石膏、黄芩、升麻，上为末，沙糖调服之。一人爱吃茶、白术、软石膏、片芩、白芍药、薄荷圆叶大者，胆星研
末，沙糖调作膏，食后津液化下。
湿热痰积流下作痛，大概因寒郁而作，即是痰饮食积并死血，专主肝经，与肾经绝无相干，不宜下。 疝湿多，
灸大敦穴。食积与瘀血成痛者，栀子、桃仁、山楂、橘核、一作枳实、茱萸，以生姜汁，顺流水作汤调下。按之
痛不定者，属虚。用桂枝、山栀（炒）、乌头（必细切，炒为末），姜汁丸，姜汤服三五十丸，以劫痛。治诸疝方，
定痛速效∶橘核（五十个） 山栀（炒） 山楂（炒） 茱萸（炒），湿胜者加荔核，等
分，丸服之。凡治 要药不痛者∶苍术（一两） 南星（一两） 白芷（一两散水） 山楂（一两） 川芎（三钱）
枳子（一作枳实三钱） 半夏（三钱） 上为末，神曲糊丸。有热加炒山栀一两，坚硬加朴硝半两，
秋冬加茱萸三钱半（一作三钱半）。治疝荔核、枸橘核，烧灰为末，酒下。治诸疝发时，海石、香附，二味为末，以生姜
汁调下，亦治心疼。治疝∶橘核、桃仁、栀子、茱萸、川乌，上研末，煎服之。枳核散单止痛，枸橘核能治木肾。
疝病有水气。湿热两种。而肿者又有挟虚而发者，当用参、术为君，佐以疏导之药，其脉沉紧豁大者是。或问，治一
人病后饮水，患左丸痛甚，灸大敦，适有摩腰膏，内用乌、附子、麝香，将以摩其囊上，抵横骨端，多湿帛覆之，痛即
止，一宿，肿亦消。予旧有柑橘积后，山行饥甚，遇橘芋食之，橘动旧积，芋复滞气，实时右丸肿大，寒热。先服调胃
药一二帖，次早注神，使气至下焦，呕逆觉积动，吐复吐后，和胃气疏通经络乃愈。治木肾方∶采雄楮树叶晒干为
末，酒糊为丸，空心盐汤下。外以一法，枇杷叶、野紫苏叶、苍耳叶、水晶葡萄叶、椒叶、浓煎汤熏洗。治木肾不
痛，南星、半夏、黄柏酒炒、苍术盐炒、山楂、白芷、炒曲、炒滑石、茱萸、昆布、枸橘。疝病、黄病久者，皆好
倒仓。疝气作痛，小便秘涩，五苓散加川楝子为细末，空心服二钱。有人请问下部 气不痛之方，彼时实许
之矣。细思，若非痛断浓味与房事，不可用药，惟促其寿。若苍术、神曲、白芷、山楂、川芎、枳子、半夏，皆要
药也，其药皆鄙贱之物，以启其慢心，人不能断欲，以爱护其根本，反陷其病，陈彦正之祸，得罪多矣。且药随时月
令，况更换君臣佐使，由是不敢僭宁犯食言之罪，因笔及之。治疝痛方∶山楂（炒四两） 枳核 茴香 山栀（以上炒
各二两） 柴胡（一两） 牡丹（一两） 桃仁（炒一两） 大茴香（炒一两） 吴茱萸（炒半两） 上作丸服。
治疝时作急痛方，苍术盐炒、香附盐炒、黄柏酒炒，为君；青皮、玄胡索、桃仁为臣；茴香为佐；益智、
附子盐炒、甘草为使，上为末，作汤服，后一痛过，再不复作矣。治肾气方∶茴香 破故纸（以上各五钱） 吴茱萸
（盐炒五钱） 胡芦巴（七钱半） 上为末，用萝卜子擂汁为丸，盐汤下。肥人肿疝作痛者，外热内寒，五苓散
加茴香。一人 疝∶山栀 山楂 枳实 香附 南星 川楝（以上各一两） 海藻 桃仁（以上各七钱半） 吴茱萸（
二钱半） 上末之，姜饼丸。一人疝痛心痛∶山栀（炒二两） 香附（一两） 苍术 神曲 麦芽（以上各五钱） 半
夏（七钱） 乌头 石碱（以上各三钱） 桂枝（一钱半，春去之） 上末之，炊饼丸，如绿豆大，每服百丸，姜汁盐
汤下。一人疝，痛作腹内块，痛止则块止∶三棱（醋煮一两） 蓬术（醋煮一两） 神曲 麦芽（以上炒各一两） 姜
黄（一两） 南星（姜制一两） 白术（二两） 木香 沉香（以上各三钱） 山栀 枳核（以上各五钱炒） 上末之，
姜饼丸。劫药神妙，乌头细切炒，栀子仁炒，宜加减用。此盖湿热，因寒郁而发，用栀子仁以去湿，用乌头以破寒郁，
况二味皆下焦之药，而乌头又为栀仁所引，其性急速，不容停留胃中也。
有一人爱吃茶，（治法用）白术、软石膏、片芩、白芍药、薄荷圆叶大者，胆星研末，沙糖调作膏，食后津液化下送服。
