论
《内经》曰∶肝脉大急沉，皆为疝。又曰∶三阳急为瘕，三阴急为疝。《难经》曰∶任脉之为病，其内苦结，男子为
七疝。夫所谓七疝者，寒、水、筋、血、气、狐、 ，七者是也。子和曰∶寒疝者，囊冷结硬如石，阴茎不举，或控睾
丸而痛，得之于坐卧湿地，或寒月涉水，或值雨雪，或坐卧砖石或风冷处，使内过劳，宜以温剂下之，久而无子。水疝
者，其状肾囊肿痛，阴汗时出，或囊肿状如水晶，或囊痒而搔出黄水，或少腹按之作水声，得之于饮水醉酒，使内过多，
汗出而遇风寒湿之气，聚于囊中，故水冷令人为卒疝，宜以逐水之剂下之（外有漏针法，恐误不录）。筋疝者，其状阴茎
肿胀，或溃而为脓，里急筋缩，或茎中作痛，痛极则痒，或挺纵不收，或出白物如精，随溲而下，得之于房室劳伤，及
邪术所使，宜以降心火之剂下之。血疝者，其状如黄瓜，在少腹两旁，横骨两端约纹中，俗名便痈，得之于重感春夏大
热，劳于使内，气血流溢，渗入脬囊，留而不去，结成痈肿，脓少血多，宜以和血之剂下之。气疝者，其状上连肾 ，
下及阴囊，多得于号哭忿怒，则气郁之而胀，号哭怒罢即气散者是也。有一治法，以针出气而愈，然针有得失，宜以散
气之药下也。或小儿亦有此疾，俗名偏坠，得之于父已年老，或年少多病，阴痿精怯，强力入房，因而有子，禀胎病也，
此证难治，惟筑宾一穴有灸之而愈者（穴法宜考灸经）。狐疝者，其状如仰瓦，卧则入少腹，行立则出腹入囊中，如狐昼
出穴而溺，夜入穴而不溺，此疝出入往来上下，正与狐相类也，亦与气疝大同小异，宜以逐气流经之剂下之。 疝者，
其状阴囊大如升斗、不痒不痛者是也，得之于地气卑湿，故江淮之间多有之，宜以去湿之剂下之。女子阴户凸出，虽亦
此类，乃热则不禁固也，不可便认为虚寒而温之补之，本名曰瘕，宜以苦药下之，以苦坚之。
愚按∶子和论七疝病源至为详悉，但其处方一以攻下之法为主治，不能使人无疑耳，既曰多由房劳致虚而作，其可
一例施之以攻下之法乎。大抵七疝为病，若非房劳所致，即是远行辛苦，涉水履冰，热血得寒而凝滞于小肠、膀胱之分，
或湿热乘虚而流入于足厥阴之经，古方一以为寒而纯用乌附等热药为治，我丹溪先生独断为湿热，此发古人之所未发者
也。夫热郁于中而寒束于外，宜其有非常之痛，故治法宜驱逐本经之湿热，消导下焦之瘀血，以寒因热用之法立方处治，
即邪易伏而病易退也。其攻下之法，愚故未敢试而行之，以俟识者再论，学人宜致思焉。
脉法
《内经》曰∶肝脉大急沉皆为疝，心脉滑搏急为心疝，肺脉沉搏为肺疝。又三阳急为瘕，三阴急为疝。又曰∶太阴
脉滑则病脾风疝，厥阴脉滑则病狐疝，少阴脉滑则病肺风疝，阳明脉滑则病心风疝，太阳脉滑则病肾风疝，少阳脉滑则
病肝风疝。
《脉经》曰∶寸口脉弦而紧，弦则卫气不行，卫气不行则恶寒，紧则不欲食，弦紧相搏，则为寒疝。
趺阳脉浮而迟，浮则为风虚，迟则为寒疝。
寒疝绕脐痛，若发则自汗出，手足厥寒，其脉沉弦者，乌头汤主之。
方法
丹溪曰∶疝气者，睾丸连小腹急痛也。有痛在睾丸者，有痛在五枢穴边者，皆足厥阴之经也。或无形，或无声，或
有形如瓜，或有声如蛙。自素问而下皆以为寒，盖寒主收引，经络得寒则收而不行，所以作痛。然亦有踢冰涉水终身不
病此者，无热故也。大抵此证始于湿热在经，郁而至久，又得寒气外束，不得疏散，所以作痛，若只作寒论，恐为未备。
或曰∶厥阴经郁积湿热，何由而致？予曰∶大劳则火起于筋，醉饱则火起于胃，房劳则火起于肾，大怒则火起于肝，火
积之久，母能令子虚，湿气便盛，浊液凝聚，并入血隧，流于厥阴，厥阴属木系于肝，为将军之官，其性急速，火性又
暴为寒所束，宜其痛之太暴也。有以乌头、栀子等分作汤服之，其效亦捷，后用此方，随形证加减与之，无不验。但湿
热又当分多少而治，湿则肿多， 病是也。又有挟虚而发者，当以参、术为君，疏导药佐之，脉甚沉紧而豁大无力者是
也，其痛亦轻，但重坠牵引耳。专主肝经，与肾经绝无相干，切不可下。劫药神效，盖湿热因寒郁而作，用栀子以降湿
热，乌头以破寒郁，况二物皆下焦之药，而乌头为栀子之所引，其性急速，不容胃中停留也。又谓按之不痛者属虚，须
加肉桂，以姜汁丸服。
一方 定疝痛。用海石、香附为末，姜汁调下。
又方 治诸疝，定痛速效。用枳实、栀子、糖球（即山楂）、茱萸各炒，湿盛者加荔枝核炒，为末丸服。或用长
流水调末子，空心服一、二钱。（一本有川楝子。）
又方 治食积与瘀血成痛者（一云，少腹痛者，有瘀血及有积热。）
栀子仁 桃仁 山楂 枳实 茱萸（各等分）
上为末，顺流水入姜汁作汤调服。
又方 治阳明经受湿热，传入大肠，恶寒发热，少腹连毛际结核闷痛不可忍。用山栀、桃仁、橘核并炒，山楂
等分，入姜汁煎，热服。
按之不痛者属虚，必用桂枝、山栀子（炒）、乌头（炮），上件为细末，姜汁打糊为丸，如梧桐子大，每服四、五十
丸，劫痛效。
一方 治 腰痛者（一本腰不痛者，一本治 要药）。苍术、南星、白芷、山楂、半夏、川芎、枳实，神曲糊丸
服。
诸疝发时，用海石、香附二味为末，生姜汁入汤调服，亦治心痛因清痰而作痛者。
又治疝方，橘核（炒）桃仁（研）、栀子（炒）、茱萸（炒）、川乌（炮）水煎服。
小肠气肾核胀痛，苍术、陈皮、川楝子各二钱半，甘草五分，紫苏一钱半，细切，酒水各一盏，连须葱白五茎，煎
服。
劫疝药，用乌头、栀子炒，擂细，顺流水入姜汁调服。
阴囊肿胀，大小便不通。
白牵牛（二两） 桑白皮 白术 木通（去节） 陈皮（各五钱）
上为细末，每服二钱，姜汤调下，空心服。
凡疝气挟虚者，必以参、术为君，佐以疏导之药如川楝子、茴香、枳实、山楂、栀子之类。
（以上丹溪方法凡十三条）
葱白散（三因） 治一切寒症作痛。
川芎 当归 枳壳（炒） 浓朴（炒） 干姜 官桂 青皮 茴香 （炒） 川楝 茯苓 麦 （炒） 三棱（炮）
神曲（炒） 莪术（炮） 熟地黄 白芍药 木香 人参（各等分）
上细切，每服五钱，加葱白三茎，盐少许，水煎空心温服。
又方 桃仁二十四个，枸橘子十四个瓦上炒，山栀子九枚去皮，吴茱萸七十粒，山楂子十四个，并炒，生姜一
指大，擂细，以顺流水一钟荡起，煎数沸，连渣服。
又方 治 不痛。用苍术、神曲、白芷、山楂、川芎、栀子、半夏，入姜煎服。
凡 证，非痛断房事与浓味，不可用药。
凡治七疝，须先灸大敦穴。（一名大顺，在足大拇指离爪甲如韭叶大，灸三壮，足厥阴井也。）
治疝气神方 其病甚至，气上冲，如有物筑塞心脏，欲死，手足冷者，二、三服除根。
硫黄（不拘多少，火中溶化，即投水中出毒，研细。）荔枝核（为末，炒焦黄色。）陈皮
