【方歌】阴虱疮虫毛际内，肝肾浊热不洁生，瘙痒抓红含紫点，
若还梅毒蜡皮形。
【注】此疮一名八脚虫，生于前阴毛际内，由肝、肾气浊生热
，兼淫欲失洗不洁搏滞而成。瘙痒难忍，抓破色红，中
含紫点。内宜服芦柏地黄丸，外用针挑破去虱，随擦银
杏无忧散易愈。若毛际内如豆如饼，发痒结如蜡皮者，
杨梅毒也。即按杨梅毒治之。
方剂：银杏无忧散
组成：水银（铅制） 轻粉
杏仁（去皮、尖，捣膏） 芦荟
雄黄 狼毒（各一钱）
麝香（一分）
除水银、杏仁膏，共研筛细，再入银杏同研匀。先
以石菖蒲煎汤洗之，用针挑破去虱，随用油唾调擦，使
药气入内，愈不复发。切忌牛、犬、鳌肉。
【方歌】银杏无忧散止痒，热滞毛际阴虱疮，铅制水银轻粉杏，
芦荟雄黄狼麝香。
又方：芦柏地黄丸（即六味地黄丸加芦荟五钱，蜜炒黄柏一两
，见面部雀斑）
【方歌】肾囊红肿发为痈，寒热口干焮痛疼，肝肾湿热流注此，
失治溃深露睾凶。
【注】此证生于肾囊，红肿焮热疼痛，身发寒热，口干饮冷，
由肝、肾湿热，下注肾囊而成，初起宜服荆防败毒散汗
之，外用葱盐熬汤烫之；寒热已退，宜服清肝渗湿汤消
解之；不应者，脓势将成也，急服滋阴内托散；若气怯
食少者，宜服托里透脓汤，外用二味拔毒散圈敷肿根。
脓胀痛者，用卧针针之，出稠脓者顺，出腥水者险，宜
服托里排脓汤，外用琥珀膏贴之，俟肿消、脓少、痛减
时，用生肌散、生肌玉红膏以生肌敛口。此痈本于肝、
肾发出，以滋阴培补气血为要。生肌敛口时，朝服六味
地黄汤，暮服人参养荣汤，滋补之甚效。此证若失治，
溃深露睾丸者险，然不可弃而不治，宜杉木灰托之，苏
子叶包之，患者仰卧，静以养之，或可取效。
方剂：清肝渗湿汤
组成：黄芩 栀子（生，研）
当归 生地
白芍药（酒炒） 川芎
柴胡 花粉
龙胆草（酒炒，各一钱） 甘草（生）
泽泻 木通（各五分）
水二钟，灯心五十寸，煎八分，食前服。
【方歌】清肝渗湿消囊痈，小水淋漓肿痛攻，芩栀四物柴花粉，
胆草灯甘泻木通。
又方：滋阴内托散
组成：当归 熟地
白芍药（酒炒） 川芎（各一钱五分）
穿山甲（炙，研） 泽泻
皂刺（各五分） 黄耆（一钱五分）
水二钟，煎八分，食前服。
【方歌】滋阴内托将溃剂，囊痈欲脓托最宜，四物穿山泻皂刺，
食前煎服入黄耆。
又方：荆防败毒散（见项部脑疽）
托里透脓汤（见头部侵脑疽）
二味拔毒散（见肿疡门）
托里排脓汤（见项部鱼尾毒）
琥珀膏（见头部发际疮）
生肌散、生肌玉红膏、人参养荣汤（俱见溃疡门）
六味地黄汤（即六味地黄丸改作煎剂。见面部雀斑）
[Verse] Scabies pedis (Pediculosis pubis) is caused by lice dwelling within the pubic hair, arising from turbid heat in the Liver and Kidney due to uncleanliness. Itching is severe; scratching causes redness with purple spots. If a waxy crust-like appearance forms, it indicates Syphilis (Yangmei Du).
[Note] This condition is also known as "Eight-legged Bug," growing at the root of the pubic hair. It results from turbid Qi generating heat in the Liver and Kidney, combined with stagnation caused by improper hygiene following sexual activity. The itching is unbearable; scratching leads to redness with purple spots in the center. Internally, use Lubai Dihuang Wan (Aloe and Phellodendron Rehmannia Pill); externally, first puncture with a needle to remove lice, then apply Yinxing Wuyou San (Ginkgo and Almond Soothing Powder), which heals easily. If nodules like beans or cakes appear in the pubic area, accompanied by itching and waxy crusting, this is Yangmei Du (Syphilis). Treat immediately according to the protocols for Yangmei Du.
Formula: Yinxing Wuyou San (Ginkgo and Almond Soothing Powder)
Composition: Mercury (processed with lead), Calomel (Calomelas), Apricot Kernels (Almendae Semen, peeled and cored, pounded into paste), Aloe (Aloes), Realgar (Realgar), Wolfbane Root (Radix Aconiti Kusnezoffii) (each 1 qian), Musk (Moschus) (1 fen).
Preparation and Administration: Except for mercury and apricot kernel paste, grind the remaining herbs together and sift into fine powder. Add Ginkgo nuts and grind uniformly. First, wash the affected area with a decoction of Acori Tatarinowii Rhizoma (Shichangpu). Puncture with a needle to remove lice, then mix the powder with saliva/oil and apply to allow medicinal qi to penetrate. This prevents recurrence. Strictly avoid consuming beef, dog meat, and turtle meat.
