托里消毒散(见肿疡门)
十全大补汤 补中益气汤 八珍汤(俱见溃疡门)
六味地黄丸(见肺痈门)
夫囊痈者,乃阴虚湿热流注于囊,结而为肿。至溃后睾丸
悬挂者,犹不伤人,以其毒从外发,治当补阴、清利湿热,取效者十有八、九。近时人误用疝家热药,多致热
甚为脓,虑难收敛。初宜龙胆泻肝汤,稍久滋阴内托散,外敷如意金黄散,俱可内消。又一种水疝,皮色光亮,
无热无红,肿痛有时,内有聚水,宜用针从便处引去水气则安。如肿痛日久,内脓已成胀痛者,可即针之;内
服十全大补汤加山茱萸、牡丹皮、泽泻治之,间以六味地黄丸服之亦愈。
初起不红微肿,肾子引痛,不作寒热,起坐自便者轻。已成红肿发热,形色光亮,疼痛有时,饮食有味者
顺。已溃脓稠,肿消痛止,新肉渐生,不痛作痒、收敛者吉。溃后腐烂,囊皮脱落,甚者睾丸突出,能食不痛
者可。
初起坚硬紫色,日夜痛甚,小便不利,大便秘泄者重。已成坚而不溃,头腐无脓,疼痛无时,常流血水者
重。溃后脓口开张,肿痛不减,身发寒热,睡卧不宁者重。
初起寒热交作,肾子肿痛,疼连小腹者,宜发散寒邪。已成红肿发热,口干 痛,小水不利,大便秘者利
之;已溃疼痛不减,脓水清稀,朝寒暮热者,宜滋阴内托;溃后不能收敛,日晡发热,饮食减少者,宜养血健
脾;溃后睾丸悬挂不能收敛者,当外用生肌,内加补托。
托里消毒散(参见肿疡门)
十全大补汤、补中益气汤、八珍汤(均参见溃疡门)
六味地黄丸(参见肺痈门)
所谓囊痈,是由于阴虚导致湿热之邪流注于阴囊,凝结而成肿块。即使溃破后睾丸悬挂外露,也尚不危及生命,因为毒邪已从外部发散,治疗应当采用补益阴液、清利湿热的方法,通常能取得八九成的疗效。近代人误用治疗疝气的热性药物,多导致热势更盛而化脓,担心难以愈合。初期适宜使用龙胆泻肝汤,病程稍久则使用滋阴内托散,外敷如意金黄散,均可使肿块内消。还有一种水疝,皮肤颜色光亮,无发热发红症状,肿痛时有时无,内部积聚水液,适宜用针从尿道处引出积水即可安宁。如果肿痛日久,内部脓液已成且胀痛明显,可以立即针刺排脓;内服十全大补汤加入山茱萸、牡丹皮、泽泻进行治疗,间歇服用六味地黄丸也能痊愈。
疾病初起时,局部不红微肿,睾丸牵引疼痛,没有寒热症状,起居饮食如常的属于轻症。病情发展至红肿发热,形态色泽光亮,疼痛有时发作,饮食有味道的属于顺证。已经溃破,脓液稠厚,肿胀消退疼痛停止,新肉逐渐生长,不痛而作痒,疮口收敛的属于吉兆。溃破后腐烂,阴囊皮肤脱落,严重的睾丸突出,但能进食且不痛的尚可救治。
疾病初起时,肿块坚硬呈紫色,日夜疼痛剧烈,小便不利,大便泄泻的属于重症。病情发展至坚硬而不溃破,头部腐烂但无脓液,疼痛无定时,经常流出血水的属于重症。溃破后脓口开张,肿痛不减,身体出现寒热,睡眠不安的属于重症。
疾病初起时,寒热交替发作,睾丸肿痛,疼痛牵连小腹的,适宜发散寒邪。病情发展至红肿发热,口干疼痛,小便不利,大便秘结的,适宜通利二便;已经溃破,疼痛不减,脓水清稀,早晨恶寒傍晚发热的,适宜滋阴内托;溃破后不能收敛,午后发热,饮食减少的,适宜养血健脾;溃破后睾丸悬挂不能收敛的,应当外用生肌药物,内服加用补托之法。
Tolli Xiaodu San (See Men of Swelling and Ulceration)
Shiquan Dabu Tang (Ten Complete Tonic Decoction), Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), Bazhen Tang (Eight Treasures Decoction) (All See Men of Ulceration)
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (See Men of Lung Abscess)
The so-called Nang Yong (Scrotal Carbuncle) arises from Yin deficiency, allowing damp-heat pathogens to flow into the scrotum, where they condense to form a swelling. Even if it ulcerates and the testis hangs exposed, it does not necessarily endanger life, as the toxin has been expelled externally. Treatment should focus on nourishing Yin and clearing/drainng damp-heat; such cases typically achieve an eight or nine out of ten success rate. In recent times, people have mistakenly used hot-natured medicines for treating hernias, often causing the heat to intensify and transform into pus, making healing difficult to anticipate. Initially, Longdan Xiegan Tang (Gentiana Liver-Draining Decoction) is appropriate; after a longer duration, Ziyang Neituo San (Nourish-Yin Internal-Supporting Powder) may be used. Applying Ruyi Jinhuang San (Ruyi Golden Yellow Powder) externally can also facilitate the internal resolution of the swelling. Another condition, Shui Shan (Hydrocele), presents with shiny skin color, no fever or redness, intermittent swelling and pain, and accumulated fluid internally. It is suitable to use a needle to drain the fluid from the urethral area to ensure peace. If swelling and pain persist for a long time, internal pus has formed causing distending pain, immediate needle drainage is indicated; internally, Shiquan Dabu Tang (Ten Complete Tonic Decoction) added with Cornus Officinalis Fructus (Shanzhuyu), Moutan Cortex (Mudanpi), and Alisma Rhizoma (Zexie) should be administered, interspersed with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), which will also lead to recovery.
In the initial stage, if there is no redness and only slight swelling, with pulling pain in the testis, no chills or fever, and normal activities and diet, it is a mild case. If it progresses to redness, swelling, and fever, with bright and shiny appearance, periodic pain, and preserved appetite, it is a favorable course. If it has ulcerated with thick pus, swelling subsides, pain stops, new flesh gradually grows, itching without pain, and wound contraction occurs, it is an auspicious sign. If after ulceration there is rotting, shedding of scrotal skin, and even protrusion of the testis, but the patient can eat and feels no pain, it is treatable.
If in the initial stage the mass is hard and purple, with severe day-and-night pain, difficulty in urination, and loose stools, it is a severe case. If it progresses to hardness without ulceration, head necrosis without pus, constant pain, and frequent discharge of bloody fluid, it is a severe case. If after ulceration the wound opens wide, swelling and pain do not decrease, chills and fever appear, and sleep is restless, it is a severe case.
In the initial stage, with alternating chills and fever, testicular swelling and pain radiating to the lower abdomen, it is appropriate to disperse cold pathogens. If it progresses to redness, swelling, fever, dry mouth and pain, difficulty in urination, and constipation, it is appropriate to promote bowel movement and urination. If already ulcerated with persistent pain, thin and clear pus, morning chills, and evening fever, it is appropriate to nourish Yin and support internally. If after ulceration the wound fails to contract, afternoon fever occurs, and appetite decreases, it is appropriate to nourish blood and strengthen the spleen. If after ulceration the testis hangs and cannot contract, external application of flesh-regenerating agents should be used, combined internally with tonifying and supporting methods.