小儿平素过食浓味，致生湿热，因湿热之气下行，流入囊中，复为风寒所束，遂结为疝，囊纵红肿，常常刺
痛，古法主乌头栀子汤（如乌头、炒栀子二味），引用顺流水，入姜汁煎服。
〔真按〕证本湿热，又袭寒邪，方用漂苍术一钱，炒黄柏一钱，制南星八分，香白芷一钱，山楂肉一钱，广
橘核钱半，六神曲五分，吴茱萸三分，炒薏米一钱，共研细末，面糊为丸，每次淡盐汤吞下一钱五分，空心服。
孕妇啼泣过伤，气结不散，蕴于胞中，令儿生下胞硬疼痛，名曰胎疝，轻者古法主十味苍柏散（如醋炒青皮、
炮附子、黄柏、南山楂、苍术、制香附、益智仁、醋炒延胡索、桃仁、炙甘草，引用小茴香）。
重者，古法主金铃散（如三棱、莪术、陈皮、赤苓、茴香、甘草、枳壳、钩藤钩，青皮、金铃子肉，以上均
焙，槟榔、南木香，不过火。共为细末，每服五分，无灰酒调服）。
〔真按〕既系胎疝，则小儿在胞中早得疝气而始生，猛烈之剂，万不宜服，即产母亦万不可服。此方但用橄
榄核、荔枝核、山楂核三味各等分，俱焙干存性，研细末，每次用五分，淡姜汤调匀送下。
小儿阴器，乃诸经之总会也，因邪客于少阴厥阴之经，湿热之气，与风冷之气相搏，气不得通，故结聚而阴
囊肿大，究之风盛多痒，湿盛多坠，热盛多疼，如外肾肤囊肿大，痒痛坠下，此风湿袭于下也，古法主疏风五苓散
（如防风、苍术、肉桂、羌活、猪苓、泽泻、赤苓、土炒白术，引用生姜）。
〔真按〕此散可用等分水泛为丸，每次用一钱，空心以淡姜汤送下。
如外肾肤囊肿疼光亮，此因心火移热于小肠故也，古法主加味五苓散（如金铃子、土炒白术、泽泻、木通、
炒茴香、赤茯苓、橘核仁、肉桂、槟榔、猪苓，引用生姜、灯芯）。
〔真按〕此散可用等分水泛为丸，每次用钱半，以生姜灯芯汤送下，空心服。
更有偏坠一法，或左或右，睾丸作肿者，此因食积不消，湿
气下行故也，古法主加味守效丸（如南星、南山楂酒炒、炒苍术各二钱，白芷、姜制半夏、橘核仁，神曲各一两，海
藻、昆布各五钱，吴茱萸、醋炒青皮、延胡索、炒荔枝核各一两，共为细末，神曲为丸），每服钱半，空心白酒下。
〔真按〕此丸可改酒泛为丸，每次用一钱，空心白滚汤送下。
Pediatric patients who have historically consumed excessive rich and greasy foods may develop damp-heat (Damp-Heat). Due to the downward flow of this damp-heat qi, it enters the scrotum. If constrained by wind-cold (Wind-Cold), it condenses into hernia (Hernia), presenting with a hanging, red, and swollen scrotum accompanied by frequent stabbing pain. Ancient methods primarily utilized Wutou Zhizi Tang (Aconite and Gardenia Decoction, composed of Aconitum carmichaelii root and stir-fried Gardenia jasminoides fruit), using flowing water as a vehicle, adding ginger juice, decocting, and administering orally.
[Chen Shouzhen’s Commentary] The pathology is fundamentally damp-heat, complicated by an invasion of cold pathogen. My prescribed formula consists of: Cangzhu (Atractylodis Rhizoma) one qian, Huangbai (Phellodendri Cortex) one qian, Zhinanning (Arisaematis Cum Bile) eight fen, Xiangbaizhi (Angelicae Dahuricae Radix) one qian, Shanzha Rou (Crataegi Fructus) one qian, Guangjuehe (Citri Reticulatae Viride Pericarpium) 1.5 qian, Liushenqu (Medicated Leaven) five fen, Wuzhuyu (Evodiae Fructus) three fen, and Chao Yimi (Coix Seed) one qian. These are ground into fine powder, bound with wheat paste into pills. Each dose is 1.5 qian, taken with light salt water on an empty stomach.
