（妇人阴疮等症见《女科撮要》、《妇人良方》）
下疳属肝经湿热下注，或阴虚火燥。治法∶肿痛发热者，血虚而有热也，四物汤加柴胡
、山栀。肿痛寒热者，肝经湿热也，小柴胡汤加龙胆草、黄连。肿痛便涩者，湿热壅滞也，龙胆
泻肝汤。肿痛腐溃者，气血虚而有火也，八物汤加山栀、柴胡。日晡热甚者，阴血虚而有热
也，小柴胡汤加参、术、芎、归。日晡倦怠者，阳气虚而下陷也，补中益气汤。其经久不愈
而发寒热者，肾水不能生肝木也，用六味丸。若筋缩纵，或为痒痛，或出白津，此筋疝也，
用龙胆泻肝汤。气虚者，补中益气加炒山栀、炒龙胆。阴虚火燥者，用六味丸。茎中痒出白
津，用补中益气汤与清心莲子饮间服。盖此症肝经阴虚为本，肿痛寒热等症为标，须用六味
丸，以生肝血。凡脾土虚不能生金水，而见一切肝症者，当佐以补中益气汤加麦门冬，以滋化源
治验
庶给士刘华甫，或茎中作痛，或窍出白津，或小便秘涩。先用小柴胡汤加山栀、泽泻、
黄连
复伤也，用补中益气而安；又用六味丸，以生肝血，滋肾水，而痊愈。
州守姜节甫，患前症。脓水淋漓，作渴吐痰，午前恶寒，午后发热。余曰∶午前恶寒，
属阳气虚弱，午后发热，属阴血不足。不信，反服二陈、黄柏、知母之类，饮食益少，大便不实
，又日晡热渴，小腹重坠，患处 痛。恪用四物、黄柏、知母之类，饮食亦不思。余以脾气
虚而下陷，先用补中益气汤，调养脾胃，以升阳气，诸症渐愈。又用六味丸，滋补肾水以生
一小儿十五岁，患前症。杂用消毒之药，虚症悉具，二年余矣。询之，乃禀所致。用萆
汤，月余诸症渐愈；又用补阴八珍、补中益气二汤而痊。
一儒者茎中作痒，发热倦怠，外皮浮肿二年矣。用八珍加柴胡、山栀，及六味地黄丸而
愈。有兼阴毛间生虫作痒者，用桃仁研烂涂之。
一儒者因劳而患 痛寒热，体倦头疼，小便赤涩。用补中益气汤加车前、牛膝、山栀而
一儒者，阴茎腐烂，肿痛不止，日晡热甚，口干体倦，食少欲呕。此肝脾血虚也，先用
六君子加柴胡、升麻，脾胃醒而诸症退；更以补中益气加炒山栀，肝火退而肿痛痊。
(For symptoms of yin sores and other conditions in women, see *Nuke Cuoyao* and *Furen Liangfang*.)
Xigan (ulcerative lesions occurring on the genital organs) is attributed to damp-heat pouring downward in the Liver channel, or to Yin deficiency with fire dryness. Treatment principles are as follows: If swelling, pain, and fever occur, it indicates blood deficiency with heat; use Siwu Tang (Four Substances Decoction) with Chaihu (Bupleuri Radix) and Shanzhi (Gardeniae Fructus). If swelling, pain, accompanied by alternating chills and fever occur, it indicates damp-heat in the Liver channel; use Xiaochaihu Tang (Minor Bupleurum Decoction) with Longdancao (Gentianae Radix) and Huanglian (Coptidis Rhizoma). If swelling, pain, and difficult urination occur, it indicates stagnation due to damp-heat; use Longdan Xiegan Tang (Gentian Liver-Draining Decoction). If swelling, pain, and putrefaction/ulceration occur, it indicates Qi and blood deficiency with fire; use Bayu Tang (Eight Substances Decoction) with Shanzhi and Chaihu. If severe fever occurs at Shen hour (3–5 PM), it indicates Yin blood deficiency with heat; use Xiaochaihu Tang with Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), and Danggui (Angelicae Sinensis Radix). If fatigue occurs at Shen hour, it indicates Qi deficiency with sinking; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If the condition persists for a long time without healing and presents with chills and fever, it indicates that Kidney Water fails to nourish Liver Wood; use Liuwei Wan (Six-Ingredient Pill with Rehmannia). If there is tendon contraction or flaccidity, itching and pain, or discharge of white fluid, this is Jinshan (tendon hernia); use Longdan Xiegan Tang. If it is Qi deficiency, use Buzhong Yiqi Tang with fried Shanzhi and fried Longdancao. If it is Yin deficiency with fire dryness, use Liuwei Wan. If there is itching in the urethra with discharge of white fluid, alternate服用 (take alternately) Buzhong Yiqi Tang and Qingxin Lianzi Yin (Clear Heart and Lotus Seed Drink). Generally, this disease takes Liver channel Yin deficiency as its root, while symptoms such as swelling, pain, chills, and fever are its branch manifestations. It is necessary to use Liuwei Wan to generate Liver blood. Whenever Spleen Earth is deficient and fails to generate Lung Metal and Kidney Water, presenting with various Liver-related syndromes, one should assist treatment with Buzhong Yiqi Tang plus Maidong (Ophiopogonis Tuber) to nourish the source of transformation.
