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Contraction of the scrotum, although it is also a manifestation syndrome of the Jueyin (Jueyin Meridian) channel, essentially, the tongue belongs to the Hand (Heart Pericardium), while the scrotum belongs to the Foot (Liver). For the tongue is the orifice of the Heart, and the Pericardium acts on behalf of the Heart; the anterior and posterior parts of the renal scrotum are all areas traversed by the Liver meridian. One must absolutely not confuse Yin Jue (Yin Cold Reversal) and Yang Jue (Yang Heat Reversal) as one. If one follows Tao Jian'an's assertion: "Cold extending beyond elbows and knees indicates Yin Cold," and recklessly uses intensely hot medicines, this is erroneous. Furthermore, among Heat Jue (Heat Reversal), there are three grades: In cases where pathogenic factors reside mostly in the collaterals with few Yangming symptoms, aromatic methods should be employed; this is what the current clause refers to. In cases where pathogens contend with the Yangming, resulting in severe Yangming excess, with heat rushing upward to attack the Pericardium, causing mental confusion and limb reversal, even general body reversal, purgative methods should be used; this is recorded in the Middle Jiao Chapter of this treatise. In cases where the disease has persisted for a long time, damaging Yin fluids and leading to reversal due to Yin deficiency, nourishing Yin and subduing Yang methods should be adopted; this is recorded in the Lower Jiao Chapter of this treatise.

Niuhuang Wan (Calculus Bovis Pill) and Zixue Dan (Purple Snow Elixir) formulas (see previous sections).

Article 18: Wen Du (Warm Toxins) causing throat pain and swelling, swelling before and behind the ears, swelling of the cheeks, bright red complexion, or throat pain absent but external swelling present, and even deafness in severe cases—commonly known as Datou Wen (Big Head Plague) or Hamax Wen (Toad Plague)—should be treated primarily with Puji Xiaodu Yin (Universal Benefit Decoction to Eliminate Toxins) minus Chaihu (Bupleuri Radix) and Shengma (Ephedrae Herba or Cimicifugae Rhizoma, here referring to Cimicifugae Rhizoma). In the initial one or two days, Huangqin (Scutellariae Radix) and Lianlian (Coptidis Rhizoma) should also be removed; adding them back after three or four days is appropriate.

Wen Du refers to turbid miasma. Any turbidity from earthly qi naturally rises with the assistance of Shaoyang (Lesser Yang) qi. In spring and summer, when earthly qi exudes, such syndromes are common; in autumn and winter, when earthly qi occasionally fails to store, such syndromes may also occur. If the body's Shaoyin (Lesser Yin) is inherently deficient and cannot ascend to assist Shaoyang, causing unrestrained rising of Shaoyang qi, such syndromes often result. Children, possessing pure Yang and excessive fire with underdeveloped Yin, also frequently exhibit such syndromes. Throat pain is described in classics as "when one Yin and one Yang knot, it is called Hou Bi (throat obstruction)." The meridians of Shaoyin and Shaoyang both traverse the throat; Shaoyin governs Minister Fire (Jun Huo), and Shaoyang governs Executive Fire (Xiang Huo); their mutual exacerbation causes disaster. Swelling in front of and behind the ears and on the cheeks occurs in areas traversed by the Shaoyang meridian; Jiache (ST6) is not solely an acupoint of the Yangming meridian. A red face indicates the color of fire. Severe deafness occurs because both Shaoyang meridians enter the ears; excess fire closes the clear orifices. Treatment methods generally do not exceed Li Dongyuan's Puji Xiaodu Yin. The brilliance of this formula lies in using Liangge San (Cool the Diaphragm Powder) as the base, adding Mabo (Mortella Semen), Jiangcan (Bombyx Batryticatus), and Yinhua (Lonicerae Japonicae Flos) to transform Qi-level pathogens, achieving the subtlety of "light substances resolving substantiality"; further adding Yuanshen (Scrophulariae Radix), Niubangzi (Arctii Fructus), and Banlangen (Isatidis Radix) to defeat toxins, benefit Lung Qi, tonify Kidney Water to counteract pathogenic fire; removing Chaihu and Shengma because diseases characterized by excessive ascending and soaring flight should not use ascending agents again; commentators claiming they are guiding herbs are very foolish! Medicines that cannot directly reach their specific meridians require guiding herbs in formulas; however, this formula consists entirely of light substances acting on the Upper Jiao, opening Heaven's Qi, and肃降 (descending) Lung Qi, so why use Shengma and Chaihu to directly ascend meridian Qi? Removing Huangqin and Huanglian is because these are interior-treating drugs; since the disease is in its early stages and has not reached the Middle Jiao, using interior drugs prematurely would violate the Middle Jiao.

