治丈夫阴痿不起，用未连原蚕蛾二升，去头足翅，炒，研为细末，蜜丸，如梧桐子
大，每夜酒服一丸。
一方
用人参细末一二钱，临晚食前，好酒，或烧酒调服。
外用诸方甚多，功少害深者六七，盖不过辛热香窜，敛涩而已。惟此二方，一则温
润和平，一则监制得所，倘补药得力，久则阳强，亦勿从此外治本病治标，终无济也。
人参（一两） 当归身（一两二钱） 白术（一两五钱） 枸杞子（一两） 大附子（半只）
川椒（三钱）
水煎成膏，入麝二分，藏锡盒中，临事津化用之。
此当湖张虎侯之秘方也。内有桂附倭硫之热，更有黄柏之苦寒以济之，有蟾酥之
毒，有雄黄之解以除之，复虑燥热苏油润之。昔人立方周匝极矣。士君子苦于阳痿必
欲外治，惟此二方可无大害。
川附子（一只） 草乌（一两） 川乌（一两） 母丁香（一两） 紫梢花（一两） 官桂（一两）
雄黄（五钱） 蟾酥（一两） 良姜（五钱） 五倍子（五钱） 倭硫（七钱五分） 黄柏（一两）
牡蛎（一两） 蛇床子（二两） 苏合油（一两） 以上制度为末，白术煎膏溶化，蟾酥为锭，
梦遗水磨涂脐中，种子酒磨润阳，午前用之，临事时洗去。
《经》曰∶任脉为病，男子内结七疝，女子带下瘕聚，（任脉起于中极之下，以上毛际，循腹
里，上关元，总诸阴之会，故诸种疝症，无不由任脉为之原，诸经为之派耳。）从少腹上冲心而痛，
不得前后为冲疝。（既上冲心，又不得大小便，能上而不能下也。）肝所生病为狐疝，（卧则入腹，
立则出腹入囊，似狐之昼出穴而溺，夜入穴而不溺，故名狐疝也。盖环阴器，上抵少腹者，乃肝经
之部分，是受疝之处也。一切疝证，非肝木受邪，即肝木自病，此言狐疝，乃肝经自病
也。）三阳为病，发寒热其传为癫疝，（三阳者，手太阳小肠、足太阳膀胱、足少阳胆也。
小肠膀胱皆在下部，胆与肝为夫妇，且支脉出气街，绕毛际，故三阳皆能病疝也。 者，顽痹不仁，
睾丸肿大如升如斗者是也。）黄脉之至也，大而虚，积气在腹中，有厥气名曰厥疝。（黄脉，土脉也。
肝木乘脾，故大而虚也。厥者，逆也，言厥逆上升也。肝部应春，于象为木，皆主上升，怒则气上，
故为厥疝。）脾传之肾，病名疝瘕，少腹冤热而痛出白。（脾受所不胜之邪，传于所胜，则脾失运化
之常。又遇寒水之藏，则稽留成有形之瘕，瘕者，即方书所云状如黄瓜者是也。有气不得申曰
冤，气聚而痛白精自出。《经》曰∶寸口脉沉而弱，疝瘕少腹痛。又曰∶脉急者，疝瘕少腹痛。）
足阳明之筋病， 疝，腹筋急；又曰∶肝脉滑甚，为 疝。（既曰足阳明病 疝，又曰肝滑为 疝，
则知此证肝木乘胃也。 者，里大脓血甚，则下脓血也。）脾脉微大为疝气，滑甚为 癃；又曰∶肾脉滑
甚为 癃。（内则裹脓血，外则小便闭，名曰 癃疝，此亦脾邪传肾也。）
张子和曰∶凡遗尿癃秘，阴痿胞痹，精滑白淫，皆男子之疝也。血涸不月，足
咽干癃秘，小腹有块，前阴突出，后阴痔核，皆女子之疝也。但女子不名疝而名瘕。
疝者，是阴气积于内，复为寒气所袭而发，故《素问》以下论疝，皆以为寒，然不
可单论曰寒，盖虽为寒郁而作，亦出醉饱无度，内蒸湿热，痰积流于厥阴，木性急速又
为寒束，是以痛甚，症虽见于肾病，实本乎肝，厥阴肝脉络于阴器耳。可见内积湿
热，郁于中，外被寒郁束于外，且有痰饮食
积，死血郁结为病，故谓专主肝经，而与肾绝无相干也。其候睾丸牵引少腹，或无形无
声，或有形如瓜，有声如蛙，激搏而痛，无有定处，不堪忍者是也。其症有七，寒、水
、血，气、狐、筋是也。寒疝者，厥阴经中受寒，故筋挛卵缩，其状囊冷，结硬如
石，阴茎不肖，或控睾丸而痛，此必得之于久坐湿地，寒气郁于外也。水疝者，囊肿痛
而状如水晶，阴汗时出，痒搔而出黄水，小腹按之而作水声，此必得之于醉酒房劳，汗
出遇风，湿热乘虚，流结囊中，二便胀秘不通也。 疝者，阴囊胀大如升斗，不痒不
痛，此因感受湿气，是以阴核气结，亦有 痛者。血疝者，状如黄瓜，在于小腹两
傍，横骨两端，俗名便痈，此乃得之重感春夏大燠劳动，使内气血流溢，渗入脬囊，结
成痈肿也。气疝者，上连肾区，下及阴囊，是或号哭忿怒，气郁急迫而胀疼，此必因父
精怯阴痿，强力入房成胎，乃胎病也。狐疝者，其状如瓦，卧则入腹，行则乃出。筋疝
者，阴茎肿胀，或溃脓而痛，里急筋缩，或茎中痛，痛极则痒，或阴不收，白物如精，
而随溺出，此得于房劳，或邪术所致也。更有木肾者，盖心火下行，肾水自温，真阳下
降，肾气自和，既温且和，焉有木强者哉！此因嗜欲内戕肾虚，以致阴阳水火不接，乃
沉寒胀大而痛硬也。然五脏皆有疝症，故曰∶肾脉大急沉为肾疝，肝脉大急沉为肝
疝，心脉搏滑急为心疝，肺脉沉搏为肺疝，三阳急为瘕，三阴急为脾疝，三阳者，足太
阳膀胱也。三阴者，足太阴脾经也。盖太阳受寒，血则凝而为瘕，太阴受寒，气则聚而
为疝，故血为瘕，疝为气，间亦有气血相兼者，于此可见五脏之各有疝也。在小儿多因