湿热痰积流注下部引起疼痛，大概是因为寒邪郁结所致，这实际上是痰饮、饮食积滞和死血（瘀血）共同作用的结果，病位主要在肝经，与肾经完全没有关系，不宜使用泻下法。疝气湿重者，灸大敦穴。由食积与瘀血引起的疼痛，用栀子、桃仁、山楂、橘核（一作枳实）、吴茱萸，以生姜汁、顺流水煎汤调服。按压时疼痛不固定者，属于虚证。用桂枝、山栀（炒）、乌头（必须细切，炒为末），姜汁泛丸，姜汤送服三五十丸，以强力止痛。治疗各种疝气的方子，定痛速效：橘核（五十个）、山栀（炒）、山楂（炒）、吴茱萸（炒），湿气重者加荔枝核，等分，制成丸剂服用。凡是治疗疝气的要药，如果不痛的：苍术（一两）、南星（一两）、白芷（一两，散水湿）、山楂（一两）、川芎（三钱）、枳子（一作枳实三钱）、半夏（三钱），研为细末，神曲糊丸。有热象加炒山栀一两，肿块坚硬加朴硝半两，秋冬季节加吴茱萸三钱半（一作三钱半）。治疗疝气用荔枝核、枸橘核，烧灰为末，酒送下。治疗各种疝气发作时，用海浮石、香附，二味研末，以生姜汁调服，也能治疗心痛。治疗疝气：橘核、桃仁、栀子、吴茱萸、川乌，研末，煎服。枳核散单用可止痛，枸橘核能治疗木肾（睾丸硬肿无痛感）。疝病有水气。分为湿热两种。而肿胀者又有夹杂虚证而发的，应当用人参、白术为君药，佐以疏导的药物，其脉象沉紧豁大的是这种情况。有人问，治疗一人在病后饮水，患左侧睾丸剧痛，灸大敦穴，恰好有摩腰膏，内用乌头、附子、麝香，准备涂抹在阴囊上，抵至横骨端，用多层的湿布覆盖，疼痛立即停止，过了一夜，肿胀也消退了。我过去有柑橘积滞，在山中行走时非常饥饿，遇到橘子和芋头就吃了，橘子动摇了旧的积滞，芋头又阻滞了气机，当时右侧睾丸肿大，伴有寒热。先服用调理胃气的药一二帖，第二天早晨凝神静气，使气机下行至下焦，感到恶心呕吐觉得积滞松动，吐了几次之后，调和胃气疏通经络就好了。治疗木肾的方子：采集雄楮树叶晒干为末，酒糊为丸，空腹盐汤送下。外用一种方法，枇杷叶、野紫苏叶、苍耳叶、水晶葡萄叶、花椒叶，浓煎汤熏洗。治疗木肾不痛的方子：南星、半夏、黄柏酒炒、苍术盐炒、山楂、白芷、炒神曲、炒滑石、吴茱萸、昆布、枸橘。疝病、黄疸病久的人，都适合倒仓法（催吐疗法）。疝气作痛，小便短涩，五苓散加川楝子为细末，空腹服二钱。有人询问下部气滞不痛的方子，我当时确实答应了他。仔细思考，如果不是戒断浓味厚腻的食物和房事，不可用药，只能促进寿命。如果是苍术、神曲、白芷、山楂、川芎、枳子、半夏，都是要药，但这些药都是低贱之物，用来开启患者的轻慢之心，人如果不能断绝欲望，来爱护根本，反而陷入疾病，陈彦正的灾祸，得罪太多了。况且药物随月份时令变化，何况更换君臣佐使的关系，因此不敢僭越宁犯食言之罪，于是笔录于此。治疗疝痛方：山楂（炒四两）、枳核、茴香、山栀（以上炒各二两）、柴胡（一两）、牡丹皮（一两）、桃仁（炒一两）、大茴香（炒一两）、吴茱萸（炒半两），制成丸剂服用。治疗疝气时常突发急痛的方子，苍术盐炒、香附盐炒、黄柏酒炒，作为君药；青皮、玄胡索、桃仁作为臣药；茴香作为佐药；益智仁、附子盐炒、甘草作为使药，研为细末，煎汤服用，下一次疼痛过后，就不再复发了。治疗肾气方：茴香、破故纸（以上各五钱）、吴茱萸（盐炒五钱）、胡芦巴（七钱半），研为细末，用萝卜子擂汁为丸，盐汤送下。肥胖之人患肿疝作痛的，外热内寒，用五苓散加茴香。一人患疝气：山栀、山楂、枳实、香附、南星、川楝（以上各一两）、海藻、桃仁（以上各七钱半）、吴茱萸（二钱半），研末，姜饼为丸。一人患疝痛伴心痛：山栀（炒二两）、香附（一两）、苍术、神曲、麦芽（以上各五钱）、半夏（七钱）、乌头、石碱（以上各三钱）、桂枝（一钱半，春季去掉），研末，炊饼为丸，如绿豆大，每次服百丸，姜汁盐汤送下。一人患疝气，疼痛时腹部有块状物，疼痛停止则块状物消失：三棱（醋煮一两）、蓬术（醋煮一两）、神曲、麦芽（以上炒各一两）、姜黄（一两）、南星（姜制一两）、白术（二两）、木香、沉香（以上各三钱）、山栀、枳核（以上各五钱炒），研末，姜饼为丸。劫痛药神妙，乌头细切炒，栀子仁炒，宜加减使用。这大概是湿热，因寒邪郁结而发，用栀子仁以去湿，用乌头以破寒郁，况且这两味药都是下焦的药，而乌头又被栀子仁所引导，其性急速，不容许停留在胃中。
