陈实功曰∶凡初婚玉茎挤夹伤损，出血疼痛者，先以葱汤洗净，随用珍珠散加
冰片掺之，腐皮渐干，痛自渐止矣。（《正宗》）
冯鲁瞻曰∶伤寒瘥后，若小便涩有血者，亦是余热毒也，名曰内外疮，亦皆有
靥。若不出脓者死，宜用黄连解毒汤加生地、当归尾、连翘、木通、滑石、牛膝、
蓄、琥珀、甘草梢之类。（《锦囊》）
王肯堂曰∶囊痈乃足厥阴肝经所主，乃湿热流入肝经而成，治当清肝家湿热，佐以养阴固肾。
又曰∶肾阴毒即阴囊疽，乃坐卧湿地，久着汗湿衣 ，寒湿下攻，阴注经络，久
而不散，遂生此证。初起阴囊红肿疼痛者是也。
朱丹溪曰∶囊痈即外肾痈也，此痈生阴囊之上，其证最酷，阴道多亏，湿热相
聚，致生此毒，若不速治则囊裂睾丸外悬，可用青荷叶包之，或紫苏叶洗去毛包之，或单油纸煮过包之。
陈远公曰∶有阴囊左右生痈者，名曰便毒，生于囊之下，粪门之前，名曰囊痈。
三处相较，便毒易治，囊痈最难治，以囊之下为悬痈，其皮肉与他处不同，在他处
皮肉或横生直生，俱易合口，而囊下横中有直，直中有横，不易收功，此皆少年贪
于酒色，忍精而战，耐饥而交，或苟合有毒之妇，或斗精有疮之妓，所谓欲泄不泄，
化为脓血是也。治必大补其虚，佐以化毒之味，以毒因虚而成，不治虚得乎！逐邪
至神丹∶金银花四两，蒲公英二两，人参一两，当归二两，生甘草一两，大黄五钱，
天花粉二钱，水煎，二服痊愈，溃者三剂收功。此方用金银花、公英佐以参归大黄
之大料，未免霸气。然大虚之证，又用大黄祛逐，似乎不宜。谁知毒盛乘初起之时，
正气未甚衰，大补泻火之为得乎！倘因循不敢治，及至流脓出血，正气萧索，始用
参补气，往往用至数斤，尚未能复元，何若早用于化毒之中，正又无伤，毒又易散，
此因势利导之法，不可不知也。（《冰鉴》）
又曰∶有饮火酒入房，精不得泄，至半夜寒热烦渴，小便淋赤，痰涎涌盛，次
日囊肿 痛，又次日囊处尽腐，玉茎下贴
囊者亦腐，人以为酒毒也，谁知肝火得酒毒湿而肆疟乎！夫酒何至作腐，盖火酒大
热之物也，人过饮火酒，多致醉死，死后身体腐烂，以火酒乃气，酒遇热自焚，人
身五脏六腑，原自有火，以火引火，安得不炎烧耶！饮火酒入房，鼓动精房之火，宜
是命门之火，非肝火也。然木能生火，肝本生相火，理之常也，入房借火酒之力，火
势必猛，火动无根，复能久乎，必精泄而火解矣。无奈精欲泄而阻抑之火无泄路，又
无可根据，火酒又无可解，于是火入于肝，将根据母自归也。惟是相火内火也，可附肝以
为家，而酒火外火也，反得木而焚体，囊与玉茎，乃筋之火也，筋属肝，因入房而
聚阴器之际，故火发而囊肿，囊肿极而茎亦腐矣。治法解酒之毒，益以补气血之品，
则湿热解而腐肉长矣。用救腐汤∶人参一两，当归二两，黄 二两，白术一两，茯
苓五钱，黄柏三钱，炒栀子三钱，苡仁五钱，泽泻三钱，白芍一两，葛根三钱，水
煎服。四剂腐肉去而新肉生，又四剂囊茎悉平复矣。酒毒成于拂抑，平肝泄火，利
湿解毒宜也。何以用参、 、归、术大补气血耶？大凡气血盛者，力能胜酒，纵酣
饮无碍，服火酒而腐，必成于火酒之毒，亦其气血之衰，力难胜酒，所以两火相合，遂
至焚身外腐，苟不急补气血，则酒毒难消，腐肉又何以速长哉！
陈实功曰∶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，时人误用疝家热药，
多致热甚为脓，必难收敛。初宜龙胆泻肝汤，稍久滋阴，外敷金黄散，如肿痛日久，
内脓已成，胀痛者即针之，内服十全大补汤加山萸肉、丹皮、泽泻治之，间以六味
地黄丸服之，自安。（《正宗》）
冯鲁瞻曰∶书曰痈疽入囊者死，是属肝经湿热，初起肿痛，小便赤涩，治宜清
利解毒为主。若脓已成而小便不利者，是
毒瓦斯未散也，当针泄之。若脓既出而反痛者，是气血虚也，当补益之。倘元气未亏
而阴囊悉溃，睾丸悬露者，亦不为害。（《锦囊》）
又曰∶若小儿患此，而由乳母多怒者，宜子母并服清肝之药。
又曰∶阴囊溃烂，睾丸脱露，名曰脱囊。用紫苏叶茎为细末，如湿干敷，如未