[Verse] Yinxing Wuyou San stops itching and treats scabies pedis caused by heat and stagnation in the pubic region, containing processed mercury, calomel, apricot kernels, aloe, realgar, wolfbane, and musk.
Another Formula: Lubai Dihuang Wan (Aloe and Phellodendron Rehmannia Pill) (This is Liuwei Dihuang Wan [Six-Ingredient Rehmannia Pill] plus 5 qian of Aloe and 1 liang of honey-fried Phellodendri Cortex [Huangbai]; also used for facial freckles).
[Verse] Redness and swelling of the scrotum manifest as carbuncle, accompanied by chills, fever, dry mouth, burning pain, and tenderness. This is caused by damp-heat flowing downward from the Liver and Kidneys. If neglected, deep ulceration exposing the testicles indicates a poor prognosis.
[Note] This condition occurs on the scrotum, presenting with redness, swelling, burning heat, pain, systemic chills and fever, and dry mouth with desire for cold drinks. It arises from damp-heat in the Liver and Kidney sinking into the scrotum. In the early stage, take Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction) to induce sweating and release the exterior; externally, apply hot compresses using decoctions of Allii Fistulosi Bulbus (Cong) and salt. Once chills and fever subside, take Qinggan Shen Shi Tang (Clear Liver and Drain Dampness Decoction) to resolve heat and dampness. If ineffective, pus formation is imminent; urgently take Ziyin Neituo San (Nourish Yin and Support Interior Decoction). If the patient has weak Qi and poor appetite, take Tuoli Tou Nong Tang (Support Interior and Expel Pus Decoction); externally, apply Erwei Baidu San (Two-Ingredient Detoxifying Powder) around the base of the swelling.
If there is distending pain from pus, puncture with a flat-headed needle. Discharge of thick pus indicates a favorable course; discharge of foul-smelling fluid indicates a dangerous course. Take Tuoli Pai Nong Tang (Support Interior and Drain Pus Decoction); externally apply Hupo Gao (Amber Plaster). When swelling subsides, pus decreases, and pain lessens, use Shengji San (Flesh-Growing Powder) and Shengji Yuhong Gao (Flesh-Growing Jade Red Ointment) to promote tissue regeneration and wound closure. This carbuncle originates from the Liver and Kidney; nourishing Yin and tonifying Qi and Blood is essential. During the tissue regeneration phase, take Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) in the morning and Renshen Yangrong Tang (Ginseng and Nutritive Qi-Supporting Decoction) in the evening for excellent nourishing effects. If neglected, deep ulceration exposing the testicles is dangerous, but treatment should not be abandoned. Use Cinnamomi Cortex Ash (Shanmu Hui) for support and Perillae Folium (Suzi Ye) for wrapping. Have the patient lie supine and rest quietly; recovery may be achieved.
Formula: Qinggan Shen Shi Tang (Clear Liver and Drain Dampness Decoction)
Composition: Scutellariae Radix (Huangqin), Gardeniae Fructus (Zhizi, raw, crushed), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix (Shengdi), Paeoniae Radix Alba (Baishaoyao, wine-fried), Chuanxiong Rhizoma (Chuanxiong), Bupleuri Radix (Chaihu), Polygonati Odorati Rhizoma (Huafen), Gentianae Radix (Longdancao, wine-fried) (each 1 qian), Glycyrrhizae Radix et Rhizoma (Gancao, raw), Alismatis Rhizoma (Zexie), Akebiae Caulis (Mutong) (each 0.5 qian).
Administration: Water 2 zhong, Junci Medulla (Dengxincao) 50 cun, decoct to 0.8 zhong. Take before meals.
[Verse] Qinggan Shen Shi Tang eliminates scrotal carbuncle, addressing dribbling urination and swelling/pain, containing Huangqin, Zhizi, Siwu Tang ingredients, Chaihu, Huafen, Longdancao, Dengxincao, Gancao, Zexie, and Mutong.
Another Formula: Ziyin Neituo San (Nourish Yin and Support Interior Decoction)
Composition: Angelicae Sinensis Radix (Danggui), Prepared Rehmanniae Radix (Shudi), Paeoniae Radix Alba (Baishaoyao, wine-fried), Chuanxiong Rhizoma (Chuanxiong) (each 1.5 qian), Manis Squama (Chuanshanjia, roasted, crushed), Alismatis Rhizoma (Zexie), Rhamni Spina (Zaoci) (each 0.5 qian), Astragali Radix (Huangqi) (1.5 qian).
Administration: Water 2 zhong, decoct to 0.8 zhong. Take before meals.
[Verse] Ziyin Neituo San is a formula for the pre-ulcerative stage, most suitable when scrotal carbuncle is about to suppurate, containing Siwu Tang ingredients, Chuanshanjia, Zexie, Zaoci, taken before meals with Huangqi.
Another Formula: Jingfang Baidu San (See Neck Carbuncle section)
Tuoli Tou Nong Tang (See Head Carbuncle Invading Brain section)
Erwei Baidu San (See Swollen Ulcer Section)
Tuoli Pai Nong Tang (See Neck Fish-Tail Toxicity section)
Hupo Gao (See Scalp Hairline Carbuncle section)
Shengji San, Shengji Yuhong Gao, Renshen Yangrong Tang (All see Ulcerated Ulcer Section)
Liuwei Dihuang Tang (Is Liuwei Dihuang Wan converted to decoction; see Facial Freckles section)