下疳阴痿，皆属肝火湿热，或禀赋肝经阴虚。肿痛发热者，肝火湿热也，先用加味小柴胡汤，再用龙胆泻肝汤。肿
痛便赤者，肝火阴虚也，用加味逍遥散加龙胆草、生地黄。溃而肿痛不消者，小柴胡汤加芎、归、黄 。溃而肿痛已消，
用四物汤加牡丹皮、柴胡。盖肝属木，得雨露则森茂，遇酷日则萎软，若误谓虚寒，投以热剂，轻则囊茎生疮，重则腐
而难敛，皆宜滋肾水生肝木、清肝火。故云∶肝气热则茎痿，宗筋弛纵，阴茎肿胀，或出白液，或痒痛，里急筋缩，挺
纵不收，或精出便下，此名筋疝，俱肝火也。
黄宗伯季子初生时，母弃于水，逾日不死，复收之，遂成喘嗽，颔腋臂股，各结块核溃而色紫，误触之痛彻于心，
服辛温化毒等剂不应，时已弱冠。余曰∶初生喘嗽者，形寒伤肺也，既长而咳嗽者，肝火刑肺也，故结核俱在肝胆部分。
始用补中益气汤，后用九味芦荟丸，不月诸症悉愈。此禀母之肝火而患也。
一小儿下疳溃烂，发热作渴，日晡尤甚，此肝疳而脾气虚也，用补中益气汤，后用九味芦荟丸，诸症悉愈。
一小儿二岁茎萎湿痒，时出白津，余以为肝火，不信，或与温补肾经，后阴囊 肿，茎中作痛，余用龙胆泻肝汤、
六味地黄丸而愈。
一小儿睾丸作痛，小便赤涩，寒热作呕，此肝火湿热不利，用小柴胡汤加山栀、车前子、茯苓而愈。（睾丸阴子也）
一小儿睾丸肿痛，小便黄涩，寒热作渴，此肝火所致，用小柴胡汤加柴胡、车前子，并九味芦荟丸间服而消。
一小儿阴茎肿痛，腹内一块或作痛，或上攻，小便不调。此禀肝火为患，用龙胆泻肝汤、九味芦荟丸。愈后形气消
烁，发热作渴，此肝火制脾土而然也，用益气汤、芦荟丸、异功散而安。
一小儿阴茎作痒，搔破出水，小便赤涩，此禀肝肾阴虚火动，用龙胆泻肝汤清肝经湿热，佐以地黄丸补肾肝阴虚而
愈。后乳母恼怒，小便涩滞，两肋肿痛，儿阴复痒，惊搐困倦，用异攻散以补脾土，用地黄丸以滋肾肝而愈。
一小儿十五岁，患下疳久不愈，形气骨立，不时寒热，小便不利，饮食少思，此禀肝疳虚羸也，朝用益气汤以培胃
气，夕用地黄丸以滋肾水为主，佐以九味芦荟丸治疳而痊。
一女子十五岁，面青善怒，体瘦作渴，天癸未至，不时寒热，口舌生疮，后患阴疮湿痒，无寐善惊，此禀肝脾虚羸
之变症也，当先救脾气。遂朝用补中益气汤，夕用加味归脾汤，诸症渐愈，却佐以九味芦荟丸而痊。
一女子十四岁，禀肝经湿热，肌体消瘦，寒热如疟，下部患疮，先用加味小柴胡汤，寒热顿退，但晡热少食，用加
味逍遥散为主，以九味芦荟丸为佐而愈。出嫁后前症仍作，另用杂药，疮口翻出如菌，余用龙胆泻肝汤、加味逍遥散而
愈。
一小儿十五岁，患下疳，书课过劳，即寒热头痛，形气殊倦，腿足疲软，左关脉洪数，左尺脉洪数而无力。余谓∶
此禀肝肾阴虚，兼饮食劳役之症也，宜先调补胃气以滋化源。不信，或以为阴虚湿热下流，恪服四苓、四物之类，诸症
益甚。余曰∶阴虚，谓脾经虚也。脾为至阴，以丁火为母，虚则宜补丁火以生己土；肾属水，以辛金为母，肾虚则宜补
辛金，生癸水也。今因脾经阳弱而阴虚，反用沉寒之剂，复伤阳气，以绝化生之源，欲保其不危，难矣！果殁。
龙胆泻肝汤 治肝经湿热不利，下部生疮，两拗肿痛，或腹中作痛，小便涩滞等症。
龙胆草（酒拌炒黄） 泽泻 车前子（炒） 木通 生地黄（酒拌） 当归（酒拌） 山栀 黄芩（炒） 甘草（各
等分）
上水煎，食前服。
加味小柴胡汤（即小柴胡加山栀、牡丹皮） 治肝胆经有热，下部湿疮，寒热晡热潮热等症。（方见热毒瘰 。）
六味丸 治肝肾阴虚，下部生疮；或发热作渴，小便频数；或肾水不足，而不能生肝木，致血燥筋挛，颔项肢
节等处结核；或溃而不能收敛；或肝肾虚弱，发热盗汗，肢体消瘦，小便赤涩，尿血下血；或大小便牵痛，气短痰嗽，
吐血眩晕，耳聋口燥，齿痛失音，腰腿疲软，此皆禀不足也。（方见作渴不止）
敷药必效散 治下疳腐溃作痛。
黄连 黄柏 龙胆草（各一两） 轻粉（五分）
上为末，油调搽，入片脑更效，若用当归膏调敷尤佳。
如圣散 治下疳腐久不愈。
五倍子（二钱） 片脑（一钱） 黄连（五分） 芦甘石（ ，三分）
上各为末，干敷，毒未尽者加黄连末三分。
九味芦荟丸（方见喉痹）
加味清胃散（方见热毒口疮）
圣愈汤（方见出血不止）
补中益气汤（方见肌肉不生）
八珍汤（方见发热不止）
加味归脾汤（方见胁痈）
四君子汤（方见腹痈）
仙方活命饮
托里消毒散（二方见热毒疮疡）