破用香油调涂，将青荷叶包上，内服芩、连、甘草、木通、当归之类，多得保全，患者勿惧。
窦汉卿曰∶囊痈倘脓熟开刀，须待脓热用油头绳扎住肾子，以小刀开海底穴，其脓血即流尽矣。
李东垣曰∶经谓痈入囊者死，将以为属肾耶？余治数人，悉以湿热入肝经施治，
而以补阴药佐之，虽脓溃皮脱，睾丸悬外，亦不致死，但未知下虚人老者何如耳。（《精要》）
汪省之曰∶囊痈乃湿热下注，浊气顺下流入膀胱，阴道有亏，湿热不利，有作
脓者，故滋阴除湿之药断不可缺，脓尽则自安耳。（《理例》）
胡公弼曰∶又有因腹肿胀，渐流入囊，肿甚而囊自裂开，睾丸悬挂在外，水出不
止，用杉木炭末敷上，外以紫苏叶浓浓包裹，令患人仰卧养息，内以龙胆泻肝汤加
滋阴药，服之自愈。（《青囊》）
陈实功说：凡是新婚之夜阴茎受到挤压夹伤，出现出血疼痛的情况，先用葱汤清洗伤口，随后使用珍珠散加入冰片撒在患处，腐烂的皮肤逐渐干燥，疼痛自然就会慢慢停止。（《外科正宗》）
冯鲁瞻说：伤寒病痊愈后，如果小便涩痛且带血，这也是余热毒邪所致，称为“内外疮”，通常都会有结痂。如果无法排出脓液则预后不良（致死），适宜使用黄连解毒汤，加入生地黄、当归尾、连翘、木通、滑石、牛膝、蓄草、琥珀、甘草梢等药物。（《外科锦囊》）
王肯堂说：囊痈属于足厥阴肝经所主，是由湿热之邪流入肝经而形成的，治疗应当清泻肝经的湿热，辅以滋养阴液、固护肾脏的方法。他又说：肾阴毒即阴囊疽，是由于坐卧湿地，长期穿着汗湿的衣服，寒湿之邪向下侵袭，注入经络，日久不散，从而产生此证。初起时表现为阴囊红肿疼痛。
朱丹溪说：囊痈即外肾痈，这种痈肿生在阴囊上方，病情最为严重，导致阴道亏损，湿热聚集，从而生成此毒。如果不迅速治疗，会导致阴囊破裂、睾丸外悬，可用青荷叶包裹，或用紫苏叶去毛后包裹，或者用单张油纸煮过后包裹。
陈远公说：阴囊左右两侧生痈的，称为“便毒”；生于阴囊下方、肛门之前的，称为“囊痈”。比较这三处病变，便毒容易治疗，囊痈最难治疗，因为阴囊下方为悬痈部位，其皮肉结构与身体其他部位不同，在其他部位皮肉无论横生还是直生都容易愈合收口，而阴囊下方纵横交错，不易收功。这都是因为年轻人贪图酒色，强忍精液行房，忍受饥饿交合，或与患有梅毒的女子苟合，或与患有疮疡的妓女交合，所谓欲泄而不能泄，化为脓血。治疗必须大补正气之虚，辅以化解毒邪的药物，因为毒邪是因虚而成，不补虚能行吗？逐邪至神丹方：金银花四两，蒲公英二两，人参一两，当归二两，生甘草一两，大黄五钱，天花粉二钱，水煎服，服用两剂可痊愈，溃烂者三剂可收功。此方重用金银花、蒲公英，佐以人参、当归、大黄等大剂量药物，未免气势太猛。但对于大虚之证，又用大黄祛逐邪气，似乎不太适宜。殊不知毒势旺盛趁着初起之时，正气尚未极度衰弱，采用大补兼泻火的方法是得当的！倘若因循守旧不敢治疗，等到流脓出血，正气萧条时，才开始用人参补气，往往用到几斤重，尚不能恢复元气，何不如早用于化解毒邪的过程中，既保护正气，又易于消散毒邪，这是因势利导的方法，不可不知道。（《石室秘录》）
他又说：有人饮酒后行房，精液不得排泄，到了半夜出现寒热、烦躁口渴，小便淋沥赤痛，痰涎涌盛，第二天阴囊肿痛，第三天阴囊处全部腐烂，贴附于阴囊下方的阴茎也腐烂了。人们以为是酒毒所致，殊不知是肝火得到酒毒和湿气助长而肆虐！酒怎么会导致腐烂呢？盖烈酒是大热之物，人过量饮用烈酒，多导致醉死，死后身体腐烂，是因为烈酒属气，酒遇热自焚，人身五脏六腑原本就有火，以火引火，怎能不炎烧呢！饮烈酒后行房，鼓动精室之火，这应该是命门之火，而非肝火。然而木能生火，肝本相生相火，这是常理。入房借助烈酒之力，火势必然猛烈，火动无根，又能维持多久呢？必定是精液泄出而火气解散。无奈精欲泄却被阻抑，火无泄路，又无可依托，烈酒又无法化解，于是火入于肝，根据母体归属肝脏。只是相火是内火，可以依附肝脏为家，而酒火是外火，反而借木性焚烧躯体，阴囊与阴茎，乃是筋之火，筋归属于肝，因为在行房聚集于阴器之际，所以火发导致阴囊肿胀，肿胀至极则阴茎也腐烂了。