血疝便毒溃鱼口， 气坠筋即疳，水疝胞痹皆癃疝，冲似小肠腰痛连。
【注】有谓血疝者，其证即便毒鱼口也。 疝者，其证即 疝也。气疝者，即偏坠也。
筋疝者，即下疳也，水疝小便不通，胞痹即膀胱气，皆癃疝也。冲疝证似小肠气，而更
连腰痛也。
治疝左右分气血，尤别虚湿热与寒，寒收引痛热多纵，湿肿重坠虚轻然。
【注】疝病，凡在左边阴丸属血分，凡在
右边阴丸属气分。凡寒则收引而痛甚，热则纵而痛微。凡湿则肿而重坠，而虚亦肿坠、但
轻轻然而不重也。
当归温疝汤 乌桂汤
中寒冷疝归芍附，桂索茴楝泽萸苓，外寒入腹川乌蜜，肉桂芍草枣姜同。
【注】当归温疝汤，即当归、白芍、附子、肉桂、延胡索、小茴香、川楝子、泽泻、吴
茱萸、白茯苓也。乌桂汤，即川乌、蜂蜜、肉桂、白芍药、炙甘草、生姜、大枣也。
乌头栀子汤
外寒内热乌栀炒，水酒加盐疝痛安， 疝不问新与久，三层茴香自可痊。
【注】此茴香丸，方在《医宗必读》。
十味苍柏散
醇酒浓味湿热疝，不谨房劳受外寒，苍柏香附青益草，茴索楂桃附子煎。
【注】此散，即苍术、黄柏、香附、青皮、益智、甘草，小茴香、南山楂、元胡索、桃
仁、附子也。
茴楝五苓散 大黄皂刺汤
膀胱水疝尿不利，五苓茴楝与葱盐，瘕硬血疝宜乎下，大黄皂刺酒来煎。
【注】大黄皂刺汤，即大黄、皂刺各三钱，酒煎服也。
羊肉汤
血分寒疝女产后，脐腹连阴胀痛疼，羊肉一斤姜五两，当归三两水八升。
夺命汤
冲疝厥疝痛上攻，脐悸奔豚气上行，吴茱一味为君主，肉桂泽泻白茯苓。
青木香丸
气疝诸疝走注痛，青木香附吴萸良，巴豆拌炒川楝肉，乌药荜澄小茴香。
【注】青木香丸，即青木香五钱，酒醋浸炒吴茱萸一两，香附醋炒一两，荜澄茄五钱，
乌药五钱，小茴香五钱，巴豆仁二十一粒，研碎拌炒川楝肉五钱，为末合均，葱涎为小丸，
每服三钱，酒盐任下立愈。及能医一切疝痛神效。
茴香楝实丸
楝实狐疝一切疝，楝肉茴香马兰芫，三萸二皮各一两，仍宜急灸大敦安。
【注】茴香楝实丸，治狐疝及一切诸疝，即川楝肉、小茴香、马兰花、芫花醋炒变焦
色，山茱萸、吴茱萸、食茱萸、青皮、陈皮各一两，为末，醋糊为小丸，酒送二钱。
【按】大敦，肝经穴，在足大指甲后有毛处，诸疝均宜灸之即安。
Blood hernia (Xue Shan), soft tissue abscess (Bian Du), and ulcerated fish-mouth (Yu Kou); Qi hernia (Qi Shan) presents with scrotal pendulousness or sinew chancre (Jin Gan); Water hernia (Shui Shan) and bladder obstruction (Bao Bi) all belong to strangury hernia (Long Shan) characterized by urinary retention; Chong hernia (Chong Shan) resembles small intestine qi pain but involves radiating lower back pain.
[Note] Some refer to blood hernia, whose symptoms are soft tissue abscess and fish-mouth. "Hernia" generally refers to inguinal hernia-like conditions. Qi hernia is unilateral scrotal swelling and descent. Sinew hernia is chancre (genital ulcer). Water hernia causes urinary obstruction; bladder qi stagnation (Bao Bi) also falls under strangury hernia. Chong hernia symptoms resemble small intestine qi pain, but the pain extends to the lower back.
Treatment of hernia requires distinguishing left from right to differentiate Blood and Qi, and further distinguishing between deficiency, damp-heat, and cold. Cold causes contraction and severe pain; heat causes relaxation and mild pain. Dampness causes swelling and heavy bearing sensation; deficiency also causes swelling and bearing sensation, but it is light rather than heavy.
Danggui Wenshan Decoction (Angelica Warm Hernia Decoction) and Wugui Tang:
For cold-induced hernia in the middle jiao, use Danggui Wenshan Decoction, containing *Dang Gui* (Angelicae Sinensis Radix), *Bai Shao* (Paeoniae Radix Alba), *Fu Zi* (Aconiti Lateralis Radix Praeparata), *Rou Gui* (Cinnamomi Cortex), *Yan Hu Suo* (Corydalis Rhizoma), *Xiao Hui Xiang* (Foeniculi Fructus), *Chuan Lian Zi* (Meliae Fructus), *Ze Xie* (Alismatis Rhizoma), *Wu Zhu Yu* (Evodiae Fructus), and *Fu Ling* (Poria). For external cold invading the abdomen, use Wugui Tang, containing *Chuan Wu Tou* (Aconiti Radix), *Feng Mi* (Mel), *Rou Gui*, *Bai Shao Yao* (Paeoniae Radix Alba), *Zhi Gan Cao* (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle), *Sheng Jiang* (Zingiberis Rhizoma Recens), and *Da Zao* (Jujubae Fructus).