下疳（生殖器部位的溃疡）和阴痿（阴茎勃起功能障碍），都属于肝火湿热，或者是先天禀赋导致的肝经阴虚。出现肿痛发热的症状，是肝火湿热的表现，治疗应先用加味小柴胡汤，再用龙胆泻肝汤。如果肿痛且小便色赤，这是肝火兼阴虚的表现，使用加味逍遥散加入龙胆草、生地黄。如果溃烂后肿痛不消退，用小柴胡汤加入川芎、当归、黄芪。如果溃烂后肿痛已经消退，使用四物汤加入牡丹皮、柴胡。因为肝属木，得到雨露滋润则茂盛，遇到烈日暴晒则萎软，如果错误地认为是虚寒证，投用热性药物，轻则导致阴囊和阴茎生疮，重则腐烂难以愈合，这些情况都适宜滋补肾水以涵养肝木、清泻肝火。所以说：肝气热则导致茎痿，宗筋弛纵无力，阴茎肿胀，或者流出白色液体，或者瘙痒疼痛，伴有里急后重、筋脉拘挛收缩，阴茎挺举或松弛无法收回，或者精液外泄、大便下血，这叫做筋疝，都是肝火所致。
黄宗伯的小儿子刚出生时，母亲将他抛弃在水中，过了一天没死，又被收留抚养，于是患上了喘咳病，下巴、腋下、手臂和大腿各处结块成核，溃破后颜色紫暗，误触会痛彻心扉，服用辛温化毒等药剂无效，当时他已经二十岁左右。我说：刚出生时的喘咳，是因为形体受寒损伤了肺脏；长大后的咳嗽，是肝火刑克肺金所致，所以结核都发生在肝胆所属的部位。开始使用补中益气汤，后来使用九味芦荟丸，不到一个月各种症状全部痊愈。这是禀受母亲的肝火而患的病。
有一个小儿下疳溃烂，发热口渴，傍晚时分尤其严重，这是肝疳且脾气虚弱，使用补中益气汤，后来使用九味芦荟丸，各种症状全部痊愈。
有一个小儿两岁，阴茎萎软潮湿瘙痒，时常流出白色津液，我认为是肝火，家属不信，有人给他服用温补肾经的药物，后来阴囊肿胀，阴茎内部疼痛，我用龙胆泻肝汤、六味地黄丸治愈。
有一个小儿睾丸疼痛，小便红赤涩痛，恶寒发热并伴有呕吐，这是肝火湿热导致的气机不利，用小柴胡汤加入山栀、车前子、茯苓而愈。（睾丸即阴子。）
有一个小儿睾丸肿痛，小便黄赤涩滞，恶寒发热口渴，这是肝火所致，用小柴胡汤加入柴胡、车前子，并与九味芦荟丸交替服用而消散。
有一个小儿阴茎肿痛，腹部有一块肿块有时作痛，有时向上攻冲，小便不调。这是禀受肝火为患，使用龙胆泻肝汤、九味芦荟丸。痊愈后形体消瘦，发热口渴，这是肝火克制脾土所致，使用益气汤、芦荟丸、异功散而安定。
有一个小儿阴茎瘙痒，抓破后出水，小便红赤涩痛，这是禀受肝肾阴虚、虚火妄动所致，使用龙胆泻肝汤清泻肝经湿热，佐以地黄丸滋补肝肾阴虚而愈。后来乳母恼怒，导致小便涩滞，两肋肿痛，婴儿阴部再次瘙痒，出现惊厥抽搐、困倦乏力，使用异功散补益脾土，用地黄丸滋补肾肝而愈。
有一个十五岁的小儿，患下疳久治不愈，形体枯瘦如骨立，不时恶寒发热，小便不利，饮食减少思虑不足，这是禀受肝疳导致的身体虚弱羸瘦，早晨服用益气汤以培补胃气，晚上服用地黄丸以滋补肾水为主，佐以九味芦荟丸治疗疳疾而痊愈。
有一个十五岁的女子，面色青黄易怒，身体消瘦口渴，月经尚未初潮，不时恶寒发热，口舌生疮，后来患阴部疮疡潮湿瘙痒，失眠多惊，这是禀受肝脾虚弱羸瘦的变症，应当先救脾气。于是早晨服用补中益气汤，晚上服用加味归脾汤，各种症状逐渐痊愈，却佐以九味芦荟丸而痊愈。
有一个十四岁的女子，禀受肝经湿热，肌体消瘦，恶寒发热像疟疾一样，下部患疮，先用加味小柴胡汤，寒热顿时退去，但只有下午发热、食欲少，以加味逍遥散为主，以九味芦荟丸为佐而愈。出嫁后前症仍然发作，另用杂药，疮口翻出像菌类一样，我用龙胆泻肝汤、加味逍遥散而愈。
有一个十五岁的小儿，患下疳，读书功课过度劳累，随即出现恶寒发热头痛，形体气息特别疲倦，腿脚疲软，左关脉洪大数急，左尺脉洪大数急而无力。我说：这是禀受肝肾阴虚，兼有饮食劳役的症状，适宜先调补胃气以滋养化源。家属不信，有人以为是阴虚湿热下流，严格服用四苓散、四物汤之类的药物，各种症状更加严重。我说：所谓阴虚，是指脾经虚弱。脾属于至阴，以丁火为母，虚弱时应该补丁火以生己土；肾属于水，以辛金为母，肾虚时应该补辛金，以生癸水。现在因为脾经阳气虚弱而导致阴虚，反而使用沉寒的药物，再次损伤阳气，断绝化生的源头，想要保全他不危险，很难啊！果然死亡。
龙胆泻肝汤 治疗肝经湿热不利，下部生疮，两胁肿痛，或者腹中作痛，小便涩滞等症状。
龙胆草（酒拌炒黄） 泽泻 车前子（炒） 木通 生地黄（酒拌） 当归（酒拌） 山栀 黄芩（炒） 甘草（各等分）
以上用水煎煮，饭前服用。
加味小柴胡汤（即小柴胡汤加山栀、牡丹皮） 治疗肝胆经有热，下部湿疮，寒热及下午潮热等症状。（方剂见热毒瘰疬。）