上三味，各等分为末，饭丸如梧桐子大，每服十四、五丸，酒下，其痛立止。自己觉疼甚不能支持，略用五、六丸，
再不可多也。
又治疝方
苍术 香附（各盐炒） 黄柏（酒炒，以上为君） 青皮（去穣） 玄胡索 益智 桃仁（以上为臣） 茴香 附
子（盐炒） 甘草（炙，以上为使）
上细切，每服五钱，顺流水煎服。
五叶汤 洗疝痛立效。
枇杷叶 野紫苏叶 椒叶 苍耳草叶 水晶蒲桃叶
上五味，不拘多少，量水煎汤浴洗。
一方 肥人肿疝作痛，发热恶寒。
五苓散加茴香煎服，神验。
吴茱萸汤（东垣） 治厥疝，腹中冷痛，积气上逆，致阴冷囊寒。
吴茱萸（五分，汤泡七次） 川乌头（炮去皮） 细辛（各七分半） 良姜 当归 干姜（炮） 官桂（各二分半）
上细切，作一服，水一盏，煎七分，温服，日进三服，不痛为度。
茴香楝实丸（东垣） 治控HT ，小肠痛结，上而不下，痛冲心膈。
茴香（炒） 楝实（去核，略炒） 食茱萸（泡） 陈皮（各一两） 马蔺花（醋炒，一两） 芫花（醋炒，五钱）
上为细末，醋糊为丸，如梧桐子大，每服十丸至二十丸，空心温酒下。
蒺藜汤（宝鉴） 治阴疝，牵引小腹痛，诸厥疝即阴疝也，喜欲房劳，痛不可忍。
蒺藜（去刺炒） 附子（炮去皮脐） 栀子仁（各一钱）
上细切，作一服，水一盏，煎至六分，食前温服。亦治前控睾小肠痛。
木香散（东垣） 治心疝，小腹痛，闷绝不已。
木香 陈皮（各五分） 良姜 诃子皮 赤芍药 枳实（炒，各二分半） 草豆蔻 川芎 黑丑（各二分）
上细切，水一盏，煎七分，去渣温服。
香壳散（局方） 治小肠气，脐腹 痛，筋急，阴股中痛，闷晕不省人事。
舶上茴香（盐炒） 枳壳（麸炒，各一两） 没药（五钱）
上为细末，每服一钱，温酒调下，不拘时，并进二、三服效。
沉香桂附丸（宝鉴） 治中气虚弱甚，脾胃虚寒，脏腑积冷，心腹疼痛，手足厥逆冷，便利无度，七疝引痛，
喜热物熨荡证。
沉香 附子（炮） 川乌（炮） 干姜（炮） 良姜（炮） 官桂 吴茱萸（汤泡去苦） 茴香（炒，各一两）
上为细末，醋煮面糊为丸，如梧桐子大，每服五十丸至七十丸，空心米饮下。
加味五苓散（元戎） 治疝气卒痛，小便秘涩。
本方加川楝子一分。
上为细末，每服二钱，空心米饮调下。
茴香楝实丸（宝鉴） 治阴疝痛不可忍及小肠气痛。
川楝子（炒） 茴香（炒） 山茱萸 吴茱萸 青皮 陈皮 芫花（醋煮，比前方宜减半） 马蔺花 食茱萸（各
等分） 较之前方，多吴茱萸、青皮、山茱萸。
上为细末，醋糊丸如梧桐子大，每服三十丸，空心温酒下。
天台乌药散（宝鉴） 治小肠疝气，牵引脐腹疼痛。
乌药 木香 茴香（炒） 青皮 良姜（炙，各五钱） 槟榔（二枚） 川楝子（十枚） 巴豆（七十枚）
上先以巴豆微打破，用川楝子麸炒黑，去麸及巴豆不用，其余药同为细末，每服一钱，温酒调下，甚者姜酒调下。
葵子汤（济生） 治膀胱实热，腹胀小便不通，口舌干燥，膀胱作痛。
赤茯苓 猪苓 冬葵子 枳实 瞿麦 木通 黄芩 车前子 滑石（各五分） 甘草（二分半）
上细切，作一服，加生姜三片，水煎空心服。
丁香楝实丸 治男子七疝，痛不可忍，妇人瘕聚带下，皆任脉所主阴经病也。乃肾肝受邪，故治同法。
当归 附子（炮） 茴香（炒） 川楝子（各一两）
上细切，用好酒三升同煮，酒尽为度，焙干为细末，每末子一两入∶
丁香 木香（各五分） 玄胡索（五钱） 全蝎（十三个，炒）
上为末，与前药同拌匀，酒糊为丸，如梧桐子大，每服三十丸，加至一百丸，空心温酒送下。
一捏金散（外集） 治七疝及奔豚气痛不可忍者，神效。（方见腹痛门。）
（丹溪活套）云；凡治七疝，多用热药而获效者，即《内经》从治之法耳，须用寒凉药监制之，不可纯用大热之剂，
如乌头、附子之类，令人久服，多服必变剧不可治矣，但宜以二陈汤加枳实、橘核、栀子、山楂等药煎，入生姜汁热辣
饮之。如有瘀血作痛者，本方加玄胡索、桃仁泥。如有气作痛者，本方加木香、茴香、楝实等药。如六脉沉细、手足厥
冷者，本方加附子、干姜、肉桂之类以佐之。如睾丸痛甚者，加荔枝核、乳香、没药为细末，调入本方煎药内，或另用
顺流水调服亦可。如木肾肿大如升斗者，本方去甘草，加海藻、昆布、荔枝核、茴香、川楝等药为末，顺流水调服。作
丸子亦可。
（祖传方）
马蔺花丸 治七疝 气，及妇人阴 坠下、小儿偏坠等证，无有不效者。
马蔺花（醋炒） 川楝实 橘核 海藻（洗净） 海带（洗净） 昆布（三味俱盐酒洗） 桃仁（去皮尖，各一两）
浓朴（姜制） 木通 枳实（麸炒黄色） 玄胡索（杵碎炒） 肉桂（去粗皮） 木香 槟榔（各五钱）
脉沉细、手足逆冷者，加川乌头一个（五钱，炮）。
上为细末，酒糊丸如梧桐子大，每服五、七十丸，或酒或姜盐汤送下。
Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When the Liver pulse is large, rapid, and deep, it indicates Shan disease (hernia). It also states: Urgency in the Three Yang meridians manifests as Jia masses (abdominal masses), while urgency in the Three Yin meridians manifests as Shan disease. The *Nan Jing* (Classic of Difficult Issues) states: Disease of the Ren Mai (Conception Vessel) involves internal distress from knotting; in men, this presents as Seven Types of Shan (hernia). The so-called Seven Types are Cold Shan, Water Shan, Sinew Shan, Blood Shan, Qi Shan, Fox Shan, and Scrotal Shan. Zhang Hezi stated: In Cold Shan, the scrotum is cold and hard like stone, the penis does not erect, or