肿痛或发热者，肝经湿热也，清肝除湿。肿痛发寒者，邪气传表也，发散之。肿痛，小
便赤涩者，肝经热湿滞壅也，疏肝导湿。
一男子患此，肿硬 痛寒热，先以人参败毒散，二剂而止，更以小柴胡汤，加黄连、青
皮，治之而愈。
一男溃而肿痛，小便赤涩，以加减龙胆泻肝汤，加青皮、黄连，二剂少愈；以小柴胡汤
，加黄柏、知母、当归、茯苓，数剂而愈。
一男子因劳，茎窍作痒，时出白物，发热口干，以清心莲子饮，治之而安。
一男子溃而肿痛发热，日晡尤甚，以小柴胡汤加黄连、知母、当归而愈。
一男子已愈，惟茎中一块不散，以小柴胡汤加青皮、荆、防服之；更以荆芥、防风、牛
膝、何首乌、滑石、甘草各五钱，煎汤，熏洗，各数剂而消。
一男子茎肿不消。
一男子溃而肿痛发热，小便秘涩，日晡尤甚。
一小儿肿痛，诸药不应，各以小柴胡汤，吞芦荟丸数服，并愈。
一男子阴茎或肿，或作痛，或挺纵不收。
一男子
张子和曰∶遗溺闭癃，阴痿浮痹，精滑白淫，皆男子之疝也，不可妄归之肾冷。若血涸不月
月罢，腰膝上热足 ，嗌干癃闭，少腹有块，或定或移，前阴突出，从阴痔核，皆女子之疝
也，但女子不谓之疝，而谓之瘕。
一男子玉茎肿痛，小便如淋，自汗，甚苦，时或虽尿血少许，尺脉洪数，按之则涩，先
用清
》云∶如自汗小便少，不可以药利之。既已自汗，则津液外亡，小便自少，若利之，则荣卫
枯竭，无以制火，烦热愈甚，当俟热退汗止，小便自行也。兼此证乃阳明，经云∶大忌利小
便。
附方
小柴胡汤（方见瘰 门）
人参败毒散（方见溃疡发热门）
加减龙胆泻肝汤 治肝经湿热，玉茎患疮，或便毒悬痈肿痛，小便赤涩，或溃烂
不愈。又治阴囊肿痛，或溃烂作痛，小便涩滞，或睾丸悬挂。
龙胆草（酒拌炒黄） 泽泻（各一钱） 车前子（炒） 木通 生地黄（酒拌） 当归尾（酒拌）
山
秘，加大黄。
芦荟丸 治下疳溃烂，或作痛。又治小儿肝积发热，口鼻生疮，及牙龈蚀烂等疮
胡黄连 黄连 芦荟 木香 白芜荑（炒） 青皮 白雷丸 鹤虱草（各一两） 麝香（三
钱）
肝脉弦长，恚怒不息，三年不愈，诸药不应，服半剂顿退，一剂而痊。
清心莲子饮 治心经蕴热，小便赤涩，或玉茎肿，或茎窍痛，及上盛下虚，心火
炎上，口苦咽干，烦躁作渴，又治发热口干，小便白浊，夜则安静，昼则发热。
黄芩（炒） 黄 （蜜炒） 石莲肉（去心） 赤茯苓 人参（各一钱） 甘草 车前子（炒）
麦门冬（去心） 地骨皮（各五分） 作一剂，水二钟，煎八分，空心并食前服。
滋肾丸 治下焦阴虚，小便涩滞；或脚膝无力，阴汗阴痿；或足热不履地，不渴
而小便闭。
黄柏（酒洗焙） 知母（酒洗焙，各一两） 肉桂（二钱） 为末，水丸如梧子大。每服百丸
，加至二百丸，煎滚汤送下。
（若患处）出现肿胀疼痛或发热，属于肝经湿热证，治宜清泻肝火、祛除湿邪。
（若患处）肿胀疼痛且伴有恶寒，属于邪气传入体表，治宜发散表邪。
（若患处）肿胀疼痛，且小便短赤涩痛，属于肝经热湿阻滞壅塞，治宜疏理肝气、引导湿邪排出。
有一位男子患此病，患处肿硬、疼痛，并伴有寒热往来症状，先用**人参败毒散**，服用两剂后症状停止；随后改用**小柴胡汤**，加入黄连、青皮，治疗而痊愈。
有一位男子患处溃烂且肿痛，小便短赤涩痛，使用加减**龙胆泻肝汤**，加入青皮、黄连，服用两剂后症状稍减；再改用**小柴胡汤**，加入黄柏、知母、当归、茯苓，服用数剂后痊愈。
有一位男子因劳累所致，尿道口瘙痒，时常流出白色分泌物，伴有发热、口干，使用**清心莲子饮**，治疗而安定。
