Changyong Tang (Intestinal Abscess Decoction) from the Yi Xin Fang

"Changyong Tang" (Intestinal Abscess Decoction) is recorded in the Yi Xin Fang. Its composition is: Yiyiren (Coix Seed, Semen Coicis) 5 qian (15g), Mudanpi (Moutan Bark, Cortex Moutan) 3 qian (9g), Taoren (Peach Kernel, Semen Persicae) 3 qian (9g), Dongguazi (Winter Melon Seed, Semen Benincasae) 5 qian (15g). Take one dose daily, decoct in about 600 ml of water down to 400 ml, strain, and take warm in two divided doses.

Changyong Tang clears heat and drains pus, activates blood and dissipates abscesses. It is indicated for intestinal abscess with formed pus, abdominal twisting pain, vexatious fullness and unease, lack of appetite, scanty dark urine, rapid pulse, and cases where purgation is contraindicated. In TCM, intestinal abscess falls within the category of acute abdominal conditions in modern surgery, acute appendicitis being by far the most common. However, this formula is not limited to surgical acute abdomen; patients with pelvic or abdominal tumors who present with the above symptoms may also be treated on the basis of this formula.

In this formula, Yiyiren and Dongguazi are common TCM herbs for dissipating abscess and draining pus; Mudanpi and Taoren activate blood and resolve stasis, while Mudanpi additionally clears heat and resolves toxicity. Patients with intestinal abscess usually present with TCM heat patterns, especially damp-heat in the lower jiao. For those with marked lower-jiao damp-heat symptoms (such as severe scanty dark urine), Zhizi (Gardenia), Huangbai (Phellodendron), Huangqin (Scutellaria), and Tufuling (Glabrous Greenbrier) may be added to clear heat and resolve toxicity; plus Zhuling (Polyporus), Zexie (Alisma), Yimucao (Motherwort), and Cheqianzi (Plantago Seed) to promote urination and drain dampness. If the patient presents with constipation and foul-smelling stools, Shengdahuang (Raw Rhubarb) and Mangxiao (Mirabilite) may be added to unblock the bowels and drain heat.