there is pain radiating to the testicles. This arises from sitting or lying on damp ground, wading in cold months, exposure to rain and snow, sitting on bricks or in windy/cold places, or excessive sexual exertion. It should be treated with warming purgative formulas. If prolonged, it may lead to infertility. In Water Shan, the symptoms include swelling and pain of the kidney/scrotum, sweating in the genital area, sometimes the scrotum looks like crystal, or it itches and exudes yellow fluid upon scratching, or percussion of the lower abdomen produces a water sound. This results from excessive drinking, drunkenness, excessive sexual activity, sweating followed by exposure to wind-cold-dampness, causing cold water to accumulate in the scrotum, leading to sudden onset of Shan. It should be treated with diuretic purgative formulas (external needle drainage method exists but is omitted for fear of error). In Sinew Shan, symptoms include penile swelling, ulceration with pus, tension and retraction of sinews, pain in the urethra which becomes itching when severe, flaccid or rigid erection, or discharge of white fluid resembling semen during urination. This arises from sexual exhaustion and malicious spells. It should be treated with formulas that clear and descend Heart Fire. In Blood Shan, the shape resembles a cucumber, located on both sides of the lower abdomen at the ends of the transverse bone creases, commonly called "pian yong" (groin abscess). This results from repeated exposure to intense heat in spring and summer combined with sexual exertion, causing qi and blood to overflow and渗 into the bladder and scrotum, stagnating and forming an abscess with little pus and much blood. It should be treated with blood-nourishing purgative formulas. In Qi Shan, the condition extends upward to the kidneys and downward to the scrotum, often caused by crying or anger leading to qi stagnation and distension, which resolves when crying or anger ceases. One treatment method involves acupuncture to release qi for cure, but acupuncture has risks; thus, qi-dispersing medicinal formulas are preferred. Children may also suffer from this, commonly known as "pian zhui" (undescended/testicular hernia), resulting from fathers who were old, frequently ill, impotent, or weak in essence, engaging in forced intercourse to conceive, leading to congenital deficiency. This condition is difficult to treat; only moxibustion at the Zhubin (KI9) acupoint can cure it (acupuncture/moxa methods should be verified in Moxa Classics). In Fox Shan, the symptom resembles an inverted tile; it enters the lower abdomen when lying down and exits into the