穿裆毒发会阴前，忧思劳伤湿郁源， 痛红顺塌陷逆，腐深漏尿收敛难。
【注】此证生于会阴穴之前，肾囊之后。由忧思、劳伤、湿郁凝结而成。初起如粟，渐
生红亮 痛，溃出稠脓者顺；若起如椒子，黑焦陷于皮肉之内，漫肿紫暗，并无 热，痛
连睾丸及腰背肛门者逆。此系皮囊空处，凡生毒患，宜速溃根浅；但遇根深迟溃，腐伤
尿管，漏尿不能收敛者至险。内治按悬痈，外治按痈疽肿疡、溃疡门。
跨马痈生肾囊旁，重坠肝肾火湿伤，红肿 痛宜速溃，初清托里勿寒凉。
【注】此证一名骗马坠，生于肾囊之旁，大腿根里侧，股缝夹空中。由肝、肾湿火结
滞而成。初如豆粒，渐渐肿如鹅卵，陨坠壅重，色红 痛，暴起高肿，速溃稠脓者顺；若
漫肿平塌，微热微红，溃出稀脓者险，多成串皮漏证。此处乃至阴之下，医治不可过用
寒凉。初宜服仙方活命饮消之，次服托里透脓汤。既溃之后，内外治法，俱按痈疽溃疡门。
仙方活命饮（见肿疡门）
托里透脓汤（见头部侵脑疽）
便毒生于腿缝间，忍精瘀血怒伤肝，坚硬木痛寒热作，初汗次下灸之痊。
【注】此证又名血疝，又名便痈，无论男女，皆可以生。发于少腹之下，腿根之上折
纹缝中，经属肝、肾。由强力房劳，忍精不泄，或欲念不遂，以致精博血留，聚于中途，
壅遏而成；或为暴怒伤肝，气滞血凝而发。初如杏核，渐如鹅卵，坚硬木痛，微热不红，令
人寒热往来，宜荆防败毒散汗之；若烦躁作渴，气郁者宜山甲内消散以消解之；若过于
坚硬大痛者，宜红花散瘀汤舒通之。前药用之不应者，宜九龙丹攻之，若无痛无热，则
不可攻下，宜阳燧锭日灸五七壮，以或软、或消、或溃为止。脓势将成不可强消，宜黄
内托散托之；甚虚者，托里透脓汤。既溃宜八珍汤、十全大补汤、补中益气汤，因证用
之。外用五色灵药撒之，化腐煨脓；兼琥珀膏、万应膏贴之，生肌敛口。斯证溃后，即
名鱼口。因生于折纹缝中，其疮口溃大，身立则口必合，身屈则口必张，形如鱼口开合
之状，故有鱼口之名。但此毒系忍精不泄，怒气伤肝而成。至于生杨梅而兼有便毒者，另
详注于杨梅门。
红花散瘀汤
红花 当归尾 皂刺（各一钱） 生军（三钱） 连翘（去心） 苏木 穿山甲（炙研） 石决明 僵
蚕（炒） 乳香 贝母（去心，研，各一钱） 黑牵牛（二钱）
酒、水各一盅，煎八分，空心服；行五六次，方食稀粥补之。
【方歌】红花散瘀消坚硬，便毒初起肿痛添，归刺军翘苏木甲，石决僵蚕乳贝牵。
黄 内托散
黄 （二钱） 白术（土炒，一钱） 当归 川芎（各二钱） 金银花 皂刺 天花粉（各一钱） 泽泻
甘草（炙，各五分）
水二盅，煎八分，食前服。
【方歌】黄 内托医便毒，肿盛不消托溃良，白术归芎银皂刺，天花泻草力同 。
荆防败毒散（见项部脑疽）
山甲内消散（见腹部中脘疽）
九龙丹（见前悬痈）
阳燧锭（见首卷烙法）
托里透脓汤（见头部侵脑疽）
八珍汤 十全大补汤 补中益气汤 五色灵药 万应膏（俱见溃疡门）
琥珀膏（见头部发际疮）
Chuangdang Du (Toxic Carbuncle in the Crotch) erupts anterior to the Huiyin acupoint. Its etiology stems from worry, overstrain, and dampness stagnation. Pain with redness and swelling indicates a favorable prognosis; collapse and blackening indicate an unfavorable one. If deep ulceration leads to urinary leakage, healing is difficult.
[Note] This condition arises anterior to the Huiyin acupoint and posterior to the scrotum. It is formed by the condensation of worry, overstrain, and dampness stagnation. Initially resembling millet grains, it gradually becomes red, bright, and painful. Ulceration discharging thick pus indicates a favorable course. If it begins like a pepper seed, appearing black and scorched, sinking into the flesh, with diffuse purple-dark swelling, no significant heat, and pain radiating to the testicles, lower back, and anus, it indicates an unfavorable course. This area is where skin folds are empty. For any toxic lesion here, rapid ulceration with shallow roots is preferred. However, if the root is deep and ulceration is delayed, causing erosion of the urethra and resulting in non-healing urinary leakage, the condition is extremely critical. Internal treatment follows the protocols for Xuan Yong (Perineal Carbuncle); external treatment follows the sections on Carbuncle Sores and Ulcers.
Kuama Yong (Cross-Horse Abscess) arises beside the scrotum, caused by Liver-Kidney fire and dampness injury, presenting with heavy dragging sensations. Redness, swelling, and pain require rapid ulceration; early treatment should employ clearing and supporting interior methods, avoiding excessive cold-natured herbs.