啼怒不止，有动阴气闭击于下，结聚不散而得之，或因胎妇啼泣过伤，令儿生下，小肠
气闭，亦变此候，凡虎口纹赤者为胎疝，纹青者是啼怒所致也。更有阴肿者，是因少阴
之经不足，而风冷乘之，少阴之经通于阴，风冷与血气相搏，故结聚成肿，及夫啼怒不
止，气闭于下，加以水湿外袭，亦令阴肿。更有外肾肤囊赤肿通明，及女阴户肿胀而痛
者，皆心火移热于膀胱，如光浮而不燥不痛者，此肝虚不能疏达也。若阴丸偏肿，结聚
一边，独大极痛者，此名偏坠，非怒气伤肝，即寒束内热，或被暑邪所侵，传注膀
胱，侵凌外肾也。是症专主肝经，治法风则散之，寒则温之，暑则解热，湿则渗水，惊
怒则调其心气，气水相搏，则行其小便，然未有不内因气结，外因寒湿，故宽小肠之
气，及温暖疏风渗湿，皆所必要。
《经》以任脉为病，而结七疝，总言病之原也。所云∶冲狐 厥瘕 癃，分言
疝之状也。巢氏强分厥 寒气盘 野狼之七种，宜张子和非之曰∶此俗工所立，谬名是
矣。反其立论，但辨阴器专属肝经受病，与小肠膀胱肾绝不相干，又分寒水筋血气狐
之七名，此其谬与巢氏无异矣，不知《内经》自有七疝，而任脉为七疝之原，疝为
筋病，皆挟肝邪则可，若言止在厥阴，不几与经相反耶，学人当以《内经》为正，不得
惑于多歧，大抵寒则多痛，热则多纵，湿则肿坠，虚者亦然，在血分者不移，在气分者
多动也。盖睾丸有两，左丸属水，水生肝木，木生心火，三部皆司血，统纳左之血
者，肝也。右丸属火，火生脾土，土生肺金，三部皆司气，统纳右之气者，肺也。故
诸寒收引则血泣而归肝，下注于左丸，诸气愤郁，则湿聚而归肺，下注于右丸，且睾丸
所络之筋，非尽由厥阴，而太阴阳明之筋，亦入络也。故患左丸者，痛多肿少，患右丸
者，痛少肿多也。丹溪以疝始于湿热，盖大劳则火起于筋，醉饱则火起于胃，房劳则火
起于肾，大怒则火起于肝，火郁之久湿气便盛，浊液凝聚，并入血队，流于厥阴，肝性
急速，为寒所束，宜其痛甚，此亦补前人之未备。或东南因此而感者多，亦未可守为规
则也。又有身体发热，耳后急生 腮，红肿
胀痛，肋病将退，而睾丸忽胀，一丸极大一丸极小，似乎偏坠，而实非，盖耳傍乃少阳
胆经之分，与肝经相为表里，少阳感受风热，而遗发于肝经也。又阴囊大，而阴茎反
缩于内，小便淋漓，行履滞碍，乃膀胱气也。盖肾与膀胱为表里，肾不能藏，为邪所
客，遗于膀胱，小便渗入肾囊耳，宜渗利之。有阴茎全缩不见，而阴囊光肿不痛，此
因肝气虚损，不能舒达也，宜温补之。小儿偏坠，多因食积不消，脾湿下行，流入肝
部。妇人小腹旁逼近阴处，并结胀痛，或皮内顶起如鹅子大，乃寒气聚于厥阴所致，小
腹受寒，其病即发，是谓阴疝，女子前阴突出，后阴痔核，皆疝类也。但不谓之疝，而
曰瘕。凡疝虽因虚而得，不可骤补，盖留而不行，其病则实，必先疏所蓄之邪，后定补
益，或补而兼温，则散而不滞矣。古人用五苓散，内加行气之药，盖猪苓泽泻，分理阴
阳，以和心与小肠之气，白术既渗腰脐间湿与死血，又助中气，以佐营运药力，茯苓淡
渗而利膀胱水，桂能伐肝邪，而温散通行，茴香治小肠之气，金铃子、橘核去膀胱之
滞，槟榔下气开导，少加木通，以道小肠之火，立方之工稳极矣。盖疝症未有不因内虚
外袭，然必先疏泄其气，所谓通则不痛，若骤加补益，攻心人腹变成危症。
疝属肝经湿热，为外寒所郁，则气不得通，而痛甚是矣。然《经》曰∶壮者气行则
已，怯者着而成病。实由肾气惫甚，酒色无度，渗利不及，以致浊气下流厥阴之分，或
遇寒，或劳碌，则痛发作，有时乃湿热为标，而肾虚为本，故丹溪用参术兼补也。大
凡疝症，不断房事，与浓味酒面，则不可治，疝症始于湿热在经，郁遏至久，又感外
寒湿热，被郁而作痛，若只作寒论，恐有未尽。古方以乌头、栀子等分，加盐酒煎服
之，名栀附汤，其效亦速，后因此方随症加减，无有不应，须分湿热多少而治之。丹溪
曰∶乌头治外束之寒，栀子治内郁之热，则内热外寒之理昭然矣，况二物皆下焦之药，
栀子为乌头所引，则势下急速，不容少缓于胃中矣。若按之痛止者，尤属虚寒，须加肉
桂，以姜汁丸服，若速欲定痛，用枳核，山楂核，荔枝核，川楝子，吴茱萸，各炒为
末，白汤调服。
心肺在上属阳，肾肝在下属阴。肾者，肝之母。肝者，肾之子。肾肝同病，乙癸同
源也。故凡肝经有病，必推化源，于肾如疝，为足厥阴肝经病，其脉环阴器，抵小腹
控睾丸，而痛者，皆肝之所属也。而《素问》又云∶肾脉生病，从少腹上冲心而痛，
不得前后为冲疝，则疵未尝不本于肾经为病者何？丹溪乃曰∶疝主肝经，与肾经绝无相
干，夫肾水脏也。膀胱为之腑，膀胱为寒水所化，疝本寒湿之气所感，以寒召寒，其邪
最速，而肾与膀胱为表里。《经》云∶诸寒收引，皆属于肾，故疝之挛急，而上冲心胃
者，正肾邪之为病也。今人病疝，一有房劳，则其病便发而不止，故《圣济录》云∶
