有虚证，或不耐劳苦而微劳即发者亦有虚证，当以脉证辨之。凡治虚疝，当察其虚在阴分，或在阳分。若虚中
挟滞者，加以疏导之药，如川楝、茴香、枳实、山楂、栀子之属，酌其宜而佐用之。（《景岳》）
大抵疝之为证，受热则缓纵不收，受寒则牵引作痛，受湿则肿胀累垂，虚者亦然。三者之间，分其孰多孰
少而为施治。在血分者不移，在气分者多动。往往有左丸偏胀而移于右丸者，亦有右丸偏胀而移于左丸者，皆
是气分之病。若积年痛发，不胀大而不能动移者，方是血分之病。屡发屡更其处者，当是厥阴风木为患。肿极
而不甚痛者，当是太阴湿土为患。又上引者，宜用桂枝、吴萸、茴香等辛热治之。下坠者。宜用川楝、黄柏、
苍术、香附苦燥治之。又痛处热而不欲人按者，湿热也。痛处寒而喜人按摩者，寒积也。以此明辨，万无差误
矣。（《医通》）
七疝 七疝者，厥疝、 疝、寒疝、气疝、盘疝、 疝、野狼疝，此名七疝也。厥逆心痛足寒，诸饮食
吐不下，名曰厥疝也。腹中气乍满，心下尽痛，气积如臂，名曰症疝也。寒饮食，即胁下腹中尽痛，名曰寒疝
也。腹中乍满乍减
而痛，名曰气疝也。腹中痛在脐旁，名曰盘疝也。腹中脐下有积聚，名曰 疝也。小腹与阴相引而痛，大便难，
名曰野狼疝也。凡七疝，皆由血气虚弱，饮食寒温不调之所生。（《病源论》）（按∶又有五疝候∶一曰石疝，
二曰血疝，三曰阴疝，四曰妒疝，五曰气疝。而不说其证状，仍不揭出。）
暴心腹厥逆，不得气息，痛达背膂，名曰尸疝。心下坚痛，不可手迫，名曰石疝。脐下坚痛，得寒冷食辄
剧，名曰寒疝。胁下坚痛，大如手，痛时出见，若不痛不见，名曰盘疝。脐下结痛，女人月事不时，名曰血疝。
少腹胀满，引膀胱急痛，名曰脉疝。（《外台》引文仲小器七疝丸主治。）
疝气病者，凡小腹睾丸为肿为痛，止作无时者皆是也。但疝证不一，如《内经》所谓狐疝者，以其出入不
常也。有言 疝者，以其顽肿不仁也。有冲疝者，以其自少腹上冲而痛也。有厥疝者，以结气在阴而气逆为疝
也。有疝瘕者，以少腹冤热而痛，出白，一名曰蛊也。有六经风疝者，如《四时刺逆从论》所言者是也。有小
肠疝者，如《邪气脏腑病形篇》所言者是也。凡此七者，总皆疝之为义。（《景岳》）
七疝之名，《内经》已有冲疝、厥疝、狐疝、 疝、 疝、卒疝、疝瘕之别，而巢氏又立厥、 、寒、气、
盘、 、野狼七名，子和又立寒、水、筋、血、气、狐、 七症，皆与《内经》不同。巢氏怪而不经，已无足论。
即子和之所谓水疝，亦即经之 疝，血疝即经之 疝，气疝即经之厥疝，筋疝即经之疝瘕，子和特更立名目，
以欺世盗名，虽为近代所宗，然学人当以《内经》为主也。（《病机汇论》）（按∶子和七疝，大抵皆 之属，
且、 同字非别证，沈氏此说未为当，姑存之。子和说见次门。）
冲疝 疝者痛也，由阴气积于内，寒气不散，上冲于
心，故使心痛，谓之心疝也。其痛也，或如锥刀所刺，或阴阴而疼，或四肢逆冷，或唇口变青，皆其候也。
（《病源论》）（按∶心疝出《脉要精微论》，而此证即为《骨空论》冲疝，仍标以其称。）
冲疝者，气上冲心下，二便不通，乃寒湿之邪，固结于内，郁积为热，加以客寒触之而发，天台乌药散，
加铁锈水调服，甚则禹攻散加炮姜、枳实、青皮下之。冲疝岁久不除，渐成冲心疝气，证与蛊胀无异，误用攻
伐，胀必转剧，惟辛温健运，庶为合宜，然亦取效良难，至于调理，尤宜详慎。每见食填中脘，浊阴之气上
逆，顷刻告变，业尝见之，此与冲心香港脚不殊也。（《医通》）
疝久成积 诸脏腑受邪，初未能为积聚，邪气留滞不去，乃成积聚。其为病也，或左右胁下如覆杯，
或脐上下如臂，或胃脘间覆大如盘，羸瘦少气，或洒淅寒热，四肢不收，饮食不为肌肤，或累累如桃李，或腹
满呕泄，寒即痛，故云寒疝积聚也。（《病源论》）
凡疝久则成积，盘附脐之上下左右，为 为瘕，作痛不已，或变 癖，或发奔豚。（《证治汇补》）
呕吐 逆气长嘘，中脘停酸，燥闷扰扰，甚而至于呕吐，最为恶候。何则？天一生水，肾实主之。宗
筋聚于阴器，惟借阳明以养之。今脾土不济，肾水上乘，必为酸汁，必为涎饮，荏苒超时，遂成暴吐。医家制
剂之始，皆知肾经恶燥，如苍术、白术、良姜之类，诚不敢发用耳。及其呕吐大作，姜、术辈用之而罔顾。若
犹未也，则吴茱萸、荜茇刚燥等剂又加多焉，虽附子亦用之而救急矣。病势至此，脾土未强，肾水已为之涸，
肾水既涸，脾土又为之焦，往往阴阳不升降，荣卫不流行，大小二便关隔涩闭，而肾汁胃汁皆自
其口出也。如此者大抵不救，临病须当识证，预与病家言之。（《直指》）
久则遂成暴吐，甚则角弓反张，切牙战汗，冷汗流不止者，难治。（《入门》）（宜参后治不可以虚骤补
条《微义》文。）
疫邪夹疝 戴麟郊曰∶疫邪夹疝，其肾囊小腹引痛，全是疝证，当照辨气色神脉舌苔法辨之，一有疫
邪，不必治疝，但治疫而疝自消。若根据常治疝法，用吴萸、桂、附、茴香诸燥品，轻者变为囊痈，重者变为呃
逆哕逆，昏沉而莫救矣。（《瘟疫汇编》）
妇人 疝之为病，不独男子有之，而妇人亦有之。经曰∶有积气在腹中，有厥气，名曰厥疝，女子同法。