scrotum when standing or walking, similar to a fox exiting its burrow to urinate during the day and returning without urinating at night. This up-and-down movement resembles a fox and is similar to Qi Shan. It should be treated with formulas that expel qi and unblock meridians. In Scrotal Shan (Ci Shan), the scrotum swells to the size of a measuring vessel, without itching or pain. This arises from low-lying damp earth, common in the Jianghuai region. It should be treated with damp-resolving formulas. Women may experience protrusion of the vaginal opening, which belongs to this category but is due to heat failing to secure; it should not be mistaken for deficiency-cold and treated with warming tonics. Its original name is Jia, and it should be treated with bitter purgatives to astringe.
My Commentary: Zhang Hezi’s discussion on the etiology of the Seven Shan is very detailed, yet his prescription strategy relies solely on purgation, raising doubts. Since he acknowledges that these conditions often arise from deficiency due to sexual exhaustion, how can one uniformly apply purgative methods? Generally, Shan diseases, if not caused by sexual exhaustion, result from arduous travel, wading through water, or stepping on ice, where hot blood coagulates due to cold in the Small Intestine and Bladder regions, or damp-heat flows into the Foot Jueyin (Liver) meridian due to deficiency. Ancient formulas universally treated this as cold, using purely heating herbs like Aconite and Asarum. My teacher, Mr. Danxi, uniquely diagnosed this as damp-heat, uncovering insights previously missed by ancients. Heat stagnates internally while cold binds externally, causing severe pain. Therefore, treatment should expel damp-heat from the affected meridian and resolve blood stasis in the lower jiao, employing the principle of "treating heat with cold" to subdue pathogens and resolve disease. I dare not trial the purgative method myself and await further discussion by experts; students should ponder this deeply.
Pulse Diagnosis
The *Huangdi Neijing* states: Large, rapid, and deep Liver pulses indicate Shan; slippery, forceful, and rapid Heart pulses indicate Heart Shan; deep and forceful Lung pulses indicate Lung Shan. It also states: Urgency in Three Yang meridians manifests as Jia; urgency in Three Yin meridians manifests as Shan. Furthermore: Slippery Taiyin pulse indicates Spleen Wind Shan; slippery Jueyin pulse indicates Fox Shan; slippery Shaoyin pulse indicates Lung Wind Shan; slippery Yangming pulse indicates Heart Wind Shan; slippery Taiyang pulse indicates Kidney Wind Shan; slippery Shaoyang pulse indicates Liver Wind Shan.
