（附少腹痛同一治法）
疝痛，属足厥阴肝经也。小腹，亦属肝经也。故疝痛与小腹痛同一治法。所谓疝者，睾丸连小腹痛也。其
痛有独在睾丸者，有独在小腹偏于一边者，有睾丸如升斗者， 疝是也，又立卧出入往来者，狐疝是也。
〔丹〕疝痛之甚者也，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。或有形，
或无形，或有声，或无声，或有形如瓜，有声如蛙者。《素问》以下历代名医，皆以为寒，盖寒主收引。经络得
寒收引不行，所以作痛，理固然也。有得寒而无疝者，又必有说，通之可也。予尝因门户上履霜雪，踢水徒
涉，不曾病此。以予素无热在内也。因而思之，此症始于湿热在经，郁而至久，又感寒气外束，湿热之邪，不
得疏散，所以作痛。若只作寒论，恐为未备。或曰∶此症多客厥阴一经，其道远，其位卑，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，本经火积之久，母能生子，
湿气便盛，厥阴属木，系于肝，为将军之官，其性急速，火性又暴，为寒所束，宜痛之亦大暴也。愚见有用乌
头、栀子等分作汤用之，其效亦敏。后因此方随症与形加减用之，无有不应。然湿热又须分多少而施治，但湿
者肿多， 疝是也。又有挟虚而发者，当以参、术为君，而以疏导药佐之，诊其脉不甚沉急，而大豁无力者是
也。然其痛亦轻，惟觉重坠牵引耳。
〔罗〕丁香楝实丸 治男子七疝，痛不可忍者，妇人瘕聚带下，皆任脉所主，阴经也。乃肝肾受病，治
法同归于一。
当归（去芦） 附子（炮，去皮脐） 川楝子 茴香（各一两）
上锉碎，以好酒三升，煮酒尽为度，焙干作细末，每药末一两，入下项药∶
丁香（五分） 全蝎（十三个） 玄胡索（五钱） 木香（五分）
上四味，同为细末，入前项当归等末，内拌匀，酒糊为丸，如桐子大。每服三十丸至百丸，温酒空心送下。
（一方无当归、木香，名苦楝丸，立效。）
凡疝气带下，皆属于风。全蝎，治风之圣药也。川楝、茴香，皆入小腹经。当归、玄胡索，和血止痛。
疝气带下，皆积寒邪于小肠之间，故以附子佐之，丁香、木香为引导也。
漆匠韩提控，疝气每发，痛不可忍，则于榻两末各置一枕，往来伏之以受，如是三年不已，服此药三剂
良愈。
丁香疝气丸 治脐下撮急疼痛，并脐下周身一遭皆急痛，小便频数清；其五脉，急洪缓涩沉，按
之皆虚，独肾脉按之不急，皆虚无力，名曰肾疝。
当归 茴香（各半两） 甘草梢（五钱） 丁香（五分） 全蝎（十三个） 玄胡（半两） 肉桂（一
钱） 防己（三钱） 川乌（半两） 羌活梢（三分） 麻黄根节（一钱）
上件为细末，酒糊丸如鸡豆大。每服五十丸，淡盐汤送下。须空心宿食消尽服之。
〔罗〕当归四逆汤 治男子妇女疝气，脐下冷痛，相引腰胯而疼。
当归梢（七分） 附子（炒） 官桂 茴香（炒。各五分） 芍药（四分） 玄胡索 川楝子 茯苓（
各三分） 泽泻（二分） 柴胡（五分）
上研为粗末，都作一服，水煎，空心。
玄胡索苦楝汤 治脐下冷撮痛，阴冷大寒。
肉桂（三分） 附子（三分） 熟地黄（一钱） 甘草梢（炙，半钱） 苦楝子（二分） 黄柏（一钱，
引用） 玄胡索（二分）
上件都作一服，水四盏，煎至一盏，根据法食前服。
上四方，桂、附治寒，玄胡、当归、川楝、茴香、丁香、木香和血调气，盖寒症挟污血滞气者宜之。
葫芦巴丸 治大人小儿小肠气，蟠肠奔豚疝气，偏坠阴肿，小腹有形如卵，上下来去，痛不可忍，或绞结绕脐
攻刺，呕吐闷乱，并皆治之。
葫芦巴（炒，二两） 茴香（盐炒，一两半） 吴茱萸（汤洗，炒，一两二钱） 川楝子（去核，炒，
一两二钱） 巴戟（去心，炒，七钱半） 川乌（炮，去皮尖，七钱半） 黑丑（炒，取头末，一两）
上研为细末，酒糊为丸如桐子大。每服十五丸至二十丸止，空心温酒送下。小儿五丸，茴香汤下，食前。
一本无黑丑。
〔《衍》〕葫芦巴，《本经》云∶得茴香、桃仁，治膀胱气甚效。尝合用桃仁麸炒各等分，拌酒糊丸，半为
散，每服五七十丸，空心食前盐酒下，散以热米饮调下，与丸子相间，空心各一二服效。
〔丹〕肾气散
茴香 破故纸 吴茱萸（盐炒。各半两） 木香（三钱半） 葫芦巴（七钱半）
上为细末，萝卜捣汁丸，盐汤下。
上三方，葫芦巴、破故纸、巴戟为君，盖疝而元阳素虚少者，宜之。
〔《本》〕 治小肠气，不可忍者。
乌药（捣碎，酒浸一宿） 高良姜（锉） 茴香（各一两） 青皮（二两，去白）
上研为末，每服二钱。遇发热，酒调下。
治远年小肠气，众医不瘥者。
