(茎之垂也)属足厥阴肝经(《素问》曰∶厥阴之脉,循阴器而络于肝,故烦满而囊缩。
张仲景曰∶伤寒六日,厥阴受病,故舌卷囊缩。《灵枢》曰∶厥阴者肝脉也,脉弗荣,则筋急,筋急则引舌与
卵,故唇青,舌卷,卵缩。又曰∶茎垂者,身中之藏,阴精之候,津液之道。故饮食喜怒不时,津液内溢,乃
下留于睾,血道不通,日大不休,俯仰不便,趋翔不能也)。
(阴丸也)属足厥阴肝经(《灵枢》曰∶足厥阴之别,循茎上睾,结于茎。其病气逆,则睾
肿卒疝,实则挺长,虚则暴痒。《素问》曰∶邪客于足厥阴之络,令人卒疝暴痛。朱丹溪曰∶疝气者,睾丸连
小腹急痛也,有痛在睾丸者,有痛在带脉下二寸五枢穴旁者,或无形无声,或有形如瓜,或有声如蛙者皆是。
此专主肝经,与肾经绝无干涉,自《素问》而下,皆以为寒也。然寒主收引,经络得寒,则引而不行,所以
作痛。殊不知此症,始于湿热在经,郁而至久,又得寒气外束,不得疏散,故痛。若但作寒论,恐为未备,常
见蹈水涉水,而终身不病此者,无热在内故也。或问厥阴经郁积湿热,何由而致?曰∶大劳则火起于脾,醉饱
则火起于胃,房劳则火起于肾,大怒则火起于肝。火积之久,子能令母虚,湿气便盛,浊液凝聚,并入血隧,
流于厥阴。肝为将军之官,其性急速,火性又暴,为寒所束,宜其痛之急也)。又属足少阴肾经(缪仲淳曰∶
疝为肾虚,寒湿之邪,乘虚客之所致,丹溪以谓与肾无干,未尽然也。但有先因湿邪为病,后成湿热者,药
宜分寒热先后二途为得也)。
(阴茎下垂的部分)归属于足厥阴肝经。《素问》说:厥阴经脉,循行经过阴器并联络肝脏,所以会出现烦闷胀满和睾丸收缩的症状。张仲景说:伤寒病到了第六天,厥阴经受邪发病,所以出现舌头卷曲和睾丸收缩。《灵枢》说:厥阴就是肝的经脉,如果经脉气血不能濡养,就会导致筋脉拘急,筋脉拘急就会牵引舌头和睾丸,所以出现嘴唇发青、舌头卷曲、睾丸上缩。又说:阴茎和阴囊是身体中的藏精之所,是阴精的外候,也是津液运行的通道。因此,如果饮食起居或情绪喜怒没有节制,津液就会在体内溢出,进而向下积聚在睾丸,导致血道不通畅,睾丸日渐肿大不止,导致弯腰转身不便,快跑行走困难。
(阴囊内的睾丸)归属于足厥阴肝经。《灵枢》说:足厥阴肝经的别络,沿着阴茎上行至睾丸,结聚于阴茎。如果这条经络的气机逆乱,就会出现睾丸肿胀突然发作的疝气;如果是实证,则表现为阴茎勃起持久不倒;如果是虚证,则表现为突然剧烈的瘙痒。《素问》说:邪气侵犯足厥阴肝经的络脉,会导致人突然发生疝气和剧烈疼痛。朱丹溪说:疝气,是指睾丸连带小腹部的紧急疼痛。有的疼痛部位在睾丸,有的疼痛部位在带脉下方二寸五枢穴旁边。有的没有形状也没有声音,有的形状像瓜一样有形,有的发出像青蛙一样的声音,这些都是疝气的表现。这些症状专门与肝经有关,与肾经完全没有关系。从《素问》以来的医家,都认为是寒邪所致。然而,寒邪主收敛牵引,经络遇到寒邪,就会被牵引而气血运行不畅,所以产生疼痛。殊不知这种病症,起始于经络中有湿热郁结,日久不散,再加上外部寒气束缚,导致湿热不得疏散,从而引起疼痛。如果仅仅将其归结为寒证,恐怕考虑得不够周全。常见有人常年涉水游泳,却终身不患此病,这是因为他们体内没有热邪的缘故。有人问:厥阴经中郁积的湿热,是如何产生的呢?回答说:过度劳累则火气生于脾,醉酒饱食则火气生于胃,房事过度则火气生于肾,大怒则火气生于肝。火气积聚久了,子脏(肝)会令母脏(肾)虚弱,湿气便随之旺盛,浊液凝聚,并入血脉隧道,流注于厥阴经。肝被称为将军之官,其性质急躁,火性又猛烈,被寒气所束缚,所以疼痛发作得非常急骤。
(睾丸部分)又归属于足少阴肾经。缪仲淳说:疝气是由于肾虚,寒湿之邪乘虚侵入所致。朱丹溪认为与肾无关,这种说法并不完全正确。但是,有先因湿邪致病,后来转化为湿热的情况,用药应当根据寒热先后不同阶段来区分治疗,这样才得当。
(The hanging part of the penis) belongs to the Foot-Jueyin Liver Meridian (Zu Jueyin Gan Jing). *Suwen* states: The Jueyin meridian runs through the genitalia and connects with the liver; therefore, one may experience irritability, fullness, and retraction of the scrotum. Zhang Zhongjing stated: In cold damage diseases, on the sixth day, when the Jueyin is affected, it results in tongue curling and testicular retraction. *Ling Shu* states: Jueyin refers to the Liver meridian. If the meridian fails to nourish, tendons become tight; tight tendons pull on the tongue and the testes, resulting in cyanotic lips, a curled tongue, and retracted testes. It further states: The penis and scrotum are the reservoirs within the body, indicators of Yin essence, and pathways for fluids. Thus, if diet, emotions, or daily activities are irregular, fluids overflow internally and accumulate downward in the testes. This leads to blocked blood channels, causing progressive enlargement without cessation, making bending and turning difficult, and hindering running and walking.
