《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 records: When infants and children present with swelling of the scrotum or testicles, it is caused by crying and anger leading to rebellious Qi and impaired circulation. Pathogenic factors take advantage of the deficiency to enter, causing unilateral enlargement of the testicular sac.
Furthermore, unregulated consumption of sweet and fatty foods, and excessive intake of raw and cold substances, lead to the generation of Gan (malnutrition) Qi. This Qi becomes knotted and fails to circulate, flowing into the yin region. Alternatively, exposure to summer-heat toxicity or wind pathogens causes Blood and Qi to contend with pathogenic factors, stagnating and accumulating without dispersing, thereby forming Yin Swelling.
Ren Zhai states: If there is Qi deficiency in the Kidney meridian, or if one sits on stone for prolonged periods allowing cold Qi to congeal, or stays close to the ground for long durations suffering from wind-damp invasion, it is rare for Yin Swelling not to occur. Occasionally, due to crying and anger, Qi becomes obstructed in the lower jiao, knotting and failing to disperse; combined with dysfunction of the water passages, this can also trigger this disease. Treatment primarily employs Tao Ren Wan (Peach Kernel Pill).
Danxi states: For prolapsed scrotum with massive swelling that hangs down and cannot retract, use the stems and leaves of Perilla frutescens (Zisu), powdered, mixed with water, and wrapped in a lotus leaf for application. Someone transmitted this prescription using wild white Perilla frutescens 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 likely shares the same efficacy.
[Zeng] Chao Yuanfang discusses: All sinews converge at the genitalia. When pathogens lodge in the Jueyin and Shaoyin meridians and contend with cold Qi, it results in scrotal swelling and pain, drawing inward and causing retraction along the meridians. Although conditions are categorized into four types: Chang Hernia (Intestinal Hernia), Qi Hernia, Shui Hernia (Hydrocele), and Luan Hernia (Testicular Hernia), if pediatric cases are not treated early, they become chronic stubborn diseases. Symptoms include curved waist and abdominal pain, spontaneous cold sweat, and the two testes retracting into the abdomen, emerging only when pain ceases; this is called "Nei Diao" (Internal Retraction). Treatments include Wu Mei San (Mume Powder), Yun Qi San (Regulating Qi Powder), Jin Zhu Wan (Gold and Calamus Pill), and Jin Ling San (Golden Bell Powder). In cases where the penis fully retracts and disappears, or the scrotum swells brightly without pain, it is due to Liver and Kidney Qi deficiency. It is appropriate to decoct Tangerine Seed (Ju Zi Ren) and use the liquid to administer Jin Ling San or Yun Qi San.
The Nei Jing states: Regarding Long Shan (Urinary Obstruction Hernia) and Fu Zhang (Skin Distension), it is because Yin Qi is abundant while pulses are distended and blocked, hence termed Long Shan. From this perspective, these conditions arise from an excess of Yin Qi. The symptom of retraction is due to tendon tension; tendons contract when exposed to cold and relax when exposed to heat. Therefore, the methods used in San Yin Fang focus on relaxing Small Intestine Qi and dispelling Wind. However, pediatric cases often result from sitting in damp, cool places and contracting wind-dampness. Use Dang Gui San (Angelica Decoction) plus Areca Seed (Bing Lang) and Atractylodes Macrocephala (Cang Zhu), decocted with water and ginger. Internally administer Qing Mu Xiang Tang (Aucklandia Decoction) and Diao Teng Gao (Uncaria Paste); externally apply Li Xiao San (Immediate Resolution Powder). In another presentation, the external genitals swell spontaneously without dryness or pain, appearing bright like an inflated balloon; this is attributed to Qi deficiency. Regulate with Yun Qi San; the Jiu Zi Wan (Allium Macranthum Pill) from San Yin Fang is indicated. Another syndrome involves reddish, swollen, and transparent skin of the external genitals, or vulvar swelling in female infants, transmitted from Heart Heat. Treat with Mu Tong San (Akebia Decoction) or Dao Chi San (Directing Outward Fire Powder). Alternatively, decoct Coix Seed (Yi Yi Ren) to administer Wu Ling San (Five-Ingredient Powder with Poria), or apply external dissipating powders. Administer Tian Hua San (Trichosanthes Powder) decocted in non-fermented wine; for those who cannot drink alcohol, decoct in water with a small amount of wine added.
