《全婴方》云∶小儿阴肿核肿者，由儿啼怒，气逆不顺，乘虚而行，阴核偏大。
又因甘肥不节，生冷过度，致生疳气，气结不行，流入阴中。或伤暑毒，或触风邪，
使血气与邪气相搏，停结不散，则成阴肿也。仁斋云∶若肾经气虚，或坐石不起，
冷气凝之，或近地经久，风邪湿气伤之，不为阴肿，几希矣。间有啼叫怒气，闭系于下，
结聚不散，加以水窦不行，亦能发为此疾。治用桃仁丸主之。丹溪谓∶脱囊肿大，
坠下不收，用紫苏茎叶为末，水调，荷叶包之，一人传此方，用野白紫苏为末，湿
则掺之，干则香油调敷，虽皮溃子坠，皆有神效，此用紫苏，盖亦同功也。〔曾〕
巢元方论曰∶诸筋会于阴器，邪客于厥阴少阴之经，与冷气相搏，则阴囊肿痛，
而引缩经中，虽分四证曰肠 、气 、水 、卵 ，然小儿患此，若治之不早，则
成痼疾，如腰曲腹痛，冷汗自出，而阴囊二子，吊缩入腹，痛止方出，名为内吊。
用乌梅散、匀气散、金茱丸、金铃散为治。有阴茎全缩不见，有阴囊光肿不痛，
此因肝肾气虚，宜以橘子仁煎汤，调下金铃散、匀气散，皆可投之。《内经》曰∶
癃疝肤胀者，阴亦盛而脉胀不通，故曰 癃疝。由是观之，乃阴气盛而致有此，
吊缩者，筋急也，筋遇寒则引缩，遇热则弛张，故《三因》所用方法，以宽小肠气，
疏风为治，然小儿此证，多因坐阴润之地，感风湿而得，用当归散加槟榔、苍术，
水姜煎服，并青木香汤、钓藤膏，外以立消散敷之。有外肾无故，而肤囊肿大，
不燥不痛，光亮如吹，此名气虚所致，以匀气散调治，《三因方》家韭子丸主之。
一证，外肾肤囊赤肿通明，及女儿阴户肿胀，乃心热之所传，皆以木通散、导赤散、
为治，或用薏苡仁煎汤调五苓散，及以外消散敷之，并投天花散，用无灰酒煎下，
不能饮者水煎，少入酒同服亦好。张涣曰∶小儿足少阴之经虚而受风邪者，冲于下
经则成阴肿病，桃仁丹主之。
桃仁丹
桃仁（七钱半，汤浸，去皮尖、双仁者，麸炒微黄） 牡丹皮 白蒺藜（微炒，去刺）
桂心（各半两） 郁李仁（二钱半，汤浸，去皮，微炒）
上件药，捣罗为细末，炼蜜和，黍米大。每服十粒，以温酒下，乳食前。量儿
大小加减。亦可水煎服。
胡连散 治阴肿生疮。
胡黄连（去须） 胡粉（各半两） 白矾（枯，二钱半）
上，捣、罗为细末。每用少许，以生油、调涂患处。
〔汤〕小儿阴肿，由啼叫怒气闭纵于下，成此疾，宜
海蛤散
海蛤（三钱） 香（炒，七钱半） 薏苡仁 白术 槟榔（各半两）
上为末。食前，温酒调下，大小加减。
桃仁丸
桃仁（去皮尖，麸炒，三钱） 桂枝（去皮） 牵牛（炒，头末） 蒺藜 牡丹皮（各二钱）
上为细末，炼蜜丸，如黍米大。用青皮、木香、葱白、入盐少许同煎汤，食
前服。
三白散 治小儿解国中肿疾，四肢肤囊浮胀，大小便不利，皆因膀胱蕴热，风湿
相乘。
桑根白皮（炒） 白术 木通（去皮节） 陈皮（去白） 白牵牛（半生半炒） 甘草（炙。各五钱）
上 咀。用水煎，食前服。
〔丹〕脱囊，即外肾肿大。
木通 甘草 当归 黄连 黄芩
上，水煎服。
〔钱〕蚯蚓散 治肾子肿硬成疝，用干蚯蚓为末，唾调敷，常避风冷湿地。（先用花椒葱汤
避风处洗，却用此敷之累验）
〔世〕治小儿囊肿如升，用甘草煎汁、调地龙末涂之，立退。累效。
敷药方
牡蛎粉（二分） 干地龙（碾末，一分）
上用津唾调，敷外肾。热者、鸡子清调敷。
牡蛎散 治小儿外肾肿大，茎物通明。
用牡蛎粉研十分细，先以唾津涂肿处，次以牡蛎粉掺。
又方 治小儿卵肿，研桃仁，唾调敷。
〔曾〕乌梅散 匀气散 金茱丸 金铃散（方并见疝） 当归散（见痢）
牡蛎大黄汤 治三五岁小儿，感受温湿之气，侵袭膀胱，致阴茎、肤囊浮肿作痛。
牡蛎（用熟黄泥包裹，炭火 透，出地上、候冷用） 大黄（纸裹，水浸透，煨过，候冷用。二味各一两）
上锉研为末。每服一钱，无灰温酒空心调服，不能饮者，温汤调，少入酒同服。
青木香汤 治小儿阴茎无故而肿，或痛缩，因阳明经有风热湿气相搏，法当宽此一
经，自愈，盖阳明受病，不能养其宗筋故也，咳嗽痰喘，亦宜服之。
青木香（去芦） 枳壳（浸，去穣，麸炒。各半两） 甘草（二钱半）
上每服二钱，水一盏，煎七分，不拘时，温服。
立消散 治膀胱久受热毒，致阴器肤囊赤肿胀痛。
赤小豆 赤芍药 生枳壳 商陆 风化朴硝（另研，后入。各半两）
上件，不过火，锉、晒为末。柏枝煎汤候冷，调二钱或三钱涂肿处，仍服
咀五苓散加车前子、薏苡仁、水煎。
木通散（见惊）
天花散 治外肾肤囊肿痛。
天花粉（二两） 甘草（三钱）
上锉。每服二钱，无灰酒一盏，煎七分，空心，温服。不能饮，用水煎，少入酒同服。
Quan Ying Fang states: When infants and children suffer from swelling of the scrotum or testicles, it is caused by crying and anger leading to rebellious and obstructed Qi, which invades due to deficiency, resulting in unilateral enlargement of the testicular sac.
