某 七疝治法。最详子和。其旨辛香以泄肝。得气疏泄而病缓矣。按法调理不愈。七味导引纳
肾。益气升举脾阳。而坠气仍然。艾灸蒸脐。原得小安。内经任脉为病。男子内结七疝。女子带
下瘕聚。同为奇经主之。故疏泄诸方。能治气实。参术升补。仅治中虚下陷。与元海奇经中病
无补。壮岁至老。病根不辍。下焦日衰。可知升阳一法。体症颇合。衰年仅可撑持。勿使病加可
矣。（督任阳虚）
生鹿茸（三钱） 鹿角霜（一钱） 当归（二钱） 生菟丝子（五钱） 沙蒺藜（一钱） 川
桂枝尖（五分）
饥时服。
朱（二一） 劳伤。温里已效。脐旁动气。少腹结疝。睾丸偏坠。皆阳气不自复。浊阴聚络。不宜
急于育子。（浊阴凝聚肝络）
当归 舶茴香 淡苁蓉 枸杞子 安息香 茯苓
孙 疝坠于右。筋缩连小腹痛。此寒主收引。议进温通厥阴之络。
川楝子（二两） 穿山甲（二两炙） 炮黑川乌（五钱去皮） 炒黑小茴香（一两） 橘核（二
两炒） 乳香（五钱）
用老韭白根汁泛丸。饥时服二钱五分。
明 脐下少腹。形象横梗。发必痛绕胁腰。以及阴囊。此乃厥阴肝气不宣。议以苦辛加左金。佐
通经脉之凝涩。
川连 吴萸 穿山甲 青木香 金铃子 延胡 青橘叶汤丸
郁（十七） 肝病。络虚气聚。少腹滞胀。前用河间金铃子散。加牡蛎橘叶。合咸苦辛胜法。小效加食。述
饥则胁腹鸣盛。而浊气下泄颇安。乃络虚不足中之有余。形质瘦怯。不可纯攻。
桃仁 当归梢 炒小茴 橘核 郁李仁 南山楂 葱白汁丸
谢（五七） 七疝皆肝。少腹坚聚有形。是闭塞不通之象。百日久恙。血络必伤。古人治疝。必用辛香。助
燥气胜之品。宜缓商矣。
归须 杜牛膝根 小茴香 川楝子 穿山甲 柏子仁
林 脉右弦。左涩。当脐痛连少腹。已属凝聚有形。呕吐黄浊。大便欲解不通。若患处漉漉有声。
痛势稍减。惟卧着体不转移。其痛更加。此属肝气疝瘕。辛香流气。所称通则不痛耳。
炒桃仁 炒橘核 金铃子 炒延胡 韭白汁 两头尖 小茴 青皮
此通泄厥阴气血方也。痛甚于下。浊结有形。非辛香无以入络。非秽浊无以直走至阴之
域。以子和方合奉议意。
施（四八） 立冬前一日。寒战后热属厥阴。食蟹咸寒沉坠。浮肿囊大。溲溺甚少。至晚肿胀愈加。显然
阳微浊聚。治从气分开泄冷湿。
粗桂枝 吴萸 川楝子 茯苓 生牡蛎 泽泻
磨青皮汁十匙。
唐（三六） 寒湿已入太阳之里。膀胱之气不利。阴囊茎肿。（膀胱寒湿凝滞）
五苓散加独活汉防己。
某 肝风筋疝。怒劳致伤。宜通补熄风。（筋疝）
苁蓉 补骨脂 归须 小茴 韭子 茯苓
胡桃肉 青盐 羊内肾蒸熟和丸。
朱 动气疝瘕。绕脐汨汨有声。男子精气不充。是下焦损伤。温补勿过刚燥。须察八脉。以推病
情。（奇脉阳虚）
淡苁蓉 归身 炒枸杞 小茴 炒沙苑 茯苓 红枣肉
汪 自云郁怒不已。夏季忽起腹胀。医以快气疏滞汤药。其胀竟入小腹下坠。青筋外突。胀甚
延及肾囊。乃肝疝之症。议子和法。（郁怒肝疝肿胀）
归须 橘核 青木香 青皮 小茴 黑山栀 青葱管
周（三六） 久久劳怒。肝木内震。胁中少腹。皆肝脉游行之所。气凝聚为胀。聚久结形为瘕疝。情怀忧
郁。永不能痊。以内起情志。不专草木微功耳。
炒小茴 黑山栀 川楝子 延胡 青木香 青皮 生香附 橘核
吴（六十） 味酸。食不化。涌吐。述少腹厥气上冲。下有宿疝。以肝浊攻胃。经云。食出完谷。是无阳也。
（肝疝犯胃）
生炮黑附子 生淡干姜 猪胆汁 吴萸 川楝子
吴（二四） 疝结少腹。按之坚。凡过饥必冲突至脘。吐酸 胀。述病从怒劳而得。内应乎肝。肝逆犯胃。
饥则胃弱肝乘上嗳下泄气则减。
肉桂 真橘核 青木香 小茴 穿山甲 粗桂枝 李根白皮
项 寒胜疝坠。亦属厥阴。盖阳明衰。厥邪来乘。须胃阳复辟。凝寒自罢。
人参（一钱半） 炮乌头（一钱） 淡干姜（一钱） 吴萸（泡淡一钱） 茯苓（三钱）
朱 七疝在肝。内经谓冲脉为病。但冲脉隶于阳明。肝木必乘克胃土。胃翻涌逆。致吐蛔呕涎。
汤饮不入。呃忒不止。皆逆乱无已。为脏厥危 矣。肝体本刚。相火内寄。一派热燥药饵。以刚
济刚。竟有缺折之虞。欲泄其浊。拟用朱南阳法。
韭白根 两头尖 金铃子 延胡 归须 肉桂心
毛 疝发已过。肢冷潮热。其纳食减半。浊阴内迫犯胃。无发汗攻表之理。议泄厥阴。以安阳明。
人参 炒黑川椒 附子 茯苓 川楝子 胡芦巴
詹 老年久疝。因嗔怒而肿大。热痛。肝失疏泄。火腑湿热蕴结不通。温补升阳固谬。盖肝性主
刚湿闭反从燥化。此龙胆苦坚不应。议柔苦制热。反佐辛热。以开血中郁痹。用东垣滋肾丸。
（久疝湿热郁）
戴（五二） 湿热下注。久则囊肿形坚。下焦血多气少。子和法中。原有虎潜诸论。后医弃置不用。惜哉。
龙胆草 黄柏 芦荟 山栀 知母 海金沙 猪苓 泽泻 细辛
陈（三五） 疝多肝病。宜乎辛泄。但形体参脉。是湿热内蕴阻塞。二便不为通爽。先以通太阳方。
寒水石 海金沙 猪苓 泽泻 通草 木香汁
倪 疝瘕结聚少腹。大便闭阻。小溲短涩。舌白渴饮。不能纳谷。无对症方药。姑与滋肾丸尝服。
千粒分十服。
许（三六） 久有疝症。十年来。寒热劳形。则右胸胁中。一股气坠。直走少腹。凡大小便用力皆然。面赤
亮。痰多。食腥腻。更令病加。此湿热久壅隧中。缓攻为宜。
控涎丹四分。间日服。十服。
又 脉沉。痰多。手骱赤疮。宿疝在下。右胁气坠少腹。前议控涎丹逐痹未应。想久聚湿热沉痼。
非皮膜经脉之壅。用浚川丸四十粒。匀二服。间日一进。竟通腑聚。然后再议。
又 通腑宣壅。粘痰既下。其疝仍聚于右。且盛于寒天冬月。卧安必有声自消。行走劳动。必有
