阴肿之证小儿生,久坐阴湿寒气凝,或因怒叫气结闭,寒热虚实择可行。
【注】此证即古名脱囊。由久坐阴湿之地,为寒气所凝而成;间或有因怒叫气闭,结聚
于下而成者,俱宜用桃仁丸主之。若寒气客于厥阴、少阴者,则阴囊肿痛,腹痛,冷汗,
引缩二子入腹,痛止方出,谓之内吊,宜乌梅散、匀气散主之。有阴茎全缩不见,或不
缩而阴囊肿大光亮,不燥不疼者,肝肾气虚也,宜橘核煎汤,调匀气散服之。囊肿及四
肢俱肿,二便不利者,膀胱蕴热,风热相乘也,宜白牵牛散主之。若女儿阴户肿胀者,心
热相传也,宜导赤汤服之,或五苓散用薏苡、车前子煎汤调服。外治法,俱敷立消散,甚效。
桃仁丸
桃仁(去皮尖,炒微黄,七钱五分) 白蒺藜(微炒,去刺) 桂心 丹皮(各五钱) 黑牵牛(头末,二钱五分)
上为细末,炼蜜和丸,如黍粒大。每服十丸,黄酒送下。
【方歌】桃仁丸逐阴肿疾,怒气闭结或湿袭,蒺藜牵牛桂丹皮,研末蜜丸如黍粒。
乌梅散
乌梅肉 甘草(半生、半炙) 元胡索(各五钱) 钩藤钩 乳香 没药(各二钱五分)
共捣粗末,每服二钱,水一盅,煎七分服。
【方歌】乌梅散用乳香没,钩藤甘草元胡索,阴囊肿兼腹中疼,煎服必先研粗末。
匀气散
桔梗(炒,二两) 陈皮(去白,一两) 茴香(炒) 缩砂仁(炒,各五钱) 甘草(炙,四钱) 姜炭(二钱
五分)
共研细末,每服五分或一钱,白滚水调下。
【方歌】匀气散因外寒侵,阴囊肿痛汗淋淋,桔梗陈皮甘草炙,茴香姜炭缩砂仁。
白牵牛散
白牵牛(半生、半熟) 甘草(炙) 橘红 白术(土炒) 桑白皮 木通(各一钱)
水煎服。
【方歌】白牵牛散草橘红,白术桑白皮木通,阴囊相兼四肢肿,能逐膀胱热结壅。
五苓散
白术(土炒) 赤茯苓(各一钱五分) 猪苓 泽泻(各一钱) 桂心(五分)
水煎服。
【方歌】五苓白术桂心加,赤茯苓除心火邪,猪苓泽泻能分利,调和脏腑效堪夸。
立消散
赤小豆 风化硝 赤芍 枳壳 商陆(俱不宜见火,晒干,共研为末,各五钱)
用侧柏叶煎汤,候冷调敷肿处。
【方歌】立消阴囊肿痛注,因受风寒湿热毒,赤小豆与风化硝,芍枳同研加商陆。
导赤汤(见口部口糜)
阴肿这一病症多见于小儿,多因久坐于阴冷潮湿之地,导致寒气凝结;或因愤怒啼哭导致气机郁闭,需根据寒、热、虚、实的不同证候选择适宜的治疗方法。
【注】此证即古称的“脱囊”。由久坐于阴湿之地,被寒气凝滞而成;间或有因愤怒啼叫导致气机闭塞,结聚于下部而形成的,均宜使用桃仁丸主治。若寒气侵袭厥阴经、少阴经,则出现阴囊肿痛、腹痛、出冷汗,牵引睾丸缩入腹中,疼痛停止后方才复出,称为“内吊”,宜用乌梅散、匀气散主治。若有阴茎完全缩回不见,或不缩但阴囊肿大光亮,不干燥也不疼痛的,属于肝肾气虚,宜用橘核煎汤,调匀气散服用。若阴囊及四肢俱肿,大小便不利的,是膀胱蕴积湿热,风热相乘所致,宜用白牵牛散主治。若是女童阴户肿胀的,是心热传变所致,宜服导赤汤,或用五苓散加薏苡仁、车前子煎汤调服。外治法,均可敷用立消散,效果显著。
桃仁丸
桃仁(去皮尖,炒至微黄,七钱五分) 白蒺藜(微炒,去刺) 桂心 丹皮(各五钱) 黑牵牛(头末,二钱五分)
以上药物研为细末,用炼蜜和丸,如黍米大小。每次服用十丸,黄酒送下。
【方歌】桃仁丸可逐除阴肿疾,怒气闭结或湿气侵袭,蒺藜、牵牛、桂枝、丹皮,研成末后用蜜制成如黍粒大小的丸药。
乌梅散
乌梅肉 甘草(半生用、半炙用) 元胡索(各五钱) 钩藤钩 乳香 没药(各二钱五分)
共捣成粗末,每次服用二钱,用水一盅,煎至七分,服用。
【方歌】乌梅散含有乳香、没药,还有钩藤、甘草、元胡索,阴囊肿大兼腹部疼痛,煎服前必须先研成粗末。
匀气散
桔梗(炒,二两) 陈皮(去白,一两) 茴香(炒) 缩砂仁(炒,各五钱) 甘草(炙,四钱) 姜炭(二钱五分)
共研为细末,每次服用五分或一钱,用白开水调服。
【方歌】匀气散因外寒侵袭所致,阴囊肿痛且冷汗淋漓,桔梗、陈皮、炙甘草,加上茴香、姜炭、缩砂仁。
白牵牛散
白牵牛(半生用、半熟用) 甘草(炙) 橘红 白术(土炒) 桑白皮 木通(各一钱)
水煎服。
【方歌】白牵牛散配伍甘草、橘红,白术、桑白皮、木通,阴囊肿大兼四肢肿胀,能逐除膀胱的热结壅滞。
五苓散
白术(土炒) 赤茯苓(各一钱五分) 猪苓 泽泻(各一钱) 桂心(五分)
水煎服。
【方歌】五苓散加入白术、桂心,赤茯苓可除心火邪气,猪苓、泽泻能分利水道,调和脏腑功效值得夸赞。
立消散
赤小豆 风化硝 赤芍 枳壳 商陆(均不宜见火,晒干,共研为末,各五钱)
用侧柏叶煎汤,待冷却后调敷于肿胀处。
【方歌】立消散针对阴囊肿痛,因受风寒湿热毒邪所致,赤小豆与风化硝,芍药、枳壳同研加入商陆。
导赤汤(参见口部口糜章节)
