《内经》谓任脉为病，男子内结七疝，女人带下瘕聚；冲脉为气逆里急（云云）。又云∶少阴脉滑，
肺风疝；太阴脉滑，脾风疝；阳明，心风疝；太阳，肾风疝；少阳脉滑，肝风疝。由外邪入于木，木阳脏，
起动风也，
故滑脉曰风。然连称疝者，盖肾肝同居下焦，而足厥阴佐任脉之生化，固肝肾之气并逆，所以肾之阴
气为疝，肝之阳气为风。又有茎垂者，身中之机，阴阳之候，津液之道，或饮食不节，喜怒不时，津液内
溢，下流于睾，血道不通，血道不通则俯仰趋翔不便，又巢氏（云云）。而张戴人非之曰∶此俗工所立谬
名也。盖环阴器，上抵少腹，属足厥阴肝经部分，此是受病之处。或在泉寒胜木气，挛缩禁于此经；或司天
燥胜木气，抑郁于此经；或忿怒悲哀，忧抑顿锉；或药淋外固，闭尾缩精壅于此经，与膀胱、肾、小肠了
不相干也。且疝者，非肝木受邪，则肝木自甚也。由是于阴疝中亦立七名，曰寒疝、水疝、筋疝、血疝、气
疝、狐疝、 疝也。寒疝，囊冷结缩如石，阴茎不举，或连控丸而痛，得于坐卧湿地及砖石，或冬月涉水，
或值雨雪，或风冷处，使内过劳，宜以温剂下之，久而无子。水疝，肾囊肿痛，阴汗时出，囊肿如水品，
或囊痒搔出黄水，或小腹按之作水声，得之饮水醉酒，使内过劳，汗出而遇水寒，湿气聚于囊中，故水多
令人为卒疝，宜以逐水之剂下之。筋疝，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，得之于房室劳伤及邪术所使，宜以降心火之剂下之。血疝，状如黄瓜，在小腹
横骨两端约中，俗云便痈，得于重感春夏大燠，劳于使内，气血流溢渗入脬囊不去，结成痈肿，
脓少血多，宜以和血之剂下之。气疝，其状上连肾区，下及阴囊，或因号泣忿怒，郁而胀，怒号罢则气
散是也，宜以散气之剂下之。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，因而有此，乃胎病也，此病不治。狐疝，其状如丸，卧则入腹，行立则出小腹入囊中，狐则昼出穴而
溺，夜则入穴不溺，此疝出入上下往来，与狐相似，亦与气疝大同小异，今人带钩钤是也，宜以逐气疏
经之药下之。 疝，囊肿缒如升斗，不痒不痛是也，得之地气卑湿，故江淮湫溏之间多此，宜以去湿之剂
下之，诸下去后，可调则调，可补则补，各量病势，勿执俗法，经谓阴盛腹胀不通者， 癃疝也，不可不
下。虽然戴人既用《内经·灵枢》、《明堂》之论，止从足厥阴分，而不及任脉，盖因力辨阴器属厥
阴部分受病，故未暇及任脉也。其治法因病在下皆先下之，不问虚实，欠于周悉。丹溪常论睾丸连小腹急
痛者，或有形无形，或有声无声，人皆为经络得寒则收引不行而作痛，不知此痛始于湿热郁
遏至久，又感外寒，湿热被郁而作痛也。初致湿热之由，盖大劳则火起于筋，醉饱则火起于胃，
房劳则火起于肾，大怒则火起于肺，火郁之久，湿气便盛，浊液凝聚，并入血隧，流于厥阴，肝木性
急，火又暴烈，为寒所束，宜其病甚而暴也。此则发明戴人之未至。又 疝不离三者之邪，热则纵，
寒则痛，湿则肿，须分三者多少而治之。两丸俱病固然也，更有偏于一者。肾有两，分左右，左属水，
水生肝木，木生心火，三部皆司血，统纳左之血，肝木之职也；右属火，火生脾土，土生肺金，三部皆司气，
统纳右之气，肺金之职也。是故诸寒收引则血泣，所以寒血从而归肝，下注于左丸∶诸气 郁则湿聚，
所以气湿从而归肺，下注于右丸。且睾丸所络之筋非尽由厥阴，而太阳、阳明之筋亦入络也，往往见患偏
左则痛多肿少，偏右则痛少肿多，可验也。
一人病后饮水，病左丸痛甚，灸大敦，以摩腰膏摩囊上，上抵横骨，炙温帛覆之，痛即止，一宿
肿亦消。予旧有甘橘积，后山行饥甚，食橘、芋，橘动旧积，芋复滞气，实时寒热，右丸肿大。先服调胃
剂一二帖，次早注神使气至下焦，觉积动，呕逆，吐
之复吐，后和胃气、疏通经络而愈。
《黄帝内经》记载：任脉发生病变，男子会出现体内结聚的七种疝气，女子则会出现带下病和瘕聚（腹内结块）；冲脉病变会导致气逆、腹部拘急。又记载：少阴脉滑利，主肺风疝；太阴脉滑利，主脾风疝；阳明脉滑利，主心风疝；太阳脉滑利，主肾风疝；少阳脉滑利，主肝风疝。这是因为外邪侵入属木的肝脏（木对应五脏中的肝，为阳脏），引发风气起动，所以滑脉代表风邪。然而连续提到“疝”字，大概是因为肾和肝都位于下焦，且足厥阴肝经辅助任脉的气化功能，确实是肝肾之气同时上逆，所以肾的阴气表现为疝，肝的阳气表现为风。还有阴茎和阴囊，是人体机枢、阴阳变化的征候、津液运行的通道。如果饮食不节制，喜怒情绪失调，津液在体内溢出，向下流注到睾丸，导致血道不通，血道不通就会使身体俯仰行走不便，这是巢元方等人的观点。