形直坠阴囊。久病急攻无效。议辛甘化风方法。古人以疝为肝病什居八九。
当归 鹿角 桂枝 肉桂 小茴 川芎 炙草 茯苓 生姜 羊肉胶丸
张（五九） 痛自肾囊。渐踞少腹之左。夫厥阴之脉。绕乎阴器。操持谋虑。都主伤肝。一气结
聚。变幻形象而痛。病名曰疝。疝分有七。暴疝多寒。久疝多热。泄气痛缓。宣通可以却病。
只因下焦乃深远之乡。气热湿郁。概可知矣。
川连 小茴 黑山栀 橘核 川楝子 青木香 郁李仁 冬葵子
陈 脉沉弦。舌灰边白。腰跨气痛。肾囊睾丸肿大。此湿热为病。乱吃发散消导。湿热下坠为疝。
治当分消。
萆 黄柏 山栀 茯苓 丹皮 防己 猪苓 泽泻
陈（二二） 辛香流气以治疝。未尝不通。服之五日。遍身疼痛。下午四肢浮肿。肌肤渐见高突块瘰。思
走泄气胜。都是阳伤。 附汤主之。（疏泄伤卫阳）
生黄 （一两） 附子（二钱）
朱（二五） 厥阴三疟久延。邪攻肝经络脉。少腹痛渐硬。气串绕阴器筋痛。乃结疝瘕之象。
病久。虽少壮。不可专于泄气。温肾宣肝为急。（疝兼疟母）
淡苁蓉 归身 枸杞子 炒黑小茴 穿山甲 全蝎
陆（三九） 疟母十年。沉痼宿 。药不能效。夫疟邪既久。邪与气血两凝。结聚络脉。药难入络耳。疟不
离乎肝胆。疝不外乎肝病。七疝。子和分剖大着。虚质不可专以辛香。下坠为甚。议有情温通。
以培生气。
鹿茸 大茴香 穿山甲 当归 水安息香 炮黑川乌 全蝎
用黑大豆炒赤淋酒一杯。滤酒汁和丸。每服二钱。暖酒送。
经云。任脉为病。男子内结七疝。女子带下瘕聚。又督脉生病。从少腹上冲心而痛。不得前
后为冲疝。又曰。脾传之肾。病名曰疝瘕。又曰三阳为病。发寒热。其传为 疝。又曰邪客于
足厥阴之络。令人卒疝暴痛。此素问言诸经之疝也。又经脉等篇云。足阳明之筋病 疝。
腹筋急。足太阴之筋病。阴器纽痛。下引脐两胁痛。足厥阴之经筋病。阴器不用。此灵枢言
诸经之疝也。后人因有筋水狐 气血寒七疝之名。其主治各有专方。立法可谓大备。然
其中不无错杂之处。终非可训之定法。惟仲景先生。独以寒疝为名。其所出三方。亦以温
散祛寒。调营补虚为主。并不杂入气分之药。而子和治法又以辛香流气为主。谓肝得疏
泄而病愈矣。其金铃虎潜诸法。可谓发前人所未发。故疝病之本。不离乎肝。又不越乎寒。
以肝脉络于阴器。为至阴之脏。足太阳之脉。属肾络膀胱。为寒水之经。故仲景所云寒疝。
腹中痛逆冷。手足不仁。腹满。脉弦而紧。恶寒不欲食。绕脐痛。及胁痛里急。是内外皆寒气
作主。无复界限。其乌头二方。专以破邪治标为急。虚实在所不论。是急则治标之义也。其
当归羊肉一方。专以补虚散寒为主。故以当归羊肉辛甘重浊。温暖下元。而不伤阴。佐以
生姜。随血肉有情之品。引入下焦温散 寒。是固本不治标也。子和所云。疝不离乎肝者。
以疝病有阴囊肿胀。或痛而里急筋缩。或茎中作痛。或牵引睾丸。或少腹攻冲作痛。或号
笑忿怒而致。此皆肝经脉络之现症。其金铃散一法。以泄肝散逆为主。故以川楝导膀胱
小肠之热。元胡和一身上下诸痛。以肝主疏泄故也。其所取虎潜一法。以柔缓导引为主。
故方中用虎骨熄肝风。壮筋骨。羊肉龟板补髓填精。佐以地黄补肾。当归补肝。使以陈皮
利气疏肝。芍药通肝调营。是治肝而顾及于肾也。及观先生治疝之法。又更有进焉者。其
旨以暴疝多寒。久疝多热。为疝病之大纲。其余随症施治。如气坠下结者。以鹿茸鹿角升
阳为主。其胀结有形。痛甚于下者。宗丹溪通阳泄浊为治。其火腑湿热郁结不通者。用柔
苦制热。反佐辛热。以开血中郁痹为主。其寒湿下坠。太阳之里。膀胱之气不和。二便不为
通利者。五苓散加减。通太阳膀胱为主。其湿热久聚。气坠少腹阴囊者。用控涎丹。浚川丸
等。逐痹通腑分消。兼辛甘化风法为主。如下焦阴阳两虚煮。用有情温通以培生气。兼通
补熄风为主。而先生于治疝之法。可谓曲尽病情。诸法备矣。仲景又有狐疝一方。究非王
道之品。兹不具赘。（邹滋九）
徐评 治疝之法。大段亦不外此。惟 疝血疝诸大症。尚未有治法。想当时未及遇此等大症
也。
【疝病医案】
某患者。七种疝气的治法，以张子和记载最为详尽。其主旨在于用辛香药物疏泄肝气，使气机得以疏泄通畅，病情随之缓解。若按此法调理却不见痊愈，则需采用七味导引药纳入肾经，益气升举脾阳，但下坠之气依然如故。艾灸蒸脐法，原本能带来些许安宁。《内经》记载：任脉为病，男子体内结聚成七疝，女子带下瘕聚。这些病症均由奇经八脉主管。因此，疏泄肝气的方剂，只能治疗气实之证；人参、白术等升补之法，仅能治疗中气虚弱下陷之证。这与元海（肾间动气）及奇经八脉的疾病无益。从壮年直到老年，病根未除，下焦日益衰败。由此可见，“升阳”这一治法，在体质和症状上颇为契合，但对于衰老之年，只能勉强支撑，只要不让病情加重即可。（督脉、任脉阳虚）
生鹿茸（三钱） 鹿角霜（一钱） 当归（二钱） 生菟丝子（五钱） 沙蒺藜（一钱） 川桂枝尖（五分）
空腹时服用。
朱姓患者（二十一岁）。因劳损致病，温里法已见效。但脐旁有动气感，少腹结块成疝，睾丸偏坠。这都是阳气不能自我恢复，浊阴凝聚于络脉所致。不宜急于求子。（浊阴凝聚肝络）
当归 舶茴香 淡苁蓉 枸杞子 安息香 茯苓
孙姓患者。疝气下坠于右侧，筋脉拘挛牵连小腹痛。这是寒邪主收引所致。建议进服温通厥阴经络的药物。
川楝子（二两） 穿山甲（二两炙） 炮黑川乌（五钱去皮） 炒黑小茴香（一两） 橘核（二两炒） 乳香（五钱）
用老韭白根汁泛丸。空腹时服用二钱五分。