The *Mai Jing* (Pulse Classic) states: At the Cun Kou position, a string-tight (Xian) and tight (Jin) pulse indicates that Wei Qi cannot circulate, leading to aversion to cold; tightness indicates loss of appetite. The combination of Xian and Jin pulses indicates Cold Shan.
At the Zu Yang position, a floating (Fu) and slow (Chi) pulse indicates wind-deficiency; slowness indicates Cold Shan.
Cold Shan presenting with periumbilical pain, spontaneous sweating upon attack, and cold extremities, with a deep-string pulse, is primarily treated with Wutou Tang.
Methods
Zhu Danxi stated: Shan Qi refers to acute pain connecting the testicles and lower abdomen. Pain may occur in the testicles or near the Wushu acupoint, both belonging to the Foot Jueyin meridian. The condition may be formless, soundless, shaped like a melon, or sound like a frog. Since the *Suwen*, it has been considered a cold syndrome because cold causes contraction and obstruction, leading to pain. However, some who kick ice or wade through water never suffer from this due to the absence of heat. Generally, this condition begins with damp-heat in the meridians, stagnating over time, compounded by external cold binding, preventing dispersion. Treating it solely as cold is insufficient. Someone asked: How does damp-heat accumulate in the Jueyin meridian? I replied: Great labor generates fire in sinews; drunkenness/full meals generate fire in the Stomach; sexual exhaustion generates fire in the Kidneys; great anger generates fire in the Liver. Prolonged fire accumulation weakens the mother element, allowing dampness to flourish. Turbid fluids condense, enter the blood vessels, and flow into the Jueyin. Jueyin belongs to Wood and connects to the Liver, the General Officer, possessing a swift nature. Fire is violent; bound by cold, pain becomes severe. A formula of equal parts Aconite and Gardenia decocted works quickly. Later, I used this base formula with modifications based on presentation, achieving consistent results. Damp-heat must be balanced in treatment; excess dampness causes swelling, characteristic of Scrotal Shan. Cases complicated by deficiency require Ginseng and Atractylodes as chief herbs, assisted by dispersing agents. Pulses are deep, tight, yet hollow and powerless; pain is mild, characterized by heaviness and traction. This pathology focuses on the Liver meridian and is unrelated to the Kidneys; purgation is contraindicated. "Jie" (seizing) medicines are highly effective because damp-heat arises from cold constraint. Gardenia clears damp-heat; Aconite breaks cold constraint. Both act on the lower jiao, and Aconite is guided by Gardenia, acting swiftly without lingering in the Stomach. Pressing-induced painlessness indicates deficiency; add Cinnamon Bark, formed into pills with Ginger Juice.
Formula 1 for stabilizing Shan pain: Use Haishi (Floating Stone) and Xiangfu (Cyperus Rhizome) powdered, taken with Ginger Juice.
Another Formula for various Shans with rapid pain relief: Use Zhi Shi (Immature Bitter Orange), Zhizi (Gardenia Fruit), Tangqiu (Hawthorn), and Zhuyu (Evodia Fruit), all stir-fried. For excess dampness, add Litchi He (Lychee Seed), stir-fried. Powder and form into pills. Or take 1-2 qian with long-flowing water on an empty stomach. (Some versions include Chuanlianzǐ).
Another Formula for pain caused by food retention and blood stasis (or lower abdominal pain due to blood stasis and accumulated heat):
Zhizi Ren (Gardenia Seed), Taoren (Peach Kernel), Shanzha (Hawthorn Fruit), Zhi Shi (Immature Bitter Orange), Zhuyu (Evodia Fruit) in equal parts.
Powder them. Take with decoction of long-flowing water and Ginger Juice.
Another Formula for Yangming Meridian affected by damp-heat transmitting to the Large Intestine, presenting with chills, fever, tender nodules in the lower abdomen extending to the pubic hair line, unbearable stifling pain: Use Zhizi (Gardenia), Taoren (Peach Kernel), Juhe (Tangerine Seed), all stir-fried, with equal parts Shanzha (Hawthorn). Decoct with Ginger Juice and take hot.
Painless upon pressure indicates deficiency: Must use Guizhi (Cinnamon Twig), Zhizi (Gardenia, stir-fried), Wutou (Aconite Root, processed). Powder finely, make pills with Ginger Juice paste, size of Sophora seeds. Take 40-50 pills per dose for rapid pain relief.
Formula for Ci Shan with lower back pain (some texts say no back pain, or essential for Ci Shan): Cangzhu (Atractylodes Rhizome), Nanting (Pinellia Tuber), Baizhi (Angelica Dahurica), Shanzha (Hawthorn), Chuanxiong (Ligusticum Rhizome), Zhi Shi (Immature Bitter Orange), Shenqu (Medicated Leaven) made into pills with Medicated Leaven paste.
During Shan attacks, use Haishi (Floating Stone) and Xiangfu (Cyperus Rhizome) powdered, taken with Ginger Juice decoction. Also treats heart pain caused by phlegm.
Another Shan formula: Juhe (Tangerine Seed, stir-fried), Taoren (Peach Kernel, crushed), Zhizi (Gardenia, stir-fried), Zhuyu (Evodia, stir-fried), Chuanwu (Aconite, processed) decocted in water.
