厥逆心痛，足寒，诸饮食吐不下，名曰厥疝。（宜桂附二陈汤之类。）
腹中气满，心下痛，气积如臂，名曰 疝。（宜东垣川楝散。）
寒饮食，即胁下、腹中尽痛，名曰寒疝。（宜仲景乌头煎、和剂胡芦巴丸之类。）
腹中乍满乍减而痛，名曰气疝。（宜苏合香丸、东垣川楝散之类。）
腹中痛在脐旁，名曰盘疝。（宜桂枝汤、东垣丁香楝实丸之类。）
腹中脐下有积聚，名曰 疝。（宜茴香散之类。）
小腹与阴相引而痛，大便难，名曰野狼疝。（宜木香散、丁香楝实丸之类。）
寒疝，其状囊冷结硬如石，阴茎不举，或控睾丸而痛。得于坐卧湿地，或寒
月涉水，或冒雨雪，或坐卧砖石，或风冷处使内过劳。宜以温剂下之。久而无子。宜东垣天台乌药散之类。
水疝，其状肾囊肿痛，阴汗时出。或囊肿而状如水晶，或囊痒而搔出黄水，或
少腹中按之作水声。得于饮水、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。有漏针去水者，人多不得其法。（宜腰子散、
五苓散、仲景牡蛎泽泻散之类。）
筋疝，其状阴茎肿胀，或溃或脓，或痛而里急筋缩，或茎中痛，痛极则痒，或
挺纵不收，或白物如精，随溲而下。久而得于房室劳伤，及邪术所使。宜以降心之
剂下之。（宜白芍、茯苓、当归、小茴香、青皮、黄柏、苍术、川楝之类。）
血疝，其状如黄瓜，在少腹两旁，横骨两端约中。俗云便痈。得于重感春夏大
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。（宜归、芍、牛膝、灵脂、青皮、木香、丹皮、没药、玄胡索之类。）
气疝，其状上连肾区，下及阴囊。或因号哭忿怒，则气郁而胀；怒哭号罢，则
气散者是也。有一治法，以针出气而愈者。然针有得失，宜以散气之药下之。或小
儿亦有此疾，俗曰偏气。得于父已年老，或年少多病，阴痿精怯，强力入房，因而
有子，胎中病也。此证不治，惟筑宾一穴灸之。（宜正气天香散之类。）
狐疝，其状如瓦。卧则入小腹，行立则出小腹入囊中。狐则昼出穴而溺；夜则
入穴而不溺。此疝出入上下往来，正与狐相类也。亦与气疝大同小异，今人带钩钤
是也。宜以逐气流经之药下之。（宜金匮蜘蛛散之类。）
疝，其状阴囊肿缒，如升如斗，不痒不痛者是也。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。女子阴户突出，虽亦此类，乃
热则不禁固也，不可便谓虚寒而涩之、燥之、补之。本名曰瘕，宜以苦下之，以苦
坚之。（宜荔核散、三层茴香丸、济生橘核丸、香附散之类。女子阴突，肝火居多，宜龙胆泻肝汤、
加味逍遥散，或少加升提之类。）
以上子和论疝七条，形证可谓详悉。但七疝七名，形证亦异，治之当各有方。而
俱云下者，恐出偏见。今拟对证方药于下。在诊之者合宜则用，亦不敢概云不可下也。
心痛伴有四肢厥冷，足部发凉，各种饮食食物呕吐且无法咽下，这种病称为厥疝。（适宜使用桂附二陈汤之类的方剂。）
腹部胀满，胃脘部疼痛，腹中有积气如手臂般大小，这种病称为[隐去]疝。（适宜使用李东垣的川楝散。）
进食寒凉饮食后，胁下和腹部全部感到疼痛，这种病称为寒疝。（适宜使用张仲景的乌头煎、《太平惠民和剂局方》的胡芦巴丸之类的方剂。）
腹部时而胀满时而减轻并伴有疼痛，这种病称为气疝。（适宜使用苏合香丸、李东垣的川楝散之类的方剂。）
腹部疼痛位于肚脐旁边，这种病称为盘疝。（适宜使用桂枝汤、李东垣的丁香楝实丸之类的方剂。）
腹部脐下有积聚包块，这种病称为[隐去]疝。（适宜使用茴香散之类的方剂。）
小腹部与阴部相互牵引而痛，大便困难，这种病称为野狼疝。（适宜使用木香散、丁香楝实丸之类的方剂。）
