李 疝病不离乎肝。然经谓任脉为病，男子内结七疝，女子带下瘕聚，皆奇经主之。宿病不理，奇脉病
结不解，今触寒辄发，动气有声，痛引睾丸。宜导滞通络，仿茴香丸。小茴、橘核、葫芦巴、延胡（俱酒炒）、
当归、鹿角胶，和丸，酒下效。
王 由吞酸传为少腹偏坠，囊肿丸痛。夫酸为肝郁，气注下为疝，皆湿热之邪。经云∶邪客于足厥阴之
络，令人卒疝暴痛，以肝脉络阴器也。子和治疝，用金铃子散，泄肝导逆，与此颇符。用吴茱萸、川楝子、
橘核、茯苓、青皮、延胡、青葱管、木通，数服而安。
赵 疝发自下，冲上猝痛，下引睾丸，此七疝中冲疝也。经言督脉生病，从少腹上冲心，而痛不得前
后为冲疝。用山栀、川楝子（去核酒炒）、荔枝核、橘核、延胡（俱酒焙）、当归、赤苓、降香。夫暴疝多寒，
久疝多热，异热疏滞，肿痛自已。
王 腹左偏坠，睾丸肿痛，寝息略定，乃举重劳力所致。盖肝脉络阴器，络虚努挣，气穿入囊，延久则
成筋疝。古人治疝，必用辛香流动之品。以肝得疏泄，其痛乃缓，服药兼宜节劳。香附（盐制）、升麻、小茴
香、橘核、延胡（酒焙）、丝瓜筋、薏米，长流水煎二服愈。
吕 因劳偏坠，脉软弱，少年宿 ，补以升之。潞参（三钱）、鹿角霜、炙黄 、当归、杜仲、熟地、杞子
（焙。各二钱）、升麻（六分）、橘核（酒炒），续断（各钱半）、姜、枣煎。十服效。
李：疝病与肝经密切相关。然而《内经》记载，任脉发生病变，男子会出现内结七种疝气，女子则出现带下及瘕聚（腹内结块），这些都属于奇经八脉主管的范畴。若旧疾未加调理，奇经脉络的病邪郁结不解，如今一受寒邪刺激就会发作，气动时伴有声响，疼痛牵引至睾丸。治疗宜采用疏导积滞、疏通经络的方法，仿照茴香丸的方义。药用小茴香、橘核、葫芦巴、延胡索（均用酒炒制）、当归、鹿角胶，制成丸剂，用酒送服效果良好。
王：病情由吞酸发展而来，进而导致少腹部偏向一侧的下坠感，阴囊肿胀且睾丸疼痛。酸味源于肝气郁结，气机下行注入下部形成疝气，这多属于湿热之邪所致。《内经》说：“邪气客居在足厥阴肝经的络脉，使人突然患疝并剧烈疼痛”，这是因为肝经络脉联络生殖器。金元四大家之一张子和治疗疝气，使用金铃子散，以疏泄肝火、引导逆乱之气，这与本病例颇为相符。药用吴茱萸、川楝子、橘核、茯苓、青皮、延胡索、青葱管、木通，服用数剂后病情安定。
赵：疝气发于下部，气冲向上突然疼痛，向下牵引睾丸，这是七疝中的“冲疝”。经文说督脉生病，气从少腹上冲至心脏，且疼痛导致前后二便不通畅，称为冲疝。药用山栀、川楝子（去核后用酒炒）、荔枝核、橘核、延胡索（均用酒焙干）、当归、赤茯苓、降香。一般来说，突发性的疝气多因寒邪所致，久治不愈的疝气多转化为热证，通过异其性质以疏散滞气，肿痛自然消除。
王：腹部左侧偏坠，睾丸肿胀疼痛，睡眠休息时稍感缓解，这是由于举重和过度劳累所致。因为肝经络脉联络生殖器，络脉空虚时用力努挣，气机穿入阴囊，拖延日久则形成筋疝。古人治疗疝气，必定使用辛香流动的药物。因为肝喜条达疏泄，气机通畅后疼痛才能缓解，服药期间也应当注意节制劳累。药用香附（盐制）、升麻、小茴香、橘核、延胡索（酒焙干）、丝瓜筋、薏苡仁，用长流水煎煮，服用两剂痊愈。
吕：因劳累导致身体偏坠，脉象软弱无力，少年时期有宿疾，治疗宜用补益兼升提的方法。药用潞党参（三钱）、鹿角霜、炙黄芪、当归、杜仲、熟地黄、枸杞子（焙干，各二钱）、升麻（六分）、橘核（酒炒）、续断（各钱半），加入生姜、大枣煎服。服用十剂后见效。
Li: Shan disease is closely related to the Liver channel. However, the Classics state that when the Ren Mai (Conception Vessel) is diseased, men suffer from seven types of internal Shan accumulation, and women experience leukorrhea and Jia Ju (abdominal masses), all of which are governed by the Extraordinary Vessels. If old ailments are not managed, the pathogenic stagnation in the Extraordinary Vessels remains unresolved. Now, exposure to cold triggers an attack, accompanied by audible Qi movement and pain radiating to the testicles. Treatment should focus on guiding out stagnation and unblocking collaterals, following the principle of Huixiang Wan (Fennel Pill). The prescription includes Xiao Hui Xiang (Foeniculum Vulgare Fruit), Ju He (Citrini Semen), Hulu Ba (Trigonellae Semen), Yan Hu Suo (Corydalis Rhizoma, all stir-fried with wine), Dang Gui (Angelicae Sinensis Radix), and Lu Jiao Jiao (Colla Cornus Cervi). These are made into pills and taken with wine for good effect.