治疗方法应解酒毒，辅以补气血的药物，则湿热解除，腐肉生长。救腐汤方：人参一两，当归二两，黄芪二两，白术一两，茯苓五钱，黄柏三钱，炒栀子三钱，薏苡仁五钱，泽泻三钱，白芍一两，葛根三钱，水煎服。服用四剂腐肉去除新肉生长，再服四剂阴囊阴茎完全平复。酒毒成因在于情志拂抑，平肝泄火、利湿解毒是适宜的。为何用人参、黄芪、当归、白术大补气血呢？大凡气血旺盛者，力量能胜酒力，即使酣饮也无妨碍，服用烈酒导致腐烂，必然是因为气血衰弱，力量难以胜任酒力，所以两火相合，导致焚烧身体外部腐烂，如果不紧急补益气血，则酒毒难消，腐肉又怎能快速生长呢！
陈实功说：囊痈，是阴虚湿热流注于阴囊，凝结而成肿块，到溃破后睾丸悬挂的，还不伤人，因为毒邪从外部发散，治疗应当滋补阴液、清利湿热，见效者十有八九。世人误用治疝气的热药，多导致热势更盛化为脓液，必定难以收敛。初起适宜用龙胆泻肝汤，稍久之后滋阴，外用金黄散敷贴。如果肿痛日久，内部脓液已成，感到胀痛的就针刺排脓，内服十全大补汤加山茱萸、牡丹皮、泽泻治疗，间或服用六味地黄丸，自然平安。（《外科正宗》）
冯鲁瞻说：医书说痈疽进入阴囊者死，这属于肝经湿热，初起肿痛，小便赤涩，治疗应以清利解毒为主。如果脓液已成而小便不利，是毒气未散，应当针刺泄脓。如果脓液已出反而疼痛，是气血虚弱，应当补益。倘若元气未亏而阴囊全部溃烂，睾丸悬露的，也不会有危害。（《外科锦囊》）
他又说：如果小儿患此病，由乳母多怒引起，宜母子同服清肝药物。
他又说：阴囊溃烂，睾丸脱出外露，称为“脱囊”。用紫苏叶茎研成细末，如湿润则干敷，如未破溃用香油调匀涂抹，再用青荷叶包裹在内，内服黄芩、黄连、甘草、木通、当归等药物，大多能保全性命，患者不必恐惧。
窦汉卿说：囊痈如果脓熟需要开刀，必须等待脓液成熟，用油头绳扎住睾丸，用小刀切开海底穴，脓血即可流尽。
李东垣说：经文说痈入阴囊者死，难道认为是属于肾脏吗？我治疗了几个人，都是用湿热入肝经来施治，并辅以滋阴药物，虽然脓溃皮脱，睾丸悬在外，也没有致死，只是不知道下元虚损的老人情况如何罢了。（《外科精要》）
汪省之说：囊痈是湿热下注，浊气顺行流入膀胱，阴道亏损，湿热不利，有的化作脓液，所以滋阴除湿的药物绝对不可缺少，脓液排尽则自然平安。（《外科理例》）
胡公弼说：又有因腹部肿胀，逐渐流入阴囊，肿胀严重而阴囊自行裂开，睾丸悬挂在外，水流不止，用杉木炭末敷上，外用紫苏叶浓密包裹，让患者仰卧休息，内服龙胆泻肝汤加滋阴药物，服用后自愈。（《青囊秘传》）
Chen Shigong stated: In cases of penile injury due to squeezing or clamping during the first marriage, presenting with bleeding and pain, one should first wash the wound with scallion soup. Subsequently, apply Zhenzhu San (Pearl Powder) mixed with Bingpian (Borneol) topically. As the necrotic skin gradually dries, the pain will naturally subside. (*Waike Zhengzong*)