硫黄 茴香（炒令黄，不可犯铜铁器。各等分）
上研为末，每服五钱，用热酒调，空心服，除根本。
川楝散
木香（一两） 茴香（一两，盐一匙，一处炒黄色，不用盐） 川楝子（一两，锉细，用巴
豆十粒打破，一处炒黄色，不用巴豆）
上研为细末，每服二钱，空心食前调下。
〔垣〕天台乌药散
乌药 木香 茴香（炒） 良姜（各五钱） 槟榔（三钱） 川楝子（十个） 巴豆（十四
粒） 青皮（半两）
上八味，先以巴豆打碎，一同楝实用麸炒，候黑色，去巴豆麸俱不用外，为细末，每服一钱，温酒调下。
痛甚，炒生姜热酒下亦得。
〔《简》〕木香楝子散 治小肠疝气，膀胱偏坠，久药不效者，服此其效如神。
川楝子（三十个，巴豆二十粒同炒黄赤色，去巴豆不用，将川楝子研为末） 萆 （半两） 石菖
蒲（一两，炒） 青木香（一两，炒） 荔枝核（二十枚，炒）
上研为细末，每服二钱，入麝香少许，空心，炒茴香、盐、酒调下。
上以巴豆炒药例。许学士云∶大抵此疾因虚而得之，不可以虚骤补。邪之所凑，其气必虚，留而不去，
其病则实矣。故必先涤去所蓄之邪热，然后补之，是以诸药多借巴豆气者，盖为此也。
〔仲〕寒疝腹中痛，逆冷，手足不仁，若身疼痛，灸刺诸药不能治，抵当乌头桂枝汤主之。
上用乌头一味，以蜜二升，煎减半，去渣，以桂枝汤五合解之，令得一升后，初服二合不知，再服三合又
不知，复加至五合。其知者，如醉状。得吐者，为中病。（桂枝汤方见伤寒门。海藏以附子建中汤加蜜
煎治疝，即此法也。）腹痛，脉弦而紧，弦则卫气不行，即恶寒，紧则不欲食，邪正相搏，即为寒疝。寒
疝绕脐痛，若发则自汗出，手足厥冷，其脉沉弦者，大乌头煎主之。（《脉经》云“邪正”作“弦紧”。）
大乌头（炒，去皮，不 咀，以水三升，煮取一升，去渣，纳蜜二升，煎令水气尽。）作汤服，食
后一服，过后再不作矣。
治诸疝方
枳实（九粒，炒） 桃仁（十四个，炒） 山栀（九个，炒，去皮） 吴茱萸（七粒，炒） 山楂（四
粒，炒） 生姜（如指大）
上味同入擂盆擂细，取顺流水一钟，入瓶内煎至微沸，带渣服。如湿胜 疝者，加荔枝核。如痛甚者，加
盐炒大茴香二钱。如痛处可按者，加薄桂少许。
又方 治疝痛。
山栀（二两，炒） 山楂（四两，炒） 枳实（炒） 茴香（各二两，炒） 柴胡 牡丹皮 八角
茴香（炒，各一两） 桃仁 茱萸（炒，半两）
上研为末，酒糊丸，空心盐汤下五六十丸。
治阳明受湿热，传入太阳，发热恶寒，小腹连毛际间，闷痛不可忍。
栀子仁（炒） 桃仁（炒） 枳实（炒） 山楂（各等分）
上味，同研细，入生姜汁半合，同水一小钟荡起，煎令沸，热服之。一方加茱萸。
杨淳三哥，因旧有肾气，上引乳边及右胁痛，多痰，有时膈上痞塞，大腑秘结，平时少汗，脉弦甚。与保
和温中各二十丸，研桃仁、郁李仁吞之。
〔《本》〕治膀胱气痛，茴香散。
茴香 金铃子肉 蓬莪术 京三棱（各一两） 甘草（半两，炙）
上为细末，每服二钱，热酒调下。每发痛甚连日，只三二服，立定。
治膀胱气，金楝散。
巴豆（一百粒，去壳） 川楝子（二十四个，汤浸去薄皮，切作片子）
上二味，用麸二升，同炒令黄赤，去麸与巴豆不用，只将川楝肉一味为末，每服三钱，温酒空心送下。余
阅古今一切名方，无如此奇特有效。一方川楝子不用巴豆炒亦妙。
〔《灵》〕胃中热，肠中寒，则疾饥，小腹痛胀。（师传篇 疾饥胃热，痛胀，肠寒也。）
〔丹〕诸疝痛处，用手按之不痛者，属虚，必用桂枝、炒山栀、细切川乌头等分，为细末，生姜自然汁打
糊为丸，如桐子大，每服三四十丸，空腹白汤下。
疝可按者，并于历代独治外寒条下求之。
丹溪云∶疝有挟虚而发者，其脉不甚沉紧，而大豁无力者是也。然其痛亦轻，惟觉重坠牵引耳。当以参、
术为君，疏导药佐之。盖疏导药即桃仁、山楂、枳实、栀仁、茱萸、川楝、玄胡索、丁香、木香之类，以佐参、
术之类是也。
〔海〕姬提领因疾，服凉剂数日，遂病脐腹下大痛，几至于死。与姜附等剂，虽稍苏，痛不已，随本方内
倍芍药，服之愈。
〔罗〕疝气治验 癸丑岁，治火儿赤怜歹病疝气，复因七月间饥饱劳役，过饮 乳，所发甚于初，面色青
黄不泽，脐腹阵痛，搐撮不可忍，腰不能伸，热物熨之稍缓，脉得沉小而急。予思《难经》有云∶任之为病，
男子内结七疝，皆积寒于小肠所致也。非大热之剂，即不能愈。遂制一方，名之曰沉香桂附丸。每服一百丸，
空心温酒下，间服天台乌药散，旬日良愈，明年秋如故。
沉香桂附丸 治中气虚弱，脾胃虚寒，饮食不美，气不调和，退阴助阳，除脏腑积冷，心腹疼痛，胁肋膨胀，
