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The pulse of hernia (Shan Qi) is wiry and rapid, with pathogenic factors accumulating internally. If the pulse is firm and rapid, survival is indicated; if it is weak and rapid, death is indicated.

Hernia refers to the accumulation of Qi causing distension, yet externally constrained, hence the pulse appears wiry and rapid, and symptoms often include abdominal pain. The character "Shan" contains "mountain" at the bottom, implying accumulation and enlargement. These conditions generally arise from cold-dampness stagnating internally. Occasionally referred to as wind-hermia or heat-hermia, they are merely due to cold-wind or damp-heat. Upon onset, patients often experience aversion to cold, alternating chills and fever, vomiting, inability to eat, resembling Taiyang disease (Sun Yang Bing). However, this is accompanied by abdominal pain, lower abdominal distension and pain, periumbilical pain, upward rushing pain to the chest and heart, radiating pain to the hypochondrium, hardness and tension below the umbilicus, intestinal borborygmus, traction pain in the testicles with swelling and heaviness, or Qi gathering in the scrotum with irregular contraction and relaxation. In severe cases, the external scrotum may be cold, damp, hot, or red, with discharge or chronic abscess formation. These result from pre-existing internal accumulations triggered by exposure to wind-cold-water-dampness or physical exertion, causing Qi to accumulate and manifest. The course may last one to two days or longer. Warmth and sweating can disperse the Qi and resolve the condition. The wiry and rapid pulse corresponds to the Jueyin Liver meridian, as hernias frequently involve the Liver. A wiry, tight, and straight pulse indicates stagnant Qi, governing various pains and distensions; hernias invariably present with pain and distension. If the pulse is wiry, rapid, and firm, it indicates rooted accumulation and robust constitutional strength, suggesting a favorable prognosis ("survival"). If the pulse is merely rapid but weak, it indicates excess pathogen and deficient healthy Qi, which is unfavorable for internal accumulation, suggesting an unfavorable prognosis ("death"). The statement that hernias primarily involve the Liver is supported by chapters such as *Wu Zang Sheng Cheng*, *Ping Ren Qi Xiang*, *Chang Ci Jie*, *Miu Ci* in *Su Wen*, and *Jing Mai* in *Ling Shu*. Additionally, *Gu Kong Lun* mentions involvement of the Ren and Du meridians. Other chapters like *Yin Yang Bie*, *Mai Yao Jing Wei*, *Yu Ji Zhen Zang*, *Da Qi*, *Si Shi Ni Cong Lun* in *Su Wen*, and *Xie Qi Zang Fu Bing Xing*, *Jing Jin* in *Ling Shu* mention involvement of other Zang-Fu organs. *Gu Kong Lun* names "internal knotted seven hernias" on the Ren meridian but does not describe their forms. Chao Yuanfang described seven hernias: Jue Hernia, Pi Hernia, Cold Hernia, Qi Hernia, Pan Hernia, Jia Hernia, and Ye Lang Hernia. Zhang Hezi established another set of seven: Cold Hernia, Water Hernia, Sinew Hernia, Blood Hernia, Qi Hernia, Fox Hernia, and Pi Hernia. Pediatric Pi Hernia and Qi disorders of the Bladder and Small Intestine are also termed hernias. Debates have been endless without consensus. Recently, Zhang Jingyue's refutation has been the most detailed and logical. It is recorded here without further addition.

Zhang Jingyue states: Examining the classics, hernia syndromes vary. "Fox Hernia" is so named for its irregular protrusion and retraction. "Pi Hernia" refers to hard, swollen, insensate masses. "Chong Hernia" involves upward rushing pain from the lower abdomen to the heart. "Jue Hernia" involves Qi accumulation in the abdomen with rebellious Qi. "Jia Hernia" involves heat and pain in the lower abdomen with white discharge, also called Gu. "Six Meridian Wind Hernias" are mentioned in *Si Shi Ni Cong Lun*. "Small Intestine Hernia" is described in *Xie Qi Zang Fu Bing Xing*: pain in the lower abdomen, lumbar spine radiating to the testicles, and frequent tenesmus belong to hernia. These constitute the meanings of various hernias. According to *Gu Kong Lun*: Disease of the Ren meridian causes seven internal hernias in men and leukorrhea with masses in women. The Ren meridian originates below Zhongji, ascends to the pubic hairline, runs along the interior of the abdomen to Guanyuan, converging all Yin meridians. Thus, hernias in the lower abdomen originate from the Ren meridian, with other meridians as branches. "Seven Hernias" is a general term, comprising six types from *Si Shi Ni Cong Lun* and one from *Xie Qi Zang Fu Bing Xing*. Since hernias belong to seven meridians, they are called seven hernias. Fox, Pi, Chong, and Jue hernias are merely aliases. Later, Chao Yuanfang listed Jue, Pi, Cold, Qi, Pan, Jia, and Ye Lang. Zhang Hezi criticized these as erroneous names created by mediocre physicians. He argued that the area surrounding the genitals and upper lower abdomen belongs to the Foot Jueyin Liver meridian, the site of hernias. He stated that all hernias involve either pathogenic invasion of Liver Wood or hyperactivity of Liver Wood, thus belonging to the Liver meridian. He established seven types: Cold, Water, Sinew, Blood, Qi, Fox, and Pi, treating them mostly with purgatives. Zhu Danxi and later scholars followed this view. However, I find this incomplete. The anterior genitalia and lower abdomen are convergence points of the Foot Three Yin, Yangming, Ren, Chong, and Du meridians; one cannot attribute them solely to the Jueyin meridian. As noted in *Si Shi Ni Cong Lun*, the six hernias involving "wind" do not refer to exogenous wind. Wind belongs to the Liver, which governs sinews. Therefore, while hernias of various meridians often involve sinews and Liver pathogenic factors, asserting they must be exclusively Jueyin is incorrect. Later discussions exceed the scope of the *Nei Jing*; students should adhere to classical principles. Regarding treatment, cold hernias typically present with pain, heat with flaccidity, dampness with swelling and prolapse, and deficiency similarly. Blood-involved hernias tend to be fixed, while Qi-involved hernias tend to move. By differentiating the six types across meridians and treating according to excess/deficiency and severity, efficacy is assured.