明姓患者。脐下少腹部，感觉横梗有形，发作时疼痛环绕胁腰，以及阴囊。这是厥阴肝气不宣畅所致。建议用苦辛药配合左金丸，辅助疏通经脉的凝涩。
川连 吴萸 穿山甲 青木香 金铃子 延胡 青橘叶汤丸
郁姓患者（十七岁）。患有肝病，络脉空虚气机聚结，少腹滞胀。先前使用河间氏的金铃子散，加牡蛎、橘叶，合咸苦辛胜法，略有成效且食欲增加。自述饥饿时胁腹鸣响严重，而浊气下泄后颇感安宁。这是络脉虚损不足中的有余之邪，形体瘦弱怯懦，不可纯用攻伐之法。
桃仁 当归梢 炒小茴 橘核 郁李仁 南山楂 葱白汁丸
谢姓患者（五十七岁）。七疝皆与肝有关。少腹坚聚有形，是闭塞不通的现象。患病百日之久，血络必然受损。古人治疗疝气，必用辛香助燥气胜湿之品。宜缓缓商议治法。
归须 杜牛膝根 小茴香 川楝子 穿山甲 柏子仁
林姓患者。脉象右弦左涩。当脐疼痛牵连少腹，已经属于凝聚成形的阶段。呕吐黄浊之物，大便想解却不通。如果患处漉漉有声，痛势稍减，只有躺着身体不移动时，疼痛更加剧烈。这属于肝气疝瘕。用辛香流通气机，即所谓“通则不痛”。
炒桃仁 炒橘核 金铃子 炒延胡 韭白汁 两头尖 小茴 青皮
这是通泄厥阴气血的方子。疼痛在下部严重，浊邪结聚成形，非辛香药无法入络，非秽浊药无法直达至阴之域。结合子和的方意与奉议之意。
施姓患者（四十八岁）。立冬前一天，先寒战后发热，属厥阴经病。食用螃蟹咸寒之物导致沉坠，浮肿囊大，小便极少。到了晚上肿胀更加厉害。显然是阳气微弱，浊阴聚积。治法应从气分开泄冷湿。
粗桂枝 吴萸 川楝子 茯苓 生牡蛎 泽泻
磨青皮汁十匙。
唐姓患者（三十六岁）。寒湿已进入太阳之里，膀胱气化不利，阴囊阴茎肿胀。（膀胱寒湿凝滞）
五苓散加独活汉防己。
某患者。肝风筋疝，因愤怒劳累致伤。宜通补熄风。（筋疝）
苁蓉 补骨脂 归须 小茴 韭子 茯苓
胡桃肉 青盐 羊内肾蒸熟和丸。
朱姓患者。动气疝瘕，绕脐汨汨有声。男子精气不充，是下焦损伤。温补勿过于刚燥。须察八脉，以推断病情。（奇脉阳虚）
淡苁蓉 归身 炒枸杞 小茴 炒沙苑 茯苓 红枣肉
汪姓患者。自称郁怒不已，夏季忽然起腹胀。医生用快气疏滞汤药，其胀竟入小腹下坠，青筋外突，胀甚延及肾囊。这是肝疝的症状。建议采用张子和的治法。（郁怒肝疝肿胀）
归须 橘核 青木香 青皮 小茴 黑山栀 青葱管
周姓患者（三十六岁）。久久劳怒，肝木内震。胁中少腹，都是肝脉游行之所。气凝聚为胀，聚久结形为瘕疝。情怀忧郁，永远不能痊愈。因为病由内起情志引起，不专靠草木药物的微小功效就能治好。
炒小茴 黑山栀 川楝子 延胡 青木香 青皮 生香附 橘核
吴姓患者（六十岁）。口味发酸，食物不消化，涌吐。自述少腹厥气上冲，下有宿疝。以肝浊攻胃，《内经》说：“食出完谷”，是无阳的表现。（肝疝犯胃）
生炮黑附子 生淡干姜 猪胆汁 吴萸 川楝子
吴姓患者（二十四岁）。疝结少腹，按之坚硬。凡是过饥必定冲突至脘部，吐酸胀。自述病从怒劳而得，内应乎肝。肝逆犯胃，饥饿时胃弱肝乘，上嗳下泄气则减轻。
肉桂 真橘核 青木香 小茴 穿山甲 粗桂枝 李根白皮
项姓患者。寒胜疝坠，也属厥阴。盖因阳明衰，厥邪来乘。须胃阳复辟，凝寒自罢。
人参（一钱半） 炮乌头（一钱） 淡干姜（一钱） 吴萸（泡淡一钱） 茯苓（三钱）
朱姓患者。七疝在肝。《内经》谓冲脉为病，但冲脉隶于阳明。肝木必乘克胃土，胃翻涌逆，致吐蛔呕涎。汤饮不入，呃忒不止，皆逆乱无已，为脏厥危矣。肝体本刚，相火内寄。一派热燥药饵，以刚济刚，竟有缺折之虞。欲泄其浊，拟用朱南阳法。
韭白根 两头尖 金铃子 延胡 归须 肉桂心
毛姓患者。疝发已过，肢冷潮热，其纳食减半。浊阴内迫犯胃，无发汗攻表之理。议泄厥阴，以安阳明。
人参 炒黑川椒 附子 茯苓 川楝子 胡芦巴
詹姓患者。老年久疝，因嗔怒而肿大、热痛。肝失疏泄，火腑湿热蕴结不通。温补升阳固谬。盖肝性主刚，湿闭反从燥化。此龙胆苦坚不应。议柔苦制热，反佐辛热，以开血中郁痹。用东垣滋肾丸。（久疝湿热郁）
戴姓患者（五十二岁）。湿热下注，久则囊肿形坚。下焦血多气少。子和法中，原有虎潜诸论。后医弃置不用，惜哉。
龙胆草 黄柏 芦荟 山栀 知母 海金沙 猪苓 泽泻 细辛
陈姓患者（三十五岁）。疝多肝病，宜乎辛泄。但形体参脉，是湿热内蕴阻塞。二便不为通爽。先以通太阳方。
寒水石 海金沙 猪苓 泽泻 通草 木香汁
倪姓患者。疝瘕结聚少腹，大便闭阻，小溲短涩，舌白渴饮，不能纳谷。无对症方药。姑与滋肾丸尝服。
千粒分十服。
许姓患者（三十六岁）。久有疝症，十年来，寒热劳形，则右胸胁中，一股气坠，直走少腹。凡大小便用力皆然。面赤亮，痰多，食腥腻，更令病加。此湿热久壅隧中，缓攻为宜。
控涎丹四分。间日服。十服。
又。脉沉，痰多，手骱赤疮，宿疝在下，右胁气坠少腹。前议控涎丹逐痹未应。想久聚湿热沉痼，非皮膜经脉之壅。用浚川丸四十粒。匀二服。间日一进。竟通腑聚。然后再议。
又。通腑宣壅，粘痰既下，其疝仍聚于右。且盛于寒天冬月。卧安必有声自消。行走劳动，必有形直坠阴囊。久病急攻无效。议辛甘化风方法。古人以疝为肝病什居八九。
当归 鹿角 桂枝 肉桂 小茴 川芎 炙草 茯苓 生姜 羊肉胶丸
张姓患者（五十九岁）。痛自肾囊，渐踞少腹之左。夫厥阴之脉，绕乎阴器。操持谋虑，都主伤肝。一气结聚，变幻形象而痛。病名曰疝。疝分有七，暴疝多寒，久疝多热。泄气痛缓，宣通可以却病。只因下焦乃深远之乡，气热湿郁，概可知矣。
川连 小茴 黑山栀 橘核 川楝子 青木香 郁李仁 冬葵子
