昔人论疝，有专主厥阴经者，有专主任脉者，有兼言五脏者。主厥阴者，谓肝之脉环阴
器，
抵少腹，是厥阴之分，乃受疝之处也。主任脉者，谓《内经》任脉为病，男子内结七疝，故
任之脉，为疝之源也。兼五脏者，谓《内经》心脉搏急为心疝，肺脉沉搏为肺疝，又太阴脉
滑为脾风疝，太阳脉滑为肾风疝，少阳脉滑为肝风疝之类是也。以愚观之，则疝病未有不本
于肝者，盖任为阴脉之海，其脉同足厥阴并行腹里，而五脏之疝，其脉曰搏急，曰滑。夫搏
急是肝脉，滑则为病风，气通于肝，故任脉诸脏，虽皆有疝，莫不连合肝经。所谓有形如瓜
，有声如蛙，或上于腹，或下于囊者，方可谓之疝病。其不与肝相干者，则不得谓之疝矣。
至论疝病之因，有主寒者，有主湿热者，有火从寒化者。要之，疝病不离寒湿热三者之邪，
寒则急，热则纵，湿则肿，而尤必以寒气为之主。其有热者，寒邪郁热于内，非热能病疝，
亦非热能变寒也，故曰热为寒郁则可，热从寒化则不可。又疝者痛也，不特睾丸肿痛为疝，
即腹中攻击作痛，控引上下者，亦得名疝。所以昔贤有腹中之疝与睾丸之疝之说。戴人且谓
妇人亦有疝。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。
诸疝名状，巢氏、戴人言之最详。巢氏辨列七疝，曰厥，曰 ，曰寒，曰气，曰盘，曰
曰野狼。其厥热心痛，吐食不下者，名曰厥疝。腹中气乍满，心下尽痛，气积如臂者，曰 疝
。寒饮食，即胁下腹中尽痛，曰寒疝。腹中乍满乍减而痛，曰气疝。腹中痛在脐旁，曰盘疝
。腹中脐下有积聚，曰 疝。小腹与阴相引而痛，大便难，曰野狼疝。此皆痛在心腹之疝也。
戴人亦分七疝，曰寒，曰水，曰筋，曰血，曰气，曰狐，曰 。寒疝，其状囊气冷，结硬如
石，阴茎不举，连控睾丸而痛，得之坐卧湿地及砖石，或冬月涉水，或风冷处使内过劳，宜
以温剂下之，久而无子。水疝，其状肾囊肿痛，阴汗时出，或囊肿状如水晶，或囊痒搔出黄
水，或小腹按之作水声，得之饮水，或醉酒使内过劳，汗出而遇风寒湿之气聚于囊中，故水
多令人为卒疝，宜以逐水之剂下之。筋疝，其状阴茎肿痛，或溃或脓，或里急筋缩，或茎中
痛，痛极则痒，或挺纵不收，或白物如精，随溲而下，得之房室劳伤及邪术所使，宜以降心
火之药下之。血疝，其状如黄瓜，在小腹两旁，横骨两端约中，俗云便痈，得之春夏重感大
燠，劳于使内，气血流溢，渗入脬囊，留而不去，结成痈肿，脓少血多，宜以和血之剂下之
。气疝，其状上连肾区，下及阴囊，或因号哭忿怒，则郁久而胀，号哭怒罢，则气散者是也
，宜以散气之剂下之。狐疝，其状如瓦，卧则入小腹，行立则出腹入囊中，狐昼出穴而溺，
夜入穴而不溺，此疝出入上下往来，正与狐相类，亦与气疝大同小异也。宜以逐气流经之药
下之。 疝，其状阴囊肿缒，如升如斗，不痒不
痛，得之地气卑湿所生，故江淮之间，湫溏之处，多感此疾，宜以去湿之药下之，此皆痛在
睾丸之疝也。
Ancient scholars discussed hernia (Shan disease), with some focusing exclusively on the Jueyin meridian, others solely on the Ren vessel, and still others discussing all five Zang organs. Those who focused on the Jueyin meridian argued that the Foot-Jueyin Liver meridian circles the genitalia and reaches the lower abdomen; thus, the area governed by the Jueyin meridian is where hernias are contracted. Those who focused on the Ren vessel cited the *Neijing* (Classic of Internal Medicine), which states that disease of the Ren vessel causes seven types of internal hernias in men; hence, the Ren vessel is the source of hernias. Those who discussed all five Zang organs referred to the *Neijing*: a rapid and tense Heart pulse indicates Heart hernia; a deep and pounding Lung pulse indicates Lung hernia; a slippery Taiyin pulse indicates Spleen wind hernia; a slippery Taiyang pulse indicates Kidney wind hernia; and a slippery Shaoyang pulse indicates Liver wind hernia, among others.