又曰∶厥阴所谓 疝，妇人少腹肿也。至若冲疝、疝瘕之属，亦皆男妇之所同病者。然惟睾丸之病，独在男子，
而他则均当详察也，观张子和曰云云（子和说出前疝属肝说），此说诚非谬也。然今人但言男子之疝，而全不
知妇人之疝，殊失之矣。（《景岳》）
戴人且谓妇人亦有疝气，凡血涸不月，少腹有块等症皆是，要不离乎肝经为病。盖肝者藏血主筋，而其气
暴，且善攻冲也。（《金匮翼》）
治宜通宜温 疝气作痛，宜通不宜塞，宜温不宜寒。通谓泻其实，不泻其虚；塞谓补其虚，不补其实。
实者邪气也，虚者正气也。若正气虚极，则先温而后泻；若邪气盛极，则先泻而后补。温者必兼于气，泻者必
兼于寒。寒则入于经而导其邪，温则疏其气，养其正也。（《奇效》）
治不可以虚骤补 顷在徽城日，歙尉宋荀甫，膀胱气作，疼不可忍，医者以刚剂与之，疼愈甚，小
便不通三日
矣，脐下虚胀，心闷。予因候之，见其面赤黑，脉洪大。予曰∶投热药太过，阴阳痞塞，气不得通，为之奈何？
宋尉尚手持四神丹数粒，云医者谓痛不止，更服之。予曰∶若服此定毙，后无悔。渠恳求治。予适有五苓散一
两许，分三服，易其名，用连须葱一茎，茴香一撮，盐一钱，水一盏半，煎七分，令接续三服，中夜下小便如
墨汁者一二升，脐下宽得睡，翌日诊之，脉已平矣，续用 砂丸与之，数日瘥。大抵此疾，因虚得之，不可以虚
而骤用补药。经云∶邪之所凑，其气必虚。留而不去，其病则实。故必先涤所蓄之邪，然后补之，是以诸方多
借巴豆气者，盖谓此也。（《本事》）
小肠气、膀胱奔豚、疝气等疾，皆因肾气虚弱，膀胱久冷，风湿乘之，伤于肾经，气滞不散，小腹刺痛，
肾经偏吊，未可骤服补药，先用疏导发散。（《和剂指南》）
疝病虽始为因虚而得，必邪实迫痛而未下，故当先泻而后补也。至有虚甚迫痛，上为吐逆，或下有遗精者，
此邪实正虚之甚矣，此欲不补可乎。但恐补之则无益，泻之则正气转陷，幸而获生者鲜矣。（《微义》）
治不宜寒凉 治此之法，固不可必其为寒，又不可必其为热。但治初受之邪，必当以温经散寒、行气
除湿为主，切不可早用寒凉，致留邪气，则遗害非浅。及其久也，则有始终以寒者，有因寒郁热者，有元阳受
伤而虚陷日甚者，但当察其形气病气，因病制方。若果有热证热脉，显然外见者，方可治以寒凉。如无热证可
据，而竟云大抵疝由湿热，则无者生之，有者甚之矣。此习俗之通弊，有不可不鉴也。（《景岳》）
治当兼用气药 治疝必先治气，故病名亦曰疝气，非无谓也。盖寒有寒气，热有热气，湿有湿气，逆
有逆气，气在阳
分，则有气中之气，气在阴分，则有血中之气。凡气实者必须破气，气虚者必须补气，故治疝者，必于诸证之
中，俱当兼用气药。（《景岳》）
温散方法（兼滋补）温法有二∶外入之寒，温必兼散；内生之寒，温必以补。子和论疝，多从劳内得之，
然并不立补法。愚谓寒从外入者，其病多实；寒从内生者，其病多虚。设不能辨而概与散法，难免虚虚之咎矣。
余采当归羊肉等方，以补子和之未备，且遵仲景之旧法也。（《金匮翼》）
疝因阴邪凑肾，寒气上攻，小腹结块，下坠睾丸，坚紧如石，得暖渐消，得寒愈胀，其气并入前后腰脐各
道筋中，上攻入胃，则大呕大吐，战栗畏寒，此下焦地气上冲，宜以参、附、姜、桂大剂，非寻常郁热比也。
（《汇补》）
《短剧》解急蜀椒汤，主寒疝气，心痛如刺，绕脐腹中尽痛，白汗出，欲绝方。
蜀椒（二百枚汗） 附子（一枚炮） 粳米（半升） 干姜（半两） 半夏（十二枚洗） 大枣（二十枚）
甘草（一两炙）
上七味切，以水七升，煮取三升，澄清热服一升。不瘥，更服一升。数用疗心腹痛，困急欲死，解结逐寒，
上下痛良。忌猪羊肉、饧、海藻、菘菜。《肘后》、《古今录验》、《范汪方》无甘草，余同。（《外台》）
《圣惠》本方加桂心、生姜。
疝气发作，当再于附子建中汤煎时，加蜜一箸头许，名蜜附子汤。（《易简》）（按∶上文曰∶建中汤，
加附子三分，名附子建中汤。）
治寒疝来去，每发绞痛方。牡蛎、甘草、桂各二两，水五升，煮取一升半，再服。（《肘后》）
半夏汤，治心脾痛，及小肠奔豚等痛患。
吴茱萸（去枝并目） 半夏（汤洗切片） 肉桂（去皮等分）
上 咀三钱重，水一大盏半，生姜十片，同煎八分，去滓热服。（《事证方后集》）
吴茱萸加附子汤。
吴茱萸 生姜（各三钱） 人参（一钱） 大枣（二枚） 附子（二钱）
水煎凉服。寒疝腰痛，牵引睾丸，屈而不伸，尺内脉来沉迟者，此方主之。（《医方考》）
生料五积散，膀胱小肠气痛，加茱萸半钱，盐少许。（《易简》）（《得效》更加茴香。）治醉饱后色欲
不节，触伤小腹，致成疝气，其疝自小腹痛连腰胯下，心头吊痛，额上汗出，根据本方加玄胡索。（《济世
全书》）
羌活附子汤，治感寒表证悉具而寒厥疝痛者，宜与此表里兼调。（《医级》）（系羌活、附子、木香、茴
香、干姜加盐煎，详见《哕》门，宜考。）
沉香散，治寒疝，小腹坚满，攻作不定，时发疼痛，肾虚受邪肿胀，及脏寒气弱，脐常痛。
沉香 附子（各一两） 川楝子（一两半）
