（治法）肾子睾丸肿痛俗名偏坠即副睾丸炎，或牵引少腹奇痛。有将睾丸引缩入少愎内者，痛不可忍。此症西药可谓无用，麻醉亦不过一时有效，不能治愈。中医治疝之药，率用川栋子、小茴香、青木香、橘核，荔枝核、山楂核、炒元胡等，轻症疝气，相当有效，甚则用附子，其效卓著。然以余之经验，最效之方，则为附子与大黄合剂，此种用药系合大热大寒，同时并用，纵有古方，未免骇俗。然余实已经过数十年之临床实验，以附子、大黄，加入普通治疝气之药中，即上列川栋子等药速收特效，不可思议，此治外疝之经验谈也。四十年前因有患疝气之赵得胜者，（第五镇辎重营前队副兵）病发作时，二睾丸完全缩入少腹内，痛苦异常。记得最重之一次，病凡十馀日，中西医治疗无效，气息已微，全身皆厥，六脉皆绝。正呈报病重矣。经医官长等复诊，均无效，不得已，余与副医官刘全禄君，合议以附子五钱，大黄三钱，合于川栋子、小茴香、橘核、荔枝核、青木香、小青皮等药中与服。不意眼下此药，大见奇效，患者已能呻吟，四肢亦渐温暖。一日连服二剂，第二日，已能言语转动，且思饮食，（已数日因呕逆不进食物）脉亦渐渐恢复，如此奇验，竟出意料之外。此后每日即照原方，（附子、大黄各二钱）连服六剂，竟而痊愈。自此以后，四十年中，凡遇他人不能治之睾丸肿痛，或缩入少腹，不论如何危笃，一用此方，无不立效，从无一例失败者，故特定为治此症之标准方也。
其治内疝之方，只要认定确系内疝上冲，即以川栋子、小茴香、吴茱萸、小青皮、青木杳，寒则可酌用附子，纵有实热之症，然绝不可用人黄，此与外疝不同之点。再参与加减之逍遥散等，无不奏效也。兹录内疝、外疝二医验于下，以资印证。
（医验）吕新甫先生，住德县文庙前街，年七十馀岁，久患内疝，时发时愈，其病状系于病将发作时，先觉腹内左右，有两条如黄瓜状有形之物，一齐上冲胸脘，直至心口，以手按之可得，因而头晕、心乱、填胀欲死，遂即呕吐，疼痛，瞀乱异常，经过一、二日，腹内硬物，渐渐消散，即化为乌有，—切病状，亦俱消失，有时亦觉有一条有形硬物上冲，饮食起居，又恢复原状矣。如此拖延，已六，七年之久，经过各医诊治，并未认定病名，殊属町笑，其治法率以消导顺气者居多，尤以降气之药，几乎每剂必备，并无丝毫效验，中间经过西医与以麻醉止痛刑，三日治疗，病势特别加重，闻系盐莫，每日三包，不但不能减轻痛苦，且又自汗不止，高年之人，非常危险。余适于民国九年回籍，为长子结婚，先生乃延余诊治，余诊脉见两手弦实，毫无中和之气，参以病状，决为内疝，肝逆犯胃。数年痼疾,经过多医并未认定病名，危哉。乃为处方如下：第一方，熟附片—钱川楝子三钱小茴香三钱青木香一钱小青皮—钱桃仁—钱吴茱萸二钱淡干姜一钱橘核二钱枸杞子一钱炒白芍二钱姜引。服第一方立见效，因来诊时，正值病发，服药后，立见消散。据病人自述，自有此症以来，服药已四、五百剂，无一次立见大效者。分服此药，病才半日，即消散，每次病发，必三、四日乃消散。乃连服三剂，又与第二方：第二方，川楝子三钱小茴香三钱豆蔻仁三分青木香一钱小青皮一钱桃仁一钱杵去皮尖吴茱萸二钱炒白芍二钱淡干姜三钱橘核二钱荔枝核二钱姜引。此方约服十馀剂，完全病愈，先生寿至耄耋，此症愈后，复经过多年，永未再发。余以此症甚多，最不易确认，故录此一案，以告学者。
薛荫槐君，住德县大寺街，年二十馀岁，于民国十二年患疝气，右睾丸肿痛特甚？先经医治，原方为川栋子、小茴香、荔枝核、橘核等普通治疝气等药，愈治愈甚，乃请余诊治。病者来时，不良于行，门坎几至不能迈过，则其肿痛可想而知。余认定此外疝症也，即与经验良方一剂，立见大效，痛减大半，五剂痛肿全消，完全病愈。兹录验方于下：熟附片二钱川楝子四钱荔枝核二钱山楂核一钱小青皮二钱熟大黄二钱小茴香二钱橘核一钱炒元胡一钱姜引煎服。此余经验多年之特效方也，凡痛引少腹，睾丸缩入腹内，痛不欲生，或睾丸肿大，痛不可忍等极剧烈之疝气，无不立奏奇效。然减去附子与大黄则不效，其他各味，不过辅佐药品，然亦不可妄为加减。惟附子与大黄之分量，不必一律，医者须斟酌病人之强弱，及病势之轻重，寒多或热多，与其脉象，临时酌定，大约自一钱至三、四钱不等。例如病者脉沉细，现寒象，则附子可用一钱五，大黄可用一钱，以此类推，神而明之，存乎其人。但附子大黄，必须并用，缺一不可，则为一定不易之理，万勿犹豫，致减本方效力也。小便短少，附子可少用，然不可完全减去。
外疝一症，往往有原因花柳病者（梅毒性），应先以西药注射，根本治其原因，则本病自愈。不但此也，凡一切病症，如有此种原因，必令患者速入专门医院，施行注射疗法，不可徒以中药治疗，耽延时日，此亦中医应有之认识，但中医对梅毒性病症，何由确认，是必对于西医病理，详细研究，自求新知，固不待言也。
(Treatment Method) Swelling and pain of the testicles, commonly known as "Pian Zhui" (Oblique Drooping), which corresponds to epididymitis. The pain may radiate to the lower abdomen causing severe pain. In some cases, the testicles are retracted into the lower abdomen, causing unbearable pain. Western medicine is often ineffective for this condition; anesthesia only provides temporary relief and cannot cure it. Chinese medicines used for treating hernia typically include Chuan Lian Zi (Fructus Toosendan), Xiao Hui Xiang (Fructus Foeniculi), Qing Mu Xiang (Radix Aucklandiae), Ju He (Pericarpium Citri Reticulatae), Li Zhi He (Semen Litchi), Shan Zha He (Endocarpium Crataegi), and Chao Yuan Hu (Rhizoma Corydalis). These are quite effective for mild cases of hernia, and in severe cases, Fu Zi (Radix Aconiti Lateralis Preparata) is even used with remarkable efficacy. However, based on my experience, the most effective formula is a combination of Fu Zi and Da Huang (Radix et Rhizoma Rhei). This medication combines extreme heat and extreme cold properties simultaneously. Even if ancient formulas exist, this approach may seem shocking to the uninitiated. Yet, I have verified this through decades of clinical practice. Adding Fu Zi and Da Huang to ordinary hernia-treating herbs (such as those listed above) yields miraculous and unexpected special effects. This is an empirical account of treating external hernias.