陈姓患者。脉沉弦，舌灰边白，腰跨气痛，肾囊睾丸肿大。此湿热为病，乱吃发散消导，湿热下坠为疝。治当分消。
萆 黄柏 山栀 茯苓 丹皮 防己 猪苓 泽泻
陈姓患者（二十二岁）。辛香流气以治疝，未尝不通。服之五日，遍身疼痛，下午四肢浮肿，肌肤渐见高突块瘰。思走泄气胜，都是阳伤。附汤主之。（疏泄伤卫阳）
生黄 （一两） 附子（二钱）
朱姓患者（二十五岁）。厥阴三疟久延，邪攻肝经络脉，少腹痛渐硬，气串绕阴器筋痛，乃结疝瘕之象。病久，虽少壮，不可专于泄气。温肾宣肝为急。（疝兼疟母）
淡苁蓉 归身 枸杞子 炒黑小茴 穿山甲 全蝎
陆姓患者（三十九岁）。疟母十年，沉痼宿疾，药不能效。夫疟邪既久，邪与气血两凝，结聚络脉，药难入络耳。疟不离乎肝胆，疝不外乎肝病。七疝，子和分剖大着。虚质不可专以辛香。下坠为甚。议有情温通，以培生气。
鹿茸 大茴香 穿山甲 当归 水安息香 炮黑川乌 全蝎
用黑大豆炒赤淋酒一杯。滤酒汁和丸。每服二钱。暖酒送。
《内经》云：任脉为病，男子内结七疝，女子带下瘕聚。又督脉生病，从少腹上冲心而痛，不得前后为冲疝。又说：脾传之肾，病名曰疝瘕。又说：三阳为病，发寒热，其传为疝。又说：邪客于足厥阴之络，令人卒疝暴痛。此《素问》言诸经之疝也。又《经脉》等篇云：足阳明之筋病疝，腹筋急。足太阴之筋病，阴器纽痛，下引脐两胁痛。足厥阴之经筋病，阴器不用。此《灵枢》言诸经之疝也。后人因有筋水狐气血寒七疝之名，其主治各有专方，立法可谓大备。然其中不无错杂之处，终非可训之定法。惟仲景先生，独以寒疝为名，其所出三方，亦以温散祛寒，调营补虚为主，并不杂入气分之药。而子和治法又以辛香流气为主，谓肝得疏泄而病愈矣。其金铃虎潜诸法，可谓发前人所未发。故疝病之本，不离乎肝，又不越乎寒。以肝脉络于阴器，为至阴之脏。足太阳之脉，属肾络膀胱，为寒水之经。故仲景所云寒疝，腹中痛逆冷，手足不仁，腹满，脉弦而紧，恶寒不欲食，绕脐痛，及胁痛里急，是内外皆寒气作主，无复界限。其乌头二方，专以破邪治标为急，虚实在所不论，是急则治标之义也。其当归羊肉一方，专以补虚散寒为主，故以当归羊肉辛甘重浊，温暖下元，而不伤阴。佐以生姜，随血肉有情之品，引入下焦温散寒。是固本不治标也。子和所云，疝不离乎肝者，以疝病有阴囊肿胀，或痛而里急筋缩，或茎中作痛，或牵引睾丸，或少腹攻冲作痛，或号笑忿怒而致。此皆肝经脉络之现症。其金铃散一法，以泄肝散逆为主，故以川楝导膀胱小肠之热，元胡和一身上下诸痛，以肝主疏泄故也。其所取虎潜一法，以柔缓导引为主，故方中用虎骨熄肝风，壮筋骨，羊肉龟板补髓填精，佐以地黄补肾，当归补肝，使以陈皮利气疏肝，芍药通肝调营，是治肝而顾及于肾也。及观先生治疝之法，又更有进焉者。其旨以暴疝多寒，久疝多热，为疝病之大纲。其余随症施治，如气坠下结者，以鹿茸鹿角升阳为主。其胀结有形，痛甚于下者，宗丹溪通阳泄浊为治。其火腑湿热郁结不通者，用柔苦制热，反佐辛热，以开血中郁痹为主。其寒湿下坠，太阳之里，膀胱之气不和，二便不为通利者，五苓散加减，通太阳膀胱为主。其湿热久聚，气坠少腹阴囊者，用控涎丹、浚川丸等，逐痹通腑分消，兼辛甘化风法为主。如下焦阴阳两虚煮，用有情温通以培生气，兼通补熄风为主。而先生于治疝之法，可谓曲尽病情，诸法备矣。仲景又有狐疝一方，究非王道之品，兹不具赘。（邹滋九评）
[Case Records on Hernia]
Patient [Name Unknown]. The treatment methods for the seven types of hernia are most detailed in Zhang Hezi's works. The main idea is to use acrid-aromatic herbs to vent the Liver, allowing Qi to flow freely and smoothly, thereby alleviating the disease. If following this method fails to cure, one should employ seven-herb guiding methods to enter the Kidney meridian, tonify Qi and raise Spleen Yang; however, the sinking Qi remains unchanged. Moxibustion steaming the navel originally provided slight relief. The *Neijing* states: "Diseases of the Ren Mai (Conception Vessel) manifest as internal nodulation of the seven hernias in men, and leukorrhea with mass accumulation in women." These conditions are governed by the Extraordinary Vessels. Therefore, formulas that vent and diffuse can only treat Qi excess