Feng Luzhan stated: After recovery from Shanghan (Cold Damage), if there is astringency in urination accompanied by blood, this is also caused by residual heat and toxin, termed "Nei Wai Chuang" (Internal and External Sores), which typically form crusts. If pus cannot be discharged, the prognosis is fatal. The appropriate prescription is Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) added with Shengdihuang (Rehmanniae Radix Recens), Dangguizhiwei (Angelicae Sinensis Radix Caudex), Lianqiao (Forsythiae Fructus), Mutong (Akebiae Caulis), Huashi (Talcum), Niuxi (Achyranthis Bidentatae Radix), Xianshe (Dichroae Radix), Hupo (Succinum), and Gancaoshao (Glycyrrhizae Radix et Rhizoma Tip). (*Waike Jinang*)
Wang Kentang stated: Nang Yong (Scrotal Abscess) is governed by the Foot Jueyin Liver Meridian and results from damp-heat flowing into the Liver Meridian. Treatment should focus on clearing damp-heat from the Liver, assisted by nourishing Yin and consolidating the Kidney. He further stated: Shen Yin Du (Kidney Yin Toxin), also known as Scrotal Carbuncle, arises from sitting or lying on damp ground or wearing sweat-dampened clothes for long periods. Cold-dampness attacks downward, injecting into the meridians, and persists without dispersing, leading to this condition. It initially presents as redness, swelling, and pain of the scrotum.
Zhu Danxi stated: Nang Yong is also called Waishen Yong (External Genital Abscess). This sore occurs on the upper part of the scrotum; its manifestation is most severe, causing deficiency of the Vagina (Yin Dao). Damp-heat gathers, generating this toxin. If not treated promptly, the scrotum may rupture and the testicles may hang outside. One can wrap them with fresh green lotus leaves, or with Perilla leaves (after removing hairs), or with boiled single-layer oil paper.
