大意
疝本湿热痰瘀。乘虚下流。复加外寒所束。经脉收引。相抟而痛。丹溪专主于肝。与肾绝无干涉。以肝主筋
下环阴器故也。然究竟肾主下焦。肾气若旺。客邪乌能停滞。故疝症必以肾虚为本。湿热为标。至于外寒。
则稍末耳。（汇补）
内因
因醉饱远行。房劳忿怒。激发五志之火。或涉水处湿。冲风冒雨。外着阴冷之邪。湿热得寒。内收血隧。或乘
虚下聚。流于肝经。肝性急速。火复暴烈。郁极而发。（丹溪）揆其大端。有痰饮食积死血水气郁结之实者。有
气虚血虚阴虚陷伏之虚者。（汇补）
外候
有痛在睾丸者。痛连小腹者。痛在五枢穴边者。或无形。或无声。或有形如瓜。或有声如蛙。（丹溪）或攻刺腰
胁或游走胸腹。或绕脐痛。或抢心痛。（入门）小腹急疾。小便频并。升于上。为呕为吐。坠于下。为肿为胀。（绳墨）
疝分七种
七疝者。寒水筋气血狐 也。寒疝囊冷。结硬如石。阴茎不举。胫痛引丸。此坐卧湿地。寒月涉水冒雨。或劳
碌热极。坐卧砖石。或风冷处使内过劳而得。宜温经散寒。水疝肾囊肿痛。阴汗时出。或肿如水晶。或发痒
而搔流黄水。或小腹按之作水声。此醉酒行房。或汗出过风。寒湿之气。聚于囊中而得。宜利水除湿。筋疝
阴囊肿胀。或溃或痛。或筋缩里急。或挺纵不收。或茎中痛极作养。或白物随溲下流。此房术丹药积郁不
散所致。宜清火解毒。血疝状如黄瓜。在小腹两傍横骨之端。俗云便毒。或睾丸偏大。阴分作痛。甚则血溢
气聚。流入脬囊。结成痈肿。此醉饱入房。或扑损积怒。血流隧道所致。宜和血消瘀。气疝上连肾俞。下及阴
囊。遇恚怒悲哀。则气滞而胀。胀罢则散。或劳役坐马。摩击睾丸。致令肿胀。此肝气怫郁所致。宜散气疏肝。
小儿每患此。俗名偏气。因父精怯弱。强力入房。乃胎病。惟灸筑宾穴可消。狐疝状如仰瓦。在小腹。立则出
囊而肿胀疼痛。卧则归腹而闷苦皆消。上下无定。如狐之昼出夜入。此脾气下陷所致。宜升阳降阴。今人
带钩钳者是也。 疝阴囊肿硬。如升如斗。不痛不痒。此感地气卑湿所生。故江淮之间。湫溏之处。多有此
疾。宜导湿利水。若暴发而疼痛者。必兼前六症。宜参治之。又有得于有生之初。父子相传。习以为常。此禀
先天之气。非三因所致之疾。不可治也。（子和）若在女子。则前阴突出。后阴痔核。亦皆疝类。但不名疝而名
瘕。故经云。任脉为病。男子内结七疝。女子带下 瘕。（汇补）
疝病分辨
疝必睾丸先痛。次连小腹。次攻胸胁。有自下而上之象。若小肠气者。脐傍钓痛。连及腰脊。膀胱气者。肿胀
溺涩。手按有声。肾气胀者。脐下绕身。撮急引痛。或连胯内。三症之发。必从腹而下及睾丸。有自上而下之
象。其偏坠木肾者。惟睾丸为病。而无攻冲诸症。（汇补）
疝分寒热
疝病本热标寒。言热者。言其本。言寒者。论其标。大要热多者。遇热即发。二便赤涩。小便肛门俱热。外肾累
垂。玉茎挺出。寒多者。遇寒即发。二便清利。小腹腰胁清冷。外肾紧缩。玉茎痿软。（入门）又寒多则痛。热多则
肿。湿多重坠。然虚疝亦下坠。不可不知也。（汇补）
内外虚实
大抵外遇寒邪。必兼头疼寒热。内郁湿热。必带阴囊红肿。劳伤肝脾者。兼下血黄瘦。劳伤肝肾者。必腰酸
遗浊。上下而痛者。多邪气之冲逆。下坠而痛者。多元气之下陷。（汇补）
疝分左右
睾丸有两。左属水。水生肝木。木生心火。三部皆司血。统纳左之血者肝也。右属火。火生脾土。土生肺金。三
部皆司气。统纳右之气者肺也。故诸寒收引。则血泣而归肝。下注于左丸。诸气 郁。则湿聚而归肺。下注
于右丸。其患左者。痛多肿少。患右者。痛少肿多。（准绳）
疝分气积
疝痛无形。走注不定者。七情四气内搏而然。疝痛有形。不移其处者。痰瘀食积下聚而成。（汇补）
疝久成积
凡疝久则成积。盘附脐之上下左右。为 为瘕。作痛不已。或变 癖。或发奔豚。（汇补）
脉法
肝脉大急而沉为疝。寸脉弦紧为寒疝。趺阳脉虚迟。亦为寒疝。疝脉牢急者生。弱急者死。
治法
外寒束热者。开散外寒。疏通内热。祛逐肝经之湿热。消导下焦之瘀血。以寒因热用之法。立方处治。则邪
易伏而病易除。（正传）若寒积下焦者。非大热之剂则不能愈。（谦甫）如热郁肝经者。非渗利之品则不能痊。
（汇补）
治禁预补
诸疝皆属于肝。肝欲散。急食辛以散之。此疾虽因虚而得。然不可虚而骤补。所谓邪之所凑。其气必虚。留
而不去。其病为实。故必先涤去所蓄之邪。然后议补。（本事方）
温散
疝因阴邪凑肾。寒气上攻。小腹结块。下坠睾丸。坚紧如石。得暖渐消。得寒愈胀。其气并入前后腰脐各道
筋中。上攻入胃。则大呕大吐。战栗畏寒。此下焦地气上冲。宜以参、附、姜、桂大剂。非寻常郁热比也。（汇补）
补虚
有劳役而发者。其脉不甚沉紧。而豁大无力。其痛不甚猖獗。而重坠牵引。羸瘦少气。呕吐少食。泻利胸满。
洒淅寒热者。当以参、术、桂、附为君。略以疏导药佐之。若泛用克伐。必变攻胃冲心而死。（汇补）
危症
疝久虚甚。上为吐逆。下有遗精者危。切牙战栗。冷汗反张者凶。（入门）
用药
主以二陈汤。寒疝。加肉桂、小茴、玄胡、香附、吴萸、川椒。水疝。猪苓、泽泻、苍术、防己。筋疝。
黄柏、山栀、赤芍、甘草、胆草、大豆。血疝。赤芍、玄胡、归尾、香附、丹皮、牛膝。气疝。青皮、香附、
枳实、木香、乌药、橘核、川楝。狐疝。柴胡、升麻、干葛、苍术。 疝。或得于胎元。或经年久病者。不必治之。
如遇外感而发。痛甚者。参前六法治之。瘀加桃仁。痰加海石。郁加木香。虚加故纸。红肿加山栀、赤芍。冰冷
加吴茱、干姜。积湿过多。阴汗如雨。倍苍术。加白芷。
湿郁成熟。皮宽燥痒。加木通、泽泻。中焦虚疝脉濡者。四君子加川楝。下焦虚疝脉沉细者。八味茴香丸。或
八珍汤加肉桂。至于湿热为病。俱宜泻南补北。不可妄用刚剂。如乌头、附子之类。
【附木肾】
木肾者。外肾坚硬顽痹。不痛不痒。阴茎不垂。常如麻木。便溺之时。闷胀不顺。此肾家虚惫。阴阳不交。水火
不济。而沉细痼冷。凝滞其间。未可纯用燥药。当行温散温利以逐其邪。俾水火交媾。荣卫流行。如寒回春
谷。自然得愈。间有跌扑惊恐。痰气瘀滞者。当消瘀行气。佐以温散之品（汇补）
【附偏坠】
睾丸坠肿。有大小左右不同。在左因怒气伤肝。外寒内郁。在右因肾气虚损。湿痰食积。皆使真气不升。客
邪下陷。宜温中行气为君。升阳疏散为辅。不可泥引而竭之之法。（汇补）
【附白液】