而张从正（字戴人）反驳说：这是庸医创立的错误名称。环抱阴器，向上抵至小腹，属于足厥阴肝经的循行部位，这才是受病的所在。或者是寒水之气克制肝木之气，导致筋脉挛缩禁固于这条经脉；或者是燥金之气克制肝木之气，导致气机抑郁于这条经脉；或者是愤怒悲哀，忧思压抑导致气机顿挫；或者是药物淋洗外用固涩，导致闭精缩尿壅滞于这条经脉，与膀胱、肾、小肠完全没有关系。况且疝病，如果不是肝木受到邪气侵犯，就是肝木自身亢盛。因此他在阴疝中又设立了七个名称，分别是寒疝、水疝、筋疝、血疝、气疝、狐疝、㿉疝。
寒疝，表现为阴囊寒冷结缩如石头，阴茎不能勃起，或者牵引睾丸疼痛，多因坐卧湿地及砖石，或冬天涉水，或遇到雨雪，或在风冷处行房事过度劳累所致，应当用温里攻下的药剂治疗，否则久治不愈会导致无子。
水疝，表现为肾囊肿痛，阴部出汗时常流出，阴囊肿胀像装水的皮袋，或者阴囊瘙痒搔破后流出黄水，或者按压小腹有水声，多因饮水醉酒，行房事过度劳累，出汗后遇水寒，湿气聚集在阴囊中，所以水湿过多会让人突发疝气，应当用逐水攻下的药剂治疗。
筋疝，表现为阴茎肿胀，或者溃烂，或者有脓，或者疼痛且内部拘急筋脉收缩，或者尿道中疼痛，痛极则痒，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，多因房劳损伤及邪术所致，应当用清降心火的药剂治疗。
血疝，形状像黄瓜，位于小腹横骨两端中间，俗称便痈，多因再次感受春夏大热，房事过度劳累，气血流溢渗入膀胱和阴囊不去，结成痈肿，脓少血多，应当用调和血分的药剂治疗。
气疝，其形状上连肾区，下及阴囊，或因号泣愤怒，气机郁结而胀满，怒号停止后气散即消，应当用理气散气的药剂治疗。小儿也有此病，俗称为偏气，多因父亲年老，或年少多病，阳痿精怯，强行入房，因而有此病，属于胎病，这种病难以治愈。
狐疝，其形状像丸状物，躺下时进入腹腔，站立行走时从小腹进入阴囊，狐狸白天出穴排尿，晚上回穴不排尿，这种疝气出入上下往来，与狐狸相似，也与气疝大同小异，就是现代人佩戴钩钤（一种固定器具）所治的病，应当用逐气疏经的药物治疗。
㿉疝（pī shàn），阴囊肿坠如升斗大小，不痒不痛，多因地势低洼潮湿，所以江淮低洼积水之地多见此病，应当用祛湿的药剂治疗。以上各种疝气，在使用攻下法之后，能调理的就调理，能补益的就补益，各根据病情轻重，不要拘泥于世俗的方法。经文说阴气盛导致腹胀不通的是癃疝，不可不用攻下法。
虽然张戴人引用了《黄帝内经·灵枢》和《明堂》的论述，只从足厥阴肝经分部论治，而没有涉及任脉，大概是因为他极力辩驳阴器属于厥阴部分受病，所以没来得及提及任脉。他的治疗方法因为病位在下，都先用攻下法，不分虚实，欠缺周全细致。朱丹溪常论述睾丸连接小腹急痛的，无论有形无形，有声无声，人们都认为经络受寒导致收敛牵引不行而作痛，不知道这种疼痛始于湿热郁遏日久，又感受外寒，湿热被郁结而作痛。最初导致湿热的原因，大概是过度劳累则火起于筋，醉饱则火起于胃，房劳则火起于肾，大怒则火起于肺，火郁积久了，湿气就旺盛，浊液凝聚，并入血脉隧道，流注于厥阴经，肝木性急，火又暴烈，被寒气束缚，所以病情严重且发作急骤。这是对张戴人理论未完善之处的补充。另外，㿉疝不离风、寒、湿三者之邪，热则松弛，寒则疼痛，湿则肿胀，必须区分这三者的多少来治疗。两丸都患病固然有之，更有偏于一侧的。肾有两个，分左右，左属水，水生肝木，木生心火，三部都主管血，统纳左侧的血，是肝木的职责；右属火，火生脾土，土生肺金，三部都主管气，统纳右侧的气，是肺金的职责。所以各种寒邪导致收敛牵引则血液凝涩，因此寒血随之归肝，向下注入左侧睾丸；各种气机郁结则湿气聚集，因此气湿随之归肺，向下注入右侧睾丸。而且睾丸所联络的筋脉并不全由厥阴经主导，太阳、阳明经的筋脉也进入络属。往往见到患侧在左边则疼痛多肿胀少，患侧在右边则疼痛少肿胀多，可以验证这一点。
