, 天枢 tiān shū), it is called a large intestine welling-abscess, whereas if in the vicinity of CV-4 (Pass Head, 关元 guān yuán), it is called a small intestine welling-abscess. Any intestinal welling-abscess that makes it difficult to the stretch out the right leg is called a leg-flexing intestinal welling-abscess. However, these distinctions are now considered to have little clinical significance. The first perceptible sign of large intestine welling-abscess is abdominal pain that gradually localizes on the right side. The pain is of fixed location and refuses pressureand is accompanied by coughing or sneezing. The right leg may flex and be difficult to stretch out. There is aversion to cold with heat effusion, with nausea and vomiting, constipation (or diarrhea in some cases), and reddish urine. The tongue fur is thin, slimy and yellow. The pulse is rapid and forceful. As the condition advances, the abdomen becomes tensed and tender, and in some cases a lump may be felt. As vigorous heat [effusion] develops, the pulse becomes surging and rapid.

Medicinal therapy: Treat with medicinals such as Rhubarb and Moutan Decoction (大黄牡丹皮汤 dà huáng mǔ dān pí tāng). If tenderness is less pronounced, the facial complexion is somber-white, and the pulse fine and weak, the condition (recognized in Western medicine as chronic appendicitis) can be treated with Coix, Aconite, and Patrinia Powder (薏苡附子败酱散 yì yǐ fù zǐ bài jiàng sǎn).

Acumoxatherapy: Base treatment mainly on ST and LI. ST-25 (Celestial Pivot, 天枢 tiān shū), ST-37 (Upper Great Hollow, 上巨虚 shàng jù xū), Appendix Point (阑尾穴 lán wěi xué), and LI-4 (Union Valley, 合谷 hé gǔ). Needle with drainage, and retain the needles for 40–60 minutes. Treatments should be given once or twice a day, and, in severe cases, every four hours.

Point selection according to signs: For heat effusion, add GV-14 (Great Hammer, 大椎 dà zhuī) and LI-11 (Pool at the Bend, 曲池 qū chí). For pain around the umbilicus or tense abdominal skin, add CV-6 (Sea of Qì, 气海 qì hǎi) and SP-14 (Abdominal Bind, 腹结 fù jié). For nausea and vomiting, add PC-6 (Inner Pass, 内关 nèi guān) and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ).

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