Gypsum (Shigao), Scutellariae Radix (Huangqin), and Cimicifugae Rhizoma (Shengma) are ground into fine powder and taken with rock sugar.
For a person addicted to tea, use Atractylodis Macrocephalae Rhizoma (Baizhu), soft Gypsum (Ruanshigao), Scutellariae Radix (Pianqing), Paeoniae Radix Alba (Baishaoyao), and large-leaf Menthae Haplocalycis Herba (Bohe), along with Star Anise Bulbil processed with gall (Danning). These are ground into powder, mixed with rock sugar to form a paste, and swallowed with saliva after meals.
Pain caused by the downward flow of damp-heat and phlegm accumulation is generally due to cold constraint. It involves phlegm-fluids, food stagnation, and fixed blood stasis (Sixin Xue). The pathology is primarily located in the Liver Meridian and has absolutely nothing to do with the Kidney Meridian; purgative methods should not be used. For hernia with excessive dampness, moxa is applied to the Dazhun (LR1) acupoint. For pain caused by food stagnation and blood stasis, Gardeniae Fructus (Zhizi), Persicae Semen (Taoren), Crataegi Fructus (Shanzha), Tangerine Seed (Juhe) [alternative: Zizyphi Fructus (Zhishi)], and Evodiae Fructus (Wuzhuyu) are decocted in ginger juice and smooth running water, then taken as a liquid preparation. If pressing on the area results in non-fixed pain, it belongs to deficiency. Use Cinnamomi Ramulus (Guizhi), Gardeniae Fructus (Zhizi, stir-fried), and Aconiti Lateralis Radix Preparata (Wutou, must be finely sliced and stir-fried into powder). Form pills with ginger juice and take 30–50 pills with ginger soup to forcefully relieve pain.