嗜欲劳伤，肾水涸竭，无以滋荣，肝气则留滞内结，发为阴疝，是疝之发于肾虚者多
矣。若以肾经绝无相干为论，而治法不从化源，日以伐肝疏导从事，则病愈剧而难疗，
更有下部稍受微寒，即发者，喻嘉言，所谓地气上攻也。投以大剂参术姜桂而安然，此
浊阴之气结聚少腹，则阴盛极矣。切勿兼用四物补阴之药而护之，益增其病矣。
治疗男子阳痿不举，用未交配过的原蚕蛾二升，去掉头、足和翅膀，炒制后研成细末，用蜂蜜制成梧桐子大小的丸药，每晚用酒送服一丸。
另一方法：用人参细末一至二钱，在傍晚饭前，用好酒或烧酒调匀服用。
外用的方剂很多，但功效少而危害大的有六七种，大概不过是辛热香窜、收敛涩滞的药物罢了。只有这两个方子，一个温润平和，一个配伍得当。如果补益药物得力，久而久之阳气强盛，也不要从这些外治法入手，因为本病治标，终究无济于事。
人参（一两） 当归身（一两二钱） 白术（一两五钱） 枸杞子（一两） 大附子（半只） 川椒（三钱）
水煎煮浓缩成膏，加入麝香二分，藏在锡盒中，行房时含化使用。
这是当湖张虎侯的秘方。方中有桂枝、附子、倭硫的温热，又有黄柏的苦寒来制约它；有蟾酥的毒性，又有雄黄的解毒作用来消除它；又担心燥热，所以加入苏合油以滋润。古人立方的周全程度到了极点。士大夫苦于阳痿，一定要用外治法，只有这两个方子可以没有大害。
川附子（一只） 草乌（一两） 川乌（一两） 母丁香（一两） 紫梢花（一两） 官桂（一两） 雄黄（五钱） 蟾酥（一两） 良姜（五钱） 五倍子（五钱） 倭硫（七钱五分） 黄柏（一两） 牡蛎（一两） 蛇床子（二两） 苏合油（一两） 以上药物按规定炮制后研成细末，用白术煎成的膏溶化，将蟾酥制成锭剂，梦遗时用唾液磨涂在肚脐中，种子酒磨润阳，午前使用，行房时洗去。
《黄帝内经》说：任脉发生病变，男子体内结聚成七种疝气，女子带下及瘕聚。（任脉起于中极穴之下，向上至毛际，沿腹部内侧上行至关元穴，总汇诸阴经之气，所以各种疝症，无不以任脉为根源，其他经脉为分支。）寒气从少腹上冲心脏并疼痛，大小便不通称为冲疝。（既上冲心脏，又不能大小便，能上而不能下。）肝脏所生的疾病称为狐疝，（躺下时睾丸缩入腹腔，站立时滑出腹腔进入阴囊，像狐狸白天出洞排尿，晚上回洞不排尿一样，所以叫狐疝。环绕生殖器，上抵少腹的部位，是肝经所主的区域，也是受疝的地方。一切疝证，不是肝木受邪，就是肝木自病，这里说的狐疝，是肝经自病。）三阳经发病，出现寒热往来，传变后成为癫疝，（三阳指手太阳小肠经、足太阳膀胱经、足少阳胆经。小肠和膀胱都在下部，胆与肝互为表里，且支脉出于气街，环绕毛际，所以三阳经都能导致疝病。[此处原文缺字，推测为“㿗”]疝，指顽痹麻木不仁，睾丸肿大如升如斗的情况。）黄脉到来时，脉象大而虚，积气在腹中，有逆气名为厥疝。（黄脉是土脉。肝木乘脾，所以脉象大而虚。厥，是逆的意思，指厥逆之气上升。肝部对应春季，在象数为木，都主上升，发怒则气上，所以称为厥疝。）脾脏的病传给肾脏，病名疝瘕，少腹冤热疼痛并流出白色精液。（脾受到所不胜之邪气的侵害，传给所胜之脏，则脾失去运化的常态。又遇到寒水的肾脏，则停滞形成有形的瘕，瘕，即医书中所说形状像黄瓜的东西。有气不得舒展称为冤，气聚而痛，白精自出。《内经》说：寸口脉沉而弱，是疝瘕少腹痛。又说：脉急者，是疝瘕少腹痛。）足阳明经的筋病，导致[此处原文缺字，推测为“㿗”]疝，腹部筋脉拘急；又说：肝脉滑甚，为[此处原文缺字，推测为“㿗”]疝。（既然说足阳明病导致[㿗]疝，又说肝脉滑导致[㿗]疝，就知道此证是肝木乘胃。[㿗]，指内部有大脓血，严重时排出脓血。）脾脉微大为疝气，滑甚为[此处原文缺字，推测为“癃”]闭；又说：肾脉滑甚为[此处原文缺字，推测为“癃”]闭。（内部包裹脓血，外部小便闭塞，名为[癃]疝，这也是脾邪传给肾。）
张子和说：凡是遗尿、癃闭、阳痿、胞痹、精滑、白淫，都是男子的疝病。血枯不来月经，足咽干燥、癃闭，小腹有肿块，前阴突出，后阴痔核，都是女子的疝病。只是女子不称疝而称瘕。
