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置雨雪或坐卧
砖石或风冷处使内过劳宜以温剂下之久而无子
水疝其状肾囊肿痛阴汗时出或囊肿而状如水晶或囊痒而操其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
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
血疝其状如黄瓜在少腹两傍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
气疝其状上连肾区下及阴囊或因号哭忿怒则气郁之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疝不治惟筑宾一穴言之
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
疝其状阴囊肿缒如升如斗不痒不痛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
按以上所论病本经络之原至为详尽但七疝名固不同治法当异然俱用攻下之法愚窃疑焉虽
仲阳
亦曰肝为相火有泻无补丹溪有曰肝只是有余肾只是不足夫厥阴一经受疝宜通勿塞固宜亦当视
其浅深而行之可也况有邪气止客于膀胱小肠之经者若干于少阴肾经则宜通勿塞之法可例用乎
诸疝治法
寒疝的症状表现为阴囊寒冷、结块坚硬如石头，阴茎不能勃起，有时牵引睾丸疼痛。这是由于坐卧湿地，或在寒冷月份涉水，或坐在雨雪中，或坐卧砖石及风冷之处，以及房事过度劳累所致。治疗应当使用温性药剂进行攻下。若久治不愈，可能导致不育。
水疝的症状表现为肾囊肿痛，阴部出汗时常流出，或者囊肿透明状如水泡，或者囊痒且擦拭时有黄水渗出，或者按压少腹部时能听到水声。这是由于饮酒醉酒、房事过度劳累，汗出后遭遇风寒湿邪气，湿气聚集于阴囊中，导致水液过多引发突然发作的疝气。治疗应当使用逐水药剂进行攻下。也有用漏针法排水的，但大多数人不得其法。
筋疝的症状表现为阴茎肿胀，或者溃烂流脓，或者疼痛且伴有里急后重感、筋脉收缩，或者尿道内疼痛，痛极时发痒，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。这是由于房室劳伤及邪术所致。治疗应当使用清降心火的药剂进行攻下。
血疝的症状表现为肿块形状像黄瓜，位于少腹两侧横骨两端之间，俗称“便痈”。这是由于再次感受春夏大热之气，房事过度，气血流溢渗入膀胱和阴囊，停留不去，结成痈肿，脓少血多。治疗应当使用调和血分的药剂进行攻下。
气疝的症状表现为上部连接肾区，下部到达阴囊，或者因为号哭、愤怒导致气机郁滞而胀满，怒哭号叫停止后气机消散则症状缓解。有一种治疗方法是用针刺出气而痊愈，但针刺有得失之分，宜使用散气的药物进行攻下。小儿也可能患有此病，俗称“偏气”，这是由于父亲年老或年少多病、阳痿精怯，却强力入房因而受孕，胎儿在胎中即有病。此疝难以治愈，只有筑宾穴这一穴位的治疗有所记载。
狐疝的症状表现为肿块像瓦片，躺卧时进入小腹，站立行走时从小腹进入阴囊。狐狸白天出洞排尿，夜晚回洞不排尿，此疝出入上下往来，正与狐狸习性相似。这也与气疝大同小异，就是今人佩戴钩钤（一种固定器具）所治疗的疾病。治疗应当使用驱逐气流经的药物进行攻下。
疝（此处指特指的一种湿疝，非泛指）的症状表现为阴囊肿垂如升如斗，不痒不痛。这是由于地气卑湿所生，所以江淮之间低洼潮湿的地方多感染此疾。治疗应当使用祛湿的药物进行攻下。女子阴户突出虽也属此类，但属于热证导致固摄不禁，不可简单认为是虚寒而使用收敛、燥湿、补益的方法。本名叫做“瘕”，应当使用苦味药攻下，并用苦味药坚阴。
按：以上所论述的病本经络之源，非常详尽。但七疝名称固然不同，治法应当各异，然而都使用攻下的方法，我私下对此表示怀疑。虽然钱仲阳也说肝为相火，有泻无补；朱丹溪说肝只是有余，肾只是不足。厥阴经受疝，适宜通利勿闭塞，这固然正确，但也应当视病情深浅而行。况且如果有邪气只客居于膀胱、小肠之经，若干涉到少阴肾经，那么“宜通勿塞”的方法可以一概使用吗？诸疝治法。
Cold Hernia (Han Shan) presents with a cold, hard, stone-like scrotal mass, impotence, and pain radiating to the testicles. It is caused by sitting or lying on damp ground, wading in water during cold months, exposure to rain and snow, sitting on bricks or stones, exposure to wind-cold, or excessive sexual activity leading to fatigue. Treatment should employ warm purgative formulas. If left untreated for a long time, it may lead to infertility.