Small Intestine Qi and Kidney Knot causing distending pain: Cangzhu (Atractylodes Rhizome), Chenpi (Tangerine Peel), Chuanlianzǐ (Sichuan Loranthus Fruit) each 2.5 qian; Gancao (Licorice Root) 0.5 qian; Zisu (Perilla Leaf) 1.5 qian. Cut finely. Decoct with one cup wine and one cup water, plus five stalks of green onion white. Take warm.
Shan-seizing medicine: Stir-fry Wutou (Aconite) and Zhizi (Gardenia), crush fine, mix with long-flowing water and Ginger Juice.
Scrotal swelling with urinary and fecal retention: Baiqianniu (White Morning Glory Seed) 2 liang; Sangbaipi (Mulberry Root Bark), Baizhu (Atractylodes Macrocephala Rhizome), Mutong (Akebia Stem), Chenpi (Tangerine Peel) each 5 qian. Powder finely. Take 2 qian per dose with Ginger Tea on an empty stomach.
For Shan Qi complicated by deficiency, always use Renshen (Ginseng) and Baizhu (Atractylodes) as chief herbs, assisted by dispersing agents such as Chuanlianzǐ, Huixiang (Fennel), Zhi Shi, Shanzha, Zhizi, etc.
(Above are thirteen methods from Danxi.)
Congbai San (from *San Yin Fang*) treats all cold-pattern pains:
Chuanxiong (Ligusticum Rhizome), Danggui (Angelica Sinensis Root), Zhike (Bitter Orange, stir-fried), Houpo (Magnolia Bark, stir-fried), Ganjiang (Dried Ginger), Guigui (Cinnamon Twig), Qingpi (Green Tangerine Peel), Huixiang (Fennel, stir-fried), Chuanlian (Melia Toosendan Fruit), Fuling (Poria), Maiya (Barley Sprout, stir-fried), Sanleng (Sparganium Rhizome, processed), Shenqu (Medicated Leaven, stir-fried), Ezhu (Curcuma Rhizome, processed), Shudihuang (Rehmannia Root, prepared), Baishao (White Peony Root), Muxiang (Vladimiria Root), Renshen (Ginseng) in equal parts.
Cut finely. Take 5 qian per dose, add three stalks of green onion, a pinch of salt. Decoct in water and take warm on an empty stomach.
Another Formula: 24 Taoren (Peach Kernels), 14 Gouqizi (Goji Berries) stir-fried on tile, 9 Zhizi (Gardenias) peeled, 70 Zhuyu (Evodia Fruits), 14 Shanzha (Hawthorns), all stir-fried. Crush 1-inch piece of fresh ginger. Mix with one cup of long-flowing water, boil briefly. Take with dregs.
Another Formula for non-painful Ci Shan: Cangzhu (Atractylodes Rhizome), Shenqu (Medicated Leaven), Baizhi (Angelica Dahurica), Shanzha (Hawthorn), Chuanxiong (Ligusticum Rhizome), Zhizi (Gardenia), Banxia (Pinellia Tuber). Decoct with Ginger.
For all Ci Shan cases, medication is ineffective unless sexual abstinence and rich flavors are strictly avoided.
When treating the Seven Shans, always moxa the Dadun (LR1) acupoint first. (Also named Dashun, located on the big toe, distance from nail corner like a leek leaf width. Moxa 3 cones. It is the Jing-Well point of the Foot Jueyin.)
Divine Formula for Treating Shan Qi: For severe cases where Qi rushes upward, feeling like an object blocking the heart, near death, with cold hands and feet. Two or three doses root out the disease.
Liuhuang (Sulfur) (any amount, melt in fire, drop into water to remove toxicity, grind fine); Lizhihe (Lychee Seed) (powdered, stir-fried until dark yellow); Chenpi (Tangerine Peel).
These three ingredients in equal parts, powder. Form rice pills size of Sophora seeds. Take 14-15 pills with wine. Pain stops immediately. If pain is unbearable, take only 5-6 pills; do not exceed this.
Another Shan Formula:
Cangzhu (Atractylodes Rhizome), Xiangfu (Cyperus Rhizome) (both salt-stir-fried); Huangbai (Phellodendron Bark) (wine-stir-fried, Chief herbs); Qingpi (Green Tangerine Peel, pith removed); Yanshusuo (Corydalis Rhizome), Yizhi (Alpinia Oxyphylla Fruit), Taoren (Peach Kernel) (Assistant herbs); Huixiang (Fennel), Fuzi (Aconite Child, salt-stir-fried), Gancao (Licorice Root, honey-roasted) (Envoy herbs).
Cut finely. Take 5 qian per dose, decoct in long-flowing water.
Wuye Tang (Five Leaves Decoction) for washing Shan pain with immediate effect:
Pipaye (Loquat Leaf), Ye Zisuye (Wild Perilla Leaf), Jiaoye (Pepper Leaf), Cang'ercaoye (Xanthium Leaf), Shuijing Putaoye (Crystal Grape Leaf).
Any amount of these five leaves. Decoct in appropriate water for bathing/washing.