上为细末，每服一钱半，水一盏半，生姜三片，枣一个，盐少许，煎至七分，空心服。（《鸡峰》）
玄附汤，治七疝，心腹冷痛，肠鸣气走，身寒自汗，大腑滑泄。
玄胡索（炒去皮） 附子（炮去皮脐各一两） 木香（不见火半两）
上 咀，每服四钱，水一盏半，生姜七片，煎至七分，去滓温服，不拘时候。（《济生》）
神应散，治诸疝，心腹绞痛不可忍。
玄胡索 胡椒（等分）
上为末，每服二大钱，酒半盏，水半盏，煎七分，食前
温服。（《三因》）
当归四逆汤，治脐腹冷痛，相引腰胯而痛。（按∶治验曰∶先灸中庭穴。）
当归尾（七分） 附子（炮） 官桂 茴香（炒） 柴胡（各五分） 芍药（四分） 茯苓 玄胡索 川楝子
（各三分酒煮） 泽泻（二分）
上十味 咀，作一服，水二盏半，煎至一盏，去滓温服，空心食前，数服而愈。（《宝鉴》按∶方后曰∶
泽泻咸平，茯苓甘平，去膀胱中留垢。）
沉香桂附丸，退阴助阳，除脏腑积冷，心腹疼痛，及疗七疝，痛引小腹不可忍，腰屈不能伸，喜热熨稍缓
方。（节录）
沉香 附子（炮去皮脐） 川乌（炮去皮脐切作小块） 干姜（炮） 良姜（炒） 茴香（炒） 官桂 吴茱萸
（各一两汤浸去苦）
上为末，醋糊丸，如梧桐子大，每服五十丸至七八十丸，热米饮汤送下，温酒吞下亦得，空心食前，日二
服。忌冷物。（《宝鉴》）
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（不拘多少铫中熔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，每服四五丸，酒下，其痛立止。自已觉疼甚不能支持，略用六丸，再不可多也。（《医学集成》）
（参《正传》录）《医统》名硫黄丸。《皆效方》名玉环笑来丹。（《本草纲目》引。）
奔豚丸。
川楝子（煨去肉一两） 茯苓 橘核（盐酒炒各一两五钱） 肉桂
The text mentions deficiency syndromes, some of which manifest as an inability to tolerate exertion, with symptoms triggered by slight labor. When treating deficiency-type hernia (Shan), one must distinguish whether the deficiency lies in the Yin aspect or the Yang aspect. If there is weakness accompanied by stagnation (Qi and blood stasis), soothing and draining herbs should be added, such as those in the category of Chuanlianzi (Toosendan Fruit), Huixiang (Fennel/Foeniculum Vulgare Fruit), Zhishi (Immature Bitter Orange), Shanzha (Hawthorn Fruit), and Zhizi (Gardenia Fruit), selected according to suitability. (From *Jingyue Quanshu*)
Generally speaking, regarding the syndrome of Hernia (Shan): when affected by heat, the sinews relax and fail to retract; when affected by cold, it causes pulling pain; when affected by dampness, it causes swelling and hanging down. Deficiency syndromes are similar. Among these three factors, treatment should be prescribed based on which factor predominates. Diseases in the Blood aspect have fixed pain locations, while diseases in the Qi aspect have mobile pain locations. It is common for the left testicle to swell and shift to the right, or for the right to shift to the left; these are all diseases of the Qi aspect. If the condition has persisted