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In males, if the scrotum swells to the size of a dou (a traditional unit of volume) and appears red, which is difficult to cure, apply crushed Ma Bian Cao (Patrinia Herba) externally, or wash with decoction; this is also effective.
Scrotal swelling as large as a dou kernel with pain.
Bai Fan (Alumen, 白矾) (2 liang), Xiong Huang (Realgar, 雄黄) (1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 甘草) (5 qian).
Decoct in water, fumigate first then wash; extremely effective.
Secret Recipe for Scrotal Cyst (from *Jin Nang*)
Chuan Jiao (Zanthoxyli Pericarpium, 川椒), Mai Ya (Hordei Fructus Germinatus, 麦芽) (stir-fried until charred), Di Fu Zi (Kochiae Fructus, 地肤子) (each 1 liang), Cong Bai Tou (Allii Fistulosi Bulbus, 葱白头) (with roots, 21 pieces, cleaned of soil but not washed).
Decoct in water to wash over the scrotum for a long time, wash again the next day, stop when swelling subsides.
For pediatric wind-heat affecting the external genitalia (Wai Shen, 外肾), causing redness, swelling, and pain, with crying day and night, desquamation resembling chicken eggshell occurs within a few days. (from *Hui Chun*) Burn old fir wood to ash, add Qing Fen (Calomelas, 轻粉), mix with clear sesame oil, and apply externally; extremely effective.
For persistent scrotal swelling, apply Bor Shui Yan (Borax, 硼砂) mixed with water; highly effective.
If children sit on the ground for long periods, or are exposed to wind pathogens, or insect bites/blows causing scrotal hardness, use Chan Tui (Cicadae Periostracum, 蝉蜕) (5 qian) decocted in one large bowl of water for washing.
Swelling and pain will subside within three washes; additionally, administer Wu Ling San (Five-Ingredient Powder with Poria) plus Deng Xin Cao (Junci Medulla, 灯心) decocted for oral intake.
Another prescription: Grind earthworm excrement from onion gardens into fine powder, mix with Gan Cao Tang (Licorice Decoction, 甘草汤) for external application.
Pediatric external genitalia redness and swelling.
Lao Shan Mu (Old Fir Wood, 老杉木) (roasted to retain properties), Gong Fen (Lead White, 宫粉) (equal parts).
Grind into powder, mix with clear sesame oil for application. Also treats adult "Embroidered Ball Wind" (Xiu Qiu Feng, 绣球风 - chronic scrotal eczema/swelling).
For renal sac and testicular swelling, decoct Mian Hua Zi Ren (Cottonseed Kernel, 棉花子仁) (1 liang) and wash frequently; swelling will naturally subside.
For Qi Luan Bao (Scrotal Emphysema), stir-fry Lao Si Gua Pi (Old Loofah Peel, 老丝瓜皮) and Lao Sheng Jiang Pi (Old Ginger Peel, 老生姜皮) together in a pot, pour hot raw Bai Jiu (White Liquor, 白酒) over it, and drink hot; sweating leads to resolution.

Chancre (Xia Gang, 下疳)
Wang Kentang stated: Chancre sores arise at the urethral meatus. (*Zhun Sheng*)
He also stated: From the lower abdomen to below the genitals, at the root of the penis (Yu Jing, 玉茎), intense itching occurs, temporarily relieved by boiling water but recurring. There may be three or four orifices oozing yellow fluid. If one suffered from severe sores in childhood, this condition may appear later; treat it as a chancroid toxin (Jie Du, 结毒).