Chen Yuangong stated: Sores appearing on the left and right sides of the scrotum are named Biandu (Genital Swelling); those appearing below the scrotum and anterior to the anus are named Nang Yong (Scrotal Abscess). Comparing these three locations, Biandu is easy to treat, while Nang Yong is the most difficult. This is because the area below the scrotum, the Huan Yuan (Perineum), has different skin and flesh structure compared to other parts. On other parts, whether growing horizontally or vertically, wounds heal easily. However, the perineum has complex horizontal and vertical structures, making it hard to close. These conditions often result from young men indulging in alcohol and sex, suppressing ejaculation during intercourse, having sex while hungry, or engaging in coitus with women carrying venereal diseases or prostitutes with sores. This is what is meant by "desire to ejaculate but unable to, transforming into pus and blood." Treatment must strongly tonify deficiency and assist with ingredients that resolve toxins, because the toxin arises from deficiency; how can it be cured without treating the deficiency? The formula Zhuxie Zhishen Dan (Toxin-Expelling Divine Pill): Jinyinhua (Lonicerae Japonicae Flos) 4 liang, Gongying (Taraxaci Herba) 2 liang, Renshen (Ginseng Radix) 1 liang, Danggui (Angelicae Sinensis Radix) 2 liang, Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) 1 liang, Dahuang (Rhei Radix et Rhizoma) 5 qian, Tianhuafen (Trichosanthis Radix) 2 qian. Decoct in water. Two doses lead to recovery; for ulcerated cases, three doses achieve healing. This formula uses large doses of Jinyinhua and Gongying, assisted by substantial amounts of Renshen, Danggui, and Dahuang, which may seem too aggressive. However, for severe deficiency, using Dahuang to purge seems inappropriate. Yet, when toxin strength is high at the onset, and righteous Qi is not yet severely depleted, using strong tonification combined with purging fire is appropriate! If one hesitates and dares not treat, waiting until pus flows and blood bleeds, when righteous Qi is exhausted, and then starts using Renshen to tonify Qi, often requiring several jin, still failing to restore vitality, why not use it early within the process of resolving toxins? This protects righteous Qi and facilitates toxin dispersion. This is the method of guiding according to the trend, which must be understood. (*Shishi Milu*)
He further stated: Some individuals drink strong liquor and engage in sexual activity, preventing ejaculation. By midnight, they experience chills, fever, restlessness, thirst, dysuria with red urine, and profuse phlegm-saliva. The next day, the scrotum swells and hurts. The following day, the entire scrotum becomes necrotic, and the penis adhering to the scrotum also rots. People attribute this to liquor toxicity, unaware that Liver Fire is exacerbated by liquor toxin and dampness. How can liquor cause rotting? Strong liquor is extremely hot. Excessive drinking often leads to death from drunkenness, after which the body rots. This is because liquor is qi; when liquor meets heat, it burns itself. The five zang and six fu organs inherently possess fire. Using fire to attract fire, how can inflammation not occur? Drinking strong liquor before sex stirs the fire of the essence chamber, which should be Mingmen Fire (Gate of Life Fire), not Liver Fire. However, Wood generates Fire; the Liver naturally generates Ministerial Fire, which is normal. With the aid of strong liquor during sex, the fire force becomes fierce. Fire moving without root, how can it last? It must cease when essence is released. Unfortunately, the desire to release is suppressed, leaving no outlet for the fire, no foundation to rely on, and no way to resolve the liquor. Thus, fire enters the Liver, returning to its mother organ. Ministerial fire is internal fire, able to attach to the Liver as home. Liquor fire is external fire, which instead burns the body through Wood. The scrotum and penis are fire of the sinews; sinews belong to the Liver. Due to gathering in the yin organs during sex, fire erupts causing scrotal swelling. Extreme swelling leads to penile necrosis. Treatment should resolve liquor toxin and supplement Qi and Blood, so that damp-heat resolves and necrotic tissue regenerates. The formula Jiufu Tang (Decoction for Saving Necrotic Tissue): Renshen (Ginseng Radix) 1 liang, Danggui (Angelicae Sinensis Radix) 2 liang, Huangqi (Astragali Radix) 2 liang, Baizhu (Atractylodis Macrocephalae Rhizoma) 1 liang, Fuling (Poria) 5 qian, Huangbai (Phellodendri Cortex) 3 qian, Chao Zhizi (Gardeniae Fructus, Stir-fried) 3 qian, Yiren (Coicis Semen) 5 qian, Zexie (Alismatis Rhizoma) 3 qian, Baishao (Paeoniae Radix Alba) 1 liang, Gegen (Puerariae Lobatae Radix) 3 qian. Decoct in water and take orally. Four doses remove necrotic tissue and generate new flesh; another four doses flatten the scrotum and penis completely. Liquor toxin forms due to suppression; soothing the Liver, draining fire, promoting diuresis, and resolving toxin is appropriate. Why use Renshen, Huangqi, Danggui, and Baizhu to strongly tonify Qi and Blood? Generally, those with abundant Qi and Blood have strength to overcome liquor; even heavy drinking causes no harm. Rotting after consuming strong liquor implies Qi and Blood were deficient, lacking strength to overcome the liquor. Thus, two fires combined led to burning the outer body. If Qi and Blood are not urgently supplemented, liquor toxin cannot be eliminated, and how can necrotic tissue grow quickly?