[Case Records]
Shuji Shi Liu Huafu sometimes experienced pain in the urethra, discharge of white fluid from the urethral orifice, or scanty and difficult urination. Initially treated with Xiaochaihu Tang plus Shanzhi, Zexie (Alismatis Rhizoma), and Huanglian; subsequently, after re-injury (or mismanagement), stabilized with Buzhong Yiqi Tang; finally cured using Liuwei Wan to generate Liver blood and nourish Kidney water.
Zhoushou Jiang Jiefu suffered from the aforementioned condition. There was continuous dripping of pus and serous fluid, thirst, expectoration, chills before noon, and fever after noon. I stated: Chills before noon indicate Yang Qi deficiency; fever after noon indicates Yin blood insufficiency. He did not believe this and instead took Erchen Tang (Two-Aged Decoction), Huangbai (Phellodendri Cortex), and Zhimu (Anemarrhenae Rhizoma). His food intake decreased further, his stools became loose, and he developed heat and thirst at Shen hour, heavy bearing sensation in the lower abdomen, and pain at the lesion site. He stubbornly continued taking Siwu Tang, Huangbai, and Zhimu, losing his appetite completely. I diagnosed Spleen Qi deficiency with sinking. I first used Buzhong Yiqi Tang to regulate the Spleen and Stomach and raise Yang Qi, after which all symptoms gradually improved. Then I used Liuwei Wan to nourish Kidney water to generate Liver wood.
A fifteen-year-old boy suffered from the aforementioned condition. Due to indiscriminate use of detoxifying drugs, all deficiency syndromes manifested, persisting for over two years. Inquiry revealed it was due to congenital predisposition. Treated with Bixie Fenqing Yin (Nettle Seed Decoction to Separate the Turbid), after which symptoms gradually improved within a month; subsequently recovered after taking Buyin Bazhen Tang (Nourish Yin Eight Treasures Decoction) and Buzhong Yiqi Tang.
A scholar experienced itching in the urethra, fever, fatigue, and external skin edema for two years. Cured using Bazhen Tang (Eight Treasures Decoction) plus Chaihu and Shanzhi, along with Liuhuang Dihuang Wan (Six-Ingredient Rehmannia Pill). In cases complicated by insects growing between the pubic hairs causing itching, crushed Tao Ren (Prunus Persica Seed) was applied topically.
A scholar, due to overwork, suffered from penile pain with chills and fever, body fatigue, headache, and red, scanty, difficult urination. Cured using Buzhong Yiqi Tang plus Cheqianzi (Plantaginis Semen), Niuxi (Achyranthis Bidentatae Radix), and Shanzhi.
Another scholar had a rotting penis with unceasing swelling and pain, severe fever at Shen hour, dry mouth, body fatigue, poor appetite, and nausea. This was Liver and Spleen blood deficiency. First, Liujunzi Tang (Six Gentlemen Decoction) plus Chaihu and Shengma (Cimicifugae Rhizoma) was used; once the Spleen and Stomach function recovered, all symptoms subsided. Subsequently, Buzhong Yiqi Tang plus fried Shanzhi was used; once Liver fire receded, swelling and pain resolved.