If pregnant women sob excessively due to grief, qi stagnation fails to disperse and accumulates in the uterus (Zi Gong). This causes the newborn’s scrotum to be hard and painful after birth, a condition termed Fetal Hernia (Tai Shan). For mild cases, ancient methods primarily used Shiwei Cangbai San (Ten-Ingredient Atractylodes and Phellodendrum Powder, composed of vinegar-processed Qingpi, prepared Fuzi, Huangbai, Nanshan Zha, Cangzhu, Zhixiangfu, Yizhiren, vinegar-processed Yanhusuo, Taoren, and honey-fried Gancao, with Xiao Hui Xiang as a guide). For severe cases, ancient methods primarily used Jinling San (Jinling Powder, composed of Sanleng, Ezhu, Chenpi, Chifuling, Huixiang, Gancao, Zhike, Goutenggou, Qingpi, and Jinlingzi Rou—all roasted; Binglang and Nanmuxiang not over-roasted). These are ground into fine powder; each dose is five fen, mixed and taken with wine free of impurities.
[Chen Shouzhen’s Commentary] Since this is diagnosed as Fetal Hernia, it implies the infant contracted hernia while in the womb before birth. Potent purgative agents must absolutely not be administered, nor should they be taken by the mother. My formula uses only equal parts of Ganlanhe (Olive Pit), Lizhihe (Lychee Seed), and Shanzhahe (Hawthorn Seed). These are roasted until dry but retaining their medicinal properties, then ground into fine powder. Each dose is five fen, mixed and taken with light ginger soup.
The external genitalia of children are the convergence point of all meridians. When pathogens invade the Shaoyin (Lesser Yin) and Jueyin (Terminal Yin) meridians, damp-heat qi combats with wind-cold qi. Qi circulation becomes obstructed, leading to accumulation and scrotal swelling. Generally, dominance of wind leads to itching; dominance of dampness leads to a sensation of heaviness or prolapse; dominance of heat leads to pain. If the skin of the external genitalia is swollen, itchy, painful, and feels heavy/prolapsed, this indicates wind-dampness attacking the lower jiao. Ancient methods primarily utilized Shufeng Wuling San (Dispel-Wind Five-Ingredient Poria Powder, composed of Fangfeng, Cangzhu, Rougui, Qianghuo, Zhuling, Zexie, Chifuling, and earth-fried Baizhu, with Shengjiang as a guide).
[Chen Shouzhen’s Commentary] This powder can be processed into pills using equal amounts of water. Each dose is one qian, taken on an empty stomach with light ginger soup.
If the skin of the external genitalia is swollen, painful, and shiny, this is because Heart Fire transfers heat to the Small Intestine. Ancient methods primarily utilized Jiawei Wuling San (Modified Five-Ingredient Poria Powder, composed of Jinlingzi, earth-fried Baizhu, Zexie, Mutong, fried Huixiang, Chifuling, Juheren, Rougui, Binglang, and Zhuling, with Shengjiang and Dengxin as guides).
[Chen Shouzhen’s Commentary] This powder can be processed into pills using equal amounts of water. Each dose is 1.5 qian, taken on an empty stomach with a decoction of Shengjiang and Dengxin.
Another variation involves unilateral descent (Pianzhui), where either the left or right testicle swells. This is caused by food retention failing to digest, with dampness descending. Ancient methods primarily utilized Jiawei Shouxiao Wan (Modified Efficacious Pill, composed of Nanning, wine-processed Nanshan Zha, and fried Cangzhu, each two qian; Baizhi, Jiangzhi Banxia, Juheren, and Shenqu, each one liang; Haizao and Kunbu, each five qian; Wuzhuyu, vinegar-processed Qingpi, Yanhusuo, and fried Lizhihe, each one liang). These are ground into fine powder and bound with Shenqu paste into pills. Each dose is 1.5 qian, taken on an empty stomach with white liquor.
[Chen Shouzhen’s Commentary] This pill can be modified to be rolled in wine. Each dose is one qian, taken on an empty stomach with plain boiled water.