Chen Shigong stated: Chancre arises from the stagnation of lustful evil fire. Its origins are threefold: First, due to aroused desire in men, erection of the penis, rampant lustful fire without release, leading to stagnant敗精 (spoiled essence) and turbid blood accumulating midway, forming swelling. Initially, there is dysuria and painful urination, followed by discharge of yellow turbid spoiled essence, gradual erosion of the penis, and eventually severe swelling, pain, and rotting. Treatment should focus on draining liver and kidney evil fire, primarily using Qing Gan Dao Zhi Tang (Clear Liver and Guide Out Stagnation Decoction, 清肝导滞汤). Second, due to unclean vaginal secretions and turbid qi remaining after intercourse, transmitting toxic essence during copulation. Initially, skin becomes swollen and shiny, like crystal; when broken, it oozes fluid, with increasing swelling, pain, and intermittent numbness/itching. Treatment should focus on detoxification and dispelling wind, primarily using Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver, 龙胆泻肝汤) combined with Ping Wei San (Peace the Middle Powder, 平胃散). Third, due to applying hot aphrodisiac drugs to the penis or washing genitals, stimulating yang fire and disturbing yin essence, attempting prolonged intercourse without ejaculation, leading to blocked essence and stagnant fire. This is caused by accumulated toxins. Initially, the penis itches and hurts, becoming hard, purple, and swollen, with nodules appearing, gradual rotting, oozing pus, and frequent erections. Treatment should focus on purging fire and detoxification, primarily using Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity, 黄连解毒汤) or Lu Hui Wan (Aloe Pill, 芦荟丸). (*Zheng Zong*)
Jiang Shiji stated: Another case involves initial chancre treated incorrectly with fumigation and astringent pastes, leading to severe toxin accumulation, resulting in "Candle Unloading" (La Zhu Xie, 蜡烛卸 - severe gangrenous chancre). (*Shuo Yue*)
He also stated: Cases of damp-heat pouring downward from the liver meridian present only with difficult urination, yellow turbidity, and penile pain; these are mild if there is no redness or swelling.
He also stated: Damp-heat pouring downward is mild; lustful fire toxin eruption is severe.
He also stated: Chancre is also called Dou Jing Chuang (Dou Jing Sore, 斗精疮); when ulceration worsens daily, it is named La Zhu Xie (Candle Unloading, 蜡烛卸).
He also stated: If dysuria persists, ulcers gradually open, color is purple without pus, and pain is like needle pricking, it is difficult to treat.
Feng Luzhan stated: Chancre is a sore on the penis, potentially eroding through and failing to heal for a long time. Internal administration of drying-dampness and detoxifying herbs, along with external fumigation and insufflation, is appropriate. It is mostly due to liver meridian damp-heat, thus clearing liver and removing dampness is especially suitable. (*Jin Nang*)
Li Dongyuan stated: Du Jing Chuang (Jealous Essence Sore, 妒精疮) occurs in young men whose essence is abundant but who have abstained from sex for a long time. Sores arise on the genitals, causing redness, swelling, discomfort, itching, and pain. (*Jing Yi*)
Shen Douyuan stated: Sores on the glans and shaft, swelling internally but covered by skin externally, resembling a sleeve covering a hand, are named Xiu Kou Gan (Sleeve Chancre, 袖口疳). These are most difficult to treat because topical medicine cannot reach the sore. The treatment method involves using eye drops mixed with Bing Pian (Borneol, 冰片) paste inside an eggshell, soaking the glans, while internally administering herbs to clear liver and kidney damp-heat. (*Qi Xuan*)
He also stated: Sores on the penis that are itchy, painful, red, and contain fluid-filled pits are caused by unclean intercourse and liver meridian damp-heat. Since the liver governs fishy odors, the sore has a fishy smell, named Sao Gan (Fishy Chancre, 臊疳); apply Er Cha (Catechu, 儿茶). He also stated: For Du Jing Chuang, wash with Di Gu Pi (Lycii Cortex, 地骨皮) rice water, burn cloth from a virgin's first menstrual blood to ash, and apply; immediate effect.
Dou Hanqing stated: Sores arising internally in the penis are named Nei Zhu Gan (Internal Borer Reed, 内蛀秆); sores arising externally are named Wai Zhu Gan (External Borer Reed, 外蛀秆).
