或问∶小腹至阴之下，玉茎之根，痒极。沸汤沃之，稍止而复作。有三四窍，黄水淋
漓何如？曰∶此广疮结毒也，询之幼时曾生恶疮。旬日后大痛肿甚，饮食少进，作结毒
治之。
〔丹〕 《外科精要》云∶痈疽入囊者死。囊属厥阴，今以死言之，将以为属少阴肾经
邪？予亲见入囊者七八人，悉以湿热入肝经施治，而用补阴药佐之，虽脓溃皮脱，睾丸
悬挂可畏者，皆不死。但不知下虚年老者如何耳。 囊痈，湿热下注也，有作脓者，此
浊气润下，将流入渗道，因阴道或亏，水道不利而然，脓尽自安，不药可也，惟在善于
调摄耳。又有因腹肿，渐流入囊肿甚，而囊自裂开，睾丸悬挂水出，以麸炭（杉木炭）末敷，
外以紫苏叶包裹，仰卧养之。 大抵此证属阴道亏，湿热不利所致。故滋阴降湿药不可
缺。常治肿痛，小便秘滞者，用除湿为主，滋阴佐之，肿痛已退，便利已和者，除湿滋阴
药相兼治之。欲其成脓，用托里为主，滋阴佐之。候脓成即针之，仍用托里滋阴。若湿
毒已尽者，专用托里，如脓清或多或敛迟者，用大补之剂，或附子饼灸之。
〔薛〕 囊痈属肝肾二经，阴虚湿热下注。若小便涩滞者，先分利以泄其毒，继补阴以
令其自消。若湿热退而仍肿痛，宜补阴托里以速其脓。脓 而便秘者，热毒壅闭也，先
用托里消毒散，后用针以泄之，脓去即解。若脓去而肿痛不减者，热毒未解也，用清肝养
荣汤。口干而小便数者，肾经虚热也，六味丸。内热晡热者。肝经血虚也，四物加参术。
体倦食少者，脾气虚热也，补中益气汤。脓水清稀者，气血俱虚也，十全大补汤，此证
虽大溃而睾丸悬露，治得其法，旬日肉渐生而愈。若专攻其疮，阴道益虚，则肿者不能
溃，溃者不能敛，少壮者多成痼疾，老弱者多致不起。亦有患痔漏久而串及于囊者，当
兼治其痔，切忌寒药克伐，亏损胃气。
一人，囊痈未作脓而肿痛，以加减龙胆泻肝汤，二剂少愈，更以四物加木通、知母、
黄柏而消。 一人脓熟作胀，致小便不利，急针。以小柴胡加黄柏、白芷、金银花，四剂
少愈，更以托里消毒散，数剂而消。 一人年逾五十，阴囊肿痛，得热愈盛，服蟠葱散，
不应。肝脉数，此囊痈也，乃肝经湿热所致。脓已成急针之，进龙胆泻肝汤，脉证悉退。更
服托里滋阴药，外敷杉木炭、紫苏末，月余而愈。 一人年逾六十，阴囊溃痛不可忍，睾
丸露出，服龙胆泻肝汤，敷麸炭、紫苏末不应。薛意此湿气炽盛，先饮槐花酒一碗，次
服前汤少愈，更服托里加滋阴药而平。设以前药不应，加之峻剂，未有不损中气以致败
也。 一弱人，肿痛未成脓，小便赤涩，以制甘草、青皮、木通、黄柏、当归、麦门，四
剂少愈，以清心莲子饮，四剂而消。 一人 肿痛甚，小便涩，发热脉数，以龙胆泻肝
汤，倍车前、木通、泽泻、茯苓，势减半，仍以前汤加黄柏、金银花四剂，又减二三，便
利如常。唯一处不消，此欲成脓，再用前汤，加金银花、皂角针、白芷六剂，微肿痛，脉
滑数，乃脓已成针之，肿痛悉退。投滋阴托里药，及紫苏末敷之而愈。 一人病势已甚，
脉洪大可畏，用前汤二剂，肿少退，以仙方活命饮二剂，痛少止，脉洪数，脓已成须针
之，否则阴囊皆溃。彼不信，更他医，果大溃，睾丸挂，复求治。脉将静，以八珍汤加
黄、黄柏、知母、山栀，更敷紫苏末，数日而痊。 一人连日饮酒，阴挺并囊湿痒，服
滋阴等药不应。薛谓∶前阴肝脉络也，阴气从挺而出，素有湿，继以酒为湿热，合干下
焦而然，经曰∶下焦如渎。又云∶在下者，引而竭之。遂以龙胆泻肝汤，及清震汤而愈。此
