Pudendal coldness, also known as pudendal coldness, refers to the subjective sensation of coldness in the external genitalia. Jingui Yaolue refers to it as "coldness of the glans," Zhubing Yuanhou Lun describes it as "deficiency fatigue pudendal coldness," Zhangshi Yitong and "Shen's Zunsheng Book" also call it "pudendal coldness." All these terms refer to the sensation of coldness in the male external genitalia, including the penis and scrotum. As for Jingui Yaolue．婦人 Zabing Pulse and Symptom Treatment Chapter, which mentions "female pudendal coldness," it is not within the scope of this discussion.

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1. Decline of the Fire from the Life Gate︰The genital organs feel cold, the course of the disease is prolonged, accompanied by weakness in the waist and knees, cold limbs and fear of cold, or even edema, shortness of breath, mental fatigue, a pale complexion, diarrhea before dawn, clear and profuse urine, impotence, seminal emission, hernia, a pale, swollen, and moist tongue or one with tooth marks, and a deep, slow or hollow pulse. This is caused by insufficient kidney qi, but it is more commonly seen in cases of life gate fire decline, and it is an early symptom or accompanying symptom of conditions such as impotence, seminal emission, hernia, and scrotal retraction. The disease cause is mostly due to sexual overexertion damaging the kidneys, or loss of blood, diarrhea with undigested food, etc., leading to insufficient kidney yang and life gate fire decline, which fails to warm the genital organs. For milder symptoms, as mentioned in Jingui Yaolue·Treatment of Blood Impediment and Deficiency Fatigue with Abnormal Pulse: "A patient with frequent seminal loss, tightness in the lower abdomen, coldness in the glans penis, dizzy vision, and hair loss," with a hollow and slow pulse, Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell or Big Aconite Root Powder with modifications can be used to dispel cold and consolidate essence. For cases with obvious symptoms of insufficient kidney yang (cold limbs and fear of cold, shortness of breath, weakness in the waist and knees, mental fatigue, clear and profuse urine, impotence, seminal emission, a swollen and moist tongue, and a deep, slow pulse), Golden Chamber Kidney Qi Pill with Pilose Antler is used to warm and tonify kidney yang. In severe cases, such as pudendal coldness like ice, cold abdominal colic, and scrotal retraction, warming the interior and dissipating cold is necessary, using formulas such as Ten Tonifying Pill or Evodia Decoction with modifications.
2. Dampness-heat in Liver Meridian︰Pudendal coldness accompanied by sweating, damp itching of the scrotum, foul odor, or premature ejaculation, impotence. Restlessness, bitter taste in the mouth, thirst, yellow tongue coating, reddish urine or turbid painful urination, dry stool, wiry pulse. The treatment focuses on clearing and disinhibiting the liver meridian, as stated in Zhangshi Yitong, "Diseases of the External Genitalia": "Impotence with cold testicles, genital sweating like water, residual foul-smelling drops after urination, coldness in the coccyx and external genitalia, aversion to cold and preference for heat, cold knees—this is dampness-heat in the liver meridian. Gentian Liver-Draining Decoction or Bupleurum Dampness-Overcoming Decoction may be selected."

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1. 《Ren Shu Bian Lan．Atrophy-Flaccidity Disease》: Liver-Tonifying Decoction treats external genitalia as cold as ice, and genital sweating. (The formula uses Astragalus Root, Ginseng, Gan Xu, Poria, Polyporus, Cimicifuga Rhizome, Bupleurum, Gui Shen, Notopterygium, Forsythia, Phelloendron Bark, Alisma, Atractylodes Rhizome, Medicated Leaven, Anemarrhena, Saposhnikovia Root, Dried Tangerine Peel, Liquorice Root)