闻之男子之外肾。犹女子之两乳。皆隶厥阴而司阳明。此灵枢分发十二
支也。厥阴者肝也。主筋。而阳明主宗筋之会。犹女子乳头属肝。而乳房属
胃也。盖女子类阴。故血主之。男子类阳。故气主之。此疝之为患。所以攻冲
胀满。而疼痛时作。名曰疝气。然肝火下注。则患左丸。肝性急速。故痛胜于
肿。脾湿下流。则患右丸。脾性缓慢。故肿胜于痛。又有外寒郁热者。气不宣
通者。肾阴不足者。瘴疠所中者。劳倦所伤者。先天禀成者。所因多端。未有
不本厥阴一经而述类象形。如荔枝橘核茴香棠球之属。以类而推。在血
分则桃仁玄胡。在气分则枳实青皮。寒则乌头。热则栀子。湿则苍术以燥
之。气则香附以理之。虚则葫芦巴以温之。然此则散于外肾者也。若结聚
于膀胱左右。攻冲时作。为患心腹。则又非前药之所能疗。须察其所因虚
实。令患者戒驰驱。除恼怒。绝房事。静以调之。俟以岁月。乃可安痊。否则归
咎于药饵。多见其不知谅也。
栀子汤 治疝气或左或右。疼痛肿大。
栀子（一钱炒黑） 山楂（二钱） 橘核（一钱） 荔枝核（一钱） 泽泻（一钱） 枳实（一钱） 归尾（一钱）
茯苓（一钱） 小茴香（一钱盐水焙） 柴胡（七分）
姜水煎。
苍术汤 治湿气郁热。睾丸肿痛。
苍术（一钱泔制） 葛根（一钱） 山栀（一钱炒黑） 茯苓（一钱） 泽泻（一钱） 广皮（一钱） 山楂（二
钱）
灯芯一握。姜一片。水煎。
肾气方
茴香 补骨脂 吴茱萸（各五钱） 葫芦巴（七钱半） 木香（三钱半）
为末。箩卜捣汁丸。盐汤下。
疝痛方
山楂（炒四两） 枳核（炒） 茴香（炒） 山栀（炒各二两） 柴胡 牡丹皮 桃仁（炒各一两） 吴茱萸（炒
五钱） 八角茴香（炒一两）
上为末。酒糊丸。桐子大。每服五十丸。空心盐汤下。
疝方
南星 山楂 苍术（各二两） 白芷 半夏 枳核 神曲（各一两） 海藻 昆布（各五钱） 玄明粉 吴茱萸（各
二钱）
为末。酒糊丸。
治疝痛作腹内块痛方
三棱 莪术（醋煮） 炒曲 姜黄 南星（各一两） 山楂（二两） 木香 沉香 香附（各三钱） 黄连（五钱
茱制） 莱菔子 桃仁 山栀 枳核（炒各半两）
为末。姜汁浸。蒸饼和丸。
丹溪治疝劫药用
乌头（细切炒） 栀子仁（炒黑）
为末。或加或减。白汤丸。
我听说男子的外肾（睾丸），就像女子的双乳一样，都归属于厥阴经，并受阳明经的调节。这是《灵枢》中关于十二经脉分布的理论。厥阴经对应肝脏，肝主筋；而阳明经主管宗筋（男性生殖器及周围筋膜）的汇聚，就像女子的乳头归属肝经，而乳房归属胃经（足阳明胃经）一样。大概女子属阴，所以以血为主；男子属阳，所以以气为主。这就是疝气致病时，出现攻冲感、胀满以及疼痛时作时止的原因，这种病被称为“疝气”。
然而，如果是肝火下注，就会患左侧睾丸的病证。因为肝性急迫，所以疼痛比肿胀更严重。如果是脾湿下流，就会患右侧睾丸的病证。因为脾性迟缓，所以肿胀比疼痛更明显。此外，还有因外寒郁积化热、气机不宣通、肾阴不足、感染瘴疠邪气、劳累过度损伤、先天禀赋不足等原因导致的。病因多种多样，但无不根源于厥阴一经。在论述其象形时，常列举如荔枝核、橘核、小茴香、棠球等形状类似睾丸的药物进行类比推导。若病在血分，则用桃仁、玄胡索；若病在气分，则用枳实、青皮；寒证用乌头；热证用栀子；湿证用苍术以燥湿；气滞用香附以理气；虚证用葫芦巴以温补。
但是，上述药物主要适用于病变在外肾的情况。如果结聚于膀胱左右两侧，攻冲疼痛时作，且危害心腹部，那就不是前面这些药物所能治疗的了。必须仔细审查病因的虚实，嘱咐患者戒除骑马奔驰等剧烈运动，消除恼怒情绪，禁绝房事，通过静养来调理，等待一段时间，才能痊愈。否则将过错归咎于药物，大多是因为患者不知体谅医理所致。
栀子汤：治疗疝气，无论左侧或右侧，疼痛伴肿大。
配方：栀子（一钱，炒黑）、山楂（二钱）、橘核（一钱）、荔枝核（一钱）、泽泻（一钱）、枳实（一钱）、当归尾（一钱）、茯苓（一钱）、小茴香（一钱，盐水焙干）、柴胡（七分）。
用法：加生姜和水煎服。
苍术汤：治疗湿气郁积化热导致的睾丸肿痛。
配方：苍术（一钱，泔水制过）、葛根（一钱）、山栀（一钱，炒黑）、茯苓（一钱）、泽泻（一钱）、广陈皮（一钱）、山楂（二钱）。
用法：加灯芯草一把、生姜一片，水煎服。
肾气方：
配方：小茴香、补骨脂、吴茱萸（各五钱）、葫芦巴（七钱半）、木香（三钱半）。
用法：研为细末，用萝卜捣汁泛丸，盐汤送服。
疝痛方：
配方：山楂（炒四两）、枳核（炒）、小茴香（炒）、山栀（炒，各二两）、柴胡、牡丹皮、桃仁（炒，各一两）、吴茱萸（炒五钱）、八角茴香（炒一两）。
用法：研为细末，用酒糊制成丸药，大小如梧桐子。每次服用五十丸，空腹时用盐汤送服。
疝方：
配方：天南星、山楂、苍术（各二两）、白芷、半夏、枳核、神曲（各一两）、海藻、昆布（各五钱）、玄明粉、吴茱萸（各二钱）。
用法：研为细末，用酒糊制成丸药。
治疗疝痛发作时伴有腹内块状疼痛的方子：
配方：三棱、莪术（醋煮）、炒神曲、姜黄、天南星（各一两）、山楂（二两）、木香、沉香、香附（各三钱）、黄连（五钱，吴茱萸制）、莱菔子、桃仁、山栀、枳核（炒，各半两）。
用法：研为细末，用姜汁浸泡，与蒸饼和匀制成丸药。