腹中雷鸣，面色不泽，手足厥逆，便利无度。又治下焦阳虚，及疗七疝，痛引小腹不可忍，腰痛不能伸，喜
热熨稍缓。
沉香 附子（炮，去皮脐） 川乌（炮，去皮脐） 干姜（炮） 良姜（炒） 官桂（去皮） 茱萸（汤洗
）茴香（炒。各一两）
上研为细末，醋煮面糊为丸，如桐子大。每服五十丸至七八十丸止，空心食前热米饮汤下，日三服。忌冷物。
〔丹〕治疝劫痛方
川乌头（细切） 栀子仁（去壳）
上各等分，煎汤服之神效。湿多 肿者，乌头为君。盖川乌头治外束之寒，栀仁治内郁之热也。
〔罗〕阴疝，足厥阴之脉，环阴器抵小腹，或痛因肾虚，寒水涸竭，泻邪补肝，宜以蒺藜汤主之。
蒺藜汤 治阴疝牵引小腹痛，诸厥疝，即阴疝也，房欲劳痛不可忍者。
蒺藜（炒，去尖） 附子（炮，去皮脐） 山栀仁（各半两）
上研为末，每服三钱，水一盏半，煎至七分，去渣，食前温服。
〔丹〕又方
橘核 桃仁 栀子 茱萸 川乌（各等分）
上研煎服。
治疝作急痛。
苍术（盐炒） 香附（盐炒） 茴香（炒，为佐） 黄柏（酒炒，为君） 青皮 玄胡索 益智
桃仁（为臣） 附子（盐水炒） 甘草（为使）
上研为末，作汤服后，一痛过，更不再作矣。
〔仲〕寒疝腹中痛，及胁痛里急者，当归生姜羊肉汤主之。
当归（三两） 生姜（五两） 羊肉（一斤）
上上三味，以水八升，煮取三升，温服七合，一日三服。若寒多者，加生姜十片。痛多而呕者，加陈皮二
两，白术一两。如加生姜者，亦加水五升，煮取三升二合服之。
〔《衍义》云∶张仲景治寒疝，用生姜羊肉汤，服之无不应验。有一妇人产当寒月，寒气入产门，腹脐以下胀
满，手不敢犯，此寒疝也，师将治之，以抵当汤谓有瘀血，非其治也，可服张仲景羊肉汤，二服遂愈。
〔丹〕诸疝痛处，用手按之大痛者，为实也。
〔罗〕疝气痛，及脚膝无力，控睾证。至真要大论云∶小腹控睾引腰脊，上冲心，唾出清水及为哕噫，甚
则入心，善忘善悲。《甲乙经》曰∶邪在小肠也。小肠病者，小腹痛引腰脊，贯肝肺。其经虚不足，则风冷乘间
而入。邪气既入，则厥证上冲肝肺，客冷散于胸，结于脐，控引睾丸，上而不下，痛而入腹，甚则冲于心胸，
盖其经络所系也。启玄子云∶控，引也。睾，阴丸也。
控引睾丸 治小肠痛结，上而不下，痛引心臆。（即东垣茴香楝实丸。按之痛为实，此方有茱萸等刚剂，
本不可入此条，缘芫花有利性故入之。）
川楝子 茴香（炒） 吴茱萸（汤洗） 青皮 陈皮（各一两） 芫花（醋炒五钱） 马蔺花（醋炒一两）
上为细末，醋糊为丸，如桐子大。每服三十丸，温酒送下，食前服。量虚实加减，以利为度。
〔《本》〕治小肠气痛撞腹，面青唇黑欲死者。
木香 茵陈 芫花 甘遂（各等分）
上四件，为末，每服二钱，水一盏，煎至七分，去渣温服。服过此药后，应犯甘草药，皆不得吃，恐与甘
遂相犯故也。其药甚妙，亦甚有理，屡有验效。
砂丸
(Note: The treatment for lower abdominal pain follows the same method as that for hernia.)
Hernia pain belongs to the Foot Jueyin Liver Meridian. The lower abdomen also belongs to the Liver Meridian. Therefore, hernia pain and lower abdominal pain are treated with the same method. What is called "hernia" refers to pain in the testicles radiating to the lower abdomen. The pain may be located solely in the testicles, or solely on one side of the lower abdomen, or the testicles may swell like a measuring vessel; this is typical hernia. Another type involves swelling that appears when standing and disappears when lying down, moving up and down, known as Fox Hernia (Hu Shen).