for years with recurrent attacks, without swelling and with a fixed location, it is a disease of the Blood aspect. Recurrent attacks with changing pain locations suggest pathology related to Jueyin Wind-Wood. Extreme swelling with mild pain suggests pathology related to Taiyin Damp-Earth. If pain radiates upward, treat with acrid-hot herbs like Guizhi (Cinnamon Twig), Wuzhuyu (Evodia Fruit), and Huixiang (Fennel). If there is a sensation of bearing down, treat with bitter-drying herbs like Chuanlianzi (Toosendan Fruit), Huangbai (Phellodendron Bark), Cangzhu (Atractylodes Rhizome), and Xiangfu (Cyperus Rhizome). Furthermore, if the painful area is hot and dislikes pressure, it is Damp-Heat; if the painful area is cold and welcomes massage, it is Cold Accumulation. By distinguishing clearly in this manner, errors will be avoided. (From *Yitong*)
The Seven Hernias refer to Jue Shan, [Missing Character] Shan, Han Shan (Cold Hernia), Qi Shan (Qi Hernia), Pan Shan (Plate Hernia), [Missing Character] Shan, and Yelang Shan (Wild Wolf Hernia). This is called the Seven Hernias. Jue Ni (Rebellious Cold) causing heart pain, cold feet, and inability to swallow food/drink is named Jue Shan. Sudden abdominal fullness, complete pain in the epigastrium, and Qi accumulation the size of an arm is named Zheng Shan (or Jia Shan). Pain throughout the hypochondrium and abdomen after consuming cold food/drinks is named Han Shan. Abdominal pain that comes and goes with fluctuating fullness is named Qi Shan. Abdominal pain located beside the umbilicus is named Pan Shan. An accumulation below the umbilicus is named [Missing Character] Shan. Pain radiating between the lower abdomen and the genitalia, accompanied by difficult defecation, is named Yelang Shan. All seven types of hernia arise from Qi and Blood deficiency and irregular diet regarding temperature. (From *Bingyuan Lun*) (Note: There is also a theory of Five Hernias: Shi Shan (Stone Hernia), Xue Shan (Blood Hernia), Yin Shan, Du Shan, and Qi Shan. However, symptoms are not described.)