有一人病后饮水，左侧睾丸疼痛剧烈，灸大敦穴，用摩腰膏按摩阴囊上方，上抵横骨，用温热的帛布覆盖，疼痛立即停止，一宿后肿胀也消退。我过去有甘橘积滞的旧疾，后来在山中行走非常饥饿，吃了橘子、芋头，橘子动摇了旧的积滞，芋头又阻滞了气机，当时出现寒热症状，右侧睾丸肿大。先服用调理胃气的药剂一二帖，第二天早上通过意念引导使气到达下焦，感觉积滞松动，产生呕吐逆意，吐了又吐，后来调和胃气、疏通经络而痊愈。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When the Ren Mai (Conception Vessel) is diseased, men suffer from seven types of internal hernia (Shan), and women suffer from leukorrhea and Jia Ju (abdominal masses); when the Chong Mai (Penetrating Vessel) is diseased, it causes Qi rebellion and abdominal urgency. It further states: A slippery pulse at Shaoyin indicates Lung Wind Shan; a slippery pulse at Taiyin indicates Spleen Wind Shan; [a slippery pulse at] Yangming indicates Heart Wind Shan; [a slippery pulse at] Taiyang indicates Kidney Wind Shan; a slippery pulse at Shaoyang indicates Liver Wind Shan. This is because external pathogens enter the Wood organ (Liver, which corresponds to Wood and is a Yang organ), stirring up Wind, hence a slippery pulse signifies Wind. However, the repeated mention of "Shan" likely exists because the Kidney and Liver both reside in the Lower Jiao, and the Foot-Jueyin Liver Meridian assists the Ren Mai in generating and transforming Qi. Indeed, it is the simultaneous rebellion of Kidney and Liver Qi that manifests as Shan due to Kidney Yin Qi and Feng (Wind) due to Liver Yang Qi. Furthermore, the penis and scrotum are the mechanism of the body, indicators of Yin and Yang, and pathways for fluids. If diet is irregular, or emotions like joy and anger are untimely, fluids overflow internally and flow downward to the testicles. If the blood channels are blocked, mobility such as bending, stretching, walking, and flying becomes inconvenient. This is the view of Chao Yuanfang et al.