有纵情酒色。而平素多火者。初起 疝。服利湿降气却疝之药。后每遇劳欲。疝必随发。发必寒热。小腹不
仁。隐隐痛连腰胁。阴囊肿大。毫毛之间。俱出白液。如米泔水。大注而下。头眩倦怠。静卧则身热渐缓。囊肿
渐缩。缩则干硬如荔枝状。直至皱起白皮。揭去一层。方得和软。若遇劳伤。其发如故。治宜六味丸。加柴胡、
黄柏、白芍、当归、山栀。（汇补）
【附阴挺】
阴茎挺纵不收。为强中之症。由多服壮阳之品。或受金石丹毒。遂使阳旺阴衰。相火无制。得泄稍软。殊不
知愈泄而阴愈伤。愈伤而茎愈强。治宜助阴抑阳。地黄汤。加牛膝、知、柏之风。（汇补）
【附肾囊风】
是症乃肝经风湿。作痒不已。喜浴热汤。甚则疙瘩顽麻。破流脂水。宜蛇床子汤熏洗。或吴茱萸汤更妙。（汇补）
疝气选方
蒺藜丸（宝鉴）
蒺藜（炒去尖） 乌头（炮去脐） 山栀（各等分）
每服三钱。为末。水煎服。
论曰。疝由湿热。因寒郁而作。故用栀子以降湿热。乌头以破滞气。况二物皆下焦之药。而乌头为栀子
所引。其性急速。不容胃中停留。直趋下焦故也。又按之痛止者属虚。须加肉桂。以姜汁丸服。其效尤速。
三因燔葱散 治一切寒疝作痛。
川芎 当归 枳壳 浓朴 官桂 青皮
干姜 茴香 茯苓 川楝 麦芽 神曲
三棱 蓬术 熟地 白芍 人参
上细切。每服五钱。葱白三茎。盐少许。水煎。
沉香桂附丸（宝鉴） 治中气虚弱。真火不足。脏腑积冷。腹胁痛。手足冷。便利无度。喜热物熨者。
沉香 肉桂 附子 川乌（炮） 良姜（炒） 茱萸 茴香（炒各一两）
为末。醋和丸。米饮下。
治 疝不痛。如升斗。俗名气胞者。或灸大敦穴。
苍术 神曲 白芷 山楂 川芎 栀子 半夏 南星
入姜煎。或加海藻、昆布。必须断酒薄味寡欲。
马兰花丸 治七疝。及妇人阴 。小儿偏坠。
马兰花（醋炒） 川楝子 橘核 海藻 海带 昆布（俱酒净）
桃仁（各一两） 浓朴 枳实 玄胡 肉桂（各二钱）
当归四逆汤（宝鉴） 治疝气属阴寒者。
当归（七分） 附子 官桂 茴香 柴胡（各五分） 芍药（四分）
玄胡 川楝 茯苓（各三分） 泽泻（二钱）
水煎。
补肾汤 治疝气属虚。遇劳即发者。
沉香（三分） 人参 茯苓 附子 黄 白术
木瓜（各一钱半） 川芎 甘草（各三分） 羌活 苏叶（各一钱）
姜、枣。呕吐。加半夏。
济生葵子汤 治膀胱湿热。腹胀溺涩者。
赤苓 猪苓 葵子 枳实 瞿麦 车前
木通 黄芩 滑石 甘草（各等分）
姜煎。
五苓散 治疝气卒痛。小便涩。
即五苓加川楝。
疝痛急救方 气上冲。心下如有筑塞。痛甚欲死。手足冷者。
用硫黄不拘多少。溶化投水中。去毒。研细。入荔枝核炒黄。陈皮为末。各等分。饭丸桐子大。每服四五丸。
酒下。其痛立止。甚者。不过六丸。不可多服。
偏坠初起。用穿山甲、茴香为末。酒调下。以干物压之。外用牡蛎、良姜 末。唾津调涂患处。须臾如火热。痛即
安。睾丸痛甚。用荔枝核、乳香、没药为细末。调入顺气治疝药中。或另用长流水调服。
肾气方
茴香 破故纸 吴萸 胡芦巴
莱菔子汁丸。盐汤下。
食积下流疝
枳实 山楂 青皮 茱萸 茴香 香附 姜汁
死血下流疝
玄胡 桃仁 山楂 归尾 川芎 栀子 姜汁
寒湿下流疝
肉桂 吴萸 小茴 羌活 紫苏 浓朴 青皮 柴胡
痰饮下流疝
苍术 南星 半夏 海石 山栀 山楂
橘核 青皮 姜汁
湿热下流疝
楝实 泽泻 猪苓 木通 滑石 山栀 橘核 黄柏 青皮
虚人疝
人参 白术 补骨脂 肉桂 附子 当归 川芎 黄 柴胡
快捷方式方
寒疝自汗欲死。用丹参末一两。热酒调下二钱。
又方 用仙人对坐草、青木香捣汁。和酒少许服之。
又方 治块物上冲者。用牡蛎六两。盐泥封固。火 二两。干姜一两焙为末。和匀。水调敷患处。小水大利。即缓。
外治法
治疝气阴囊如斗者。
木鳖子七粒。皂角二条煨黄。玄胡五钱。川椒一合去目炒。共为末。以烧酒调如稀粥。涂在肾囊上。外以
绵纸包裹。再以布包缚。随缩随收。一时即愈。
秘法外洗
经霜楮树叶半斤。水煮滚。置阔口大坛内。乘热坐熏其囊。温则倾出洗之。每日三次。其效甚速。
五叶汤 洗疝痛。
枇杷叶 野紫苏 椒叶 苍耳叶 水晶葡萄叶
煎汤熏洗。
【大意】
疝气的病机本源于湿热、痰浊和瘀血。这些病理产物乘人体正气虚弱之时下注，再加上外感寒邪束缚，导致经脉收缩牵引，相互搏结而引发疼痛。朱丹溪认为疝气主要责之于肝脏，与肾脏完全没有关系，这是因为肝经主司筋脉，且环绕阴器。然而究其根本，肾主司下焦，若肾气旺盛，外来的邪气怎能停滞？所以疝证必须以肾虚为本，湿热为标。至于外感寒邪，则是次要的因素。（出自《证治汇补》）
【内因】
由于醉酒饱食后远行，或房事过度、愤怒，激发了五志之火；或者涉水处于潮湿环境，迎风冒雨，外受阴冷之邪。湿热遇到寒邪，向内收敛进入血脉隧道，或者乘虚下聚，流注于肝经。肝性急迫，火势又暴烈，郁积到极点而发作。（出自朱丹溪）概括其主要方面，有痰饮、饮食积滞、死血、水气、郁结等实证；也有气虚、血虚、阴虚陷伏等虚证。（出自《证治汇补》）
【外候】
有的疼痛在睾丸，有的疼痛牵连小腹，有的疼痛在五枢穴旁边。有的无形态变化，有的无声音，有的形态像瓜一样肿大，有的发出像青蛙一样的叫声。（出自朱丹溪）有的攻刺腰胁，有的游走于胸腹，有的绕脐疼痛，有的抢心痛。（出自《医学入门》）小腹部拘急紧迫，小便频数。病气升于上，表现为呕吐；坠于下，表现为肿胀胀满。（出自《医宗绳墨》）
【疝分七种】
七种疝气，是指寒疝、水疝、筋疝、血疝、气疝、狐疝、㿗疝（此处原文缺字，根据上下文及后世整理通常为“㿗疝”或指代最后一种）。
寒疝：阴囊寒冷，结硬如石头，阴茎不能勃起，小腿疼痛牵引睾丸。这是由于坐卧湿地，或在寒冷月份涉水冒雨，或者劳累极度发热后坐卧砖石，或在风冷处行房事过劳所致。宜用温经散寒法。
水疝：肾囊肿痛，阴部出汗时常流出，或者肿得像水晶一样透明，或者发痒搔抓后流出黄水，或者按压小腹有水声。这是由于醉酒行房，或者汗出当风，寒湿之气聚于阴囊中所致。宜用利水除湿法。
筋疝：阴囊肿胀，或者溃烂或者疼痛，或者筋脉收缩里急，或者阴茎挺纵不收，或者尿道中剧痛作痒，或者有白色分泌物随小便流出。这是由于房术丹药积郁不散所致。宜用清火解毒法。
