《素问》云∶人迎与气口俱盛四倍以上，为关格。格之脉羸，不能极于天地之精气，则死。《灵枢》云∶
邪在六腑则阳脉不和，不和则阳脉盛；邪在五脏则阴脉不和，不和则阴脉盛。阳气太盛则阴气不得相营，
故曰关；阴气太盛，则阳气不得相营，故曰格。关格者，不得尽命而死。此《灵》、《素》之论关格，以脉
言，而非症也。自仲景宗之，而谓在尺为关，在寸为格。关则不得小便，格则吐逆。夫人迎四倍，寸口四倍。
则非尺寸之谓，而曰吐逆者，此隔食症也。曰不得小
便者，此癃闭症也。自此叔和以后，俱莫能辨，悉以尺寸言关格。而洁古则曰∶寒在上，热在下。夫脉两
寸俱盛四倍以上，而可谓之寒在上、热在下乎？东垣则以清气反行浊道曰格，浊气反行清道曰关。丹溪但
言膈中觉有所碍，不能升降，是有格而无关。元方以大小便不通为关格，其说尤为舛错。后丹溪竟以关
格立症分门，致后学茫然莫辨。独马元台力辨诸子之非，谓关格非隔食、癃闭之症。夫巢、张、李、朱为
医之宗，尚与《内经》相乖，况下工？岂知关格为脉体，而非病名者哉！
巢氏序疝症，有厥疝、寒疝、气疝、盘疝、 疝、狐疝、瘕疝之名。子和非其谬立名色，以环阴器、
抵少腹者，属足厥阴肝经部，是受疝处也。故凡疝，非肝木受邪，则肝木自甚，皆属肝经，因立七疝之
名，曰∶寒、水、气、狐、筋、血、 ，治多用下法。丹溪以来，皆宗其说，而亦未得也。夫前阴小腹
间，乃足三阴、阳明，冲、任、督三脉所聚，岂得独以厥阴经为言？但如本篇六疝，皆兼言风者，本非外
入之风，风属肝，肝主筋，故凡病各经之疝，谓其病多在筋，皆挟肝邪则可，若谓必在厥阴一经，则不可也。
《素问》中说：人迎脉和气口脉都盛大到四倍以上，称为关格。格脉表现为虚弱，无法承受天地精气的滋养，就会死亡。《灵枢》中说：邪气侵犯六腑则阳脉不和，不和则阳脉盛大；邪气侵犯五脏则阴脉不和，不和则阴脉盛大。阳气过于盛大，阴气就不能与之相互营运，所以叫“关”；阴气过于盛大，阳气就不能与之相互营运，所以叫“格”。关格证，会导致人无法尽天年而死。这是《灵枢》和《素问》论述关格，是从脉象而言的，而不是指症状。自从张仲景遵循这一说法，认为在尺部为关，在寸部为格。关则导致小便不通，格则导致呕吐逆反。如果人迎脉大四倍，寸口脉大四倍，这就不是指寸部和尺部的脉象了，而所谓呕吐逆反，这是膈食症（噎膈）。所谓小便不通，这是癃闭症。从王叔和以后，都不能辨别清楚，全都用寸尺脉来解释关格。而李东垣（洁古）却说：寒邪在上焦，热邪在下焦。如果两寸脉都盛大四倍以上，怎么能说是寒在上、热在下呢？李东垣则认为清气反而行于浊道叫做格，浊气反而行于清道叫做关。朱丹溪只说胸膈中觉得有阻碍，不能升降，这只有格而没有关。元代方约之把大小便不通称为关格，他的说法更是错误。后来朱丹溪竟然以关格立症分门别类，致使后学者茫然不知如何辨别。只有马元台极力辩驳诸家之说，认为关格不是膈食、癃闭的症状。巢元方、张仲景、李东垣、朱丹溪作为医学宗师，尚且与《内经》原意相违背，何况医术低下的医生呢？哪里知道关格是脉象形态，而不是病名呢！
巢元方在疝症的序言中，有厥疝、寒疝、气疝、盘疝、瘕疝、狐疝、瘕疝的名称。张子和非议他谬立名目，认为环绕阴器、抵少腹的部位，属于足厥阴肝经所主，是受疝的地方。所以凡是疝症，如果不是肝木受邪，就是肝木自身亢盛，都属于肝经，因此创立了七疝的名称，即：寒、水、气、狐、筋、血、瘕，治疗多用攻下法。自朱丹溪以来，都遵循这种说法，但也是不对的。前阴和小腹之间，是足三阴经、足阳明经以及冲脉、任脉、督脉这三条奇经汇聚的地方，怎么能唯独以厥阴经来论说呢？只是像本篇提到的六种疝症，都兼谈风邪，其实并非外来的风邪，风属肝，肝主筋，所以凡是各经发生的疝症，说它们的病变多在筋脉，都挟带肝邪是可以的，如果说必定只在厥阴一经，那就不对了。
According to the *Suwen* (Basic Questions): When both the Renying pulse and the Qikou pulse are four times or more than their normal strength, it is called Guan-Ge (Obstruction and Rejection). The Ge pulse appears weak; if it cannot sustain the essence and qi of heaven and earth, death will ensue. According to the *Lingxu* (Spiritual Pivot): When pathogenic factors affect the Fu organs, the Yang pulses become discordant; when discordant, the Yang pulses become excessive. When pathogenic factors affect the Zang organs, the Yin pulses become discordant; when discordant, the Yin pulses become excessive. When Yang qi is excessively excessive, Yin qi cannot circulate with it mutually, hence it is called "Guan" (Closure); when Yin qi is excessively excessive, Yang qi cannot circulate with it mutually, hence it is called "Ge" (Rejection). Guan-Ge leads to premature death. This discussion of Guan-Ge in the *Lingxu* and *Suwen* refers to pulse manifestations, not symptoms. Since Zhang Zhongjing adopted this view, he stated that Guan occurs at the Chi position (wrist) and Ge occurs at the Cun position (wrist). Guan results in urinary retention, while Ge results in vomiting and regurgitation. If the Renying pulse is four times larger