A formula for treating various hernias with rapid pain relief: Tangerine Seed (Juhe, 50 pieces), Gardeniae Fructus (Zhizi, stir-fried), Crataegi Fructus (Shanzha, stir-fried), and Evodiae Fructus (Wuzhuyu, stir-fried). If dampness is predominant, add Litchi Seed (Lihe). Mix in equal proportions and take as pills.
Essential herbs for treating hernia when there is no pain: Atractylodis Rhizoma (Cangzhu, 1 liang), Arisaematis Rhizoma (Nanxing, 1 liang), Angelicae Dahuricae Radix (Baizhi, 1 liang, to disperse water-dampness), Crataegi Fructus (Shanzha, 1 liang), Chuanxiong Rhizoma (Chuanxiong, 3 qian), Ziziphus Jujuba Seed (Zizige) [alternative: Zizyphi Fructus (Zhishi, 3 qian)], Pinelliae Rhizoma (Banxia, 3 qian). Grind into powder and make pills with Fomentatio Mass (Shenqu) paste. Add stir-fried Gardeniae Fructus (Zhizi, 1 liang) if there is heat; add Natrii Sulfas (Pu-xiao, 0.5 liang) if masses are hard; add Evodiae Fructus (Wuzhuyu, 3.5 qian) [alternative: 3 qian] in autumn and winter.
To treat hernia, burn Litchi Seed (Lihe) and Citri Reticulatae Viridis Pericarpium (Goujuhe) to ash, grind into powder, and take with wine. To treat attacks of various hernias, use Halloysitum Rubrum (Haishi) and Cyperi Rhizoma (Xiangfu), grind into powder, and take with ginger juice; this also treats heartache.
Another treatment for hernia: Tangerine Seed (Juhe), Persicae Semen (Taoren), Gardeniae Fructus (Zhizi), Evodiae Fructus (Wuzhuyu), and Aconiti Radix (Chuanwu). Grind into powder and decoct for administration.
Zhihe San (枳核散) alone relieves pain; Citri Reticulatae Viridis Pericarpium (Goujuhe) can treat "Wood Hernia" (Mushen - hardness/swelling of testicles without pain). Hernia disease involves water qi. It is divided into two types: damp-heat. Swelling may also occur due to accompanying deficiency; in such cases, Ginseng Radix (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) should be used as the sovereign drug, assisted by draining and guiding herbs. The pulse will be deep, tight, wide, and empty.
Question: Regarding the treatment of a patient who suffered severe left testicular pain after drinking water post-illness: Moxa was applied to Dazhun (LR1). Coincidentally, a waist-massage ointment containing Aconiti Radix (Wutou), Aconiti Lateralis Radix Preparata (Fuzi), and Moschus (Shexiang) was available. It was intended to be rubbed onto the scrotum up to the pubic bone end, covered with multiple layers of wet cloth. The pain stopped immediately, and after one night, the swelling subsided.
I previously had an accumulation from citrus fruits. While hiking, I was very hungry and ate oranges and taro. The orange disturbed the old accumulation, and the taro further stagnated the qi. Immediately, my right testicle swelled, accompanied by chills and fever. First, I took one or two doses of stomach-regulating medicine. The next morning, I focused my spirit to direct qi to the lower jiao. Feeling nausea and vomiting, the accumulation moved. After repeated vomiting, harmonizing the stomach qi and unblocking the meridians led to recovery.
Formula for Wood Hernia: Collect leaves of the male Mulberry tree (Xiongchu), dry them, grind into powder, make pills with wine paste, and take with salt water on an empty stomach. External method: Decoct Loquat Leaf (Pipaye), Wild Perilla Leaf (Yezisuye), Xanthii Fructus (Cangerzi), Grape Leaf (Shuijingputao ye), and Zanthoxyli Pericarpium (Jiaoye) strongly for fumigation and washing.
Formula for painless Wood Hernia: Arisaematis Rhizoma (Nanxing), Pinelliae Rhizoma (Banxia), Phellodendri Cortex (Huangbai, stir-fried with wine), Atractylodis Rhizoma (Cangzhu, stir-fried with salt), Crataegi Fructus (Shanzha), Angelicae Dahuricae Radix (Baizhi), stir-fried Fomentatio Mass (Chaoqu), stir-fried Talcum (Huashi), Evodiae Fructus (Wuzhuyu), Eckloniae Thallus (Kunbu), and Citri Reticulatae Viridis Pericarpium (Gouju).