血疝：形状像黄瓜，位于小腹两侧横骨端。俗称便毒。或者睾丸偏大，阴部作痛，严重时血液溢出，气聚流入膀胱，结成痈肿。这是由于醉饱后入房，或者跌扑损伤、积怒，导致血流注于血脉隧道所致。宜用和血消瘀法。
气疝：上连肾俞，下及阴囊，遇到愤怒悲哀时，气机阻滞而胀，胀罢则消散。或者因为劳役、骑马、摩擦撞击睾丸，导致肿胀。这是肝气郁结所致。宜用散气疏肝法。小儿常患此病，俗名偏气，是因为父亲精气怯弱，强力入房，属于胎病，只有灸筑宾穴可以消除。
狐疝：形状像仰放的瓦片，位于小腹，站立时脱出阴囊而肿胀疼痛，躺下时回纳腹部而闷苦皆消。上下不定，像狐狸白天出来晚上进去。这是脾气下陷所致。宜用升阳降阴法。现在人佩戴钩钳治疗的就是这种。
㿗疝：阴囊肿硬，像升斗一样大，不痛不痒。这是感受地气卑湿所生。所以在江淮之间低洼潮湿的地方，多有此疾。宜用导湿利水法。如果是突发且疼痛的，必定兼有前六种症状，应参考治疗。又有从出生之初就有的，父子相传，习以为常，这是禀受先天之气，不是三因（内因、外因、不内外因）导致的疾病，无法治愈。（出自刘完素/子和）如果在女子身上，则前阴突出，后阴痔核，也都属于疝类，但不叫疝而叫瘕。所以经文说：“任脉为病，男子内结七疝，女子带下瘕聚。”（出自《证治汇补》）
【疝病分辨】
疝气一定是睾丸先痛，其次牵连小腹，再攻冲胸胁，有自下而上的趋势。如果是小肠气，则是脐旁牵引样疼痛，连及腰脊。如果是膀胱气，则是肿胀、排尿涩滞，手按有声。如果是肾气胀，则是脐下绕身，撮急引痛，或者连及胯内。这三种病的发作，必定是从腹部向下波及睾丸，有自上而下的趋势。如果是偏坠或木肾，只有睾丸发病，而没有攻冲的各种症状。（出自《证治汇补》）
【疝分寒热】
疝病本质是热，表象是寒。说热，是说它的本质；说寒，是说它的表象。大体上热多的人，遇热即发作，大小便赤涩，小便和肛门都感觉热，外生殖器下垂，阴茎挺出。寒多的人，遇寒即发作，大小便清利，小腹腰胁清冷，外生殖器紧缩，阴茎痿软。（出自《医学入门》）另外，寒多则痛，热多则肿，湿重则沉重下坠。然而虚证疝气也会下坠，不可不知道。（出自《证治汇补》）
【内外虚实】
大致外感寒邪，必定兼有头痛、恶寒发热；内郁湿热，必定带有阴囊红肿。劳伤肝脾者，兼有便血、面色萎黄消瘦；劳伤肝肾者，必定腰酸、遗精滑浊。上下攻冲而痛的，多是邪气冲逆；下坠而痛的，多是元气下陷。（出自《证治汇补》）
【疝分左右】
睾丸有两个，左侧属水，水生肝木，木生心火，这三部都主管血，统纳左侧血的脏器是肝。右侧属火，火生脾土，土生肺金，这三部都主管气，统纳右侧气的脏器是肺。所以各种寒邪收引，则血液凝涩而归聚于肝，下注于左侧睾丸；各种气机郁结，则湿气聚积而归聚于肺，下注于右侧睾丸。患病在左侧的，痛多肿少；患病在右侧的，痛少肿多。（出自《医学准绳六要》）
【疝分气积】
疝痛无形，走窜不定，是由于七情四气内搏所致。疝痛有形，位置不移，是由于痰瘀食积下聚而成。（出自《证治汇补》）
【疝久成积】
凡是疝气日久则形成积聚，盘踞附着在脐的上下左右，成为癥或瘕，疼痛不止，或者变成癖块，或者发展为奔豚。（出自《证治汇补》）
【脉法】
肝脉大而急且沉，为疝气。寸脉弦紧，为寒疝。趺阳脉虚迟，也为寒疝。疝气脉象牢急者生，弱急者死。
【治法】
外寒束表、内有郁热者，需开散外寒，疏通内热，祛除肝经湿热，消导下焦瘀血，采用“寒因热用”的方法，立方治疗，则邪气易伏，病易除。（出自《景岳全书·正传》）如果寒积在下焦，非大热之剂不能痊愈。（出自李谦甫）如果热郁在肝经，非渗利之品不能痊愈。（出自《证治汇补》）
【治禁预补】
各种疝气都属于肝，肝喜条达疏散，急需食用辛味药以发散它。此病虽然因虚而得，但不可因虚而骤然进补。所谓邪气聚集之处，正气必然虚弱，但邪气停留不去，病势转为实证。所以必须先涤除蓄积的邪气，然后讨论补益。（出自《济生方·本事方》）
【温散】
疝气因阴邪凑集肾脏，寒气上攻，小腹结块，下坠至睾丸，坚硬紧绷如石头，得暖渐消，得寒更胀。寒气并入前后腰脐各道筋中，上攻入胃，则大呕大吐，战栗畏寒。这是下焦地气上冲，宜用人参、附子、干姜、肉桂大剂量用药，这不是寻常的郁热可比。（出自《证治汇补》）
【补虚】
有因劳役而发作的，脉象不甚沉紧，而是豁大无力，疼痛不甚猖獗，但有重坠牵引感，身体羸瘦，少气，呕吐，食欲不振，腹泻，胸满，洒淅寒热。应当以人参、白术、肉桂、附子为君药，略加疏导药作为佐使。如果泛用克伐药物，必定变为攻胃冲心而死。（出自《证治汇补》）
【危症】
疝气日久，虚损严重，上为吐逆，下有遗精的，病情危重。咬牙战栗，冷汗出，角弓反张的，凶险。（出自《医学入门》）
【用药】
主方用二陈汤。寒疝，加肉桂、小茴香、玄胡索、香附、吴茱萸、川椒。水疝，加猪苓、泽泻、苍术、防己。筋疝，加黄柏、山栀、赤芍、甘草、龙胆草、大豆。血疝，加赤芍、玄胡索、当归尾、香附、牡丹皮、牛膝。气疝，加青皮、香附、枳实、木香、乌药、橘核、川楝子。狐疝，加柴胡、升麻、干葛、苍术。㿗疝，或者是胎元所得，或者经年久病者，不必治疗。如果遇到外感而发作，疼痛剧烈的，参照前六种方法治疗。瘀血加桃仁，痰多加海浮石，郁结加木香，虚证加破故纸（补骨脂），红肿加山栀、赤芍，冰冷加吴茱萸、干姜。积湿过多，阴汗如雨，倍用苍术，加白芷。湿郁成熟，皮肤宽缓干燥瘙痒，加木通、泽泻。中焦虚疝脉濡者，用四君子汤加川楝子。下焦虚疝脉沉细者，用八味茴香丸，或者八珍汤加肉桂。至于湿热为病，都宜泻南补北（清心火补肾水），不可妄用刚燥之剂，如乌头、附子之类。
【附木肾】
木肾，指外生殖器坚硬顽痹，不痛不痒，阴茎不垂，常如麻木，大小便时闷胀不顺。这是肾家虚惫，阴阳不交，水火不济，沉细痼冷凝滞其间。不可纯用燥药，应当行温散温利之法以驱逐邪气，使水火交媾，营卫流行，如寒回春谷，自然得愈。间或有跌扑惊恐，痰气瘀滞者，应当消瘀行气，佐以温散之品。（出自《证治汇补》）
【附偏坠】
睾丸坠肿，有大小左右不同。在左侧因怒气伤肝，外寒内郁；在右侧因肾气虚损，湿痰食积。都使真气不升，客邪下陷。宜以温中行气为君，升阳疏散为辅，不可拘泥于引而竭之的方法。（出自《证治汇补》）
【附白液】