The syndrome of Yin swelling (scrotal swelling) often occurs in children, primarily due to prolonged sitting in cold and damp environments causing the congealing of Cold Qi (Cold Energy), or due to anger and crying leading to Qi stagnation and closure. Treatment should be selected based on the differentiation of Cold, Heat, Deficiency, and Excess patterns.
[Note] This syndrome is known in ancient texts as Tuo Nang (Scrotal Gangrene/Necrosis). It is caused by prolonged sitting in damp places, where Cold pathogen congeals; occasionally, it arises from anger and crying causing Qi obstruction and accumulation in the lower body. In such cases, Tao Ren Wan (Peach Kernel Pill) is generally indicated. If Cold pathogen invades the Jueyin (Liver Meridian) and Shaoyin (Kidney Meridian), symptoms include scrotal swelling and pain, abdominal pain, cold sweating, and retraction of the testes into the abdomen, returning only after the pain subsides; this is called Nei Diao (Internal Retraction). Wumei San (Mume Powder) and Yunqi San (Harmonizing Qi Powder) are indicated. If the penis is completely retracted and invisible, or if the scrotum is swollen, large, bright, dry-free, and painless, it indicates Deficiency of Liver and Kidney Qi. Juhe Decoction (Citrus Seed Decoction) taken with Yunqi San is indicated. If both the scrotum and limbs are swollen, accompanied by difficulty in urination and defecation, it is due to Heat-Turbidity accumulating in the Bladder combined with Wind-Heat. Bai Qian Niu San (White Morning Glory Powder) is indicated. If the vulva of a female child is swollen, it is due to Heart Heat transmission. Dao Chi Tang (Directing Out the Red Decoction) is indicated, or Wuling San (Five-Ingredient Powder with Poria) decocted with Yi Yi Ren (Coix Seed) and Che Qian Zi (Plantago Seed) for administration. For external treatment, Li Xiao San (Instant Resolution Powder) can be applied externally with excellent effect.