寒疝的症状是阴囊寒冷、结硬如石头，阴茎不能勃起，或者牵引睾丸疼痛。这是由于坐卧湿地，或在寒冷月份涉水，或冒雨雪行走，或坐卧砖石，或在受风冷的地方行房事过度劳累所致。适宜用温里攻下的药剂治疗。病程长久会导致不育。适宜使用李东垣的天台乌药散之类的方剂。
水疝的症状是肾囊肿痛，阴部出汗时常流出。或者囊肿像水晶一样透明，或者囊痒抓挠后流出黄水，或者按压少腹部能听到水声。这是由于饮水过量、醉酒，行房事过度劳累，出汗后遭遇风寒湿邪气，聚集在阴囊中，导致水液增多，使人突发疝气。适宜用水逐剂攻下治疗。有用漏针法排水的，但很多人不得其法。（适宜使用腰子散、五苓散、张仲景的牡蛎泽泻散之类的方剂。）
筋疝的症状是阴茎肿胀，或者溃烂流脓，或者疼痛且内部拘急筋脉收缩，或者尿道内疼痛，痛到极致则发痒，或者阴茎挺纵不收，或者有白色分泌物像精液一样，随小便排出。这长久以来是由于房劳损伤，以及邪术所致。适宜用清心降火的药剂治疗。（适宜使用白芍、茯苓、当归、小茴香、青皮、黄柏、苍术、川楝之类的药材。）
血疝的症状形状像黄瓜，位于少腹两侧，横骨两端中间的位置。俗称便痈。这是由于再次感受春夏季节的大热，行房事过度劳累，气血流溢，渗入膀胱和阴囊。停留不去，结成痈肿，脓少血多。适宜用调和血液的药剂治疗。（适宜使用当归、白芍、牛膝、五灵脂、青皮、木香、牡丹皮、没药、玄胡索之类的药材。）
气疝的症状向上连接肾区，向下到达阴囊。有时因为大哭或愤怒，导致气机郁滞而胀大；当怒哭停止后，气机消散，症状缓解，这就是气疝。有一种治疗方法是用针刺出气而痊愈。然而针刺有得失之分，适宜用理气散结的药物攻下。也有小儿患此病，俗称偏气。这是由于父亲年事已高，或年少多病，阳痿精怯，却强力入房，因而得子，属于胎中疾病。此证如果不治疗，只灸筑宾一穴即可。（适宜使用正气天香散之类的方剂。）
狐疝的症状形状像瓦片。躺下时进入小腹，站立行走时从小腹出来进入阴囊。狐狸白天出洞排尿，晚上回洞不排尿。这种疝气出入上下往来，正与狐狸的特性相似。这也与气疝大同小异，就是现在人所说的带钩钤（一种疝气带）。适宜用驱逐气流经的药物攻下。（适宜使用《金匮要略》的蜘蛛散之类的方剂。）
[隐去]疝的症状是阴囊肿垂，像升斗一样大，不痒不痛。这是由于地气卑湿所生。所以在江淮之间，低洼潮湿的地方，多感染此疾，适宜用祛湿的药物攻下。女子阴户突出，虽然也属此类，但这是因为热盛导致固摄不禁，不可简单地认为是虚寒而用收敛、燥湿、补益的方法。本名叫做瘕，适宜用苦味药攻下，用苦味药坚阴。（适宜使用荔核散、三层茴香丸、济生橘核丸、香附散之类的方剂。女子阴户突出，多为肝火所致，适宜使用龙胆泻肝汤、加味逍遥散，或少加升提类药物。）
以上张子和论述疝气的七条，形态和症状可谓详细完备。但是七种疝气七个名称，形态和症状也各不相同，治疗时应当各有方药。而都说是“下”法，恐怕出于偏见。现在拟定对症的方药如下。由诊治者根据情况合适则使用，也不敢一概说不可用下法。
Heart pain accompanied by cold extremities, cold feet, vomiting of all food and fluids without ability to swallow, is named Jue Shan (Jue Hernia). (Suitable for formulas such as Guizhi Fuzi Erchen Tang [Cinnamon Twig and Aconite Two-Ingredient Chen Decoction].)