六味丸 治疗肝肾阴虚，下部生疮；或者发热口渴，小便频数；或者肾水不足，不能生肝木，导致血燥筋脉拘挛，下巴、颈部、肢体关节等处结核；或者溃破而不能收敛；或者肝肾虚弱，发热盗汗，肢体消瘦，小便红赤涩痛，尿血便血；或者大小便牵拉疼痛，气短痰咳，吐血眩晕，耳聋口燥，牙齿疼痛失音，腰腿疲软，这些都是禀赋不足所致。（方剂见作渴不止）
敷药必效散 治疗下疳腐烂溃破作痛。
黄连 黄柏 龙胆草（各一两） 轻粉（五分）
以上研为粉末，用油调和涂抹，加入冰片效果更好，如果用当归膏调敷尤其佳。
如圣散 治疗下疳腐烂久治不愈。
五倍子（二钱） 冰片（一钱） 黄连（五分） 炉甘石（煅，三分）
以上分别研为粉末，干敷，毒素未尽者加黄连末三分。
九味芦荟丸（方剂见喉痹）
加味清胃散（方剂见热毒口疮）
圣愈汤（方剂见出血不止）
补中益气汤（方剂见肌肉不生）
八珍汤（方剂见发热不止）
加味归脾汤（方剂见胁痈）
四君子汤（方剂见腹痈）
仙方活命饮
托里消毒散（两个方剂见热毒疮疡）
Yin gan (ulcers of the genitalia) and yin wei (impotence) all belong to Liver fire with damp-heat, or are due to congenital Yin deficiency of the Liver meridian. If there is swelling, pain, and fever, it is Liver fire with damp-heat; treat first with Jia Wei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction), then use Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction). If there is swelling, pain, and dark urine, it is Liver fire with Yin deficiency; use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) added with Long Dan Cao (Radix Gentianae Scabrae) and Sheng Di Huang (Rhizoma Rehmanniae Recens). If ulcerated but swelling and pain do not subside, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Xiong (Rhizoma Chuanxiong), Gui (Radix Angelicae Sinensis), and Huang Qi (Radix Astragali Membranacei). If ulcerated but swelling and pain have subsided, use Si Wu Tang (Four Substances Decoction) added with Mu Dan Pi (Cortex Moutan Radicis) and Chai Hu (Radix Bupleuri). The Liver belongs to Wood; it thrives when nourished by rain and dew, but wilts under scorching sun. If mistakenly treated as cold-deficiency and administered hot-pungent drugs, mild cases may result in sores on the scrotum and penis, while severe cases may lead to putrefaction that is difficult to heal. All such conditions should be treated by nourishing Kidney Water to