下疳生于前阴，一名妒精疮，属肝经湿热下注而成。其来有三∶有由欲念萌而未遂，未
经发泄，而邪火遏郁，败精浊血，留滞经隧，结而为肿者；有因交合不结，以致淫毒传袭而
发者；有由房术热药，涂沫洗搽，使精久不泄，邪火煽动，郁滞而生者，皆由蕴毒所致。初
起或先小便淋涩溺痛，次流黄浊败精，遂阴茎痒痛，坚硬紫胀，渐渐破损，渐渐腐烂，脓水
淋漓，其臭腥躁，以肝性臊也；亦有先皮肿光亮如水晶，破流毒水，肿痛日生，麻痒时发者
。治法当以疏利肝肾火邪、除湿解毒为主，若清肝导滞汤、龙胆泻肝汤、黄连解毒汤、萆
汤、芦荟丸之类，随宜酌用；外掺珍珠散、五宝丹。盖此证形异名殊，轻重不一。生于马口
者，名下疳；生玉茎上者，名蛀疳；茎上生疮，外皮肿胀包裹者，名袖口疳；龟头外肿如瘤
者，名鸡嗉疳；疳久而腐烂偏卸者，名蜡烛疳；又有臊疳、杨梅疳、旋根疳诸种。要之，无
外因而病者，不过去其湿热，或滋其真阴，湿热既清，其疮自愈，无足虑也。惟感触淫邪，
毒自少阴直入精宫而发者，不易愈。即治如前法，犹必令患者食淡、戒房事，若能守禁，则
服药自然有效，一月收功者，只消半月而愈矣。
夫肾岩翻花者，俗名翻花下疳。此非由交合不洁、触染淫秽而生。由其人肝肾素亏，或
又郁虑忧思，相火内灼，水不涵木，肝经血燥，而络脉空虚，久之损者愈损，阴精消涸，火
邪郁结，遂遘疾于肝肾部分。初起马口之内，生肉一粒，如竖肉之状，坚硬而痒，即有脂水
。延至一、二年，或五、六载时，觉疼痛应心，玉茎渐渐肿胀，其马口之竖肉处，翻花若榴
子样，此肾岩已成也。渐至龟头破烂，凸出凹进，痛楚难胜，甚或鲜血流注，斯时必脾胃
衰弱，饮食不思，即食亦无味，形神困惫；或血流至两三次，则玉茎尽为烂去；如精液不能
灌输，即溘然而毙矣。此证初觉时，须用大补阴丸，或知柏八味，兼用八珍、十全大补之属
。其病者，再能怡养保 ，可以冀其久延岁月。若至成功后，百无一生，必非药力之所能为
矣。此与舌疳、失营、乳岩为四大绝证，犹内科中有疯、痨、臌、膈，不可不知。
下疳发生于前阴部位，又名妒精疮，是由肝经湿热下注所形成的。其病因主要有三种：一是因欲望萌动而未得发泄，导致邪火郁遏，败精与浊血滞留于经络隧道，凝结而成肿块；二是因性交不洁，致使淫毒传染而发病；三是因使用房中术的热药，涂抹、清洗或搽擦，使精液久不得泄，邪火煽动，气机郁滞而生病。这些情况皆由蕴积之毒所致。
初起时，有的先出现小便淋沥涩痛，随后流出黄浊的败精，接着阴茎瘙痒疼痛，变得坚硬、紫胀，逐渐破损、腐烂，脓水淋漓，气味腥臭躁烈（这是因为肝的气味为臊）；也有的先表现为皮肤肿胀光亮如水晶状，破溃后流出毒水，肿痛日益加重，时常发作麻木和瘙痒。治疗原则应以疏利肝肾之火邪、除湿解毒为主，可根据情况酌情选用清肝导滞汤、龙胆泻肝汤、黄连解毒汤、萆薢分清饮、芦荟丸等方剂；外用可掺敷珍珠散、五宝丹。
总之，此证形态各异、名称不同，病情轻重不一。生于马口（尿道口）的，名为下疳；生于玉茎（阴茎体）上的，名为蛀疳；阴茎上生疮，外皮肿胀包裹的，名为袖口疳；龟头外部肿胀如瘤状的，名为鸡嗉疳；疳症日久，腐烂偏向一侧脱落的，名为蜡烛疳；此外还有臊疳、杨梅疳、旋根疳等多种类型。大凡没有外感邪因而致病者，只需去除湿热，或滋养真阴，待湿热清除后，疮疡自会愈合，不足为虑。唯有感触淫邪，毒气从少阴经直入精宫而发作者，则难以治愈。即使按照上述方法治疗，也必须要求患者饮食清淡、禁止房事，若能严守禁忌，服药自然有效，原本需一个月痊愈的病症，半个月即可康复。
所谓肾岩翻花，俗称翻花下疳。此病并非由性交不洁、接触感染秽毒而生。而是由于患者肝肾素来亏虚，或因忧郁思虑过度，导致相火内灼，肾水不能涵养肝木，致使肝经血燥，络脉空虚。久而久之，亏损者愈亏，阴精枯竭，火邪郁结，遂在肝肾部位发病。初起时，在马口之内长出一粒肉赘，形状像竖起的肉条，质地坚硬且伴有瘙痒，并有脂水渗出。经过一两年，或五六年后，感到疼痛牵连心脏，玉茎逐渐肿胀，马口处的竖肉翻出，状如石榴籽，此时肾岩已成。进而发展到龟头破烂，凹凸不平，痛苦难忍，甚至鲜血直流。此时患者必然脾胃衰弱，不思饮食，即便进食也无味，形体和精神极度困倦疲惫；如果流血两三次，玉茎便会完全烂掉；若精液无法灌输，便会突然死亡。此证初觉时，须用大补阴丸，或知柏地黄丸，兼用八珍汤、十全大补汤之类。患病者若能再能怡情养性、保养精神，还可以期望延长寿命。若至病情后期（成功后），十无一生，绝非药物之力所能挽回。此病与舌疳、失营、乳岩并称为四大绝证，犹如内科中的疯、痨、臌、膈四证一样，不可不知。
Chancre occurs in the anterior yin region, also known as "Jealousy of Essence Sore" (Du Jing Chuang), formed by damp-heat pouring downward due to Liver meridian involvement. Its etiology has three sources: first, desires arise but are not fulfilled, leading to suppression of pathogenic fire, causing ruined essence and turbid blood to stagnate in the collaterals and meridians, condensing into a swelling; second, it arises from unclean sexual intercourse resulting in the transmission of licentious toxins; third, the use of hot medicines for sexual techniques, applied via smearing, washing, or rubbing, prevents ejaculation for a long time, stirring up pathogenic fire and causing stagnation. All these cases result from accumulated toxins.