Wutou Zhizi Decoction:
For external cold and internal heat, stir-fried *Chuan Wu Tou* and *Zhi Zi* (Gardeniae Fructus) are decocted with water, wine, and a little salt to relieve hernia pain. Regardless of whether the hernia is new or chronic, San Ceng Hui Xiang Wan (Three-Layer Fennel Pill) can cure it.
[Note] This Hui Xiang Wan formula is recorded in *Yi Zong Bi Du*.
Shiwei Cangbai San:
For hernia caused by damp-heat from rich food and alcohol, or external cold contracted due to imprudent sexual activity, decoct *Cang Zhu* (Atractylodis Rhizoma), *Huang Bai* (Phellodendri Cortex), *Xiang Fu* (Cyperi Rhizoma), *Qing Pi* (Citri Reticulatae Pericarpium Viride), *Yi Zhi Ren* (Alpiniae Oxyphyllae Fructus), *Gan Cao* (Glycyrrhizae Radix et Rhizoma), *Xiao Hui Xiang*, *Nan Shan Zha* (Crataegi Fructus), *Yuan Hu Suo* (Corydalis Rhizoma), *Tao Ren* (Persicae Semen), and *Fu Zi*.
Huilian Wuling San and Dahuang Zaoci Tang:
For bladder water hernia causing difficult urination, use Wuling San plus *Xiao Hui Xiang*, *Chuan Lian Zi*, scallion white, and salt. For hard masses in blood hernia, purgation is indicated; decoct *Da Huang* (Rhei Radix et Rhizoma) and *Zao Ci* (Gleditsiae Spina) in wine.
[Note] Dahuang Zaoci Tang consists of three qian each of Da Huang and Zao Ci, decocted in wine.
Yangrou Tang:
For blood-deficiency cold hernia, common after childbirth in women, presenting with distending and painful swelling from the umbilicus to the yin region, use one jin of mutton, five liang of ginger, three liang of *Dang Gui*, and eight sheng of water for decoction.
Duoming Tang:
For Chong hernia and Jue hernia with pain rushing upward, abdominal palpitations, and Ben Tun (running piglet) qi ascending, use *Wu Zhu Yu* as the sovereign herb, combined with *Rou Gui*, *Ze Xie*, and *Fu Ling*.
Qingmuxiang Wan:
For Qi hernia and other wandering hernia pains, *Qing Mu Xiang* (Aucklandiae Radix), *Xiang Fu*, and *Wu Yu* are effective. Add *Ba Dou* (Crotonis Fructus) stir-fried with *Chuan Lian Rou* (Meliae Semen), *Wu Yao* (Linderae Radix), *Bi Cheng Qie* (Schizonepetae Fructus? Note: Usually Piperis Longi Fructus or similar, here likely Schisandra or Pepper derivative contextually, strictly translating name), and *Xiao Hui Xiang*.
[Note] Qingmuxiang Wan uses five qian of Qing Mu Xiang, one liang of Wu Zhu Yu soaked and stir-fried in wine and vinegar, one liang of Xiang Fu stir-fried in vinegar, five qian of Bi Cheng Qie, five qian of Wu Yao, five qian of Xiao Hui Xiang, twenty-one kernels of Ba Dou, and five qian of stir-fried Chuan Lian Rou. These are ground into powder, mixed evenly, formed into small pills with scallion juice, taken three qian per dose with wine or salt water for immediate relief. It is also miraculous for treating all kinds of hernia pain.
Huixiang Lianshi Wan:
*Lian Shi* (Meliae Fructus) treats fox hernia (intermittent inguinal hernia) and all types of hernia. The formula contains *Lian Rou* (Meliae Semen), *Xiao Hui Xiang*, *Ma Lan* (Kalimeris Indica), *Yuan Hua* (Genkwa Flos), *Shan Zhu Yu* (Corni Fructus), *Wu Zhu Yu*, *Shi Zhu Yu* (Zanthoxyli Fructus?), *Qing Pi*, and *Chen Pi* (Citri Reticulatae Pericarpium), one liang each. It is advisable to urgently moxa the Dazhun acupoint for stabilization.
[Note] Huixiang Lianshi Wan treats fox hernia and all hernias, containing Meliae Semen, Foeniculi Fructus, Kalimeris Indica, Genkwa Flos stir-fried with vinegar until dark-colored, Corni Fructus, Evodiae Fructus, Zanthoxyli Fructus, Citri Reticulatae Pericarpium Viride, and Citri Reticulatae Pericarpium, one liang each. Ground into powder, formed into small pills with vinegar paste, taken two qian with wine.
[Commentary] Dazhun (LR1) is an acupoint of the Liver Meridian, located behind the nail on the big toe where hair grows. Moxibustion on this point is suitable for all hernias to bring relief.