有人纵情酒色，平素多火，初起患疝，服用利湿降气却疝的药物，后来每次遇劳欲，疝必随之发作，发作必伴寒热，小腹不知痛觉，隐隐痛连腰胁，阴囊肿大，毫毛之间，都流出白色液体，像米泔水一样大量流出，头晕倦怠，静卧则身热渐缓，囊肿渐缩，缩后干硬如荔枝状，直至皱起白皮，揭去一层，才恢复和软。若遇劳伤，其发作如故。治疗宜用六味丸，加柴胡、黄柏、白芍、当归、山栀。（出自《证治汇补》）
【附阴挺】
阴茎挺纵不收，称为强中之症。由多服壮阳之品，或受金石丹毒，遂使阳旺阴衰，相火无制，射精后稍软。殊不知愈泄而阴愈伤，愈伤而茎愈强。治疗宜助阴抑阳，用地黄汤，加牛膝、知母、黄柏之风（意指仿照此类药性）。（出自《证治汇补》）
【附肾囊风】
此症乃肝经风湿，作痒不已，喜欢洗热汤，严重时疙瘩顽麻，破溃流脂水。宜用蛇床子汤熏洗，或者吴茱萸汤更好。（出自《证治汇补》）
【疝气选方】
蒺藜丸（出自《宝鉴》）
蒺藜（炒去尖）、乌头（炮去脐）、山栀（各等分）
每服三钱，研为末，水煎服。
论曰：疝由湿热，因寒郁而作，故用栀子以降湿热，乌头以破滞气。况且这两味药都是下焦之药，而乌头被栀子所引，其性急速，不容在胃中停留，直趋下焦。又按之痛止者属虚，须加肉桂，以姜汁丸服，其效尤速。
三因燔葱散 治一切寒疝作痛。
川芎、当归、枳壳、浓朴、官桂、青皮、干姜、茴香、茯苓、川楝、麦芽、神曲、三棱、蓬术、熟地、白芍、人参
上细切，每服五钱，葱白三茎，盐少许，水煎。
沉香桂附丸（出自《宝鉴》） 治中气虚弱，真火不足，脏腑积冷，腹胁痛，手足冷，便利无度，喜热物熨者。
沉香、肉桂、附子、川乌（炮）、良姜（炒）、茱萸、茴香（炒各一两）
为末，醋和丸，米饮送下。
治㿗疝不痛，如升斗，俗名气胞者，也可灸大敦穴。
苍术、神曲、白芷、山楂、川芎、栀子、半夏、南星
入姜煎，或加海藻、昆布。必须断酒薄味寡欲。
马兰花丸 治七疝，及妇人阴挺，小儿偏坠。
马兰花（醋炒）、川楝子、橘核、海藻、海带、昆布（俱酒净）、桃仁（各一两）、浓朴、枳实、玄胡、肉桂（各二钱）
当归四逆汤（出自《宝鉴》） 治疝气属阴寒者。
当归（七分）、附子、官桂、茴香、柴胡（各五分）、芍药（四分）、玄胡、川楝、茯苓（各三分）、泽泻（二钱）
水煎。
补肾汤 治疝气属虚，遇劳即发者。
沉香（三分）、人参、茯苓、附子、黄芪、白术、木瓜（各一钱半）、川芎、甘草（各三分）、羌活、苏叶（各一钱）
姜、枣。呕吐，加半夏。
济生葵子汤 治膀胱湿热，腹胀溺涩者。
赤苓、猪苓、葵子、枳实、瞿麦、车前、木通、黄芩、滑石、甘草（各等分）
姜煎。
疝痛急救方 气上冲，心下如有筑塞，痛甚欲死，手足冷者。
用硫黄不拘多少，溶化投水中，去毒，研细，入荔枝核炒黄，陈皮为末，各等分。饭丸桐子大，每服四五丸，酒下，其痛立止。甚者，不过六丸，不可多服。
偏坠初起，用穿山甲、茴香为末，酒调下，以干物压之。外用牡蛎、良姜末，唾津调涂患处，须臾如火热，痛即安。睾丸痛甚，用荔枝核、乳香、没药为细末，调入顺气治疝药中，或另用长流水调服。
痰饮下流疝
苍术、南星、半夏、海石、山栀、山楂、橘核、青皮、姜汁
湿热下流疝
楝实、泽泻、猪苓、木通、滑石、山栀、橘核、黄柏、青皮
虚人疝
人参、白术、补骨脂、肉桂、附子、当归、川芎、黄芪、柴胡
快捷方式方
寒疝自汗欲死，用丹参末一两，热酒调下二钱。
又方：用仙人对坐草、青木香捣汁，和酒少许服之。
又方：治块物上冲者，用牡蛎六两，盐泥封固，火煅二两，干姜一两焙为末，和匀，水调敷患处，小水大利，即缓。
【外治法】
治疝气阴囊如斗者。
木鳖子七粒，皂角二条煨黄，玄胡五钱，川椒一合去目炒，共为末，以烧酒调如稀粥，涂在肾囊上，外以绵纸包裹，再以布包缚，随缩随收，一时即愈。
【秘法外洗】
经霜楮树叶半斤，水煮滚，置阔口大坛内，乘热坐熏其囊，温则倾出洗之，每日三次，其效甚速。
[General Principle]
The pathogenesis of Shan (Hernia) originates from Damp-Heat, Phlegm, and Blood Stasis. These pathological products flow downward when the body's healthy Qi is deficient, and are further constrained by external Cold pathogens, causing the meridians to contract and pull, leading to pain through mutual contention. Zhu Danxi believed that Shan primarily involves the Liver meridian and has absolutely no relation to the Kidney, because the Liver governs the sinews and its meridian circles the genitalia. However, fundamentally, the Kidney governs the Lower Jiao. If Kidney Qi is robust, how can exogenous pathogens stagnate? Therefore, the root of Shan must be considered as Kidney Deficiency, with Damp-Heat as the branch manifestation. As for external Cold, it is merely a secondary factor. (From *Zhengzhi Huibu*)
[Internal Causes]