Furthermore, excessive consumption of sweet, fatty foods and raw, cold items generates Gan Qi (wasting-thirst syndrome related to parasites or malnutrition), causing Qi stagnation and obstruction, flowing into the genital region. Alternatively, exposure to summer-heat toxicity or wind pathogens causes Blood and Qi to contend with pathogenic factors, stagnating and accumulating without dispersing, thus forming Yin swelling.
Ren Zhai stated: If the Kidney channel Qi is deficient, or if one sits on stone for long periods allowing cold Qi to condense, or stays near the ground for extended periods suffering wind-damp invasion, it is rare not to develop Yin swelling. Occasionally, crying and anger cause Qi closure at the lower body, aggregating without dispersing; combined with blocked water passages, this can also trigger this disease. Treatment primarily uses Tao Ren Wan (Peach Kernel Pill).
Danxi stated: For prolapsed scrotal swelling that hangs down and cannot retract, use powdered Perilla stem and leaf, mixed with water, and wrapped in a lotus leaf for application. Someone transmitted this prescription using wild white Perilla powder; if the area is moist, sprinkle the powder; if dry, mix with sesame oil for topical application. Even if the skin ulcerates and the testes descend, it yields miraculous effects. The use of Perilla here shares similar efficacy.
Chao Yuanfang discussed: All sinews converge at the genitalia. When pathogens lodge in the Jueyin and Shaoyin channels and contend with cold Qi, it causes scrotal swelling and pain, drawing inward along the meridians. Although conditions are categorized into four types: Chang Hernia (Intestinal Hernia), Qi Hernia, Shui Hernia (Water Hernia), and Luan Hernia (Testicular Hernia), if pediatric cases are not treated early, they become chronic ailments. Symptoms include curved waist and abdominal pain, spontaneous cold sweating, and the two testes retracting into the abdomen until pain subsides, known as Nei Diao (Internal Retraction).
Treatment employs Wu Mei San (Mume Powder), Yun Qi San (Regulate Qi Powder), Jin Zhu Wan (Gold Evodia Pill), and Jin Ling San (Golden Bell Powder). In cases where the penis completely retracts and becomes invisible, or the scrotum swells brightly without pain, due to Liver and Kidney Qi deficiency, decocting Tangerine kernel to administer Jin Ling San or Yun Qi San is appropriate.
