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Individuals who develop carbuncles and sores on the left and right sides of the scrotum are named "Bian Du" (Inguinal Abscess). Those occurring below the scrotum, anterior to the anus, are named "Nang Yong" (Scrotal Carbuncle).
Comparing these three locations [Note: Text mentions three but details two], Bian Du is easy to treat, whereas Nang Yong is the most difficult to heal. This is because the area below the scrotum is called Xuan Yong (Hanging Carbuncle); its skin and flesh differ from other parts. In other areas, skin and flesh textures are either horizontal or vertical, making wounds easy to close; however, in the Xuan Yong area, horizontal and vertical textures intermingle, so once damaged, it is difficult to achieve healing. Nevertheless, there are methods for treatment, and it is not inherently difficult. Such carbuncles often arise because young men indulge in alcohol and lust, engaging in promiscuous activities in brothels, enduring semen retention during intercourse, having sex while hungry, forcibly raising Qi after ejaculation, or re-stimulating Yang when essence is nearly exhausted. They may also engage in reckless unions with women carrying toxins or prostitutes suffering from sores. Consequently, such carbuncles frequently occur. This is what is meant by "desire to release but unable to do so, transforming into pus and blood." The treatment method must strongly tonify deficiency and assist with ingredients that resolve toxicity, because toxicity arises from deficiency; can one succeed without treating the deficiency? Use Zhuxie Zhishen Dan (Miraculous Decoction for Expelling Evil):
Jinyinhua (Lonicerae Japonicae Flos, 4 liang) Gongyingying (Taraxaci Herba, 2 liang) Renshen (Ginseng Radix et Rhizoma, 1 liang) Danggui (Angelicae Sinensis Radix, 2 liang) Sheng Gancao (Glycyrrhizae Radix et Rhizoma Recens, 1 liang) Dahuang (Rhei Radix et Rhizoma, 5 qian)
Tianhuafen (Trichosanthis Radix, 2 qian) Decoct in water and take orally. After one dose, toxicity dissipates; after two doses, full recovery occurs; for ulcerated cases, three doses suffice for healing.
This prescription uses four liang of Jinyinhua and two liang of Gongyingying, assisted by large doses of Renshen, Danggui, and Dahuang, which may seem overly aggressive. However, for severe deficiency conditions, using Dahuang for purging seems inappropriate. Yet, knowing that toxicity is at its peak, and taking advantage of the early stage when Zheng Qi (Upright Qi) has not yet severely declined, strong tonification combined with draining fire is appropriate. If one delays treatment due to hesitation or fear, waiting until pus and blood flow out and Zheng Qi becomes depleted before starting to tonify Qi with Renshen and Huangqi (Astragali Radix), one might use several jin (ancient weight unit) and still fail to recover. Why not use them earlier during the process of resolving toxicity, thereby protecting Zheng Qi while facilitating the dispersion of toxicity? This is a method of following the trend and utilizing the pathway, which one must understand.
Some individuals consume distilled spirits (Shaojiu) and then engage in sexual activity, preventing ejaculation. By midnight, they experience alternating chills and fever, restlessness, thirst, dysuria with red urine, and profuse phlegm-saliva. The next day, the scrotum swells and the abdomen hurts; by the third day, the scrotal tissue completely necroses, and the part of the penis adjacent to the scrotum also necroses. People assume this is caused by alcohol toxicity, but who knows it is actually Liver Fire exacerbated by alcohol toxin and dampness? How can alcohol cause necrosis? Distilled spirits are extremely hot substances. Excessive consumption often leads to death from drunkenness, after which the body may rot, because distilled spirits are qi-like; when alcohol meets heat, it self-ignites. The human body's zang-fu organs naturally contain fire; using fire to attract fire, how can it not burn? Consuming distilled spirits and engaging in sex stirs up the fire of the essence chamber. One might think this is Mingmen Fire (Gate of Life Fire) rather than Liver Fire. However, Wood generates Fire; the Liver belongs to Wood, and Liver Wood is born from Ministerial Fire (Xiang Huo), which is a natural principle. Engaging in sex while borrowing the power of distilled spirits makes the fire force fierce. Fire moving without root cannot last long; inevitably, if essence could be released externally, the fire would subside. Unfortunately, although essence desires release, the suppressed fire has no outlet, and the fire lacks foundation, while the distilled spirit remains unresolvable. Thus, the fire enters the Liver, attaching itself to the Mother organ (Liver/Wood relationship) and settling there. Only Ministerial Fire is internal fire, capable of dwelling in the Liver; whereas Alcohol Fire is external fire, which, upon encountering Wood, burns the body. The scrotum and penis are gatherings of sinews, and sinews belong to the Liver. Due to sexual activity, fire gathers at the genitalia. Therefore, when fire erupts, the scrotum swells; when swelling reaches its extreme, the penis also necroses. The treatment method involves resolving alcohol toxicity and benefiting Qi and Blood tonics, so that damp-heat resolves and necrotic flesh can regenerate. Use Jiufu Tang (Decoction for Saving Necrotic Flesh):
Renshen (Ginseng Radix et Rhizoma, 1 liang) Danggui (Angelicae Sinensis Radix, 1 liang) Huangqi (Astragali Radix, 2 liang) Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang) Fuling (Poria, 5 qian) Huangbai (Phellodendri Cortex, 3 qian) Yiren (Coicis Semen, 5 qian)
Zexie (Alismatis Rhizoma, 3 qian) Baishao (Paeoniae Radix Alba, 1 liang) Gegen (Puerariae Lobatae Radix, 3 qian) Chao Hei Zhizi (Gardeniae Fructus Carbonized, 3 qian) Decoct in water and take orally. After four doses, necrotic flesh detaches and new flesh grows; after another four doses, the scrotum and penis completely flatten and recover.
Alcohol toxicity forms due to suppression and obstruction; soothing the Liver, draining fire, and promoting diuresis to resolve dampness and detoxify is appropriate. Why use Renshen, Huangqi, Danggui, and Baizhu to strongly tonify Qi and Blood? Generally, those with abundant Qi and Blood have strength to overcome alcohol; even heavy drinking causes no harm. Necrosis after consuming distilled spirits must result from the toxicity of the spirits, indicating deficient Qi and Blood where strength fails to overcome the alcohol. Thus, two fires combine, leading to burning and external necrosis. If Qi and Blood are not urgently tonified, alcohol toxicity will be hard to eliminate, and how can necrotic flesh grow quickly?