patterns; Ginseng and Atractylodes macrocephala tonification methods only treat Middle Jiao deficiency with sinking; these have no benefit for diseases involving Yuan Hai (the source of vitality at the Kidney level) and the Extraordinary Vessels. From adulthood to old age, the root of the disease persists, and the Lower Jiao declines daily. Thus, while the "raising Yang" method aligns well with the constitution and symptoms, for an elderly patient, it can only maintain stability, preventing further aggravation of the disease. (Yang Deficiency of Du Mai and Ren Mai)
Raw Deer Antler (3 qian), Deer Horn Frost (1 qian), Angelicae Sinensis Radix (2 qian), Raw Cuscutae Semen (5 qian), Tribuli Fructus (1 qian), Cinnamomi Ramulus Acumen (0.5 qian).
Take on an empty stomach.
Patient Zhu (21 years old). Due to overwork injury, warming the interior was effective. However, there is pulsating Qi beside the navel, a hernia mass in the lower abdomen, and unilateral testicular descent. These indicate that Yang Qi cannot restore itself, and turbid Yin accumulates in the collaterals. It is inappropriate to rush into treating for conception. (Turbid Yin Condensing in Liver Collaterals)
Angelicae Sinensis Radix, Imported Fennel Fruit, Cistanche Deserticola Stem (light), Lycii Fructus, Benzoin Resin, Poria.
Patient Sun. Hernia descends to the right, with tendon contraction connecting to lower abdominal pain. This is due to Cold pathogen causing contraction and drawing inward. It is proposed to administer herbs that warm and unblock the Jueyin Liver collaterals.
Toosendan Fruit (2 liang), Pangolin Scales (2 liang, roasted), Prepared Aconitum Carmichaelii Root (Blackened) (5 qian, peeled), Stir-fried Blackened Fennel Fruit (1 liang), Citrus Aurantium Unripe Fruit Kernel (2 liang, stir-fried), Frankincense (5 qian).
Pill form using juice from old Chinese Leek roots. Take 2.5 qian on an empty stomach.
Patient Ming. Below the navel and in the lower abdomen, there is a sensation of horizontal obstruction. Upon onset, pain wraps around the hypochondrium, waist, and scrotum. This is due to Jueyin Liver Qi failing to circulate freely. It is proposed to use bitter-acrid herbs combined with Zuojin Wan to assist in unblocking collateral stagnation.