generate Liver Wood and clearing Liver Fire. Thus it is said: When Liver Qi is hot, the penis becomes flaccid, the Zong Jin (confluence of sinews) relaxes, the penis swells, white discharge may occur, or there may be itching and pain, tenesmus, and tendon contraction; the penis may remain erect or flaccid without control, or semen may leak and blood pass in stool. This is called Jin Shan (Sinew Hernia), all caused by Liver Fire.
The youngest son of Huang Zongbo was abandoned in water at birth but survived after a day and was taken back, subsequently developing asthma and cough. Lumps formed and ulcerated in his chin, axillae, arms, and thighs, turning purple; touching them caused excruciating pain. Treatment with acrid-warm detoxifying agents failed. By age twenty, I said: The asthma at birth was due to cold damaging the Lung; the subsequent cough is due to Liver Fire insulting the Lung, hence the tubercles are located in the Liver and Gallbladder regions. Initially, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used, followed by Jiu Wei Lu Hui Wan (Nine-Ingredient Aloe Pill), and within a month all symptoms resolved. This illness was contracted from the mother's Liver Fire.
A child suffered from ulcerated Yin gan with fever and thirst, worse in the late afternoon. This is Liver Gan (worm disease associated with the Liver) with Spleen Qi deficiency. Use Bu Zhong Yi Qi Tang, followed by Jiu Wei Lu Hui Wan, resulting in complete recovery.
A two-year-old child had a flaccid, damp, and itchy penis with occasional white discharge. I diagnosed Liver Fire, but the family disagreed. Another physician prescribed warm-tonifying Kidney channel herbs, leading to scrotal swelling and penile pain. I cured him using Long Dan Xie Gan Tang and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia).