Sudden Jue Ni (reversal) of the heart and abdomen, inability to breathe, pain reaching the back and spine is named Shi Shan (Corpse Hernia). Hard and painful epigastrium that cannot be touched is named Shi Shan (Stone Hernia). Hard and painful lower abdomen that worsens with cold food is named Han Shan (Cold Hernia). Hard and painful hypochondrium, the size of a hand, appearing only during pain, is named Pan Shan (Plate Hernia). Knotting pain below the umbilicus with irregular menstruation in women is named Xue Shan (Blood Hernia). Lower abdominal fullness pulling into urgent bladder pain is named Mai Shan (Pulse Hernia). (From *Waitai* citing Wen Zhong's Xiaoqi Qishen Wan indications)
Disease of Hernia Qi (Shan Qi) includes any case where the lower abdomen and testicles swell or hurt, with intermittent onset and no fixed timing. However, hernia syndromes vary. As stated in *Neijing*, Huxian (Fox Hernia) is so named because its protrusion is irregular. [Missing Character] Shan is so named because of hard swelling and numbness. Chong Shan (Rushing Hernia) is so named because Qi rushes up from the lower abdomen causing pain. Jue Shan is so named because Qi knots in the Yin region and rebels to form hernia. Shanjia (Hernia Mass) is so named because of stifling heat and pain in the lower abdomen with white discharge, also called Gu. Liu Jing Fengshan (Six Meridian Wind Hernia) refers to what is said in *Sishi Cini Cong Lun*. Xiaochang Shan (Small Intestine Hernia) refers to what is said in *Xieqi Zangfu Bingxing Pian*. These seven collectively define the meaning of Hernia. (From *Jingyue Quanshu*)
Regarding the names of the Seven Hernias, *Neijing* already distinguished Chong, Jue, Hu, [Missing Character], [Missing Character], Zu, and Shanjia. Chao Shi (Chao Yuanfang) established Jue, [Missing Character], Han, Qi, Pan, [Missing Character], and Yelang. Zhang Hezi established Han, Shui, Jin, Xue, Qi, Hu, and [Missing Character]. All differ from *Neijing*. Chao’s theories are strange and unorthodox and need not be discussed. Even Zhang Hezi’s Shui Shan is essentially Jing’s [Missing Character] Shan; Xue Shan is Jing’s Shanjia; Qi Shan is Jing’s Jue Shan; Jin Shan is Jing’s Shanjia. Zhang merely changed names to deceive the world. Although revered in modern times, scholars should prioritize *Neijing*. (From *Bingji Huilun*) (Note: Zhang Hezi’s seven hernias largely belong to [Missing Character] type. Also, [Missing Character] and [Missing Character] are the same character, not different syndromes; Shen’s view here is inappropriate, but preserved for reference. See next section for Zhang’s theory.)
Chong Shan means pain. It occurs when Yin Qi accumulates internally, Cold Qi does not disperse, and rushes upward to the Heart, causing heart pain, hence called Xin Shan (Heart Hernia). The pain may feel like needle pricking, dull ache, cold extremities, or blue lips. These are its signs. (From *Bingyuan Lun*) (Note: Xin Shan appears in *Maiyao Jingwei Lun*, but this syndrome corresponds to Chong Shan in *Gukong Lun*; labeled accordingly.)