Coptidis Rhizome, Evodiae Fructus, Pangolin Scales, Aquilariae Lignum cum Resina, Toosendan Fruit, Corydalis Rhizome. Pill form with Green Tangerine Leaf decoction.
Patient Yu (17 years old). Liver disease, collateral deficiency with Qi aggregation, causing stagnation and distension in the lower abdomen. Previously used Jinlingzi San from Hejian, added Oyster Shell and Tangerine Leaf, combined with salty-bitter-acrid overcoming method, yielding slight improvement and increased appetite. The patient reports intense borborygmus in the hypochondrium and abdomen when hungry, but feels relieved after turbid Qi descends. This indicates excess within deficiency of the collaterals. The body is thin and weak; pure attacking methods should not be used.
Persicae Semen, Tip of Angelicae Sinensis Radix, Stir-fried Small Fennel, Citrus Aurantium Unripe Fruit Kernel, Prunus Armeniaca Seed, Hawthorn Fruit. Pill form with Scallion White Juice.
Patient Xie (57 years old). All seven hernias relate to the Liver. Hard masses in the lower abdomen indicate blockage and lack of free flow. After a hundred days of illness, blood collaterals must be damaged. Ancients treated hernias using acrid-aromatic herbs that aid dryness to overcome dampness. Treatment should be deliberated slowly.
Tip of Angelicae Sinensis Radix, Achyranthes Bidentata Root, Small Fennel, Toosendan Fruit, Pangolin Scales, Biota Seed.
Patient Lin. Pulse is wiry on the right and choppy on the left. Pain at the umbilicus radiates to the lower abdomen, indicating condensation into a tangible mass. Vomiting yellow turbid fluid, desire to defecate but unable to do so. If the affected area makes gurgling sounds, pain slightly decreases. Only when lying still without moving does pain intensify. This belongs to Liver Qi Hernia-Mass. Use acrid-aromatic herbs to circulate Qi, following the principle that "free flow prevents pain."
Stir-fried Persicae Semen, Stir-fried Citrus Aurantium Unripe Fruit Kernel, Toosendan Fruit, Stir-fried Corydalis Rhizome, Chinese Leek White Juice, Acorus Tatarinowii Rhizome, Small Fennel, Green Tangerine Peel.
This is a formula to unblock and drain Jueyin Qi and Blood. Severe pain below, turbid condensation forming a mass; only acrid-aromatic herbs can enter the collaterals, only foul-smelling herbs can reach the extreme Yin regions. Combining Hezi's method with Fengyi's intent.
Patient Shi (48 years old). One day before Start of Winter, chills followed by fever belong to Jueyin. Eating crab (salty-cold) caused sinking, edema, and large scrotum. Urination is very scant. Swelling worsens by evening. Clearly, Yang is weak and Turbid Yin accumulates. Treatment should separate Qi and drain cold-dampness.
Rough Cinnamon Twig, Evodiae Fructus, Toosendan Fruit, Poria, Raw Oyster Shell, Alisma Rhizome.
Ten spoons of crushed Green Tangerine Peel juice.
Patient Tang (36 years old). Cold-Damp has entered the interior of Taiyang. Bladder Qi transformation is unfavorable. Scrotal and penile swelling. (Bladder Cold-Damp Stagnation)
Wuling San plus Actaea Racemosa Root and Stephania Tetrandra.
Patient [Name Unknown]. Liver Wind Tendon Hernia, injured by anger and overwork. Should unblock and tonify to extinguish wind. (Tendon Hernia)
Cistanche Deserticola Stem, Psoralea Fructus, Tip of Angelicae Sinensis Radix, Small Fennel, Chinese Leek Seed, Poria.
Walnut Meat, Green Salt, Steamed Sheep Kidney, pilled together.
Patient Zhu. Pulsating Hernia-Mass, gurgling sound around the navel. Men's essence is insufficient, indicating Lower Jiao damage. Warming and tonifying should not be overly acrid-hot. Must examine the Eight Extraordinary Vessels to deduce the condition. (Yang Deficiency of Extraordinary Vessels)
Light Cistanche Deserticola Stem, Body of Angelicae Sinensis Radix, Stir-fried Lycii Fructus, Small Fennel, Stir-fried Astragalus Complanatus Seed, Poria, Red Date Flesh.
Patient Wang. Claims continuous depression and anger. Suddenly developed abdominal distension in summer. Doctors used Qi-moving and stagnation-resolving decoctions, but distension sank into the lower abdomen, varicose veins protruded externally, and swelling extended to the scrotum. This is a Liver Hernia symptom. Adopt Zhang Hezi's method. (Depression/Anger Liver Hernia Swelling)
Tip of Angelicae Sinensis Radix, Citrus Aurantium Unripe Fruit Kernel, Aquilariae Lignum cum Resina, Green Tangerine Peel, Small Fennel, Gardenia Fruit, Green Scallion Tube.
Patient Zhou (36 years old). Long-term overwork and anger cause internal trembling of Liver Wood. Hypochondrium and lower abdomen are pathways of Liver Meridian circulation. Qi aggregates causing distension; long-standing aggregation forms masses/hernias. Emotional depression means permanent non-recovery. Since the disease originates from emotions, herbal medicine alone has limited efficacy.
Stir-fried Small Fennel, Gardenia Fruit, Toosendan Fruit, Corydalis Rhizome, Aquilariae Lignum cum Resina, Green Tangerine Peel, Raw Cyperi Rhizome, Citrus Aurantium Unripe Fruit Kernel.
Patient Wu (60 years old). Sour taste, indigestion, projectile vomiting. Reports Jue Qi rushing up from lower abdomen, with chronic hernia below. Liver Turbidity attacks Stomach. *Jingyun* states: "Vomiting undigested food" indicates absence of Yang. (Liver Hernia Attacking Stomach)
Raw Prepared Blackened Aconite Root, Raw Light Dried Ginger, Pig Bile, Evodiae Fructus, Toosendan Fruit.