A child presented with testicular pain, red and scanty urination, aversion to cold, fever, and vomiting. This is Liver fire and damp-heat causing obstruction. Cure was achieved with Xiao Chai Hu Tang added with Shan Zhi (Fructus Gardeniae Jasminoidis), Che Qian Zi (Semen Plantaginis), and Fu Ling (Poria). (Testicles are referred to as Yin Zi.)
A child had swollen and painful testicles, yellow and obstructed urination, aversion to cold, fever, and thirst. This is caused by Liver Fire. Cure was achieved with Xiao Chai Hu Tang added with Chai Hu and Che Qian Zi, alternating with Jiu Wei Lu Hui Wan.
A child had a swollen and painful penis, an abdominal mass causing intermittent pain or upward rushing, and irregular urination. This is caused by inherited Liver Fire. Use Long Dan Xie Gan Tang and Jiu Wei Lu Hui Wan. After recovery, the child became emaciated with fever and thirst, indicating Liver Fire suppressing Spleen Earth. Stability was restored with Yi Qi Tang (Qi-Tonifying Decoction), Lu Hui Wan (Aloe Pill), and Yi Gong San (Benefit the Work Powder).
A child had an itchy penis, broken by scratching with weeping exudate, and red, obstructed urination. This is due to inherited Liver-Kidney Yin deficiency with hyperactive fire. Use Long Dan Xie Gan Tang to clear Liver meridian damp-heat, assisted by Di Huang Wan (Rehmannia Pill) to nourish Liver-Kidney Yin. Later, the wet nurse's anger caused obstructed urination and bilateral hypochondriac swelling/pain, leading to recurrent penile itching, fright convulsions, and fatigue. Yi Gong San was used to tonify Spleen Earth, and Di Huang Wan to nourish Liver-Kidney Yin, resulting in cure.
A fifteen-year-old boy had chronic Yin gan, appearing skeletal with intermittent chills and fever, difficult urination, and poor appetite. This is congenital Liver Gan causing emaciation. Morning administration of Yi Qi Tang to cultivate Stomach Qi, evening administration of Di Huang Wan to nourish Kidney Water, assisted by Jiu Wei Lu Hui Wan for Gan disease, led to recovery.
A fifteen-year-old girl presented with a bluish complexion, irritability, emaciation, thirst, amenorrhea, intermittent chills and fever, and oral ulcers. She later developed vulvar sores with dampness and itching, insomnia, and fright. These are variations of inherited Liver-Spleen deficiency and emaciation; prioritize rescuing Spleen Qi. Morning use of Bu Zhong Yi Qi Tang, evening use of Jia Wei Gui Pi Tang (Modified Spleen-Restoring Decoction), gradually resolved symptoms, assisted by Jiu Wei Lu Hui Wan for full recovery.
A fourteen-year-old girl had inherited Liver meridian damp-heat, emaciation, and malaria-like chills and fever, with lower body sores. Initial treatment with Jia Wei Xiao Chai Hu Tang rapidly resolved chills and fever, but afternoon fever and poor appetite persisted. Treated primarily with Jia Wei Xiao Yao San, assisted by Jiu Wei Lu Hui Wan, resulted in cure. After marriage, symptoms recurred due to miscellaneous drugs, causing fungating sores. Cured with Long Dan Xie Gan Tang and Jia Wei Xiao Yao San.
A fifteen-year-old boy had Yin gan; excessive study and labor induced chills, fever, headache, extreme fatigue, and weak legs. The left Guan pulse was surging and rapid; the left Chi pulse was surging, rapid, and deficient. I stated this is inherited Liver-Kidney Yin deficiency complicated by dietary and occupational strain; initially regulate and tonify Stomach Qi to nourish the source of transformation. Disregarded, he was treated for Yin deficiency with damp-heat sinking using Si Ling San (Four-Poria Powder) and Si Wu Tang, worsening symptoms. I explained: Yin deficiency here refers to Spleen meridian deficiency. The Spleen is Supreme Yin, with Ding Fire as its mother; deficiency requires tonifying Ding Fire to generate Ji Earth. The Kidney belongs to Water, with Xin Metal as its mother; Kidney deficiency requires tonifying Xin Metal to generate Gui Water. Now, due to weak Spleen Yang causing apparent Yin deficiency, heavy-cold drugs were used, further damaging Yang Qi and cutting off the source of generation. Survival was unlikely. He indeed died.
Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction): Treats Liver meridian damp-heat obstruction, lower body sores, bilateral hypochondriac swelling/pain, abdominal pain, and obstructed urination.
Ingredients: Long Dan Cao (Radix Gentianae Scabrae, stir-fried with wine), Ze Xie (Rhizoma Alismatis), Che Qian Zi (Semen Plantaginis, stir-fried), Mu Tong (Caulis Akebiae), Sheng Di Huang (Rhizoma Rehmanniae Recens, mixed with wine), Dang Gui (Radix Angelicae Sinensis, mixed with wine), Shan Zhi (Fructus Gardeniae Jasminoidis), Huang Qin (Radix Scutellariae Baicalensis, stir-fried), Gan Cao (Radix Glycyrrhizae Uralensis). Equal parts.
Decoct in water, take before meals.
Jia Wei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction): i.e., Xiao Chai Hu Tang added with Shan Zhi and Mu Dan Pi. Treats heat in Liver/Gallbladder meridians, lower body damp sores, chills/fever, and afternoon tidal fever. (Formula see Re Du Luo Li [Heat-Toxin Scrofula].)
Liu Wei Wan (Six-Ingredient Pill): Treats Liver-Kidney Yin deficiency with lower body sores; or fever/thirst, frequent urination; or insufficient Kidney Water failing to generate Liver Wood, causing dry Blood and tendon spasms, tubercles in chin/neck/extremities; or ulceration failing to heal; or Liver-Kidney weakness with fever/night sweats, emaciation, red/scanty urination, hematuria/hematochezia; or pain during defecation/urination, shortness of breath/phlegm-cough, hematemesis/dizziness, deafness/dry mouth, toothache/aphonia, weak waist/legs. These are all due to congenital insufficiency. (Formula see Ke Bu Zhi [Incessant Thirst].)
Fu Yao Bi Xiao San (Highly Effective External Application Powder): Treats painful putrefaction of Yin gan.
Ingredients: Huang Lian (Rhizoma Coptidis), Huang Bo (Cortex Phellodendri Amurensis), Long Dan Cao (Radix Gentianae Scabrae) (1 liang each); Qing Fen (Calomel) (5 fen).
Grind into powder, mix with oil for application. Adding Pian Nao (Borneolum Syntheticum) enhances efficacy; mixing with Dang Gui Gao (Angelica Ointment) is especially good.
Ru Sheng San (Like-Sage Powder): Treats chronic non-healing putrefaction of Yin gan.
Ingredients: Wu Bei Zi (Galla Chinensis) (2 qian), Pian Nao (Borneolum Syntheticum) (1 qian), Huang Lian (Rhizoma Coptidis) (5 fen), Lu Gan Shi (Calamina) (calcined, 3 fen).
Grind separately into powder, apply dry. If toxins remain incomplete, add 3 fen of Huang Lian powder.
Jiu Wei Lu Hui Wan (Nine-Ingredient Aloe Pill) (Formula see Hou Bi [Pharyngitis]).
Jia Wei Qing Wei San (Modified Clear Stomach Powder) (Formula see Re Du Kou Chuang [Heat-Toxin Mouth Ulcers]).
Sheng Yu Tang (Sage-Saving Decoction) (Formula see Chu Xue Bu Zhi [Unceasing Bleeding]).
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) (Formula see Ji Rou Bu Sheng [Failure of Muscle Regeneration]).
Ba Zhen Tang (Eight-Treasure Decoction) (Formula see Fa Re Bu Zhi [Unceasing Fever]).
Jia Wei Gui Pi Tang (Modified Spleen-Restoring Decoction) (Formula see Xie Yong [Hypochondriac Abscess]).
Si Jun Zi Tang (Four-Gentlemen Decoction) (Formula see Fu Yong [Abdominal Abscess]).
Xian Fang Huo Ming Yin (Immortal Formula for Preserving Life Decoction).
Tuo Li Xiao Du San (Support Interior and Eliminate Toxin Powder) (Two formulas see Re Du Chuang Yang [Heat-Toxin Sores and Ulcers]).