闻之男子之外肾。犹女子之两乳。皆隶厥阴而司阳明。此灵枢分发十二
支也。厥阴者肝也。主筋。而阳明主宗筋之会。犹女子乳头属肝。而乳房属
胃也。盖女子类阴。故血主之。男子类阳。故气主之。此疝之为患。所以攻冲
胀满。而疼痛时作。名曰疝气。然肝火下注。则患左丸。肝性急速。故痛胜于
肿。脾湿下流。则患右丸。脾性缓慢。故肿胜于痛。又有外寒郁热者。气不宣
通者。肾阴不足者。瘴疠所中者。劳倦所伤者。先天禀成者。所因多端。未有
不本厥阴一经而述类象形。如荔枝橘核茴香棠球之属。以类而推。在血
分则桃仁玄胡。在气分则枳实青皮。寒则乌头。热则栀子。湿则苍术以燥
之。气则香附以理之。虚则葫芦巴以温之。然此则散于外肾者也。若结聚
于膀胱左右。攻冲时作。为患心腹。则又非前药之所能疗。须察其所因虚
实。令患者戒驰驱。除恼怒。绝房事。静以调之。俟以岁月。乃可安痊。否则归
咎于药饵。多见其不知谅也。
栀子汤 治疝气或左或右。疼痛肿大。
栀子（一钱炒黑） 山楂（二钱） 橘核（一钱） 荔枝核（一钱） 泽泻（一钱） 枳实（一钱） 归尾（一钱）
茯苓（一钱） 小茴香（一钱盐水焙） 柴胡（七分）
姜水煎。
苍术汤 治湿气郁热。睾丸肿痛。
苍术（一钱泔制） 葛根（一钱） 山栀（一钱炒黑） 茯苓（一钱） 泽泻（一钱） 广皮（一钱） 山楂（二
钱）
灯芯一握。姜一片。水煎。
肾气方
茴香 补骨脂 吴茱萸（各五钱） 葫芦巴（七钱半） 木香（三钱半）
为末。箩卜捣汁丸。盐汤下。
疝痛方
山楂（炒四两） 枳核（炒） 茴香（炒） 山栀（炒各二两） 柴胡 牡丹皮 桃仁（炒各一两） 吴茱萸（炒
五钱） 八角茴香（炒一两）
上为末。酒糊丸。桐子大。每服五十丸。空心盐汤下。
疝方
南星 山楂 苍术（各二两） 白芷 半夏 枳核 神曲（各一两） 海藻 昆布（各五钱） 玄明粉 吴茱萸（各
二钱）
为末。酒糊丸。
治疝痛作腹内块痛方
三棱 莪术（醋煮） 炒曲 姜黄 南星（各一两） 山楂（二两） 木香 沉香 香附（各三钱） 黄连（五钱
茱制） 莱菔子 桃仁 山栀 枳核（炒各半两）
为末。姜汁浸。蒸饼和丸。
丹溪治疝劫药用
乌头（细切炒） 栀子仁（炒黑）
为末。或加或减。白汤丸。
It is heard that the external kidneys (testicles) of men are like the two breasts of women; both belong to the Jueyin (Liver/Gallbladder) channel and are governed by the Yangming (Stomach/Large Intestine) channel. This refers to the distribution of the twelve branches as described in the *Ling Shu* (Spiritual Pivot). The Jueyin corresponds to the Liver, which governs the sinews, while the Yangming governs the convergence of the Zongjin (general sinews, specifically referring to the male genitalia and surrounding fascia), just as the nipples of women belong to the Liver channel, while the breasts belong to the Stomach channel (Foot-Yangming Stomach Meridian). Generally, women are Yin-dominant, so blood is primary; men are Yang-dominant, so Qi is primary. This is why Shan-Qi (Hernia Qi) manifests with a sensation of rushing attack, distension and fullness, and intermittent pain, hence the name "Shan Qi".
However, if Liver Fire sinks downward, it affects the left testicle. Since the nature of the Liver is rapid and urgent, pain exceeds swelling. If Spleen Dampness flows downward, it affects the right testicle. Since the nature of the Spleen is slow and sluggish, swelling exceeds pain. Furthermore, there are cases caused by external cold stagnating into heat, obstruction of Qi circulation, deficiency of Kidney Yin, infection by miasma pathogens, injury from overexertion, or congenital endowment deficiencies. The causes are manifold, but they all fundamentally stem from the Jueyin channel alone. In describing their morphology, one often draws analogies to herbs resembling testicles, such as Litchi Seed (Litchi Nucis Pericarpium), Citrus Aurantium Fruit (Ju He), Fennel Seed (Xiao Hui Xiang), and Tang Qiu. By analogy: if the pathology is in the Blood level, use Peach Kernel (Tao Ren) and Corydalis Rhizome (Yan Hu Suo); if in the Qi level, use Immature Bitter Orange (Zhi Shi) and Green Tangerina Peel (Qing Pi); for Cold, use Aconite Root (Wu Tou); for Heat, use Gardenia Fruit (Zhi Zi); for Dampness, use Atractylodes Rhizome (Cang Zhu) to dry it; for Qi stagnation, use Cyperus Rhizome (Xiang Fu) to regulate it; for Deficiency, use Fenugreek Seed (Hu Lu Ba) to warm it.