Chong Shan involves Qi rushing to the epigastrium, obstruction of urination and defecation. This is due to Cold-Damp pathogens consolidating internally, stagnating and generating Heat, triggered by external Cold. Tiantai Wuyao San (Tiantai Cyperus Powder) mixed with Iron Rust Water can be used. For severe cases, Yugong San (Yu Gong Powder) with Paojiang (Prepared Ginger) and Zhishi (Immature Bitter Orange) can be used to purge. Chronic Chong Shan may evolve into Chongxin Shan Qi, resembling Gu Zhang (Distension). Misusing purgatives will worsen distension. Only acrid-warm methods to strengthen transport are appropriate, though efficacy is difficult. Careful regulation is needed. Often, food stagnation in the Middle Jiao causes Turbid Yin to rebel upward, leading to sudden deterioration. This is similar to Chongxin Hongkong Foot (Gout/Jia Ji). (From *Yitong*)
Accumulation from Long-standing Hernia: Pathogens affecting organs do not immediately form accumulations. If pathogens linger, they form accumulations. Symptoms include masses under the ribs like inverted cups, masses near the umbilicus like arms, large masses in the epigastrium, emaciation, shortness of breath, alternating chills and fever, limb weakness, poor appetite conversion to muscle, or masses like peaches/plums, abdominal fullness, vomiting, diarrhea, and cold-induced pain. Hence, it is called Han Shan Ji Zhu. (From *Bingyuan Lun*)
Long-standing hernia eventually forms accumulations, attaching around the umbilicus, becoming [Missing Character] or Jia, causing persistent pain, transforming into Pi (masses), or triggering Ben Tun (Running Piglet). (From *Zhengzhi Huibu*)
Vomiting: Rebellious Qi, long sighs, acid retention in the epigastrium, dry irritability, progressing to vomiting, is a dire sign. Why? Heaven generates Water, governed by the Kidney. Sinews gather at the genitalia, relying on Yangming Stomach for nourishment. Now, Spleen Earth fails to assist, Kidney Water ascends, producing acid juices and phlegm-fluids. Over time, this becomes violent vomiting. Physicians know Kidney channel dislikes dryness, avoiding herbs like Cangzhu, Baizhu, Liangjiang initially. But when vomiting is severe, they use Jiang (Ginger) and Zhu (Atractylodes) recklessly. If unresolved, they add more acrid-dry herbs like Wuzhuyu and Bibo, even Fuzi for emergency. At this stage, Spleen Earth is weak, Kidney Water is exhausted. With Kidney Water gone, Spleen Earth scorches. Yin and Yang fail to ascend/descend, Ying and Wei fail to circulate. Bowel/bladder obstruction occurs, and Kidney/Stomach fluids vomit out. Such cases are generally incurable. Recognize the syndrome and warn the family. (From *Zhizhi Fang*)
If prolonged, it leads to violent vomiting. Severe cases show opisthotonos, teeth grinding, shivering sweat, and continuous cold sweat—difficult to treat. (From *Rumen*) (Refer to "Do Not Tonify Sudden Deficiency" section in *Wei Yi*).
Epidemic Pathogen Complicated with Hernia: Dai Linjiao states that epidemic pathogens complicating hernia present with scrotal and lower abdominal pulling pain, fully presenting as hernia syndrome. Diagnose via complexion, spirit, pulse, tongue coating. If epidemic pathogen is present, do not treat hernia specifically; treat the epidemic, and hernia will resolve. Using standard hernia treatments with acrid-hot herbs like Wuzhuyu, Guizhi, Fuzi, Huixiang may cause scrotal abscess in mild cases or hiccups/retching and coma in severe cases. (From *Wenyi Huibian*)
Women also suffer from Hernia. Classics state: Accumulated Qi in abdomen with rebellious Qi is Jue Shan, treated similarly in women. Also, Jueyin [Missing Character] Shan manifests as lower abdominal swelling in women. Chong Shan and Shanjia affect both genders. However, testicular disease is unique to men; other aspects require careful examination. Zhang Hezi’s view is correct. Modern neglect of female hernia is a mistake. (From *Jingyue Quanshu*)
Dairen also stated women have Hernia Qi, including blood depletion amenorrhea and lower abdominal masses, all related to Liver channel. Liver stores blood and governs sinews, its Qi is volatile and attacking. (From *Jinkui Yi*)
Treatment should involve dredging and warming. Hernia pain requires dredging, not blocking; warming, not cooling. Dredging drains excess, not deficiency. Blocking tonifies deficiency, not excess. Excess is pathogen; deficiency is healthy Qi. If healthy Qi is extremely deficient, warm first then drain. If pathogen is extremely excessive, drain first then tonify. Warming must accompany Qi movement; draining must accompany clearing Heat. Cooling enters meridians to guide out pathogens; warming disperses Qi and nourishes healthy Qi. (From *Qixiao Liangfang*)