或不应，宜补肝汤及四生散治之。 儒者陈时用，考试不利，一夕饮烧酒入房，妻不纳，
翌日阴囊肿胀 痛，遣人求治。薛以除湿热，清肝火之剂，城门夜闭不及归服。翌早报云∶
夜来阴囊悉腐，玉茎下面贴囊者亦腐，此肝火挟酒毒而湿热炽盛也，仍以前药，加参、 、
归、术四剂，腐肉尽脱，睾丸悬挂，用大补气血，并涂当归膏，囊茎全复而愈。
一人患此，肿痛发热，以小柴胡加青皮、
黄连，四剂少愈，更以龙胆泻肝汤而消。给事陆贞山，肿赤胀痛，小便涩滞，寒热作渴，
此肝肾阴虚，湿热下注也，当清肝火，除湿毒。遂用柴胡、炒龙胆、吴茱萸、炒黄连、当
归、银花、皂角刺、赤芍药、防风，木通、甘草节，一剂肿痛渐退，少加防风、木通、川
芎、茯苓作饮，下滋肾丸以补阴，其热肿俱退。但内有一条筋不消，此肝经血气虚损也，
当滋肾水，用六味丸料，去茯苓加五味二剂，再用补中益气加茯苓作饮，送滋肾丸，筋顿
消而愈。
加味泻肝汤 治肝经湿热不利，阴囊肿痛。或溃烂皮脱，睾丸悬挂，或便毒及下疳
肿痛，或溃烂并皆治之。
龙胆草（酒拌，炒） 当归尾 车前子（炒） 泽泻 生地黄 芍药（炒） 黄连（炒） 黄柏（酒拌，炒）
知母（酒拌，炒） 防风（各一钱） 甘草梢（五分）
作一剂。水二盅，煎八分，食前服。外敷乌金散。
京兆朱二峰，阴囊胀痛，彼以为疝。薛诊其脉，数而滑，此囊痈也，因肝肾二经阴
虚，湿热所致，脓已成矣。服活命饮一剂而溃，更用补阴托里而敛。 一膏粱之客，阴
囊肿胀，小便不利，此中焦积热，乘虚下注，先用龙胆泻肝汤加黄柏、知母、黄连、牛膝，
四剂渐愈，后用补阴八珍汤加柴胡、山栀而愈。后不守禁忌，前证复作，仍用补阴八珍
汤、补中益气汤、六味丸而痊。又因劳发热，自用四物、黄柏、知母之类，虚证悉具，疮
口开大。薛谓五脏气血俱虚也，朝用补中益气，夕用六君子加当归，各五十余剂，疮口
渐敛，又用六味丸调补而愈。 府庠李达卿，素肾虚发热，久服黄柏、知母之类，形体渐
瘦，遗精白浊，晡热唾痰。薛曰∶此肾水亏损，虚火内炽，用补中益气之类，加五味、麦
门，前症将愈。又别用清热凉血之剂，饮食少思，唾痰不止。薛以为脾肺复虚，不能摄
涎归源，仍用前汤加茯苓、半夏而愈。后入房头晕吐痰，腰骨作痛，大小便道牵痛。薛
曰∶此精己耗而复竭所致，危殆之证也，遂朝用前汤加麦门、五味，夕用六味丸料加五
味子，萆 ，五十余剂诸证顿退。后又入房，阴囊、阴茎作痛，别用淡渗之剂，阴囊内溃。
薛用补阴托里之剂，出脓甚多，喜肿消痛止，竟不善调养，以致大便不通，小便如淋，痰
涎上涌。薛曰∶肾虚之证复作矣，诚为可虑。有保其可生者，用礞石滚痰丸，牛黄清心丸
之类，吐痰愈加。薛曰∶非惟无以保其生，而反促其危矣！固辞不治，后果殁。 一男子，
醉而入房，阴囊肿胀大如斗，小腹胀闷，小水淋赤，发热口干，痰涎壅甚，此膀胱阴虚，
酒毒所乘也，用六味丸料，加车前、牛膝作饮，下滋肾丸，诸证顿退，再加五味、麦门
二剂而愈。却以补中益气加麦门、五味，调理而康。若用淡渗，复损真阴，决致不起。
加味小柴胡汤 治囊痈腐烂，或饮食少思，日晡发热。
柴胡 人参 黄芩（炒） 川芎 白术（炒） 盐水（浸，炒） 当归（酒洗） 黄柏（酒拌，炒） 知
母（酒拌，炒） 甘草（各一钱） 半夏（五分）
作一剂。水二盅，煎八分，食前服。痛甚加黄连。小便不利，加木通。
知州王汝道，先晡热发热，肢体倦怠，入房则腿足酸软，足必热至腿膝，六脉洪数，两