Patients with chronic hernia or jaundice are suitable for "Dao Cang" (forced vomiting therapy).
For hernia pain with scanty and difficult urination, Wuling San (Five-Ingredient Powder with Poria) plus Toosendan Fructus (Chuanlianzi) ground into powder, taken on an empty stomach, 2 qian.
Someone asked for a formula for lower body qi stagnation without pain. I initially agreed. Upon reflection, unless one abstains from rich flavors and sexual activity, medication alone cannot help but only prolong life. Herbs like Cangzhu, Shenqu, Baizhi, Shanzha, Chuanxiong, Zizige, and Banxia are essential, but they are common/cheap items. Using them might encourage arrogance/laxity. If one cannot control desires to protect the root, the disease worsens. Chen Yanzheng's misfortune serves as a warning; many have offended greatly. Moreover, medicines vary by season, and the roles of sovereign, minister, assistant, and envoy change. Therefore, I dare not overstep and would rather commit the sin of eating my words than prescribe incorrectly. Thus, I record this.
Formula for Hernia Pain: Crataegi Fructus (Shanzha, stir-fried 4 liang), Zhihe, Huixiang, Gardeniae Fructus (Zhizi, stir-fried 2 liang each), Bupleuri Radix (Chaihu, 1 liang), Moutan Cortex (Mudan, 1 liang), Persicae Semen (Taoren, stir-fried 1 liang), Large Star Anise (Da huixiang, stir-fried 1 liang), Evodiae Fructus (Wuzhuyu, stir-fried 0.5 liang). Make pills.
Formula for sudden acute hernia pain: Sovereign: Stir-fried Cangzhu with salt, stir-fried Xiangfu with salt, stir-fried Huangbai with wine. Minister: Qingpi, Corydalis Rhizoma (Yanyhusuo), Persicae Semen (Taoren). Assistant: Huixiang. Envoy: Alpinia Oxyphylla Fructus (Yizhi), Aconiti Radix Preparata (Fuzi, stir-fried with salt), Glycyrrhizae Radix et Rhizoma (Gancao). Grind into powder, decoct and take. After one episode of pain passes, it will not recur.
Formula for Kidney Qi: Huixiang, Psoraleae Fructus (Poguzhi, 5 qian each), Evodiae Fructus (Wuzhuyu, salt-fried 5 qian), Trichosanthis Semen (Huluba, 7.5 qian). Grind into powder, make pills with radish seed juice, take with salt water.
For obese patients with swollen hernia pain (external heat, internal cold), use Wuling San plus Huixiang.
Case 1: Hernia. Zhizi, Shanzha, Zhishi, Xiangfu, Nanxing, Chuanlian (each 1 liang), Haizao, Taoren (each 7.5 qian), Wuzhuyu (2.5 qian). Grind into powder, make pills with ginger cake.
Case 2: Hernia pain with heartache. Zhizi (stir-fried 2 liang), Xiangfu (1 liang), Cangzhu, Shenqu, Maiya (each 5 qian), Banxia (7 qian), Wutou, Shijian (each 3 qian), Guizhi (1.5 qian, omit in spring). Grind into powder, make pills with steamed bread, size of mung beans. Take 100 pills per dose with ginger juice and salt water.
Case 3: Hernia with abdominal mass during pain, mass disappears when pain stops. Sanleng (vinegar-boiled 1 liang), Pengzhu (vinegar-boiled 1 liang), Shenqu, Maiya (stir-fried 1 liang each), Jianghuang (1 liang), Nanxing (ginger-processed 1 liang), Baizhu (2 liang), Muxiang, Chenxiang (each 3 qian), Zhizi, Zhihe (stir-fried 5 qian each). Grind into powder, make pills with ginger cake.
The "Jie Yao" (forceful pain-relieving medicine) is miraculous: Wutou finely sliced and stir-fried, Zhizi Ren (gardenia seed kernel) stir-fried. Dosage should be adjusted. This condition is damp-heat triggered by cold constraint. Zhizi Ren removes dampness; Wutou breaks cold constraint. Both act on the lower jiao, and Wutou is guided by Zhizi Ren. Their nature is rapid, preventing retention in the stomach.