However, Zhang Congzheng (courtesy name Dairen) refutes this, stating: These are erroneous names established by mediocre physicians. The area surrounding the genitalia, extending upward to the lower abdomen, belongs to the Foot-Jueyin Liver Meridian; this is where the disease resides. It may be that Cold Water Qi overcomes Wood Qi, causing spasms and constriction in this meridian; or Dryness Metal Qi overcomes Wood Qi, causing depression in this meridian; or anger and sorrow cause Qi stagnation and frustration; or external astringent treatments cause closure and retention of essence, blocking this meridian. It has nothing to do with the Bladder, Kidney, or Small Intestine. Moreover, Shan disease involves either the Liver Wood being invaded by pathogens or the Liver Wood becoming excessive itself. Therefore, he established seven names within Yin Shan: Han Shan (Cold Shan), Shui Shan (Water Shan), Jin Shan (Sinew Shan), Xue Shan (Blood Shan), Qi Shan (Qi Shan), Hu Shan (Fox Shan), and Pi Shan (Flaccid Shan).
Han Shan (Cold Shan): The scrotum is cold, hard, and contracted like stone; the penis does not erect; pain may radiate to the testicles. It results from sitting/lying on wet ground or bricks, wading in winter, exposure to rain/snow/wind-cold, or excessive sexual exertion. Treatment requires warming and purgative formulas; otherwise, infertility may result.
Shui Shan (Water Shan): Swelling and pain of the scrotal sac; intermittent sweating from the yin region; the scrotum swells like a water-filled bag; itching may yield yellow fluid; pressing the lower abdomen produces a water sound. It results from drinking alcohol/water excessively, sexual exhaustion, sweating followed by exposure to cold water, leading to dampness accumulation in the scrotum. Excess water can cause sudden Shan. Treatment requires diuretic and purgative formulas.
Jin Shan (Sinew Shan): Swelling of the penis, ulceration, pus formation, pain with internal tension and sinew contraction, penile pain that becomes itchy when severe, priapism, or white discharge resembling semen during urination. It results from sexual exhaustion or malicious arts. Treatment requires formulas that descend Heart Fire.
Xue Shan (Blood Shan): Shape resembles a cucumber, located between the two ends of the Henggu acupoint in the lower abdomen, commonly called Bian Yong (urinary abscess). It results from exposure to extreme heat in spring/summer combined with sexual exhaustion, causing Qi and Blood to overflow into the bladder and scrotum, forming an abscess with little pus and much blood. Treatment requires blood-nourishing and regulating formulas.
Qi Shan (Qi Shan): Extends from the kidney region to the scrotum. It arises from weeping or anger, causing Qi stagnation and distension; the distension resolves when the emotional outburst ceases and Qi disperses. Treatment requires Qi-dispersing formulas. Children also suffer from this,俗称 Pian Qi (Lateral Qi), often due to an aged father, or a young father who was frequently ill, impotent, or weak in essence, engaging in forced intercourse. This is a congenital defect and is difficult to cure.
