Welling-abscess

1. Also external welling-abscess. A large suppuration in the flesh characterized by a painful swelling and redness that is clearly circumscribed, and that before rupturing is soft and characterized by a thin shiny skin. Before suppuration begins, it can be easily dispersed; when pus has formed, it easily ruptures; after rupture, it easily closes and heals. It may be associated with generalized heat, thirst, yellow tongue fur and a rapid pulse.

Biomedical correspondence: superficial abscess; cellulitis; acute purulent lymphadenitis.

A welling-abscess results from congealing and stagnation of qì and blood arising when damp-heat and fire toxin block the channels. This pathomechanism can usually be traced to excessive consumption of rich foods or to toxin contracted through unclean wounds. The term welling-abscess is often used in contradistinction to flat-abscess (1), and the difference between them is pointed out in The Inner Classic (内经 nèi jīng): welling-abscesses are shallow and light; flat-absceses are deep and heavy; welling-abscess effuse from the six bowels; flat-abscess effuse from the five viscera. Orthodox External Medicine (外科正宗 wài kē zhèng zōng) explains the difference in greater detail: welling-abscess means congestion; it is yáng; it is ascribed to toxin of the six bowels prevailing in the outer; it appears suddenly and is floating [i.e., superficial or buoyant] and shallow. Because it originates from the yáng aspect, and because yáng qì is light, clear, and floating, it [the welling-abscess] rises high, easily swells, easily forms pus, easily putrefies, and easily closesand does not damage the sinew and boneand is easy to treat. Flat-abscess, meaning 沮 [obstruction; marsh], is yīn; it is ascribed to toxin of the five viscera attacking the inner body; it develops slowly and its location is deep. Because it originates from the yīn aspect, and because yīn-blood is heavy and turbid, it [the flat-abscess] is sinking in nature, damages the sinew, erodes the boneand is difficult to cure.

2. Also internal welling-abscess. A suppuration in the chest or abdomen affecting the organs; probably so called because it shares many of the yáng qualities of external welling-abscess, except for its location in the body. They include intestinal welling-abscess, pulmonary welling-abscess, liver welling-abscess, and stomach welling-abscess, which correspond roughly to appendicitis, pulmonary abscess, liver abscess, and pathologies of the stomach respectively in Western medicine. Compare flat-abscess.

Etymology

Chin 痈 yōng is composed of the illness signifier 疒 with 雝 yōng formerly interchangeable with 壅 yōng, yǒng meaning congestion. Orthodox External Medicine (外科正宗 wài kē zhèng zōng, yōng jū mén) states, 痈 means 壅. The character thus denotes a disease associated with congestion, reflecting the etiology.

NB: The same character is now used in Western medicine to render the concept of carbuncle. The original definition in Chinese medicine is much wider.