囊痈属肝经湿热，或禀胎肝热所致。初起肿痛，小便赤涩者，湿热壅滞也，先用龙胆泻肝汤，如不消，用仙方活命
饮。若肿痛数日不止，欲作脓也，用托里消毒散。若肿未溃而小便不利者，毒瓦斯壅滞也，当分利之。脓已成而小便不利，
毒瓦斯未解也，当针泄之。脓出而反痛者，气血虚也，当补益之。若元气无亏，虽阴囊悉溃，睾丸悬露，亦不为害。若乳
母恚怒，令儿患此者，加味逍遥散。肝经气血虚者，八珍散加味，柴胡、山栀，俱加漏芦，子母并服。
一小儿小便涩滞，肿痛寒热，此肝经湿热也，用龙胆泻肝汤而消。但内热倦怠，此兼脾气虚弱也，用四君子加柴胡、
山栀、芎、归而愈。
一小儿肿痛寒热，用克伐之药，不能成脓；用托里清肝散而脓溃；用托里散而疮敛。后寒热如疟，小便闭塞，用小
柴胡汤加山栀、龙胆草、车前子而愈。
一小儿患此，大溃痛甚，烦躁饮冷，此余毒尚在，与活命饮二剂，肿痛顿退；又用四君、柴胡、山栀四剂，诸症悉
退，及托里散而痊。
一小儿阴囊赤肿作痛，针而脓出顿安，忽发热作渴，此邪气去而真气虚也，用圣愈汤及八味、柴胡、山栀，将愈。
因乳母恚怒复作，用加味逍遥散加漏芦与母服，其儿顿愈。
一小儿阴囊每患赤肿，必因其母恚怒及饮酒而发，余审其因怒，用加味逍遥散加漏芦。饮酒，用加味清胃散加干葛、
神曲，与母服之，其儿随愈。
一小儿阴肿，小便赤涩，此禀肝经有热也，用加味小柴胡加漏芦与母服，子日饮数滴，四剂而愈。
一小儿患此，肿硬不消，发热作痛，大便不实，饮食无味，此消导过多而脾胃伤也，先用异功散数剂，元气渐复；
又用托里散加柴胡、山栀而脓成，针之脓出，发热恶寒，此血气俱虚也；用大补汤加柴胡、山栀，寒热顿止，又数剂而
渐愈。后因劳，发热肿痛，用益气汤、托里散，疮口渐敛而愈。
一小儿十六岁患此，脓清晡热，遗精盗汗，此禀元气虚甚也，用大补汤、地黄丸料各二十余剂，元气稍复，又各三
十余剂，汗止热退。犯房事患处顿黯，昏愦吃逆，手足并冷，此脾气虚寒之恶症，用独参汤四剂而苏，用大补汤加干姜
四分，阳气渐复，乃去干姜，又二十余剂而痊。
一小儿患此，溃而肿硬不消，服败毒散，敷寒凉药，肌
肉不生，疮口开张，脓清色黯，自汗，余谓非补脾则肌肉不生。彼欲速效，乃外用生肌散反助其邪，致生瘀肉，填塞疮
口，半载不愈。余用异功散加当归、黄 三十余剂，又用托里散、隔蒜灸而愈。
一小儿囊痈出血，久不愈，左颊色青赤，此心肝二经风热而血不归经也，先用加味逍遥散、六味地黄丸，清肝热、
滋肾水而血止，用托里散而疮愈。
一小儿患前症，脓清发热，久而不敛，左颊青、两颐赤。余谓禀肝肾阴虚而两位青赤，脾胃气虚而脓清不敛，当补
足三阴为善。不悟，泛用杂药，后果殁。
一小儿患前症久不愈，面色皎白，左颊为甚。余谓∶前症属肝木，面白属肺金，左颊属肝经，乃金来克木为贼邪，
况小便如淋，乃肝肾二经气绝也，辞不治。后果殁于金旺之日。盖肝为肾之子，肾为肝之母，设预为调补肾水，必不致
于危也。
托里清肝散
人参 黄 （炒） 当归 川芎 芍药（炒） 白术 茯苓 金银花 白芷（炒） 甘草（炒） 连翘 柴胡（各
七分） 山栀（四分）
上每服二三钱，水煎。
钱氏蚯蚓散 治肾子肿硬，先用葱椒汤煎洗，次以干蚯蚓粪，津唾调敷，须避风冷湿地。
世传治小儿阴囊肿大，用甘草煎浓汁，调蚯蚓粪涂之，立效。
山药膏 治两拗及小腹肿痛或痒，用山药研烂频敷患处，干则易之。
补中益气汤（方见肌肉不生）
异功散（方见用败毒之药）
八珍汤
加味逍遥散（二方见发热不止）
活命饮
托里散（二方见热毒疮疡）
加味小柴胡汤（方见热毒瘰 ）
圣愈汤（方见出血不止）
十全大补汤（方见便痈）
加味清胃散
四君子汤（二方见腹痈）
地黄丸（方见作渴不止）