Forty years ago, there was a patient named Zhao Desheng (Deputy Soldier of the Forward Company, Ammunition Battalion, Fifth Town). During attacks, both his testicles were completely retracted into his lower abdomen, causing extreme suffering. I remember the most severe episode lasted over ten days. Both Chinese and Western treatments failed. His breath was faint, his whole body was cold (Jue syndrome), and all six pulses were imperceptible. The case was reported as critical. After consultation by senior medical officers, who also found no solution, my deputy medical officer, Liu Quanlu, and I decided to prescribe Fu Zi (5 qian) and Da Huang (3 qian), combined with Chuan Lian Zi, Xiao Hui Xiang, Ju He, Li Zhi He, Qing Mu Xiang, and Xiao Qing Pi. Unexpectedly, this prescription produced a miraculous effect. The patient began to moan, and his limbs gradually warmed. After taking two doses in one day, on the second day he could speak and move, and desired food (having been unable to eat for several days due to vomiting and reflux). His pulse gradually recovered. Such a miraculous result was beyond our expectations. Thereafter, we administered the original prescription daily (Fu Zi and Da Huang each 2 qian) for six consecutive doses, resulting in a complete cure. Since then, for forty years, whenever I encountered cases of testicular swelling and pain or retraction into the lower abdomen that others could not treat, regardless of how critical, this formula always worked immediately without a single failure. Therefore, I specifically established it as the standard formula for this condition.
For treating internal hernias, once confirmed as upward rushing of internal hernia, use Chuan Lian Zi, Xiao Hui Xiang, Wu Zhu Yu (Fructus Evodiae), Xiao Qing Pi (Exocarpium Citri Reticulatae Viride), and Qing Mu Xiang. If the pattern is cold, Fu Zi may be added酌情 (as appropriate). Even if there are excess heat symptoms, Da Huang must absolutely not be used. This differs from external hernias. Combined with modified Xiao Yao San (Free and Easy Wanderer Powder), these treatments are invariably effective. Herein are recorded two medical cases of internal and external hernias for verification.
(Medical Case 1) Mr. Lv Xinpu, residing at Wen Miao Qian Street, De County, was over seventy years old. He suffered from internal hernia for many years, with intermittent remissions and exacerbations. His symptoms manifested as follows: just before an attack, he would feel two cucumber-shaped solid masses rising simultaneously from the left and right sides of his abdomen towards the chest and epigastrium, reaching up to the heart area. These could be palpated by hand. Consequently, he experienced dizziness, mental agitation, abdominal distension feeling like death, followed by vomiting, pain, and extreme confusion. After one or two days, the hard masses in the abdomen would gradually dissipate, and all symptoms would disappear. Sometimes, only one solid mass would rise, after which diet and daily life would return to normal. This persisted for six or seven years. Various doctors treated him but failed to diagnose the disease name, which was laughable. Their treatment mostly involved digestive aids and qi-regulating herbs, especially descending qi herbs in almost every prescription, yet with no efficacy. He underwent Western anesthesia for pain relief; after three days of treatment, his condition worsened significantly. It was reported that morphine was used (three packets daily). Not only did it fail to relieve pain, but it also caused continuous spontaneous sweating, which was very dangerous for an elderly person.