Caused by traveling far after excessive drinking and eating, or by sexual exhaustion and anger, which ignite the fire of the Five Emotions; or by wading in water and staying in damp places, exposing oneself to wind and rain, thereby suffering from Yin-Cold pathogens externally. When Damp-Heat encounters Cold, it retracts inward into the blood vessels, or gathers downward due to deficiency, flowing into the Liver meridian. The Liver nature is swift and urgent, and the fire is violent; when depression reaches its extreme, it erupts. (From Zhu Danxi) Summarizing the main aspects, there are excess patterns such as Phlegm-Dampness, Food Retention, Dead Blood, Water-Qi, and Depression; and deficiency patterns such as Qi Deficiency, Blood Deficiency, and Yin Deficiency with sinking. (From *Zhengzhi Huibu*)
[External Manifestations]
Pain may be located in the testicles, radiating to the lower abdomen, or near the Wushu acupoint (GB29). There may be no visible shape change or sound, or the shape may be swollen like a melon, or emit sounds like a frog. (From Zhu Danxi) Pain may pierce the waist and hypochondrium, wander in the chest and abdomen, circle the umbilicus, or seize the heart area. (From *Yixue Rumen*) The lower abdomen feels tight and urgent, with frequent urination. If the pathogenic qi rises upward, it manifests as vomiting; if it sinks downward, it manifests as swelling and distension. (From *Yizong Shengmo*)
[Seven Types of Shan]
The seven types of Shan refer to Cold Shan, Water Shan, Sinew Shan, Blood Shan, Qi Shan, Fox Shan, and Tui Shan.
Cold Shan: The scrotum is cold, hard as stone, the penis does not erect, and calf pain radiates to the testicles. This results from sitting on wet ground, wading in water or going out in rain during cold months, or sitting on bricks after extreme heat from labor, or excessive sexual activity in windy/cold places. Treatment should warm the meridians and dispel Cold.
Water Shan: Swelling and pain in the kidney/scrotum, intermittent sweating from the genitalia, swelling transparent like crystal, itching with yellow fluid discharge upon scratching, or water sounds upon pressing the lower abdomen. This results from sexual activity after drunkenness, or exposure to wind while sweating, causing Cold-Dampness to gather in the scrotum. Treatment should promote urination and drain Dampness.
Sinew Shan: Scrotal swelling, ulceration or pain, tendon contraction with urgency, flaccidity or protrusion of the penis, severe pain and itching in the urethra, or white discharge with urine. This results from the accumulation and stagnation of sexual techniques and elixirs. Treatment should clear Heat and resolve toxicity.