囊痈属于肝经湿热，或是由于先天禀赋导致肝热所致。初起时出现肿痛，小便颜色红赤且排尿涩痛不畅的，是湿热壅滞的表现，先用龙胆泻肝汤治疗；如果症状没有消退，改用仙方活命饮。如果肿痛持续数日不止，即将化脓的，用托里消毒散。如果肿胀尚未溃破但小便不通利的，是毒邪壅滞，应当通过分利小便的方法治疗。如果脓液已经形成但小便仍不通利，是毒邪未解，应当针刺排脓。如果脓液排出后反而疼痛加剧的，是气血虚弱，应当进行补益。如果元气没有亏损，即使阴囊完全溃烂，睾丸暴露在外，也不会造成危害。如果是因乳母愤怒情绪影响，导致婴儿患此病的，使用加味逍遥散。对于肝经气血虚弱的情况，使用八珍散加味，加入柴胡、山栀，同时加入漏芦，母子共同服用。
有一个小儿小便涩滞不畅，伴有肿痛、寒热往来，这是肝经湿热的表现，使用龙胆泻肝汤治疗后痊愈。但随后出现内热、倦怠乏力，这是兼有脾气虚弱，使用四君子汤加入柴胡、山栀、川芎、当归后治愈。
另一个小儿出现肿痛、寒热，之前使用了攻伐药物，不能促使成脓；后来使用托里清肝散，脓液溃破；再使用托里散，疮口收敛。之后出现类似疟疾的寒热症状，小便闭塞，使用小柴胡汤加入山栀、龙胆草、车前子后治愈。
还有一个小儿患此病，严重溃烂且疼痛剧烈，烦躁不安，想喝冷水，这是余毒尚存，给予活命饮两剂，肿痛立刻消退；又用四君子汤、柴胡、山栀四剂，所有症状全部消退，最后用托里散而痊愈。
一个小儿阴囊红肿疼痛，针刺后脓液排出，症状顿时缓解，忽然发热口渴，这是邪气已去但真气虚弱，使用圣愈汤及八味丸、柴胡、山栀，病情逐渐好转。因为乳母愤怒导致复发，让乳母服用加味逍遥散加漏芦，患儿随即痊愈。
一个小儿阴囊反复发生红肿，必定是因为母亲愤怒或饮酒而诱发。我审察病因，因愤怒引起的，用加味逍遥散加漏芦；因饮酒引起的，用加味清胃散加干葛、神曲，让母亲服用，患儿随之痊愈。
一个小儿阴囊肿胀，小便红赤涩痛，这是禀受肝经有热，让母亲服用加味小柴胡汤加漏芦，患儿每天饮用几滴，四剂后痊愈。
一个小儿患此病，肿胀坚硬不消，发热疼痛，大便不成形，饮食无味，这是因为过度使用消导药物损伤了脾胃。先用异功散数剂，元气逐渐恢复；再用托里散加柴胡、山栀，脓液形成，针刺后脓出，出现发热恶寒，这是气血俱虚；使用大补汤加柴胡、山栀，寒热症状立刻停止，又服数剂后逐渐痊愈。后来因劳累，再次发热肿痛，使用益气汤、托里散，疮口逐渐收敛而愈。
一个十六岁的小儿患此病，脓液清稀，午后发热，遗精盗汗，这是禀赋元气非常虚弱，使用大补汤、地黄丸各二十多剂，元气稍复，又各服三十多剂，汗止热退。因房事导致患处颜色突然变暗，昏愦呃逆，手足冰冷，这是脾气虚寒的危重证候，使用独参汤四剂苏醒，再用大补汤加干姜四分，阳气逐渐恢复，然后去掉干姜，又服二十多剂而痊愈。
一个小儿患此病，溃烂后肿胀坚硬不消，服用败毒散，外敷寒凉药物，肌肉不生，疮口开张，脓液清稀颜色暗黑，自汗，我认为如果不补脾则肌肉无法生长。患者追求速效，外用生肌散反而助长邪气，导致长出瘀肉，填塞疮口，半年不愈。我用异功散加当归、黄芪三十多剂，又用托里散、隔蒜灸而痊愈。
一个小儿囊痈出血，久治不愈，左脸颊颜色青赤，这是心肝二经风热导致血不归经，先用加味逍遥散、六味地黄丸，清肝热、滋肾水使血止，再用托里散使疮口愈合。
一个小儿患前述病症，脓液清稀发热，久而不收敛，左颊青色、两腮发红。我认为这是禀赋肝肾阴虚导致两颊青赤，脾胃气虚导致脓清不敛，应当补足足三阴经为佳。患者不醒悟，泛用各种杂药，后果死亡。
一个小儿患前述病症久治不愈，面色苍白，左颊尤为明显。我认为：前述病症属肝木，面白属肺金，左颊属肝经，这是金来克木的贼邪，况且小便如淋，是肝肾二经气绝的表现，我推辞不治。后果在金旺之日死亡。因为肝为肾之子，肾为肝之母，如果预先调补肾水，必然不至于危险。
托里清肝散
人参、黄芪（炒）、当归、川芎、芍药（炒）、白术、茯苓、金银花、白芷（炒）、甘草（炒）、连翘、柴胡（各七分），山栀（四分）。
以上每服二三钱，水煎服。
钱氏蚯蚓散 治疗肾子肿硬，先用葱椒汤煎洗，然后用干蚯蚓粪，用唾液调和敷贴，必须避开风冷湿地。