疝，是阴气积聚在内，又受寒气侵袭而发作，所以《素问》以下论述疝，都认为与寒有关，然而不能单论为寒，大概虽然因寒郁而作，但也出自醉饱无度，内蒸湿热，痰积流注于厥阴肝经，肝性急速又被寒邪束缚，所以疼痛剧烈，症状虽见于肾病，实则本乎肝，因为厥阴肝经络于阴器。可见内积湿热，郁于中焦，外被寒邪郁束于体表，且有痰饮食积，死血郁结致病，所以说专主肝经，而与肾绝无相干。其候表现为睾丸牵引少腹，或无形无声，或有形如瓜，有声如蛙，激搏而痛，没有固定位置，痛苦不堪忍受。其症有七种：寒、水、[㿗]、血、气、狐、筋。寒疝，是厥阴经中受寒，所以筋挛卵缩，其状阴囊冷，结硬如石，阴茎不举，或牵引睾丸疼痛，这必定是因为久坐湿地，寒气郁于体外所致。水疝，阴囊肿痛而状如水晶，阴汗时常流出，瘙痒搔抓而出黄水，小腹按压有水声，这必定是因为醉酒房劳，出汗遇风，湿热乘虚流结于囊中，导致二便胀秘不通。[㿗]疝，阴囊胀大如升斗，不痒不痛，这是因为感受湿气，所以阴核气结，也有[㿗]痛的情况。血疝，状如黄瓜，位于小腹两旁，横骨两端，俗名便痈，这是因为重感春夏大热劳动，使内气血流溢，渗入脬囊，结成痈肿。气疝，上连肾区，下及阴囊，有时因号哭忿怒，气郁急迫而胀疼，这必定因为父亲精怯阳痿，强力入房成胎，乃胎病。狐疝，其状如瓦，躺下时缩入腹腔，行走时滑出。筋疝，阴茎肿胀，或溃脓而痛，里急筋缩，或茎中痛，痛极则痒，或阴器不收，白物如精，随溺而出，这得于房劳，或邪术所致。更有木肾者，盖心火下行，肾水自温，真阳下降，肾气自和，既温且和，哪有阳强不痿的呢！这是因为嗜欲内伤肾虚，以致阴阳水火不接，乃沉寒胀大而痛硬。然而五脏皆有疝症，所以说：肾脉大急沉为肾疝，肝脉大急沉为肝疝，心脉搏滑急为心疝，肺脉沉搏为肺疝，三阳急为瘕，三阴急为脾疝，三阳指足太阳膀胱经。三阴指足太阴脾经。盖太阳受寒，血则凝而为瘕，太阴受寒，气则聚而为疝，所以血为瘕，疝为气，间亦有气血相兼者，于此可见五脏之各有疝也。在小儿多因啼哭愤怒不止，有动阴气闭击于下，结聚不散而得之，或因胎妇啼泣过伤，令儿生下，小肠气闭，亦变此候，凡虎口纹赤者为胎疝，纹青者是啼怒所致也。更有阴肿者，是因少阴之经不足，而风冷乘之，少阴之经通于阴，风冷与血气相搏，故结聚成肿，及夫啼怒不止，气闭于下，加以水湿外袭，亦令阴肿。更有外肾肤囊赤肿通明，及女阴户肿胀而痛者，皆心火移热于膀胱，如光浮而不燥不痛者，此肝虚不能疏达也。若阴丸偏肿，结聚一边，独大极痛者，此名偏坠，非怒气伤肝，即寒束内热，或被暑邪所侵，传注膀胱，侵凌外肾也。是症专主肝经，治法风则散之，寒则温之，暑则解热，湿则渗水，惊怒则调其心气，气水相搏，则行其小便，然未有不内因气结，外因寒湿，故宽小肠之气，及温暖疏风渗湿，皆所必要。
《内经》以任脉为病，而结七疝，总言病之原也。所云：冲、狐、[㿗]、厥、瘕、[癃]，分言疝之状也。巢氏强分厥、[㿗]、寒气盘、野狼之七种，宜张子和非之曰：此俗工所立，谬名是矣。反其立论，但辨阴器专属肝经受病，与小肠膀胱肾绝不相干，又分寒、水、筋、血、气、狐之七名，此其谬与巢氏无异矣，不知《内经》自有七疝，而任脉为七疝之原，疝为筋病，皆挟肝邪则可，若言止在厥阴，不几与经相反耶，学人当以《内经》为正，不得惑于多歧，大抵寒则多痛，热则多纵，湿则肿坠，虚者亦然，在血分者不移，在气分者多动也。盖睾丸有两，左丸属水，水生肝木，木生心火，三部皆司血，统纳左之血者，肝也。右丸属火，火生脾土，土生肺金，三部皆司气，统纳右之气者，肺也。故诸寒收引则血泣而归肝，下注于左丸，诸气愤郁，则湿聚而归肺，下注于右丸，且睾丸所络之筋，非尽由厥阴，而太阴阳明之筋，亦入络也。故患左丸者，痛多肿少，患右丸者，痛少肿多也。丹溪以疝始于湿热，盖大劳则火起于筋，醉饱则火起于胃，房劳则火起于肾，大怒则火起于肝，火郁之久湿气便盛，浊液凝聚，并入血队，流于厥阴，肝性急速，为寒所束，宜其痛甚，此亦补前人之未备。或东南因此而感者多，亦未可守为规则也。又有身体发热，耳后急生[痄]腮，红肿胀痛，肋病将退，而睾丸忽胀，一丸极大一丸极小，似乎偏坠，而实非，盖耳傍乃少阳胆经之分，与肝经相为表里，少阳感受风热，而遗发于肝经也。又阴囊大，而阴茎反缩于内，小便淋漓，行履滞碍，乃膀胱气也。盖肾与膀胱为表里，肾不能藏，为邪所客，遗于膀胱，小便渗入肾囊耳，宜渗利之。有阴茎全缩不见，而阴囊光肿不痛，此因肝气虚损，不能舒达也，宜温补之。小儿偏坠，多因食积不消，脾湿下行，流入肝部。妇人小腹旁逼近阴处，并结胀痛，或皮内顶起如鹅子大，乃寒气聚于厥阴所致，小腹受寒，其病即发，是谓阴疝，女子前阴突出，后阴痔核，皆疝类也。但不谓之疝，而曰瘕。凡疝虽因虚而得，不可骤补，盖留而不行，其病则实，必先疏所蓄之邪，后定补益，或补而兼温，则散而不滞矣。古人用五苓散，内加行气之药，盖猪苓泽泻，分理阴阳，以和心与小肠之气，白术既渗腰脐间湿与死血，又助中气，以佐营运药力，茯苓淡渗而利膀胱水，桂能伐肝邪，而温散通行，茴香治小肠之气，金铃子、橘核去膀胱之滞，槟榔下气开导，少加木通，以道小肠之火，立方之工稳极矣。盖疝症未有不因内虚外袭，然必先疏泄其气，所谓通则不痛，若骤加补益，攻心人腹变成危症。