Hu Shan (Fox Shan): Resembles a ball; retracts into the abdomen when lying down, and protrudes from the lower abdomen into the scrotum when standing or walking. Like a fox that exits its burrow to urinate by day and returns without urinating by night, this Shan moves up and down, similar to Fox behavior, and is closely related to Qi Shan. It corresponds to conditions treated with hooks or supports today. Treatment requires formulas that expel Qi and unblock meridians.
Pi Shan (Flaccid Shan): The scrotum hangs heavily like a measuring vessel, without itching or pain. It results from low-lying, damp environments, common in the Jianghuai region. Treatment requires damp-draining formulas. After using purgatives for these conditions, one should regulate or tonify according to the condition, avoiding rigid adherence to folk methods. The Classics state that Yin excess causing abdominal distension and blockage is Long Shan (Urine Retention Shan), which must be purged.
Although Zhang Dairen cited the *Lingshu* chapter of the *Neijing* and the *Mingtang*, focusing solely on the Foot-Jueyin division and neglecting the Ren Mai, it was because he strongly argued that the genitalia belong to the Jueyin domain. His treatment method, applying purgatives indiscriminately regardless of deficiency or excess due to the lower location of the disease, lacked thoroughness. Zhu Danxi often discussed pain connecting the testicles and lower abdomen, whether palpable or not, audible or silent. People attribute this to Cold contracting the meridians, but fail to realize the pain originates from long-standing Damp-Heat stagnation exacerbated by external Cold. The initial cause of Damp-Heat is: fatigue generates Fire in the sinews; drunkenness/full meals generate Fire in the Stomach; sexual excess generates Fire in the Kidneys; great anger generates Fire in the Lungs. Prolonged Fire stagnation leads to abundant Dampness; turbid fluids condense and enter the blood vessels, flowing into the Jueyin channel. Since Liver Wood is swift and Fire is fierce, constrained by Cold, the disease becomes severe and acute. This elaborates on Zhang Dairen's omissions. Furthermore, Pi Shan involves Wind, Cold, and Dampness: Heat causes flaccidity, Cold causes pain, Dampness causes swelling. One must distinguish their proportions. While both testicles can be affected, unilateral involvement is also common. The Kidneys are paired, left and right. The Left belongs to Water, which generates Liver Wood, which generates Heart Fire; all three govern Blood, and the Liver manages the Blood on the left. The Right belongs to Fire, which generates Spleen Earth, which generates Lung Metal; all three govern Qi, and the Lung manages the Qi on the right. Thus, Cold causing contraction leads to blood stasis, so Cold-Blood follows the Liver and descends to the left testicle. Qi stagnation leads to Dampness accumulation, so Qi-Dampness follows the Lung and descends to the right testicle. Moreover, the tendons connecting the testicles are not exclusively Jueyin; Taiyang and Yangming tendons also connect. Often, left-sided lesions present with more pain and less swelling, while right-sided lesions present with less pain and more swelling, which serves as verification.
A patient suffered severe pain in the left testicle after drinking water post-illness. Da Dun (LR1) was moxibusted, and Yao Gao (Waist Rubbing Paste) was applied to the scrotum up to Henggu (ST30), covered with warm cloth. Pain ceased immediately, and swelling subsided overnight. I previously had a chronic accumulation from citrus fruits. Once, while hiking and starving, I ate oranges and taro. The oranges disturbed the old accumulation, and the taro stagnated Qi, causing immediate chills and fever, and swelling of the right testicle. I first took one or two doses of Tiao Wei (Regulate the Stomach) formula. The next morning, I used Yishi (Mind Instruction) to guide Qi to the Lower Jiao. Feeling the accumulation move, I experienced retching and vomiting repeatedly. Finally, harmonizing the Stomach Qi and unblocking the meridians led to recovery.