[Zhu Danxi] Severe hernia pain is the most serious type, characterized by acute pain in the testicles radiating to the lower abdomen. Pain may be in the testicles or near the Wushu acupoint (Wushu, GB29), both belonging to the Foot Jueyin Liver Meridian. It may present with visible form or invisible, with sound or without sound, shaped like a melon, or making sounds like a frog. Suwen and famous doctors of subsequent dynasties all attributed it to Cold, because Cold governs contraction and pulling. When meridians contract due to Cold, qi and blood cannot flow smoothly, causing pain; this is logical. However, some suffer from Cold but do not develop hernia; there must be an explanation, which can be understood through medical principles. I once trod on frost and snow on doors and waded through water barefoot, yet did not suffer from this disease, because my interior was originally free of Heat. Reflecting on this, this condition begins with Damp-Heat stagnating in the meridians, accumulating over time, and then being constrained by external Cold, preventing the dispersion of Damp-Heat pathogenic factors, thus causing pain. If one only treats it as a Cold syndrome, it may be incomplete. One might ask: This syndrome mostly affects the Jueyin meridian, which has a long pathway and low status; how does Damp-Heat accumulate? I say: Excessive labor generates Fire in the sinews; drunkenness and overeating generate Fire in the Stomach; sexual excess generates Fire in the Kidney; extreme anger generates Fire in the Liver. After Fire accumulates in the primary meridian for a long time, the mother organ fails to nourish the child, leading to excessive Dampness. Jueyin belongs to Wood, is associated with the Liver, which is the "General," possessing a rapid nature; Fire is also violent. Constrained by Cold, the pain is naturally sudden and severe. My view is to use Aconite Root (Wutou) and Gardenia Fruit (Zhizi) in equal parts decocted as a soup; the effect is rapid. Later, I modified this formula according to symptoms and constitution, achieving consistent success. However, Damp-Heat must be differentiated by proportion for treatment; usually, Damp-dominant cases show significant swelling, which is characteristic of hernia. There are also cases complicated by Deficiency, where Ginseng Root (Renshen) and Atractylodes Rhizome (Baizhu) should be used as the sovereign drug, assisted by draining and guiding herbs. Pulse diagnosis reveals a pulse that is not deep and tight, but large, empty, and powerless. In such cases, the pain is also mild, mainly feeling heavy dragging and traction.
[Luo Tianyi] Dingxiang Lianshi Wan (Clove and Chinaberry Pill) treats seven types of hernia in men with unbearable pain, as well as masses and leukorrhea in women. These are all governed by the Ren Mai (Conception Vessel), belonging to Yin meridians. The pathology lies in the Liver and Kidney, and the treatment methods ultimately converge.
Dang Gui (Angelicae Sinensis Radix, remove radicle) Fuzi (Prepared Aconiti Lateralis Radix, peel and remove umbilicus) Chuan Lian Zi (Toosendan Fructus) Huixiang (Foeniculi Fructus) (each 1 liang)
Crush the above ingredients, boil in 3 sheng of good wine until the wine is exhausted, dry by baking, and grind into fine powder. For every 1 liang of powder, add the following:
Dingxiang (Caryophylli Flos, 5 fen) Quan Xie (Scorpio, 13 pieces) Yanhusuo (Corydalis Rhizoma, 5 qian) Muxiang (Aucklandiae Radix, 5 fen)
Grind these four ingredients into fine powder, mix evenly with the previous Dang Gui powder, make pills with wine paste, size of Sophora japonica seeds. Take 30 to 100 pills per dose, with warm wine on an empty stomach.
(Another prescription without Dang Gui and Muxiang is named Kulian Wan, with immediate effect.)
Generally, hernia and leukorrhea belong to Wind. Quan Xie (Scorpio) is the holy medicine for treating Wind. Chuan Lian Zi (Toosendan Fructus) and Huixiang (Foeniculi Fructus) enter the lower abdomen meridians. Dang Gui (Angelicae Sinensis Radix) and Yanhusuo (Corydalis Rhizoma) harmonize blood and stop pain.
Hernia and leukorrhea result from Cold pathogenic factors accumulating between the Small Intestine and the Bladder, so Fuzi (Prepared Aconiti Lateralis Radix) is used to assist, while Dingxiang (Caryophylli Flos) and Muxiang (Aucklandiae Radix) serve as guides.
Han Tikong, a lacquer worker, suffered from hernia attacks with unbearable pain for three years, lying back and forth on pillows at both ends of his bed. He took this medicine for three doses and recovered well.
Dingxiang Shiqi Wan (Clove Hernia Pill) treats cramping pain below the navel, extending around the entire circumference of the navel, with frequent clear urination. The five pulses (rapid, surging, slow, choppy, deep) are all weak upon palpation, except the Kidney pulse which is not rapid but weak and powerless; this is named Kidney Hernia.
Dang Gui (Angelicae Sinensis Radix) Huixiang (Foeniculi Fructus) (each 0.5 liang) Gancao Shao (Glycyrrhizae Radix et Rhizoma, tip) (5 qian) Dingxiang (Caryophylli Flos, 5 fen) Quan Xie (Scorpio, 13 pieces) Yanhu (Corydalis Rhizoma, 0.5 liang) Rougui (Cinnamomi Cortex, 1 qian) Fangji (Stephaniae Tetrandrae Rhizoma, 3 qian) Chuan Wu (Sichuan Aconiti Radix, 0.5 liang) Qianghuo Shao (Notopterygii Rhizoma et Radix, tip) (3 fen) Mahuang Genjie (Ephedrae Herba, root joint) (1 qian)
Grind the above ingredients into fine powder, make pills with wine paste, size of chicken beans. Take 50 pills per dose, with light salt water. Must be taken on an empty stomach after food residue is digested.
[Luo Tianyi] Danggui Sini Tang (Angelica Decoction for Cold Extremities) treats hernia in men and women, cold pain below the navel radiating to the waist and hips.