Initially, some present with dysuria and painful urination, followed by the discharge of yellow, turbid ruined essence, then itching and pain in the penis, becoming hard, purple, and swollen, gradually breaking down and rotting, with dripping pus that has a fishy and pungent odor (reflecting the Liver's affinity for the fishy smell); others may initially show skin swelling that is bright and translucent like crystal, which breaks to release toxic fluid, with worsening swelling and pain, and intermittent numbness and itching. The treatment principle should focus on venting and draining pathogenic fire from the Liver and Kidney, removing dampness, and detoxifying. Formulas such as Qing Gan Dao Zhi Tang (Clear Liver and Guide Out Stagnation Decoction), Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver), Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity), Bi Xie Fen Qing Yin (Dioscorea Hypoglauca Decoction to Separate the Clear), and Lu Hui Wan (Aloe Pill) may be selected according to circumstances; externally, Zhen Zhu San (Pearl Powder) or Wu Bao Dan (Five Treasures Pellet) can be applied.
In summary, this condition presents with diverse forms and names, varying in severity. Chancre occurring at the Ma Kou (urethral meatus) is named Xia Gan; that on the Yu Jing (penile shaft) is named Zhu Gan; sores on the shaft wrapped in swollen outer skin are named Xiu Kou Gan; external swelling of the glans resembling a crop is named Ji Su Gan; chancre that rots and falls off to one side after a long duration is named La Zhu Gan; additionally, there are various types such as Sao Gan, Yang Mei Gan, and Xuan Gen Gan. Generally, cases without exogenous pathogens require only the removal of damp-heat or nourishment of True Yin; once damp-heat is cleared, the sore heals spontaneously and is not a cause for concern. However, cases where licentious pathogens are contracted, and toxins enter directly from the Shaoyin meridian into the Essence Palace, are difficult to cure. Even when treated as described, the patient must maintain a bland diet and abstain from sexual activity. If these prohibitions are observed, medication will naturally be effective, reducing a one-month recovery period to half a month.
Shen Yan Fan Hua (Kidney Rock Turning Flower), commonly known as Fan Hua Xia Gan, does not arise from unclean sexual contact or infection with filth. It results from inherent deficiency of the Liver and Kidney, exacerbated by depression and excessive worry, causing Ministerial Fire to scorch internally. When Kidney Water fails to nourish Liver Wood, Liver Blood becomes dry and collaterals become empty. Over time, deficiency worsens, Yin Essence dries up, and Fire Pathogens stagnate, leading to disease in the Liver and Kidney regions. Initially, a fleshy nodule appears inside the Ma Kou, resembling an upright piece of meat, hard and itchy, with serous discharge. After one or two years, or five to six years, pain radiates to the heart, the Yu Jing swells gradually, and the fleshy growth at the Ma Kou turns outward like pomegranate seeds, indicating that Shen Yan is established. Gradually, the glans becomes ulcerated, convex and concave, with unbearable pain, or even profuse bleeding. At this stage, Spleen and Stomach function inevitably weakens, appetite is lost, food tastes bland, and physical and mental energy is exhausted; if bleeding occurs two or three times, the Yu Jing may completely rot away; if semen cannot be conveyed, sudden death ensues. Upon initial detection, Da Bu Yin Wan (Major Supplement Yin Pill) or Zhi Bai Ba Wei Wan (Anemarrhena, Phellodendron and Eight Ingredient Pill) should be used, combined with Ba Zhen Tang (Eight Treasure Decoction) or Shi Quan Da Bu Tang (Complete Great Tonifying Decoction). If the patient can further cultivate their spirit and preserve health, life extension may be hoped for. Once the condition reaches its advanced stage ("success"), survival is rare, and medicinal power alone cannot save them. This condition, along with She Gan (Tongue Chancre), Shi Ying (Lost Camp), and Ru Yan (Breast Rock), constitutes the Four Major Incurable Syndromes, analogous to Feng (Madness), Lao (Consumption), Gu (Abdominal Distension), and Ge (Diaphragmatic Obstruction) in Internal Medicine, and must be understood.