子和所谓血疝,即今人所谓囊痈也。睾丸肿痛,溃出脓血,以病在血分,故名血疝。血
行则疝亦愈,故当和血。
桃仁当归汤 治疝因瘀血作痛。
桃仁(去皮,二钱) 当归梢(酒洗) 延胡索(各一钱半) 川芎 生地黄 赤芍药 吴茱
萸青皮(醋炒,各一钱) 牡丹皮(八分)
水二盅,姜三片,煎八分,食前服。
气聚则塞,气散则通,是痛之休作,由气之聚散也。故曰治疝必先治气。
青木香丸
黑牵牛(二十两,炒香,取末十二两) 补骨脂(炒) 荜澄茄(各四两) 木香(二两) 槟
榔(用酸粟米饭裹湿纸包,火中煨令纸焦,去饭,四两)
上为细末,清水滴为丸,如绿豆大,每服三十丸,熟水下。
疝气有寒束于外,郁热在内,攻刺急痛者,法必寒热兼行,如仓卒散之类。丹溪云∶用
之无有不效。盖川乌头,治外束之寒;山栀仁,治内郁之热也。
仓卒散
山栀仁(四十九个,烧半过) 附子(一枚,炮)
上锉散,每服二钱,水一盏,酒半盏,煎七分,入盐一捻,温服即愈。
丹溪方
山栀仁 川乌 吴茱萸 橘核 桃仁(各等分)
上研,水煎服。
许学士云∶疝病多因虚而得之,不可以虚而骤补,邪之所凑,其气必虚,留而不去,其
病则实,故必涤去所畜之邪,然后补之,是以治疝诸药,多借巴豆气者,盖为此也。
天台乌药散(东垣,下同)
天台乌药 木香 茴香(炒) 青皮(去白) 良姜(炒,各五分) 槟榔(锉,二枚) 川楝
(十个) 巴豆(十四枚)
上八味,先以巴豆打碎,同楝实用麸炒,候黑色,去巴豆、麸俱不用,外为细末,每服
一钱,温酒调下。
川楝子散
川楝子(锉散,用巴豆十四粒打破,一处炒黄色,去巴豆) 木香 茴香(盐一匙炒黄,
去盐,各一两)
上为细末,每服二钱,空心食前,温酒调下。
子和所说的“血疝”,就是现在人们所说的“囊痈”。睾丸肿胀疼痛,溃破后流出脓血,因为病位在血分,所以命名为血疝。血液运行通畅则疝气自愈,因此治疗应当调和血液。
桃仁当归汤:治疗因瘀血阻滞引起的疝气疼痛。
药材组成:桃仁(去皮,二钱)、当归梢(酒洗)、延胡索(各一钱半)、川芎、生地黄、赤芍药、吴茱萸、青皮(醋炒,各一钱)、牡丹皮(八分)。
煎服法:加水两盅,生姜三片,煎至八分,饭前服用。
气机聚集则闭塞不通,气机疏散则通畅,疼痛的发作与停止,是由气的聚散决定的。所以说,治疗疝气必须先调理气机。
青木香丸:
药材组成:黑牵牛(二十两,炒香,取粉末十二两)、补骨脂(炒)、荜澄茄(各四两)、木香(二两)、槟榔(用酸粟米饭包裹湿纸,在火中煨至纸焦,去掉米饭和纸,四两)。
制法与用法:将上述药物研成细末,用清水滴入制成丸剂,大小如绿豆。每次服用三十丸,用熟水送服。
疝气有寒邪束缚于体表,郁热蕴结于体内,导致攻冲刺痛、剧烈疼痛的情况,治疗方法必须寒热并用,例如仓卒散这类方剂。丹溪说:使用此方没有不有效的。这是因为川乌头能治疗外束之寒,山栀仁能治疗内郁之热。
仓卒散:
药材组成:山栀仁(四十九个,烧至半熟)、附子(一枚,炮制)。
制法与用法:将药物切碎捣散,每次服用二钱,加水一盏、酒半盏,煎至七分,加入少许盐,温服即可痊愈。
另外附上丹溪方:
药材组成:山栀仁、川乌、吴茱萸、橘核、桃仁(各等分)。
制法与用法:将药物研碎,加水煎服。
许学士说:疝病多因正气虚弱而得病,不能因为虚证就急于进补。邪气聚集之处,正气必然虚弱;若邪气停留不去,病症就会表现为实证。因此,必须先涤除体内积滞的邪气,然后再进行补益。这也是为什么治疗疝病的各种药物,多借用巴豆的辛烈之气的原因。
天台乌药散(东垣创制,下同):
药材组成:天台乌药、木香、茴香(炒)、青皮(去白)、良姜(炒,各五分)、槟榔(锉碎,二枚)、川楝子(十个)、巴豆(十四枚)。
制法与用法:以上八味药,先将巴豆打碎,与川楝子实一起用麦麸炒至黑色,然后去掉巴豆和麦麸,不再使用。其余药物研成细末,每次服用一钱,用温酒调下。
川楝子散:
药材组成:川楝子(锉碎,用巴豆十四粒打破,一同炒至黄色,去掉巴豆)、木香、茴香(用一匙盐炒黄,去掉盐,各一两)。
制法与用法:将药物研成细末,每次服用二钱,空腹或饭前,用温酒调下。
Zihe (He Zi) referred to as "Blood Hernia" (Xue Shan) is what modern people call "Scrotal Abscess" (Nang Yong). Swelling and pain of the testicles, with pus and blood discharging upon ulceration, is named Blood Hernia because the pathology resides in the Blood aspect. When Blood circulation flows smoothly, the hernia heals; therefore, treatment should focus on harmonizing the Blood.