有一位男子患处溃烂、肿痛且发热，傍晚时分症状尤为严重，使用**小柴胡汤**加入黄连、知母、当归，治疗而痊愈。
有一位男子病情已愈，但仅余阴茎中有一块硬结不散，使用**小柴胡汤**加入青皮、荆芥、防风服用；另外用荆芥、防风、牛膝、何首乌、滑石、甘草各五钱，煎煮成汤，用于熏洗患处，经过数剂治疗后硬结消散。
有一位男子阴茎肿胀不消。
有一位男子患处溃烂、肿痛且发热，小便闭塞涩痛，傍晚时分症状尤为严重。
有一位小儿患处肿痛，服用多种药物无效，均用小**柴胡汤**送服芦荟丸，数次服药后并皆痊愈。
有一位男子阴茎时而肿胀，时而疼痛，时而挺纵不收。
有一位男子……
张子和说：遗尿、小便不通、阳痿、阴部麻木痹痛、精液滑泄、白淫等，都是男子的疝病，不可随意归结为肾冷。如果女性出现血枯闭经、腰膝上部发热足部寒冷、咽喉干燥、小便不通、少腹部有肿块、或固定不移或游走不定、前阴突出、阴痔核等，都是女子的疝病，只是女子不称之为疝，而称之为瘕。
有一位男子玉茎（阴茎）肿痛，小便如淋证般涩痛，自汗出，非常痛苦，有时偶尔尿出少许血，尺脉洪大数急，重按则涩滞，先用清……（此处原文残缺，结合下文推测为清热利湿或相关方药，但根据后文引用《内经》及辨证，重点在于禁利小便）。
《黄帝内经》云：“如果自汗且小便量少，不可以用药强行利尿。”既然已经自汗，说明津液外泄亡失，小便自然减少，如果强行利尿，会导致营卫枯竭，无法制约虚火，烦热会更加严重，应当等待热退汗止，小便自然会通利。此外，此证属于阳明经病，《内经》云：大忌利尿。
附方
**小柴胡汤**（方剂见瘰疬门）
加减**龙胆泻肝汤** 治疗肝经湿热，玉茎患疮，或便毒悬痈肿痛，小便短赤涩痛，或溃烂不愈。又治疗阴囊肿痛，或溃烂作痛，小便涩滞，或睾丸下垂。
龙胆草（酒拌炒至黄色） 泽泻（各一钱） 车前子（炒） 木通 生地黄（酒拌） 当归尾（酒拌） ……（此处原文可能有缺漏，通常含柴胡、黄芩等），若大便秘结，加大黄。
芦荟丸 治疗下疳溃烂，或作痛。又治疗小儿肝积发热，口鼻生疮，以及牙龈蚀烂等疮疡。
胡黄连 黄连 芦荟 木香 白芜荑（炒） 青皮 白雷丸 鹤虱草（各一两） 麝香（三钱） ……（此处原文可能有缺漏，通常为制作丸剂的辅料或制法描述）。
肝脉弦长，因愤怒不止，三年不愈，多种药物无效，服用半剂即迅速消退，服用一剂而痊愈。（注：此段似为某方剂疗效描述，前文可能对应芦荟丸或其他疏肝方，但原文排版较乱，此处依字面翻译）。
**清心莲子饮** 治疗心经蕴热，小便短赤涩痛，或玉茎肿胀，或尿道口疼痛，以及上盛下虚，心火上炎，口苦咽干，烦躁口渴，又治疗发热口干，小便白浊，夜间安静，白天发热。
黄芩（炒） 黄芪（蜜炒） 石莲肉（去心） 赤茯苓 人参（各一钱） 甘草 车前子（炒） 麦门冬（去心） 地骨皮（各五分） 作为一剂，用水二钟，煎至八分，空腹及食前服用。
**滋肾丸** 治疗下焦阴虚，小便涩滞；或脚膝无力，阴汗阳痿；或足底发热不愿着地，口不渴而小便闭塞。
黄柏（酒洗焙干） 知母（酒洗焙干，各一两） 肉桂（二钱） 研为细末，用水泛丸如梧桐子大。每次服用一百丸，加至二百丸，用滚开水送服。
If swelling, pain, or fever occurs at the lesion site, it is due to damp-heat in the Liver channel; the treatment should clear the Liver and remove dampness.
