经曰∶邪客于足厥阴之络，令人卒疝暴痛。又曰∶病在少腹痛，不得大小便，病名曰疝。是诸疝皆起于厥阴
之为病也，厥阴环阴器，入少腹，任脉起于中极之下，以上毛际，循腹里，上关元，故诸病疝莫不属之也。小儿
病此，多因先天不足，本脏虚弱，复因外感风邪，内食生冷，寒邪凝结而成者有之，或因湿热郁于中，复被寒邪
束于外，邪气乘虚并于血队，流入厥阴，厥阴
属肝，其性急速，故牵引睾丸，少腹绞痛，又有胎疝一证，多因孕妇啼泣过伤，动于阴气，结聚不散，令儿生下
即成此证。大抵热则疝多纵，寒则疝多痛，在血分者疝不移，在气分者疝多动，湿肿则疝坠必重，虚肿则疝坠必
轻，明乎此则治小儿诸疝无余蕴矣。
小儿平日过食生冷，或卧湿地，以致阴结于内，气滞不行，为日既久，复为风冷所束，水湿所伤，故发寒
疝，囊冷结硬，牵引少腹作痛，初得此证，兼有表邪者，古法主乌头桂枝汤（如桂枝、赤芍、炙甘草、乌头，引
用生姜）。
寒甚者，古法主金茱丸（如金铃子肉一两，吴茱萸五钱，共为细末，酒煮面糊为丸，如麻子大，每服数丸，
盐汤送下）。
〔真按〕小儿疝因寒邪所袭，内则少腹绞痛，外则睾丸肿大，并腹痛啼哭，皆里证，无表证，初起方用白
归身一钱，开口吴萸三分，青化桂五分，黑姜炭八分，南木香五分，小茴香一钱，炙甘草五分，煎好、加入盐七
分，为引，空心温服）。
日久则将本方改为丸剂，早晚空心服一钱，尤效。
《黄帝内经》说：邪气侵袭足厥阴肝经的络脉，使人突然发生疝气并剧烈疼痛。又说：病位在少腹部，大小便不通畅，这种病名叫疝。这些各种类型的疝气，都是起源于足厥阴肝经的病变。因为足厥阴肝经环绕外生殖器，进入少腹部；任脉起始于中极穴下方，向上经过阴毛边缘，沿腹腔内部上行至关元穴，所以各种疝气病症没有不属于这两条经脉的。
小儿患此病，大多是因为先天禀赋不足，本脏（肾）虚弱，再加上外感风邪，内伤生冷食物，导致寒邪凝结而成；或者因湿热郁结在体内，又被外部寒邪束缚，邪气乘虚侵入血分，流入厥阴肝经。厥阴肝经属于肝，肝性急迫，所以牵引睾丸，引起少腹绞痛。此外还有“胎疝”这一证型，多因孕妇哭泣过度损伤身体，扰动阴气，结聚不散，致使婴儿出生后即刻形成此证。
大抵而言，热证导致的疝气多表现为松弛下垂，寒证导致的疝气多表现为疼痛；病在血分的疝气位置固定不移，病在气分的疝气则变动不居；湿邪引起的肿胀则疝气下坠感必然沉重，虚损引起的肿胀则疝气下坠感必然轻微。明白这些道理，治疗小儿各种疝气就没有什么遗漏了。
小儿平日如果过食生冷，或睡卧在潮湿之地，导致阴寒凝结于体内，气机阻滞运行不畅，日子久了，又受到风冷束缚、水湿伤害，因此发作寒疝。症状表现为阴囊寒冷结硬，牵引少腹部疼痛。刚得此病，兼有表邪（如恶寒发热等）的，古法主张使用乌头桂枝汤（包含桂枝、赤芍、炙甘草、乌头，引用生姜为引）。
寒邪严重的，古法主张使用金茱丸（由一两金铃子肉、五钱吴茱萸组成，共研为细末，用酒煮面糊制成丸子，大小如麻子，每次服用几丸，用盐汤送服）。
〔真按〕（陈守真按语）小儿疝气因寒邪侵袭，内部表现为少腹绞痛，外部表现为睾丸肿大，伴有腹痛啼哭，这些都是里证，没有表证。初起时方用白归身一钱，开口吴茱萸三分，青化桂五分，黑姜炭八分，南木香五分，小茴香一钱，炙甘草五分，煎好后加入盐七分作为药引，空腹温服。
病程日久则将上述方剂改为丸剂，早晚空腹各服一钱，尤其有效。
The *Classic of Difficult Issues* (Jing Yue) states: "When pathogenic factors invade the collaterals of the Foot Jueyin (Liver Meridian), it causes sudden onset of hernia and acute pain." It also states: "When the disease is located in the lower abdomen, accompanied by difficulty in urination and defecation, the disease is named Hernia." Thus, all types of hernias originate from disorders of the Foot Jueyin. The Foot Jueyin meridian surrounds the external genitalia and enters the lower abdomen; the Ren Mai (Conception Vessel) originates below the Zhongji point (CV3), ascends to the pubic hairline, follows the interior of the abdomen, and reaches the Guanyuan point (CV4). Therefore, all hernia diseases are attributed to these meridians.