Taoren Danggui Tang (Peach Kernel and Angelica Caudex Decoction): Treats hernia pain caused by Blood stasis.
Ingredients: Taoren (Peach Kernel, peeled, 2 qian), Danggui Shao (Angelica Caudex, washed with wine), Yanhusuo (Corydalis Rhizome, each 1.5 qian), Chuanxiong (Ligusticum Rhizome), Sheng Dihuang (Rehmannia Root, fresh), Chi Shaoyao (Red Peony Root), Wuzhuyu (Evodia Fruit), Qingpi (Citrus Reticulata Green Peel, stir-fried with vinegar, each 1 qian), Mudanpi (Moutan Cortex, 8 fen).
Preparation and Administration: Add two zhong of water and three slices of ginger, decoct until reduced to eight fen, take before meals.
Qi aggregation causes obstruction, while Qi dispersion leads to patency. The onset and cessation of pain are determined by the aggregation and dispersion of Qi. Hence it is said that treating hernia requires first regulating Qi.
Qingmuxiang Wan (Black Morning Glory Pill):
Ingredients: Heiqianniu (Black Morning Glory Seed, 20 liang, stir-fried until fragrant, powder taken is 12 liang), Buguzhi (Psoralea Fruit, stir-fried), Bichengqie (Long Pepper Fruit, each 4 liang), Muxiang (Vladimiria Root, 2 liang), Binglang (Areca Seed, wrapped in sour millet rice and wet paper, roasted in fire until paper is charred, remove rice, 4 liang).
Preparation and Administration: Grind into fine powder, form pills with clear water, size of mung beans. Take 30 pills per dose, swallow with cooked water.
In cases of Hernia Qi where cold binds externally and heat stagnates internally, causing stabbing and acute pain, the method must combine cold and heat treatments, such as Cangcu San. Danxi stated: "There is no case where this formula fails." This is because Chuan Wutou (Aconite Lateralis Radix Preparata) treats external binding cold, while Shanzhiren (Gardeniae Fructus) treats internal stagnant heat.
Cangcu San (Hasty Powder):
Ingredients: Shanzhiren (Gardeniae Fructus, 49 pieces, roasted until half-done), Fuzi (Aconite Lateralis Radix Preparata, one piece, processed).
Preparation and Administration: Chop and crush into powder. Take 2 qian per dose, add one zhan of water and half a zhan of wine, decoct to seven fen, add a pinch of salt, take warm for recovery.
Additionally, Danxi's Formula:
Ingredients: Shanzhiren (Gardeniae Fructus), Chuanwu (Aconitum Carmichaelii Deoxyaconitine Mother Root), Wuzhuyu (Evodia Fruit), Juhe (Citrus Aurantium Seed), Taoren (Peach Kernel, equal parts).
Preparation and Administration: Grind together, decoct with water and take.
Xu Xueshi (Scholar Xu) stated: Hernia diseases often arise from deficiency; one cannot abruptly tonify due to deficiency. Where pathogenic factors gather, Qi is necessarily deficient; if they remain without departing, the condition manifests as excess. Therefore, one must first cleanse the accumulated pathogens before tonifying. This is why various herbs for treating hernia often borrow the pungent qi of Badou (Croton Seed).
Tiantai Wuyao San (Tiantai Magnolia Bark Powder):
Ingredients: Tiantai Wuyao (Illicium Anisatum Fruit), Muxiang (Vladimiria Root), Huixiang (Fennel Fruit, stir-fried), Qingpi (Citrus Reticulata Green Peel, remove white pith), Liangjiang (Galangal Rhizome, stir-fried, each 5 fen), Binglang (Areca Seed, crushed, two pieces), Chuanlian (Toosendan Fruit, ten pieces), Badou (Croton Seed, fourteen pieces).
Preparation and Administration: Of the above eight ingredients, first crush Badou, stir-fry together with Chuanlian fruits using bran until black. Remove Badou and bran, do not use them. Grind the remaining into fine powder. Take 1 qian per dose, mix with warm wine and swallow.
Chuanlianzi San (Melia Toosendan Powder):
Ingredients: Chuanlianzi (Toosendan Fruit, crushed, stir-fried together with fourteen broken Badou seeds until yellow, remove Badou), Muxiang (Vladimiria Root), Huixiang (Fennel Fruit, stir-fried with one spoon of salt until yellow, remove salt, each 1 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, on an empty stomach or before meals, mix with warm wine and swallow.