Blood Shan: Shape like a cucumber, located at the ends of the transverse bones on both sides of the lower abdomen. Commonly known as "Bian Du" (groin abscess). One testicle may be larger, with pain in the yin region. Severe cases involve blood overflow and Qi aggregation flowing into the bladder, forming an abscess. This results from sexual activity after overeating/drinking, or trauma and accumulated anger, causing blood to flow into the vessel tunnels. Treatment should harmonize blood and resolve stasis.
Qi Shan: Extends from Shenshu (BL23) to the scrotum. Distension occurs due to Qi stagnation when experiencing anger or sorrow, resolving after the distension subsides. Or caused by labor, horse riding, or friction/impact on the testicles. This is due to Liver Qi depression. Treatment should dissipate Qi and soothe the Liver. Children often suffer from this, commonly called "Pian Qi" (one-sided hernia), resulting from the father's weak essence and forced sexual activity during conception, constituting a congenital disease. Only moxibustion at Zhubin (KI9) can eliminate it.
Fox Shan: Shape like an inverted tile, located in the lower abdomen. It protrudes from the scrotum causing swelling and pain when standing, and retracts into the abdomen when lying down, relieving discomfort. It moves up and down unpredictably, like a fox coming out by day and entering by night. This is due to Spleen Qi sinking. Treatment should raise Yang and descend Yin. This corresponds to the use of hooks/clamps by modern practitioners.
Tui Shan: The scrotum is swollen and hard, large as a measuring cup, without pain or itching. This arises from contracting the dampness of the earth's qi. Thus, it is common in low-lying, marshy areas between the Jianghuai regions. Treatment should guide out Dampness and promote urination. If sudden onset with pain, it likely combines with the previous six symptoms and should be treated accordingly. Some are present from birth, passed down father to son, habitual, stemming from congenital Qi, not caused by the Three Categories of pathogens, and thus incurable. (From Liu Wansu/Zihe Zheng) In women, prolapse of the anterior vagina or hemorrhoids at the posterior anus also belong to the category of Shan, but are named Jia (masses). Hence, the classic states: "Ren Mai pathology causes Seven Shan in men and leukorrhea/Jia in women." (From *Zhengzhi Huibu*)
[Differentiation of Shan Disease]
Shan always begins with testicular pain, then connects to the lower abdomen, and finally attacks the chest and hypochondrium, showing a trend from bottom to top. Xiao Chang Qi (Small Intestine Qi) presents as hook-like pain beside the umbilicus, connecting to the lumbar spine. Bladder Qi presents as swelling and dysuria, with audible sounds upon palpation. Shen Qi Zhang (Kidney Qi Distension) presents as encircling pain below the umbilicus, pulling and cramping, possibly connecting to the inner thigh. The onset of these three conditions always spreads from the abdomen down to the testicles, showing a trend from top to bottom. Pian Zhui (One-sided sagging) or Mu Shen (Wooden Kidney) involves only the testicles without attacking/rushing symptoms. (From *Zhengzhi Huibu*)
[Cold and Heat Differentiation]
Shan disease is fundamentally Heat but superficially Cold. Speaking of Heat refers to its root; speaking of Cold refers to its branch. Generally, those with more Heat flare up when exposed to heat, with red and scanty urination/stool, and heat sensation in the urethra and anus, with pendulous external genitals and erect penis. Those with more Cold flare up when exposed to cold, with clear and profuse urination/stool, coldness in the lower abdomen, waist, and hypochondrium, with contracted external genitals and flaccid penis. (From *Yixue Rumen*) Furthermore, Cold predominance leads to pain, Heat predominance to swelling, and heavy Dampness to heaviness/sagging. However, Deficiency Shan also presents with sagging, which must be noted. (From *Zhengzhi Huibu*)
[Exterior, Interior, Excess, and Deficiency]
Generally, exterior Cold invasion accompanies headache and aversion to cold/fever. Interior Damp-Heat stagnation accompanies redness and swelling of the scrotum. Labor injury to Liver and Spleen accompanies hematochezia and sallow emaciation. Labor injury to Liver and Kidney accompanies sore waist and turbid seminal emission. Pain moving up and down indicates rebellious pathogenic Qi. Pain with sagging indicates sinking of Yuan Qi. (From *Zhengzhi Huibu*)
[Left and Right Differentiation]
There are two testicles. The left belongs to Water, Water generates Liver Wood, Wood generates Heart Fire; these three organs govern Blood, and the Liver controls Blood on the left. The right belongs to Fire, Fire generates Spleen Earth, Earth generates Lung Metal; these three organs govern Qi, and the Lung controls Qi on the right. Therefore, Cold contraction causes Blood to coagulate and return to the Liver, sinking to the left testicle. Qi depression causes Dampness to gather and return to the Lung, sinking to the right testicle. Left-sided lesions have more pain and less swelling; right-sided lesions have less pain and more swelling. (From *Yixue Zhunsheng*)
[Qi and Accumulation Differentiation]
Formless Shan pain that wanders不定ly is caused by internal conflict of Seven Emotions and Four Qi. Formidable Shan pain that remains fixed is caused by the downward gathering of Phlegm, Stasis, and Food Retention. (From *Zhengzhi Huibu*)
[Long-standing Shan Becoming Accumulation]
Long-standing Shan becomes accumulation, attaching around the upper and lower left and right of the umbilicus, forming Zheng or Jia masses, with incessant pain, potentially transforming into Pi masses or Ben Tun (running piglet). (From *Zhengzhi Huibu*)
[Pulse Diagnosis]
A Liver pulse that is large, urgent, and deep indicates Shan. A Chi (cun) pulse that is string-taut and tight indicates Cold Shan. A Duyang pulse that is deficient and slow also indicates Cold Shan. A firm and urgent pulse in Shan indicates survival; a weak and urgent pulse indicates death.
