[总诀]男女前阴总属肝,肝经萦绕在其端。气抟湿热求真诀,按法施方本已探。
前阴痒湿,以及赤肿生疮者,肝经之湿热也。宜龙胆泻肝汤。
胆草(二钱) 泽泻(二钱) 车前(二钱) 甘草(一钱) 栀子(二钱) 木通(一钱) 柴胡(一
钱) 生地(三钱) 当归(二钱) 黄芩(三钱)
歌曰∶前阴痒湿总医肝,归地柴芩栀草攒。
前泽木通和胆草,湿除热退治何难。
阴囊胀结,痛引小腹以内者,肝经之疝气也。宜茴香五苓散。
小茴(二钱) 荔核(二钱) 橘核(一钱) 楝核(一钱) 归尾(三钱) 香附(三钱) 白术(二
钱) 台乌药(二钱) 猪苓(二钱) 泽泻(二钱) 桂尖(一钱) 槟榔(一钱) 云苓(三钱) 白芍
(二钱)
歌曰∶阴囊胀结用茴香,归芍云苓香附匡。
白术乌药猪共泽,荔枝楝橘与槟榔。
(伯未按∶方中酌加柴胡钱半。)
前阴暴缩,或兼转筋入腹者,肝肾之虚寒也。宜加味四逆汤。
干姜(二钱) 附子(二钱) 乌头(炮,一钱) 当归(三钱) 人参(二钱) 云苓(三钱) 甘草
(炙,二钱)
歌曰∶前阴暴缩总虚寒,姜附乌头急与餐。
苓草参归仍共济,不难填肾与温肝。
阴囊缩入,兼见舌卷心热者,肝经之热邪也。宜生犀泻肝汤。
生地(三钱) 犀角(二钱) 白芍(三钱) 大黄(一钱) 当归(二钱) 知母(三钱) 苁蓉(三
钱)
歌曰∶阴囊缩入舌兼收,地芍犀黄要急投。
知母当归清血热,苁蓉加入病能瘳。
阴茎虫蚀,以及妇人阴蚀者,古之狐惑病也。宜外洗苦参汤。
苦参、雄黄煎洗(亦可内服龙胆泻肝汤)。
歌曰∶阴茎虫蚀泻肝汤,龙草柴芩归地良。
前泽木通和胆草,苦参外洗合雄黄。
【总诀】
男女的前阴部位在中医理论中均归属于肝脏,足厥阴肝经的经脉环绕并连接于前阴末端。若气机郁结导致湿热蕴蒸,需寻求正确的诊疗法则,按照既定方法施治方剂,这已经是经过探索验证的有效途径。
前阴出现瘙痒、潮湿,以及红肿、生疮等症状,属于肝经湿热证。适宜使用龙胆泻肝汤(清泻肝胆实火、清利肝经湿热之方)。
药材组成:龙胆草(二钱)、泽泻(二钱)、车前子(二钱)、甘草(一钱)、栀子(二钱)、木通(一钱)、柴胡(一钱)、生地黄(三钱)、当归(二钱)、黄芩(三钱)。
歌诀曰:前阴瘙痒潮湿总由肝经病变引起,当归、生地黄、柴胡、黄芩、栀子、甘草汇聚一方。
泽泻、木通配合龙胆草,湿气去除、热邪退散,治疗有何困难?