Danggui Shao (Angelicae Sinensis Radix, tip) (7 fen) Fuzi (Prepared Aconiti Lateralis Radix, stir-fried) Guanzi Gui (Cinnamomi Ramulus) Huixiang (Foeniculi Fructus, stir-fried) (each 5 fen) Shaoyao (Paeoniae Radix Alba) (4 fen) Yanhusuo (Corydalis Rhizoma) Chuan Lian Zi (Toosendan Fructus) Fuling (Poria) (each 3 fen) Zexie (Alismatis Rhizoma) (2 fen) Chaihu (Bupleuri Radix) (5 fen)
Grind into coarse powder, take as one dose, decoct in water, take on an empty stomach.
Yanhusuo Kulian Tang (Corydalis and Chinaberry Decoction) treats cold cramping pain below the navel and severe cold in the genitalia.
Rougui (Cinnamomi Cortex, 3 fen) Fuzi (Prepared Aconiti Lateralis Radix, 3 fen) Shudihuang (Rehmanniae Radix Praeparata, 1 qian) Gancao Shao (Glycyrrhizae Radix et Rhizoma, roasted, half qian) Kulian Zi (Meliae Fructus, 2 fen) Huangbai (Phellodendri Cortex, 1 qian, as guide) Yanhusuo (Corydalis Rhizoma, 2 fen)
Take as one dose, decoct 4 zhan of water to 1 zhan, take before meals according to standard method.
The above four formulas use Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconiti Lateralis Radix) to treat Cold, and Yanhusuo (Corydalis Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chuan Lian Zi (Toosendan Fructus), Huixiang (Foeniculi Fructus), Dingxiang (Caryophylli Flos), and Muxiang (Aucklandiae Radix) to harmonize blood and regulate qi. They are suitable for Cold syndromes complicated by stagnant blood and qi.
Huluba Wan (Trigonella Foenum-Graecum Pill) treats intestinal gas in adults and children, Pan Chang Ben Tun hernia, unilateral scrotal swelling, solid mass in the lower abdomen resembling an egg, moving up and down with unbearable pain, or twisting pain around the navel, vomiting, and confusion. All are treated by this formula.
Huluba (Trigonellae Semen, roasted, 2 liang) Huixiang (Foeniculi Fructus, salt-roasted, 1.5 liang) Wuzhuyu (Evodiae Fructus, washed with water, roasted, 1.2 liang) Chuan Lian Zi (Toosendan Fructus, pitted, roasted, 1.2 liang) Bajitian (Morinda Officinalis Radix, heart removed, roasted, 0.75 liang) Chuan Wu (Sichuan Aconiti Radix, processed, peel and tip removed, 0.75 liang) Hei Chou (Momordicae Semen, roasted, take top powder, 1 liang)
Grind into fine powder, make pills with wine paste, size of Sophora japonica seeds. Take 15 to 20 pills per dose, with warm wine on an empty stomach. Children take 5 pills with Foeniculum tea before meals.
One version lacks Hei Chou.
[Yanyi] Huluba (Trigonellae Semen): Benjing states that combined with Huixiang (Foeniculi Fructus) and Taoren (Persicae Semen), it effectively treats Bladder Qi. I once compounded them with Taoren (Persicae Semen) stir-fried with bran in equal parts, made into pills with wine paste, half as powder. Take 50-70 pills on an empty stomach before meals with salt wine; powder mixed with hot rice drink. Alternate pills and powder, taking 1-2 doses on an empty stomach each time for effectiveness.
[Zhu Danxi] Shenqi San (Kidney Qi Powder)
Huixiang (Foeniculi Fructus) Pogu Zhi (Psoraleae Fructus) Wuzhuyu (Evodiae Fructus, salt-roasted) (each 0.5 liang) Muxiang (Aucklandiae Radix, 3.5 qian) Huluba (Trigonellae Semen, 7.5 qian)
Grind into fine powder, make pills with radish juice, take with salt water.
In the above three formulas, Huluba (Trigonellae Semen), Pogu Zhi (Psoraleae Fructus), and Bajitian (Morinda Officinalis Radix) are the sovereign drugs. They are suitable for hernia patients with inherent deficiency of Yuan Yang (Original Yang).
[Bencao] Treats unbearable intestinal gas.
Wuyao (Linderae Radix, crushed, soaked in wine overnight) Gaoliangjiang (Alpiniae Officinarum Rhizoma, chopped) Huixiang (Foeniculi Fructus) (each 1 liang) Qingpi (Citri Reticulatae Pericarpium Viride, 2 liang, remove white pith)
Grind into powder, take 2 qian per dose. If fever occurs, take with wine.
Treats chronic intestinal gas unresponsive to other doctors.
Liuhuang (Sulfur) Huixiang (Foeniculi Fructus, roasted yellow, avoid copper/iron) (equal parts)
Grind into powder, take 5 qian per dose, mixed with hot wine, take on an empty stomach to eliminate the root cause.
Chuanlian San (Chinaberry Powder)
Muxiang (Aucklandiae Radix, 1 liang) Huixiang (Foeniculi Fructus, 1 liang, stir-fry with one spoon of salt until yellow, discard salt) Chuan Lian Zi (Toosendan Fructus, 1 liang, chop finely, stir-fry with 10 broken Bitter Beans until yellow, discard Bitter Beans)
Grind into fine powder, take 2 qian per dose on an empty stomach before meals.