[Treatment Principles]
For exterior Cold constraining interior Heat, one must release the exterior Cold, unblock interior Heat, remove Damp-Heat from the Liver meridian, and digest Stasis in the Lower Jiao. Using the method of "treating Cold with Heat," the formula will subdue the pathogen and cure the disease easily. (From *Jingyue Quanshu*) For Cold accumulation in the Lower Jiao, only strong Hot formulas can cure it. (From Li Qianfu) For Heat depression in the Liver meridian, only draining/diuretic herbs can cure it. (From *Zhengzhi Huibu*)
[Contraindication of Premature Tonification]
All Shan belong to the Liver. The Liver desires dispersion; urgently consume Pungent herbs to disperse it. Although this disease arises from Deficiency, one must not tonify abruptly due to Deficiency. Where pathogenic Qi gathers, Healthy Qi is necessarily deficient, but if the pathogen stays and does not leave, the condition becomes Excess. Therefore, one must first cleanse the accumulated pathogens before discussing tonification. (From *Jisheng Fang*)
[Warming and Dispersing]
Shan caused by Yin pathogens gathering in the Kidney, with Cold Qi attacking upward, forms lumps in the lower abdomen that sag to the testicles, hard and tight as stone, gradually diminishing with warmth and worsening with cold. The Qi merges into the tendons of the lower back, navel, and channels, attacking the stomach, causing severe vomiting, shivering, and aversion to cold. This is Lower Jiao earth Qi rushing upward. Use large doses of Ginseng, Aconite, Ginger, and Cinnamon Twig. This is not comparable to ordinary Heat depression. (From *Zhengzhi Huibu*)
[Tonifying Deficiency]
For cases triggered by labor, the pulse is not deeply tight but wide and forceless. The pain is not fierce but feels heavy and dragging. The patient is emaciated, short of breath, vomiting, anorexic, diarrheic, with chest fullness, and chills/fevers. Use Ginseng, Atractylodes, Cinnamon Twig, and Aconite as sovereign herbs, assisted slightly by regulating herbs. If astringent/draining herbs are used indiscriminately, it will lead to attacking the Stomach and rushing to the Heart, causing death. (From *Zhengzhi Huibu*)
[Critical Symptoms]
Long-standing Shan with severe Deficiency, presenting with upward vomiting/regurgitation and downward seminal emission, is critical. Teeth grinding, shivering, cold sweat, and opisthotonos are ominous. (From *Yixue Rumen*)
[Herbal Medication]
The main formula is Er Chen Tang.
For Cold Shan: Add Cinnamon Twig, Fennel, Corydalis, Cyperus, Evodia, Sichuan Pepper.
For Water Shan: Add Polyporus, Alisma, Atractylodes, Stephania.
For Sinew Shan: Add Phellodendron, Gardenia, Red Peony, Licorice, Gentian, Soybean.
For Blood Shan: Add Red Peony, Corydalis, Angelica Sinensis Tail, Cyperus, Moutan, Achyranthes.
For Qi Shan: Add Green Tangerine Peel, Cyperus, Immature Bitter Orange, Aucklandia, Lindera, Citrus Seed, Toosendan.
For Fox Shan: Add Bupleurum, Cimicifuga, Kudzu, Atractylodes.
For Tui Shan: If congenital or chronic long-term illness, do not treat. If triggered by external contraction with severe pain, refer to the previous six methods. Add Peach Kernel for Stasis, Pyrocollodium for Phlegm, Aucklandia for Depression, Psoralea for Deficiency. Add Gardenia and Red Peony for redness/swelling; add Evodia and Dried Ginger for coldness. For excessive Dampness with profuse sweating, double Atractylodes and add Angelica Dahurica. For Dampness turning mature with loose, dry, itchy skin, add Akebia and Alisma. For Middle Jiao Deficiency Shan with soggy pulse, use Si Jun Zi Tang plus Toosendan. For Lower Jiao Deficiency Shan with deep/thin pulse, use Ba Wei Hui Xiang Wan or Ba Zhen Tang plus Cinnamon Twig. For Damp-Heat diseases, one should Drain South (Heart) and Tonify North (Kidney); do not recklessly use harsh/hot agents like Aconitum or Aconite.
[Appendix: Wooden Kidney]
Wooden Kidney refers to the external genitals being hard, numb, and insensitive, neither painful nor itchy, with the penis not hanging down, often feeling numb. Urination and defecation feel obstructed and distended. This is due to Kidney deficiency and exhaustion, lack of interaction between Yin and Yang, failure of Water and Fire to assist each other, and stagnation of deep, thin, chronic cold. Do not use purely drying herbs; instead, use warming dispersal and warming diuresis to drive out pathogens, allowing Water and Fire to interact and Ying-Wei to circulate freely, leading to natural recovery. Occasionally, due to trauma/fright or Phlegm-Qi-Stasis, use blood-resolving and Qi-regulating methods assisted by warming dispersants. (From *Zhengzhi Huibu*)
[Appendix: One-Sided Sagging]
Testicular sagging and swelling vary in size and side. Left-side cases result from Anger injuring the Liver, with exterior Cold and interior depression. Right-side cases result from Kidney Qi deficiency, with Damp-Phlegm and Food Retention. Both cause Healthy Qi to fail to rise and Pathogenic Qi to sink. Treatment should prioritize warming the middle and regulating Qi, assisted by raising Yang and dispersing. Do not rigidly apply methods that merely draw down and exhaust. (From *Zhengzhi Huibu*)
[Appendix: White Fluid]
Some indulge in alcohol and sex, having inherent Heat. Initially suffering from Shan, they take Damp-draining and Qi-descending herbs. Later, every time labor or desire occurs, Shan flares with chills/fever, insensitivity in the lower abdomen, dull pain radiating to waist/hypochondrium, scrotal swelling, and white fluid resembling rice wash water pouring out from between hairs. Dizziness and fatigue ensue; resting slows fever and shrinks the scrotum until it becomes dry and hard like a lychee, wrinkling with white skin peeling off before softening again. Relapse occurs with labor. Treatment: Liu Wei Di Huang Wan plus Bupleurum, Phellodendron, White Peony, Angelica, Gardenia. (From *Zhengzhi Huibu*)
[Appendix: Yin Protrusion]
Penile protrusion and inability to retract, known as "Qiang Zhong" (Strong Middle). Caused by excessive intake of Yang-tonics or mineral elixirs/poisons, leading to Excess Yang and Deficient Yin, unrestrained Ministerial Fire. Softens slightly after ejaculation. Ignoring that ejaculation injures Yin further, making the penis stronger. Treatment: Assist Yin and suppress Yang using Di Huang Tang plus Achyranthes, Anemarrhena, Phellodendron. (From *Zhengzhi Huibu*)
[Appendix: Scrotal Wind]
This condition is Liver Meridian Wind-Dampness, causing incessant itching, preference for hot baths, severe nodules and numbness, breaking and flowing fatty fluid. Treatment: Smoke/wash with She Chuang Zi Decoction, or Wu Zhu Yu Decoction is better. (From *Zhengzhi Huibu*)
[Selected Formulas for Shan Qi]
Ji Li Wan (From *Bao Jian*): Tribulus (stir-fried, spines removed), Aconite (processed, navel removed), Gardenia (equal parts). Take 3 qian, powdered, decocted in water.