疝属肝经湿热，为外寒所郁，则气不得通，而痛甚是矣。然《经》曰：壮者气行则已，怯者着而成病。实由肾气惫甚，酒色无度，渗利不及，以致浊气下流厥阴之分，或遇寒，或劳碌，则痛发作，有时乃湿热为标，而肾虚为本，故丹溪用参术兼补也。大凡疝症，不断房事，与浓味酒面，则不可治，疝症始于湿热在经，郁遏至久，又感外寒湿热，被郁而作痛，若只作寒论，恐有未尽。古方以乌头、栀子等分，加盐酒煎服之，名栀附汤，其效亦速，后因此方随症加减，无有不应，须分湿热多少而治之。丹溪曰：乌头治外束之寒，栀子治内郁之热，则内热外寒之理昭然矣，况二物皆下焦之药，栀子为乌头所引，则势下急速，不容少缓于胃中矣。若按之痛止者，尤属虚寒，须加肉桂，以姜汁丸服，若速欲定痛，用枳核，山楂核，荔枝核，川楝子，吴茱萸，各炒为末，白汤调服。
心肺在上属阳，肾肝在下属阴。肾者，肝之母。肝者，肾之子。肾肝同病，乙癸同源也。故凡肝经有病，必推化源，于肾如疝，为足厥阴肝经病，其脉环阴器，抵小腹控睾丸，而痛者，皆肝之所属也。而《素问》又云：肾脉生病，从少腹上冲心而痛，不得前后为冲疝，则疵未尝不本于肾经为病者何？丹溪乃曰：疝主肝经，与肾经绝无相干，夫肾水脏也。膀胱为之腑，膀胱为寒水所化，疝本寒湿之气所感，以寒召寒，其邪最速，而肾与膀胱为表里。《经》云：诸寒收引，皆属于肾，故疝之挛急，而上冲心胃者，正肾邪之为病也。今人病疝，一有房劳，则其病便发而不止，故《圣济录》云：嗜欲劳伤，肾水涸竭，无以滋荣，肝气则留滞内结，发为阴疝，是疝之发于肾虚者多矣。若以肾经绝无相干为论，而治法不从化源，日以伐肝疏导从事，则病愈剧而难疗，更有下部稍受微寒，即发者，喻嘉言，所谓地气上攻也。投以大剂参术姜桂而安然，此浊阴之气结聚少腹，则阴盛极矣。切勿兼用四物补阴之药而护之，益增其病矣。
Treatment for male impotence (Yang Wei, 阳痿) involves using two sheng of un-mated silkworm moths (Yuan Can E, 原蚕蛾), removing the head, feet, and wings, stir-frying them, grinding into a fine powder, making pills with honey the size of paulownia seeds, taking one pill nightly with wine.
Another method: Use one to two qian of fine ginseng powder (Renshen, 人参), taken before evening meals, mixed with good wine or distilled liquor.
There are many external prescriptions, but six or seven have little effect and deep harm, generally consisting only of pungent, hot, aromatic, penetrating, astringent, and binding drugs. Only these two formulas are mild and harmonious, or properly controlled. If the tonifying medicine is effective, yang strength will eventually return; there is no need to rely on such external treatments. Treating the branch rather than the root ultimately yields no benefit.
Ginseng (Renshen, 人参) (1 liang), Angelica sinensis body (Danggui Shen, 当归身) (1.2 liang), Atractylodes macrocephala (Baizhu, 白术) (1.5 liang), Goji berry (Gouqizi, 枸杞子) (1 liang), Large Aconite (Da Fuzi, 大附子) (half piece), Sichuan pepper (Chuanjiao, 川椒) (3 qian).
Decoct in water until concentrated into an ointment, add 2 fen of musk (Shexiang, 麝香), store in a tin box, dissolve in saliva for external use during intercourse.
