（阴缩 阴纵 阴痿 阴冷 阴肿痛 阴中痒）
前阴所过之脉有二。一曰肝脉。二曰督脉。经云。足厥阴之脉。入毛中。过阴器。抵少腹。
是肝脉之所过也。又云。督脉者。起于少腹以下骨中央。女子入系廷孔。循阴器。男子循茎下至
篡。与女子等。是督脉之所过也。
阴缩阴纵 经曰。足厥阴之筋。伤于寒则阴缩入。伤于热则挺纵不收。治在行水清阴器。阴
缩。谓前阴受寒入腹内也。本虚。四逆汤加人参、肉桂。挟表邪发热。黄 建中加熟附三五分。
挟食。枳实理中汤加熟附五七分。发热面
赤戴阳。稍加黄连三四分。阴纵者。谓前阴受热。挺纵不收也。小柴胡汤加酒黄柏。湿热。龙胆
泻肝汤。强中有肝火盛强。有金石性发。其证茎盛不衰。精出不止。多发消渴痈疽。若因下焦伏
火。宜用知母、生地、麦冬、黄芩、黑参、甜桔梗、黄连、栝蒌根、地骨皮、石膏、生甘草、大
豆、猪肾之类。以解毒为主。若因肾虚肝热。宜用熟地、龟板、丹皮、茯苓、黑参、沙参、天冬、
麦冬、泽泻、五味之类。以补阴为主。夏子由奇方。治玉茎长硬不痿。精出。捏之则脆痒如刺针。
方用补骨脂、家韭子各一两为末。每服三钱。水煎日三。
阴痿。当责之精衰。斫丧太过所致。经云。足厥阴之经。伤于内则不起是也。仲景八味丸特
妙。甚者。加人参、鹿茸。或加巴戟、苁蓉、锁阳、枸杞。然亦有郁火甚而致痿者。经云。壮火
食气。譬人在夏暑而倦怠。遇冬寒而坚强。予尝治肾经郁火。令服滋肾丸而效。故须审察。不可
偏认火衰也。薛立斋云。按阴茎属肝之经络。若因肝经湿热而患者。用龙胆泻肝汤。以清肝火。
导湿热。若因肝经燥热而患者。用六味丸。以滋肾水。养肝血。而痿自起。阴痿弱而两丸冷。阴
汗如水。小便后有余滴臊气。尻臀并前阴冷。恶寒而喜热。膝亦冷。此肝经湿热。宜龙胆泻肝汤、
柴胡胜湿汤选用。肾脉强盛。右尺尤甚。此相火盛而反痿。宜滋肾丸、六味丸。
妇人阴冷。肥盛者。多是湿痰下流所致。二陈加二术、羌、防。男子外肾冷。两髀枢阴汗。
前阴痿弱。阴囊湿痒臊气。柴胡胜湿汤。
阴肿痛。乃风热客于阴经。肾虚不能宣散而肿。发歇疼痛。宜桂枝汤加羌、防、荆芥、当归、
细辛、通草。但肿而不痛者。是湿热。防己茯苓汤加羌活、泽泻。但痛而不肿者。瘀积火滞。舒
筋三圣散加归尾、赤芍、生甘草梢、妇人产后受风。多有
此证。芎、归、羌、防、荆芥、乳香、没药。煎汤熏洗之。
阴中痒。亦是肝家湿热。小柴胡汤下滋肾丸。瘦人燥痒属阴虚。六味丸三钱。滋肾丸一钱和
服。外用蛇床子煎汤洗之。丹方。治妇人阴痿。甘蔗楂烧灰。入冰片擦之立止。尺脉数。妇人阴
中生疮。下部 。久之有虫。用猪肝煮熟。切长条。蘸鹤虱末。（即天名精子。）纳阴中。引虫
出。乃杀虫要药。妇人瘕聚。阴中肿痛不可忍。有物如茄突出。与男子之疝无异。因湿热者。柴
胡清肝散、龙胆泻肝汤选用。外以枳实切碎炒热。帛包熨之。冷再易。但是阴痛俱效。
(Yin Retraction, Yin Flaccidity, Impotence, Cold Genitals, Swelling and Pain of Genitals, Itching in the Vagina)
There are two meridians passing through the anterior yin region. One is the Liver Meridian, and the other is the Governor Vessel (Du Mai). The classics state: "The Foot-Jueyin Liver Meridian enters the pubic hair area, passes through the genitalia, and reaches the lower abdomen." This is the pathway of the Liver Meridian. It also states: "The Governor Vessel originates from the center below the lower abdomen. In women, it enters and connects to the Ting Kong (opening of the uterus/vagina), follows along the genitalia; in men, it follows down the penis to the perineum (Huiyuan), which is the same as in women." This is the pathway of the Governor Vessel.