尺为甚。余以足三阴虚，欲滋补化源。彼反服苦寒降火之剂，后阴囊肿胀，用治疝之药，
肿胀益甚，形气愈虚。服温补之剂，肿痛上攻，小便不利，两尺脉洪滑，按之虚甚，余
曰∶此囊痈也，因气血虚而不能溃。先用补中益气汤加山药、山茱萸、车前子、柴胡、山
栀，一剂肿胀顿消，随用六味丸料加车前、牛膝、柴胡、山栀，一剂小便渐通，乃用活命
饮与前二药，消息兼用至二十余剂。囊裂出秽脓甚多，乃用托里消毒散六剂，脓秽清，又
用托里散数剂，脓水渐少，更用补阴托里散，及十全大补汤五十余剂而痊。 一人年逾五
十，患此疮口不敛，诊之微有湿热。治以龙胆泻肝汤，湿热悉退，乃以托里药，及豆豉
饼灸而愈。次年复患湿热颇盛，仍用前汤四剂而退，又以滋阴药而消。若溃后虚而不补，
少壮者成漏，老弱者不治。脓清作渴，脉大者，亦不治。 一人患此久不敛，以十全大
补汤加五味、麦门、灸以豆豉饼，月余而平。
一弱人，脓熟胀痛，大小便秘，急针之，脓出三碗许即鼾睡，觉神思少健。但针迟，故
用托里药，至三十余剂始瘥。若服解毒药，即溃尽矣。
〔似是而非〕
一人囊肿，状如水晶，时痛时痒出水，小腹按之作水声，小便频数，脉迟缓，此醉后
饮水入房，汗出遇风寒湿毒乘聚于囊，名水疝也。先以导水丸二服，腹水已去，小便如
常，再以胃苓散倍白术、茯苓，更用气针，引去聚水而瘥。 一人年逾四十，阴囊肿痛，以
热手熨之少缓，服五苓散不应，尺脉迟软，此下虚寒邪所袭而然，名曰阴疝，非疮毒也。治
以蟠葱散少可，更服葫芦巴丸而平。 一人年逾三十，阴囊湿痒，茎出白物如脓，举则
急痛，此肝疝也。用龙胆泻肝汤而愈。阴茎或肿，或缩，或挺，或痒，皆宜此药治之。
治肾痈，用石蟹热水磨服。
锻石散 治肾漏，阴囊先肿后穿破，出黄水，疮口如鱼口，能致命。
上用五倍子同锻石炒黄色，去灰摊地，出火毒，砂盆内研细末。不犯铜铁，干掺上五
七次可。
治外肾痈疮
抱鸡卵壳 鹰爪黄连 轻粉（各等分）
上为细末。用煎过清油，调涂。
乌金散
麸炭 紫苏叶（各等分）
上为末。香油调搽。
A question was asked: From the lower abdomen to below the yin (genitals), at the root of the jade stem (penis), there is extreme itching. Pouring boiling water on it provides temporary relief, but it recurs. There are three or four orifices with dripping yellow fluid. What should be done? The answer is: This is a condensation toxin from broad sores (late-stage syphilis). Inquiry reveals that in childhood, he once suffered from malignant sores. Ten days later, severe pain and swelling occurred, and food intake decreased. It should be treated as a condensation toxin.