In children, this condition often arises from congenital deficiency and weakness of the Zang organs (specifically the Kidney), compounded by external contraction of Wind pathogens and internal injury from consuming cold or raw foods, leading to the coagulation of Cold pathogens. Alternatively, Damp-Heat may stagnate internally while being constrained externally by Cold, allowing pathogenic factors to exploit the deficiency and enter the Blood aspect, flowing into the Jueyin. Since Jueyin belongs to the Liver, and the Liver's nature is swift and urgent, it pulls on the testicles, causing colicky pain in the lower abdomen. There is also a syndrome known as "Fetal Hernia," which often results from excessive crying and emotional distress by the pregnant mother, disturbing Yin Qi, causing it to knot and fail to disperse, resulting in the infant presenting with this condition immediately after birth.
Generally speaking, Heat-type hernias tend to present with flaccidity and prolapse, whereas Cold-type hernias tend to present with pain. Hernias rooted in the Blood aspect remain fixed in location, while those rooted in the Qi aspect are mobile. Swelling caused by Dampness leads to heavy prolapse, while swelling caused by Deficiency leads to light prolapse. Understanding these principles leaves no gaps in the treatment of various pediatric hernias.
If children habitually overconsume cold or raw foods, or lie on damp ground, Yin-Cold may coagulate internally, causing Qi stagnation and impaired circulation. After a prolonged period, if further constrained by Wind-Cold and injured by Water-Dampness, Cold Hernia will manifest. Symptoms include a cold, hard, and knotted scrotum, with traction pain in the lower abdomen. For early-stage cases accompanied by Exterior Pathogens (such as aversion to cold or fever), ancient methods primarily prescribe Wutou Guizhi Tang (Cinnamon Twig and Aconite Decoction), comprising Guizhi Tang (Cinnamon Twig Decoction) ingredients such as Guizhi (Ramulus Cinnamomi Cassiae), Chishao (Radix Paeoniae Rubra), Zhigancao (Radix Glycyrrhizae Preparata), and Wutou (Radix Aconiti Lateralis Preparata), using Shengjiang (Rhizoma Zingiberis Recens) as an guiding agent.
For severe Cold conditions, ancient methods prescribe Jin Zhu Wan (Golden Melon Pill), consisting of one liang of Jinlingzi Rou (Semen Toosendan) and five qian of Wuzhuyu (Fructus Evodiae), ground into fine powder, mixed with wine-boiled wheat paste to form pills the size of hemp seeds. Several pills are taken per dose, washed down with salt water.
[Commentary by Chen Shouzhen]: Pediatric hernia caused by Cold pathogen invasion presents internally with colicky lower abdominal pain and externally with swollen testicles, accompanied by abdominal pain and crying. These are all Interior Syndromes, lacking Exterior Syndrome signs. For initial treatment, use Baigui Shen (Radix Angelicae Sinensis) 1 qian, Kaikou Wuyu (Fructus Evodiae) 3 fen, Qinghuagui (Ramulus Cinnamomi Cassiae) 5 fen, Heijiang Tan (Carbonized Rhizoma Zingiberis Officinalis) 8 fen, Nanmuxiang (Radix Aucklandiae) 5 fen, Xiaohuixiang (Fructus Foeniculi) 1 qian, and Zhigancao (Radix Glycyrrhizae Preparata) 5 fen. After decocting, add 7 fen of salt as a guiding agent, and take warm on an empty stomach.
For chronic cases lasting long periods, convert the above formula into a pill form. Take 1 qian each morning and evening on an empty stomach for superior efficacy.