If swelling, pain, accompanied by aversion to cold, occurs, it indicates that the pathogenic factor has transmitted to the exterior; the treatment should disperse the exterior.
If swelling, pain, with dark and scanty urine, occurs, it is due to stagnation and obstruction of heat and dampness in the Liver channel; the treatment should soothe the Liver and guide out dampness.
A male patient suffered from this condition, presenting with hard swelling, pain, and alternating chills and fever. He was first treated with *Renshen Baidu San* (Ginseng Decoction to Defeat Pathogenic Factors) for two doses, after which the symptoms ceased. Subsequently, he was treated with *Xiaochaihu Tang* (Minor Bupleurum Decoction) added with Huanglian (Coptidis Rhizoma) and Qingpi (Aurantii Fructus Immaturus), resulting in a cure.
A male patient presented with ulceration, swelling, pain, and dark, scanty, painful urination. He was administered modified *Longdan Xiegan Tang* (Gentian Decoction to Drain the Liver) added with Qingpi and Huanglian. After two doses, the symptoms slightly improved. He was then treated with *Xiaochaihu Tang* added with Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Danggui (Angelicae Sinensis Radix), and Fuling (Poria), leading to recovery after several doses.
A male patient, due to overwork, experienced itching at the urethral orifice, frequent discharge of white matter, fever, and dry mouth. He was treated with *Qingxin Lianzi Yin* (Clear Heart Lotus Seed Decoction), resulting in stabilization.
A male patient presented with ulceration, swelling, pain, and fever, which were particularly severe in the late afternoon. He was cured by treating with *Xiaochaihu Tang* added with Huanglian, Zhimu, and Danggui.
A male patient had recovered, except for a single induration in the penis that did not dissipate. He was treated with *Xiaochaihu Tang* added with Qingpi, Jingjie (Schizonepetae Herba), and Fangfeng (Saposhnikoviae Radix). Additionally, a decoction of Jingjie, Fangfeng, Niuxi (Achyranthis Bidentatae Radix), Heshouwu (Polygoni Multiflori Radix), Huashi (Talcum), and Gancao (Glycyrrhizae Radix et Rhizoma), each five qian, was prepared for fumigation and washing of the affected area. After several doses, the induration disappeared.
A male patient presented with persistent penile swelling.
A male patient presented with ulceration, swelling, pain, fever, constipation and difficult urination, with symptoms worsening in the late afternoon.
A pediatric patient presented with swelling and pain, unresponsive to various medications. All were treated with *Xiaochaihu Tang* taken with *Lushan Wan* (Aloe Pill), resulting in recovery after several administrations.
A male patient presented with intermittent penile swelling, pain, or protrusion without retraction.
One male patient...
Zhang Zihe stated: Enuresis, strangury, impotence, and genital numbness/paralysis, seminal emission, and leukorrhea are all hernias in men, and should not be rashlessly attributed to Kidney cold. If women experience blood depletion with amenorrhea, heat in the waist and knees with cold feet, dry throat, strangury, masses in the lower abdomen that are either fixed or migratory, protrusion of the anterior yin, and hemorrhoidal nodules, these are hernias in women. However, they are not called hernias in women but rather "jia" (masses).
A male patient presented with swelling and pain of the jade stem (penis), urinary symptoms resembling strangury, spontaneous sweating, severe distress, and occasional slight hematuria. The chi pulse was surging and rapid, but choppy upon deep pressure. Initially, using Qing... [text incomplete].