Patient Wu (24 years old). Hernia knots in lower abdomen, hard upon pressure. Hunger inevitably causes conflict reaching the epigastrium, acid regurgitation, and distension. Disease originated from anger and overwork, internally corresponding to the Liver. Liver rebellion attacks Stomach. When hungry, Stomach is weak, Liver overcomes it; belching upward and Qi draining downward reduces symptoms.
Cinnamon Bark, True Citrus Aurantium Unripe Fruit Kernel, Aquilariae Lignum cum Resina, Small Fennel, Pangolin Scales, Rough Cinnamon Twig, Li Root Bark.
Patient Xiang. Cold dominance causes hernia descent, also belonging to Jueyin. Because Yangming is deficient, Jue pathogen invades. Stomach Yang must recover, and condensed Cold will cease.
Ginseng (1.5 qian), Prepared Aconitum Carmichaelii Root (1 qian), Light Dried Ginger (1 qian), Evodiae Fructus (soaked light, 1 qian), Poria (3 qian).
Patient Zhu. Seven Hernias reside in the Liver. *Neijing* states Chong Mai disease, but Chong Mai belongs to Yangming. Liver Wood necessarily overacts on Stomach Earth. Stomach rebels and vomits, causing vomiting of roundworms and saliva. No soup or drink can stay down, hiccups ceaseless. All indicate chaotic reversal, leading to critical Zang Cold. Liver substance is inherently rigid, with Minister Fire residing internally. A batch of hot-dry medicines, using rigidity to supplement rigidity, risks fracture. To drain turbidity, adopt Zhu Nanyang's method.
Chinese Leek White Root, Acorus Tatarinowii Rhizome, Toosendan Fruit, Corydalis Rhizome, Tip of Angelicae Sinensis Radix, Cinnamon Heart.
Patient Mao. Hernia flare-up passed, limbs cold, tidal fever, food intake halved. Turbid Yin internally presses and attacks Stomach. No rationale for sweating or attacking the exterior. Propose draining Jueyin to calm Yangming.
Ginseng, Stir-fried Blackened Sichuan Pepper, Aconite, Poria, Toosendan Fruit, Hermodactyl Tubers.
Patient Zhan. Elderly with chronic hernia, swollen and painful after anger. Liver fails to vent, Fire Fu organs' damp-heat accumulates and blocks. Warming/tonifying raising Yang is definitely wrong. Liver nature is rigid; damp closure turns to dryness. Longdan Ku Jian is ineffective. Propose soft-bitter to control heat, counter-assist with acrid-hot to open blood stasis. Use Dongyuan Zishen Wan. (Chronic Hernia Damp-Heat Stagnation)
Patient Dai (52 years old). Damp-heat flows downward, long-term causing hard scrotal swelling. Lower Jiao has much Blood, little Qi. Hezi's methods include Tiger-Hide theories. Later doctors discarded them. Regrettable.
Gentiana Scabra Root, Phellodendron Bark, Aloe, Gardenia Fruit, Anemarrhena Rhizome, Lettuce Seed, Polyporus, Alisma Rhizome, Asarum Root.
Patient Chen (35 years old). Hernia mostly involves Liver, suitable for acrid-draining. But examining form and pulse indicates internal damp-heat obstruction. Urination and defecation are not clear. First use a formula to unblock Taiyang.
Calcium Silicate, Lettuce Seed, Polyporus, Alisma Rhizome, Tongcao, Costus Juice.
Patient Ni. Hernia-mass knots in lower abdomen, bowel obstruction, scanty urine, white tongue, thirst, inability to eat. No specific formula. Temporarily try Zishen Wan.
Divide 1000 pills into ten doses.
Patient Xu (36 years old). Chronic hernia for ten years. Cold-heat and labor cause Qi sinking from right hypochondrium directly to lower abdomen. Occurs during urination/defecation effort. Face red and shiny, profuse phlegm. Eating fish/grease worsens disease. Damp-heat long obstructs tunnels; slow attacking is appropriate.
Kongyan Dan 0.25 qian. Take every other day. Ten doses.
Again. Pulse deep, phlegm heavy, hand joints red sores, chronic hernia below, Qi sinking from right hypochondrium to lower abdomen. Previous Kongyan Dan failed to remove bi-syndrome. Likely long-stagnant damp-heat is deep-rooted, not merely skin/fascia/collateral obstruction. Use Xunchuan Wan 40 pills. Divide into two doses. Advance every other day. Finally clears bowel accumulation. Then re-evaluate.
Again. Clearing bowels and dispersing obstruction, sticky phlegm discharged, yet hernia still gathers on the right, worse in cold winter months. Resting eliminates sound; walking/labor causes tangible descent into scrotum. Chronic disease, rapid attacking ineffective. Propose Acrid-Sweet transforming Wind method. Ancients considered 80-90% of hernias as Liver diseases.
Angelicae Sinensis Radix, Deer Antler, Cinnamon Twig, Cinnamon Bark, Small Fennel, Ligusticum Chuanxiong Rhizome, Honey-fried Licorice Root, Poria, Fresh Ginger, Lamb Fat pill.
Patient Zhang (59 years old). Pain starts from scrotum, gradually occupying left lower abdomen. Jueyin meridian surrounds genitalia. Careful planning/investment injures Liver. Qi aggregation transforms shape and causes pain. Disease named Hernia. Seven types of hernia: acute hernia mostly Cold, chronic hernia mostly Heat. Releasing Qi relieves pain; promoting flow cures disease. Lower Jiao is distant; Qi-Heat and Damp-Stagnation are evident.
Coptidis Rhizome, Small Fennel, Gardenia Fruit, Citrus Aurantium Unripe Fruit Kernel, Toosendan Fruit, Aquilariae Lignum cum Resina, Prunus Armeniaca Seed, Malva Verticillata Seed.
Patient Chen. Pulse deep-wiry, tongue gray edges white, waist/hip Qi pain, scrotal/testicular swelling. This is Damp-Heat disease. Randomly taking diaphoretic/digestive aids causes Damp-Heat to sink into hernia. Treatment should separate and eliminate.