[Xue Ji] *Waike Jingyao* (Essentials of Surgery) states: Carbuncles and sores entering the scrotum result in death. The scrotum belongs to the Jueyin Liver Meridian. Now, saying it results in death, does this imply it belongs to the Shaoyin Kidney Meridian? I have personally seen seven or eight cases of scrotal involvement, all treated by clearing damp-heat and draining the Liver Meridian, assisted by Yin-nourishing herbs. Although pus ruptured, skin peeled off, and testicles hung exposed—frighteningly—the patients did not die. However, I do not know how to treat elderly patients with deficiency in the lower jiao. Scrotal carbuncle is caused by damp-heat sinking downward. Some cases suppurate; this is due to turbid qi sinking and flowing into the urinary tract, occurring because of deficiency in the yin pathway (anterior yin) and obstruction of the water passages. Once the pus is exhausted, peace returns naturally; medication may not even be necessary, provided one manages care well. In other cases, abdominal swelling gradually flows into the scrotum, causing severe swelling, leading to spontaneous rupture of the scrotum, with testicles hanging out and fluid leaking. Apply bran charcoal (cedar charcoal) powder externally, wrap with Perilla leaves, and keep the patient supine for recovery. Generally, this condition stems from deficiency of the yin pathway and obstructed damp-heat. Therefore, herbs that nourish Yin and descend dampness are indispensable. For typical treatment of swelling, pain, and constipated urine, prioritize draining dampness with Yin-nourishing herbs as an adjunct. When swelling and pain subside and bowel/bladder functions normalize, combine damp-draining and Yin-nourishing herbs. To promote suppuration, prioritize interior-supporting methods with Yin-nourishing herbs as an adjunct. Once pus forms, puncture it immediately, continuing with interior-supporting and Yin-nourishing methods. If damp-toxins are fully exhausted, use only interior-supporting methods. If pus is clear, excessive, or healing is slow, use major tonifying formulas or moxa cones made with Aconite Cake.
[Xue Ji] Scrotal carbuncle belongs to the Liver and Kidney meridians, characterized by Yin deficiency with damp-heat sinking downward. If urination is astringent and obstructed, first promote diuresis to drain toxins, then nourish Yin to allow self-resolution. If damp-heat subsides but swelling and pain persist, nourish Yin and support the interior to accelerate suppuration. If suppuration occurs accompanied by constipation, it indicates heat-toxin blockage; first use Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder), then puncture to drain pus, which resolves the condition. If swelling and pain persist after pus drainage, heat-toxins remain unresolved; use Qinggan Yangrong Tang (Clear Liver and Nourish Ying Decoction). Dry mouth with frequent urination indicates deficient heat in the Kidney Meridian; use Liuwei Wan (Six-Ingredient Pill). Internal heat or afternoon fever indicates Blood deficiency in the Liver Meridian; use Siwu Tang (Four-Substance Decoction) plus Ginseng and Atractylodes. Fatigue and poor appetite indicate Spleen Qi deficiency with heat; use Buzhong Yiqi Tang (Center-Boosting Qi-Supplementing Decoction). Clear and thin pus indicates dual deficiency of Qi and Blood; use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction). Although this condition involves extensive ulceration with exposed testicles, if treated correctly, muscles regenerate within ten days, leading to recovery. If one exclusively attacks the sore, the yin pathway becomes more deficient, resulting in inability to suppurate when swollen or heal when ulcerated. Young and strong individuals often develop chronic fistulas, while old and weak individuals may die. Also, hemorrhoids or fistulas lingering for years may spread to the scrotum; treat both simultaneously. Avoid cold/cold-natured herbs that attack and damage Stomach Qi.
Case 1: A patient had scrotal carbuncle without suppuration, presenting with swelling and pain. After two doses of Modified Longdan Xiegan Tang (Modified Gentian Liver-Draining Decoction), symptoms improved slightly. Subsequently, Siwu Tang plus Tongcao, Anemarrhena, and Phellodendron resolved the condition.
Case 2: A patient had mature pus causing distension and urinary difficulty. Emergency puncture was performed. Xiao Chaihu Tang plus Phellodendren, Angelica Dahurica, and Honeysuckle were given for four doses, improving symptoms slightly. Then, Tuoli Xiaodu San was used for several doses until resolution.
Case 3: A man over fifty had scrotal swelling and pain, worsening with heat. Panchong San was ineffective. The Liver pulse was rapid, indicating scrotal carbuncle due to damp-heat in the Liver Meridian. Upon confirmation of pus formation, immediate puncture was performed, followed by Longdan Xiegan Tang, resolving all pulse and symptom signs. He then took interior-supporting and Yin-nourishing herbs, with external application of cedar charcoal and Perilla powder, recovering in over a month.