[Note] Also known as Pian Ma Zhui, this condition arises beside the scrotum, on the inner side of the upper thigh root, within the inguinal fold. It is caused by the stagnation of Liver-Kidney damp-fire. Initially bean-sized, it gradually swells like a goose egg, becoming heavy and pendulous, red and painful. Rapid high swelling followed by ulceration discharging thick pus indicates a favorable course. Diffuse flat swelling, slight heat and redness, and discharge of thin pus indicate danger, often leading to fistula formation. This area is at the lowest point of Yin; treatment must not overuse cold-natured herbs. Early stage: administer Xianfang Huoming Yin to dissipate, followed by Tuoli Tou Nong Tang. After ulceration, internal and external treatments follow the Carbuncle Ulcer section.
Xianfang Huoming Yin (see Section on Sores)
Tuoli Tou Nong Tang (see Section on Brain-Penetrating Carbuncle of the Head)
Biandu (Groin Gland Swelling/Inguinal Adenitis) arises between the leg folds, caused by retained semen, blood stasis, and Liver injury from anger. Symptoms include hardness, numbness/pain, and alternating chills and fever. Early treatment involves sweating, followed by purging or moxibustion for cure.
[Note] Also known as Xue Shan (Blood Hernia) or Bian Yong, this condition can occur in both men and women. It develops below the lower abdomen, above the crease of the upper thigh root, belonging to the Liver and Kidney meridians. Etiology includes strenuous sexual activity, retention of semen without emission, or unfulfilled desires, causing essence and blood to bind and accumulate midway, leading to obstruction; or sudden anger injuring the Liver, causing Qi stagnation and Blood coagulation. Initially almond-sized, it grows to the size of a goose egg, hard, numb, and painful, with slight heat but no redness, causing alternating chills and fever. Use Jingfang Baidu San to induce sweating; if irritability and thirst with Qi stagnation are present, use Shanjia Neixiao San to dissipate; if excessively hard and painful, use Honghua Saiyu Tang to soothe and unblock. If previous remedies fail, use Jiulong Dan to attack; if there is no pain or heat, do not purge, but use Yangsui Ding for daily moxibustion (5-7 moxa cones) until softening, resolution, or ulceration occurs. When pus is forming, do not force dissolution; use Huangqi Neituo San to support and expel toxins. For severe deficiency, use Tuoli Tou Nong Tang. After ulceration, use Bazhen Tang, Shiquan Dabu Tang, or Buzhong Yiqi Tang according to the syndrome. Externally, apply Wuse Lingyao to resolve putrefaction and nourish pus; combine with Hupo Gao and Wanying Gao plasters to generate flesh and close wounds. After ulceration, this condition is named Yukou (Fish Mouth). Due to its location in the crease, when standing the wound closes, and when bending the wound opens, resembling a fish mouth. This toxicity results from retained semen and Liver injury from anger. Cases involving Chancre (Mei Du) combined with Biandu are detailed in the Chancre section.
Honghua Saiyu Tang
Safflower (Honghua), Tail of Angelica Sinensis (Danggui Wei), Gleditsia Spine (Zaoci) (1 qian each), Raw Rhubarb (Sheng Jun) (3 qian), Forsythia (Lianqiao, decentered), Sappan Wood (Sumu), Pangolin Scale (Chuanshanjia, roasted and ground), Abalone Shell (Shijueming), Silkworm (Jiangcan, stir-fried), Frankincense (Ruxiang), Fritillaria (Beimu, decentered, ground) (1 qian each), Black Morning Glory Seed (Hei Qianniu) (2 qian).
Decoct with one cup of wine and one cup of water to yield 0.8 cup; take on an empty stomach. After 5-6 bowel movements, consume thin congee to replenish.
[Formula Verse] Honghua dissolves hardness, relieving initial swelling and pain of groin swelling; Danggui, Zaoci, Jun, Lianqiao, Sumu, and Jia; Shijue, Jiangcan, Ruxiang, Beimu, and Qian.
Huangqi Neituo San
Astragalus (Huangqi) (2 qian), Atractylodes Macrocephala (Baizhu, soil-fried) (1 qian), Angelica Sinensis (Danggui), Ligusticum Chuanxiong (Chuanxiong) (2 qian each), Honeysuckle (Jinyinhua), Gleditsia Spine (Zaoci), Trichosanthes Root (Tianhuafen) (1 qian each), Alisma (Zexie), Licorice (Gancao, roasted) (0.5 fen each).
Decoct with two cups of water to yield 0.8 cup; take before meals.
[Formula Verse] Huangqi Neituo treats groin swelling, effective for resolving large swellings and promoting ulceration; Baizhu, Danggui, Chuanxiong, Jinyinhua, Zaoci, Tianhuafen, Zexie, and Gancao work together.
Jingfang Baidu San (see Section on Neck Carbuncle)
Shanjia Neixiao San (see Section on Epigastrium Carbuncle)
Jiulong Dan (see preceding Xuan Yong)
Yangsui Ding (see Volume 1 Moxibustion Methods)
Tuoli Tou Nong Tang (see Section on Brain-Penetrating Carbuncle of the Head)
Bazhen Tang, Shiquan Dabu Tang, Buzhong Yiqi Tang, Wuse Lingyao, Wanying Gao (all see Ulcer Section)
Hupo Gao (see Section on Hairline Carbuncle of the Head)