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(Zhang Zhongjing's original text lacks this treatment method; here, the treatment methods from Nanyang Haicang are adopted to supplement it.)

Bian Que stated: Tongue retraction and scrotal contraction indicate a fatal prognosis. Sun Simiao stated: In Yin-Yang Exchange disease, if the testes retract and the tongue protrudes, it is also a fatal sign. Generally, scrotal contraction may result from extreme heat or extreme cold. For cases of extreme heat, purgation is appropriate; for cases of extreme cold, urgent warming is required. Purgation should utilize Da Chengqi Tang (Major Order the Qi Decoction); warming should utilize Fuzi Sini Jia Zhuyu Tang (Aconite Decoction of Reverting Yang plus Evodia) combined with moxibustion at Guanyuan (CV-4) and Qihai (CV-6), as well as treatments such as onion ironing.

The *Huoren Shu* (Book of Saving Lives) records: In Shanghan (Cold Damage) disease, after six or seven days, if there is irritability, fullness, and scrotal contraction, with pulse positions at both cun and chi being faint and slow, this indicates pathogen involvement in the Foot-Jueyin Liver Meridian. In Jueyin disease, if the pulse is faintly floating, recovery is imminent; if not floating, recovery is not yet achieved, and Xiao Jianzhong Tang (Minor Construct the Middle Decoction) is indicated. If the pulse is floating and slow, scrotal contraction will definitely not occur; external symptoms must include fever and aversion to cold resembling malaria, indicating impending recovery, and Guizhi Mahuang Ge Ban Tang (Decoction of Cinnamon Twig and Ephedra Combined Half-Half) is indicated. If the pulse at both cun and chi is deep and short, scrotal contraction is certain, and toxic factors have entered the abdomen; Chengqi Tang (Order the Qi Decoction) should be used for purgation. Generally, in Shanghan disease, organ transmission follows the sequence where Yang meridians are affected first, subsequently transmitting to Yin meridians. Since Yang governs generation, Taiyang Water transmits to Foot-Yangming Earth, then to Foot-Shaoyang Wood, which constitutes minor pathogenic influence. Since Yin governs killing, Wood transmits to Foot-Taiyin Earth, Earth to Foot-Shaoyin Water, and Water to Foot-Jueyin Wood. By the sixth or seventh day, transmission reaches Jueyin Liver Wood, which inevitably transfers qi to overcome Spleen Earth. If Spleen Earth suffers further evil, all five zang and six fu organs become critical, Ying and Wei circulation ceases, deafness occurs, scrotal contraction appears, consciousness is lost, and death ensues. At this stage, rapid purgation with Chengqi Tang can preserve five parts of life and lose one part. Ancients stated: Heat disease of the Spleen endangers the five zang; furthermore, if Earth is invaded by Wood, death results. If on the sixth or seventh day transmission reaches Jueyin and the pulse becomes faintly slow or faintly floating, these are pulses of the Spleen and Stomach, indicating that Spleen qi is completely unovercome, pathogens have no place to reside, adversity turns to prosperity, Ying and Wei will recover, Water ascends and Fire descends, resulting in alternating chills and fever followed by profuse sweating and resolution.

Haicang (Zhang Yuansu) discussed: In Jueyin syndrome, symptoms include irritability, fullness, scrotal contraction, obstruction of urination and defecation, fever, thirst with desire to drink, abdominal fullness, and a faintly slow chi pulse. Irritability is caused by Fire; fullness is caused by Wood. Although roundworm expulsion does not occur, scrotal contraction and urgency indicate Wood pathology. The combination of Fire and Wood leads to extremity cold reversal and cyanosis of the fingernails/toenails, obstruction of urination and defecation, and blockage of pathways. Fever and thirst with desire to drink indicate pathogen presence in the interior, warranting warming and purgative methods. Regarding the aforementioned syndromes, if urination and defecation are both unobstructed, the lower pathway is clear, thirst is absent, and there is no desire to drink, the pathogen is not in the interior. In such cases, warming and moxibustion should be applied to connect interior and exterior to restore Yang qi, and Zhengyang San (Uphold Yang Powder) is indicated.

Formula for Zhengyang San:
Shexiang (Musk, 1 qian, finely ground, acrid and warm, treats abdominal urgency, fullness, stagnation, and wind toxicity); Ganjiang (Dried Ginger, processed); Gancao (Licorice Root, honey-fried, each 2.5 qian); Fuzi (Prepared Aconite Lateral Root, 1 liang, processed, skin and umbilicus removed, acrid and salty, warm, treats wind, opens orifices, alleviates abdominal fullness and scrotal contraction); Zaojiao (Gleditsia Sinensis Fruit, 2 liang, fried in lard, husk and string removed, salty and warm). Grind all into fine powder. Take 2 qian per dose, mixed with white water and taken warm.

Formula for Huiyang Dan:
Liuhuang (Sulfur, half liang, sour and warm, extremely hot, treats heart and abdominal swelling/gathering, cold phlegm accumulation, qi in left hypochondrium, cough with upward rushing qi, cold feet, and weakness); Fuzi (Prepared Aconite Lateral Root, processed, half liang); Muxiang (Costus Root, half liang, acrid and warm, treats localized cold in muscles, deficiency of vital qi, and essence depletion); Quanxie (Scorpion, half liang, sweet and acrid, treats all wind disorders); Bichengqie (Black Cardamom, half liang, acrid and warm, treats skin wind and abdominal distension); Wuzhuyu (Evodia Fruit, washed and stir-fried, half liang, acrid and warm, extremely hot, treats wind-stroke, food stagnation, rebellious qi, benefits the five zang, and regulates qi); Ganjiang (Dried Ginger, processed, 2.5 qian). Grind into powder, mix with wine paste to form pills the size of Sophora japonica seeds. Take 30–50 pills with ginger decoction. Administer two to three doses. After medication, cover with clothing and blankets to induce sweating.