bubble_chart Concept

The condition where the penis, testicles, and scrotum retract due to certain reasons is called retracted genital disease. Lingshu. Pathogenic qi zang-fu organs, in the chapter "Disease Forms," refers to it as "retracted genital disease." The "Cold-Damage Disease Treatise" calls it "spasms in the yin," while Zhubing Yuanhou Lun refers to it as "yin contraction." Suwen. Re Lun calls it "scrotal retraction," and Lingshu. Jingmai and the "Apoplexy Involving Zang-organs Classic" refer to it as "testicular retraction." Leizheng Huorenshu calls it "scrotal retraction" and "testicular retraction." By the Yuan, Ming, and Qing dynasties, it was referred to as "retracted genital disease" (in "Shen's Zunsheng Book"), "scrotal retraction" (Yonglei Qianfang, "Ancient and Modern Medical Mirror"), and "external kidney retraction" (Shoushi Baoyuan). Although the names differ, the disease cause and mechanism of disease are the same, with only varying degrees of clinical severity. Retracted genital disease includes the retraction of the penis, testicles, and scrotum, and the symptoms are severe. In cases of testicular or scrotal retraction, the penis may not necessarily retract, making the symptoms milder than retracted genital disease. Since the disease cause, mechanism of disease, and treatment methods are the same, they can be collectively referred to as retracted genital disease and discussed together.

bubble_chart Pattern Analysis

1. Cold Damage Direct Attack︰Mostly manifested as retraction of the testicles or scrotum, or even as retracted genital disease. Fear of cold and cold limbs, in severe cases reversal cold of limbs. The body is still and lethargic, with faint low voice. Cold breath from the mouth and nose, even cyanotic lips. Generalized pain and heaviness, with severe abdominal pain. Clear and profuse urine, or even incontinence of urine. Or vomiting clear water and cold saliva, or diarrhea with undigested food. Pale tongue, deep, faint, and slow pulse. The patient has a constitutional spleen-kidney yang deficiency, contracts cold pathogens, or is in the recovery phase of extreme fatigue or serious illness, and is then attacked by cold pathogens, which directly invade the Jueyin. The foot Jueyin liver governs the tendons, and its meridian "passes the genitalia and reaches the lower abdomen" (Lingshu．Jingmai chapter). Cold is a yin pathogen with a contracting nature. When the Jueyin is affected by cold, the cold stagnates in the Jingmai, leading to cervical malignancy with cachexia, hence the lower abdominal spasm and pain, and retraction of the genitalia. The liver's Jingmai "circles the lips internally" and "connects with the root of the tongue" (Lingshu．Jingmai chapter). Therefore, when cold pathogens directly attack the Jueyin severely, retracted genital disease is often accompanied by curled tongue and cyanotic lips. Although it is an external contraction of cold pathogens, because the cold directly attacks the interior, there are no fever and chills of the exterior pattern, but rather a complete presentation of non-fever, fear of cold, cold limbs or even reversal cold of limbs, generalized pain, a still body with clear consciousness, cold breath from the mouth and nose, pale tongue, deep, faint, and slow pulse—all signs of pudendal coldness. The treatment should warm and disperse the Jueyin pudendal coldness pathogens, using formulas such as Angelica Cold-Extremities plus Evodia and Fresh Ginger Decoction or Restoring Yang Return-to-Root Decoction with modifications. This condition arises from cold pathogens directly attacking the Jueyin, while contracting cold externally.
2. Post-recovery Overexertion Relapse︰Retracted genital disease is accompanied by lower abdominal rectal urgency, pain, and spasms extending to the vaginal area. There is a shortage of qi, the body feels heavy and fatigued, heaviness of the head with dizzy vision and reluctance to move, lumbago, and stiffness in the knees and shins. In severe cases, there may be fear of cold, reversal cold of the limbs, a pale tongue, and deep, thin pulses. Post-recovery overfatigue relapse retracted genital disease is associated with yang exhaustion and virtual yin collapse! Prolonged illness, severe illness, or cold-damage disease in its critical stage, if not properly managed, coupled with unrestrained sexual activity, can lead to retracted genital disease. Mild cases manifest as a heavy body, heaviness of the head, lumbago, lower abdominal rectal urgency, shortage of qi, fear of cold, cold limbs, a pale tongue, and thin pulses. These symptoms indicate qi deficiency and yang decline, and treatment should focus on warming yang and tonifying qi, using the Gu Yang Decoction. Severe cases involve impending yang collapse, with cold body, reversal cold of the limbs, clear nasal discharge, dark complexion, deficiency-type dyspnea, cold sweating, unconsciousness, and barely perceptible pulses. Emergency treatment to restore yang and stop collapse is required, using San Xian Powder or the Restoring Yang Elixir.
3. Deep-seated Cold and Chronic Cold Syndrome︰The individual has long suffered from yang deficiency, retracted genital disease, fear of cold, cold limbs, and in severe cases, reversal cold of the limbs. Symptoms include poor appetite, stomach pain, vomiting, persistent cold pain in the lower abdomen, chronic diarrhea or diarrhea before dawn, cold and heavy sensation in the lower back and knees, heel pain and soreness in the shins, frequent urination or dribbling incontinence, impotence, seminal emission, and cold sperm. The tongue appears pale, and the pulse is thin. The prolonged decline of spleen and kidney yang qi, combined with consumption of cold and raw foods or prolonged exposure to cold in the pudendal area, further damages the already deficient spleen yang. Thus, accompanying symptoms often manifest as spleen yang deficiency, such as poor appetite, abdominal pain, vomiting, and diarrhea. External cold and internal consumption of cold substances harm the body. The treatment method focuses on dispelling cold pathogens that directly attack the Jueyin channel by warming and dispersing pudendal coldness. For deep-seated cold and retracted genital disease, the emphasis is on warming the yang of the spleen and kidneys, particularly activating and warming spleen yang. Prescriptions such as Lianyang Dan and Guyang Tang with modifications are used.
4. Yang Exhaustion Collapse︰Lower abdominal tightness and pain, with retraction of the penis, testicles, and scrotum. Cold body and bluish nose, even a dull and dark complexion, reversal cold of limbs, gasping and panting, cold sweating, and in severe cases, loss of consciousness with a faint and fading pulse. Post-recovery overfatigue relapse retracted genital disease and yang exhaustion with yin collapse retraction! After prolonged illness, severe illness, or recovery from critical cold-damage disease, excessive sexual indulgence leads to retracted genital disease. Mild cases manifest as heavy body, heaviness of the head, lumbago, rectal urgency in the lower abdomen, shortness of qi, fear of cold, cold limbs, pale tongue, and thin pulse. These symptoms indicate qi deficiency and yang decline, and treatment should focus on warming yang and tonifying qi, using the Gu Yang Decoction. Severe cases involve imminent yang collapse, with cold body, reversal cold of limbs, clear nasal discharge, dark face, deficiency-type dyspnea, cold sweating, loss of consciousness, and a faint, fading pulse. Emergency treatment requires restoring yang to stop collapse, using the San Xian Powder or Restoring Yang Elixir.