In my opinion, hernia disease invariably originates from the Liver. The Ren vessel is the sea of Yin vessels, running parallel with the Foot-Jueyin Liver meridian within the abdomen. Regarding hernias of the five Zang organs, their pulses are described as "rapid/tense" (Boji) or "slippery" (Hua). A "rapid/tense" pulse is characteristic of the Liver, while a "slippery" pulse indicates Wind pathogen, and Wind Qi connects to the Liver. Therefore, although the Ren vessel and various Zang organs may present with hernias, they are all connected to the Liver meridian. Only conditions manifesting as solid masses like melons, sounds like frogs, or moving upward to the abdomen or downward into the scrotum can be truly called hernia disease. Conditions not involving the Liver cannot be classified as hernias.
Regarding the etiology of hernia, some attribute it primarily to Cold, others to Damp-Heat, and some to Fire transforming from Cold. In essence, hernia involves pathogens of Cold, Dampness, and Heat. Cold causes tension/spasm, Heat causes flaccidity, and Dampness causes swelling, but Cold is particularly dominant. Cases with Heat symptoms arise because Cold pathogens stagnate and transform into Heat internally; it is not that Heat directly causes hernia, nor that Heat transforms into Cold. Thus, it is correct to say "Heat is constrained by Cold," but incorrect to say "Heat transforms from Cold." Furthermore, "Shan" implies pain. It is not only testicular swelling and pain that constitutes hernia; abdominal attacks of pain radiating up and down also qualify as hernia. Hence, ancient sages distinguished between abdominal hernia and testicular hernia. Dai Ren even stated that women can suffer from hernia. Symptoms such as blood depletion leading to amenorrhea or masses in the lower abdomen fall under this category, yet they do not deviate from Liver meridian pathology, because the Liver stores Blood, governs tendons, and its Qi is violent and prone to attacking and rushing.
Regarding the names and manifestations of various hernias, Chao Yuanfang and Dai Ren provided the most detailed accounts. Chao Yuanfang identified seven types: Jue, [Missing Character], Han, Qi, Pan, [Missing Character], and Yelang.
1. **Jue Hernia**: Characterized by cold extremities, heart pain, and inability to keep food down.
2. **[Missing Character] Hernia** (likely Zha): Characterized by sudden abdominal fullness, complete pain in the epigastrium, and Qi accumulation resembling the size of an arm.
3. **Han (Cold) Hernia**: Pain throughout the hypochondrium and abdomen after consuming cold food/drink.
4. **Qi (Gas) Hernia**: Abdominal pain alternating with periods of fullness and relief.
5. **Pan (Coiled) Hernia**: Abdominal pain located beside the umbilicus.
6. **[Missing Character] Hernia**: Accumulations below the umbilicus in the abdomen.
7. **Yelang (Wild Wolf) Hernia**: Pain radiating between the lower abdomen and genitals, accompanied by difficult defecation.
These are all hernias affecting the heart and abdomen.
Dai Ren also categorized seven types: Han, Shui, Jin, Xue, Qi, Hu, and [Missing Character].
1. **Han (Cold) Hernia**: Scrotal Qi feels cold, hardening like stone; penis fails to erect; pain radiates to testes. Caused by sitting/lying on wet ground or bricks, wading in winter, or excessive sexual activity in cold/windy places. Treatment: Warm purgatives. Prognosis: Infertility if chronic.
2. **Shui (Water) Hernia**: Swollen and painful kidney/scrotum; frequent sweating of Yin; cysts may look like crystals or itch with yellow discharge; water sound upon pressing lower abdomen. Caused by excessive drinking, sexual activity after intoxication, sweating followed by exposure to Wind-Cold-Dampness accumulating in the scrotum. Excess water leads to sudden hernia. Treatment: Water-draining purgatives.
3. **Jin (Tendon) Hernia**: Swollen and painful penis; ulceration or suppuration; tenesmus with tendon contraction; penile pain so severe it causes itching; priapism or inability to retract; white discharge resembling semen during urination. Caused by sexual exhaustion or evil arts. Treatment: Herbs to descend Heart Fire.
4. **Xue (Blood) Hernia**: Shape like a cucumber, located on both sides of the lower abdomen at the midpoint of the transverse bones (pubic symphysis area); commonly called "Bian Yong" (genital abscess). Caused by heavy heat exposure in spring/summer combined with sexual exertion, causing Qi and Blood to overflow into the bladder and scrotum, forming an abscess with more blood than pus. Treatment: Blood-regulating purgatives.
5. **Qi (Gas) Hernia**: Extends from the Kidney region to the scrotum. Swells due to prolonged stagnation from crying or anger; resolves when Qi disperses after the emotion subsides. Treatment: Qi-scattering purgatives.
6. **Hu (Fox) Hernia**: Shape like a tile. Enters the lower abdomen when lying down; exits into the scrotum when standing or walking. Like a fox entering/exiting its burrow, this hernia moves up and down, similar to Fox behavior, and closely resembles Qi hernia. Treatment: Purging agents to move Qi through meridians.
7. **[Missing Character] Hernia** (likely Shi/Dampness Hernia): Scrotum swells and hangs heavily like a measuring cup; no itching or pain. Caused by low-lying damp Earth Qi. Common in Jianghuai regions' marshy areas. Treatment: Dampness-dispelling purgatives.
These are all hernias affecting the testicles.