Abdominal fullness, pain in the epigastrium, accumulation of Qi resembling an arm in size within the abdomen, is named [Omitted] Shan. (Suitable for Chuanlian San [Toosendan Fruit Powder] by Li Dongyuan.)
Pain throughout the hypochondrium and abdomen immediately after consuming cold food or drink, is named Han Shan (Cold Hernia). (Suitable for Wutou Jian [Aconite Decoction] by Zhang Zhongjing, or Huluba Wan [Trigonella Seed Pill] from the *Taiping Huimin Heji Jufang* [Formulas of the Bureau of Taiping People's Welfare].)
Intermittent abdominal fullness and reduction with pain, is named Qi Shan (Qi Hernia). (Suitable for Suhexiang Wan [Styrax Pill] or Chuanlian San [Toosendan Fruit Powder] by Li Dongyuan.)
Abdominal pain located beside the umbilicus, is named Pan Shan (Plate Hernia). (Suitable for Guizhi Tang [Cinnamon Twig Decoction] or Dingxiang Lianshi Wan [Clove and Toosendan Fruit Pill] by Li Dongyuan.)
Accumulation masses below the umbilicus in the abdomen, is named [Omitted] Shan. (Suitable for Huixiang San [Fennel Powder].)
Drawing pain between the lower abdomen and the genitalia, accompanied by difficult defecation, is named Yelang Shan (Wild Wolf Hernia). (Suitable for Muxiang San [Costus Root Powder] or Dingxiang Lianshi Wan [Clove and Toosendan Fruit Pill].)
Han Shan (Cold Hernia): Its presentation involves a cold, hard scrotum like stone, flaccid penis, or pain radiating to the testicles. It arises from sitting or lying on damp ground, wading in water during cold months, exposure to wind, rain, or snow, sitting on bricks or stones, or excessive sexual activity in windy and cold environments. It should be treated with warming purgatives. Prolonged cases may lead to infertility. Suitable for Tiantai Wuyao San [Tiantai Asarum Powder] by Li Dongyuan.
Shui Shan (Water Hernia): Its presentation involves swelling and pain of the renal sac (scrotum), intermittent sweating from the genitalia. The scrotum may appear transparent like crystal, or itchiness may cause yellow fluid discharge upon scratching, or percussion of the lower abdomen may produce a fluid sound. It arises from excessive drinking, intoxication, excessive sexual activity, sweating followed by exposure to wind-cold-damp pathogens, causing fluid accumulation in the scrotum, leading to sudden hernia. It should be treated with diuretic purgatives. Some use needle drainage to remove fluid, but many lack proper technique. (Suitable for Yaozi San [Kidney Powder], Wuling San [Five-Ingredient Powder], or Mushe Zexie San [Oyster Shell and Alisma Powder] by Zhang Zhongjing.)