The above four syndromes are all classified as pudendal coldness deficiency pattern. The cold-damage disease directly attacking retracted genital disease is caused by external contraction of cold evil directly attacking the Jueyin, with a sudden onset, and should be treated by warming and dispersing the Jueyin pudendal coldness evil. The chronic cold retracted genital disease is due to long-term illness leading to spleen and stomach yang deficiency, further aggravated by the consumption of cold foods damaging spleen yang, and should be treated by warming and tonifying the yang of the spleen and kidney. The relapse of retracted genital disease due to overfatigue after recovery is caused by prolonged illness and lack of restraint in sexual activity, and should be treated by tonifying qi and warming yang. The yang exhaustion and yin collapse retraction is a critical and severe condition, which may result from long-term chronic coldness and repeated exposure to cold evil, or may occur after recovery from overfatigue relapse and lack of restraint in sexual activity, and should be urgently treated by tonifying yang to secure collapse and to restrain the excessive yang. Although the symptoms of the four conditions are similar, their causes and severity differ, the general treatment principle is to warm yang and tonify deficiency, and cold and cool remedies should be strictly avoided.

bubble_chart Documentation

1. Leizheng HuorenshuVolume 5: "Double invasion cold-damage disease, ... when both the Shaoyang and Jueyin are affected, then deafness, scrotal retraction, and cold extremities occur."
2. 《Gujin Yijian．Cold-damage Disease》: "When cold-damage disease spreads to the Jueyin meridian, the disease reaches its extreme heat. ... Generally, the deeper the heat, the deeper the cold extremities, resulting in a curled tongue and retracted testicles. Extreme coldness in the pudendum also shows a curled tongue and retracted testicles, requiring careful and detailed analysis."