厥逆心痛，足寒，诸饮食吐不下，名曰厥疝。（宜桂附二陈汤之类。）
腹中气满，心下痛，气积如臂，名曰 疝。（宜东垣川楝散。）
寒饮食，即胁下、腹中尽痛，名曰寒疝。（宜仲景乌头煎、和剂胡芦巴丸之类。）
腹中乍满乍减而痛，名曰气疝。（宜苏合香丸、东垣川楝散之类。）
腹中痛在脐旁，名曰盘疝。（宜桂枝汤、东垣丁香楝实丸之类。）
腹中脐下有积聚，名曰 疝。（宜茴香散之类。）
小腹与阴相引而痛，大便难，名曰野狼疝。（宜木香散、丁香楝实丸之类。）
寒疝，其状囊冷结硬如石，阴茎不举，或控睾丸而痛。得于坐卧湿地，或寒
月涉水，或冒雨雪，或坐卧砖石，或风冷处使内过劳。宜以温剂下之。久而无子。宜东垣天台乌药散之类。
水疝，其状肾囊肿痛，阴汗时出。或囊肿而状如水晶，或囊痒而搔出黄水，或
少腹中按之作水声。得于饮水、醉酒，使内过劳，汗出而遇风寒湿之气，聚于囊中，
故水多，令人为卒疝。宜以逐水之剂下之。有漏针去水者，人多不得其法。（宜腰子散、
五苓散、仲景牡蛎泽泻散之类。）
筋疝，其状阴茎肿胀，或溃或脓，或痛而里急筋缩，或茎中痛，痛极则痒，或
挺纵不收，或白物如精，随溲而下。久而得于房室劳伤，及邪术所使。宜以降心之
剂下之。（宜白芍、茯苓、当归、小茴香、青皮、黄柏、苍术、川楝之类。）
血疝，其状如黄瓜，在少腹两旁，横骨两端约中。俗云便痈。得于重感春夏大
燠，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。（宜归、芍、牛膝、灵脂、青皮、木香、丹皮、没药、玄胡索之类。）
气疝，其状上连肾区，下及阴囊。或因号哭忿怒，则气郁而胀；怒哭号罢，则
气散者是也。有一治法，以针出气而愈者。然针有得失，宜以散气之药下之。或小
儿亦有此疾，俗曰偏气。得于父已年老，或年少多病，阴痿精怯，强力入房，因而
有子，胎中病也。此证不治，惟筑宾一穴灸之。（宜正气天香散之类。）
狐疝，其状如瓦。卧则入小腹，行立则出小腹入囊中。狐则昼出穴而溺；夜则
入穴而不溺。此疝出入上下往来，正与狐相类也。亦与气疝大同小异，今人带钩钤
是也。宜以逐气流经之药下之。（宜金匮蜘蛛散之类。）
疝，其状阴囊肿缒，如升如斗，不痒不痛者是也。得之地气卑湿所生。故江
淮之间，湫溏之处，多感此疾，宜以去湿之药下之。女子阴户突出，虽亦此类，乃
热则不禁固也，不可便谓虚寒而涩之、燥之、补之。本名曰瘕，宜以苦下之，以苦
坚之。（宜荔核散、三层茴香丸、济生橘核丸、香附散之类。女子阴突，肝火居多，宜龙胆泻肝汤、
加味逍遥散，或少加升提之类。）
以上子和论疝七条，形证可谓详悉。但七疝七名，形证亦异，治之当各有方。而
俱云下者，恐出偏见。今拟对证方药于下。在诊之者合宜则用，亦不敢概云不可下也。
Heart pain accompanied by cold extremities, cold feet, vomiting of all food and fluids without ability to swallow, is named Jue Shan (Jue Hernia). (Suitable for formulas such as Guizhi Fuzi Erchen Tang [Cinnamon Twig and Aconite Two-Ingredient Chen Decoction].)
Abdominal fullness, pain in the epigastrium, accumulation of Qi resembling an arm in size within the abdomen, is named [Omitted] Shan. (Suitable for Chuanlian San [Toosendan Fruit Powder] by Li Dongyuan.)
Pain throughout the hypochondrium and abdomen immediately after consuming cold food or drink, is named Han Shan (Cold Hernia). (Suitable for Wutou Jian [Aconite Decoction] by Zhang Zhongjing, or Huluba Wan [Trigonella Seed Pill] from the *Taiping Huimin Heji Jufang* [Formulas of the Bureau of Taiping People's Welfare].)
Intermittent abdominal fullness and reduction with pain, is named Qi Shan (Qi Hernia). (Suitable for Suhexiang Wan [Styrax Pill] or Chuanlian San [Toosendan Fruit Powder] by Li Dongyuan.)
Abdominal pain located beside the umbilicus, is named Pan Shan (Plate Hernia). (Suitable for Guizhi Tang [Cinnamon Twig Decoction] or Dingxiang Lianshi Wan [Clove and Toosendan Fruit Pill] by Li Dongyuan.)
Accumulation masses below the umbilicus in the abdomen, is named [Omitted] Shan. (Suitable for Huixiang San [Fennel Powder].)
Drawing pain between the lower abdomen and the genitalia, accompanied by difficult defecation, is named Yelang Shan (Wild Wolf Hernia). (Suitable for Muxiang San [Costus Root Powder] or Dingxiang Lianshi Wan [Clove and Toosendan Fruit Pill].)
