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A welling-abscess (yōng) affecting the liver. It is attributed either to liver depression transforming into fire, qì stagnation and blood stasis, or to accumulated dampness engendering phlegm. It starts with dull pain at LR-14 (Cycle Gate, 期门 qī mén), followed by the gradual development of distending pain in the right rib-side that refuses pressure and prevents the patient from lying on the right side. There is often aversion to cold with heat effusion, and the pulse is wiry and rapid. As the condition progresses, the pain becomes more acute, and a persistent heat effusion is present. If it continues, unless successfully treated, it can burst, giving rise to coughing and vomiting of pus or the passage of pus in the stool.

Biomedical correspondence: hepatic abscess, suppurative cholecystitis and inflammation of the biliary tract, and hepatic echinococcosis.

Medicinal therapy: In the initial stage, when due to liver fire, clear the liver and drain fire with Bupleurum Liver-Coursing Powder (柴胡疏肝散 chái hú shū gān sǎn); when due to damp phlegm, rectify qì and transform phlegm using Qì-Clearing Phlegm-Transforming Pill (清气化痰丸 qīng qì huà tán wán) plus cyperus (Cyperi Rhizoma, 香附子 xiāng fù zǐ), Chinese angelica (Angelicae Sinensis Radix, 当归 dāng guī), and curcuma (Curcumae Radix, 郁金 yù jīn). When pus has formed, treat by clearing the liver and draining fire assisted by expelling pus; after rupture, add lung-clearing and intestine-clearing medicinals. For topical treatment, see intestinal welling-abscess. After healing, use Four Agents Decoction (四物汤 sì wù tāng) for adjustment.

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