世传治疗小儿阴囊肿大，用甘草煎浓汁，调蚯蚓粪涂之，立即见效。
山药膏 治疗两胁及小腹肿痛或瘙痒，用山药研烂频繁敷于患处，干了就更换。
补中益气汤（方见肌肉不生）
异功散（方见用败毒之药）
八珍汤
加味逍遥散（二方见发热不止）
活命饮
托里散（二方见热毒疮疡）
加味小柴胡汤（方见热毒瘰疬）
圣愈汤（方见出血不止）
十全大补汤（方见便痈）
加味清胃散
四君子汤（二方见腹痈）
地黄丸（方见作渴不止）
Cystic abscess (Nangyong) belongs to damp-heat in the Liver channel, or is caused by congenital Liver heat. In the initial stage, if swelling and pain occur with red, scanty, and difficult urination, it indicates stagnation of damp-heat; treat first with Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver). If it does not subside, use Xianfang Huoming Yin (Immortal Life-Deciding Decoction). If swelling and pain persist for several days without subsiding, indicating impending suppuration, use Tuoli Xiaodu San (Supporting Interior and Detoxifying Powder). If swelling has not ulcerated but urination is obstructed, it indicates stagnation of toxic factors; promote diuresis to separate and drain. If pus has formed but urination remains obstructed, it indicates unresolved toxic factors; puncture to drain. If pain worsens after pus discharge, it indicates deficiency of Qi and Blood; tonify and supplement. If Yuan Qi (Original Qi) is not depleted, even if the scrotum completely ulcerates and the testicles are exposed, it will not cause harm. If the condition is caused by a wet nurse's anger affecting the infant, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). For deficiency of Qi and Blood in the Liver channel, use Bazhen San (Eight Treasures Powder) with modifications, adding Chaihu (Bupleurum), Shanzhi (Gardenia), and Loulu (Euphorbia lathyris), taken by both mother and child.
