川楝子(煨去肉,一两) 茯苓 橘核(盐酒炒,各一两五钱) 肉桂(三钱) 附子(炮) 吴茱萸
(汤泡七次,各五钱) 荔枝子(煨,八钱) 小茴香 木香(各七钱
熬砂糖为丸。每服二钱,淡盐汤下。若有热者,去附、桂。
理中汤 (见中寒。
疝者,少腹痛,引睾丸也。经云∶任脉为病,男子外结七疝,女子带下瘕聚。七疝者,
一曰冲疝,气上冲心,二便不通也。二曰狐疝,卧则入腹,立则出腹也。三曰 疝,阴囊肿
大,如升如斗也。四曰厥疝,肝气上逆也。五日瘕疝,腹有 痞,痛而热,时下白浊也
六曰 疝,内裹脓血也。七曰 癃疝,内裹脓血,小便不通也。愚按厥疝即冲疝
癃疝,即 疝,其名有七,其实五者而已。疝之根起于各脏,而归并总在厥阴
以肝主筋,又主痛也。治疝之法非一,而分别不外气血,气则游走不定,血则凝聚不散也
通治七疝。
橘核二两(盐酒炒) 小茴香 川楝子(煨,去肉) 桃仁(去皮、尖及双仁者,炒) 香附
(醋炒) 山楂子(炒,各一两) 广木香 红花(各五钱
以神曲三两,打糊为丸。每服三钱。
冲疝,用白茯苓一钱,松子仁三钱,煎汤送下。狐疝,用当归二钱,牛膝一钱五分,煎
酒送下。 疝,用白茯苓、陈皮、赤茯苓各一钱,煎汤送下。厥疝,治同冲疝。瘕疝,
用丹参、白茯苓各一钱五分煎汤送下。 疝,本方内加五灵脂一两(醋炒)、赤芍一两五
钱(酒炒),服时用牛膝一钱五分,当归尾三钱,煎酒送下。 癃疝,治法同上。此症若
寒气深重,本方内加吴茱萸、肉桂心各五钱,甚则加附子一枚。若表寒束其内热,腹痛热辣
或流白浊者,本方内加黑山栀五钱,川萆 一两,吴茱萸三钱(汤泡七次)。吴萸散表寒,
山栀清内热,二者并行,丹溪心法也。
小肠气者,脐下转痛,失气则快。
膀胱气者,脐热痛,涩于小便,即胞痹也。
者,状如弓弦,筋病也。
癖者,隐伏于内,疼痛着骨也。
者,有块可 ,血病也。
瘕者,假也,忽聚忽散,气病也。
以上诸症,虽作痛,不引睾丸,故不以疝名之。然而治法,可以仿佛前丸加减,或轻或
川楝子(煨制去肉,一两) 茯苓 橘核(用盐和酒炒制,各一两五钱) 肉桂(三钱) 附子(炮制) 吴茱萸(用汤浸泡七次,各五钱) 荔枝核(煨制,八钱) 小茴香 木香(各七钱)
熬砂糖制成丸药。每次服用二钱,用淡盐汤送服。如果有热象的,去掉附子和肉桂。
理中汤 (见中寒章节)。
疝气,是指少腹部疼痛,牵引至睾丸。医经说:任脉发生病变,男子会出现外结七种疝气,女子会出现带下病和瘕聚病。所谓七疝,
第一种叫冲疝,气向上冲撞心脏,大小便不通畅。第二种叫狐疝,躺下时疝块进入腹腔,站立时疝块出于腹腔。第三种叫㿗疝,阴囊肿大,像升斗一样大。第四种叫厥疝,肝气上逆。第五种叫瘕疝,腹中有痞块,疼痛且发热,时常排出白色浊物。第六种叫睾疝,内部包裹着脓血。第七种叫癃疝,内部包裹着脓血,小便不通畅。我按察认为,厥疝就是冲疝,癃疝就是睾疝,名称虽有七种,实际上只有五种罢了。疝气的根源起于各个脏腑,但最终归结都在厥阴经,因为肝脏主管筋脉,又主管疼痛。治疗疝气的方法不止一种,但分辨不出气血两个方面,气则游走不定,血则凝聚不散。
通治七种疝气。
橘核二两(用盐和酒炒制) 小茴香 川楝子(煨制,去肉) 桃仁(去皮、尖及双仁者,炒制) 香附(醋炒制) 山楂子(炒制,各一两) 广木香 红花(各五钱)
用神曲三两,打糊制成丸药。每次服用三钱。
冲疝,用白茯苓一钱,松子仁三钱,煎汤送服。狐疝,用当归二钱,牛膝一钱五分,煎酒送服。㿗疝,用白茯苓、陈皮、赤茯苓各一钱,煎汤送服。厥疝,治疗方法同冲疝。瘕疝,
用丹参、白茯苓各一钱五分煎汤送服。睾疝,在本方内加五灵脂一两(醋炒制)、赤芍一两五钱(酒炒制),服用时用牛膝一钱五分,当归尾三钱,煎酒送服。癃疝,治疗方法同上。此症如果寒气深重,本方内加吴茱萸、肉桂心各五钱,严重时加附子一枚。如果表寒束缚住内热,腹痛灼热或流出白色浊物的,本方内加黑山栀五钱,川萆薢一两,吴茱萸三钱(用汤浸泡七次)。吴茱萸发散表寒,山栀清解内热,两者并行使用,这是朱丹溪《丹溪心法》中的方法。
小肠气,表现为脐下转动性疼痛,放屁后感觉爽快。
膀胱气,表现为脐部热痛,小便涩滞,这就是胞痹。
弦疝,形状像弓弦,属于筋的病。
癖积,隐伏在体内,疼痛牵连骨骼。
积块,有肿块可以触摸到,属于血的病。
瘕聚,假的意思,忽聚忽散,属于气的病。
以上各种病症,虽然发作疼痛,但不牵引睾丸,所以不称为疝气。然而治疗方法,可以参照前面的丸药进行加减,或轻或重……
Chuanlianzi (Fruit of Sichuan Loranthus, *Tutcheria chinensis*, baked to remove the flesh, 1 liang) Fuling (Poria, *Poria cocos*) Juhe (Seed of Tangerine, *Citrus reticulata*, stir-fried with salt and wine, each 1.5 liang) Rougui (Cinnamon Twig, *Cinnamomum cassia* (3 qian) Fuzi (Prepared Aconite Root, *Aconitum carmichaelii*) Wuzhuyu (Evodia Fruit, *Evodia rutaecarpa* (soaked in decoction seven times, each 5 qian) Lizhihe (Seed of Lychee, *Litchi chinensis*, baked, 8 qian) Xiaohuixiang (Fennel Fruit, *Foeniculum vulgare*) Muxiang (Costus Root, *Saussurea costus* (each 7 qian)