The Neijing states: Regarding Long Shan Fu Zhang (Obstructive Hernia and Skin Distension), when Yin Qi is excessive and pulses are swollen and obstructed, it is called Long Shan. Thus, this condition arises from excess Yin Qi. Retraction indicates tendon tension; tendons contract when encountering cold and relax when encountering heat. Therefore, methods in San Yin Fang focus on relaxing Small Intestine Qi and dispelling wind. However, pediatric cases often result from sitting in damp, yin places and contracting wind-dampness. Use Dang Gui San (Angelica Decoction) added with Areca Seed and Atractylodes Macrocephala Rhizome, decocted with water and ginger, alongside Qing Mu Xiang Tang (Aucklandia Decoction) and Diao Teng Gao (Uncaria Paste), applied externally with Li Xiao San (Immediate Resolution Powder).
In another presentation, the external genitals swell inexplicably, with skin sacs becoming distended but neither dry nor painful, shining like inflated bladders; this is attributed to Qi deficiency, treated with Yun Qi San. The Jiu Zi Wan (Allium Seed Pill) in San Yin Fang is indicated.
Another syndrome involves red, swollen, transparent skin sacs on the external genitals, or vulvar swelling in girls, transmitted from Heart Heat. These are treated with Mu Tong San (Akebia Decoction) or Dao Chi San (Direct Outward Red Powder), or Yi Yi Ren decoction administered with Wu Ling San (Five Ingredient Powder with Poria), plus external application of Xiao San (Resolution Powder). Tian Hua San (Trichosanthes Powder) is also used, decocted with non-fermented wine; for those who cannot drink alcohol, decoct with water, adding a little wine is beneficial.
Zhang Huan stated: When the Foot-Shaoyin channel is deficient and exposed to wind pathogens, affecting the lower channels, it results in Yin swelling, treated with Tao Ren Dan (Peach Kernel Elixir).
Tao Ren Dan (Peach Kernel Elixir)
Tao Ren (Peach Kernel, 7.5 qian, soaked in hot water, peel and tips removed, double-kernels discarded, bran-fried until slightly yellow) Mudan Pi (Tree Peony Bark) Bai Ji Li (Tribulus Fruit, lightly fried, spines removed) Gui Xin (Cinnamon Heart) (each 0.5 liang) Yu Li Ren (Bush Cherry Kernel, 2.5 qian, soaked in hot water, peeled, lightly fried)
Crush and sieve these ingredients into fine powder. Mix with refined honey to form pills the size of millet seeds. Take 10 pills each time, washed down with warm wine, before milk or food meals. Adjust dosage according to the child's age and size. Can also be taken as a decoction.
Hu Lian San (Coptis Powder) Treats Yin swelling with sores.
Hu Huang Lian (Coptis Rhizome, remove roots) Hu Fen (Lead White) (each 0.5 liang) Bai Fan (Alum, calcined, 2.5 qian)
Crush and sieve into fine powder. Apply a small amount mixed with raw sesame oil to the affected area.
[Tang] Pediatric Yin swelling, caused by crying and anger leading to Qi closure in the lower body, requires Hai Ge San (Clam Shell Powder).
Hai Ge (Clam Shell, 3 qian) Chen Xiang (Agarwood, fried, 7.5 qian) Yi Yi Ren (Coix Seed) Bai Zhu (Atractylodes Macrocephala Rhizome) Bing Lang (Areca Seed) (each 0.5 liang)
Grind into powder. Take before meals, mixed with warm wine, adjusting for age/size.
Tao Ren Wan (Peach Kernel Pill)
Tao Ren (Peach Kernel, peeled and tipped, bran-fried, 3 qian) Gui Zhi (Cinnamon Twig, peeled) Qian Niu (Morning Glory Seed, fried, head-end powder) Ji Li (Tribulus) Mu Dan Pi (Tree Peony Bark) (each 2 qian)
Grind into fine powder, mix with refined honey to make pills the size of millet seeds. Decoct Qing Pi (Citrus Unripe Peel), Mu Xiang (Aucklandia Root), Cong Bai (Scallion White), and a pinch of salt in water. Take before meals.
San Bai San (Three Whites Powder) Treats pediatric fontanelle swelling, floating distension of skin sacs on limbs, and difficulty urinating/defecating, all due to Bladder heat accumulation compounded by wind-dampness.