Puji Xiaodu Yin minus Shengma, Chaihu, Huangqin, Huanglian Formula:
Qiaoliao (Forsythiae Fructus) (1 liang), Bohe (Menthae Haplocalycis Herba) (3 qian), Mabo (Mortella Semen) (4 qian), Niubangzi (Arctii Fructus) (6 qian),
Jiesui (Schizonepetae Spica) (3 qian), Jiangcan (Bombyx Batryticatus) (5 qian), Yuanshen (Scrophulariae Radix) (1 liang), Yinhua (Lonicerae Japonicae Flos) (1 liang), Banlangen (Isatidis Radix) (5 qian), Kugeng (Platycodonis Radix) (1 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (5 qian).
Grind all into coarse powder. Take 6 qian per dose, or 8 qian for severe cases. Decoct with fresh Reed Rhizome soup, strain, and drink. Administer approximately every two hours; for severe cases, every hour.

Article 19: External swelling caused by Wen Du is treated primarily with Shuixian Gao (Narcissus Ointment), which also treats all kinds of carbuncles and sores.
Note: Narcissus obtains the essence of Metal and Water, blooms in deep winter, tastes bitter and slightly pungent, is cold, slippery, and non-toxic. Bitterness descends fire and defeats toxins; pungency disperses stagnation of pathogenic heat; coldness overcomes heat; slipperiness promotes phlegm discharge. Its miraculous use lies entirely in the sticky nature of its juice, which draws toxins outward, preventing pathogenic toxins from deeply invading organs and harming humans.

Shuixian Gao Formula:
Narcissus bulb, any amount. Peel off old reddish skin and rootlets. Pound in a stone mortar until it forms a paste. Apply to the swollen area, leaving a central hole to allow heat to escape. Replace when dry. Continue until small yellow blisters the size of millet grains appear on the skin.

Article 20: After applying Shuixian Gao for Wen Du, if small yellow blisters the size of millet grains appear between the skin layers, do not continue applying Shuixian Gao. Over-application causes severe pain and ulceration. Treat with Sanhuang Erxiang San (Three Yellows and Two Fragrances Powder).
Sanhuang (Three Yellows) strongly drains various fires without damaging the skin; Erxiang (Two Fragrances) penetrates collaterals to clear residual heat and relieve pain.

Sanhuang Erxiang San Formula (Bitter-Pungent Aromatic Method):
Huanglian (Coptidis Rhizoma) (1 liang), Huangbai (Phellodendri Cortex) (1 liang), Sheng Dahuang (Rhei Radix et Rhizoma, raw) (1 liang), Ruxiang (Olibanum) (5 qian), Moyao (Myrrha) (5 qian).
Grind into extremely fine powder. Initially, mix with fine tea juice for topical application; replace when dry. Subsequently, mix with sesame oil for application.

Article 21: For Wen Du causing mental confusion and delirious speech, first administer An Gong Niu Huang Wan (An Gong Calculus Bovis Pill) or Zixue Dan (Purple Snow Elixir), followed by Qinggong Tang (Clear the Palace Decoction).

An Gong Niu Huang Wan, Zixue Dan, Qinggong Tang (methods see previous sections).