[Li Dongyuan] Tiantai Wuyao San (Tiantai Lindera Powder)
Wuyao (Linderae Radix) Muxiang (Aucklandiae Radix) Huixiang (Foeniculi Fructus, roasted) Liangjiang (Alpiniae Officinarum Rhizoma) (each 5 qian) Binglang (Arecae Semen, 3 qian) Chuan Lian Zi (Toosendan Fructus, 10 pieces) Badou (Crotonis Fructus, 14 grains) Qingpi (Citri Reticulatae Pericarpium Viride, 0.5 liang)
Crush Badou (Crotonis Fructus), stir-fry together with Chuan Lian Zi (Toosendan Fructus) using bran until black. Discard Badou (Crotonis Fructus) and bran. Grind remaining into fine powder. Take 1 qian per dose with warm wine.
For severe pain, take with stir-fried ginger and hot wine.
[Jianyao Jizhong Fang] Muxiang Lianzi San (Aucklandia and Chinaberry Powder) Treats intestinal hernia, bladder unilateral descent, ineffective after long-term medication. Effect is miraculous.
Chuan Lian Zi (Toosendan Fructus, 30 pieces, stir-fry with 20 Badou (Crotonis Fructus) until yellow-red, discard Badou, grind Chuan Lian Zi into powder) Bibi (Dioscoreae Hypoglaucae Rhizoma, 0.5 liang) Shichangpu (Acori Tatarinowii Rhizoma, 1 liang, roasted) Qingmuxiang (Pseudostellariae Radix, 1 liang, roasted) Lizhihe (Litchi Seed, 20 pieces, roasted)
Grind into fine powder, take 2 qian per dose with a little Moschus (Musk), on an empty stomach, mixed with stir-fried Huixiang (Foeniculi Fructus), salt, and wine.
This illustrates the use of Badou (Crotonis Fructus) in frying herbs. Xu Xueshi said: Generally, this disease arises from deficiency and should not be tonified abruptly. Where pathogenic factors gather, qi is necessarily deficient; if they linger, the condition becomes excess. Thus, one must first cleanse accumulated pathogenic heat before tonifying. Hence, many herbs borrow the qi of Badou (Crotonis Fructus) for this reason.
[Zhang Zhongjing] Cold Hernia with abdominal pain, cold limbs, numbness in hands and feet, body pain unresponsive to moxibustion, acupuncture, and medicines, is treated with Didang Wutou Guizhi Tang (Vitalizing Aconite and Cinnamon Twig Decoction).
Use one piece of Wutou (Aconiti Radix), decoct with 2 sheng of honey until reduced by half, strain, and dissolve with 5 he of Guizhi Tang (Cinnamon Twig Decoction) to obtain 1 sheng. Initial dose 2 he; if no effect, take 3 he; if still no effect, increase to 5 he. Effective cases feel like intoxication. Vomiting indicates hitting the target. (Guizhi Tang formula see Shanghan section. Haizang uses Fuzi Jianzhong Tang added with honey for hernia, which is this method.) Abdominal pain with wiry and tight pulse: wiry means defensive qi does not flow, leading to aversion to cold; tight means loss of appetite. Struggle between pathogen and righteous qi constitutes Cold Hernia. Cold Hernia with periumbilical pain, sweating during attacks, cold extremities, and deep wiry pulse is treated with Da Wutou Jian (Great Aconite Decoction). (Maijing reads "pathogen/righteous" as "wiry/tight".)
Da Wutou (Aconiti Radix, roasted, peeled, not chewed, decoct 3 sheng water to 1 sheng, strain, add 2 sheng honey, boil until water evaporates). Make soup, take after meal. Do not repeat dose.
Formula for Various Hernias
Zhishi (Immature Bitter Orange Fruit, 9 grains, roasted) Taoren (Persicae Semen, 14 grains, roasted) Shanzhi (Gardeniae Fructus, 9 grains, roasted, peeled) Wuzhuyu (Evodiae Fructus, 7 grains, roasted) Shanzha (Crataegi Fructus, 4 grains, roasted) Shengjiang (Zingiberis Rhizoma Recens, finger-sized)
Pound all ingredients finely in a mortar, take one cup of flowing water, boil in a bottle until slightly boiling, take with dregs. For Damp-dominant hernia swelling, add Lizhihe (Litchi Seed). For severe pain, add 2 qian salt-roasted Huixiang (Foeniculi Fructus). For tender pain points, add a little Baogui (Thin Cinnamon Bark).
Another Formula for Hernia Pain
Shanzhi (Gardeniae Fructus, 2 liang, roasted) Shanzha (Crataegi Fructus, 4 liang, roasted) Zhishi (Immature Bitter Orange Fruit, roasted) Huixiang (Foeniculi Fructus) (each 2 liang, roasted) Chaihu (Bupleuri Radix) Mudanpi (Moutan Cortex) Bajiao Huixiang (Illicii Fructus, roasted) (each 1 liang) Taoren (Persicae Semen) Yuyu (Evodiae Fructus, roasted, 0.5 liang)
Grind into powder, make pills with wine paste, take 50-60 pills on an empty stomach with salt water.
Treats Yangming channel affected by Damp-Heat transmitting to Taiyang channel, with fever, aversion to cold, stuffy pain from lower abdomen to pubic region.
Zhizi Ren (Gardeniae Fructus, roasted) Taoren (Persicae Semen, roasted) Zhishi (Immature Bitter Orange Fruit, roasted) Shanzha (Crataegi Fructus) (equal parts)
Grind finely, add half he of fresh Ginger Juice (Shengjiang Zhi), mix with one small cup of water, boil, take hot. Another version adds Yuyu (Evodiae Fructus).