Case 4: A man over sixty had unbearable scrotal ulceration and pain with exposed testicles. Longdan Xiegan Tang and applications of bran charcoal/Perilla were ineffective. Xue Ji attributed this to intense dampness. First, a bowl of Sophora flower wine was drunk, followed by the previous decoction for slight improvement. Then, interior-supporting herbs with Yin-nourishing agents brought stability. Had the previous medicine failed, adding harsh purgatives would have damaged Middle Qi, leading to collapse.
Case 5: A weak patient had pre-suppurative swelling/pain and red, astringent urine. Zhi Gancao, Qingpi, Tongcao, Huangbai, Danggui, and Ophiopogon were used for four doses, showing slight improvement. Qingxin Lianzi Yin cleared the condition in four subsequent doses.
Case 6: A patient had severe swelling/pain, astringent urine, fever, and rapid pulse. Longdan Xiegan Tang was used with doubled Cheqianzi, Tongcao, Ze-xie, and Poria. Symptoms halved. The same formula plus Huangbai and Honeysuckle for four doses reduced symptoms further, restoring normal excretion. One area remained unabsorbed, indicating impending suppuration. The formula plus Honeysuckle, Gleditsia spine, and Angelica Dahurica for six doses resulted in mild swelling/pain and slippery-rapid pulse, confirming pus formation. Puncture relieved all symptoms. Yin-nourishing and interior-supporting herbs plus Perilla powder led to recovery.
Case 7: A patient had severe disease with terrifyingly flooding pulse. Two doses of the previous formula reduced swelling slightly. Xianfang Huoming Yin for two doses stopped pain slightly, but pulse remained flooding-rapid, indicating pus requiring puncture; otherwise, total scrotal溃烂 would occur. The patient refused, sought another doctor, and indeed suffered massive溃烂 with hanging testicles. Returning for treatment, the pulse was calming. Bazhen Tang plus Astragalus, Phellodendron, Anemarrhena, and Gardenia was used, along with Perilla powder application, leading to recovery in days.
Case 8: A patient drank alcohol daily, suffering from penile protrusion and scrotal dampness/itching. Yin-nourishing herbs failed. Xue Ji stated: The anterior yin is governed by the Liver Meridian. Yin energy protrudes; chronic dampness combined with alcohol creates damp-heat attacking the Lower Jiao. As the Classics say: "The Lower Jiao is like a ditch." And: "What is below, draw it out and exhaust it." Thus, Longdan Xiegan Tang and Qingzhen Tang cured him. If ineffective, Bugan Tang and Sisheng San should be used.
Case 9: Scholar Chen Shiyong, disappointed in exams, drank burning wine and attempted intercourse, but his wife refused. Next day, scrotal swelling and pain occurred. Treatment was sought. Xue Ji prescribed damp-heat draining and Liver-fire clearing agents, but gates closed before administration. Report next morning: scrotum completely rotted overnight, including the part of the penis adhering to the scrotum. This was Liver fire carrying wine toxicity with intense damp-heat. The previous formula plus Ginseng, [missing character], Danggui, and Atractylodes for four doses shed dead flesh, exposing testicles. Major Qi-Blood tonification and Angelica ointment application restored the scrotum and penis completely.
Case 10: Patient had swelling, pain, fever. Xiao Chaihu Tang plus Qingpi and Coptis for four doses improved slightly. Longdan Xiegan Tang resolved it.
Case 11: Official Lu Zhenshan had red/swollen painful scrotum, astringent urine, chills/fever, thirst. This was Liver/Kidney Yin deficiency with damp-heat sinking. Clear Liver fire, drain damp-toxins. Chaihu, fried Gentian, Evodia, fried Coptis, Danggui, Honeysuckle, Gleditsia spine, Red Peony, Fangfeng, Tongcao, and licorice joint were used. One dose reduced swelling/pain. Add Fangfeng, Tongcao, Chuanxiong, Poria as tea, swallow Zishui Wan to nourish Yin. Heat and swelling subsided. However, a tendon inside remained unabsorbed, indicating Liver Meridian Blood/Qi deficiency. Nourish Kidney Water using Liuwei Wan formula minus Poria plus Schisandra for two doses. Then, Buzhong Yiqi plus Poria as tea, swallowing Zishui Wan. The tendon instantly disappeared, curing the case.
