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Swelling of the scrotum is caused by the condensation of pathogenic factors. When wind predominates, itching occurs; when dampness predominates, a sensation of bearing down occurs; when heat predominates, pain is severe. For cases dominated by wind, Shufeng Wuling San (Wind-Dispersing Five-Ingredient Decoction) may be used; for cases of unilateral testicular swelling (Hernia/Scrofula with unilateral swelling), Shouxiao Wan (Effectiveness-Preserving Pill) is noted for its efficacy.

[Annotation]
The external genitalia are the convergence point of all meridians. Pathogenic factors invade the Shaoyin and Jueyin meridians, where damp-heat and cold-wind pathogens contend with each other. This obstruction prevents the smooth flow of Qi, leading to condensation and resulting in scrotal swelling. Generally speaking, excess wind manifests as itching, excess dampness as a bearing-down sensation, and excess heat as pain. If the external genitalia (scrotal skin and testes) swell with itching, pain, and a bearing-down sensation, this indicates an invasion of wind-dampness into the lower body, and Shufeng Wuling San (Wind-Dispersing Five-Ingredient Decoction) is indicated. If the scrotal skin appears bright and shiny, this is due to Heart Fire transferring heat to the Small Intestine, and Jiawei Wuling San (Modified Five-Ingredient Decoction) or Daochi San (Guide Out Red Powder) are indicated. There is also a condition known as unilateral swelling (Pianzhui), where either the left or right testis swells. This is caused by food stagnation that fails to digest, causing dampness to descend downward. Jiawei Shouxiao Wan (Modified Effectiveness-Preserving Pill) is indicated.

(Shufeng Wuling San [Wind-Dispersing Five-Ingredient Decoction]) Fangfeng (Saposhnikoviae Radix), Cangzhu (Atractylodis Rhizoma, soaked in rice water), Rougui (Cinnamomi Cortex), Qianghuo (Notopterygii Rhizoma et Radix), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Chi Fuling (Poria with Red Core), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil). Decoct with fresh ginger water.
(Fangge [Prescription Verse])
For scrotal swelling, Shufeng Wuling San is used,
With Saposhnikovia, Atractylodes, Cinnamon Twig, and Notopterygium.
Polyporus, Alisma, Poria with red core, and Atractylodes macrocephala,
Add fresh ginger when decocting and taking orally.

(Jiawei Wuling San [Modified Five-Ingredient Decoction]) Jinlingzi (Meliae Toosendan Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Zexie (Alismatis Rhizoma), Mutong (Akebiae Caulis), Huixiang (Foeniculi Fructus, stir-fried), Chi Fuling (Poria with Red Core), Juhe Ren (Citri Reticulatae Semen), Rougui (Cinnamomi Cortex), Binglang (Arecae Semen), Zhuling (Polyporus). Decoct with fresh ginger and Centelli Herba (Jiangxin) water.
(Fangge [Prescription Verse])
In Wuling San, add Meliae Toosendan Fructus,
Along with Atractylodes macrocephala, Alisma, and Akebiae Caulis.
Foeniculum, Poria with red core, and Citrus seeds are matched,
Combined with Cinnamon Twig, Areca nut, and Polyporus.

(Daochi San [Guide Out Red Powder]) See the section on "Urination Difficulty" (Bu Xiao Bian).

(Jiawei Shouxiao Wan [Modified Effectiveness-Preserving Pill]) Nanxing (Arisaematis Rhizoma), Shanzha Rou (Crataegi Fructus flesh, wine-fried), Cangzhu (Atractylodis Rhizoma, 2 qian each, stir-fried), Baizhi (Angelicae Dahuricae Radix), Banxia (Pinelliae Rhizoma, ginger-processed), Juhe Ren (Citri Reticulatae Semen), Shenqu (Massa Medicata Fermentata, 1 liang each, stir-fried), Haizao (Sargassum, stir-fried), Kunbu (Eckloniae Thallus, 5 qian each), Wuzhuyu (Evodiae Fructus), Qingpi (Citri Reticulatae Pericarpium Viride, vinegar-processed), Yuanhusuo (Corydalis Rhizoma, vinegar-processed), Lizhi He (Litchi Semen, 1 liang each, stir-fried). Grind all above into powder, bind with Massa Medicata Fermentata paste to form pills the size of Sophora japonica seeds. Take 30 pills per dose, swallowed with wine on an empty stomach.