A child presented with difficult urination, swelling, pain, and alternating chills and fever, indicating damp-heat in the Liver channel; treated with Longdan Xiegan Tang and recovered. However, internal heat and fatigue followed, indicating concurrent Spleen Qi deficiency; treated with Sijunzi Tang (Four Gentlemen Decoction) plus Chaihu, Shanzhi, Xiong (Ligusticum), and Gui (Angelica sinensis), resulting in recovery.
Another child presented with swelling, pain, and chills/fever. Previous use of purgative drugs failed to induce suppuration; treated with Tuoli Qinggan San (Supporting Interior and Clearing Liver Powder), leading to pus discharge; then treated with Tuoli San (Supporting Interior Powder), leading to wound contraction. Later, malaria-like chills and fever occurred with urinary obstruction; treated with Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Shanzhi, Longdancao (Gentiana root), and Cheqianzi (Plantago seed), resulting in recovery.
Another child suffered severe ulceration and pain, restlessness, and thirst for cold drinks, indicating residual toxins. Given Huoming Yin (Life-Deciding Decoction) for two doses, swelling and pain subsided immediately. Then given Sijunzi Tang, Chaihu, and Shanzhi for four doses, all symptoms resolved, and finally cured with Tuoli San.
A child had red, swollen, painful scrotum. After puncturing and draining pus, symptoms relieved instantly, but sudden fever and thirst appeared, indicating that pathogenic factors were gone but True Qi was deficient. Treated with Shengyu Tang (Sage Recovery Decoction) and Bawei Wan (Eight Flavor Pill), plus Chaihu and Shanzhi, leading to gradual improvement. Due to recurrence caused by the wet nurse's anger, the nurse took Jiawei Xiaoyao San plus Loulu, and the child recovered immediately.
A child suffered recurrent scrotal redness and swelling, triggered by the mother's anger or alcohol consumption. Investigating the cause: for anger-induced cases, used Jiawei Xiaoyao San plus Loulu; for alcohol-induced cases, used Jiawei Qingwei San (Modified Stomach-Clearing Decoction) plus Ge Gen (Kudzu root) and Shen Qu (Medicated Leaven), administered to the mother, leading to the child's recovery.
A child had scrotal swelling with red, difficult urination, indicating inherited Liver heat. The mother took Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction) plus Loulu; the child drank a few drops daily, recovering after four doses.
A child had hard, non-resolving swelling, fever, pain, loose stools, and loss of taste, caused by excessive use of digestive-promoting drugs damaging the Spleen and Stomach. First, Yigong San (Yi Gong Powder) was given for several doses to gradually restore Yuan Qi. Then, Tuoli San plus Chaihu and Shanzhi was used to form pus, which was drained by puncture. Fever and aversion to cold followed, indicating dual deficiency of Qi and Blood; treated with Dabu Tang (Great Tonification Decoction) plus Chaihu and Shanzhi, stopping chills and fever. After several more doses, gradual recovery occurred. Later, due to overexertion, fever and swelling recurred; treated with Yiqi Tang (Qi-Supporting Decoction) and Tuoli San, leading to wound contraction and recovery.
A sixteen-year-old child presented with thin pus, afternoon tidal fever, seminal emission, and night sweats, indicating severe congenital Yuan Qi deficiency. Treated with Dabu Tang and Dihuang Wan (Rehmannia Pill) for over twenty doses each, slightly restoring Yuan Qi. After another thirty-plus doses, sweating and fever ceased. Intercourse caused sudden darkening of the lesion, coma, hiccups, and cold limbs, indicating critical Spleen Qi deficiency and cold. Revived with Dushen Tang (Single Ginseng Decoction) for four doses. Then, Dabu Tang plus Ganjiang (Dried Ginger) 4 fen was used to gradually restore Yang Qi. Ganjiang was removed, and after twenty more doses, full recovery was achieved.