This is a secret formula from Zhang Huhou of Danghu. It contains the heat of Cinnamon Twig (Guizhi, 桂枝), Aconite (Fuzi, 附子), and native sulfur (Woliu, 倭硫), balanced by the bitter cold of Phellodendron bark (Huangbai, 黄柏); it includes the toxicity of Toad venom (Chansu, 蟾酥), countered by the detoxifying property of Realgar (Xionghuang, 雄黄); and Sushe oil (Suheyous, 苏合油) is added to counteract dryness and provide moisture. The ancients' comprehensiveness in formulating was extreme. For scholars suffering from impotence who insist on external treatment, only these two formulas pose minimal risk.
Sichuan Aconite (Chuan Fuzi, 川附子) (1 piece), Grass Aconite (Caowu, 草乌) (1 liang), Sichuan Aconite (Chuanwu, 川乌) (1 liang), Mother Clove (Mudingxiang, 母丁香) (1 liang), Zixiaohua (Zixiaohua, 紫梢花) (1 liang), Official Cinnamon (Guangui, 官桂) (1 liang), Realgar (Xionghuang, 雄黄) (5 qian), Toad venom (Chansu, 蟾酥) (1 liang), Galangal (Liangjiang, 良姜) (5 qian), Chinese gallnut (Wubeizi, 五倍子) (5 qian), Native sulfur (Woliu, 倭硫) (7.5 qian), Phellodendron bark (Huangbai, 黄柏) (1 liang), Oyster shell (Muli, 牡蛎) (1 liang), Cnidium fruit (Chuanshangzi, 蛇床子) (2 liang), Storax oil (Suheyous, 苏合油) (1 liang). Process the above ingredients into powder, dissolve in Atractylodes macrocephala (Baizhu, 白术) decoction paste, form Toad venom (Chansu, 蟾酥) into pellets. For nocturnal emission, grind with cold water and apply to the navel; for seed-enriching purposes, grind with seed wine for morning use, wash off before intercourse.
The *Classic* states: When the Ren Mai (Conception Vessel, 任脉) is diseased, men develop seven types of hernia (Shan Zheng, 疝症), and women experience leukorrhea and masses (Jia Ju, 瘕聚). (The Ren Mai originates below Zhongji (CV3), ascends to the pubic region, follows the interior of the abdomen to Guanyuan (CV4), gathering all yin meridians; thus, all hernias originate from the Ren Mai, with other meridians as branches.) Qi rushing from the lower abdomen to the heart causing pain, with inability to pass urine or stool, is called Chong Shan (Pulsating Hernia, 冲疝). (It rushes up to the heart yet cannot pass stool or urine, moving up but not down.) Diseases generated by the Liver include Hu Shan (Fox Hernia, 狐疝). (When lying down, the testis retracts into the abdomen; when standing, it protrudes into the scrotum, resembling a fox that urinates outside its burrow by day and not at night, hence the name. The area surrounding the genitalia and reaching the lower abdomen belongs to the Liver meridian, which is where hernias occur. All hernias result either from pathogenic invasion of Liver Wood or intrinsic Liver disease; this Fox Hernia represents intrinsic Liver meridian disease.) Diseases of the Three Yang meridians manifest with chills and fever, transmitting to become Dian Shan (Epileptic Hernia, 癫疝). (Three Yang refers to Hand-Taiyang Small Intestine, Foot-Taiyang Bladder, and Foot-Shaoyang Gallbladder. Small Intestine and Bladder are located inferiorly; Gallbladder is paired with Liver, and its collateral branches emerge at Qichuang, encircling the pubic region; thus, all Three Yang meridians can cause hernias.) [Missing character, likely 'Tui'] Shan refers to numbness and induration, with testes swollen like a measuring cup or bowl. When the Yellow Pulse appears, large and empty, with accumulated qi in the abdomen and rebellious qi, it is named Jue Shan (Rebellious Hernia, 厥疝). (Yellow pulse is Earth pulse. Liver Wood overacting on Spleen makes it large and empty. Jue means rebellion, referring to upward rebellious qi. Liver corresponds to Spring and Wood, both governing ascent; anger causes qi to rise, hence Rebellious Hernia.) When Spleen disease transmits to Kidney, the condition is named Shan Jia (Hernia Mass, 疝瘕), with burning pain in the lower abdomen and discharge of white fluid. (Spleen receives pathogenic factors from its unconquered element and transmits to its conquered element, losing its normal transformation function. Meeting the Cold Water Kidney, the pathogen stagnates forming a tangible mass; Jia is described in medical texts as cucumber-shaped. Yuan denotes trapped qi; qi accumulation causes pain and spontaneous white discharge. The *Classic* says: Cun Kou pulse sinking and weak indicates Shan Jia lower abdominal pain. Also: Rapid pulse indicates Shan Jia lower abdominal pain.) Diseases of the Foot-Yangming tendon manifest as [missing character, likely 'Tui'] Shan and abdominal tendon tension; also: Excessively slippery Liver pulse indicates [missing character, likely 'Tui'] Shan. (Since Foot-Yangming causes [Tui] Shan and slippery Liver pulse causes [Tui] Shan, this indicates Liver Wood overacting on Stomach. [Tui] implies severe internal pus and blood, leading to purulent bloody discharge.) Micro-large Spleen pulse indicates Shan Qi (Hernia Qi, 疝气); excessively slippery indicates Long Bi (Strangury, 癃闭); also: Excessively slippery Kidney pulse indicates Long Bi. (Internal pus and blood, external urinary obstruction, named Long Shan Strangury, resulting from Spleen pathogen transmitting to Kidney.)
Zhang Zihe said: Enuresis, strangury, impotence, bladder bi, spermatorrhea, and leukorrhea are all male hernias. Blood depletion with amenorrhea, dry throat and legs, strangury, lower abdominal masses, anterior prolapse, posterior hemorrhoids are all female hernias. However, females do not call it Shan but Jia.