Hu Gongbi stated: Du Jing Chuang involves ulceration and suppuration of the glans, with itching or pain. It often affects unmarried youths whose essence is overflowing; upon erection, if they do not ejaculate or force ejaculation, they rupture the tender skin of the glans. Over time, this leads to ulceration, putrefaction, and suppuration, sometimes endangering life. Treatment requires abstinence from sex, external washing with Huang Bo Pi San (Phellodendron Bark Powder, 黄柏皮散), drying, and insufflating He Zi Hui San (Terminalia Ash Powder, 诃子灰散) or Yin Fen Shen Dan (Silver Powder Divine Elixir, 银粉神丹). (*Qing Nang*)
Chen Yuan Gong stated: When chancre forms on the glans, taking detoxifying medicines causes toxins to exit via urine and feces. If the large intestine is dry and constipated, the medicine cannot pass through the large intestine and must exit via the urethra. Since the urethral opening is narrow, toxins cannot fully escape, accumulating externally where they erupt and cause rotting. Often, the entire glans rots away. While people use external applications, internal treatment is crucial. Without first clearing fire-toxin, merely applying external astringents is like pressing grass with a stone. Therefore, treat internally first with San Du Shen Dan (Dispersing Toxin Divine Elixir): Fu Ling (Poria, 茯苓) 1 liang, Huang Bo (Phellodendri Cortex, 黄柏), Sheng Gan Cao (Raw Licorice, 生甘草), Hei Zhi Ren (Black Gardenia Seed, 黑栀仁) each 3 qian, Rou Gui (Cinnamon Bark, 肉桂) 1 qian. Decoct and take orally. After four doses, fire-toxin exits via urine, pain subsides slightly. Then apply Sheng Shi Dan (Generating Shape Elixir): Chao Huang Bo (Stir-fried Phellodendrum, 炒黄柏) 3 liang, Er Cha (Catechu, 儿茶), Sheng Gan Cao (Raw Licorice, 生甘草) each 1 liang, Da Huang (Rhei Radix et Rhizoma, 大黄) 3 qian, Dan Sha (Cinnabar, 丹砂) not exposed to fire, Ru Xiang (Olibanum, 乳香), Mo Yao (Myrrha, 没药) each 1 qian, Bing Pian (Borneol, 冰片), She Xiang (Musk, 麝香) each 3 fen. Grind to powder and insufflate; pain stops immediately. In a few days, pus and blood dry, muscles regenerate, healing in a month, though the glans may not fully regrow. After healing, take Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction, 十全大补汤) for one to two months to restore erectile function and fertility. If too many detoxifying and fire-purging agents are taken, the Ming Men (Gate of Life, 命门) becomes cold, and the organ becomes icy cold, preventing recovery of yang warmth. This is the correct sequence of treatment. (*Bing Jian*)
*Xin Fa* stated: Chancre is collectively named Gan Chuang (Chancre Sore, 疳疮) or Du Jing Chuang (Jealous Essence Sore, 妒精疮), arising in the anterior yin. The Classics state: The anterior yin is governed by the sinews of the clan; the Du Meridian circulates through the genitals and meets at the perineum. It also states: The Kidney opens into the two yins. Thus, sores here belong to the Liver, Du, and Kidney meridians. Names differ based on morphology. Sores at the Ma Kou (Horse Mouth/Urethral Meatus, 马口) are named Xia Gang (Lower Chancre, 下疳). Sores on the Yu Jing (Penis Shaft, 玉茎) are named Zhu Gan (Borer Chancre, 蛀疳). Sores on the shaft wrapped in swollen skin are named Xiu Kou Gan (Sleeve Chancre, 袖口疳). Glans swelling like a tumor is named Ji Su Gan (Chicken Crop Chancre, 鸡嗉疳). Chronic chancre with unilateral ulceration is named La Zhu Gan (Candle Chancre, 蜡烛疳). Pain radiating to testes with scrotal heaviness is named Ji Zhun Gan (Chicken Gizzard Chancre, 鸡肫疳). Painful, itchy, shallow ulcers resembling peeled rotten apricots are named Sao Gan (Itching Chancre, 瘙疳). Sores beside the meatus with pores like palm eyes, itchy internally with slight pus upon pressure, are named Xuan Gen Gan (Rotating Root Chancre, 旋根疳). During Yáng Méi Chuāng (Syphilis Chancre, 杨梅疮), if incorrect fumigation/application causes rotting like a mortar, it is named Yang Mei Gan (Yang Mei Chancre, 杨梅疳). During syphilis, if ingestion of Qing Fen (Calomelas, 轻粉) and Mercury creates a coercive drug causing stabbing pain in the urinary tract, it is named Yang Mei Nei Gan (Internal Yang Mei Chancre, 杨梅内疳).
Gu Cheng stated: In treating chancre, the first prohibition is for patients to eat salty food. If they adhere to a bland diet, healing takes half the usual time (half a month instead of one month).