Formula for obese patients with swollen Shan pain, fever, and aversion to cold:
Wuling San (Five-Ingredient Powder with Poria) added with Huixiang (Fennel), decocted and taken. Highly effective.
Wuzhuyu Tang (Li Dongyuan) treats Jue Shan, cold pain in abdomen, rising stagnant Qi causing cold genitals and scrotum:
Wuzhuyu (Evodia Fruit) 0.5 qian (soaked in boiling water seven times); Chuanwutou (Aconite Root, processed, peeled); Xixin (Asarum) each 0.75 qian; Liangjiang (Galangal Root), Danggui (Angelica Sinensis Root), Ganjiang (Dried Ginger, processed), Guigui (Cinnamon Twig) each 0.25 qian.
Cut finely. One dose. Decoct one cup water to 0.7 cup. Take warm. Three doses daily until pain ceases.
Huixiang Lianshi Wan (Fennel and Melia Pill, Li Dongyuan) treats testicular retraction, Small Intestine knotting pain rising upward without descending, pain rushing to chest/diaphragm:
Huixiang (Fennel, stir-fried), Lianshi (Melia Fruit, pitted, lightly stir-fried), Shizhuyu (Edible Evodia, soaked), Chenpi (Tangerine Peel) each 1 liang; Malanhua (Iris Laevigata Flower, vinegar-stir-fried) 1 liang; Yuanhua (Genkwa Flower, vinegar-stir-fried) 0.5 liang.
Powder. Make pills with vinegar paste, size of Sophora seeds. Take 10-20 pills with warm wine on an empty stomach.
Jili Tang (from *Weisheng Baojian*) treats Yin Shan, pulling pain to lower abdomen. All Jue Shans are Yin Shans, characterized by desire for sex and unbearable pain:
Jili (Tribulus Fruit, thorns removed, stir-fried), Fuzi (Aconite Child, processed, peeled, navel removed), Zhiren (Gardenia Seed) each 1 qian.
Cut finely. One dose. Decoct one cup water to 0.6 cup. Take warm before meals. Also treats previous testicular retraction and Small Intestine pain.
Muxiang San (Li Dongyuan) treats Xin Shan, lower abdominal pain, extreme suffocation:
Muxiang (Vladimiria Root), Chenpi (Tangerine Peel) each 0.5 qian; Liangjiang (Galangal Root), Hezipi (Chebula Fruit Peel), Chishao (Red Peony Root), Zhishi (Immature Bitter Orange, stir-fried) each 0.25 qian; Caodoukou (Black Cardamom), Chuanxiong (Ligusticum Rhizome), Heiqiu (Black Morning Glory Seed) each 0.2 qian.
Cut finely. One dose. Decoct one cup water to 0.7 cup. Strain and take warm.
Xiangke San (from *Ju Fang*) treats Small Intestine Qi, umbilical/abdominal pain, tendon tension, pain in inner thigh, fainting/unconsciousness:
Bo Shang Huixiang (Imported Fennel, salt-stir-fried), Zhike (Bitter Orange, bran-stir-fried) each 1 liang; Moyao (Myrrh) 0.5 liang.
Powder. Take 1 qian per dose with warm wine, anytime. Taking 2-3 doses together is effective.
Chenxiang Gui Fu Wan (from *Weisheng Baojian*) treats severe Middle Qi deficiency, Spleen/Stomach deficiency-cold, accumulated cold in organs, heart/abdominal pain, cold extremities, frequent loose stools, pain radiating from Seven Shans, preference for hot compresses:
Chenxiang (Aquilaria Wood), Fuzi (Aconite Child, processed), Chuanwu (Aconite Root, processed), Ganjiang (Dried Ginger, processed), Liangjiang (Galangal Root, processed), Guigui (Cinnamon Twig), Wuzhuyu (Evodia Fruit, soaked to remove bitterness), Huixiang (Fennel, stir-fried) each 1 liang.
Powder. Make pills with vinegar-boiled wheat flour paste, size of Sophora seeds. Take 50-70 pills with rice drink on an empty stomach.
Jiawei Wuling San (Yuan Rong) treats sudden Shan Qi pain, scanty/difficult urination:
Add Chuanlianzǐ (Sichuan Loranthus Fruit) 0.1 fen to the base formula.
Powder. Take 2 qian per dose with rice drink on an empty stomach.
Huixiang Lianshi Wan (from *Weisheg Baojian*) treats unbearable Yin Shan pain and Small Intestine Qi pain:
Chuanlianzǐ (Sichuan Loranthus Fruit, stir-fried), Huixiang (Fennel, stir-fried), Shanzhuyu (Cornus Fruit), Wuzhuyu (Evodia Fruit), Qingpi (Green Tangerine Peel), Chenpi (Tangerine Peel), Yuanhua (Genkwa Flower, vinegar-boiled, half dose compared to previous formula), Malanhua (Iris Laevigata Flower), Shizhuyu (Edible Evodia) in equal parts. Compared to the previous formula, this adds more Wuzhuyu, Qingpi, and Shanzhuyu.
Powder. Make pills with vinegar paste, size of Sophora seeds. Take 30 pills with warm wine on an empty stomach.