Boil rock sugar to make pills. Take 2 qian per dose, administered with light salt water. If there are signs of heat, remove Fuzi and Rougui.
Lizhong Tang (See section on Cold Damage to the Middle Jiao).
Shanqi (Hernia) refers to pain in the lower abdomen radiating to the testicles. The Classics state: "When the Ren Mai (Conception Vessel) is diseased, men suffer from seven types of external hernias, while women suffer from leukorrhea and mass accumulation." The so-called seven hernias are:
The first is called Chongshanqi (Rushing Hernia), where Qi rushes upward to the heart, accompanied by obstruction of both urination and defecation. The second is called Hushanqi (Fox Hernia), where the mass enters the abdomen when lying down and exits when standing. The third is called Weishanqi (Scrotal Hernia), characterized by a swollen scrotum as large as a measuring cup. The fourth is called Jueshanqi (Rebellious Hernia), caused by rebellious Liver Qi. The fifth is called Jiashanqi (Mass Hernia), featuring abdominal masses, pain with heat, and frequent discharge of white turbid matter. The sixth is called Gaoshanqi (Testicular Hernia), containing pus and blood internally. The seventh is called Longshanqi (Obstructive Hernia), also containing pus and blood internally, with obstructed urination. In my opinion, Jueshanqi is essentially Chongshanqi, and Longshanqi is essentially Gaoshanqi; although there are seven names, there are actually only five pathologies. The root of hernias originates from various Zang-Fu organs but ultimately converges in the Jueyin (Liver) channel, because the Liver governs the sinews and is associated with pain. Methods for treating hernias are numerous, but differentiation primarily concerns Qi and Blood: Qi moves freely and unpredictably, whereas Blood coagulates and stagnates.
General treatment for the seven hernias.