However, these remedies apply primarily to lesions on the external kidneys. If nodules accumulate on the left and right of the Bladder, causing intermittent attacking pain and affecting the heart and abdomen, the aforementioned medicines cannot cure it. One must carefully examine the etiology regarding excess or deficiency, instruct the patient to avoid strenuous activities like horse riding, eliminate anger and frustration, abstain from sexual intercourse, and regulate the condition through quiet rest. Only after waiting for a period of time can recovery be achieved. Otherwise, blaming the medication shows a lack of understanding of medical principles.
Gardenia Decoction (Zhi Zi Tang): Treats Shan Qi (Hernia Qi) with pain and swelling, either on the left or right side.
Ingredients: Gardenia Fruit (Zhi Zi, 1 qian, stir-fried until black), Hawthorn Fruit (Shan Zha, 2 qian), Citrus Aurantium Fruit (Ju He, 1 qian), Litchi Seed (Li Zhi He, 1 qian), Alisma Rhizome (Ze Xie, 1 qian), Immature Bitter Orange (Zhi Shi, 1 qian), Angelica Sinensis Root Tail (Gui Wei, 1 qian), Poria (Fu Ling, 1 qian), Small Fennel Seed (Xiao Hui Xiang, 1 qian, baked in salt water), Bupleurum Root (Chai Hu, 0.7 fen).
Preparation: Decoct with ginger and water.
Atractylodes Decoction (Cang Zhu Tang): Treats testicular swelling and pain caused by Dampness stagnating into Heat.
Ingredients: Atractylodes Rhizome (Cang Zhu, 1 qian, processed with rice wash water), Kudzu Root (Ge Gen, 1 qian), Gardenia Fruit (Zhi Zi, 1 qian, stir-fried until black), Poria (Fu Ling, 1 qian), Alisma Rhizome (Ze Xie, 1 qian), Broad-leaved Mandarin Peel (Guang Pi, 1 qian), Hawthorn Fruit (Shan Zha, 2 qian).
Preparation: Decoct with a handful of Juncus Arter (Deng Xin) and one slice of ginger in water.
Kidney Qi Formula (Shen Qi Fang):
Ingredients: Small Fennel Seed (Xiao Hui Xiang), Psoralea Fruit (Bu Gu Zhi), Evodia Fruit (Wu Zhu Yu) (each 5 qian), Fenugreek Seed (Hu Lu Ba, 7.5 qian), Costus Root (Mu Xiang, 3.5 qian).
Preparation: Grind into powder. Make pills using juice extracted from crushed radish. Take with salt water.
Shan Pain Formula (Shan Tong Fang):
Ingredients: Hawthorn Fruit (Shan Zha, 4 liang, stir-fried), Immature Bitter Orange (Zhi He, stir-fried), Small Fennel Seed (Xiao Hui Xiang, stir-fried), Gardenia Fruit (Shan Zhi/Zhi Zi, stir-fried, each 2 liang), Bupleurum Root (Chai Hu), Moutan Cortex (Mu Dan Pi), Peach Kernel (Tao Ren, stir-fried, each 1 liang), Evodia Fruit (Wu Zhu Yu, stir-fried, 5 qian), Star Anise (Ba Jiao Hui Xiang, stir-fried, 1 liang).
Preparation: Grind into powder. Make pills using wine paste, size of Sophora seeds (Tong Zi Da). Take 50 pills per dose, empty stomach, with salt water.
Shan Formula (Shan Fang):
Ingredients: Arisaema Rhizome (Nan Xing), Hawthorn Fruit (Shan Zha), Atractylodes Rhizome (Cang Zhu) (each 2 liang), Angelica Dahurica Root (Bai Zhi), Pinellia Tuber (Ban Xia), Immature Bitter Orange (Zhi He), Medicated Leaven (Shen Qu) (each 1 liang), Sargassum (Hai Zao), Ecklonia/Kelp (Kun Bu) (each 5 qian), Mirabilite (Xuan Ming Fen), Evodia Fruit (Wu Zhu Yu) (each 2 qian).
Preparation: Grind into powder. Make pills using wine paste.
Formula for Treating Shan Pain with Abdominal Mass Pain:
Ingredients: Burreed Tuber (San Leng), Curcuma Rhizome (E Zhu) (boiled in vinegar), Stir-fried Medicated Leaven (Chao Qu), Turmeric (Jiang Huang), Arisaema Rhizome (Nan Xing) (each 1 liang), Hawthorn Fruit (Shan Zha, 2 liang), Costus Root (Mu Xiang), Agarwood (Chen Xiang), Cyperus Rhizome (Xiang Fu) (each 3 qian), Coptis Rhizome (Huang Lian, 5 qian, processed with Wu Zhu Yu), Radish Seed (Lai Fu Zi), Peach Kernel (Tao Ren), Gardenia Fruit (Zhi Zi), Immature Bitter Orange (Zhi He, stir-fried, each half liang).
Preparation: Grind into powder. Soak in ginger juice. Mix with steamed bread dough to make pills.
Danxi's Herbs for Seizing Pathogens in Shan Treatment:
Ingredients: Aconite Root (Wu Tou, finely sliced and stir-fried), Gardenia Seed (Zhi Zi Ren, stir-fried until black).
Preparation: Grind into powder. Adjust dosage as needed. Make pills with plain boiled water.