Sang Bai Pi (Mulberry Root Bark, fried) Bai Zhu (Atractylodes Macrocephala Rhizome) Mu Tong (Akebia Stem) Chen Pi (Citrus Ripe Peel, pith removed) Bai Qian Niu (White Morning Glory Seed, half raw, half fried) Gan Cao (Licorice Root, honey-fried) (each 5 qian)
Cut into pieces. Decoct in water, take before meals.
[Dan] Tuo Nang (Proscrotum) refers to external genital swelling.
Mu Tong (Akebia Stem) Gan Cao (Licorice Root) Dang Gui (Angelica Sinensis Root) Huang Lian (Coptis Rhizome) Huang Qin (Scutellaria Root)
Decoct in water and take.
[Qian] Qiu Yin San (Earthworm Powder) Treats hard, swollen testicles forming hernia. Use dried earthworm powder mixed with saliva for topical application. Avoid wind, cold, and damp places. (First wash in a decoction of Sichuan Pepper and Scallion in a wind-free place, then apply this powder; repeatedly effective.)
[Shi] To treat pediatric scrotal swelling as large as a measuring cup, use Licorice juice mixed with Earthworm powder for topical application; it recedes immediately. Repeatedly effective.
Topical Application Formula
Mu Li Fen (Oyster Shell Powder, 2 fen) Gan Di Long (Dried Earthworm, ground, 1 fen)
Mix with saliva and apply to external genitals. For heat patterns, mix with egg white.
Mu Li San (Oyster Shell Powder) Treats pediatric external genital swelling with transparent penis.
Grind Oyster Shell Powder very finely. First apply saliva to the swollen area, then sprinkle the powder.
Another Prescription: For pediatric testicular swelling, grind Peach Kernels, mix with saliva, and apply.
[Zeng] Wu Mei San (Mume Powder), Yun Qi San (Regulate Qi Powder), Jin Zhu Wan (Gold Evodia Pill), Jin Ling San (Golden Bell Powder) (See Hernia chapter for formulas), Dang Gui San (Angelica Decoction) (See Dysentery chapter).
Mu Li Da Huang Tang (Oyster and Rhubarb Decoction) Treats 3-5 year old children who contracted warm-damp qi invading the Bladder, causing penile and scrotal edema and pain.
Mu Li (Oyster Shell, wrapped in cooked yellow clay, calcined over charcoal fire until through, removed from ground, cooled) Da Huang (Rhubarb Root, wrapped in paper, soaked in water until through, baked, cooled) (Each 1 liang)
Crush and grind into powder. Take 1 qian each time, mixed with warm non-fermented wine on an empty stomach. If unable to drink wine, mix with warm water, adding a little wine is acceptable.
Qing Mu Xiang Tang (Aucklandia Decoction) Treats unexplained penile swelling or painful retraction in children, caused by wind-heat-dampness contending in the Yangming channel. The method should relax this channel for self-healing, as Yangming pathology fails to nourish the Zongjin (Major Sinew). It is also suitable for cough with phlegm and wheezing.
Qing Mu Xiang (Aucklandia Root, remove rhizome base) Zhi Ke (Bitter Orange, soaked, pith removed, bran-fried) (each 0.5 liang) Gan Cao (Licorice Root, 2.5 qian)
Take 2 qian each time, with one cup of water, decoct to 0.7 cups. Take warm at any time.
Li Xiao San (Immediate Resolution Powder) Treats prolonged Bladder heat-toxin causing red, swollen, painful skin sacs on genitalia.
Chi Xiao Dou (Red Adzuki Bean) Chi Shao Yao (Red Peony Root) Sheng Zhi Ke (Raw Bitter Orange) Shang Lu (Phytolacca Root) Feng Hua Po Xiao (Weathered Mirabilite, separately ground, added last) (each 0.5 liang)
Do not roast excessively. Cut, dry, and grind into powder. Decoct Cypress Branches, cool the liquid, and mix 2-3 qian of powder to apply to the swelling. Continue taking chopped Wu Ling San (Five Ingredient Powder with Poria) added with Che Qian Zi (Plantago Seed) and Yi Yi Ren (Coix Seed), decocted in water.
Mu Tong San (Akebia Decoction) (See Convulsion chapter)
Tian Hua San (Trichosanthes Powder) Treats external genital skin sac swelling and pain.
Tian Hua Fen (Trichosanthes Root, 2 liang) Gan Cao (Licorice Root, 3 qian)
Cut into pieces. Take 2 qian each time, with one cup of non-fermented wine, decoct to 0.7 cups. Take warm on an empty stomach. If unable to drink wine, decoct with water, adding a little wine is acceptable.