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Cold Hernia (Han Shan) presents with a cold, hard, stone-like scrotal mass, impotence, and pain radiating to the testicles. It is caused by sitting or lying on damp ground, wading in water during cold months, exposure to rain and snow, sitting on bricks or stones, exposure to wind-cold, or excessive sexual activity leading to fatigue. Treatment should employ warm purgative formulas. If left untreated for a long time, it may lead to infertility.

Water Hernia (Shui Shan) presents with swelling and pain of the spermatic cord/scrotum, spontaneous sweating from the genital area, translucent cysts resembling crystal blisters, itching with yellow discharge upon wiping, or a splashing sound upon palpation of the lower abdomen. It results from alcohol intoxication, excessive sexual activity causing sweating followed by exposure to wind-cold-dampness, leading to fluid accumulation in the scrotum. This excess fluid causes acute hernia attacks. Treatment should employ diuretic purgative formulas. Some use needle drainage to remove fluid, but many lack proper technique.

Sinew Hernia (Jin Shan) presents with penile swelling, ulceration, suppuration, pain with tenesmus and sinew retraction, urethral pain that becomes itchy when severe, persistent erection without flaccidity, or white discharge resembling semen passing with urine. It is caused by sexual exhaustion and pathogenic influences. Treatment should employ formulas that clear and descend Heart Fire.

Blood Hernia (Xue Shan) presents with a cucumber-shaped mass located between the ends of the pubic bones on both sides of the lower abdomen, commonly known as "Bian Yong" (Perineal Abscess). It results from repeated exposure to intense heat in spring and summer, excessive sexual activity causing Qi and Blood to overflow and infiltrate the bladder and scrotum, stagnating and forming an abscess with little pus and much blood. Treatment should employ formulas that harmonize the Blood.

Qi Hernia (Qi Shan) presents with swelling extending from the Kidney region down to the scrotum, exacerbated by crying or anger due to Qi stagnation, and relieved when the emotional outburst subsides and Qi disperses. One treatment method involves acupuncture to release Qi, though success varies; pharmacologically, Qi-dispersing purgatives are indicated. Children may also suffer from this,俗称 "Pian Qi" (Lateral Hernia), attributed to conception when the father was old, ill, impotent, or had weak essence but engaged in forceful intercourse. This condition is difficult to cure; only the acupoint Zhubin (KI9) has specific therapeutic records.

Fox Hernia (Hu Shan) presents with a mass resembling a tile that enters the lower abdomen when lying down and descends into the scrotum when standing or walking. Similar to a fox that urinates outside its den during the day but not at night, this hernia moves up and down, mirroring the fox's behavior. It is similar to Qi Hernia and corresponds to conditions treated with modern supportive belts/hooks. Treatment should employ formulas that expel Qi and unblock meridians.

Damp Hernia (referred to simply as "Shan" in context, distinct from general hernia) presents with a pendulous scrotum like a measuring cup or bucket, without itching or pain. It arises from low-lying damp earth qi, common in the marshy regions of Jianghuai. Treatment should employ damp-resolving purgatives. In women, vaginal prolusion may present similarly but is due to Heat failing to secure containment; it should not be mistaken for Deficiency-Cold and treated with astringents, drying agents, or tonics. Originally termed "Jia" (Mass), it should be treated with bitter purgatives and bitter-astringents.

Commentary: The above discussion details the meridian origins of these diseases thoroughly. Although the names of the Seven Hernias differ and treatments should vary, all employ purgative methods, which I question. Qian Zhongyang stated that the Liver is Ministerial Fire, requiring draining rather than tonifying. Zhu Danxi stated that the Liver is always in excess, while the Kidney is always deficient. For Jueyin Meridian hernias, unblocking without obstructing is appropriate, yet one must consider the depth of the pathology. Furthermore, if pathogens reside only in the Bladder and Small Intestine meridians, does the principle of "unblocking Jueyin" apply universally? Methods for treating various hernias.