[Yin Retraction and Yin Flaccidity]
The classics say: "The sinews of the Foot-Jueyin, when injured by cold, cause retraction of the genitals; when injured by heat, they cause protrusion and flaccidity that cannot be controlled." Treatment should focus on promoting urination to clear heat from the genitalia. "Yin Retraction" refers to the anterior genitals being invaded by cold into the abdomen. If due to root deficiency, use Sini Decoction (Four Reversal Decoction) with added Ginseng and Cinnamon Twig. If complicated by exterior pathogenic factors with fever, use Huangqi Jianzhong Decoction (Astragalus Middle-Nourishing Decoction) with 3-5 fen of Prepared Aconite Root. If complicated by food stagnation, use Zhishi Lizhong Decoction (Immature Bitter Orange Middle-Regulating Decoction) with 5-7 fen of Prepared Aconite Root. If there is fever with facial redness resembling floating deficient yang (Daiyang), add a small amount of Coptis Rhizome (3-4 fen). "Yin Flaccidity" refers to the anterior genitals affected by heat, causing protrusion and flaccidity that cannot be controlled. Use Xiaochaihu Decoction (Minor Bupleurum Decoction) with added Wine-processed Phellodendron Bark. If due to damp-heat, use Longdan Xiegan Decoction (Gentian Liver-Draining Decoction). If it is "Qiangzhong" (excessive sexual potency/priapism) due to excessive Liver Fire or the effect of mineral drugs, the symptoms include persistent erection without decline and continuous seminal emission, often leading to complications like Xiao Ke (wasting-thirst) and abscesses. If caused by latent fire in the lower jiao, use Anemarrhena Rhizome, Rehmannia Root, Ophiopogon Tuber, Scutellaria Root, Scrophularia Root, Sweet Licorice Root, Trichosanthes Root, Cortex Lycii Radicis, Gypsum, Raw Licorice Root, Soybean, and Pig Kidney, focusing primarily on detoxification. If caused by Kidney deficiency with Liver heat, use Prepared Rehmannia Root, Turtle Shell, Moutan Cortex, Poria, Scrophularia Root, Glehnia Root, Asparagus Tuber, Ophiopogon Tuber, Alisma Rhizome, and Schisandra Berry, focusing primarily on nourishing yin. Xi Ziyu's miraculous formula treats a hard, non-retractile penis with seminal emission, feeling brittle and itchy like needle pricks upon pinching. It uses Psoralea Fruit and Leek Seed, each one liang, ground into powder. Take three qian per dose, decocted in water, three times daily.
