bubble_chart Concept

Scrotal cutaneous pruritus refers to an abnormality of scrotal cutaneous pruritus. This condition, recorded under various names in ancient medical texts, is referred to as "damp itching of the lower yin" in

Zhubing Yuanhou Lun, as "scrotal wind pattern" in Waike Zhengzong, Waike Dacheng, and others, and as "xiu qiu wind" in the essential techniques of Yizong Jinjian and Waike Xinfa. In mild cases, it manifests only as scrotal cutaneous pruritus, while in severe cases, the scrotal skin thickens, or yellow fluid may ooze and scabs may form due to scratching.

bubble_chart Pattern Analysis

1. Dampness-heat︰Initially, the genital area becomes extremely dry and itchy, with a preference for bathing in hot water. In severe cases, raised bumps resembling red foxtail millet may appear, accompanied by intense numbness and itching. Scratching may lead to oozing of water from the affected area, causing pain as if scorched by fire. The tongue coating is yellow and greasy, and the pulse is wiry, slippery, and rapid. This condition arises from constitutional liver channel stagnation-heat, combined with the invasion of external wind-dampness pathogens. The struggle between these factors and liver heat prevents the outward discharge of dampness-heat, which then follows the liver channel downward to the scrotum, resulting in severe cutaneous pruritus. Treatment should focus on clearing and purging dampness-heat from the liver and gallbladder. The recommended formula is Gentian Liver-Draining Decoction with modifications. For external use, a Purslane Herb wash can be applied.
2. Yin Deficiency with Blood Dryness︰Scrotal cutaneous pruritus is unbearably itchy, causing restlessness whether sitting or lying down. The scrotal skin becomes rough and thickened, with scratching-induced bleeding, scratch marks, and blood scabs. It may also be accompanied by thirst, irritability, a red tongue texture, and a thready, rapid pulse. This condition is caused by liver-kidney yin deficiency, which leads to dryness transforming into wind. Excessive dryness internally and wind stirring externally prevent the scrotal skin from receiving nourishment, resulting in cutaneous pruritus. Key points for differentiation: - In cases of dampness-heat accumulation, the scrotum feels burning, itchy, and painful as if scorched by fire, with scratching causing oozing fluid and a relatively acute onset. - In cases of yin deficiency and blood dryness, the scrotum experiences intense intermittent itching, scratch marks with blood scabs, and prolonged roughness and thickening of the skin, with a relatively gradual onset.
3. Lower Jiao Cold-dampness︰The scrotum is damp, cutaneous pruritus is mild, accompanied by soreness and weakness of the waist and knees, a sagging and distended lower abdomen, dysuria, swelling and heaviness of the lower limbs, a white and moist tongue coating, and a deep, slow, and weak pulse. The lower energizer is the residence of the liver and kidneys. If the kidney qi is inherently insufficient, the liver meridian is imbalanced, or one has long lived in damp and low-lying areas, or been exposed to the moisture of fog and Rain Water (2nd solar term), the cold-dampness pathogen may invade the scrotum, leading to cutaneous pruritus. Its characteristics include a damp scrotum, mild cutaneous pruritus, possible swelling of the lower limbs, a white and moist tongue coating, etc. The treatment should focus on warming the meridians and dissipating cold, as well as dispelling dampness to relieve itching. The recommended formula is Five Accumulations Powder with modifications.

Scrotal cutaneous pruritus is closely related to the liver and kidneys. In treatment, it is not advisable to merely relieve the itching. Instead, it is essential to regulate the internal organs' yin-yang and qi-blood, supplemented by remedies that dispel wind, overcome dampness, disperse cold, and clear heat, or combined with external treatments. Only by treating both the symptoms and the root cause can the therapeutic efficacy be improved.

bubble_chart Documentation

1. The "Shi Cai San Shu: Mechanism of Disease - Sha Zhuan" states: "For external genitalia itching, use Jiao Fen San (a powder made from Ephedra, Cnidium, Cibot Rhizome, Polyporus, Pricklyash Peel, Carthamus, Chinese Angelica, Cassia Bark, and calomel, applied dry)."