Tao Ren Wan (Peach Kernel Pill)
Tao Ren (Peach Kernel, peeled, tip removed, stir-fried until slightly yellow, 7.5 qian) Bai Ji Li (Tribulus Fruit, lightly stir-fried, thorns removed) Gui Xin (Cinnamon Twig Heart) Dan Pi (Moutan Bark, each 5 qian) Hei Qian Niu (Black Morning Glory Seed, first extraction powder, 2.5 qian)
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of millet seeds. Take 10 pills per dose, washed down with yellow wine.
[Fang Ge - Prescription Verse] Tao Ren Wan expels Yin swelling disease, [caused by] angry Qi closure or dampness invasion; Ji Li, Qian Niu, Gui, and Dan Pi, ground into powder and formed into pills like millet seeds with honey.
Wumei San (Mume Powder)
Wu Mei Rou (Mume Flesh) Gan Cao (Licorice Root, half raw, half roasted) Yuan Hu Suo (Corydalis Rhizome, each 5 qian) Gou Teng Gou (Uncaria Hook) Ru Xiang (Frankincense) Mo Yao (Myrrh, each 2.5 qian)
Pound together into coarse powder. Take 2 qian per dose, decoct in one cup of water until reduced to 0.7 cups, then take.
[Fang Ge - Prescription Verse] Wumei San uses Ru Xiang and Mo Yao, along with Gou Teng, Gan Cao, and Yuan Hu Suo; for scrotal swelling and abdominal pain, grind into coarse powder before decocting and taking.
Yunqi San (Harmonizing Qi Powder)
Jie Geng (Platycodon Root, stir-fried, 2 liang) Chen Pi (Aged Tangerine Peel, pith removed, 1 liang) Hui Xiang (Fennel Fruit, stir-fried) Suo Sha Ren (Amomum Fruit, stir-fried, each 5 qian) Gan Cao (Licorice Root, roasted, 4 qian) Jiang Tan (Charred Ginger, 2.5 qian)
Grind into fine powder. Take 0.5 qian or 1 qian per dose, mixed with boiling water.
[Fang Ge - Prescription Verse] Yunqi San is due to external Cold invasion, [causing] scrotal swelling/pain and profuse sweating; Jie Geng, Chen Pi, and roasted Gan Cao, plus Hui Xiang, Jiang Tan, and Suo Sha Ren.
Bai Qian Niu San (White Morning Glory Powder)
Bai Qian Niu (White Morning Glory Seed, half raw, half cooked) Gan Cao (Licorice Root, roasted) Ju Hong (Tangerine Peel Red Layer) Bai Zhu (Atractylodes Macrocephala Rhizome, soil-stir-fried) Sang Bai Pi (Mulberry Root Bark) Mu Tong (Akebia Stem, each 1 qian)
Decoct in water and take.
[Fang Ge - Prescription Verse] Bai Qian Niu San combines with Gan Cao and Ju Hong, Bai Zhu, Sang Bai Pi, and Mu Tong; for scrotal swelling accompanying limb edema, it can expel Heat-Turbidity congestion in the Bladder.
Wuling San (Five-Ingredient Powder with Poria)
Bai Zhu (Atractylodes Macrocephala Rhizome, soil-stir-fried) Chi Fu Ling (Red Poria, each 1.5 qian) Zhu Ling (Polyporus) Ze Xie (Alisma Rhizome, each 1 qian) Gui Xin (Cinnamon Twig Heart, 0.5 qian)
Decoct in water and take.
[Fang Ge - Prescription Verse] Wuling San adds Bai Zhu and Gui Xin; Chi Fu Ling clears Heart Fire evil; Zhu Ling and Ze Xie promote diuresis to separate fluids; harmonizing Zang-Fu organs, its efficacy is praiseworthy.
Li Xiao San (Instant Resolution Powder)
Chi Xiao Dou (Adzuki Bean) Feng Hua Xiao (Weathered Niter) Chi Shao (Red Peony Root) Zhi Ke (Bitter Orange Fruit) Shang Lu (Phytolacca Root) (None should be exposed to fire; sun-dry, grind together into powder, each 5 qian)
Decoct Ce Bai Ye (Biota Tops) in water, wait for it to cool, mix with powder, and apply topically to the swollen area.
[Fang Ge - Prescription Verse] Li Xiao San targets scrotal swelling and pain, caused by Wind-Cold-Damp-Heat-Toxin; Chi Xiao Dou and Feng Hua Xiao, Shao and Zhi ground together adding Shang Lu.
Dao Chi Tang (Directing Out the Red Decoction) (See Mouth Section: Aphthous Ulcers)