Jiawei Xiegan Tang treats Liver Meridian damp-heat obstruction, scrotal swelling/pain. Or ulceration with skin peeling/hanging testicles, or buboes/chancres swelling/pain, or ulcerations—all are treated.
Gentian Root (wine-mixed, fried), Angelica Tail, Plantago Seed (fried), Alisma, Rehmannia Root, Peony (fried), Coptis (fried), Phellodendron Bark (wine-mixed, fried), Anemarrhena Rhizome (wine-mixed, fried), Saposhnikovia Root (each 1 qian), Licorice Tip (0.5 qian).
Make one dose. Boil in 2 cups water to 0.8 cup. Take before meals. External application: Wujin San.
Zhu Erfeng from Jingzhao had scrotal swelling/pain, mistaking it for hernia. Xue Ji palpated a rapid-slipping pulse, diagnosing scrotal carbuncle due to Liver/Kidney Yin deficiency and damp-heat, with pus formed. Huoming Yin for one dose caused rupture; Bu Yin Tuo Li (Nourish Yin Support Interior) promoted healing.
A wealthy guest had scrotal swelling and urinary difficulty, caused by Middle Jiao accumulated heat sinking due to deficiency. Longdan Xiegan Tang plus Phellodendron, Anemarrhena, Coptis, and Achyranthes for four doses improved gradually. Later, Bu Yin Bazhen Tang plus Chaihu and Gardenia cured him. Non-compliance with taboos caused recurrence. Bu Yin Bazhen Tang, Buzhong Yiqi Tang, and Liuwei Wan cured him again. Fat fever from labor led to self-medication with Siwu, Phellodendron, Anemarrhena, resulting in full deficiency signs and large open sores. Xue Ji diagnosed dual deficiency of Five Organs' Qi/Blood. Morning: Buzhong Yiqi. Evening: Liujunzi plus Danggui. Over 50 doses each gradually closed sores. Liuwei Wan regulated and cured.
Li Daqing from Fuyang had chronic Kidney deficiency fever, long-term use of Phellodendron/Anemarrhena led to emaciation, spermatorrhea, white turbidity, afternoon fever, and phlegm spitting. Xue Ji said: Kidney Water deficiency with internal deficient fire. Use Buzhong Yiqi plus Schisandra and Ophiopogon; prior symptoms healed. Using separate cooling-blood herbs caused poor appetite and persistent phlegm. Xue Ji diagnosed Spleen/Lung re-deficiency failing to control saliva. Previous formula plus Poria and Pinellia cured. Intercourse led to dizziness, phlegm vomiting, back pain,牵引 pain in urinary/bowel tracts. Xue Ji said: Essence consumed and exhausted; critical condition. Morning: Previous formula plus Ophiopogon/Schisandra. Evening: Liuwei Wan formula plus Schisandra and Dioscorea Hypoglauca. Over 50 doses resolved symptoms. Intercourse again caused scrotal/penile pain. Diuretics caused internal scrotal溃烂. Bu Yin Tuo Li herbs drained much pus. Swelling/pain stopped, but poor care led to constipation, stranguria-like urination, surging phlegm-saliva. Xue Ji said: Kidney deficiency relapsed; worrying. Someone guaranteed life using Mengshi Gun Tan Wan or Niuhuang Qingxin Wan, increasing phlegm vomiting. Xue Ji said: Not only no life preservation, but accelerated danger! Refused treatment, died subsequently.
A man, drunk and having intercourse, had scrotal swelling as large as a bucket, lower abdominal distension, red dribbling urine, fever, dry mouth, abundant phlegm-saliva. Bladder Yin deficiency attacked by wine toxicity. Liuwei Wan formula plus Plantago and Achyranthes as tea, swallowing Zishui Wan, resolved symptoms. Plus Schisandra/Ophiopogon for two doses cured. Regulate with Buzhong Yiqi plus Ophiopogon/Schisandra to health. Diuretics would damage True Yin, leading to death.
Jiawei Xiao Chaihu Tang treats scrotal carbuncle ulceration, poor appetite, afternoon fever.
