Patient Zhang Moumou, male 21 years old 2012-10-24 Initial diagnosis. Lu Yongkun, Department of Encephalopathy, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine Patient presented with epigastric pain with no obvious cause 1 month ago, then shifted to periumbilical pain, no fever, no pressure pain, 2 days later pain shifted to right lower abdomen with fixed location, pressure pain, rebound pain in right lower abdomen, and fever, no diarrhea, mucous jelly and pus and blood stool, given intravenous antibiotics, condition improved. 2 days ago reappeared right lower abdomen pain with Fever of 37.2℃, pressure pain and rebound pain at the wheal point, limited muscle tension in the right lower abdomen, and no positive signs for the rest. Blood count: WBC:10.7×10*9/L,N%:75.6%. He was physically fit with abdominal distension and poor appetite, with a red tongue, yellowish greasy coating and counted pulse. The diagnosis is intestinal carbuncle, with damp-heat and poisonous evil accumulating in the intestine. Treatment is to clear heat, dispel dampness and detoxify the intestines, move Qi, disperse stasis and drain pus, and pass stools. Prescription: Raw rhubarb (later down) 15 g, peony peel 30 g, peach kernel 15 g, winter melon seed 30 g, mangosteen 6 g (divided and swallowed), sorrel 60 g, coix seed 30 g, Chai Hu 15 g, scutellaria baicalensis 12 g, Huang Lian 6 g, red peony 25 g, red vine 60 g, honeysuckle 30 g, raw white atractylodes 10 g, heliotrope 12 g, chicken naijin 15 g, windproof 10 g. 3 doses of decoction in water, one dose daily divided into Take twice with warmth. The second diagnosis (2012-10-27) on the second day of taking the above body temperature dropped to normal, abdominal pain reduced, stool thin paste, two to three times daily stool, abdominal distension reduced, poor appetite improved, body pressure pain reduced, T: 36.8 ℃, BP: 110/60mmHg, routine blood tests: WBC: 7.8×10*9/L, N70.9%, tongue red, thin yellow greasy coating, all symptoms reduced, still use The previous formula is still used, with rhubarb and peony bark reduced and Huanglian and Fangfeng removed. Prescription: 6g raw rhubarb (later), 15g peony bark, 15g peach kernel, 30g winter melon seed, 6g mangosteen (divided), 60g septoria, 30g coix seed, 15g Chaihu, 12g scutellaria, 15g red peony, 60g red vine, 30g honeysuckle, 10g atractylodes, 12g hedgehog, 15g chicken naijin, 15g each of jiao sanxian. 3 doses of decoction in water, one dose daily divided into two warm doses. The third diagnosis (2012-10-30) The third diagnosis (2012-10-30) the above patient abdominal pain disappeared, stool thin paste, daily stool twice, abdominal distension disappeared, poor nausea improved, slight pressure pain in the right lower abdomen, light red tongue, thin greasy moss, the symptoms basically disappeared. Still using the front, but the body is weak after the disease, strengthen to support the root. Herbs: 6g raw rhubarb, 15g peony skin, 30g winter melon seeds, 3g Radix et Rhizoma Pseudostellariae, 30g septoriae, 30g coix seeds, 15g Chai Hu, 12g Scutellariae, 30g red vine, 30g honeysuckle, 25g Atractylodes macrocephala, 6g Citrus aurantium, 15g chicken naijin, 15g Jiao Sanxian, 15g Radix Codonopsis pilosulae, 30g raw yam. 5 doses of decoction in water, one dose daily divided into two warm doses. The abdominal pain has not recurred for nearly two years since the return visit, and his physical strength has recovered and he is in good spirits. The main manifestation of intestinal carbuncle is fever, pain and urgency in the right lower abdomen, or palpable mass. Intestinal carbuncle can include today’s acute and chronic appendicitis and periappendiceal abscess. This disease is mostly caused by the damage to the spleen and stomach due to the consumption of thick food, cold and cold food, and overeating, resulting in unfavorable gastrointestinal transmission and transformation functions and congestion of qi; or by the damage to the blood channels of the intestinal bowels due to rapid and violent running after a full meal or fall and injury, resulting in blood stagnation and heat in the intestinal bowels, resulting in blood defeat and flesh decay and carbuncle and pus. The Jin Kui Essentials: “intestinal carbuncle, less abdominal swelling and plumpness, press the pain like gonorrhea, urine from the regulation, sometimes fever, sweating, and vicious cold, the pulse is slow and tight pus has not yet become, can be lowered, when there is blood. The pulse is flooded by the pus has become, can not be down also. This is the main treatment for rhubarb and peony peel soup. In “The Essential Guide to the Golden Horoscope”, the intestinal carbuncle is a disease in which the body is wrong, the abdominal skin is urgent, the skin is moist and swollen, there is no accumulation in the abdomen, there is no heat in the body, and the pulse is counted. The above case is characterized by metastatic right lower abdominal pain with fever, pressure pain and rebound pain, which is undoubtedly diagnosed as intestinal carbuncle. This formula is based on the combination of Dahuang Mudanpi Tang and Semen Coicis and Fructus Abelmoschus. In this formula, rhubarb can activate blood circulation, remove blood stasis, clear heat and detoxify the toxin, and laxate and induce accumulation. Mangosteen can remove heat and relax the bowels, moisten dryness and soften hardness, clear fire and reduce swelling. Mudanpi, Paeonia lactiflora, and peach kernel cool the blood and detoxify it, while Chai Hu and Citrus aurantium dredge the liver and move the qi, which can promote the dissipation of abscesses. It is important to use raw Coix seeds to relieve dampness and swelling, and to use Fructus sanguinis to drain pus and break up blood to detoxify, while red vine and honeysuckle are important medicines for treating intestinal canker, which can clear heat and detoxify, invigorate blood and relieve pain. The role of the lesser herbs is threefold: (1) to help the coix seeds and septoria to resolve dampness; (2) to invigorate Yang Qi and prevent the coldness of the drugs from suppressing Yang Qi; (3) the herbs are good at walking and can be used in the flexure of the intestines. The “Justice of the Materia Medica” says that “the herb is good at walking, so it is a pure Yang medicine that passes through the twelve meridians.” Keywords: appendicitis, intestinal canker, damp-heat and poisonous intestinal tract. Dahuang Mudan Tang combined with Coix lacrymae and Radix et Rhizoma septicae is used to clear heat, remove dampness and detoxify the intestines, move Qi, disperse blood stasis, drain pus and pass stools.