Yang Chun San Ge, suffering from old Kidney Qi rising to breast and right hypochondrium, phlegm, chest oppression, constipation, scant sweating, very wiry pulse. Given Baohe Wan (Harmonize Harmony Pill) and Wenzhong Wan (Warm Middle Pill) 20 each, pounded Taoren (Persicae Semen) and Yuliren (Prunus Armeniaca Seed) swallowed.
[Bencao] Treats Bladder Qi pain, Huixiang San (Fennel Powder).
Huixiang (Foeniculi Fructus) Jinlingzi Rou (Toosendan Fructus flesh) Peng Ezhu (Curcumae Rhizoma) Jing Sanleng (Sparganii Rhizoma) (each 1 liang) Gancao (Glycyrrhizae Radix et Rhizoma, roasted, 0.5 liang)
Grind into powder, take 2 qian per dose with hot wine. For severe continuous pain, 2-3 doses stop it immediately.
Treats Bladder Qi, Jinlian San (Golden Chinaberry Powder).
Badou (Crotonis Fructus, 100 grains, shelled) Chuan Lian Zi (Toosendan Fructus, 24 pieces, soaked in water, peel removed, sliced)
Stir-fry with 2 sheng of bran until yellow-red. Discard bran and Badou (Crotonis Fructus). Grind Chuan Lian Zi (Toosendan Fructus) flesh into powder. Take 3 qian per dose with warm wine on an empty stomach. I have read ancient and modern prescriptions, none so unique and effective. Another version uses Chuan Lian Zi (Toosendan Fructus) fried without Badou (Crotonis Fructus), which is also excellent.
[Lingshu] Heat in Stomach, Cold in Intestines leads to hunger, lower abdominal pain and distension. (Shichuan Chapter: Hunger due to Stomach Heat, pain/distension due to Intestine Cold.)
[Zhu Danxi] For hernia pain points that do not hurt when pressed, it is Deficiency. Use Guizhi (Cinnamon Twig), roasted Zhizi (Gardeniae Fructus), and finely cut Chuan Wu (Sichuan Aconiti Radix) in equal parts. Grind into powder, make pills with fresh Ginger Juice (Shengjiang Zhi), size of Sophora japonica seeds. Take 30-40 pills on an empty stomach with plain water.
For hernia that can be pressed, seek treatment under the "treating external Cold alone" sections of past dynasties.
Danxi said: Hernia can occur with Deficiency, pulse not deep/tight but large/empty/powerless. Pain is mild, feeling heavy dragging. Use Renshen (Ginseng Root) and Baizhu (Atractylodes Rhizome) as sovereign, assisted by draining herbs like Taoren (Persicae Semen), Shanzha (Crataegi Fructus), Zhishi (Immature Bitter Orange Fruit), Zhiren (Gardeniae Fructus), Yuyu (Evodiae Fructus), Chuan Lian Zi (Toosendan Fructus), Yanhusuo (Corydalis Rhizoma), Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix).
[Wang Haizang] Ji Tiling, after taking cooling agents for days, developed severe lower abdominal pain nearly fatal. Given Jiangfu (Ginger and Aconite) agents, slightly revived but pain persisted. Increased Shaoyao (Paeoniae Radix) in the formula, cured.
[Luo Tianyi] Hernia Case Study: In Guichou year, treated Hu'er Chilian Dai with hernia. Due to hunger/fullness and labor in July, plus excessive milk intake, symptoms worsened. Complexion green-yellow dull, paroxysmal abdominal pain, spasms unbearable, unable to extend waist, relieved by hot compress, pulse deep/small/rapid. Recalling Nanjing: "Ren Mai disease causes seven hernias in men, all due to Cold accumulation in Small Intestine." Only great hot agents can cure. Formulated Chenxiang Guifu Wan (Agarwood and Aconite-Cinnamon Pill). Take 100 pills on empty stomach with warm wine, alternate with Tiantai Wuyao San (Tiantai Lindera Powder). Recovered well in 10 days, relapsed next autumn.
Chenxiang Guifu Wan (Agarwood and Aconite-Cinnamon Pill) Treats middle qi deficiency, spleen/stomach cold, poor diet, qi disharmony, retreating yin assisting yang, removing internal cold, epigastric/abdominal pain, hypochondriac distension, borborygmus, dull complexion, cold extremities, uncontrolled bowel movements. Also treats lower jiao yang deficiency and seven hernias with pain radiating to lower abdomen, lumbar stiffness relieved by heat.
Chenxiang (Aquilariae Lignum Resinatum) Fuzi (Prepared Aconiti Lateralis Radix, peeled) Chuan Wu (Sichuan Aconiti Radix, peeled) Ganjiang (Zingiberis Rhizoma, dried) Liangjiang (Alpiniae Officinarum Rhizoma, stir-fried) Guanzi Gui (Cinnamomi Ramulus, peeled) Yuyu (Evodiae Fructus, washed) Huixiang (Foeniculi Fructus, roasted) (each 1 liang)
Grind into powder, make pills with vinegar-boiled wheat paste, size of Sophora japonica seeds. Take 50-80 pills on empty stomach before meals with hot rice drink, 3 times daily. Avoid cold foods.
[Zhu Danxi] Emergency Formula for Hernia Pain
Chuan Wutou (Sichuan Aconiti Radix, finely cut) Zhizi Ren (Gardeniae Fructus, shelled)
Equal parts, decoct and take. Miraculous effect. For Damp-dominant swelling, use Wutou (Aconiti Radix) as sovereign. Chuan Wutou (Sichuan Aconiti Radix) treats external Cold; Zhiren (Gardeniae Fructus) treats internal Heat.
