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The *Classic of Difficult Issues* (Jing Yue) states: "When pathogenic factors invade the collaterals of the Foot Jueyin (Liver Meridian), it causes sudden onset of hernia and acute pain." It also states: "When the disease is located in the lower abdomen, accompanied by difficulty in urination and defecation, the disease is named Hernia." Thus, all types of hernias originate from disorders of the Foot Jueyin. The Foot Jueyin meridian surrounds the external genitalia and enters the lower abdomen; the Ren Mai (Conception Vessel) originates below the Zhongji point (CV3), ascends to the pubic hairline, follows the interior of the abdomen, and reaches the Guanyuan point (CV4). Therefore, all hernia diseases are attributed to these meridians.

In children, this condition often arises from congenital deficiency and weakness of the Zang organs (specifically the Kidney), compounded by external contraction of Wind pathogens and internal injury from consuming cold or raw foods, leading to the coagulation of Cold pathogens. Alternatively, Damp-Heat may stagnate internally while being constrained externally by Cold, allowing pathogenic factors to exploit the deficiency and enter the Blood aspect, flowing into the Jueyin. Since Jueyin belongs to the Liver, and the Liver's nature is swift and urgent, it pulls on the testicles, causing colicky pain in the lower abdomen. There is also a syndrome known as "Fetal Hernia," which often results from excessive crying and emotional distress by the pregnant mother, disturbing Yin Qi, causing it to knot and fail to disperse, resulting in the infant presenting with this condition immediately after birth.

Generally speaking, Heat-type hernias tend to present with flaccidity and prolapse, whereas Cold-type hernias tend to present with pain. Hernias rooted in the Blood aspect remain fixed in location, while those rooted in the Qi aspect are mobile. Swelling caused by Dampness leads to heavy prolapse, while swelling caused by Deficiency leads to light prolapse. Understanding these principles leaves no gaps in the treatment of various pediatric hernias.

If children habitually overconsume cold or raw foods, or lie on damp ground, Yin-Cold may coagulate internally, causing Qi stagnation and impaired circulation. After a prolonged period, if further constrained by Wind-Cold and injured by Water-Dampness, Cold Hernia will manifest. Symptoms include a cold, hard, and knotted scrotum, with traction pain in the lower abdomen. For early-stage cases accompanied by Exterior Pathogens (such as aversion to cold or fever), ancient methods primarily prescribe Wutou Guizhi Tang (Cinnamon Twig and Aconite Decoction), comprising Guizhi Tang (Cinnamon Twig Decoction) ingredients such as Guizhi (Ramulus Cinnamomi Cassiae), Chishao (Radix Paeoniae Rubra), Zhigancao (Radix Glycyrrhizae Preparata), and Wutou (Radix Aconiti Lateralis Preparata), using Shengjiang (Rhizoma Zingiberis Recens) as an guiding agent.

For severe Cold conditions, ancient methods prescribe Jin Zhu Wan (Golden Melon Pill), consisting of one liang of Jinlingzi Rou (Semen Toosendan) and five qian of Wuzhuyu (Fructus Evodiae), ground into fine powder, mixed with wine-boiled wheat paste to form pills the size of hemp seeds. Several pills are taken per dose, washed down with salt water.

[Commentary by Chen Shouzhen]: Pediatric hernia caused by Cold pathogen invasion presents internally with colicky lower abdominal pain and externally with swollen testicles, accompanied by abdominal pain and crying. These are all Interior Syndromes, lacking Exterior Syndrome signs. For initial treatment, use Baigui Shen (Radix Angelicae Sinensis) 1 qian, Kaikou Wuyu (Fructus Evodiae) 3 fen, Qinghuagui (Ramulus Cinnamomi Cassiae) 5 fen, Heijiang Tan (Carbonized Rhizoma Zingiberis Officinalis) 8 fen, Nanmuxiang (Radix Aucklandiae) 5 fen, Xiaohuixiang (Fructus Foeniculi) 1 qian, and Zhigancao (Radix Glycyrrhizae Preparata) 5 fen. After decocting, add 7 fen of salt as a guiding agent, and take warm on an empty stomach.

For chronic cases lasting long periods, convert the above formula into a pill form. Take 1 qian each morning and evening on an empty stomach for superior efficacy.