Zhang Huan states: When the Foot-Shaoyin meridian of infants and children is deficient and subjected to wind pathogens, attacking the lower meridians results in Yin Swelling. Treat with Tao Ren Dan (Peach Kernel Elixir).
Tao Ren Dan (Peach Kernel Elixir)
Ingredients: Tao Ren (Peach Kernel, 7.5 qian, soaked in hot water, peeled, removed of tips and double-kernels, stir-baked with bran until slightly yellow), Mudan Pi (Tree Peony Bark), Bai Ji Li (Tribulus Fruit, lightly stir-baked, spines removed), Gui Xin (Cinnamon Twig Heart), Yu Li Ren (Bush Cherry Seed, 2.5 qian, soaked in hot water, peeled, lightly stir-baked) [Gui Xin, Mudan Pi, Bai Ji Li each 0.5 liang].
Preparation: Pound and sieve the above ingredients into fine powder. Mix with refined honey to form pills the size of millet seeds. Take 10 pills per dose, 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)
Indication: Yin swelling with sores.
Ingredients: Hu Huang Lian (Coptis Rhizome, remove roots), Hu Fen (Lead White), Bai Fan (Alum, calcined, 2.5 qian) [Hu Huang Lian and Hu Fen each 0.5 liang].
Preparation: Pound 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 obstructing the lower jiao should be treated with Hai Ge San (Clam Shell Powder).
Hai Ge San
Ingredients: Hai Ge (Clam Shell, 3 qian), Mu Xiang (Costus Root, stir-baked, 7.5 qian), Yi Yi Ren (Coix Seed), Bai Zhu (Atractylodes Macrocephala Rhizome), Bing Lang (Areca Seed) [Mu Xiang, Yi Yi Ren, Bai Zhu, Bing Lang each 0.5 liang].
Preparation: Powder the above ingredients. Take before meals, administered with warm wine. Adjust dosage by age.
Tao Ren Wan (Peach Kernel Pill)
Ingredients: Tao Ren (Peach Kernel, peeled, tips removed, stir-baked with bran, 3 qian), Gui Zhi (Cinnamon Twig, peeled), Qian Niu (Morning Glory Seed, stir-baked, first extraction powder), Ji Li (Tribulus Fruit), Mu Dan Pi (Tree Peony Bark) [Qian Niu, Ji Li, Mu Dan Pi each 2 qian].
Preparation: Powder the above ingredients. Mix with refined honey to form pills the size of millet seeds. Decoct Qing Pi (Citrus Aurantium Peel), Mu Xiang (Costus Root), Cong Bai (Scallion White), and a pinch of salt in water. Take before meals.
San Bai San (Three Whites Powder)
Indication: Swelling in pediatric fontanelle, edematous swelling of limbs and skin sacs, difficulty in urination and defecation, all caused by Heat accumulation in the Bladder and multiplication of Wind-Damp.
Ingredients: Sang Gen Bai Pi (Mulberry Root Bark, stir-baked), Bai Zhu (Atractylodes Macrocephala Rhizome), Mu Tong (Akebia Stem), Chen Pi (Tangerine Peel, pith removed), Bai Qian Niu (White Morning Glory Seed, half raw half stir-baked), Gan Cao (Licorice Root, honey-fried) [Each 5 qian].
Preparation: Cut into pieces. Decoct in water. Take before meals.
[Dan] Tuo Nang (Protruding Scrotum) refers to enlargement of the external genitals.
Ingredients: Mu Tong (Akebia Stem), Gan Cao (Licorice Root), Dang Gui (Angelica Sinensis Root), Huang Lian (Coptis Rhizome), Huang Qin (Scutellaria Root).
Preparation: Decoct in water and take.