Tiantai Wuyao San (from *Weisheng Baojian*) treats Small Intestine Shan Qi, pulling pain to umbilicus/abdomen:
Wuyao (Lindera Root), Muxiang (Vladimiria Root), Huixiang (Fennel, stir-fried), Qingpi (Green Tangerine Peel), Liangjiang (Galangal Root, roasted) each 5 qian; Binglang (Areca Seed) 2 pieces; Chuanlianzǐ (Sichuan Loranthus Fruit) 10 pieces; Badou (Croton Seed) 70 pieces.
First, slightly crack Badou. Stir-fry Chuanlianzǐ with bran until black. Remove bran and Badou. Powder remaining herbs. Take 1 qian per dose with warm wine. For severe cases, use Ginger-Wine mixture.
Kuizi Tang (from *Jisheng Fang*) treats Bladder Excess-Heat, abdominal distension, urinary retention, dry mouth/tongue, Bladder pain:
Chifuling (Red Poria), Zhuling (Polyporus), Dongkuizi (Winter Okra Seed), Zhishi (Immature Bitter Orange), Qumai (Persicaria Herba), Mutong (Akebia Stem), Huangqin (Scutellaria Root), Cheqianzi (Plantago Seed), Huashi (Talcum) each 0.5 qian; Gancao (Licorice Root) 0.25 qian.
Cut finely. One dose. Add three slices of fresh ginger. Decoct in water and take on an empty stomach.
Dingxiang Lianshi Wan treats Seven Shans in men with unbearable pain, and Jia masses/leukorrhea in women. These are Yin Meridian diseases governed by the Ren Mai, involving pathogenic invasion of Kidney and Liver, hence treated similarly.
Danggui (Angelica Sinensis Root), Fuzi (Aconite Child, processed), Huixiang (Fennel, stir-fried), Chuanlianzǐ (Sichuan Loranthus Fruit) each 1 liang.
Cut finely. Boil with 3 sheng of good wine until wine is exhausted. Dry and powder. To every 1 liang of powder, add:
Dingxiang (Clove), Muxiang (Vladimiria Root) each 0.5 qian; Yanshusuo (Corydalis Rhizome) 5 qian; Quanxie (Scorpion, stir-fried) 13 pieces.
Powder. Mix with previous powder. Make pills with wine paste, size of Sophora seeds. Take 30 pills, increasing to 100, with warm wine on an empty stomach.
Yiniejīn San (from *Wai Ji*) treats Seven Shans and Ben Tun Qi (rushing Qi) with unbearable pain. Highly effective. (Formula see Abdominal Pain section.)
(Danxi Flexible Protocol) states: Most treatments for Seven Shans using hot herbs succeed due to the *Neijing* principle of "following treatment." However, cooling herbs must be used to moderate them. Do not use purely hot agents like Aconite or Fuzi for long-term/heavy use, as this will worsen the condition beyond cure. Instead, use Erchen Tang (Two-Aged Phlegm Decoction) added with Zhishi (Immature Bitter Orange), Juhe (Tangerine Seed), Zhizi (Gardenia), Shanzha (Hawthorn), etc., decocted with Ginger Juice and taken hot/spicy. For blood stasis pain, add Yanshusuo (Corydalis) and Taoren paste. For Qi pain, add Muxiang (Vladimiria), Huixiang (Fennel), Lianshi (Melia). For deep/thin pulses and cold extremities, add Fuzi (Aconite), Ganjiang (Dried Ginger), Rougui (Cinnamon Bark) to assist. For severe testicular pain, add Lizhihe (Lychee Seed), Rushi (Frankincense), Moyao (Myrrh) powder mixed into the decoction, or taken separately with long-flowing water. For "Wood Kidney" (hard scrotal swelling) size of a vessel, remove Gancao (Licorice), add Haizao (Sargassum), Kunbu (Kelp), Lizhihe (Lychee Seed), Huixiang (Fennel), Chuanlianzǐ (Sichuan Loranthus) powder, taken with long-flowing water. Can also be made into pills.
(Ancestral Formula)
Malinhua Wan treats Seven Shans/Ci Qi, female uterine/vaginal prolapse, pediatric undescended testis, etc., with universal efficacy.
Malinhua (Iris Laevigata Flower, vinegar-stir-fried), Chuanlianshi (Sichuan Loranthus Fruit), Juhe (Tangerine Seed), Haizao (Sargassum, washed), Haidai (Kelp, washed), Kunbu (Kelp, washed) (these three washed with salt and wine), Taoren (Peach Kernel, skin/point removed) each 1 liang; Houpo (Magnolia Bark, ginger-processed), Mutong (Akebia Stem), Zhishi (Immature Bitter Orange, bran-stir-fried yellow), Yanshusuo (Corydalis Rhizome, crushed/stir-fried), Rougui (Cinnamon Bark, bark removed), Muxiang (Vladimiria Root), Binglang (Areca Seed) each 5 qian.
For deep/thin pulses and cold extremities, add one Chuanwutou (Aconite Root) (5 qian, processed).
Powder. Make pills with wine paste, size of Sophora seeds. Take 50-70 pills with wine or Ginger-Salt tea.