阴囊肿胀结块,疼痛牵引至小腹内部者,属于肝经疝气病。适宜使用茴香五苓散(温肾暖肝、利水渗湿之方)。
药材组成:小茴香(二钱)、荔枝核(二钱)、橘核(一钱)、川楝子(二钱)、当归尾(三钱)、香附(三钱)、白术(二钱)、台乌药(二钱)、猪苓(二钱)、泽泻(二钱)、桂枝尖(一钱)、槟榔(一钱)、茯苓(三钱)、白芍(二钱)。
歌诀曰:阴囊肿胀结块宜用茴香等药,当归、白芍、茯苓、香附匡扶正气。
白术、乌药、猪苓与泽泻同用,加上荔枝核、川楝子、橘核及槟榔。
(伯未按语:方中酌情加入半钱柴胡。)
前阴突然收缩,或者兼有筋脉拘挛牵引入腹者,属于肝肾虚寒证。适宜使用加味四逆汤(回阳救逆、温补肝肾之方)。
药材组成:干姜(二钱)、附子(二钱)、乌头(炮制,一钱)、当归(三钱)、人参(二钱)、茯苓(三钱)、炙甘草(二钱)。
歌诀曰:前阴突然收缩总因虚寒所致,急用干姜、附子、乌头服用。
茯苓、甘草、人参、当归共同济助阳气,不难填补肾精与温暖肝脉。
阴囊缩入体内,同时见舌体卷曲、心中烦热者,属于肝经热邪证。适宜使用生犀泻肝汤(清热凉肝之方)。
药材组成:生地黄(三钱)、犀角(二钱)、白芍(三钱)、大黄(一钱)、当归(二钱)、知母(三钱)、肉苁蓉(三钱)。
歌诀曰:阴囊缩入且舌体卷曲紧缩,生地黄、白芍、犀角、大黄要紧急投用。
知母、当归清除血分热邪,加入肉苁蓉则疾病能愈。
阴茎如被虫蚀咬般不适,以及妇女外阴腐蚀溃烂者,即古代的狐惑病。适宜外用苦参汤清洗。
药材组成:苦参、雄黄煎水外洗(也可内服龙胆泻肝汤)。
歌诀曰:阴茎虫蚀感应泻肝汤,龙胆草、甘草、柴胡、黄芩、当归、生地黄疗效良好。
车前子、泽泻、木通配合龙胆草,苦参外洗合用雄黄。
[General Principle]
The external genitalia of both men and women are generally attributed to the Liver (Liver). The Foot-Jueyin Liver Meridian (Foot-Jueyin Gan Jing) winds around and connects to the extremity of the anterior yin. When qi stagnation leads to damp-heat accumulation, one must seek the correct therapeutic principle; applying formulas according to established methods has already been explored and verified.
Itching, dampness, redness, swelling, and ulceration of the anterior yin belong to Damp-Heat in the Liver Meridian (Damp-Heat in the Liver Channel). Longdan Xiegan Tang (Gentiana Decoction for Draining the Liver) is appropriate.
Ingredients: Gentianae Radix et Rhizoma (Longdancao, 2 qian), Alismatis Rhizoma (Zexie, 2 qian), Plantaginis Seed (Cheqian, 2 qian), Glycyrrhizae Radix et Rhizoma (Gancao, 1 qian), Gardeniae Fructus (Zhizi, 2 qian), Akebiae Caulis (Mutong, 1 qian), Bupleuri Radix (Chaihu, 1 qian), Rehmanniae Radix (Shengdi, 3 qian), Angelicae Sinensis Radix (Danggui, 2 qian), Scutellariae Radix (Huangqin, 3 qian).
Song says: Itching and dampness of the anterior yin are always treated via the Liver; Angelicae Sinensis Radix, Rehmanniae Radix, Bupleuri Radix, Scutellariae Radix, Gardeniae Fructus, and Glycyrrhizae Radix are gathered together.
Alismatis Rhizoma, Akebiae Caulis, and Gentianae Radix et Rhizoma combined; once dampness is removed and heat recedes, treatment is not difficult.
Swelling and induration of the scrotum, with pain radiating into the lower abdomen, belongs to Hernia Qi (Shan Qi) of the Liver Meridian. Huixiang Wuling San (Fennel Five-Ling Powder) is appropriate.