Commentary: Shan arises from Damp-Heat constrained by Cold. Gardenia drains Damp-Heat; Aconite breaks Qi stagnation. Both act on the Lower Jiao; Aconite is guided by Gardenia, acting swiftly without lingering in the Stomach, going straight to the Lower Jiao. If pain stops upon pressure, it is Deficiency; add Cinnamon Twig, pill with Ginger Juice for faster effect.
San Yin Fan Cong San: Treats all Cold Shan pain.
Chuanxiong, Angelica, Bitter Orange, Magnolia Bark, Cinnamon Twig, Green Tangerine Peel, Dried Ginger, Fennel, Poria, Toosendan, Malt, Medicated Leaven, Burreed Rhizome, Curcuma, Rehmannia, White Peony, Ginseng.
Finely cut. Take 5 qian, with 3 stalks of Scallion White, a little Salt, decocted in water.
Chen Xiang Gui Fu Wan (From *Bao Jian*): Treats Weak Middle Qi, insufficient True Fire, Cold accumulation in Zang-Fu, abdominal/hypochondriac pain, cold hands/feet, uncontrolled bowel/bladder, preference for hot compresses.
Agarwood, Cinnamon Twig, Aconite, Chuanwu (processed), Galangal (stir-fried), Evodia, Fennel (stir-fried, 1 liang each).
Powdered, pill with Vinegar, taken with Rice Drink.
Also treats Tui Shan without pain, large as a cup, commonly called Qi Bao. Moxibustion at Dadun (LR1) is also effective.
Atractylodes, Medicated Leaven, Angelica Dahurica, Hawthorn, Chuanxiong, Gardenia, Pinellia, Arisaema.
Decoct with Ginger, or add Sargassum, Laminaria. Must abstain from alcohol, eat bland diet, and reduce desires.
Ma Lan Hua Wan: Treats Seven Shan, female vaginal prolapse, infant one-sided sagging.
Ma Lan Flower (vinegar-fried), Toosendan, Citrus Seed, Sargassum, Kelp, Laminaria (wine-cleaned), Peach Kernel (1 liang each), Magnolia Bark, Immature Bitter Orange, Corydalis, Cinnamon Twig (2 qian each).
Dang Gui Si Ni Tang (From *Bao Jian*): Treats Shan Qi of Yin-Cold nature.
Angelica (7 fen), Aconite, Cinnamon Twig, Fennel, Bupleurum (5 fen each), Peony (4 fen), Corydalis, Toosendan, Poria (3 fen each), Alisma (2 qian).
Decoct in water.
Bu Shen Tang: Treats Deficient Shan Qi, triggered by labor.
Agarwood (3 fen), Ginseng, Poria, Aconite, Astragalus, Atractylodes, Chaenomelis Fruit (1.5 qian each), Chuanxiong, Licorice (3 fen each), Notopterygium, Perilla Leaf (1 qian each).
Ginger, Jujube. For vomiting, add Pinellia.
Jisheng Kui Zi Tang: Treats Bladder Damp-Heat, abdominal distension, dysuria.
Red Poria, Polyporus, Abelmoschus Seed, Immature Bitter Orange, Dianthus, Plantago Seed, Akebia, Scutellaria, Talc, Licorice (equal parts).
Decoct with Ginger.
Wu Ling San: Treats sudden Shan pain, scanty urination.
Wu Ling San plus Toosendan.
Shan Tong Ji Jiu Fang: For Qi rushing upward, sensation of obstruction in epigastrium, severe pain欲死, cold hands/feet.
Use Sulfur (any amount), melt in water, remove toxicity, powder finely. Mix with stir-fried Lychee Seed and Powdered Tangerine Peel (equal parts). Pill with rice paste, size of Paulownia seeds. Take 4-5 pills with wine; pain stops immediately. Severe cases: max 6 pills. Do not overdose.
For early one-sided sagging: Powder Pangolin Scale and Fennel, take with wine, press with dry cloth. Externally: Powder Oyster Shell and Galangal, mix with saliva, apply to site. Burns like fire, pain relieves instantly.
For severe testicular pain: Powder Lychee Seed, Frankincense, Myrrh, mix into Qi-regulating Shan medicine, or take with running water.
Shen Qi Fang:
Fennel, Psoralea, Evodia, Epimedium.
Pill with Radish Juice, take with Salt Water.
Food Retention Flowing Downward Shan:
Immature Bitter Orange, Hawthorn, Green Tangerine Peel, Evodia, Fennel, Cyperus, Ginger Juice.
Dead Blood Flowing Downward Shan:
Corydalis, Peach Kernel, Hawthorn, Angelica Tail, Chuanxiong, Gardenia, Ginger Juice.
Cold-Damp Flowing Downward Shan:
Cinnamon Twig, Evodia, Small Fennel, Notopterygium, Perilla, Magnolia Bark, Green Tangerine Peel, Bupleurum.
Phlegm-Fluid Flowing Downward Shan:
Atractylodes, Arisaema, Pinellia, Pyrocollodium, Gardenia, Hawthorn, Citrus Seed, Green Tangerine Peel, Ginger Juice.
Damp-Heat Flowing Downward Shan:
Toosendan, Alisma, Polyporus, Akebia, Talc, Gardenia, Citrus Seed, Phellodendron, Green Tangerine Peel.
Deficient Person Shan:
Ginseng, Atractylodes, Psoralea, Cinnamon Twig, Aconite, Angelica, Chuanxiong, Astragalus, Bupleurum.
Quick Method Formulas:
Cold Shan with spontaneous sweating欲死: Take 1 liang Salvia powder with 2 qian hot wine.
Another method: Crush Xian Ren Dui Zuo Cao and Qing Mu Xiang, extract juice, mix with small amount of wine.
Another method: For rising mass, use 6 liang Oyster Shell sealed with salt mud, calcined with 2 liang Charcoal, 1 liang dried Ginger (baked and powdered). Mix evenly, apply with water to site. Profuse urination brings relief.
[External Treatments]
For Shan Qi with scrotum large as a bucket:
7 Semen Momordicae, 2 Gleditsia Sinensis (roasted yellow), 5 qian Corydalis, 1 he Sichuan Pepper (de-eyed, stir-fried). Powder together, mix with Baijiu to porridge consistency. Apply to scrotum, wrap with cotton paper and cloth. Shrinks immediately, cured in an instant.
[Secret External Wash]
Half jin Mulberry Leaves after frost, boil in water. Place in wide-mouthed jar. Sit over steam while hot. Pour out when warm to wash. Three times daily. Very fast effect.
Wu Ye Tang: Wash for Shan pain.
Loquat Leaf, Wild Perilla, Pepper Leaf, Xanthium Leaf, Crystal Grape Leaf.
Decoct for fumigation and washing.