Jin Shan (Sinew Hernia): Its presentation involves penile swelling, ulceration or suppuration, pain with internal tension and sinew contraction, pain within the urethra, extreme pain turning into itching, persistent erection without retraction, or white discharge resembling semen passing with urine. Long-standing cases arise from sexual exhaustion and injury, or influence of evil arts. It should be treated with heart-clearing and descending agents. (Suitable for herbs such as Baishao [White Peony Root], Fuling [Poria], Danggui [Angelica Sinensis], Xiaohuixiang [Small Fennel], Qingpi [Green Tangerine Peel], Huangbai [Phellodendron Bark], Cangzhu [Atractylodes Rhizome], Chuanlian [Toosendan Fruit].)
Xue Shan (Blood Hernia): Its presentation resembles a cucumber, located on both sides of the lower abdomen at the midpoint of the transverse bones. Commonly known as Bian Yong (Genital Abscess). It arises from repeated exposure to the intense heat of spring and summer, excessive sexual activity causing blood and Qi overflow, infiltrating the bladder and scrotum. Retention leads to abscess formation with little pus and much blood. It should be treated with blood-nourishing and harmonizing agents. (Suitable for herbs such as Danggui [Angelica Sinensis], Shaoyao [Peony Root], Niuxi [Achyranthes Root], Lingzhi [Trogopterus Dung], Qingpi [Green Tangerine Peel], Muxiang [Costus Root], Danpi [Moutan Cortex], Moyao [Myrrh], Yanhusuo [Corydalis Rhizome].)
Qi Shan (Qi Hernia): Its presentation extends upward to the kidney region and downward to the scrotum. It may occur due to loud crying or anger, causing Qi stagnation and distension; when anger and crying cease, the Qi dissipates. One treatment method involves acupuncture to release Qi for cure. However, acupuncture has risks and benefits; it is better to use Qi-dispersing medicines. Children may also suffer from this, commonly called Pian Qi (Lateral Qi Hernia). This occurs when the father is old or chronically ill with impotence and weak essence, yet engages in forced intercourse to conceive, resulting in a congenital disease. If untreated, moxibustion on the Zhubin (KI9) acupoint alone suffices. (Suitable for Zhengqi Tianxiang San [Righteous Qi Heavenly Fragrance Powder].)
Hu Shan (Fox Hernia): Its presentation resembles a tile. When lying down, it enters the lower abdomen; when standing or walking, it exits the lower abdomen into the scrotum. Foxes exit their burrows during the day to urinate and return at night without urinating. This hernia moves up and down, similar to the fox. It is largely similar to Qi Hernia, corresponding to what modern people call "Gouqian" (a type of truss). It should be treated with medicines that expel Qi and unblock meridians. (Suitable for Zhizhu San [Spider Powder] from *Jingui Yaolue*.)
[Omitted] Shan: Its presentation involves a pendulous scrotum large as a measuring vessel, without itching or pain. It arises from low-lying damp earth qi. Therefore, in the Jianghuai region, in marshy areas, many contract this disease. It should be treated with damp-draining medicines. In women, prolapse of the vaginal opening belongs to this category, caused by heat failing to secure and hold. It should not be simply treated as deficiency-cold with astringents, drying agents, or tonics. Originally named Jia (Mass), it should be treated with bitter purgatives and bitter-astringents. (Suitable for Lihé San [Lychee Seed Powder], Sancang Huixiang Wan [Three-Layer Fennel Pill], Jisheng Juzhe Wan [Bureau of Relief's Orange Seed Pill], Xiangfu San [Cyperus Powder]. For female prolapse, often due to Liver Fire, Longdan Xiegan Tang [Gentian Liver-Draining Decoction], Jiawei Xiaoyao San [Modified Free and Easy Wanderer Powder], or mild lifting agents are suitable.)
The above seven points on Hernia discussed by Zhang Zihe detail the forms and symptoms comprehensively. However, since the seven types of Hernia have different names, forms, and symptoms, treatment should employ specific formulas for each. The assertion that all require "purging" (Xia) may reflect a biased view. Below are proposed symptomatic formulas. Practitioners should use them if appropriate; I dare not categorically state that purging is inadvisable.