Dioscorea Hypoglauca Rhizome, Phellodendron Bark, Gardenia Fruit, Poria, Moutan Cortex, Stephania Tetrandra, Polyporus, Alisma Rhizome.
Patient Chen (22 years old). Acrid-aromatic circulating Qi treats hernia, never ineffective. After five days, whole body pain, afternoon limb edema, skin rising lumps/nodules. Thinking draining Qi victory damages Yang. Fuzi Decoction governs. (Draining damages Wei Yang)
Raw Astragalus Membranaceus Root (1 liang), Aconite Root (2 qian).
Patient Zhu (25 years old). Jueyin Triple Malaria prolonged, pathogen attacks Liver meridian collaterals, lower abdomen pain hardens, Qi strings around genitalia tendon pain, indicating Hernia-Mass formation. Long illness, even if young, cannot solely focus on draining Qi. Warming Kidney and venting Liver is urgent. (Hernia complicated by Malaria Mass)
Light Cistanche Deserticola Stem, Body of Angelicae Sinensis Radix, Lycii Fructus, Stir-fried Blackened Small Fennel, Pangolin Scales, Whole Scorpion.
Patient Lu (39 years old). Malaria mass for ten years, deep-rooted chronic disease, drugs ineffective. Pathogen long-standing, conflates with Qi and Blood, knots in collaterals, drugs difficult to enter collaterals. Malaria relates to Liver/Gallbladder, Hernia relates to Liver. Hezi's analysis of seven hernias is significant. Deficient constitution cannot solely use acrid-aromatic. Descending is severe. Propose有情 (sentient/organic) warming-unblocking to nurture Sheng Qi.
Deer Antler, Star Anise, Pangolin Scales, Angelicae Sinensis Radix, Water Benzoin, Prepared Blackened Aconitum Carmichaelii Root, Whole Scorpion.
Use black soybeans stir-fried red, drenched with wine one cup. Filter wine juice to pill. Take 2 qian each time, send down with warm wine.
*Neijing* says: Ren Mai disease, men internal seven hernias, women leukorrhea/masses. Du Mai disease, rushing from lower abdomen to heart pain, inability to pass front/back is Chong Hernia. Also: Spleen transmitting to Kidney, disease name Shan-Mass. Also: Three Yang disease, chills/fever, transmitting to Hernia. Also: Pathogen enters Foot Jueyin collateral, causing sudden hernia violent pain. This is *Suwen* discussing hernias of various meridians. *Jingmai* chapters say: Foot Yangming tendon disease hernia, abdominal tendon tight. Foot Taiyin tendon disease, genital twisting pain, radiating to umbilicus/hypochondrium. Foot Jueyin tendon disease, genital uselessness. This is *Lingshu* discussing hernias of various meridians. Later generations named Tendon/Water/Hu/Qi/Blood/Cold Seven Hernias, each with specific formulas, legislation comprehensive. However, mixed errors exist, not definitive laws. Only Zhongjing uniquely named Cold Hernia, his three formulas focus on warming/dispersing Cold, regulating Ying, tonifying deficiency, not mixing Qi-level drugs. Hezi's method focuses on acrid-aromatic circulating Qi, stating Liver venting cures disease. Jinling/Tiger-Hide methods were pioneering. Thus, hernia root lies in Liver, not exceeding Cold. Liver meridian connects to genitalia, extreme Yin organ. Foot Taiyang meridian connects Kidney/Bladder, Cold-Water meridian. Zhongjing's Cold Hernia: abdominal pain, cold reversal, numb limbs, fullness, wiry-tight pulse, aversion to cold/anorexia, periumbilical pain, hypochondriac tension. Internal/External Cold dominates without boundary. Aconite formulas focus on breaking pathogen/treating branch urgently, regardless of deficiency/excess, meaning urgent treatment of branch. Dangui Lamb Mutton formula focuses on tonifying deficiency/dispersing Cold. Dangui/Lamb are acrid-sweet/heavy, warming Lower Yuan without injuring Yin. Assisted by Fresh Ginger, entering Lower Jiao with sentient meat products to warm-disperse Cold. This is securing root, not treating branch. Hezi's "Hernia不离 Liver" because hernia symptoms include scrotal swelling, pain/tension/tendon contraction, glans pain, testicular traction, lower abdominal attacking pain, or laughter/anger-induced. These are Liver meridian manifestations. Jinling San method vents Liver/scatters rebellion. Toosendan guides Bladder/Small Intestine heat, Corydalis harmonizes upper/lower pain, due to Liver governing venting. Tiger-Hide method uses soft-gentle guiding. Tiger bone extinguishes Liver wind/strengthens bones, Lamb/Turtle shell supplements marrow/fills essence, Rehmannia tonifies Kidney, Angelica tonifies Liver, Tangerine peel benefits Qi/vents Liver, Peony unblocks Liver/regulates Ying. Treating Liver while considering Kidney. Observing Mr.'s hernia methods, further advancement: Acute hernia mostly Cold, chronic mostly Heat, general outline. Others treat according to symptoms: Qi sinking/knotting, Deer Antler raises Yang. Distension/mass/pain below, follow Danxi's unblocking Yang/draining turbidity. Fire Fu damp-heat blockage, soft-bitter controls heat, counter-assist acrid-hot to open blood stasis. Cold-Damp sinking, Taiyang interior, Bladder Qi disharmony, urinary/fecal difficulty, Wuling San modification, unblocking Taiyang/Bladder. Damp-Heat long gathering, Qi sinking to lower abdomen/scrotum, Kongyan Dan/Xunchuan Wan, removing bi/clearing bowls/separating, combined with Acrid-Sweet transforming Wind. Lower Jiao Yin-Yang dual deficiency, sentient warming-unblocking to nurture Sheng Qi, combined with unblocking/tonifying/extinguishing wind. Mr.'s hernia methods exhaust pathology, all methods prepared. Zhongjing's Hu Hernia formula is not kingly product, omitted here. (Zou Zijiu commentary)
Xu Commentary: Hernia treatment generally does not exceed this. However, Water Hernia and Blood Hernia major cases lacked treatment methods, likely not encountered then.