Juhe (Seed of Tangerine, *Citrus reticulata*, 2 liang, stir-fried with salt and wine) Xiaohuixiang (Fennel Fruit, *Foeniculum vulgare*) Chuanlianzi (Fruit of Sichuan Loranthus, *Tutcheria chinensis*, 8 qian, baked to remove flesh) Taoren (Peach Seed, *Prunus persica*, peeled, tip and double kernels removed, stir-fried) Xiangfu (Rhizoma Cyperi, *Cyperus rotundus*, vinegar-fried) Shanzhazhi (Hawthorn Seed, *Crataegus pinnatifida*, stir-fried, each 1 liang) Guangmuxiang (Costus Root, *Saussurea costus*) Honghua (Safflower Flower, *Carthamus tinctorius* (each 5 qian)
Use Shenqu (Medicated Leaven, *Medicated Leaven*, 3 liang) mixed with paste to form pills. Take 3 qian per dose.
For Chongshanqi (Rushing Hernia), administer with a decoction of Baifuling (White Poria, *Poria cocos*, 1 qian) and Songziren (Pine Seed Kernel, *Pinus koraiensis*, 3 qian). For Hushanqi (Fox Hernia), administer with a decoction of Danggui (Angelica Sinensis Root, *Angelica sinensis*, 2 qian) and Niuxi (Achyranthes Root, *Achyranthes bidentata*, 1.5 qian) in wine. For Weishanqi (Scrotal Hernia), administer with a decoction of Baifuling (White Poria, *Poria cocos*, 1 qian), Chenpi (Dried Tangerine Peel, *Citrus reticulata*, 1 qian), and Chifuling (Red Poria, *Poria cocos*, 1 qian). For Jueshanqi (Rebellious Hernia), the treatment is the same as for Chongshanqi. For Jiashanqi (Mass Hernia), administer with a decoction of Danshen (Salvia Root, *Salvia miltiorrhiza*, 1.5 qian) and Baifuling (White Poria, *Poria cocos*, 1.5 qian). For Gaoshanqi (Testicular Hernia), add Wulingzhi (Trogopterus Dung, *Trogopterus dung*, 1 liang, vinegar-fried) and Chishao (Red Peony Root, *Paeonia lactiflora*, 1.5 qian, wine-fried) to the base formula; administer with Niuxi (Achyranthes Root, *Achyranthes bidentata*, 1.5 qian) and Dangguiwei (Tail of Angelica Sinensis Root, *Angelica sinensis*, 3 qian) in wine. For Longshanqi (Obstructive Hernia), the treatment is the same as above. If cold pathogen is deep and severe, add Wuzhuyu (Evodia Fruit, *Evodia rutaecarpa*, 5 qian) and Rouguixin (Heart of Cinnamon Twig, *Cinnamomum cassia*, 5 qian) to the base formula; if extreme, add one Fuzi (Prepared Aconite Root, *Aconitum carmichaelii*). If exterior cold binds interior heat, causing burning abdominal pain or discharge of white turbid matter, add Heishanzhi (Black Gardenia Fruit, *Gardenia jasminoides*, 5 qian), Chuanbixie (Grassleaf Fern Rhizome, *Dioscorea hypoglauca*, 1 liang), and Wuzhuyu (Evodia Fruit, *Evodia rutaecarpa*, 3 qian, soaked in decoction seven times) to the base formula. Wuzhuyu disperses exterior cold, while Shanzhi clears interior heat; using them together is the method from Zhu Danxi's *Danxi Xinfa*.
Xiaochangqi (Small Intestine Qi) presents as twisting pain below the umbilicus, relieved by passing gas.
Nangpangqi (Bladder Qi) presents as heat and pain at the umbilicus, with difficult urination, which is also known as Baobi (Bladder Bi Syndrome).
Xianshanqi (String Hernia) resembles a bowstring and is a disease of the sinews.
Pixi (Paralytic Mass) lies hidden internally, with pain penetrating to the bone.
Jiku (Accumulated Mass) has palpable lumps and is a disease of Blood.
Jiaju (Floating Mass) implies falsity; it gathers and scatters suddenly, and is a disease of Qi.
Although all the above conditions cause pain, they do not radiate to the testicles, so they are not named "hernia" (Shan). However, the treatment methods can be modified based on the aforementioned pill, adjusting dosage according to severity...