Wang: The condition progressed from acid regurgitation to a dragging sensation in the lower abdomen on one side, with swelling of the scrotum and pain in the testicles. Sourness arises from Liver Qi stagnation; when Qi sinks downward into the lower jiao, it forms Shan, which is often caused by Damp-Heat pathogens. The Classics say: "When pathogenic factors lodge in the Luo vessels of the Foot-Jueyin (Liver) channel, sudden Shan and acute pain occur," because the Liver channel connects to the genitalia. Zhang Zihe treated Shan using Jin Ling Zi San (Chuanlinsan), to drain the Liver and guide rebellious Qi downward, which aligns well with this case. The prescription consists of Wu Zhu Yu (Evodiae Fructus), Chuan Lian Zi (Meliae Toosendan Fructus), Ju He (Citrini Semen), Fu Ling (Poria), Qing Pi (Citri Reticulatae Pericarpium Viride), Yan Hu Suo (Corydalis Rhizoma), Qing Cong Guan (Allii Fistulosi Caulis), and Mu Tong (Akebiae Caulis). After several doses, the patient stabilized.
Zhao: The Shan originates from below, with Qi rushing upward causing sudden pain, and downward radiation to the testicles. This is the "Chong Shan" among the seven types of Shan. The Classics state: "When the Du Mai (Governing Vessel) is diseased, Qi rushes from the lower abdomen up to the heart, and pain prevents normal urination and defecation, called Chong Shan." The prescription includes Shan Zhi (Gardeniae Fructus), Chuan Lian Zi (Meliae Toosendan Fructus, pitted and wine-fried), Li Zhi He (Litchi Seed), Ju He (Citrini Semen), Yan Hu Suo (Corydalis Rhizoma, all wine-baked), Dang Gui (Angelicae Sinensis Radix), Chi Ling Shen (Polyporus cum Mycelium), and Jiang Xiang (Dalbergiae Odoriferae Lignum). Generally, acute Shan is mostly due to Cold, while chronic Shan tends toward Heat. By addressing the heat/cold nature to disperse stagnation, swelling and pain will resolve spontaneously.
Wang: There is a dragging sensation on the left side of the abdomen, with swollen and painful testicles, slightly relieved during sleep. This was caused by heavy lifting and overexertion. Since the Liver channel connects to the genitalia, when the Luo vessels are deficient and strain occurs, Qi penetrates into the scrotum. Prolonged duration leads to Jin Shan (Sinew Shan). Ancients treating Shan always used pungent, aromatic, and moving herbs. Because the Liver prefers free flow and discharge, pain subsides only when Qi moves freely. During medication, physical exertion should be restrained. The prescription includes Xiang Fu (Cyperi Rhizoma, salt-processed), Sheng Ma (Ephedrae Caulis or Cimicifugae Rhizoma - *Note: Context implies Cimicifugae for lifting*, but usually Sheng Ma refers to Ephedrae in some contexts or Cimicifugae in others; here likely Cimicifugae for lifting Qi given the context of prolapse, but strictly translating name as Sheng Ma*), Xiao Hui Xiang (Foeniculum Vulgare Fruit), Ju He (Citrini Semen), Yan Hu Suo (Corydalis Rhizoma, wine-baked), Si Gua Jin (Luffae Fibroreticulata Retinervium), and Yi Mi (Coicis Semen). Decocted in long-flowing water, two doses resulted in cure.
Lv: Due to labor-induced dragging sensation, with weak and soft pulse. As there is a childhood history of illness, treatment requires tonification combined with lifting. The prescription includes Lu Shen (Codonopsis Radix, 3 qian), Lu Jiao Shuang (Cornu Cervi Degelatinatum), Zhi Huang Qi (Astragali Radix, honey-fried), Dang Gui (Angelicae Sinensis Radix), Du Zhong (Eucommiae Cortex), Shu Di Huang (Rehmanniae Radix Praeparata), Qi Zi (Lycii Fructus, baked, each 2 qian), Sheng Ma (Cimicifugae Rhizoma, 6 fen), Ju He (Citrini Semen, wine-fried), and Xu Duan (Dipsaci Radix, each 1.5 qian). Decocted with Jiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus). Ten doses showed efficacy.