Shan occurs when yin qi accumulates internally and is attacked by cold, so the *Suwen* attributes hernias to cold. However, it cannot be attributed solely to cold. Although caused by cold stagnation, it also arises from excessive drinking and eating, generating internal damp-heat, phlegm accumulating in Jueyin Liver, and the rapid nature of Liver wood being constrained by cold, causing severe pain. Though symptoms appear in Kidney disease, the root lies in the Liver, as Jueyin Liver meridian connects to the genitalia. Thus, internal damp-heat stagnation in the middle, external cold constraint, along with phlegm, food retention, and stagnant blood, indicate the disease primarily involves the Liver meridian, having nothing to do with the Kidney. Symptoms include testicular traction pain in the lower abdomen, sometimes formless and soundless, sometimes shaped like a melon, sounding like a frog, with throbbing pain without fixed location, unbearable. There are seven types: Han (Cold), Shui (Water), [Tui], Xue (Blood), Qi (Qi), Hu (Fox), Jin (Tendon). Han Shan (Cold Hernia) results from cold in Jueyin meridian, causing tendon spasm and testicular retraction, with a cold, hard scrotum and flaccid penis, or testicular pain, usually from sitting long on wet ground, allowing cold to stagnate externally. Shui Shan (Water Hernia) presents with painful, crystal-like scrotal swelling, sweating from the genitals, yellow fluid upon scratching, and water sounds upon pressing the lower abdomen, usually from drunkenness and sexual excess, sweating followed by wind exposure, allowing damp-heat to flow into the scrotum, causing urinary and fecal obstruction. [Tui] Shan presents with scrotal swelling like a cup or bowl, without itching or pain, due to dampness causing qi knotting in the genitalia, sometimes with [Tui] pain. Xue Shan (Blood Hernia) resembles a cucumber, located on both sides of the lower abdomen near the horizontal bone ends, commonly called "piss abscess," caused by heavy exertion in hot seasons, causing qi and blood to overflow into the bladder sac, forming an abscess. Qi Shan (Qi Hernia) extends from the kidney region to the scrotum, often triggered by crying or anger, causing qi stagnation and distending pain, usually a congenital defect from paternal weakness and forced intercourse during conception. Hu Shan (Fox Hernia) resembles a tile, retracting into the abdomen when lying down and protruding when walking. Jin Shan (Tendon Hernia) involves penile swelling, ulceration with pus and pain, tenesmus and tendon shortening, penile pain, intense itching, or non-retractile prepuce with white fluid resembling semen during urination, caused by sexual excess or sorcery. Mu Shen (Wood Kidney/Indurated Testis) occurs when Heart fire descends and Kidney water warms, true yang descends and Kidney qi harmonizes; if warm and harmonious, why would there be persistent erection? This results from desire injuring Kidney deficiency, causing disconnection between yin and yang/water and fire, leading to cold-induced swelling, hardness, and pain. However, all five zang organs have hernias: Large-rapid-sinking Kidney pulse indicates Kidney Shan; Large-rapid-sinking Liver pulse indicates Liver Shan; Wiry-slipping-rapid Heart pulse indicates Heart Shan; Deep-pounding Lung pulse indicates Lung Shan; Rapid Three Yang indicates Jia; Rapid Three Yin indicates Spleen Shan. Three Yang refers to Foot-Taiyang Bladder; Three Yin refers to Foot-Taiyin Spleen. Taiyang cold causes blood coagulation into Jia; Taiyin cold causes qi aggregation into Shan. Thus, blood forms Jia, qi forms Shan, though they can combine, showing each zang has its own hernia. In children, it often results from prolonged crying and anger moving yin qi downward, knotting and not dispersing, or from maternal excessive weeping affecting the fetus, causing small intestine qi closure after birth. Red tiger-mouth lines indicate fetal Shan; green lines indicate crying-induced Shan. Scrotal swelling occurs due to Shaoyin meridian insufficiency allowing wind-cold invasion; Shaoyin connects to the genitals, and wind-cold clashes with qi and blood, causing swelling. Prolonged crying and anger close qi downward, combined with external dampness, also causes swelling. Red, transparent scrotal swelling or female vulvar swelling and pain result from Heart fire transferring heat to the Bladder; clear swelling without dryness or pain indicates Liver deficiency failing to soothe. Unilateral testicular swelling, knotting on one side, extremely large and painful, is called Pian Zhui (Unilateral Descent, 偏坠), caused by anger injuring Liver, cold constraining internal heat, or summer-heat invading and transmitting to Bladder, attacking external kidneys. This disease primarily involves the Liver meridian; treatment disperses wind, warms cold, resolves summer-heat, leaches dampness, regulates Heart qi for fright/anger, promotes urination for qi-water clash. Internal qi knotting and external cold-dampness are essential factors; widening Small Intestine qi, warming, dispersing wind, and leaching dampness are necessary.