Ingredients: Foeniculi Fructus (Xiaohui, 2 qian), Litchi Semen (Lihe, 2 qian), Citri Reticulatae Pericarpium Viride (Juhe, 1 qian), Meliae Semen (Lianhe, 1 qian), Angelicae Sinensis Radix (Weibu, 3 qian), Cyperi Rhizoma (Xiangfu, 3 qian), Atractylodis Macrocephalae Rhizoma (Baizhu, 2 qian), Linderae Radix (Taiwuyao, 2 qian), Polyporus (Zhuling, 2 qian), Alismatis Rhizoma (Zexie, 2 qian), Cinnamomi Ramulus (Guijian, 1 qian), Arecae Semen (Binglang, 1 qian), Poria (Yunling, 3 qian), Paeoniae Radix Alba (Baishao, 2 qian).
Song says: For scrotal swelling and induration, use Foeniculi Fructus; Angelicae Sinensis Radix, Paeoniae Radix Alba, Poria, and Cyperi Rhizoma support the treatment.
Atractylodis Macrocephalae Rhizoma, Linderae Radix, Polyporus, and Alismatis Rhizoma together; add Litchi Semen, Meliae Semen, Citri Reticulatae Pericarpium Viride, and Arecae Semen.
(Note by Bo An: Add half a qian of Bupleuri Radix to the formula as appropriate.)
Sudden retraction of the anterior yin, or accompanied by spasms/tendon contraction pulling into the abdomen, belongs to Deficiency-Cold of the Liver and Kidney. Jiawei Sini Tang (Modified Four Reversal Decoction) is appropriate.
Ingredients: Zingiberis Rhizoma Recens (Ganjiang, 2 qian), Aconiti Lateralis Radix Praeparata (Fuzi, 2 qian), Aconiti Radix (Wutou, processed, 1 qian), Angelicae Sinensis Radix (Danggui, 3 qian), Ginseng Radix (Renshen, 2 qian), Poria (Yunling, 3 qian), Glycyrrhizae Radix et Rhizoma (Zhi Gancao, roasted, 2 qian).
Song says: Sudden retraction of the anterior yin is always due to Deficiency-Cold; quickly administer Ginger, Aconite, and Aconite Root.
Poria, Glycyrrhizae Radix et Rhizoma, Ginseng Radix, and Angelicae Sinensis Radix assist together; it is not difficult to tonify the Kidney and warm the Liver.
Retraction of the scrotum into the body, accompanied by tongue curling and heart heat, belongs to Heat Pathogen of the Liver Meridian. Shengxi Xiegan Tang (Raw Rhinoceros Horn Draining Liver Decoction) is appropriate.
Ingredients: Rehmanniae Radix (Shengdi, 3 qian), Rhinocerotis Cornu (Xijiao, 2 qian), Paeoniae Radix Alba (Baishao, 3 qian), Rhei Radix et Rhizoma (Dahuang, 1 qian), Angelicae Sinensis Radix (Danggui, 2 qian), Anemarrhenae Rhizoma (Zhimu, 3 qian), Cynomorii Herba (Congrong, 3 qian).
Song says: When the scrotum retracts and the tongue curls, Rehmanniae Radix, Paeoniae Radix Alba, Rhinocerotis Cornu, and Rhei Radix et Rhizoma should be administered urgently.
Anemarrhenae Rhizoma and Angelicae Sinensis Radix clear blood heat; adding Cynomorii Herba can cure the disease.
Erosion-like sensation of the penis, and erosion/ulceration of the female vulva, corresponds to the ancient disease of Huhu (Foxes' Illness). External washing with Kushen Tang (Sophora Decoction) is appropriate.
Ingredients: Sophorae Flavescentis Radix (Kushen), Realgar (Xionghuang) decocted for washing (Longdan Xiegan Tang may also be taken internally).
Song says: For penile erosion sensation, use the Draining Liver Decoction; Gentianae Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Bupleuri Radix, Scutellariae Radix, Angelicae Sinensis Radix, and Rehmanniae Radix are beneficial.
Plantaginis Seed, Alismatis Rhizoma, and Akebiae Caulis combine with Gentianae Radix et Rhizoma; Sophorae Flavescentis Radix externally washed combined with Realgar.