A child had ulcerated, hard, non-resolving swelling after taking Baidu San (Detoxifying Powder) and applying cold-cooling external medicines. Muscle tissue did not regenerate, wounds remained open, pus was thin and dark, and spontaneous sweating occurred. I stated that without Spleen tonification, muscle would not grow. Seeking quick results, the patient used external Shengji San (Muscle-Generating Powder), which aggravated pathogens, causing granulation tissue overgrowth blocking the wound, lasting half a year. I used Yigong San plus Danggui (Angelica sinensis) and Huangqi (Astragalus) for thirty-plus doses, then Tuoli San and Garlic-separated Moxibustion, resulting in cure.
A child had bleeding from cystic abscess, unhealed for a long time, with blue-red complexion on the left cheek, indicating Wind-Heat in Heart and Liver channels causing blood to leave its vessels. First, Jiawei Xiaoyao San and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) were used to clear Liver heat and nourish Kidney Water, stopping bleeding. Then, Tuoli San healed the wound.
A child with previous symptoms had thin pus, fever, and non-healing wounds, with blue left cheek and red cheeks. I diagnosed this as congenital Yin deficiency of Liver and Kidneys causing blue/red cheeks, and Spleen/Stomach Qi deficiency causing thin pus and non-healing. Recommended tonifying the three Yin meridians of the foot. Ignoring this, miscellaneous drugs were used, leading to death.
A child with prolonged non-healing previous symptoms had pale face, especially on the left cheek. I reasoned: previous symptoms belong to Liver Wood, pale face belongs to Lung Metal, left cheek belongs to Liver channel; this is Metal overcoming Wood (Thief Evil). Furthermore, urine resembling stranguria indicates exhaustion of Qi in Liver and Kidney channels. I declined treatment. The child died on a day when Metal was prosperous. Since Liver is the son of Kidney, and Kidney is the mother of Liver, if Kidney Water had been regulated beforehand, crisis could have been avoided.
Tuoli Qinggan San (Supporting Interior and Clearing Liver Powder)
Renshen (Ginseng), Huangqi (Astragalus, stir-fried), Danggui (Angelica sinensis), Chuanxiong (Ligusticum), Shaoyao (Peony, stir-fried), Baizhu (Atractylodes macrocephala), Fuling (Poria), Jinyinhua (Honeysuckle), Baizhi (Angelica dahurica, stir-fried), Gancao (Licorice, stir-fried), Lianqiao (Forsythia), Chaihu (Bupleurum) [each 0.7 qian], Shanzhi (Gardenia) [0.4 qian].
Take 2-3 qian per dose, decoct in water.
Qian Shi Leiwan San (Qian's Earthworm Powder)
Treats hard swelling of the testicles. First wash with Congjiao Tang (Scallion and Pepper Decoction), then apply dry earthworm feces mixed with saliva. Avoid wind, cold, and damp places.
Worldly prescription for pediatric scrotal swelling: Boil Gancao (Licorice) into thick juice, mix with earthworm feces, and apply externally for immediate effect.
Shanyao Gao (Chinese Yam Paste)
Treats swelling/pain or itching in the hypochondrium and lower abdomen. Grind Shanyao (Dioscorea opposita) into paste and apply frequently to the affected area; replace when dry.
Buzhong Yiqi Tang (Middle-Supporting Qi-Boosting Decoction) [See formula for "Muscle Not Growing"]
Yigong San (Yi Gong Powder) [See formula for "Use of Detoxifying Drugs"]
Bazhen Tang (Eight Treasures Decoction)
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) [See formulas for "Unremitting Fever"]
Huoming Yin (Life-Deciding Decoction)
Tuoli San (Supporting Interior Powder) [See formulas for "Heat-Toxic Sores"]
Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction) [See formula for "Heat-Toxic Scrofula"]
Shengyu Tang (Sage Recovery Decoction) [See formula for "Unstoppable Bleeding"]
Shiquan Dabu Tang (Ten Complete Great Tonification Decoction) [See formula for "Perineal Abscess"]
Jiawei Qingwei San (Modified Stomach-Clearing Powder)
Sijunzi Tang (Four Gentlemen Decoction) [See formulas for "Abdominal Abscess"]
Dihuang Wan (Rehmannia Pill) [See formula for "Unremitting Thirst"]