Do Not Tonify Sudden Deficiency: In Huicheng, Song Xunfu, County Magistrate, suffered Bladder Qi attack with unbearable pain. Doctors gave harsh hot medicines, worsening pain and causing three days of urinary retention, lower abdominal distension, and chest oppression. His face was dark red, pulse surging. I said: "Excessive hot medicine caused Yin-Yang blockage and Qi stagnation." He held Sizhen Dan, saying doctors advised taking it for pain. I warned: "Taking this will kill you." He begged for treatment. I had Wuling San, divided into three doses, renamed, decocted with Scallion Stem, Huixiang, Salt. After three doses, he passed black urine, relief followed. Next day, pulse normalized. Continued with Shasha Wan, cured in days. This disease arises from deficiency; do not tonify suddenly. Classics say: Where pathogen gathers, Qi is deficient. Linger, it becomes excess. Must cleanse accumulated pathogen before tonifying. Hence, formulas use Radix Crotonis (Badou) acridity for this purpose. (From *Benshi Fang*)
Small Intestine Qi, Bladder Ben Tun, Hernia Qi all stem from Kidney Qi deficiency, chronic Bladder cold, Wind-Damp invasion damaging Kidney channel, Qi stagnation, stabbing lower abdominal pain, Kidney channel pulling. Do not tonify suddenly; first dredge and disperse. (From *Heji Zhinan*)
Although hernia starts from deficiency, it presents with pathogenic excess forcing pain without downward release, so drain first, then tonify. In cases of extreme deficiency with forced pain, upper vomiting, or lower spermatorrhea, pathogen is excess and healthy Qi is deficient. Is it possible not to tonify? But tonification may be useless, and draining may collapse healthy Qi. Survival is rare. (From *Wei Yi*)
Treatment Should Avoid Cold-Cooling: Do not assume it is always Cold or always Heat. Initially, treat new pathogens with warming meridians, dispelling cold, moving Qi, and drying dampness. Do not use cold-cooling early, lest pathogens remain. Later, some remain cold, some transform cold into heat, some suffer Yuan Yang injury with progressive deficiency. Observe body, Qi, and disease nature to prescribe. Only if clear Heat signs/pulses exist, use cold-cooling. Assuming all hernia is Damp-Heat is a common error. (From *Jingyue Quanshu*)
Treatment Must Combine Qi-Moving Herbs: Treating hernia requires treating Qi, hence the name Shan Qi. Cold has Cold Qi, Heat has Heat Qi, Damp has Damp Qi, Rebellion has Rebellious Qi. Qi in Yang aspect is Qi within Qi; Qi in Yin aspect is Qi within Blood. Excess Qi requires breaking Qi; Deficient Qi requires tonifying Qi. Thus, treat hernia by combining Qi-moving herbs in all syndromes. (From *Jingyue Quanshu*)
Warming and Dispersing Methods (Including Tonification): Two types of warming: External Cold requires warming with dispersing; Internal Cold requires warming with tonifying. Zhang Hezi attributed hernia mostly to internal labor/injury but did not establish tonification methods. I argue: External Cold is usually Excess; Internal Cold is usually Deficiency. Indiscriminate dispersing harms the deficient. I collected Danggui Yangrou Tang etc. to supplement Zhang, following Zhang Zhongjing’s methods. (From *Jinkui Yi*)
Hernia caused by Yin pathogens gathering in Kidney, Cold Qi attacking upward, lower abdominal mass, descending testicles, hard as stone, resolving with warmth, worsening with cold. Qi merges into tendons of lower back/womb/navel, attacking Stomach causing violent vomiting, shivering, aversion to cold. This is Lower Jiao Earth Qi rushing up. Use large doses of Renshen, Fuzi, Jiang, Guizhi. Not comparable to ordinary stagnant heat. (From *Huibu*)
*Duanju* Jieji Shujiao Tang treats Han Shan Qi, stabbing heart pain, periumbilical pain, profuse sweating, near death.
Shujiao (200 pods), Fuzi (1 prepared), Jingmi (0.5 sheng), Ganjiang (0.5 liang), Banxia (12 washed), Dazao (20), Gancao (1 roasted).
Cut seven ingredients, boil in 7 sheng water to 3 sheng. Strain, take 1 sheng hot. Repeat if necessary. Treats heart/abdominal pain, critical distress, resolves knots, expels cold. Avoid pork/mutton, malt, seaweed, cabbage. (*Waitai* cites *Zhouhou*, *Gujin Luyan*, *Fanwang Fang* omit Gancao).
*Shenghui Fang* adds Guixin and Shengjiang to this formula.
For Hernia Qi attacks, add honey to Fuzi Jianzhong Tang decoction, named Mifu Zi Tang. (From *Yijian*) (Note: Above says Jianzhong Tang + Fuzi = Fuzi Jianzhong Tang).
Formula for Han Shan coming and going, colicky pain: Musli, Gancao, Guizhi (2 liang each). Boil in 5 sheng water to 1.5 sheng. Take twice. (*Zhouhou*)
Banxia Tang treats Heart/Spleen pain and Small Intestine Ben Tun.