(The testicles, also known as the "Yin Wan") belong to the Foot-Jueyin Liver Meridian (Zu Jueyin Gan Jing). *Ling Shu* states: The collateral branch of the Foot-Jueyin ascends along the penis to the testes, where it knots at the penis. If Qi rebels in this channel, it causes sudden swelling of the testes and acute hernia (Shan); in excess conditions, it manifests as persistent erection; in deficiency conditions, it manifests as sudden severe itching. *Suwen* states: When pathogenic factors invade the collaterals of the Foot-Jueyin, they cause sudden hernia and acute pain. Zhu Danxi stated: Hernia refers to urgent pain connecting the testes and the lower abdomen. Some pain is located in the testes, while other pain is located two cun below the Dai Mai (Girdle Vessel), beside the Wushu (GB26) acupoint. Some present without shape or sound, some have a shape like a melon, and some produce sounds like frogs; all these are manifestations of hernia. These conditions are specifically related to the Liver Meridian and have absolutely no connection with the Kidney Meridian. Since *Suwen*, physicians have generally attributed them to Cold. However, Cold governs contraction and pulling; when meridians encounter Cold, they contract and stagnate, thus causing pain. One must realize that this condition originates from Damp-Heat stagnating in the meridian over a long period, compounded by external Cold binding the exterior, preventing dispersion, thereby causing pain. If one merely attributes it to Cold, the analysis is incomplete. It is common to see individuals who wade in water or swim throughout their lives without suffering from this disease, because they lack internal Heat. One might ask: How does Damp-Heat accumulate in the Jueyin Meridian? The answer is: Excessive labor generates Fire in the Spleen; drunkenness and overeating generate Fire in the Stomach; sexual exhaustion generates Fire in the Kidney; and extreme anger generates Fire in the Liver. After Fire accumulates for a long time, the Zi organ (Liver) weakens the Mu organ (Kidney), leading to an abundance of Dampness. Turbid fluids condense, merge into the blood vessels, and flow into the Jueyin. The Liver is called the "General"; its nature is rapid, and Fire nature is violent. Constrained by Cold, the pain naturally arises urgently.
(The testicular region) also belongs to the Foot-Shaoyin Kidney Meridian (Zu Shaoyin Shen Jing). Miao Zhongchun stated: Hernia is caused by Kidney Deficiency, allowing Cold-Damp pathogens to invade due to the void. Zhu Danxi’s assertion that it has nothing to do with the Kidney is not entirely accurate. However, there are cases where the disease begins with Dampness and later transforms into Damp-Heat; in such instances, medication should distinguish between treating Cold and Heat in sequence, which is the appropriate approach.