Water Hernia (Shui Shan) presents with swelling and pain of the spermatic cord/scrotum, spontaneous sweating from the genital area, translucent cysts resembling crystal blisters, itching with yellow discharge upon wiping, or a splashing sound upon palpation of the lower abdomen. It results from alcohol intoxication, excessive sexual activity causing sweating followed by exposure to wind-cold-dampness, leading to fluid accumulation in the scrotum. This excess fluid causes acute hernia attacks. Treatment should employ diuretic purgative formulas. Some use needle drainage to remove fluid, but many lack proper technique.
Sinew Hernia (Jin Shan) presents with penile swelling, ulceration, suppuration, pain with tenesmus and sinew retraction, urethral pain that becomes itchy when severe, persistent erection without flaccidity, or white discharge resembling semen passing with urine. It is caused by sexual exhaustion and pathogenic influences. Treatment should employ formulas that clear and descend Heart Fire.
Blood Hernia (Xue Shan) presents with a cucumber-shaped mass located between the ends of the pubic bones on both sides of the lower abdomen, commonly known as "Bian Yong" (Perineal Abscess). It results from repeated exposure to intense heat in spring and summer, excessive sexual activity causing Qi and Blood to overflow and infiltrate the bladder and scrotum, stagnating and forming an abscess with little pus and much blood. Treatment should employ formulas that harmonize the Blood.
Qi Hernia (Qi Shan) presents with swelling extending from the Kidney region down to the scrotum, exacerbated by crying or anger due to Qi stagnation, and relieved when the emotional outburst subsides and Qi disperses. One treatment method involves acupuncture to release Qi, though success varies; pharmacologically, Qi-dispersing purgatives are indicated. Children may also suffer from this,俗称 "Pian Qi" (Lateral Hernia), attributed to conception when the father was old, ill, impotent, or had weak essence but engaged in forceful intercourse. This condition is difficult to cure; only the acupoint Zhubin (KI9) has specific therapeutic records.
Fox Hernia (Hu Shan) presents with a mass resembling a tile that enters the lower abdomen when lying down and descends into the scrotum when standing or walking. Similar to a fox that urinates outside its den during the day but not at night, this hernia moves up and down, mirroring the fox's behavior. It is similar to Qi Hernia and corresponds to conditions treated with modern supportive belts/hooks. Treatment should employ formulas that expel Qi and unblock meridians.
Damp Hernia (referred to simply as "Shan" in context, distinct from general hernia) presents with a pendulous scrotum like a measuring cup or bucket, without itching or pain. It arises from low-lying damp earth qi, common in the marshy regions of Jianghuai. Treatment should employ damp-resolving purgatives. In women, vaginal prolusion may present similarly but is due to Heat failing to secure containment; it should not be mistaken for Deficiency-Cold and treated with astringents, drying agents, or tonics. Originally termed "Jia" (Mass), it should be treated with bitter purgatives and bitter-astringents.
Commentary: The above discussion details the meridian origins of these diseases thoroughly. Although the names of the Seven Hernias differ and treatments should vary, all employ purgative methods, which I question. Qian Zhongyang stated that the Liver is Ministerial Fire, requiring draining rather than tonifying. Zhu Danxi stated that the Liver is always in excess, while the Kidney is always deficient. For Jueyin Meridian hernias, unblocking without obstructing is appropriate, yet one must consider the depth of the pathology. Furthermore, if pathogens reside only in the Bladder and Small Intestine meridians, does the principle of "unblocking Jueyin" apply universally? Methods for treating various hernias.