It is heard that the external kidneys (testicles) of men are like the two breasts of women; both belong to the Jueyin (Liver/Gallbladder) channel and are governed by the Yangming (Stomach/Large Intestine) channel. This refers to the distribution of the twelve branches as described in the *Ling Shu* (Spiritual Pivot). The Jueyin corresponds to the Liver, which governs the sinews, while the Yangming governs the convergence of the Zongjin (general sinews, specifically referring to the male genitalia and surrounding fascia), just as the nipples of women belong to the Liver channel, while the breasts belong to the Stomach channel (Foot-Yangming Stomach Meridian). Generally, women are Yin-dominant, so blood is primary; men are Yang-dominant, so Qi is primary. This is why Shan-Qi (Hernia Qi) manifests with a sensation of rushing attack, distension and fullness, and intermittent pain, hence the name "Shan Qi".
However, if Liver Fire sinks downward, it affects the left testicle. Since the nature of the Liver is rapid and urgent, pain exceeds swelling. If Spleen Dampness flows downward, it affects the right testicle. Since the nature of the Spleen is slow and sluggish, swelling exceeds pain. Furthermore, there are cases caused by external cold stagnating into heat, obstruction of Qi circulation, deficiency of Kidney Yin, infection by miasma pathogens, injury from overexertion, or congenital endowment deficiencies. The causes are manifold, but they all fundamentally stem from the Jueyin channel alone. In describing their morphology, one often draws analogies to herbs resembling testicles, such as Litchi Seed (Litchi Nucis Pericarpium), Citrus Aurantium Fruit (Ju He), Fennel Seed (Xiao Hui Xiang), and Tang Qiu. By analogy: if the pathology is in the Blood level, use Peach Kernel (Tao Ren) and Corydalis Rhizome (Yan Hu Suo); if in the Qi level, use Immature Bitter Orange (Zhi Shi) and Green Tangerina Peel (Qing Pi); for Cold, use Aconite Root (Wu Tou); for Heat, use Gardenia Fruit (Zhi Zi); for Dampness, use Atractylodes Rhizome (Cang Zhu) to dry it; for Qi stagnation, use Cyperus Rhizome (Xiang Fu) to regulate it; for Deficiency, use Fenugreek Seed (Hu Lu Ba) to warm it.
However, these remedies apply primarily to lesions on the external kidneys. If nodules accumulate on the left and right of the Bladder, causing intermittent attacking pain and affecting the heart and abdomen, the aforementioned medicines cannot cure it. One must carefully examine the etiology regarding excess or deficiency, instruct the patient to avoid strenuous activities like horse riding, eliminate anger and frustration, abstain from sexual intercourse, and regulate the condition through quiet rest. Only after waiting for a period of time can recovery be achieved. Otherwise, blaming the medication shows a lack of understanding of medical principles.