[Luo Tianyi] Yin Hernia: Foot Jueyin meridian circles genitals to lower abdomen. Pain due to Kidney deficiency, exhaustion of Cold Water. Drain pathogen, tonify Liver. Use Jili Tang (Tribulus Decoction).
Jili Tang (Tribulus Terrestris Decoction) Treats Yin hernia radiating to lower abdomen, various Jue hernias (i.e., Yin hernia), unbearable pain from sexual fatigue.
Jili (Tribuli Fructus, roasted, remove spines) Fuzi (Prepared Aconiti Lateralis Radix, peeled) Zhizi Ren (Gardeniae Fructus, roasted) (each 0.5 liang)
Grind into powder, take 3 qian per dose, decoct 1.5 zhan water to 0.7 zhan, strain, take warm before meals.
[Zhu Danxi] Another Formula
Juhe (Citri Reticulatae Pericarpium Immaturum) Taoren (Persicae Semen) Zhizi (Gardeniae Fructus) Yuyu (Evodiae Fructus) Chuan Wu (Sichuan Aconiti Radix) (equal parts)
Grind and decoct.
Treats urgent hernia pain.
Cangzhu (Atractylodis Rhizoma, salt-roasted) Xiangfu (Cyperi Rhizoma, salt-roasted) Huixiang (Foeniculi Fructus, roasted, assistant) Huangbai (Phellodendri Cortex, wine-roasted, sovereign) Qingpi (Citri Reticulatae Pericarpium Viride) Yanhusuo (Corydalis Rhizoma) Yizhi (Alpiniae Oxyphyllae Fructus) Taoren (Persicae Semen, minister) Fuzi (Prepared Aconiti Lateralis Radix, salt-water roasted) Gancao (Glycyrrhizae Radix et Rhizoma, envoy)
Grind into powder, decoct and take. Pain ceases permanently after one course.
[Zhang Zhongjing] Cold Hernia with abdominal pain and hypochondriac tension is treated with Danggui Shengjiang Yangrou Tang (Angelica, Ginger, and Mutton Decoction).
Dang Gui (Angelicae Sinensis Radix, 3 liang) Shengjiang (Zingiberis Rhizoma Recens, 5 liang) Yangrou (Ovis/Aries Carcass, 1 jin)
Decoct 3 ingredients in 8 sheng water to 3 sheng. Take 7 he warm, 3 times daily. If more Cold, add 10 slices of Ginger. If pain with vomiting, add 2 liang Chenpi (Citri Reticulatae Pericarpium) and 1 liang Baizhu (Atractylodis Macrocephalae Rhizoma). If adding Ginger, add 5 sheng water, boil to 3.2 sheng.
[Yanyi says: Zhang Zhongjing's Mutton Soup for Cold Hernia is always effective. A woman gave birth in cold month, Cold entered birth canal, lower abdomen full, too painful to touch. This is Cold Hernia. Master intended to treat with Didang Tang (Vitalizing Decoction) assuming blood stasis, but this was incorrect. Advised Zhang Zhongjing's Mutton Soup. Two doses cured her.
[Zhu Danxi] Hernia pain points that hurt severely when pressed indicate Excess.
[Luo Tianyi] Hernia pain, leg/knee weakness, Testicular Retraction Syndrome. Zhizhen Dayulun says: Lower abdomen retracts testicles, draws to waist/spine, rushes to heart, salivates clear fluid, hiccups. Severe cases affect heart, forgetfulness, sadness. Jiayi Jing says: Pathogen in Small Intestine. Small Intestine disease: lower abdominal pain drawing to waist/spine, penetrating Liver/Lungs. Meridian deficiency allows Wind/Cold invasion. Pathogen enters, Jue syndrome rushes to Liver/Lungs, Cold scatters in chest, knots at navel, retracts testicles, rises but does not descend, pain enters abdomen, rushes to heart/chest. This is due to meridian connections. Qixuanzi says: Kong means draw/retract. Gao means testicle.
Kongyin Jiegao (Retracting Testicles) Treats Small Intestine knotting, rising pain to heart/chest. (i.e., Dongyuan Huixiang Lianshi Wan. Pressing hurts indicates Excess. This formula contains rigid herbs like Yuyu (Evodiae Fructus), normally unsuitable here, but included because Yuanhua (Genkwa Flos) has purgative properties.)
Chuan Lian Zi (Toosendan Fructus) Huixiang (Foeniculi Fructus, roasted) Wuzhuyu (Evodiae Fructus, water-washed) Qingpi (Citri Reticulatae Pericarpium Viride) Chenpi (Citri Reticulatae Pericarpium) (each 1 liang) Yuanhua (Genkwa Flos, vinegar-roasted, 5 qian) Malinhua (Iris Laevigata Flos, vinegar-roasted, 1 liang)
Grind into powder, make pills with vinegar paste, size of Sophora japonica seeds. Take 30 pills with warm wine before meals. Adjust dosage based on deficiency/excess, using purgation as limit.
[Bencao] Treats Small Intestine Qi pain hitting abdomen, blue face/black lips, near death.
Muxiang (Aucklandiae Radix) Yinchén (Artemisiae Scopariae Herba) Yuanhua (Genkwa Flos) Gansui (Kansui Radix) (equal parts)
Grind into powder, take 2 qian per dose, decoct 1 zhan water to 0.7 zhan, strain, take warm. After taking this medicine, avoid Gancao (Glycyrrhizae Radix et Rhizoma) to prevent incompatibility with Gansui (Kansui Radix). The medicine is wonderful and logical, frequently effective.
Shawan (Sand Pill)