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A male patient suffered from wind-cold pathogen that was not dispersed in time, causing cold to penetrate the scrotum, resulting in severe swelling and pain. He was bathed with a decoction of Wanling Dan (Ten Thousand Spirits Pill) to induce sweating, which immediately expelled the cold pathogen; subsequently, he took Siwu Tang (Four Substances Decoction) added with Ze Xie (Alisma Rhizome), Cang Zhu (Atractylodis Rhizoma), Shan Zhi (Gardeniae Fructus), and Tian Hua Fen (Trichosanthis Radix), while applying Ruyi Jinhuang San (Ruyi Golden Yellow Powder) externally several times, leading to complete recovery.

Another male patient presented with massive scrotal swelling without heat or distending pain, soft upon pressure and rebounding quickly. This was due to dampness flowing and accumulating without dispersing. A lancet was used to drain approximately one bowl of yellow fluid, followed by oral administration of Daoshui Xiaoshen Wan (Water-Draining Kidney-Reducing Pill) for over a month until the swelling subsided. Thereafter, Muxiang Bushen Wan (Costus Root Tonifying Kidney Pill) was taken to prevent recurrence.

A third male patient had suffered for more than ten days with severe swelling and distending pain, indicating internal pus formation. Puncture released about one bowl of pus, after which Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) added with Ze Xie (Alisma Rhizome) and Dan Pi (Moutan Cortex) was administered for over ten doses, resulting in wound contraction and healing.

An elderly male with a history of hernia experienced pain triggered by anger injuring the Liver. Self-medication with Pancong Sanre drugs exacerbated the swelling and pain. Examination revealed hardness on half of the scrotum with skin breakdown turning purple-black, signaling impending rotting and exposure of the testicle. Disbelieving this prognosis, he sought other physicians hoping for internal resolution. They prescribed Longdan Xiegan Tang (Gentian Liver-Draining Decoction) internally and Sihuang San (Four Yellows Powder) and other cooling agents externally. Consequently, the area indeed rotted, appetite decreased, deficiency-heat and insomnia appeared, and severe pain led to stupor. Upon re-evaluation, I stated: Diseases have primary and secondary aspects; treatment requires flexibility. Initial medication did not address true hernia. Typical hernia involves lower abdominal pain radiating to the testicles, characterized by excess cold and deficient heat, with a preference for hot drinks. This case resulted from anger injuring the Liver, causing yin deficiency with damp-heat, manifesting as scrotal redness, swelling, heat, dark scanty urine, internal heat, dry mouth, heaviness, and pain—symptoms of Scrotal Carbuncle (Nang Yong). Initially, clearing damp-heat was indicated, yet warming herbs for hernia were used; once pus formed, nourishing yin was appropriate, yet liver-draining cooling agents were applied. Given the elderly patient's qi and blood deficiency, both attacking and tonifying strategies were erroneous, endangering life. The priority became nourishing qi and blood, securing the root, assisted by calming spirit and relieving pain herbs to restore yuan qi. Survival depended on correct intervention. Thus, Bazhen Tang (Eight Treasures Decoction) added with Mai Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Fructus), Yuan Zhi (Polygalae Radix), and Mu Dan Pi (Moutan Cortex) was given. Externally, licorice decoction was used to wash the necrotic area, and all blackened dead tissue was trimmed away, exposing the testicle. After several days, benefiting from tonification, symptoms receded, appetite improved, external necrosis cleared, and most of the testicle was exposed. Yuhong Gao (Jade Red Ointment) was applied under a plaster dressing. Muscle regeneration occurred gradually, and after six months of regulation, stability was achieved.

Another male patient suffered swelling and pain for over ten days, hard without pus, with the scrotal head swollen and purple-rotten at the top, indicating external rotting. Chan Su Ding (Toad Venom Tablet) powder was sprinkled on the lesion and covered with a plaster. After three days, necrotic tissue detached. Yuhong Gao (Jade Red Ointment) and Taiyi Gao (Supreme One Elixir Plaster) were applied externally, while internal nourishing-yin and tonifying-kidney medicines were administered for recovery.

A sixth male patient contracted cold after sexual intercourse, causing scrotal traction pain radiating to the lower abdomen, aversion to cold, and fever. Pulse diagnosis showed tight, rapid, and forceless qualities. One dose of Wuji San (Five Accumulations Powder) resolved the chills and fever, alleviating pain slightly. Subsequently, Bazhen Tang (Eight Treasures Decoction) added with Rou Gui (Cinnamon Bark), Dan Pi (Moutan Cortex), and Ze Xie (Alisma Rhizome) was taken for several doses, resulting in cure.