[Qian] Qiu Yin San (Earthworm Powder)
Indication: Hard swelling of the testicles forming hernia. Use dried earthworms powdered, mixed with saliva for topical application. Avoid wind, cold, and damp places regularly. (First wash in a decoction of Sichuan Pepper and Scallion in a wind-sheltered place, then apply this powder; repeatedly verified effective.)
[Shi] To treat pediatric scrotal swelling as large as a measuring cup, decoct Licorice Root juice, mix with Earthworm (Di Long) powder, and apply. Reduction occurs immediately. Repeatedly effective.
Topical Application Formula
Ingredients: Mu Li Fen (Oyster Shell Powder, 2 fen), Gan Di Long (Dried Earthworm, powdered, 1 fen).
Usage: Mix with saliva and apply to the external genitals. For heat syndromes, mix with egg white for application.
Mu Li San (Oyster Shell Powder)
Indication: Enlargement of external genitals in children, with transparent swelling of the penis.
Usage: Grind Oyster Shell Powder to extreme fineness. First apply saliva to the swollen area, then sprinkle the Oyster Shell Powder.
Another Prescription
Indication: Testicular swelling in children. Crush Peach Kernels, mix with saliva, and apply.
[Zeng] Wu Mei San (Mume Powder), Yun Qi San (Regulating Qi Powder), Jin Zhu Wan (Gold and Calamus Pill), Jin Ling San (Golden Bell Powder) [Formulas see Hernia section]; Dang Gui San (Angelica Decoction) [See Dysentery section].
Mu Li Da Huang Tang (Oyster and Rhubarb Decoction)
Indication: Infants aged three to five years contracting warm-damp qi, invading the Bladder, causing edema and pain in the penis and scrotal skin.
Ingredients: Mu Li (Oyster Shell, wrapped in cooked yellow clay, calcined over charcoal fire until penetrating, removed from earth, cooled); Da Huang (Rhubarb Root, wrapped in paper, soaked in water until penetrated, baked, cooled) [Both 1 liang].
Preparation: Cut and grind into powder. Take 1 qian per dose, mixed with warm non-fermented wine on an empty stomach. For those who cannot drink alcohol, mix with warm water, adding a little wine.
Qing Mu Xiang Tang (Aucklandia Decoction)
Indication: Spontaneous swelling or painful retraction of the penis in children, caused by contention of Wind-Heat and Dampness in the Yangming Meridian. The treatment method should relax this meridian for self-healing, as Yangming pathology fails to nourish the Zongjin (Major Sinew). Also suitable for cough with phlegm and wheezing.
Ingredients: Qing Mu Xiang (Aucklandia Root, remove rhizome), Zhi Ke (Bitter Orange, soaked, pith removed, stir-baked with bran) [Each 0.5 liang], Gan Cao (Licorice Root, 2.5 qian).
Preparation: Take 2 qian per dose. Decoct in one sheng of water until reduced to 0.7 sheng. Take warm at any time.
Li Xiao San (Immediate Resolution Powder)
Indication: Chronic Heat-Toxin in the Bladder causing reddish, swollen, and painful scrotal skin.
Ingredients: 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 later) [Each 0.5 liang].
Preparation: Do not over-roast. Cut, dry, and powder. Decoct Cypress Branches in water, cool, and mix 2-3 qian of powder to apply to the swollen area. Simultaneously, take chopped Wu Ling San (Five-Ingredient Powder with Poria) plus Che Qian Zi (Plantago Seed) and Yi Yi Ren (Coix Seed), decocted in water.
Mu Tong San (Akebia Decoction) [See Convulsion Section]
Tian Hua San (Trichosanthes Powder)
Indication: Painful swelling of external genital skin.
Ingredients: Tian Hua Fen (Trichosanthes Root, 2 liang), Gan Cao (Licorice Root, 3 qian).
Preparation: Cut into pieces. Take 2 qian per dose. Decoct in one sheng of non-fermented wine until reduced to 0.7 sheng. Take warm on an empty stomach. For those who cannot drink alcohol, decoct in water with a small amount of wine added.