Chen Shigong stated: Nang Yong (Scrotal Abscess) is caused by Yin deficiency with damp-heat flowing into the scrotum, condensing into a swelling. Even if the testicles hang after ulceration, it does not endanger life, as the toxin emanates externally. Treatment should nourish Yin and clear/drain damp-heat; efficacy is achieved in 80-90% of cases. Modern practitioners mistakenly use hot herbs for hernia, often exacerbating heat into pus, making convergence difficult. Initially, Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver) is suitable. Later, nourish Yin. Apply Jinhuang San (Golden Yellow Powder) externally. If swelling and pain persist for a long time and internal pus forms, causing distending pain, puncture to drain. Internally, administer Shiquan Dabu Tang (Ten Substance Tonifying Decoction) added with Shanzhuyu (Corni Fructus), Mudanpi (Moutan Cortex), and Zexie (Alismatis Rhizoma). Intermittently administer Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) for peace. (*Waike Zhengzong*)
Feng Luzhan stated: Books say sores/carbuncles entering the scrotum are fatal, belonging to damp-heat in the Liver Meridian. Initial swelling and pain with red, astringent urination should be treated primarily with clearing, draining, and detoxifying. If pus forms and urination is difficult, the toxic gas has not dispersed; puncture to drain. If pain persists after pus discharge, it indicates Qi and Blood deficiency; tonify them. If primordial Qi is intact but the scrotum fully ulcerates with exposed testicles, it is also harmless. (*Waike Jinang*)
He further stated: If children suffer from this due to their wet nurse's frequent anger, both mother and child should take herbs to clear the Liver.
He further stated: Ulceration of the scrotum with exposed testicles is called Tuonang (Scrotal Detachment). Grind Perilla stems into fine powder. Apply dry if wet, or mix with sesame oil if unbroken. Wrap with fresh green lotus leaves. Internally administer Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Mutong (Akebiae Caulis), Danggui (Angelicae Sinensis Radix), etc. Most patients survive; do not fear.
Dou Hanqing stated: For Nang Yong requiring surgical incision when pus is ripe, wait until the pus is mature. Tie the testicles tightly with an oiled hair rope. Use a small knife to open the Haidi Acupoint (Sea Bottom Point). Pus and blood will flow out completely.
Li Dongyuan stated: The classic says carbuncles entering the scrotum are fatal. Does this imply it belongs to the Kidney? I treated several patients, addressing damp-heat entering the Liver Meridian, assisted by Yin-nourishing herbs. Even with pus discharge, skin shedding, and hanging testicles, death did not occur. I am only unsure about elderly patients with lower deficiency. (*Waike Jingyao*)
Wang Shengzhi stated: Nang Yong is caused by damp-heat sinking downward, turbid qi flowing smoothly into the Bladder. Deficiency of the Vagina leads to obstructed damp-heat, sometimes forming pus. Therefore, herbs for nourishing Yin and removing dampness are absolutely indispensable. Once pus is exhausted, peace returns. (*Waike Lili*)
Hu Gongbi stated: There are cases where abdominal swelling gradually flows into the scrotum. Severe swelling causes the scrotum to split open, with testicles hanging outside and continuous fluid leakage. Apply fir wood charcoal powder. Wrap thickly with Perilla leaves. Have the patient lie supine to rest. Internally administer Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver) added with Yin-nourishing herbs. Self-healing occurs upon ingestion. (*Qingnang Mijuan*)