Wuzhuyu (de-stemmed/de-eyed), Banxia (boiled/sliced), Rougui (bark removed, equal parts).
Grind to 3 qian dose. Decoct in 1.5 cup water with 10 ginger slices to 0.8 portion. Strain, take hot. (*Shizheng Fang Houji*)
Wuzhuyu Plus Fuzi Tang.
Wuzhuyu, Shengjiang (3 qian each), Renshen (1 qian), Dazao (2), Fuzi (2 qian).
Decoct, take cool. Treats Han Shan lumbar pain radiating to testicles, flexed legs, deep-slow Chi pulse. (*Yifang Kao*)
Shengliao Wuji San for Bladder/Small Intestine Qi pain: Add Wuzhuyu (0.5 qian), salt. (*Yijian*) (*Defu* adds Huixiang). For post-meal/excess sexual activity injuring lower abdomen causing hernia radiating to waist/hips, heart-hanging pain, forehead sweat: Add Yanhusuo to base formula. (*Jishi Quanshu*)
Qianghuo Fuzi Tang for exterior cold signs with cold-jue hernia pain, harmonizing interior/exterior. (*Yiji*) (Contains Qianghuo, Fuzi, Muxiang, Huixiang, Ganjiang, salt. See *Yue* section).
Chenxiang San for Han Shan, hard/full lower abdomen, wandering pain, Kidney deficiency with swelling, organ cold/weakness, constant umbilical pain.
Chenxiang, Fuzi (1 liang each), Chuanlianzi (1.5 liang).
Powder. Take 1.5 qian with 1.5 cup water, 3 ginger slices, 1 jujube, salt. Decoct to 0.7 portion. Take fasting. (*Jifeng*)
Xuanfu Tang for Seven Hernias, cold pain in heart/abdomen, borborygmus, cold sweating, loose stools.
Yanhusuo (stir-fried/skin removed), Fuzi (prepared/skin/umbilicus removed, 1 liang each), Muxiang (0.5 liang).
Grind. Take 4 qian with 1.5 cup water, 7 ginger slices. Decoct to 0.7 portion. Strain, take warm. (*Jisheng*)
Shenyingsan for various hernias, unbearable heart/abdominal colic.
Yanhusuo, Hujiao (equal parts).
Powder. Take 2 daqian with 0.5 cup wine, 0.5 cup water. Decoct to 0.7 portion. Take warm before meals. (*Sanyin*)
Danggui Sini Tang for cold pain in umbilicus/abdomen radiating to waist/hips. (Note: Pre-treatment: Moxibustion on Zhongting point).
Dangguiwei (0.7 fen), Fuzi (prepared), Guanyi Gui, Huixiang (stir-fried), Chaihu (0.5 fen each), Shaoyao (0.4 fen), Fuling, Yanhusuo, Chuanlianzi (0.3 fen each, wine-boiled), Zexie (0.2 fen).
Ten ingredients. One dose, 2.5 cups water, decoct to 1 cup. Strain, take warm fasting. Cure after several doses. (*Weisheng Baojian*) Note: Zexie salty/neutral, Fuling sweet/neutral, remove bladder turbidity.
Chenxiang GuiFu Wan: Retract Yin, assist Yang, remove organ cold, heart/abdominal pain, Seven Hernias, unbearable lower abdominal pain radiating, flexed waist, relieved by heat.
Chenxiang, Fuzi (prepared), Chuanwu (prepared/cut), Ganjiang (prepared), Liangjiang (stir-fried), Huixiang (stir-fried), Guanyi Gui, Wuzhuyu (soaked in hot water to remove bitterness, 1 liang each).
Powder, vinegar paste pills (wutong seed size). Take 50-80 pills with hot rice water or warm wine. Fasting, twice daily. Avoid cold. (*Weisheng Baojian*)
Divine Formula for Hernia Qi: Severe Qi rushing up, feeling of obstruction in heart, cold limbs. Root cure in 2-3 doses.
Liu Huang (melted, quenched in water to detoxify, powdered), Lizhihe (powdered/stir-fried yellow), Chenpi.
Equal parts powder. Rice pills (wutong seed size). Take 4-5 pills with wine. Pain stops immediately. Max 6 pills even if severe pain. (*Yixue Jicheng*) (Also known as Liu Huang Wan in *Yitong*, Yuhuan Xiaolai Dan in *Jie Xiao Fang*).
Ben Tun Wan.
Chuanlianzi (roasted/flesh removed, 1 liang), Fuling, Juhe (salt/wine stir-fried, 1.5 liang each), Rougui