Library

Tolli Xiaodu San (See Men of Swelling and Ulceration)
Shiquan Dabu Tang (Ten Complete Tonic Decoction), Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), Bazhen Tang (Eight Treasures Decoction) (All See Men of Ulceration)
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (See Men of Lung Abscess)

The so-called Nang Yong (Scrotal Carbuncle) arises from Yin deficiency, allowing damp-heat pathogens to flow into the scrotum, where they condense to form a swelling. Even if it ulcerates and the testis hangs exposed, it does not necessarily endanger life, as the toxin has been expelled externally. Treatment should focus on nourishing Yin and clearing/drainng damp-heat; such cases typically achieve an eight or nine out of ten success rate. In recent times, people have mistakenly used hot-natured medicines for treating hernias, often causing the heat to intensify and transform into pus, making healing difficult to anticipate. Initially, Longdan Xiegan Tang (Gentiana Liver-Draining Decoction) is appropriate; after a longer duration, Ziyang Neituo San (Nourish-Yin Internal-Supporting Powder) may be used. Applying Ruyi Jinhuang San (Ruyi Golden Yellow Powder) externally can also facilitate the internal resolution of the swelling. Another condition, Shui Shan (Hydrocele), presents with shiny skin color, no fever or redness, intermittent swelling and pain, and accumulated fluid internally. It is suitable to use a needle to drain the fluid from the urethral area to ensure peace. If swelling and pain persist for a long time, internal pus has formed causing distending pain, immediate needle drainage is indicated; internally, Shiquan Dabu Tang (Ten Complete Tonic Decoction) added with Cornus Officinalis Fructus (Shanzhuyu), Moutan Cortex (Mudanpi), and Alisma Rhizoma (Zexie) should be administered, interspersed with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), which will also lead to recovery.

In the initial stage, if there is no redness and only slight swelling, with pulling pain in the testis, no chills or fever, and normal activities and diet, it is a mild case. If it progresses to redness, swelling, and fever, with bright and shiny appearance, periodic pain, and preserved appetite, it is a favorable course. If it has ulcerated with thick pus, swelling subsides, pain stops, new flesh gradually grows, itching without pain, and wound contraction occurs, it is an auspicious sign. If after ulceration there is rotting, shedding of scrotal skin, and even protrusion of the testis, but the patient can eat and feels no pain, it is treatable.

If in the initial stage the mass is hard and purple, with severe day-and-night pain, difficulty in urination, and loose stools, it is a severe case. If it progresses to hardness without ulceration, head necrosis without pus, constant pain, and frequent discharge of bloody fluid, it is a severe case. If after ulceration the wound opens wide, swelling and pain do not decrease, chills and fever appear, and sleep is restless, it is a severe case.

In the initial stage, with alternating chills and fever, testicular swelling and pain radiating to the lower abdomen, it is appropriate to disperse cold pathogens. If it progresses to redness, swelling, fever, dry mouth and pain, difficulty in urination, and constipation, it is appropriate to promote bowel movement and urination. If already ulcerated with persistent pain, thin and clear pus, morning chills, and evening fever, it is appropriate to nourish Yin and support internally. If after ulceration the wound fails to contract, afternoon fever occurs, and appetite decreases, it is appropriate to nourish blood and strengthen the spleen. If after ulceration the testis hangs and cannot contract, external application of flesh-regenerating agents should be used, combined internally with tonifying and supporting methods.