and the Cunkou pulse is four times larger, this does not refer merely to the Cun and Chi positions. As for vomiting and regurgitation, this is a symptom of Geshi syndrome (Dysphagia/Regurgitation). As for urinary retention, this is a symptom of Longbi syndrome (Strangury/Urinary Retention). Since Wang Shuhe, scholars have failed to distinguish these concepts, attributing Guan-Ge entirely to the Cun and Chi pulse positions. Li Dongyuan (Jiegu) stated: Cold is above, Heat is below. How can one say there is cold above and heat below when both Cun pulses are four times excessive? Li Dongyuan also posited that clear qi flowing into turbid pathways is called Ge, and turbid qi flowing into clear pathways is called Guan. Zhu Danxi only mentioned a sensation of obstruction in the chest and diaphragm with impaired ascending and descending functions, describing only Ge without Guan. Fang Yuezheng of the Yuan dynasty defined Guan-Ge as the blockage of both urination and defecation, a view that is particularly erroneous. Later, Zhu Danxi established Guan-Ge as a distinct disease category, causing confusion among later students. Only Ma Yuantai vigorously refuted these errors, asserting that Guan-Ge is not synonymous with Geshi or Longbi. Although Chao Yuanfang, Zhang Zhongjing, Li Dongyuan, and Zhu Danxi are considered medical patriarchs, their views deviate from the *Neijing*; how much more so for inferior physicians? Few realize that Guan-Ge is a pulse pattern, not a disease name.
Chao Yuanfang, in his preface to hernia syndromes, listed Jue Hernia, Han Hernia, Qi Hernia, Pan Hernia, Xia Hernia, Hu Hernia, and Jia Hernia. Zhang Zihe criticized the arbitrary naming, arguing that the area surrounding the genitals and reaching the lower abdomen belongs to the Foot-Jueyin Liver Meridian, which is where hernias occur. Therefore, all hernias, whether caused by pathogenic invasion of Liver Wood or hyperactivity of Liver Wood itself, belong to the Liver Meridian. He established the names of the Seven Hernias: Cold, Water, Qi, Fox, Sinew, Blood, and Jia, advocating purgative methods for treatment. Since Zhu Danxi, most have followed this theory, but it is incorrect. The anterior region and lower abdomen are convergence points for the Three Foot-Yin meridians, the Foot-Yangming meridian, and the Chong, Ren, and Du vessels. How can they be attributed solely to the Jueyin Meridian? Regarding the six types of hernia mentioned in this chapter, wind is often discussed. However, this is not external wind. Wind corresponds to the Liver, and the Liver governs the sinews. Thus, it is acceptable to say that hernias affecting various meridians often involve the sinews and carry Liver pathogenic factors. However, claiming they must exclusively reside in the Jueyin Meridian is incorrect.