[Impotence]
One should attribute this to the depletion of essence, caused by excessive sexual indulgence. The classics state: "The Foot-Jueyin Meridian, when internally injured, results in failure to erect," which is exactly this condition. Zhang Zhongjing's Bajun Wan (Eight-Ingredient Pill, i.e., Jin Gui Shen Qi Wan) is particularly effective. For severe cases, add Ginseng and Deer Antler. Alternatively, add Morinda Root, Cistanche Stem, Yang Stalk, and Goji Berry. However, impotence can also result from severe stagnant fire. The classics state: "Vigorous fire consumes qi," likening it to feeling fatigued in summer heat but strong in winter cold. I once treated a patient with stagnant fire in the Kidney meridian who recovered after taking Zishen Wan (Kidney-Nourishing Pill). Therefore, careful examination is required; one must not unilaterally assume it is due to fire deficiency (Mingmen Fire Deficiency). Xue Lizhai stated: The penis belongs to the Liver meridian network. If caused by damp-heat in the Liver meridian, use Longdan Xiegan Decoction to clear Liver fire and drain damp-heat. If caused by dry-heat in the Liver meridian, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to nourish Kidney water and nourish Liver blood, so that impotence naturally resolves. If impotence is accompanied by cold testicles, profuse vaginal sweating, post-urination dribbling with a fishy odor, coldness in the sacrum, buttocks, and anterior genitals, aversion to cold with preference for warmth, and cold knees, this is damp-heat in the Liver meridian. Selectively use Longdan Xiegan Decoction or Chaihu Shengshi Decoction (Bupleurum Damp-Dispelling Decoction). If the Kidney pulse is strong, especially at the Right Chi position, this indicates excessive Ministerial Fire causing impotence despite its presence. Use Zishen Wan or Liuwei Dihuang Wan.
In women with cold genitals, obesity is often caused by damp-phlegm sinking downward. Use Erchen Decoction (Two-Aged Decoction) plus Atractylodes Macrocephala Rhizome, Atractylodes Rhizome, Notopterygium Rhizome, and Saposhnikovia Root. In men with cold external kidneys (testicles), sweating in the groin and inner thighs, weak anterior genitals, and damp, itchy, foul-smelling scrotum, use Chaihu Shengshi Decoction.
[Swelling and Pain of Genitals]
This is caused by wind-heat lodging in the Yin meridians, where Kidney deficiency fails to disperse the swelling, leading to intermittent pain. Use Guizhi Decoction (Cinnamon Twig Decoction) plus Notopterygium Rhizome, Saposhnikovia Root, Schizonepeta Spike, Angelica Sinensis Root, Asarum Root, and Tetrapanax Pith. If swollen but not painful, it is damp-heat. Use Fangji Huangqi Decoction variant (Fangji Fuling Decoction) plus Notopterygium Rhizome and Alisma Rhizome. If painful but not swollen, it is blood stasis accumulation with fire stagnation. Use Shujin Sansheng San (Three-Saints Powder for Relaxing Sinews) plus Angelica Sinensis Tail, Red Peony Root, and the tip of Raw Licorice Root. Women who contract wind after childbirth often have this syndrome. Use Ligusticum Chuanxiong Rhizome, Angelica Sinensis Root, Notopterygium Rhizome, Saposhnikovia Root, Schizonepeta Spike, Frankincense, and Myrrh decocted for fumigation and washing.
[Itching in the Vagina]
This is also due to damp-heat in the Liver. Use Xiaochaihu Decoction administered with Zishen Wan. In thin individuals, dry itching belongs to yin deficiency. Take six qian of Liuwei Dihuang Wan and two qian of Zishen Wan together. Externally, wash with a decoction of Cnidium Fruit. A folk prescription for treating female impotence: burn sugarcane dregs to ash, mix with borneol, and apply externally to stop it immediately. If the Chi pulse is rapid, and a woman has sores in the vagina with chronic dampness and worms over time, cook pork liver, cut it into long strips, dip them in Telosma Cordata Seed powder (Tianmingzi), and insert into the vagina to draw out the worms. This is an important vermifuge. For women with Jia Ju (abdominal masses) causing unbearable pain and swelling in the vagina, with a mass protruding like an eggplant (similar to male hernia), if caused by damp-heat, selectively use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) or Longdan Xiegan Decoction. Externally, chop Zhi Shi (Immature Bitter Orange), stir-fry until hot, wrap in cloth, and apply as a warm compress. Replace when cool. This is effective for all types of genital pain.