The *Classic* states Ren Mai disease causes seven hernias, summarizing the origin. Chong, Hu, [Tui], Jue, Jia, Long describe specific conditions. Chao Yuanfang divided them into Jue, [Tui], Han, Qi, Pan, Ye Lang seven types; Zhang Zihe criticized this as layman's error. Arguing only Liver meridian is involved, unrelated to Small Intestine, Bladder, or Kidney, and dividing into Han, Shui, Jin, Xue, Qi, Hu seven names, this error matches Chao's. The *Neijing* defines seven hernias with Ren Mai as the source; hernias are tendon diseases involving Liver pathogen. Claiming only Jueyin is involved contradicts the Classic. Scholars should follow the *Neijing*. Generally, cold causes pain, heat causes flaccidity, dampness causes swelling/descent, deficiency mimics this; blood involvement is stationary, qi involvement is mobile. Two testes: Left belongs to Water, generating Liver Wood, generating Heart Fire; all three govern blood, Liver controls left blood. Right belongs to Fire, generating Spleen Earth, generating Lung Metal; all three govern qi, Lung controls right qi. Thus, cold contraction causes blood stasis returning to Liver, descending to left testis; qi stagnation causes dampness gathering in Lung, descending to right testis. Tendons connecting testes are not solely Jueyin; Taiyin and Yangming tendons also connect. Hence, left testis issues have more pain, less swelling; right testis issues have less pain, more swelling. Danxi attributed hernia onset to damp-heat: Great labor ignites fire in tendons, drunkenness/eating ignites fire in Stomach, sexual excess ignites fire in Kidney, great anger ignites fire in Liver. Prolonged fire stagnation increases dampness, turbid fluids condense, enter blood team, flow to Jueyin. Liver's rapid nature constrained by cold causes severe pain, supplementing previous theories. Common in Southeast Asia, but not a universal rule. Fever with sudden mumps behind ears, red/swollen/painful, resolving rib pain but sudden testicular swelling (one large, one small, seeming unilateral but not), occurs because ear region is Shaoyang Gallbladder, paired with Liver; Shaoyang wind-heat transmits to Liver. Large scrotum with retracted penis, dribbling urine, difficulty walking, is Bladder qi issue. Kidney and Bladder are exterior-interior; Kidney fails to store, pathogen resides in Bladder, urine leaks into kidney sac; promote diuresis. Complete penile retraction with smooth, painless scrotal swelling indicates Liver qi deficiency failing to extend; tonify and warm. Children's unilateral descent often from food retention, Spleen dampness flowing to Liver. Women's lower abdominal pain near genitals, subcutaneous goose-egg-sized lump, is cold qi aggregating in Jueyin; lower abdominal cold triggers it, called Yin Shan. Female anterior prolapse and posterior hemorrhoids are hernia types, called Jia. Though hernias arise from deficiency, do not tonify abruptly; stagnation creates excess. First drain accumulated pathogens, then tonify, or combine tonification with warming to prevent stagnation. Ancients used Wu Ling San adding qi-moving herbs: Polyporus and Alisma regulate yin/yang, harmonize Heart/Small Intestine; Atractylodes leaches dampness/blood stasis in waist/navel, boosts middle qi to aid transport; Poria leaches Bladder water; Cinnamon attacks Liver pathogen, warms/disperses; Fennel treats Small Intestine qi; Golden Bell Fruit and Tangerine Seed remove Bladder stagnation; Areca nut directs qi downward; slight Akebia guides Small Intestine fire. The prescription is stable. Hernias always involve internal deficiency and external invasion; first vent qi ("unblocked, no pain"); abrupt tonification can cause critical cardiac/abdominal symptoms.
Hernia belongs to Liver meridian damp-heat constrained by external cold, blocking qi and causing severe pain. The *Classic* says: Strong people recover as qi moves; weak people develop disease. Actually, severe Kidney qi exhaustion, excessive alcohol/sex, insufficient diuresis, cause turbid qi to flow to Jueyin. Cold or劳累 triggers pain. Sometimes damp-heat is branch, Kidney deficiency is root, hence Danxi uses Ginseng/Atractylodes tonification. Generally, hernias cannot be cured without abstaining from sex and rich foods/alcohol. Hernias start with damp-heat in meridians, prolonged stagnation, external cold/damp-heat constraint causing pain; treating only as cold is incomplete. Ancient formula: Equal parts Aconite and Gardenia, boiled with salt/wine, named Zhi Fu Tang, acts quickly. Later modifications based on symptoms are effective; treat according to damp-heat ratio. Danxi said: Aconite treats external cold, Gardenia treats internal heat, clarifying internal heat/external cold logic. Both are lower jiao drugs; Gardenia guided by Aconite acts rapidly downwards, not lingering in Stomach. If pressure stops pain, it is deficiency-cold; add Cinnamon, take as Ginger juice pills. For quick pain relief, use Walnut kernel, Hawthorn kernel, Lychee kernel, Sichuan Chinaberry, Evodia, stir-fried to powder, taken with warm water.
Heart/Lung are upper yang; Kidney/Liver are lower yin. Kidney is Liver mother; Liver is Kidney child. Kidney/Liver share disease, Yi/Gui share source. Thus, Liver meridian diseases must trace back to Kidney source. Hernia is Foot-Jueyin Liver disease; pulse circles genitals, reaches lower abdomen, controls testicular pain, all belonging to Liver. Yet *Suwen* says: Kidney pulse disease, qi rushing from lower abdomen to heart, unable to pass urine/stool is Chong Shan. Why does it originate in Kidney meridian? Danxi said: Hernia belongs to Liver, unrelated to Kidney. Kidney is Water organ; Bladder is its fu, formed from cold water. Hernia originates from cold-damp invasion; cold attracts cold, pathogen is fast; Kidney/Bladder are exterior-interior. *Classic* says: All cold contractions belong to Kidney. Thus, hernia spasms and rushing to heart/stomach are indeed Kidney pathogen disease. Modern hernia patients flare after sexual activity, so *Shengji Lu* says: Desire/labor injure, Kidney water dries up, failing to nourish, Liver qi stagnates internally, causing Yin Shan. Thus, hernias often stem from Kidney deficiency. If arguing Kidney is unrelated and treating only by draining Liver, disease worsens. Minor lower body cold triggers it, as Yu Jiayan called "Earth qi attacking upwards." Large doses of Ginseng, Atractylodes, Ginger, Cinnamon bring peace; this is turbid yin qi aggregating in lower abdomen, extreme yin excess. Do not combine with Si Wu Tang (Four Substances Decoction) to tonify yin, as it worsens disease.