Bupleurum, Ginseng, Scutellaria (fried), Chuanxiong, Atractylodes (fried), Salt water (soaked, fried), Angelica (wine-washed), Phellodendron (wine-mixed, fried), Anemarrhena (wine-mixed, fried), Licorice (each 1 qian), Pinellia (0.5 fen).
One dose. Boil 2 cups water to 0.8 cup. Take before meals. Severe pain add Coptis. Urinary difficulty add Tongcao.
Wang Rudao, Prefect, had afternoon fever, limb fatigue. Intercourse caused leg/foot soreness, heat rising to knees. Six pulses flooding-rapid, especially Chi positions. Diagnosed Foot Three Yin deficiency, intended to tonify source. Patient took bitter-cold fire-clearing herbs instead. Later scrotal swelling worsened with hernia meds, shape/Qi became more deficient. Warm-tonifying herbs caused swelling/pain to attack upward, urinary difficulty, Chi pulses flooding-slipping, empty on pressure. Diagnosed scrotal carbuncle due to Qi/Blood deficiency unable to suppurate. First, Buzhong Yiqi Tang plus Dioscorea, Cornus, Plantago, Bupleurum, Gardenia. One dose eliminated swelling. Then Liuwei Wan formula plus Plantago, Achyranthes, Bupleurum, Gardenia. One dose improved urination. Then Huoming Yin combined with previous two medicines, adjusted over 20+ doses. Scrotum ruptured, discharging much foul pus. Tuoli Xiaodu San for six doses cleared pus/foulness. Tuoli San for several doses reduced fluid. Bu Yin Tuo Li San and Shiquan Dabu Tang for 50+ doses cured.
Patient over 50 had non-healing sore, slight damp-heat detected. Longdan Xiegan Tang cleared damp-heat. Interior-supporting herbs and Fermented Soybean Cake Moxa cured. Next year, recurrent damp-heat treated with four doses of previous formula, then Yin-nourishing herbs resolved it. Post-ulcer deficiency without tonification leads to fistula in young/strong, death in old/weak. Clear pus with thirst and large pulse also untreatable.
Another patient with long-standing non-healing sore used Shiquan Dabu Tang plus Schisandra/Ophiopogon, Fermented Soybean Cake Moxa, flat in over a month.
Weak patient with mature pus swelling/pain, constipation. Urgent puncture released ~3 bowls of pus, followed by snoring sleep. Woke with slightly improved spirit. Delayed needle required interior-supporting herbs for 30+ doses to recover. Detox herbs would have caused complete溃烂.
[Similar but Different]
Patient with scrotal cyst, crystal-like, intermittent pain/itching with fluid discharge, water sound on lower abdomen pressing, frequent urination, slow-slow pulse. Caused by drinking water after drunken intercourse, sweating then encountering wind-cold-damp-toxin gathering in scrotum. Named Shui Han (Water Hernia). Dao Shui Wan twice removed abdominal water, urination normalized. Weiling San with doubled Atractylodes/Poria, plus Qi Needle to drain accumulated water, cured.
Patient over 40 had scrotal swelling/pain, hot hand compressions gave slight relief, Wuling San ineffective. Chi pulse slow-soft. Lower deficiency attacked by cold pathogen. Named Yin Han (Yin Hernia), not sore-toxin. Panchong San helped slightly, Huluba Wan stabilized.
Patient over 30 had scrotal dampness/itching, penis discharging white pus-like matter, acute pain upon erection. Gan Han (Liver Hernia). Longdan Xiegan Tang cured. Penile swelling/shrinkage/protrusion/itching all treatable with this herb.
Treat Kidney Carbuncle: Grind Stone Crab in hot water and drink.
Duanshi San treats Kidney Fistula, scrotal swelling then bursting, yellow fluid discharge, sore opening like fish mouth, fatal.
Use Chinese Gall mixed with Furnace Lime, stir-fry yellow, remove ash, spread on ground to remove fire toxicity, grind fine in mortar. Avoid copper/iron. Dry sprinkle 5-7 times acceptable.
Treat External Genital Carbuncles/Sores
Hen Eggshell, Eagle-claw Coptis, Calomel (equal parts)
Grind fine. Mix with boiled clear sesame oil, apply.
Wujin San
Bran Charcoal, Perilla Leaf (equal parts)
Grind fine. Mix with Sesame Oil, apply.