In the ninth year of the Republic of China (1920), I returned home for my eldest son's wedding. Mr. Lv invited me to treat him. My pulse diagnosis revealed wiry and excess pulses in both hands, lacking any harmonious quality. Combining this with his symptoms, I diagnosed internal hernia with Liver Qi rebellion invading the Stomach. A chronic ailment of several years, undiagnosed by many doctors—how perilous! I prescribed the following: First Prescription: Shu Fu Pian (Prepared Aconite Root Slice) 1 qian, Chuan Lian Zi 3 qian, Xiao Hui Xiang 3 qian, Qing Mu Xiang 1 qian, Xiao Qing Pi 1 qian, Tao Ren (Semen Persicae) 1 qian, Wu Zhu Yu 2 qian, Dan Gan Jiang (Dried Ginger) 1 qian, Ju He 2 qian, Gou Qi Zi (Fructus Lycii) 1 qian, Chao Bai Shao (Fried White Peony Root) 2 qian, with Fresh Ginger as a guide. Upon taking the first prescription, immediate improvement was seen. Since he was symptomatic during the visit, the masses dissipated immediately after ingestion. According to the patient, since the onset of this illness, he had taken four or five hundred doses of medicine, never experiencing such immediate dramatic effect. With divided doses of this medicine, the symptoms dissipated within half a day, whereas previously each attack took three to four days to resolve. He continued taking three doses, after which I gave the Second Prescription: Second Prescription: Chuan Lian Zi 3 qian, Xiao Hui Xiang 3 qian, Dou Kou Ren (Semen Cardamomi) 3 fen, Qing Mu Xiang 1 qian, Xiao Qing Pi 1 qian, Tao Ren 1 qian, Wu Zhu Yu (deprived of skin and pits) 2 qian, Chao Bai Shao 2 qian, Dan Gan Jiang 3 qian, Ju He 2 qian, Li Zhi He 2 qian, with Fresh Ginger as a guide. After taking approximately more than ten doses of this prescription, he was completely cured. Mr. Lv lived to be ninety years old. After this cure, many years passed without recurrence. I record this case because such conditions are common yet difficult to confirm, hoping to inform scholars.
Mr. Xue Yinhuai, residing at Da Si Street, De County, was in his twenties. In the twelfth year of the Republic of China (1923), he suffered from hernia, with severe swelling and pain in the right testicle. Initially treated elsewhere with ordinary hernia herbs such as Chuan Lian Zi, Xiao Hui Xiang, Li Zhi He, and Ju He, the condition worsened with treatment. He then sought my care. When he arrived, he walked poorly, barely able to step over thresholds, indicating the severity of his swelling and pain. I identified this as an external hernia and administered one dose of my empirical excellent formula. Immediate significant improvement was observed, with pain reduced by more than half. After five doses, the pain and swelling completely disappeared, and he was fully cured. The prescription is recorded below: Shu Fu Pian 2 qian, Chuan Lian Zi 4 qian, Li Zhi He 2 qian, Shan Zha He 1 qian, Xiao Qing Pi 2 qian, Shu Da Huang (Prepared Rhizoma et Radix Rhei) 2 qian, Xiao Hui Xiang 2 qian, Ju He 1 qian, Chao Yuan Hu 1 qian, decocted with Fresh Ginger. This is my empirical special-effect formula. For extremely severe hernias characterized by pain radiating to the lower abdomen, testicular retraction into the abdomen causing agony, or massive testicular swelling with unbearable pain, this formula produces immediate miraculous results. However, removing Fu Zi and Da Huang renders it ineffective. The other herbs serve only as adjuvants, yet their dosages should not be altered arbitrarily. Only the proportions of Fu Zi and Da Huang need not be uniform; physicians must adjust them based on the patient's constitution, the severity of the disease, whether cold or heat predominates, and the pulse characteristics. Dosages generally range from 1 qian to 3-4 qian. For example, if the pulse is deep and fine, indicating cold, Fu Zi can be used at 1.5 qian and Da Huang at 1 qian, and so forth. The subtlety lies in flexible application depending on the physician. However, Fu Zi and Da Huang must be used together; neither can be omitted. This is an immutable principle. Do not hesitate, lest you diminish the efficacy of this formula. If urine output is scant, Fu Zi dosage may be reduced, but it should not be completely removed.
External hernia cases often have syphilis (Liu Bing) as the underlying cause. In such instances, Western medicine injections should be administered first to address the root cause, allowing the primary disease to heal itself. Moreover, for any condition with such an etiology, patients must be directed to specialized hospitals for injection therapy. Relying solely on Chinese medicine and delaying treatment is inadvisable. This is an awareness that Traditional Chinese Medicine practitioners should possess. However, how does TCM identify syphilitic conditions? This necessarily requires detailed study of Western pathological mechanisms and self-driven acquisition of new knowledge, which goes without saying.