The *Huangdi Neijing* states: "If there is spontaneous sweating and scanty urine, diuretics should not be used." Since spontaneous sweating has occurred, body fluids have been lost externally, and urine naturally becomes scanty. If diuretics are used, Ying and Wei will become depleted, failing to control fire, causing irritability and heat to worsen. One should wait for the heat to subside and sweating to stop, after which urination will normalize on its own. Furthermore, this syndrome belongs to the Yangming channel. The classics state: Diuresis is strictly contraindicated.
Attached Formulas
*Xiaochaihu Tang* (Minor Bupleurum Decoction) (See formula in Luoli section)
*Renshen Baidu San* (Ginseng Decoction to Defeat Pathogenic Factors) (See formula in Kaiyang Ulcer Fever section)
Modified *Longdan Xiegan Tang* (Gentian Decoction to Drain the Liver): Treats damp-heat in the Liver channel, ulcers on the penis, or painful swelling of inguinal abscesses (*bi du*) and perineal abscesses (*xuan yong*), with dark, scanty, painful urination, or non-healing ulcerations. Also treats scrotal swelling and pain, ulceration with pain, difficult urination, or testicular descent.
Longdan Cao (Gentianae Radix, stir-fried with wine until yellow) and Zexie (Alismatis Rhizoma), one qian each; Cheqianzi (Plantaginis Semen, stir-fried); Mutong (Akebiae Caulis); Sheng Dihuang (Rehmanniae Radix, stir-fried with wine); Danggui Wei (Angelicae Sinensis Radix tail, stir-fried with wine)... [text missing]; if constipation exists, add Dahuang (Rhei Radix et Rhizoma).
*Lushan Wan* (Aloe Pill): Treats ulcerated chancre with pain. Also treats children's liver accumulation with fever, sores in the mouth and nose, and gum erosion.
Huhuanglian (Coptidis Rhizoma? Note: Text says Hu Huanglian, likely Phellodendri or Coptis variant contextually, but literally Hu黄连), Huanglian (Coptidis Rhizoma), Lushen (Aloes), Muxiang (Aucklandiae Radix), Bai Wuyi (Chrysanthemi Indici Flos? Note: Text says Bai Wuyi, likely Toosendan Fructus or similar antiparasitic), Qingpi (Aurantii Fructus Immaturus), Bai Leiwang (Meli Semen?), Heshiqao (Daphnes Genkwa Flower? Note: Text says Heshiqiao/Cao, likely distinct herb), each one liang; Shexiang (Moschus), three qian. [Preparation details missing].
Liver pulse is string-long. Due to unceasing anger, the condition persisted for three years without success from other medicines. Taking half a dose led to immediate relief, and one dose resulted in complete recovery.
*Qingxin Lianzi Yin* (Clear Heart Lotus Seed Decoction): Treats latent heat in the Heart channel, dark and scanty painful urination, penile swelling, or urethral pain, as well as upper excess and lower deficiency, flaming Heart fire upward, bitter taste in the mouth, dry throat, irritability, and thirst. Also treats fever with dry mouth, turbid white urine, quietness at night, and fever during the day.
Huangqin (Scutellariae Radix, stir-fried), Huangqi (Astragali Radix, honey-stir-fried), Shilian Rou (Nelumbinis Semen), Chifuling (Poria with Red Coir), Renshen (Ginseng Radix et Rhizoma), each one qian; Gancao (Glycyrrhizae Radix et Rhizoma); Cheqianzi (Plantaginis Semen, stir-fried); Maimendong (Ophiopogonis Radix, heart removed); Digupi (Lycii Cortex), each five fen. As one dose, boil two zhong of water to eight fen. Take on an empty stomach and before meals.
*Zishen Wan* (Kidney-Nourishing Pill): Treats Yin deficiency in the Lower Jiao with difficult urination; or weakness in legs and knees, sweaty yin, and impotence; or hot feet unwilling to touch the ground, no thirst but closed urination.
Huangbai (Phellodendri Cortex, washed with wine and baked), Zhi Mu (Anemarrhenae Rhizoma, washed with wine and baked), each one liang; Rougui (Cinnamomi Cortex), two qian. Grind into powder, make pills with water like wutong seeds. Take 100 pills per dose, increasing to 200 pills, swallowed with boiling water.