Han Shan (Cold Hernia): Its presentation involves a cold, hard scrotum like stone, flaccid penis, or pain radiating to the testicles. It arises from sitting or lying on damp ground, wading in water during cold months, exposure to wind, rain, or snow, sitting on bricks or stones, or excessive sexual activity in windy and cold environments. It should be treated with warming purgatives. Prolonged cases may lead to infertility. Suitable for Tiantai Wuyao San [Tiantai Asarum Powder] by Li Dongyuan.
Shui Shan (Water Hernia): Its presentation involves swelling and pain of the renal sac (scrotum), intermittent sweating from the genitalia. The scrotum may appear transparent like crystal, or itchiness may cause yellow fluid discharge upon scratching, or percussion of the lower abdomen may produce a fluid sound. It arises from excessive drinking, intoxication, excessive sexual activity, sweating followed by exposure to wind-cold-damp pathogens, causing fluid accumulation in the scrotum, leading to sudden hernia. It should be treated with diuretic purgatives. Some use needle drainage to remove fluid, but many lack proper technique. (Suitable for Yaozi San [Kidney Powder], Wuling San [Five-Ingredient Powder], or Mushe Zexie San [Oyster Shell and Alisma Powder] by Zhang Zhongjing.)
Jin Shan (Sinew Hernia): Its presentation involves penile swelling, ulceration or suppuration, pain with internal tension and sinew contraction, pain within the urethra, extreme pain turning into itching, persistent erection without retraction, or white discharge resembling semen passing with urine. Long-standing cases arise from sexual exhaustion and injury, or influence of evil arts. It should be treated with heart-clearing and descending agents. (Suitable for herbs such as Baishao [White Peony Root], Fuling [Poria], Danggui [Angelica Sinensis], Xiaohuixiang [Small Fennel], Qingpi [Green Tangerine Peel], Huangbai [Phellodendron Bark], Cangzhu [Atractylodes Rhizome], Chuanlian [Toosendan Fruit].)
Xue Shan (Blood Hernia): Its presentation resembles a cucumber, located on both sides of the lower abdomen at the midpoint of the transverse bones. Commonly known as Bian Yong (Genital Abscess). It arises from repeated exposure to the intense heat of spring and summer, excessive sexual activity causing blood and Qi overflow, infiltrating the bladder and scrotum. Retention leads to abscess formation with little pus and much blood. It should be treated with blood-nourishing and harmonizing agents. (Suitable for herbs such as Danggui [Angelica Sinensis], Shaoyao [Peony Root], Niuxi [Achyranthes Root], Lingzhi [Trogopterus Dung], Qingpi [Green Tangerine Peel], Muxiang [Costus Root], Danpi [Moutan Cortex], Moyao [Myrrh], Yanhusuo [Corydalis Rhizome].)
Qi Shan (Qi Hernia): Its presentation extends upward to the kidney region and downward to the scrotum. It may occur due to loud crying or anger, causing Qi stagnation and distension; when anger and crying cease, the Qi dissipates. One treatment method involves acupuncture to release Qi for cure. However, acupuncture has risks and benefits; it is better to use Qi-dispersing medicines. Children may also suffer from this, commonly called Pian Qi (Lateral Qi Hernia). This occurs when the father is old or chronically ill with impotence and weak essence, yet engages in forced intercourse to conceive, resulting in a congenital disease. If untreated, moxibustion on the Zhubin (KI9) acupoint alone suffices. (Suitable for Zhengqi Tianxiang San [Righteous Qi Heavenly Fragrance Powder].)
Hu Shan (Fox Hernia): Its presentation resembles a tile. When lying down, it enters the lower abdomen; when standing or walking, it exits the lower abdomen into the scrotum. Foxes exit their burrows during the day to urinate and return at night without urinating. This hernia moves up and down, similar to the fox. It is largely similar to Qi Hernia, corresponding to what modern people call "Gouqian" (a type of truss). It should be treated with medicines that expel Qi and unblock meridians. (Suitable for Zhizhu San [Spider Powder] from *Jingui Yaolue*.)
[Omitted] Shan: Its presentation involves a pendulous scrotum large as a measuring vessel, without itching or pain. It arises from low-lying damp earth qi. Therefore, in the Jianghuai region, in marshy areas, many contract this disease. It should be treated with damp-draining medicines. In women, prolapse of the vaginal opening belongs to this category, caused by heat failing to secure and hold. It should not be simply treated as deficiency-cold with astringents, drying agents, or tonics. Originally named Jia (Mass), it should be treated with bitter purgatives and bitter-astringents. (Suitable for Lihé San [Lychee Seed Powder], Sancang Huixiang Wan [Three-Layer Fennel Pill], Jisheng Juzhe Wan [Bureau of Relief's Orange Seed Pill], Xiangfu San [Cyperus Powder]. For female prolapse, often due to Liver Fire, Longdan Xiegan Tang [Gentian Liver-Draining Decoction], Jiawei Xiaoyao San [Modified Free and Easy Wanderer Powder], or mild lifting agents are suitable.)
The above seven points on Hernia discussed by Zhang Zihe detail the forms and symptoms comprehensively. However, since the seven types of Hernia have different names, forms, and symptoms, treatment should employ specific formulas for each. The assertion that all require "purging" (Xia) may reflect a biased view. Below are proposed symptomatic formulas. Practitioners should use them if appropriate; I dare not categorically state that purging is inadvisable.