Gardenia Decoction (Zhi Zi Tang): Treats Shan Qi (Hernia Qi) with pain and swelling, either on the left or right side.
Ingredients: Gardenia Fruit (Zhi Zi, 1 qian, stir-fried until black), Hawthorn Fruit (Shan Zha, 2 qian), Citrus Aurantium Fruit (Ju He, 1 qian), Litchi Seed (Li Zhi He, 1 qian), Alisma Rhizome (Ze Xie, 1 qian), Immature Bitter Orange (Zhi Shi, 1 qian), Angelica Sinensis Root Tail (Gui Wei, 1 qian), Poria (Fu Ling, 1 qian), Small Fennel Seed (Xiao Hui Xiang, 1 qian, baked in salt water), Bupleurum Root (Chai Hu, 0.7 fen).
Preparation: Decoct with ginger and water.
Atractylodes Decoction (Cang Zhu Tang): Treats testicular swelling and pain caused by Dampness stagnating into Heat.
Ingredients: Atractylodes Rhizome (Cang Zhu, 1 qian, processed with rice wash water), Kudzu Root (Ge Gen, 1 qian), Gardenia Fruit (Zhi Zi, 1 qian, stir-fried until black), Poria (Fu Ling, 1 qian), Alisma Rhizome (Ze Xie, 1 qian), Broad-leaved Mandarin Peel (Guang Pi, 1 qian), Hawthorn Fruit (Shan Zha, 2 qian).
Preparation: Decoct with a handful of Juncus Arter (Deng Xin) and one slice of ginger in water.
Kidney Qi Formula (Shen Qi Fang):
Ingredients: Small Fennel Seed (Xiao Hui Xiang), Psoralea Fruit (Bu Gu Zhi), Evodia Fruit (Wu Zhu Yu) (each 5 qian), Fenugreek Seed (Hu Lu Ba, 7.5 qian), Costus Root (Mu Xiang, 3.5 qian).
Preparation: Grind into powder. Make pills using juice extracted from crushed radish. Take with salt water.
Shan Pain Formula (Shan Tong Fang):
Ingredients: Hawthorn Fruit (Shan Zha, 4 liang, stir-fried), Immature Bitter Orange (Zhi He, stir-fried), Small Fennel Seed (Xiao Hui Xiang, stir-fried), Gardenia Fruit (Shan Zhi/Zhi Zi, stir-fried, each 2 liang), Bupleurum Root (Chai Hu), Moutan Cortex (Mu Dan Pi), Peach Kernel (Tao Ren, stir-fried, each 1 liang), Evodia Fruit (Wu Zhu Yu, stir-fried, 5 qian), Star Anise (Ba Jiao Hui Xiang, stir-fried, 1 liang).
Preparation: Grind into powder. Make pills using wine paste, size of Sophora seeds (Tong Zi Da). Take 50 pills per dose, empty stomach, with salt water.
Shan Formula (Shan Fang):
Ingredients: Arisaema Rhizome (Nan Xing), Hawthorn Fruit (Shan Zha), Atractylodes Rhizome (Cang Zhu) (each 2 liang), Angelica Dahurica Root (Bai Zhi), Pinellia Tuber (Ban Xia), Immature Bitter Orange (Zhi He), Medicated Leaven (Shen Qu) (each 1 liang), Sargassum (Hai Zao), Ecklonia/Kelp (Kun Bu) (each 5 qian), Mirabilite (Xuan Ming Fen), Evodia Fruit (Wu Zhu Yu) (each 2 qian).
Preparation: Grind into powder. Make pills using wine paste.
Formula for Treating Shan Pain with Abdominal Mass Pain:
Ingredients: Burreed Tuber (San Leng), Curcuma Rhizome (E Zhu) (boiled in vinegar), Stir-fried Medicated Leaven (Chao Qu), Turmeric (Jiang Huang), Arisaema Rhizome (Nan Xing) (each 1 liang), Hawthorn Fruit (Shan Zha, 2 liang), Costus Root (Mu Xiang), Agarwood (Chen Xiang), Cyperus Rhizome (Xiang Fu) (each 3 qian), Coptis Rhizome (Huang Lian, 5 qian, processed with Wu Zhu Yu), Radish Seed (Lai Fu Zi), Peach Kernel (Tao Ren), Gardenia Fruit (Zhi Zi), Immature Bitter Orange (Zhi He, stir-fried, each half liang).
Preparation: Grind into powder. Soak in ginger juice. Mix with steamed bread dough to make pills.
Danxi's Herbs for Seizing Pathogens in Shan Treatment:
Ingredients: Aconite Root (Wu Tou, finely sliced and stir-fried), Gardenia Seed (Zhi Zi Ren, stir-fried until black).
Preparation: Grind into powder. Adjust dosage as needed. Make pills with plain boiled water.